男性慢性盆腔疼痛综合征（CPPS）在普通人群中发病率高达5%-10%，严重影响男性的生活质量，但至今仍无有效治疗方法，这与CPPS的发病机制至今不详密切相关。近期的研究显示，脑在慢性痛的形成和维持中具有重要作用，诸多与痛相关的脑区结构和功能在不同慢性痛中显示出明显异常。然而，在CPPS的发病机制中，脑究竟起什么样的作用目前还不清楚。因此，本项目拟以男性CPPS患者为研究对象，采用多模态MRI（fMRI、MR结构像、DTI、ASL）并辅助分子生物学和免疫学检测手段，探讨CPPS患者脑结构与功能的异常变化，分析CPPS患者精神心理及相关的内分泌变化与脑异常的关系，以探讨CPPS的脑机制，进而对CPPS的发病机制给予进一步阐释，同时也为慢性痛的机理研究提供更丰富的研究资料。

Male chronic pelvic pain syndrome (CPPS) occurs in 5% to 10% of the male population and seriously affects their quality of life. Unfortunately, so far there's still no effective treatment for CPPS because of the lack of knowledge about its mechanism. Previous studies have shown that the brain plays an important role in chronic pain, and some brain regions have revealed abnormal changes related to various chronic pains. However, it remains unclear about the mechanism of brain in CPPS, especially the abnormal changes in brain which are directly related to the disease development. Therefore, in the present study, the longitudinal study design will be used, and then we will use multi-modal imaging techniques including arterial spin labeling (ASL),structural MRI(sMRI), diffusion tensor imaging (DTI) and functional MRI (fMRI) combining with immunology and molecular biology to explore the brain mechanism of CPPS. In the imaging study part, the key brain areas which are closely related to CPPS development will be defined by ASL, and then the structure and connectivity of key areas will be further analyzed by sMRI, DTI and fMRI. By investigating the brain structural and functional abnormality along with the development of the CPPS and the role of emotional problems in the brain abnormality of CPPS, the results of the present study will provide new evidence for the pathological mechanism of CPPS and more data for the study on pathogenesis of chronic pain.

男性慢性盆腔疼痛综合征（Chronic pelvic pain syndrome, CPPS）在普通人群中发病率高达9% -16%。在男性 CPPS所产生的泌尿生殖器不适感和性功能减退等一系列临床症状中，泌尿系慢性疼痛对患者的生活质量影响最为严重。然而，男性CPPS的发病机制至今尚未明确，导致目前仍无有效治疗方法。前期的一些研究结果表明脑在男性CPPS病人的疼痛调节中起着关键作用。多模态磁共振成像可以无创地对功能性疾病的脑机制展开研究。本研究通过采用包括功能磁共振成像、三维高分辨率脑结构成像、扩散张量成像和三维动脉自旋标记灌注成像等方法在内的多模态磁共振成像技术结合临床症状和精神心理评估量表对男性CPPS病人进行研究，有助于在脑科学领域进一步阐明男性CPPS的脑发病机制。我们目前的研究结果显示，与健康对照被试相比，男性CPPS病人的前扣带回、岛叶、前额叶、脑干、丘脑和小脑等多个脑区存在功能或结构方面的异常改变。此外，在男性CPPS病人中，这些脑区的变化程度与前列腺炎症状评分量表的总分及疼痛评分之间具有相关性。与健康对照被试相比，男性CPPS病人双侧前扣带回、岛叶和内侧前额叶皮层区的局部一致性显著减低（P < 0.05, family discovery rate校正），而脑干和丘脑区的局部一致性显著增高（P < 0.05, family discovery rate 校正）。目前的这些研究结果表明脑的下行疼痛抑制通路受损与上行疼痛传导通路异常所造成的痛觉敏感性增加共同导致了男性CPPS病人的疼痛调节功能障碍，进一步揭示了男性CPPS的脑发病机制。