Altered brain responses to noxious dentoalveolar stimuli in high-impact temporomandibular disorder pain patients.
Altered brain responses to noxious dentoalveolar stimuli in high-impact temporomandibular disorder pain patients.
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DOI：
10.1371/journal.pone.0266349
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Moana-Filho, Estephan J.
中科院分区：
文献类型：
--
作者：
Peck, Connor M.;Bereiter, David A.;Eberly, Lynn E.;Lenglet, Christophe;Moana-Filho, Estephan J.
高冲击性颞下颌关节紊乱病（TMD）疼痛可能涉及与适应不良中枢疼痛调制相关的脑机制。我们研究了大脑刺激三叉神经的网站通常不与TMD疼痛的反应，通过施加有害的牙槽骨压力高，低影响TMD疼痛的情况下，无痛控制功能磁共振成像（fMRI）。根据颞下颌关节紊乱病诊断标准（DC/TMD）和慢性疼痛分级量表，招募了50名女性参与者，并将其分为三组：对照组（n = 17），低冲击（n = 17）和高冲击TMD（n = 16）。多模态全脑MRI是根据人类连接组项目寿命协议获得的，包括刺激诱发的功能性MRI扫描，在此期间，对参与者的颊牙龈施加疼痛的牙槽压力。分组分析采用非参数排列测试的包裹皮质和皮质下神经影像学数据。有没有显着的组间差异，脑激活/失活诱发的伤害性牙槽骨压力。对于单个组平均激活/失活，根据TMD疼痛等级发现存活阈值的包裹数量的梯度，在高影响组中观察到最高数量。在慢性TMD疼痛组中激活的大脑区域中，有那些先前与感觉辨别和动机情感疼痛处理有关的区域。这些结果表明，牙槽骨压力疼痛引起异常的大脑反应的感觉加工的伤害性刺激在高冲击TMD疼痛参与者，这支持存在适应不良的大脑可塑性在慢性TMD疼痛。
High-impact temporomandibular disorder (TMD) pain may involve brain mechanisms related to maladaptive central pain modulation. We investigated brain responses to stimulation of trigeminal sites not typically associated with TMD pain by applying noxious dentoalveolar pressure to high- and low-impact TMD pain cases and pain-free controls during functional magnetic resonance imaging (fMRI). Fifty female participants were recruited and assigned to one of three groups based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and Graded Chronic Pain Scale: controls (n = 17), low-impact (n = 17) and high-impact TMD (n = 16). Multimodal whole-brain MRI was acquired following the Human Connectome Project Lifespan protocol, including stimulus-evoked fMRI scans during which painful dentoalveolar pressure was applied to the buccal gingiva of participants. Group analyses were performed using non-parametric permutation tests for parcellated cortical and subcortical neuroimaging data. There were no significant between-group differences for brain activations/deactivations evoked by the noxious dentoalveolar pressure. For individual group mean activations/deactivations, a gradient in the number of parcels surviving thresholding was found according to the TMD pain grade, with the highest number seen in the high-impact group. Among the brain regions activated in chronic TMD pain groups were those previously implicated in sensory-discriminative and motivational-affective pain processing. These results suggest that dentoalveolar pressure pain evokes abnormal brain responses to sensory processing of noxious stimuli in high-impact TMD pain participants, which supports the presence of maladaptive brain plasticity in chronic TMD pain.
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