An fMRI analysis of the functional organization within the brain of experimental superficial and deep orofacial pain

该项目将研究人类大脑如何处理人类颚肌疼痛的一些重要方面，这些方面与临床相关但知之甚少。例如，我们不明白为什么下颌肌肉疼痛对皮肤疼痛有如此不同的行为影响。下颌肌肉疼痛与皮肤疼痛所没有的重要情绪因素有关。此外，皮肤疼痛通常具有尖锐或灼烧的性质，定位良好，易于治疗，而颌骨肌肉疼痛是一种深度疼痛，具有钝痛的性质，可能涉及面部，头部和颈部的相关部位。与男性相比，下颌肌肉疼痛在女性中更常见的原因也不清楚。慢性下颌肌肉疼痛是颞下颌紊乱症患者的主要症状，是最常见的非牙齿口腔面部疼痛，涉及下颌关节和或下颌肌肉的疼痛，通常限制下颌运动。慢性颌肌疼痛严重影响生活质量，但其诊断和管理是困难的。尽管慢性口腔面部疼痛的广泛流行，我们对慢性人类口腔面部疼痛的中枢加工的信息很少。这一建议将提高我们对下颚肌肉疼痛是如何在大脑中处理的基本理解。中枢神经系统处理和表现颚肌疼痛的方式将有助于解释为什么这些疼痛在临床上表现不同，并应提供关于女性和男性在颚肌疼痛表现上的差异的重要信息。这些关于慢性口面部疼痛的中枢处理的信息对于指导新的或特定的管理策略至关重要。我们的长期目标是提高颞下颌疾病患者的诊断和管理，目前的应用代表了一个重要的新研究方向。

This project will investigate how the human brain processes a number of important aspects of human jaw muscle pain that are clinically relevant but poorly understood. For example, we do not understand why jaw muscle pain has such different behavioural effects to skin pain. Jaw muscle pain is associated with a significant emotional component not seen in with skin pains. Also, skin pain usually has a sharp or burning quality, is well-localized and is readily treated, while jaw muscle pain is a deep pain that has a dull, aching quality that may be referred to related sites of the face, head and neck. It is also not known why jaw muscle pain is more common in females in comparison to males. Chronic jaw muscle pain is a major symptom of patients with Temporomandibular Disorders, the most common form of non-dental orofacial pain and that involves pain in or about the jaw joint and-or jaw muscles, and often limitation of jaw movement. Chronic jaw muscle pain can have a severe effect on quality of life but its diagnosis and management is difficult. Despite the widespread prevalence of chronic orofacial pains, we have little information on the central processing of chronic human orofacial pain. This proposal will improve our fundamental understanding of how jaw muscle pain is processed in the brain. The way that the central nervous system processes and represents jaw muscle pain will help explain why these pains present differently in the clinic and should provide important information on the differences between females and males in the representation of jaw muscle pain. This information on the central processing of chronic orofacial pain is crucial to inform the direction of novel or specific management strategies. Our long-term goal is to improve the diagnosis and management of patients with Temporomandibular Disorders, and the present application represents a major new direction of research.