TY - JOUR
T1 - White matter brain and trigeminal nerve abnormalities in temporomandibular disorder
AU - Moayedi, Massieh
AU - Weissman-Fogel, Irit
AU - Salomons, Tim Vaughn
AU - Crawley, Adrian Philip
AU - Goldberg, Michael Brian
AU - Freeman, Bruce Victor
AU - Tenenbaum, Howard Charles
AU - Davis, Karen Deborah
N1 - Funding Information: We thank Mr. Eugen Hlasny and Mr. Keith Ta for expert technical assistance, Dr. Yair Lenga for patient screening, Dr. Nathalie Erpelding and Ms. Danielle D. DeSouza for editing, and Drs. Stephen Smith, Heidi Johansen-Berg, and Thomas Nichols for their expert guidance and feedback on the analyses. This study was funded by: Canadian Institute of Health Research (CIHR) grant and funds from the Canada Research Chair program [MOP 53304] (to KDD); CIHR studentship (to MM); Ontario Graduate Scholarship (to MM); CIHR Strategic Training programs: Pain: Molecules to Community (to MM and IWF), and Cell Signals in Mucosal Inflammation and Pain [STP-53877] (to MM); University of Toronto Centre for the Study of Pain Clinician/Scientist Research fellowship (to IWF and TVS).
PY - 2012/7
Y1 - 2012/7
N2 - Temporomandibular disorder (TMD) is a prevalent chronic pain disorder that remains poorly understood. Recent imaging studies reported functional and gray matter abnormalities in brain areas implicated in sensorimotor, modulatory, and cognitive function in TMD, but it is not known whether there are white matter (WM) abnormalities along the trigeminal nerve (CNV) or in the brain. Here, we used diffusion tensor imaging, and found that, compared to healthy controls, TMD patients had 1) lower fractional anisotropy (FA) in both CNVs; 2) a negative correlation between FA of the right CNV and pain duration; and 3) diffuse abnormalities in the microstructure of WM tracts related to sensory, motor, cognitive, and pain functions, with a highly significant focal abnormality in the corpus callosum. Using probabilistic tractography, we found that the corpus callosum in patients had a higher connection probability to the frontal pole, and a lower connection probability to the dorsolateral prefrontal cortex, compared to controls. Finally, we found that 1) FA in tracts adjacent to the ventrolateral prefrontal cortex and tracts coursing through the thalamus negatively correlated with pain intensity; 2) FA in the internal capsule negatively correlated with pain intensity and unpleasantness; and 3) decreases in brain FA were associated with increases in mean diffusivity and radial diffusivity, markers of inflammation and oedema. These data provide novel evidence for CNV microstructural abnormalities that may be caused by increased nociceptive activity, accompanied by abnormalities along central WM pathways in TMD.
AB - Temporomandibular disorder (TMD) is a prevalent chronic pain disorder that remains poorly understood. Recent imaging studies reported functional and gray matter abnormalities in brain areas implicated in sensorimotor, modulatory, and cognitive function in TMD, but it is not known whether there are white matter (WM) abnormalities along the trigeminal nerve (CNV) or in the brain. Here, we used diffusion tensor imaging, and found that, compared to healthy controls, TMD patients had 1) lower fractional anisotropy (FA) in both CNVs; 2) a negative correlation between FA of the right CNV and pain duration; and 3) diffuse abnormalities in the microstructure of WM tracts related to sensory, motor, cognitive, and pain functions, with a highly significant focal abnormality in the corpus callosum. Using probabilistic tractography, we found that the corpus callosum in patients had a higher connection probability to the frontal pole, and a lower connection probability to the dorsolateral prefrontal cortex, compared to controls. Finally, we found that 1) FA in tracts adjacent to the ventrolateral prefrontal cortex and tracts coursing through the thalamus negatively correlated with pain intensity; 2) FA in the internal capsule negatively correlated with pain intensity and unpleasantness; and 3) decreases in brain FA were associated with increases in mean diffusivity and radial diffusivity, markers of inflammation and oedema. These data provide novel evidence for CNV microstructural abnormalities that may be caused by increased nociceptive activity, accompanied by abnormalities along central WM pathways in TMD.
KW - Chronic pain
KW - DTI
KW - MRI
KW - Plasticity
KW - TMD
KW - Trigeminal nerve
KW - White matter
UR - http://www.scopus.com/inward/record.url?scp=84862507680&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.pain.2012.04.003
DO - https://doi.org/10.1016/j.pain.2012.04.003
M3 - Article
C2 - 22647428
SN - 0304-3959
VL - 153
SP - 1467
EP - 1477
JO - Pain
JF - Pain
IS - 7
ER -