Chronic myofascial temporomandibular pain is associated with neural abnormalities in the trigeminal and limbic systems.
Chronic myofascial temporomandibular pain is associated with neural abnormalities in the trigeminal and limbic systems.
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DOI：
10.1016/j.pain.2010.01.006
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发表时间：
2010-05
期刊：
影响因子：
7.4
通讯作者：
Mackey SC
中科院分区：
文献类型：
--
作者：
Younger JW;Shen YF;Goddard G;Mackey SC
颞下颌关节肌筋膜痛(M-TMD)是一种常见但知之甚少的慢性疾病。目前尚不清楚这种情况是外周问题还是中枢神经系统(CNS)疾病。为了研究M-TMD的可能的中枢神经系统底物，我们比较了15名患有M-TMD的女性和15名年龄和性别匹配的健康对照组的脑形态。使用磁共振成像(MRI)进行高分辨率结构脑和脑干扫描，并使用基于体素的形态计量学方法分析数据。与对照组相比，M-TMD组在三叉神经皮质通路的几个区域，包括脑干、三叉神经感觉核、丘脑和初级躯体感觉皮质，灰质体积明显减少或增加。此外，M-TMD患者在后壳核、苍白球和前岛叶等边缘区域的灰质体积比对照组增加。在M-TMD组中，颌骨疼痛、疼痛耐受性和疼痛持续时间与脑和脑干灰质体积有不同的相关性。自我报告的疼痛严重程度与嘴侧前扣带回皮质和后扣带回灰质增加有关。对压力痛觉测量的敏感性与三叉神经感觉核团对应的桥脑灰质减少有关。疼痛持续时间越长，后扣带回、海马体、中脑和小脑的灰质越多。在M-TMD患者中发现的灰质异常模式提示三叉神经和边缘系统失调，以及壳核、丘脑和体感皮质潜在的躯体定位重组。
Myofascial pain of the temporomandibular region (M-TMD) is a common, but poorly understood chronic disorder. It is unknown whether the condition is a peripheral problem, or a disorder of the central nervous system (CNS). To investigate possible CNS substrates of M-TMD, we compared the brain morphology of 15 women with M-TMD to 15 age- and gender-matched healthy controls. High-resolution structural brain and brainstem scans were carried out using magnetic resonance imaging (MRI), and data were analyzed using a voxel-based morphometry approach. The M-TMD group evidenced decreased or increased gray matter volume compared to controls in several areas of the trigeminothalamocortical pathway, including brainstem trigeminal sensory nuclei, the thalamus, and the primary somatosensory cortex. In addition, M-TMD individuals showed increased gray matter volume compared to controls in limbic regions such as the posterior putamen, globus pallidus, and anterior insula. Within the M-TMD group, jaw pain, pain tolerance, and pain duration were differentially associated with brain and brainstem gray matter volume. Self-reported pain severity was associated with increased gray matter in the rostral anterior cingulate cortex and posterior cingulate. Sensitivity to pressure algometry was associated with decreased gray matter in the pons, corresponding to the trigeminal sensory nuclei. Longer pain duration was associated with greater gray matter in the posterior cingulate, hippocampus, midbrain, and cerebellum. The pattern of gray matter abnormality found in M-TMD individuals suggests the involvement of trigeminal and limbic system dysregulation, as well as potential somatotopic reorganization in the putamen, thalamus, and somatosensory cortex.
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影响因子：
2.8
作者：
Kopietz, Rainer;Sakar, Vehbi;Wiesmann, Martin
通讯作者：
Wiesmann, Martin
影响因子：
5.3
作者：
Kuchinad, Anil;Schweinhardt, Petra;Bushnell, M. Catherine
通讯作者：
Bushnell, M. Catherine
影响因子：
5.3
作者：
Apkarian, AV;Sosa, Y;Gitelman, DR
通讯作者：
Gitelman, DR
影响因子：
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作者：
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通讯作者：
Paulus MP
影响因子：
2.9
作者：
Chudler, EH
通讯作者：
Chudler, EH