Brain Connectivity Patterns in Chronic Temporomandibular Joint Disorders
This study addresses the timely problem of painful temporomandibular disorders (TMD), the most common cause of orofacial pain second only to tooth pain. Findings from previous studies suggest that dysregulation of connectivity within specific brain circuits is part of chronic pain pathophysiology. This study will identify connectivity patterns within those brain circuits as potential signatures for pain- related disability in chronic TMD pain participants. New knowledge regarding these brain connectivity patterns is expected to be significant because it will support improved phenotyping of this heterogeneous participant population. It is also expected that this finding can potentially be extrapolated to other chronic pain conditions, such as back pain, migraine headache, and fibromyalgia that are frequently comorbid conditions in chronic TMD participants.
• Provide signed and dated informed consent form.
• Willing to comply with all study procedures and be available for the duration of study participation.
• All participants will be females (biological sex by self-report) between ages 18 to 65 years (inclusive), as this includes the majority of the patient population at risk for chronic TMD pain.
• Cases and controls will be matched for age within ±3 years, and all participants must be able to understand commands in English to follow study procedures (e.g., during sensory testing).
∙ Pain-free controls
• TMD-Pain screener score less than 3 out of 7 (Screener available as part of the DC/TMD)
• No previous diagnosis for the most common pain-related TMD as defined in the DC/TMD criteria (myalgia, arthralgia, headache attributed to TMD)
• No significant orofacial pain (jaw pain, TMJ pain) in past 3 months (significant meaning 5 or more days in any month or any pain during the past month)
• No report of significant pain in the last 3 months elsewhere in the body (significant meaning 5 or more days in any month or any pain during the past month), e.g., low back pain, fibromyalgia, migraine headaches
• Not meeting any of the most common pain-related TMD diagnosis as described in the DC/TMD criteria (myalgia, arthralgia, headache attributed to TMD) upon clinical examination following the DC/TMD protocol
∙ Chronic painful TMD cases
• TMD-pain screener score equal to or greater than 3
• Primary TMD caseness criteria: myalgia (masticatory muscle pain) based on clinical exam following the DC/TMD protocol
‣ Concurrent arthralgia (TMJ pain) and/or headache attributed to TMD allowed
• Myofascial pain must meet the following criteria:
‣ Onset \>3 months, occurring \>15 days/month on average for \>3 months
⁃ Minimum 10 jaw pain episodes since onset, each episode lasting at least 30 minutes and no less than 2 hours within the day, OR unremitting
• Low-impact TMD pain cases: Graded Chronic Pain Scale (GCPS) grade IIa or lower
• High-impact TMD pain cases: GCPS grade IIb or greater
• Be age 18-65 (inclusive)
• Provide a signed and dated informed consent form.
• Be willing to comply with all study procedures and be available for the duration of study participation.
• Be able to understand commands in English to follow study procedures.