磨牙症和颞下颌关节紊乱相关疼痛患者咬牙的神经相关性研究。
Neural Correlates of Tooth Clenching in Patients with Bruxism and Temporomandibular Disorder-Related Pain.
出版信息
J Oral Facial Pain Headache. 2023;37(2):139-148. doi: 10.11607/ofph.3091.
AIMS
To measure brain activity in patients with bruxism and temporomandibular disorder (TMD)-related pain in comparison to controls using functional magnetic resonance imaging (fMRI) and to investigate whether modulations in jaw clenching led to different pain reports and/or changes in neural activity in motor and pain processing areas within and between both groups.
METHODS
A total of 40 participants (21 patients with bruxism and TMD-related pain and 19 healthy controls) performed a tooth-clenching task while lying inside a 3T MRI scanner. Participants were instructed to mildly or strongly clench their teeth for brief periods of 12 seconds and to subsequently rate their clenching intensity and pain experience after each clenching period.
RESULTS
Patients reported significantly more pain during strong clenching compared to mild clenching. Further results showed significant differences between patients and controls in activity in areas of brain networks commonly associated with pain processing, which were also correlated with reported pain intensity. There was no evidence for differences in activity in motor-related areas between groups, which contrasts with findings of previous research.
CONCLUSIONS
Brain activity in patients with bruxism and TMD-related pain is correlated more with pain processing than with motoric differences.
目的
使用功能磁共振成像（fMRI）比较磨牙症和与颞下颌关节紊乱（TMD）相关的疼痛患者与对照组的大脑活动，并研究在颌部咬紧时的调节是否会导致两组内和组间的疼痛报告和/或运动和疼痛处理区域的神经活动发生变化。
方法
共有 40 名参与者（21 名磨牙症和与 TMD 相关的疼痛患者和 19 名健康对照组）在 3T MRI 扫描仪内进行了牙齿咬紧任务。参与者被指示短暂地轻咬或强咬牙 12 秒钟，并在每次咬紧后评估他们的咬紧强度和疼痛体验。
结果
与轻度咬紧相比，患者在强咬紧时报告的疼痛明显更多。进一步的结果表明，患者和对照组之间在与疼痛处理相关的大脑网络区域的活动方面存在显著差异，这些差异也与报告的疼痛强度相关。两组之间在与运动相关的区域的活动中没有证据表明存在差异，这与先前的研究结果形成对比。
结论
磨牙症和与 TMD 相关的疼痛患者的大脑活动与疼痛处理的相关性大于与运动差异的相关性。
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