State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Hum Brain Mapp. 2018 Jun;39(6):2563-2572. doi: 10.1002/hbm.24023. Epub 2018 Mar 5.
Although temporomandibular disorders (TMD) have been associated with abnormal gray matter volumes in cortical areas and in the striatum, the corticostriatal functional connectivity (FC) of patients with TMD has not been studied. Here, we studied 30 patients with TMD and 20 healthy controls that underwent clinical evaluations, including Helkimo indices, pain assessments, and resting-state functional magnetic resonance imaging scans. The FCs of the striatal regions with the other brain areas were examined with a seed-based approach. As seeds, we used the dorsal caudate, ventral caudate/nucleus accumbens, dorsal caudal putamen, and ventral rostral putamen regions. Voxel-wise comparisons with controls revealed that the patients with TMD exhibited reduced FCs in the ventral corticostriatal circuitry, between the ventral striatum and ventral frontal cortices, including the anterior cingulate cortex and anterior insula; in the dorsal corticostriatal circuitry, between the dorsal striatum and the dorsal cortices, including the precentral gyrus and supramarginal gyrus; and also within the striatum. Additionally, we explored correlations between the reduced corticostriatal FCs and clinical measurements. These results directly supported the hypothesis that TMD is associated with reduced FCs in brain corticostriatal networks and that these reduced FCs may underlie the deficits in motor control, pain processing, and cognition in TMD. Our findings may contribute to the understanding of the etiologies and pathologies of TMD.
虽然颞下颌关节紊乱（TMD）与皮质区域和纹状体的异常灰质体积有关，但 TMD 患者的皮质纹状体功能连接（FC）尚未得到研究。在这里，我们研究了 30 名 TMD 患者和 20 名健康对照者，他们接受了临床评估，包括 Helkimo 指数、疼痛评估和静息态功能磁共振成像扫描。使用基于种子的方法检查了纹状体区域与其他脑区的 FC。作为种子，我们使用了背侧尾状核、腹侧尾状核/伏隔核、背侧壳核和腹侧壳核。与对照组的体素比较显示，TMD 患者的腹侧皮质纹状体回路、腹侧纹状体与腹侧额叶皮质之间的 FC 减少，包括前扣带皮层和前岛叶；在背侧皮质纹状体回路中，背侧纹状体与包括中央前回和缘上回在内的背侧皮质之间的 FC 减少；并且在纹状体内部也减少了。此外，我们还探讨了皮质纹状体 FC 减少与临床测量之间的相关性。这些结果直接支持了这样的假设，即 TMD 与大脑皮质纹状体网络中的 FC 减少有关，而这些减少的 FC 可能是 TMD 中运动控制、疼痛处理和认知缺陷的基础。我们的发现可能有助于理解 TMD 的病因和病理学。
