Neuroimaging the influence of anxiety on chronic orofacial pain

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Project Summary The goal of this proposal is to reveal key distinctions in the circuitry being affected in Burning Mouth Syndrome (BMS) separate from anxiety. To solve this problem we will investigate the differences between high-anxiety individuals and healthy controls before, and during pain exposure in the functional MRI scanner. Our lab previ- ously compared BMS patients to healthy controls and found increased connectivity between the hypothalamus and pain regions of the brain. However, it is imperical to run this test on healthy individuals with high and low anxiety to distinguish if any of these changes are due to anxiety or truly to the BMS. By adding these compar- isons to our preliminary project we will be able to understand true disease state changes due to BMS versus anxiety. We hypothesize that high anxiety individuals will have higher connectivity between the hypothalamus, amygdala, and regions associated with negative affect such as the amygdala and insula. We further hypothe- size that BMS individuals will have higher functional connectivity between the hypothalamus and pain circuitry regions—such as the cingulate cortex, the periaqueductal grey region, and thalamus—as seen in our prelimi- nary study. This contribution is significant and innovative since it will answer whether BMS should solely be de- fined as a chronic pain condition or a psychological condition. Completion of this proposal will aid in the cre- ation of specialized treatments for chronic pain instead of treating anxiety alone. Lastly, this proposal outlines the career development of an independent researcher, which includes the strengthening writing skills for sub- mission of peer-reviewed publications, the frequent presentation of results at local, national, and international conferences, and further training in neuroimgaging analysis.