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伴有疼痛灾难化的慢性颞下颌关节紊乱病疼痛患者灰质体积改变:一项基于体素的形态学研究

Altered gray matter volume in chronic temporomandibular disorder pain with pain catastrophizing: a voxel-based morphometry study.

作者信息

Nguyen Thi-Thu, Nguyen Anh Ho-Quynh, Le Quang-Khang, Nguyen Thi-Kim-Anh

机构信息

Department of Basic Dental Sciences, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

Department of Radiology, Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.

出版信息

BMC Oral Health. 2025 Jun 2;25(1):881. doi: 10.1186/s12903-025-06243-4.

DOI:10.1186/s12903-025-06243-4
PMID:40457334
Abstract

BACKGROUND

Chronic temporomandibular disorder (TMD) pain with pain catastrophizing (PC) is associated with altered brain morphology; however, its neuroanatomical underpinnings remain unclear. This study aimed to investigate gray matter volume (GMV) in the brain regions of chronic TMD pain patients with PC using voxel-based morphometry.

METHODS

A case-control study was conducted with 28 participants, including 14 chronic TMD pain patients with high PC and 14 age- and sex-matched healthy controls. T1-weighted magnetic resonance imaging (MRI) data were acquired using a 3-Tesla scanner and analyzed with Statistical Parametric Mapping 12 (SPM12). Whole-brain and Region-of-Interest (ROI) analyses were performed to assess GMV differences and associations between GMV with clinical variables.

RESULTS

Whole-brain analysis revealed no significant GMV differences between groups. However, ROIs analyses showed significantly smaller GMV in the bilateral hippocampus, left parahippocampal gyrus, and right putamen in the patient group. Additionally, GMV in the orbital part of the inferior frontal gyrus was negatively associated with pain duration.

CONCLUSION

This study suggests that central nervous system alterations are linked to chronic TMD pain condition with pain catastrophizing. These findings contribute to understanding the neurobiological basis of chronic musculoskeletal pain and highlight the need for further research into the role of cognitive-emotional factors in pain-related neural adaptations.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

伴有疼痛灾难化(PC)的慢性颞下颌关节紊乱症(TMD)疼痛与脑形态改变有关;然而,其神经解剖学基础仍不清楚。本研究旨在使用基于体素的形态测量法研究伴有PC的慢性TMD疼痛患者脑区的灰质体积(GMV)。

方法

进行了一项病例对照研究,纳入28名参与者,包括14名伴有高PC的慢性TMD疼痛患者和14名年龄及性别匹配的健康对照者。使用3特斯拉扫描仪获取T1加权磁共振成像(MRI)数据,并采用统计参数映射12(SPM12)进行分析。进行全脑和感兴趣区域(ROI)分析,以评估GMV差异以及GMV与临床变量之间的关联。

结果

全脑分析显示两组之间GMV无显著差异。然而,ROI分析显示患者组双侧海马体、左侧海马旁回和右侧壳核的GMV明显较小。此外,额下回眶部的GMV与疼痛持续时间呈负相关。

结论

本研究表明,中枢神经系统改变与伴有疼痛灾难化的慢性TMD疼痛状况有关。这些发现有助于理解慢性肌肉骨骼疼痛的神经生物学基础,并强调需要进一步研究认知 - 情感因素在疼痛相关神经适应中的作用。

临床试验编号

不适用。

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本文引用的文献

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Pain Catastrophizing: How Far Have We Come.疼痛灾难化:我们已经取得了多大进展。
Neurol Int. 2024 Apr 26;16(3):483-501. doi: 10.3390/neurolint16030036.
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Hippocampus diffusivity abnormalities in classical trigeminal neuralgia.经典三叉神经痛中海马扩散率异常
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Chronic pain is associated with less grey matter volume in the anterior cingulum, anterior and posterior insula and hippocampus across three different chronic pain conditions.在三种不同的慢性疼痛状况下,慢性疼痛与前扣带、前岛叶、后岛叶及海马体中灰质体积减少有关。
Eur J Pain. 2023 Nov;27(10):1239-1248. doi: 10.1002/ejp.2153. Epub 2023 Jun 27.
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The establishment, maintenance, and adaptation of high- and low-impact chronic pain: a framework for biopsychosocial pain research.高影响和低影响慢性疼痛的建立、维持及适应性:生物心理社会疼痛研究框架
Pain. 2023 Oct 1;164(10):2143-2147. doi: 10.1097/j.pain.0000000000002951. Epub 2023 Jun 16.
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Individual Differences in Pain Catastrophizing and Regional Gray Matter Volume Among Community-dwelling Adults With Chronic Pain: A Voxel-based Morphology Study.社区慢性疼痛成年人疼痛灾难化的个体差异与局部脑灰质体积:基于体素的形态学研究。
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Hippocampus and its involvement in Alzheimer's disease: a review.海马体及其在阿尔茨海默病中的作用:综述
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Acute and Chronic Temporomandibular Disorder Pain: A critical review of differentiating factors and predictors of acute to chronic pain transition.急性和慢性颞下颌关节紊乱疼痛:对急性到慢性疼痛转变的鉴别因素和预测因素的批判性回顾。
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