Highlights
- •Testing the brain´s gray matter volume (GMV) in temporomandibular disorder (TMD).
- •TMD patients showed a reduction of GMV in anterior cingulate and med. frontal cortex.
- •GMV in population based participants with chronic face pain showed no reduction.
Abstract
Temporomandibular pain (TMD) is a frequent symptom comprising pain around the mandibular
jaw with a high dependence on stressors. Chronic pain has been associated with changes
of the brains gray matter volume (GMV), but previous studies on GMV alterations associated
with TMD have yielded contradictory results. This might be caused by divergent samples
and study methods. We here tested GMV alterations using voxel based morphometry in
three clinical samples (summing up to 47 TMD patients) and a population sample with
57 participants who indicated facial pain for the last 6 months. The GMV of pain patients
was compared against age-matched and gender-matched participants without chronic pain
(60 for the clinical sample comparison and 381 for the cohort sample comparison) who
underwent the same assessments as the patient group (MRI measurements and data evaluation
using CAT12). In a region of interest analysis, only the clinical samples showed an
effect of decreased GMV in the anterior medial cingulate cortex reaching into the
medial prefrontal cortex, known to be especially vulnerable for chronic pain gray
matter volume reduction. The analysis of the population-based sample did not reveal
relevant GMV differences.
Overall, an important question remains as to whether most inconsistent results from
voxel based morphometry-studies in chronic pain are related to chance results facilitated
by small sample size and selection of patient samples.
Perspective
Using voxel based morphometry 2 samples with chronic temperomandibular pain were compared
to controls investigating the brains GMV. Only the clinical sample showed a decrease
in anterior cingulate GMV. Contradicting results on GMV loss in temperomandibular
pain might be based on small samples in prior studies.
Key Words
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Article info
Publication history
Published online: January 30, 2021
Accepted:
January 24,
2021
Received in revised form:
January 4,
2021
Received:
September 4,
2020
Footnotes
M.D. and N.G. contributed equally to this work.
The investigation of the clinical sample included was supported by a grant from the Deutsche Forschungsgemeinschaft (DFG; LO 795/25-1, KO 1598/6-1). The investigation of the population based sample (SHIP) is part of the Community Medicine Research net (CMR) (http://www.medizin.uni-greifswald.de/icm) of the University Medicine Greifswald, which is supported by the German Federal State of Mecklenburg-West Pomerania. MRI scans in SHIP and SHIP-TREND have been supported by a joint grant from Siemens Healthineers, Erlangen, Germany and the Federal State of Mecklenburg-West Pomerania.
The Study of Health in Pomerania (SHIP) is supported by the German Federal State of Mecklenburg-West Pomerania. MRI scans in SHIP and SHIP-TREND have been supported by a joint grant from Siemens Healthineers, Erlangen, Germany and the Federal State of Mecklenburg-West Pomerania. The clinical studies were supported by a grant from the Deutsche Forschungsgemeinschaft (DFG; LO 795/25-1, KO 1598/6-1).
Conflicts of interest: The authors declare that they had no interest conflicts when evaluating and writing this study. The funding organizations had no impact on the study results.
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© 2021 by United States Association for the Study of Pain, Inc.
