Department of Biologic and Materials Sciences, School of Dentistry, 1011 N. University Ave., University of Michigan, Ann Arbor, MI 48109-1078, USA.
J Dent Res. 2012 May;91(5):485-90. doi: 10.1177/0022034512443366. Epub 2012 Mar 26.
Temporomandibular disorders (TMD) include craniocervical pain conditions with unclear etiologies. Central changes are suspected; however, few neuroimaging studies of TMD exist. Single-voxel proton magnetic resonance spectroscopy ((1)H-MRS) was used before and after pressure-pain testing to assess glutamate (Glu), glutamine (Gln), N-acetylaspartate (NAA), and choline (Cho) levels in the right and left posterior insulae of 11 individuals with myofascial TMD and 11 matched control individuals. Glu levels were significantly lower in all individuals after pain testing. Among those with TMD, left-insular Gln levels were related to reported pain, left posterior insular NAA and Cho levels were significantly higher at baseline than in control individuals, and NAA levels were significantly correlated with pain-symptom duration, suggesting adaptive changes. The results suggest that significant central cellular and molecular changes can occur in individuals with TMD.
颞下颌关节紊乱（TMD）包括病因不明的颅颈疼痛疾病。怀疑存在中枢变化，但 TMD 的神经影像学研究较少。使用单体质子磁共振波谱（(1)H-MRS）在压力疼痛测试前后评估 11 名肌筋膜 TMD 患者和 11 名匹配对照个体的右侧和左侧后岛叶中的谷氨酸（Glu）、谷氨酰胺（Gln）、N-乙酰天冬氨酸（NAA）和胆碱（Cho）水平。所有个体在疼痛测试后 Glu 水平均显著降低。在 TMD 患者中，左侧岛叶 Gln 水平与报告的疼痛相关，左侧后岛叶 NAA 和 Cho 水平在基线时明显高于对照组，并且 NAA 水平与疼痛症状持续时间呈显著相关性，表明存在适应性变化。结果表明，TMD 个体可能会发生显著的中枢细胞和分子变化。
