The DOI matches its Crossref record; 122 of the 125 references it cites were found in a registry or an index; none of the 129 sources its claims cite is checked for support yet.
Central changes associated with chronic pelvic pain and endometriosis
Open accessAbstract
BACKGROUND: Chronic pelvic pain (CPP) is a significant public health problem with 1 million affected women in the UK. Although many pathologies are associated with CPP, the pain experienced is often disproportionate to the extent of disease identified and frequently no pathology is found (chronic pelvic pain syndrome). The central nervous system (CNS) is central to the experience of pain and chronic pain conditions in general are associated with alterations in both the structure and function of the CNS. This review describes the available evidence for central changes in association with conditions presenting with CPP. METHODS: A detailed literature search was performed to identify relevant papers, however, this is not a systematic review. RESULTS: CPP is associated with central changes similar to those identified in other pain conditions. Specifically these include, alterations in the behavioural and central response to noxious stimulation, changes in brain structure (both increases and decreases in the volume of specific brain regions), altered activity of both the hypothalamic-pituitary-adrenal axis and the autonomic nervous system (ANS) and psychological distress. CONCLUSIONS: The evidence reviewed in this paper demonstrates that CPP is associated with significant central changes when compared with healthy pain-free women. Moreover, the presence of these changes has the potential to both exacerbate symptoms and to predispose these women to the development of additional chronic conditions. These findings support the use of adjunctive medication targeting the CNS in these women.
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Claims the paper makes
93 Not checked yet · 24 Own interpretation · 4 Own method · 4 No basis given
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although these functional neuroimaging techniques have yet to be applied to women with endometriosis-associated pain”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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In the paper
“Whilst there is some evidence that this increased sensitivity may in part be reversible after successful treatment of the underlying pathology”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Behavioural responses to experimental pain in women with CPP
What the sources say
- Not checked yetcites Bajaj et al., 2003
- Not checked yetcites He et al., 2010
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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In the paper
“Again, the findings are not consistent, but increased behavioural responses to noxious stimulation at a distant site have been demonstrated in women with CPP including in association with dysmenorrhoea (Giamberardino et al., 1997; Granot et al., 2001; Bajaj et al., 2002; Vincent et al., 2011), endometriosis (Bajaj et al., 2003; Laursen et al., 2005; He et al., 2010; Neziri et al., 2010; As-Sanie”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Behavioural responses to experimental pain in women with CPP
What the sources say
- Not checked yetcites Giamberardino et al., 1997
- Not checked yetcites Bajaj et al., 2003
- Not checked yetcites Wilder-Smith and Robert-Yap, 2007
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In women with IBS, four studies found that dual painful stimulation decreased pain in healthy controls, while not significantly decreasing pain in patients”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Changes in endogenous pain inhibition
What the sources say
- Not checked yetcites Wilder-Smith et al., 2004
- Not checked yetcites Song et al., 2006
- Not checked yetcites Wilder-Smith and Robert-Yap, 2007
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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In the paper
“When studies are limited to those only including female subjects, the findings are regionally similar, with rectal distension eliciting decreased activation in the amygdala and hippocampus (Wilder-Smith et al., 2004) and increased activation in the insular and prefrontal cortices (Elsenbruch et al., 2010) in women with IBS compared with healthy women.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Wilder-Smith et al., 2004
- Not checked yetcites Elsenbruch et al., 2010
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“the first of these (Tu et al., 2009), showed that brain metabolism during menstruation was different in women experiencing dysmenorrhoea compared with those whose periods were not painful”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Tu et al., 2009
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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In the paper
“A recent meta-analysis of the studies investigating differences in the brain response to rectal distension between individuals with IBS and controls found differences in activation of the amygdala, thalamus, prefrontal, anterior cingulate, and insular cortices”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Tillisch et al., 2011
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“It is therefore not surprising that IBS is the pelvic pain condition most investigated with neuroimaging”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Thus despite requiring a lower temperature for stimulation to produce the same perception of pain intensity, there was increased activity in two important pain-processing regions, the inferior/middle temporal gyrus and left entorhinal cortex (ERC), when compared with controls.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Vincent et al., 2011
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, in the latter study, significance was lost when anxiety and depression measures were included.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Elsenbruch et al., 2010
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Of note, this study also identified subtle differences in the central response to stimulation between vulvodynia patients with different clinical presentations (primary versus secondary and provoked versus unprovoked pain).”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Hampson et al., 2013
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“More strikingly, the second study showed that even when women with dysmenorrhoea were not experiencing pain (Days 10–12 and 20–22 of the menstrual cycle), their brain response to noxious stimulation was different from that of control women”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Vincent et al., 2011
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Similarly, women with CPP have shown increased behavioural response to stimulation (both noxious and innocuous) of their bladder (Ness et al., 2005; Powell-Boone et al., 2005) and bowel (Song et al., 2006; Brinkert et al., 2007; Wilder-Smith and Robert-Yap, 2007; Elsenbruch et al., 2010; Piche et al., 2010).”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Behavioural responses to experimental pain in women with CPP
What the sources say
- Not checked yetcites Ness et al., 2005
- Not checked yetcites Powell-Boone et al., 2005
- Not checked yetcites Song et al., 2006
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Moreover, the strength of activation in the ERC during these non-menstrual phases was positively correlated with reported pain severity at menstruation.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Vincent et al., 2011
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Similar findings were reported by the second study (Hampson et al., 2013), with patients showing increased activation of known pain processing regions in response to both vulval and thumb stimulation compared with controls.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Hampson et al., 2013
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Whilst psychophysical pain studies have identified an increased behavioural response to at least one noxious stimulus in all pelvic pain conditions investigated”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“However, women with provoked vestibulodynia were shown to have similar endogenous pain modulation to healthy controls”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Changes in endogenous pain inhibition
What the sources say
- Not checked yetcites Johannesson et al., 2007
- Not checked yetcites Sutton et al., 2012
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Volumetric studies have also been undertaken in women with dysmenorrhoea, provoked vestibulodynia and CPP, both without an obvious cause, and related to endometriosis and IBS”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“moreover there were also reductions in the cingulate, insula and putamen in those with endometriosis-related CPP”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
What the sources say
- Not checked yetcites As-Sanie et al., 2012
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Psychological distress has been observed in women with CPP.”
§ Central changes associated with chronic pelvic pain and endometriosis > Psychological Changes
What the sources say
- Not checked yetcites Dorn et al., 2009
- Not checked yetcites Sepulcri Rde and do Amaral, 2009
- Not checked yetcites Smorgick et al., 2013
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“They found a significantly higher incidence of autonomic symptoms in the women with CPP, however, there are a number of difficulties in interpreting these results.”
§ Central changes associated with chronic pelvic pain and endometriosis > Autonomic Nervous System Changes
What the sources say
- Not checked yetcites Janicki et al., 2013
plaincorrelationaln = 16- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In two of these studies, levels of reported stress were also assessed and found to be higher in patients than controls, despite their lower cortisol levels”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
What the sources say
- Not checked yetcites Petrelluzzi et al., 2008
- Not checked yetcites Ehrstrom et al., 2009
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, the more interesting finding was that women with endometriosis but without CPP had an increase in the volume of their periaqueductal grey (PAG)”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
What the sources say
- Not checked yetcites As-Sanie et al., 2012
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Furthermore, the volume of the PAG in these women correlated positively with the amount of pressure required to induce pain (i.e. the bigger their PAG the more pressure they could tolerate before reporting pain).”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
What the sources say
- Not checked yetcites As-Sanie et al., 2012
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In women with IBS, altered ANS functioning (increased sympathetic and/or decreased parasympathetic activity) has been observed during sleep (Thompson et al., 2002), over a 24 h period (Heitkemper et al., 1998), and after stimulation of the sympathetic nervous system (Waring et al., 2004) when compared with healthy women.”
§ Central changes associated with chronic pelvic pain and endometriosis > Autonomic Nervous System Changes
What the sources say
- Not checked yetcites Thompson et al., 2002
- Not checked yetcites Heitkemper et al., 1998
- Not checked yetcites Waring et al., 2004
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“As expected the women with CPP (whether or not there was endometriosis present) had reduced brain volume in the thalamus”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
What the sources say
- Not checked yetcites As-Sanie et al., 2012
plaincorrelationaln = 23- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“CPP is associated with central changes similar to those identified in other pain conditions.”
- Also stated in: § Introduction · plain
“women with CPP do exhibit central changes analogous to those observed in other chronic pain conditions”
§ Central changes associated with chronic pelvic pain and endometriosis > Abstract > RESULTS
What the sources say
- Not checked yetcites Apkarian et al., 2005
- Not checked yetcites Tracey and Bushnell, 2009
- Not checked yetcites Kaya et al., 2013
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Introduction · plain
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The evidence reviewed in this paper demonstrates that CPP is associated with significant central changes when compared with healthy pain-free women.”
§ Central changes associated with chronic pelvic pain and endometriosis > Abstract > CONCLUSIONS
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“In many cases, however, detailed investigation of the pelvis/pelvic viscera via both imaging and surgery reveals no abnormality (chronic pelvic pain syndrome (CPPS))”
§ Central changes associated with chronic pelvic pain and endometriosis > Introduction
What the sources say
- Not checked yetcites Baranowski et al., 2012
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“it is noteworthy that the mechanisms amplifying the experience appear to vary between pelvic pain conditions”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The increased activity in the midbrain of individuals with IBS identified in the recent fMRI meta-analysis may well be a reflection of increased activity/dysfunction of the endogenous modulatory systems”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Changes in endogenous pain inhibition
What the sources say
- Not checked yetcites Tillisch et al., 2011
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When interpreting the results of these studies to date it is not possible to determine the extent to which any increase in response to noxious stimuli reflects local changes (skin/organ or peripheral nerves) as opposed to truly reflecting central changes.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Behavioural responses to experimental pain in women with CPP
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Such observations are likely to reflect plastic changes in the CNS, leading to increased sensitivity to noxious stimuli (central sensitization)”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Behavioural responses to experimental pain in women with CPP
What the sources say
- Not checked yetcites Latremoliere and Woolf (2009)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“the conscious experience of pain is the result of co-ordinated activity within the central nervous system (CNS)”
§ Central changes associated with chronic pelvic pain and endometriosis > Introduction
What the sources say
- Not checked yetcites Tracey and Mantyh, 2007
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Dysfunctional pain inhibition has been demonstrated in a variety of chronic pain states”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Changes in endogenous pain inhibition
What the sources say
- Not checked yetcites Tracey and Mantyh (2007)
- Not checked yetcites Tracey and Bushnell (2009)
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The extent to which an individual is able to engage these mechanisms depends on a variety of factors including genetics (Mogil, 1999; Zubieta et al., 2003), psychological state and cognitive factors”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Changes in endogenous pain inhibition
What the sources say
- Not checked yetcites Mogil, 1999
- Not checked yetcites Zubieta et al., 2003
- Not checked yetcites Tracey and Mantyh, 2007
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“these results emphasize potential overactivity of the CNS leading to increased sensitivity in the patient cohort, as seen in other chronic pain conditions”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“There is now a significant body of literature demonstrating that chronic pain, regardless of cause, is associated with alterations in brain function, particularly with regard to the processing of pain and other sensory information”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP
What the sources say
- Not checked yetcites Apkarian et al., 2005
- Not checked yetcites Tracey and Bushnell, 2009
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This observation suggests that the pain mechanisms underlying the symptoms in vulvodynia may differ depending on the clinical phenotype”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In many cases the volume of specific brain regions correlated with the duration of the symptom suggesting that these volumetric changes are a consequence rather than a cause of the pain.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
What the sources say
- Not checked yetcites May, 2011
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In healthy controls, experimentally increasing sympathetic activity has been shown to heighten visceral organ sensitivity to distension”
§ Central changes associated with chronic pelvic pain and endometriosis > Autonomic Nervous System Changes
What the sources say
- Not checked yetcites Iovino et al., 1995
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“dysfunction in the activity of the HPA axis is an almost universal finding in chronic pain conditions”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
What the sources say
- Not checked yetcites Griep et al., 1998
- Not checked yetcites Gaab et al., 2005
- Not checked yetcites Galli et al., 2009
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“a reduction in serum cortisol levels would be expected to exacerbate symptoms from any underlying infective or inflammatory pathology”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, while studies are conflicting, the literature suggests that women with CPP may have altered endogenous pain modulation.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Changes in endogenous pain inhibition
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Of particular note, these changes are not global across the brain but occur in specific regions which are functionally involved in the processing of pain”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
What the sources say
- Not checked yetcites May, 2011
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Perhaps surprisingly, many chronic pain conditions have been associated with a reduction in brain volume.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
What the sources say
- Not checked yetcites May, 2011
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The findings in CPP are consistent with other chronic pain conditions”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
What the sources say
- Not checked yetcites Griep et al., 1998
- Not checked yetcites Gaab et al., 2005
- Not checked yetcites Galli et al., 2009
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Endometriosis is an unusual condition because of the potential of a variety of different mechanisms to generate pain (see Fig. 3).”
§ Central changes associated with chronic pelvic pain and endometriosis > Is Endometriosis Particularly Vulnerable to Central Changes?
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In this context, the central changes observed in women with dysmenorrhoea (Tu et al., 2009, 2010, 2013; Vincent et al., 2011) are of particular concern given the high prevalence of dysmenorrhoea in adolescents and young women.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
What the sources say
- Not checked yetcites Tu et al., 2009, 2010, 2013; Vincent et al., 2011
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“therefore a reduction in circulating glucocorticoids would be expected to exacerbate these pathologies (Silverman and Sternberg, 2012).”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Exacerbation of symptoms
What the sources say
- Not checked yetcites Silverman and Sternberg, 2012
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Many pathologies associated with CPP in women have an infective or inflammatory component.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Additionally, many of the changes described above can aggravate pain even if the peripheral nociceptive input stays constant.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Exacerbation of symptoms
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Neuroimaging studies have shown that psychological factors can augment the pain experience by specific mechanisms that are different from those observed when the noxious input is increased”
§ Central changes associated with chronic pelvic pain and endometriosis > Psychological Changes
What the sources say
- Not checked yetcites Tracey and Mantyh (2007)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The evidence reviewed in this paper demonstrates that CPP, whilst perceived as a peripheral (pelvic) condition, is in fact associated with significant central changes when compared with healthy pain-free women.”
§ Central changes associated with chronic pelvic pain and endometriosis > Conclusions
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“This is true for conditions within the pelvis (e.g. IBS and IC/PBS (Rodriguez et al., 2009)) and at distant sites (e.g. CPP and migraine (Karp et al., 2011; Yang et al., 2012)).”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
What the sources say
- Not checked yetcites Rodriguez et al., 2009
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The disruption of the HPA axis may be particularly important in endometriosis because of its potential to enhance both the pelvic inflammatory environment and allow increased growth of lesions.”
§ Central changes associated with chronic pelvic pain and endometriosis > Is Endometriosis Particularly Vulnerable to Central Changes?
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Such an increase in disease burden alone could be expected to intensify symptoms.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Exacerbation of symptoms
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Furthermore, the development of central sensitization, as has been demonstrated in a number of conditions associated with CPP (Kaya et al., 2013), can lead to the generation of pain without a peripheral noxious input potentially at least partly explaining the pain that persists despite optimum treatment of identified pathology.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Exacerbation of symptoms
What the sources say
- Not checked yetcites Kaya et al., 2013
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“It is of particular concern that many of the symptoms of CPP start in adolescence or early adult life (Zondervan et al., 1999a, b; Brosens et al., 2013), a time when the CNS is very plastic (Blakemore and Choudhury, 2006; Kalia, 2008) and thus potentially more vulnerable to repeated episodes of pain.”
§ Central changes associated with chronic pelvic pain and endometriosis > Conclusions
What the sources say
- Not checked yetcites Zondervan et al., 1999a, b; Brosens et al., 2013
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, activity of the HPA axis may conceivably be a biological mechanism relating these conditions.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Chronic fatigue syndrome (CFS) has been correlated with vulvodynia (Arnold et al., 2007) and IBS (Whitehead et al., 2002), whilst endometriosis is associated with a variety of autoimmune and endocrine conditions including hypothyroidism, systemic lupus erythematosus and multiple sclerosis (Sinaii et al., 2002).”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
What the sources say
- Not checked yetcites Sinaii et al., 2002
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“These include a loss of a variety of endogenous analgesic mechanisms including that mediated by cortisol and an amplification of pain by psychological factors such as anxiety and depression (Tracey and Mantyh, 2007).”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Exacerbation of symptoms
What the sources say
- Not checked yetcites Tracey and Mantyh, 2007
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The correlation between CPP and other clinical conditions is not exclusive to those in the realm of pain.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Furthermore, the development of central sensitization, as has been demonstrated in a number of conditions associated with CPP (Kaya et al., 2013), can lead to the generation of pain without a peripheral noxious input potentially at least partly explaining the pain that persists despite optimum treatment of identified pathology.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Exacerbation of symptoms
What the sources say
- Not checked yetcites Kaya et al., 2013
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“These concerns could be expected to increase both anxiety and pain catastrophising (an exaggerated negative response in anticipation of pain (Quartana et al., 2009)) thereby amplifying the pain experience.”
§ Central changes associated with chronic pelvic pain and endometriosis > Is Endometriosis Particularly Vulnerable to Central Changes?
What the sources say
- Not checked yetcites Quartana et al., 2009
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Many women with endometriosis are likely to have significant concerns about their fertility.
In the paper
“Thus anxiety amplifies pain by increasing activity within the hippocampus and entorhinal cortex”
§ Central changes associated with chronic pelvic pain and endometriosis > Psychological Changes
What the sources say
- Not checked yetcites Ploghaus et al., 2001
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“These include a loss of a variety of endogenous analgesic mechanisms including that mediated by cortisol and an amplification of pain by psychological factors such as anxiety and depression (Tracey and Mantyh, 2007).”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Exacerbation of symptoms
What the sources say
- Not checked yetcites Tracey and Mantyh, 2007
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, the development of central sensitization, as has been demonstrated in a number of conditions associated with CPP (Kaya et al., 2013), can lead to the generation of pain without a peripheral noxious input potentially at least partly explaining the pain that persists despite optimum treatment of identified pathology.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Exacerbation of symptoms
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Similarly, the association of endometriosis with dyspareunia could be expected to increase psychological distress in these women (Meana et al., 1999).”
§ Central changes associated with chronic pelvic pain and endometriosis > Is Endometriosis Particularly Vulnerable to Central Changes?
What the sources say
- Not checked yetcites Meana et al., 1999
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Endometriosis is associated with dyspareunia.
In the paper
“This is true for conditions within the pelvis (e.g. IBS and IC/PBS (Rodriguez et al., 2009)) and at distant sites (e.g. CPP and migraine (Karp et al., 2011; Yang et al., 2012)).”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
What the sources say
- Not checked yetcites Karp et al., 2011; Yang et al., 2012
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 41
- Probably not a substantial claim. 19
None of the sources cited for this claim have been checked yet.
In the paper
“However, these findings are not consistent, as not all studies observed an increase in all measures of the pain experience”
- Also stated in: § Behavioural responses to experimental pain in women with CPP · plain
“whilst some studies did not observe any heightened response in women with CPP”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Behavioural responses to experimental pain in women with CPP
What the sources say
- Not checked yetcites Wilder-Smith et al., 2004
- Not checked yetcites Ringel et al., 2008
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Behavioural responses to experimental pain in women with CPP · plain
In the paper
“In the first, pressure stimulation of the vulva elicited activation of similar pain regions between women with provoked vestibulodynia and healthy controls; however, the women with provoked vestibulodynia demonstrated significantly stronger activation in several of these regions”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Pukall et al., 2005
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“As before, however, these findings are not consistent in all reported studies (see Supplementary data, Table SIII) including one study that found no differences; however, it only investigated regions within the cingulate cortex”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Ringel et al., 2008
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In response to painful distension of the sigmoid colon and rectum, individuals with IBS have demonstrated decreases in parasympathetic and increases in sympathetic nervous system activity when compared with healthy controls (although this finding was only significant in men with IBS)”
§ Central changes associated with chronic pelvic pain and endometriosis > Autonomic Nervous System Changes
What the sources say
- Not checked yetcites Tillisch et al., 2005
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Thus, abnormally low cortisol levels have been observed in women with endometriosis and CPP (Petrelluzzi et al., 2008), dysmenorrhoea (Vincent et al., 2011) and provoked vulvodynia (Ehrstrom et al., 2009) and replicated over repeated measurements”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
What the sources say
- Not checked yetcites Petrelluzzi et al., 2008
- Not checked yetcites Vincent et al., 2011
- Not checked yetcites Ehrstrom et al., 2009
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Although these increases were observed in different brain regions from those where reductions in volume have been observed in other conditions, these regions are also known to be involved in the processing of noxious stimuli.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Interestingly, although decreases in grey matter were observed in many pain processing regions, areas with an increased volume were also observed”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
What the sources say
- Not checked yetcites Schweinhardt et al., 2008
- Not checked yetcites Blankstein et al., 2010
- Not checked yetcites Seminowicz et al., 2010
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In women with endometriosis, the circadian pattern of cortisol secretion was maintained but suppression of cortisol secretion occurred throughout the day”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
What the sources say
- Not checked yetcites Petrelluzzi et al., 2008
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Thus even women who only suffer with dysmenorrhoea (as opposed to pain throughout the month) have increased tendencies for depression and anxiety (Dorn et al., 2009), although this is not a universal finding (Vincent et al., 2011).”
§ Central changes associated with chronic pelvic pain and endometriosis > Psychological Changes
What the sources say
- Not checked yetcites Dorn et al., 2009
- Not checked yetcites Vincent et al., 2011
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Similarly, women with endometriosis (Sepulcri Rde and do Amaral, 2009; Smorgick et al., 2013) and provoked vestibulodynia (Nunns and Mandal, 1997) are more likely to have anxiety or depression, but may otherwise be psychologically healthy”
§ Central changes associated with chronic pelvic pain and endometriosis > Psychological Changes
What the sources say
- Not checked yetcites Sepulcri Rde and do Amaral, 2009
- Not checked yetcites Smorgick et al., 2013
- Not checked yetcites Nunns and Mandal, 1997
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Whilst this was once considered a fixed matrix, it is now known to be dynamic and dependent on various factors, such that the regions involved will vary, essentially producing a ‘cerebral signature’ of pain”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Tracey and Mantyh (2007)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“it does not appear to be purely a reflection of the presence of ongoing pain, as women with dysmenorrhoea demonstrated enhanced behavioural responses to noxious stimulation of both the abdomen and arm throughout the menstrual cycle and not just at the time they were experiencing pain”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Behavioural responses to experimental pain in women with CPP
What the sources say
- Not checked yetcites Vincent et al., 2011
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Moreover, the presence of these changes has the potential to both exacerbate symptoms and to predispose these women to the development of additional chronic conditions.”
§ Central changes associated with chronic pelvic pain and endometriosis > Abstract > CONCLUSIONS
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The amplification within these regions might be due to compromised spinal and/or brainstem pain modulatory circuits in the patient cohort, since neural activity often differed by magnitude, not just brain region.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Furthermore, even when pathology is identified and treated the pain may still persist, suggesting that the pathology was either an incidental finding or that other mechanisms continue to generate pain without the need for a peripheral input”
§ Central changes associated with chronic pelvic pain and endometriosis > Introduction
What the sources say
- Not checked yetcites Baranowski, 2009
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Some of the findings described above and in Supplementary data, Table SIII may represent abnormal pain inhibition, as many of the studies identify changes in the prefrontal cortices, amygdala and insula, which are key regions of the descending pain inhibitory system.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Changes in endogenous pain inhibition
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“DNIC is a mechanism by which painful stimuli to one location decreases perceived pain elicited by noxious stimuli at a distant part of the body”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Changes in endogenous pain inhibition
What the sources say
- Not checked yetcites McMahon (2013)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“it has even been suggested that the inability to engage these systems may predispose to the development of chronic pain after an acute insult”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Changes in endogenous pain inhibition
What the sources say
- Not checked yetcites De Felice et al., 2011
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“there is a network of brain regions that responds to a noxious stimulus and therefore may contribute to the generation of the experience of pain”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Identifying changes in central processing using neuroimaging
What the sources say
- Not checked yetcites Tracey and Mantyh (2007)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is possible that methodological differences in these studies (inclusion criteria, differing experimental pain techniques, methods for determining pain thresholds, pain rating protocols, number of study visits, and sample sizes) contributed to this inconsistency”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Behavioural responses to experimental pain in women with CPP
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“It is well established that endogenous central pain inhibitory mechanisms exist, mediated through a variety of spinal and cortical mechanisms”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Function in Women with CPP > Changes in endogenous pain inhibition
What the sources say
- Not checked yetcites McMahon (2013)
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Firstly, the autonomic symptom profile included symptoms relating to bowel and bladder function yet ten of the fifteen CPP patients had pain with a full bladder and/or with bowel movement.”
§ Central changes associated with chronic pelvic pain and endometriosis > Autonomic Nervous System Changes
plainn = 15- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“cortisol, as one of the principal players in the HPA axis, appears to be central to the phenomenon of stress-induced analgesia (Filaretov et al., 1996) and therefore a reduction in cortisol levels secondary to dysfunction of the HPA axis may exacerbate pain.”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
What the sources say
- Not checked yetcites Filaretov et al., 1996
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Secondly, there was no assessment of drug use in the CPP cohort and, as the authors describe, many of the autonomic symptoms may be secondary to the drugs prescribed to treat their pain.”
§ Central changes associated with chronic pelvic pain and endometriosis > Autonomic Nervous System Changes
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The mechanisms behind these alterations in brain volume are not completely understood but may include a direct neurotoxic effect of repeated episodes of pain leading to neuronal atrophy or death, an effect of altered metabolic activity or neurotransmitter concentration, neurotoxic effects of drugs, neurodegeneration secondary to pain-related inactivity, and an effect related to psychological”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
What the sources say
- Not checked yetcites May, 2008
- Not checked yetcites May, 2011
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The authors suggest that this may be due to the PAG’s role in descending pain inhibition and potentially may explain why some women with endometriosis have little or no pain despite a significant burden of disease.”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mechanism(s) by which suppression of the HPA axis is produced are as yet unclear.”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Burnout of the system has been proposed as one possibility (Hellhammer and Wade, 1993; Fries et al., 2005) and the recent finding that cortisol levels were negatively correlated with the duration of dysmenorrhoea (Vincent et al., 2011) would be consistent with this, suggesting that HPA axis suppression is a consequence not a cause of their symptoms.”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
What the sources say
- Not checked yetcites Hellhammer and Wade, 1993
- Not checked yetcites Fries et al., 2005
- Not checked yetcites Vincent et al., 2011
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In view of the negative impact of chronic stress on important physiological processes including the immune system and memory function”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
What the sources say
- Not checked yetcites McEwen, 2005
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“it has been proposed that suppression of HPA axis activity might in fact be a protective mechanism”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
What the sources say
- Not checked yetcites Fries et al., 2005
hedgedconditional- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it.
In the paper
“The volume of the grey matter in the anterior cingulate cortex is reduced in almost all these conditions; however, reductions are also commonly seen in the volume of other regions particularly the thalamus, insula and prefrontal cortices”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
What the sources say
- Not checked yetcites May, 2011
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“It has been suggested that abnormal functioning of the ANS might responsible for some of the symptoms associated with IBS”
§ Central changes associated with chronic pelvic pain and endometriosis > Autonomic Nervous System Changes
What the sources say
- Not checked yetcites Bockus et al., 1928
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Activation of the HPA axis is central to the stress response”
§ Central changes associated with chronic pelvic pain and endometriosis > Changes in Activity of the Hypothalamic–Pituitary–Adrenal Axis
What the sources say
- Not checked yetcites Frodl and O’Keane, 2013
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Whether these changes in ANS activity are unique to IBS or, as with the other changes described here, are common to all patients with CPP is as yet unclear.”
§ Central changes associated with chronic pelvic pain and endometriosis > Autonomic Nervous System Changes
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, the sample size was small and the symptoms not validated by a medical practitioner.”
§ Central changes associated with chronic pelvic pain and endometriosis > Autonomic Nervous System Changes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A number of reasons have been proposed to explain why increases in brain volume are seen with these specific pain conditions in contrast to the other conditions investigated, including the fact that the patients are generally younger, pain is intermittent/cyclical/provoked as opposed to continuous and that most women with these conditions do not use large doses of pain modifying drugs for a”
§ Central changes associated with chronic pelvic pain and endometriosis > Brain Structure in Women with CPP
What the sources say
- Not checked yetcites Schweinhardt et al., 2008
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For example, a reduction in circulating cortisol could increase the chances of repeated urinary tract infections, or central sensitization could predispose to the development of chronic whiplash after a minor car accident.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“In the context of dysmenorrhoea, Tu and colleagues observed regionally specific (prefrontal and orbitofrontal cortices) metabolic increases in the brain during dysmenorrhoea, which they suggest may be related to negative psychological symptoms”
§ Central changes associated with chronic pelvic pain and endometriosis > Psychological Changes
What the sources say
- Not checked yetcites Tu et al., 2009
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“It is of particular concern that many of the symptoms of CPP start in adolescence or early adult life (Zondervan et al., 1999a, b; Brosens et al., 2013), a time when the CNS is very plastic (Blakemore and Choudhury, 2006; Kalia, 2008) and thus potentially more vulnerable to repeated episodes of pain.”
§ Central changes associated with chronic pelvic pain and endometriosis > Conclusions
What the sources say
- Not checked yetcites Blakemore and Choudhury, 2006; Kalia, 2008
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Unfortunately, we currently know very little about why some people develop chronic pain.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“There are a number of reasons as to why this might occur including common predisposing factors, such as genetics (Diatchenko et al., 2007) or psychological/cognitive state (for review, see Blackburn-Munro (2004)), and similar neural mechanisms (Giamberardino et al., 2010).”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
What the sources say
- Not checked yetcites Diatchenko et al., 2007
- Not checked yetcites Blackburn-Munro (2004)
- Not checked yetcites Giamberardino et al., 2010
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Chronic fatigue syndrome (CFS) has been correlated with vulvodynia (Arnold et al., 2007) and IBS (Whitehead et al., 2002), whilst endometriosis is associated with a variety of autoimmune and endocrine conditions including hypothyroidism, systemic lupus erythematosus and multiple sclerosis (Sinaii et al., 2002).”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
What the sources say
- Not checked yetcites Arnold et al., 2007
- Not checked yetcites Whitehead et al., 2002
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“However, it is also plausible that the central changes secondary to one chronic pain condition could then predispose to the development of another (Woolf, 2011).”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
What the sources say
- Not checked yetcites Woolf, 2011
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“It is plausible that these central changes contribute to the well-established disparity between the extent of disease observed at laparoscopy and the pain experienced (Vercellini et al., 2007) and to the persistence of pain despite adequate surgical treatment.”
§ Central changes associated with chronic pelvic pain and endometriosis > Is Endometriosis Particularly Vulnerable to Central Changes?
What the sources say
- Not checked yetcites Vercellini et al., 2007
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“whilst depression enhances the affective component of pain, increasing unpleasantness, and appears to disrupt activity within a network of brain regions including the amygdala and inferior frontal gyrus”
§ Central changes associated with chronic pelvic pain and endometriosis > Psychological Changes
What the sources say
- Not checked yetcites Berna et al., 2010
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For example, a reduction in circulating cortisol could increase the chances of repeated urinary tract infections, or central sensitization could predispose to the development of chronic whiplash after a minor car accident.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Furthermore, women with fertility concerns are more likely to undergo surgical treatment of their disease (Dunselman et al., 2014), thereby increasing the potential for further damage to pelvic and endometriotic nerves.”
§ Central changes associated with chronic pelvic pain and endometriosis > Is Endometriosis Particularly Vulnerable to Central Changes?
What the sources say
- Not checked yetcites Dunselman et al., 2014
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Such prompt treatment, as well as being welcomed by the patient, may prevent development or progression of central changes and potentially development of other symptoms/pain conditions, in addition to improving symptoms from any other pain conditions already present (Giamberardino et al., 2010).”
§ Central changes associated with chronic pelvic pain and endometriosis > Conclusions
What the sources say
- Not checked yetcites Giamberardino et al., 2010
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although it remains to be ascertained whether central changes are a cause, effect or both of the painful symptoms, it appears likely that their presence has the potential to not only exacerbate symptoms, but also to predispose these women to the development of additional chronic conditions.”
§ Central changes associated with chronic pelvic pain and endometriosis > Conclusions
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Other chronic conditions have also been associated with HPA axis dysfunction, including CFS and major depression, as has post-traumatic stress disorder (Yehuda et al., 1991; Pariante and Lightman, 2008; Papadopoulos and Cleare, 2012).”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
What the sources say
- Not checked yetcites Yehuda et al., 1991; Pariante and Lightman, 2008; Papadopoulos and Cleare, 2012
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Furthermore, if this symptom significantly impacts on their relationship, both self-esteem and social support may be reduced, potentially further worsening their pain experience (Culley et al., 2013).”
§ Central changes associated with chronic pelvic pain and endometriosis > Is Endometriosis Particularly Vulnerable to Central Changes?
What the sources say
- Not checked yetcites Culley et al., 2013
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“This is common practice in other chronic pain conditions (Dworkin et al., 2010; Richards et al., 2012) but is currently poorly investigated in CPP specifically (Sator-Katzenschlager et al., 2005; Horne et al., 2012).”
§ Central changes associated with chronic pelvic pain and endometriosis > Conclusions
What the sources say
- Not checked yetcites Dworkin et al., 2010; Richards et al., 2012
- Not checked yetcites Sator-Katzenschlager et al., 2005; Horne et al., 2012
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“These include direct compression/infiltration of nerves by the lesions, inflammatory pain due to the enhanced inflammatory environment of the pelvis and ‘neuropathic’ pain secondary to damage of pelvic nerves during surgery or of the new nerves directly infiltrating the lesions (Stratton and Berkley, 2011).”
§ Central changes associated with chronic pelvic pain and endometriosis > Is Endometriosis Particularly Vulnerable to Central Changes?
What the sources say
- Not checked yetcites Stratton and Berkley, 2011
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A similar situation has been previously proposed to occur in rheumatoid arthritis (Straub and Cutolo, 2001).”
§ Central changes associated with chronic pelvic pain and endometriosis > Is Endometriosis Particularly Vulnerable to Central Changes?
What the sources say
- Not checked yetcites Straub and Cutolo, 2001
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Moreover, it could underlie the frequently discussed, though not well proven (Raphael et al., 2004), link between abuse and chronic pain.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes > Predisposition to other chronic conditions
What the sources say
- Not checked yetcites Raphael et al., 2004
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A major criticism of many of the studies cited in this review is that they are ‘snapshot’ studies and therefore they can only inform us about central factors that occur in association with chronic pain, rather than giving us any information about cause and effect.”
§ Central changes associated with chronic pelvic pain and endometriosis > Implications of Central Changes
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Endometriosis is a common finding in women with chronic pelvic pain who present to gynaecologists.
“As endometriosis is such a common finding in women with CPP presenting to gynaecologists, we will highlight areas where there is evidence relating specifically to endometriosis.”
The paper relies on this without support.
Chronic pain can be considered a repeated stressor, both physiologically and psychologically.
“Given that chronicpain can be considered as a repeated stressor, both physiologically and psychologically, it is probably not surprising that dysfunction in the activity of the HPA axis is an almost universal finding in chronic pain conditions”
The paper relies on this without support.
Many pathologies associated with CPP in women have an infective or inflammatory component.
“Many of the pathologies associated with CPP in women have an infective or inflammatory component (endometriosis, adenomyosis, potentially interstitial cystitis/painful bladder syndrome (IC/PBS), chronic pelvic inflammatory disease (PID), etc.), therefore a reduction in circulating glucocorticoids would be expected to exacerbate these pathologies (Silverman and Sternberg, 2012).”
The paper relies on this without support.
Chronic pain conditions cluster, and having one pain condition can increase the likelihood of developing another.
“It is well known that chronic pain conditions cluster and that having one pain condition can increase the likelihood of developing another.”
The paper relies on this without support.
Many women with endometriosis are likely to have significant concerns about their fertility.
“Moreover, many women with endometriosis are likely to have significant concerns about their fertility.”
The paper relies on this without support.
Dysmenorrhoea has a high prevalence in adolescents and young women.
“In this context, the central changes observed in women with dysmenorrhoea (Tu et al., 2009, 2010, 2013; Vincent et al., 2011) are of particular concern given the high prevalence of dysmenorrhoea in adolescents and young women.”
The paper relies on this without support.
Endometriosis is associated with dyspareunia.
“Similarly, the association of endometriosis with dyspareunia could be expected to increase psychological distress in these women (Meana et al., 1999).”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“a number of central changes are observed: alterations in the behavioral and central response to noxious stimulation, changes in brain structure, altered activity of both the HPA and the autonomic nervous system and psychological distress [131], with larger volume in regions involved in pain modulation and endocrine function regulation [137–139].”
From Hormonal treatments for endometriosis: The endocrine background (2022) · cites this paper as [131]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“under the influence of hormonal aberrations, stress, inflammation, and the interplay between the peripheral and central nervous systems [129–131].”
From Hormonal treatments for endometriosis: The endocrine background (2022) · cites this paper as [131]
In the citing paper
“Interestingly, functional neuroanatomic studies using magnetic resonance imaging have demonstrated that women with symptomatic endometriosis display hypersensitivity to pain owing to increased neuronal connectivity in areas of central pain perception (59).”
From Biomarkers in endometriosis: Challenges and opportunities (2017) · cites this paper as [59]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Central changes associated with chronic pelvic pain and endometriosis > Autonomic Nervous System Changes
“a small cohort of women with CPP (n = 16) and pain-free controls (n = 15) (Janicki et al., 2013).”
§ Central changes associated with chronic pelvic pain and endometriosis > Autonomic Nervous System Changes
“ten of the fifteen CPP patients had pain with a full bladder and/or with bowel movement.”
Citations
Cites
Central sensitization: implications for the diagnosis and treatment of pain
Woolf, C. J. (2011) · Pain · doi:10.1016/j.pain.2010.09.030 · Cited by 4,771 · cited 1×
“However, it is also plausible that the central changes secondary to one chronic pain condition could then predispose to the development of another (Woolf, 2011).”
Central sensitization: a generator of pain hypersensitivity by central neural plasticity
Latremoliere, A., & Woolf, C. J. (2009) · The Journal of Pain · doi:10.1016/j.jpain.2009.06.012 · Cited by 3,913 · cited 2×
“Such observations are likely to reflect plastic changes in the CNS, leading to increased sensitivity to noxious stimuli (central sensitization) (for review, see Latremoliere and Woolf (2009)).”
Human brain mechanisms of pain perception and regulation in health and disease
Apkarian, A. V., Bushnell, M. C., Treede, R., & Zubieta, J. (2005) · European Journal of Pain · doi:10.1016/j.ejpain.2004.11.001 · Cited by 3,126 · cited 3×
“There is now a significant body of literature demonstrating that chronic pain, regardless of cause, is associated with alterations in brain function, particularly with regard to the processing of pain and other sensory information (Apkarian et al., 2005; Tracey and Bushnell, 2009).”
Classification of chronic pain
Merskey, H. (1994) · Medical Entomology and Zoology · Cited by 2,952
Development of the adolescent brain: implications for executive function and social cognition
Blakemore, S., & Choudhury, S. (2006) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2006.01611.x · Cited by 2,328 · cited 1×
“…is of particular concern that many of the symptoms of CPP start in adolescence or early adult life (Zondervan et al., 1999a, b; Brosens et al., 2013), a time when the CNS is very plastic (Blakemore and Choudhury, 2006; Kalia, 2008) and thus potentially more vulnerable to repeated episodes of pain.”
ESHRE guideline: management of women with endometriosis
Dunselman, G. A. J., Vermeulen, N., Becker, C., Calhaz-Jorge, C., D'Hooghe, T., De Bie, B., Heikinheimo, O., Horne, A. W., Kiesel, L., Nap, A., et al. (2014) · Human Reproduction · doi:10.1093/humrep/det457 · Cited by 2,211 · cited 1×
“Furthermore, women with fertility concerns are more likely to undergo surgical treatment of their disease (Dunselman et al., 2014), thereby increasing the potential for further damage to pelvic and endometriotic nerves.”
Self-citationThe HPA axis in major depression: classical theories and new developments
Pariante, C. M., & Lightman, S. L. (2008) · Trends in Neurosciences · doi:10.1016/j.tins.2008.06.006 · Cited by 2,009 · cited 1×
“Other chronic conditions have also been associated with HPA axis dysfunction, including CFS and major depression, as has post-traumatic stress disorder (Yehuda et al., 1991; Pariante and Lightman, 2008; Papadopoulos and Cleare, 2012).”
The Cerebral Signature for Pain Perception and Its Modulation
Tracey, I., & Mantyh, P. W. (2007) · Neuron · doi:10.1016/j.neuron.2007.07.012 · Cited by 1,843 · cited 20×
“It is of particular concern that many of the symptoms of CPP start in adolescence or early adult life (Zondervan et al., 1999a, b; Brosens et al., 2013), a time when the CNS is very plastic (Blakemore and Choudhury, 2006; Kalia, 2008) and thus potentially more vulnerable to repeated episodes of pain.”
InfluentialPain catastrophizing: a critical review.
Quartana, P. J., Campbell, C. M., & Edwards, R. R. (2009) · Expert Review of Neurotherapeutics · doi:10.1586/ern.09.34 · Cited by 1,405 · cited 2×
“to increase both anxiety and pain catastrophising (an exaggerated negative response in anticipation of pain (Quartana et al., 2009)) thereby amplifying the pain experience.”
Dworkin, R. H., O'connor, A., Audette, J. F., Baron, R., Gourlay, G. K., Haanpää, M. L., Kent, J. L., Krane, E. J., Lebel, A., Levy, R. M., et al. (2010) · Mayo Clinic Proceedings · doi:10.4065/mcp.2009.0649 · Cited by 1,342 · cited 2×
“This is common practice in other chronic pain conditions (Dworkin et al., 2010; Richards et al., 2012) but is currently poorly investigated in CPP specifically (Sator-Katzenschlager et al.”
Cited by
Sorted by citations
Endometriosis is a chronic systemic disease: Clinical challenges and novel innovations
Taylor, H. S., Kotlyar, A. M., & Flores, V. A. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00389-5 · Cited by 1,425
Zondervan, K. T., Becker, C. M., Koga, K., Missmer, S. A., Taylor, R. N., & Viganò, P. (2018) · Nature Reviews Disease Primers · doi:10.1038/s41572-018-0008-5 · Cited by 1,257
Self-citationBulun, S. E., Yilmaz, B. D., Sison, C., Miyazaki, K., Bernardi, L., Liu, S., Kohlmeier, A., Yin, P., Milad, M., & Wei, J. (2019) · Endocrine Reviews · doi:10.1210/er.2018-00242 · Cited by 844
Pathophysiology, diagnosis, and management of endometriosis
Horne, A. W., & Missmer, S. A. (2022) · BMJ · doi:10.1136/bmj-2022-070750 · Cited by 661
“46 47 Among endometriosis patients with central sensitization, the removal of the endometriotic lesions is unlikely to result in adequate pain remediation owing to continued activation of the central nervous system.”
BackgroundDysmenorrhea and related disorders
Bernardi, M. G., Lazzeri, L., Perelli, F., dos Reis, F. M., & Petraglia, F. (2017) · F1000Research · doi:10.12688/f1000research.11682.1 · Cited by 388
Metadata
- Authors
- Brawn, J., Morotti, M., Zondervan, K. T., Becker, C. M., & Vincent, K.
- Affiliations
- University of Oxford (GB)
- John Radcliffe Hospital (GB)
- Corresponding author
- Brawn, Jennifer
- Venue
- Human Reproduction Update
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-06-11
- Volume
- 20
- Issue
- 5
- Pages
- 737-747
- ISSN
- 1355-4786 (ISSN-L)
- 1460-2369
- PMC
- PMC4501205
- OpenAlex
- W2136897269
- Cited by
- 274
- References
- 125
- Citations by year
- 2026: 19 · 2025: 21 · 2024: 26 · 2023: 34 · 2022: 20 · 2021: 21 · 2020: 21 · 2019: 22 · 2018: 20 · 2017: 31 · 2016: 20 · 2015: 14 · 2014: 5
- FWCI
- 3.67
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Human Reproduction Update (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Wellcome Trust (085235)
- National Institute for Health and Care Research (CL-2008-13-002)
- Academy of Medical Sciences (AMS-SGCL8-Vincent)
- Medical Research Council (MR/K011480/1)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic pelvic pain, endometriosis, central nervous system changes, chronic pain, brain structure, hypothalamic-pituitary-adrenal axis, autonomic nervous system, psychological distress
- MeSH terms
- Brain, Endometriosis, Female, Humans, Hypothalamo-Hypophyseal System, Pituitary-Adrenal System, Stress, Psychological, Pelvic Pain, Chronic Pain
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