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2000
Volume 21, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603

Abstract

Background

Pain with a persistent and recurrent onset is one of the most important symptoms of temporomandibular disorders (TMD). Recent evidence indicated the dysfunction of the central nervous system was more linked to TMD pain. This study aimed to explore the abnormal structural and perfusion alterations in patients with painful TMD (p-TMD) to understand the comprehension of neuro-pathophysiological mechanisms.

Methods

Forty-one p-TMD patients and 33 normal controls (NC) were recruited, and high-resolution structural brain and 3D PCASL data were obtained from a 3.0T MR scanner. The voxel-based analysis of the whole cerebral gray matter (GMV) was performed, and the GMV and cerebral blood flow (CBF) value of the altered positive areas were extracted to investigate the significant correlation with clinical variables.

Results

The brain regions with significantly increased GMV in p-TMD group were listed as follows: right putamen, right superior frontal gyrus, left superior frontal gyrus medial segment, right supplementary motor cortex, left postcentral gyrus, right middle temporal gyrus, right postcentral gyrus medial segment, right temporal pole, right inferior temporal gyrus and right opercular part of the inferior frontal gyrus (<0.001, cluster>39). However, there were no brain regions with significantly decreased GMV in the p-TMD group. Cerebral perfusion analysis identified that only the right postcentral gyrus medial segment presented significantly higher CBF value in the p-TMD group than in the NC group over all the brain regions with increased GMV. Within the p-TMD group, pain intensity, anxiety, depression, and jaw functional limitation scores were differentially associated with GMV and CBF value.

Conclusion

The voxel-based morphometric and perfusion findings collectively implicate maladaptive plasticity in both the sensory-discriminative and affective-motivational dimensions of pain processing in p-TMD pathophysiology.

This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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2025-06-10
2025-09-04
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References

  1. ManfrediniD. Guarda-NardiniL. WinocurE. PiccottiF. AhlbergJ. LobbezooF. Research diagnostic criteria for temporomandibular disorders: A systematic review of axis I epidemiologic findings.Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod.2011112445346210.1016/j.tripleo.2011.04.02121835653
    [Google Scholar]
  2. ValesanL.F. Da-CasC.D. RéusJ.C. DenardinA.C.S. GaranhaniR.R. BonottoD. JanuzziE. de SouzaB.D.M. Prevalence of temporomandibular joint disorders: A systematic review and meta-analysis.Clin. Oral Investig.202125244145310.1007/s00784‑020‑03710‑w33409693
    [Google Scholar]
  3. SuenagaS. NagayamaK. NagasawaT. IndoH. MajimaH.J. The usefulness of diagnostic imaging for the assessment of pain symptoms in temporomandibular disorders.Jpn. Dent. Sci. Rev.20165249310610.1016/j.jdsr.2016.04.00428408961
    [Google Scholar]
  4. ResendeC.M.B.M. RochaL.G.D.S. PaivaR.P. CavalcantiC.S. AlmeidaE.O. RoncalliA.G. BarbosaG.A.S. Relationship between anxiety, quality of life, and sociodemographic characteristics and temporomandibular disorder.Oral Surg. Oral Med. Oral Pathol. Oral Radiol.2020129212513210.1016/j.oooo.2019.10.00731784398
    [Google Scholar]
  5. HartwigA.C. MathiasS.I. LawA.S. GebhartG.F. Characterization and opioid modulation of inflammatory temporomandibular joint pain in the rat.J. Oral Maxillofac. Surg.200361111302130910.1016/S0278‑2391(03)00732‑814613087
    [Google Scholar]
  6. HendersonL.A. PeckC.C. PetersenE.T. RaeC.D. YoussefA.M. ReevesJ.M. WilcoxS.L. AkhterR. MurrayG.M. GustinS.M. Chronic pain: Lost inhibition?J. Neurosci.201333177574758210.1523/JNEUROSCI.0174‑13.201323616562
    [Google Scholar]
  7. JensenK.B. SrinivasanP. SpaethR. TanY. KosekE. PetzkeF. CarvilleS. FranssonP. MarcusH. WilliamsS.C.R. ChoyE. VittonO. GracelyR. IngvarM. KongJ. Overlapping structural and functional brain changes in patients with long-term exposure to fibromyalgia pain.Arthritis Rheum.201365123293330310.1002/art.3817023982850
    [Google Scholar]
  8. Fernández-de-las-PeñasC. Galán-del-RíoF. Fernández-CarneroJ. PesqueraJ. Arendt-NielsenL. SvenssonP. Bilateral widespread mechanical pain sensitivity in women with myofascial temporomandibular disorder: Evidence of impairment in central nociceptive processing.J. Pain200910111170117810.1016/j.jpain.2009.04.01719592309
    [Google Scholar]
  9. YoungerJ.W. ShenY.F. GoddardG. MackeyS.C. Chronic myofascial temporomandibular pain is associated with neural abnormalities in the trigeminal and limbic systems.Pain2010149222222810.1016/j.pain.2010.01.00620236763
    [Google Scholar]
  10. ArkinkE.B. BleekerE.J.W. SchmitzN. SchoonmanG.G. WuO. FerrariM.D. van BuchemM.A. van OschM.J.P. KruitM.C. Cerebral perfusion changes in migraineurs: A voxelwise comparison of interictal dynamic susceptibility contrast MRI measurements.Cephalalgia201232427928810.1177/033310241143598522290556
    [Google Scholar]
  11. HeS. LiF. GuT. MaH. LiX. ZouS. HuangX. LuiS. GongQ. ChenS. Reduced corticostriatal functional connectivity in temporomandibular disorders.Hum. Brain Mapp.20183962563257210.1002/hbm.2402329504182
    [Google Scholar]
  12. ZhangJ. LiX. JinZ. LiangM. MaX. Spontaneous brain activity and connectivity in female patients with temporomandibular joint synovitis pain: A pilot functional magnetic resonance imaging study.Oral Surg. Oral Med. Oral Pathol. Oral Radiol.2018126436337410.1016/j.oooo.2018.04.01230037632
    [Google Scholar]
  13. WuB. LouX. WuX. MaL. Intra‐ and interscanner reliability and reproducibility of 3D whole‐brain pseudo‐continuous arterial spin‐labeling MR perfusion at 3T.J. Magn. Reson. Imaging201439240240910.1002/jmri.2417523723043
    [Google Scholar]
  14. SchiffmanE. OhrbachR. Executive summary of the diagnostic criteria for temporomandibular disorders for clinical and research applications.J. Am. Dent. Assoc.2016147643844510.1016/j.adaj.2016.01.00726922248
    [Google Scholar]
  15. SchiffmanE. OhrbachR. TrueloveE. LookJ. AndersonG. GouletJ.P. ListT. SvenssonP. GonzalezY. LobbezooF. MichelottiA. BrooksS.L. CeustersW. DrangsholtM. EttlinD. GaulC. GoldbergL.J. HaythornthwaiteJ.A. HollenderL. MaixnerW. van der MeulenM. MurrayG.M. NixdorfD.R. PallaS. PeterssonA. PionchonP. SmithB. VisscherC.M. ZakrzewskaJ. DworkinS.F. SmithB. VisscherC.M. ZakrzewskaJ. DworkinS.F. International RDC/TMD Consortium Network, International association for Dental Research Orofacial Pain Special Interest Group, International Association for the Study of Pain Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: Recommendations of the international RDC/TMD consortium network* and orofacial pain special interest group†.J. Oral Facial Pain Headache201428162710.11607/jop.115124482784
    [Google Scholar]
  16. ChenZ. ChenX. LiuM. LiuM. MaL. YuS. Evaluation of gray matter perfusion in episodic migraine using voxel-wise comparison of 3D pseudo-continuous arterial spin labeling.J. Headache Pain20181913610.1186/s10194‑018‑0866‑y29796865
    [Google Scholar]
  17. HayasakaS. NicholsT.E. Validating cluster size inference: Random field and permutation methods.Neuroimage20032042343235610.1016/j.neuroimage.2003.08.00314683734
    [Google Scholar]
  18. AshburnerJ. FristonK.J. Voxel-based morphometry--the methods.Neuroimage200011680582110.1006/nimg.2000.058210860804
    [Google Scholar]
  19. BingelU. SchoellE. HerkenW. BüchelC. MayA. Habituation to painful stimulation involves the antinociceptive system.Pain20071311213010.1016/j.pain.2006.12.00517258858
    [Google Scholar]
  20. Schmidt-WilckeT. LeinischE. GänbauerS. DraganskiB. BogdahnU. AltmeppenJ. MayA. Affective components and intensity of pain correlate with structural differences in gray matter in chronic back pain patients.Pain20061251899710.1016/j.pain.2006.05.00416750298
    [Google Scholar]
  21. SchweinhardtP. KuchinadA. PukallC.F. BushnellM.C. Increased gray matter density in young women with chronic vulvar pain.Pain2008140341141910.1016/j.pain.2008.09.01418930351
    [Google Scholar]
  22. LiuH. HouH. LiF. ZhengR. ZhangY. ChengJ. HanS. Structural and functional brain changes in patients with classic trigeminal neuralgia: A combination of voxel-based morphometry and resting-state functional MRI study.Front. Neurosci.20221693076510.3389/fnins.2022.93076535844235
    [Google Scholar]
  23. WangY. CaoD. RemeniukB. KrimmelS. SeminowiczD.A. ZhangM. Altered brain structure and function associated with sensory and affective components of classic trigeminal neuralgia.Pain201715881561157010.1097/j.pain.000000000000095128520647
    [Google Scholar]
  24. ChenZ.Y. LiuM.Q. WangB.T. FanW.P. ZhangX.H. HuM. WangY.Y. Evaluation of brain volume changes in patients with painful temporomandibular disorders using voxel-based morphometry.Chung Hua Kou Chiang Hsueh Tsa Chih202055962462832878396
    [Google Scholar]
  25. DougalS. PhelpsE.A. DavachiL. The role of medial temporal lobe in item recognition and source recollection of emotional stimuli.Cogn. Affect. Behav. Neurosci.20077323324210.3758/CABN.7.3.23317993209
    [Google Scholar]
  26. LiottiM. MaybergH.S. BrannanS.K. McGinnisS. JerabekP. FoxP.T. Differential limbic–cortical correlates of sadness and anxiety in healthy subjects: Implications for affective disorders.Biol. Psychiatry2000481304210.1016/S0006‑3223(00)00874‑X10913505
    [Google Scholar]
  27. RoschK.S. MostofskyS. Development of the frontal lobe.Handb. Clin. Neurol.201916335136710.1016/B978‑0‑12‑804281‑6.00019‑731590741
    [Google Scholar]
  28. YangF.C. ChouK.H. FuhJ.L. HuangC.C. LirngJ.F. LinY.Y. LinC.P. WangS.J. Altered gray matter volume in the frontal pain modulation network in patients with cluster headache.Pain2013154680180710.1016/j.pain.2013.02.00523582154
    [Google Scholar]
  29. WangP. DuH. ChenN. GuoJ. GongQ. ZhangJ. HeL. Regional homogeneity abnormalities in patients with tensiontype headache: A resting-state fMRI study.Neurosci. Bull.201430694995510.1007/s12264‑013‑1468‑625098351
    [Google Scholar]
  30. MansourA.R. FarmerM.A. BalikiM.N. ApkarianA.V. Chronic pain: The role of learning and brain plasticity.Restor. Neurol. Neurosci.201432112913910.3233/RNN‑13900323603439
    [Google Scholar]
  31. GalianoA. MengualE. García de EulateR. GaldeanoI. VidorretaM. RecioM. RiverolM. ZubietaJ.L. Fernández-SearaM.A. Coupling of cerebral blood flow and functional connectivity is decreased in healthy aging.Brain Imaging Behav.202014243645010.1007/s11682‑019‑00157‑w31250268
    [Google Scholar]
  32. YoussefA.M. GustinS.M. NashP.G. ReevesJ.M. PetersenE.T. PeckC.C. MurrayG.M. HendersonL.A. Differential brain activity in subjects with painful trigeminal neuropathy and painful temporomandibular disorder.Pain2014155346747510.1016/j.pain.2013.11.00824269492
    [Google Scholar]
  33. UchidaS. BoisS. GuillemotJ.P. LeblondH. PichéM. Systemic blood pressure alters cortical blood flow and neurovascular coupling during nociceptive processing in the primary somatosensory cortex of the rat.Neuroscience201734325025910.1016/j.neuroscience.2016.12.01427998779
    [Google Scholar]
  34. WolfM.E. HeldV.E. FörsterA. GriebeM. SzaboK. GassA. HennericiM.G. KernR. Pearls & Oy-sters: Dynamics of altered cerebral perfusion and neurovascular coupling in migraine aura.Neurology20117722e127e12810.1212/WNL.0b013e31823a0ceb22123784
    [Google Scholar]
  35. UgawaY. Sensory input and basal ganglia.Rinsho Shinkeigaku2012521186286510.5692/clinicalneurol.52.86223196445
    [Google Scholar]
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  • Article Type:
    Research Article
Keyword(s): Brain structure; Pain; Perfusion; Temporomandibular disorders; Voxel-based analysis
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