TY - JOUR
T1 - Structural MRI findings in the brain related to pain distribution in chronic overlapping pain conditions
T2 - An explorative case–control study in females with fibromyalgia, temporomandibular disorder-related chronic pain and pain-free controls
AU - Lam, Julia
AU - Mårtensson, Johan
AU - Westergren, Hans
AU - Svensson, Peter
AU - Sundgren, Pia C.
AU - Alstergren, Per
PY - 2024/11
Y1 - 2024/11
N2 - Background: Few neuroimaging studies have investigated structural brain differences associated with variations in pain distribution. Objective: To explore structural differences of the brain in fibromyalgia (FM), temporomandibular disorder pain (TMD) and healthy pain-free controls (CON) using structural and diffusion MRI. Methods: A case–control exploratory study with three study groups with different pain distribution were recruited: FM (n = 16; mean age [standard deviation]: 44 [14] years), TMD (n = 17, 39 [14] years) and CON (n = 10, 37 [14] years). Participants were recruited at the University Dental Clinic in Malmö, Sweden. T1-weighted and diffusion MRIs were acquired, clinical and psychosocial measures were obtained. Main outcome measures were subcortical volume, cortical thickness, white matter microstructure and whole brain grey matter intensity. Results: Patients with FM had smaller volume in the right thalamus than patients with TMD (p =.020) and CON (p =.030). The right thalamus volume was negatively correlated to pain intensity (r = −0.37, p =.022) and pain-related disability (r = −0.45, p =.004). The FM group had lower cortical thickness in the right anterior prefrontal cortex than CON (p =.005). Cortical thickness in this area was negatively correlated to pain intensity (r [37] = − 0.48, p =.002). Conclusions: This study suggests that thalamus grey matter alterations are associated with FM and TMD, and that anterior prefrontal cortex grey matter alterations are associated with FM but not TMD. Studies on chronic overlapping pain conditions are needed in relation to possible nociplastic pain mechanisms in the brain and central nervous system.
AB - Background: Few neuroimaging studies have investigated structural brain differences associated with variations in pain distribution. Objective: To explore structural differences of the brain in fibromyalgia (FM), temporomandibular disorder pain (TMD) and healthy pain-free controls (CON) using structural and diffusion MRI. Methods: A case–control exploratory study with three study groups with different pain distribution were recruited: FM (n = 16; mean age [standard deviation]: 44 [14] years), TMD (n = 17, 39 [14] years) and CON (n = 10, 37 [14] years). Participants were recruited at the University Dental Clinic in Malmö, Sweden. T1-weighted and diffusion MRIs were acquired, clinical and psychosocial measures were obtained. Main outcome measures were subcortical volume, cortical thickness, white matter microstructure and whole brain grey matter intensity. Results: Patients with FM had smaller volume in the right thalamus than patients with TMD (p =.020) and CON (p =.030). The right thalamus volume was negatively correlated to pain intensity (r = −0.37, p =.022) and pain-related disability (r = −0.45, p =.004). The FM group had lower cortical thickness in the right anterior prefrontal cortex than CON (p =.005). Cortical thickness in this area was negatively correlated to pain intensity (r [37] = − 0.48, p =.002). Conclusions: This study suggests that thalamus grey matter alterations are associated with FM and TMD, and that anterior prefrontal cortex grey matter alterations are associated with FM but not TMD. Studies on chronic overlapping pain conditions are needed in relation to possible nociplastic pain mechanisms in the brain and central nervous system.
KW - chronic pain
KW - diffusion tensor imaging
KW - fibromyalgia
KW - magnetic resonance imaging
KW - pain perception
KW - temporomandibular joint disorders
U2 - 10.1111/joor.13842
DO - 10.1111/joor.13842
M3 - Article
C2 - 39152537
AN - SCOPUS:85201298424
SN - 0305-182X
VL - 51
SP - 2415
EP - 2426
JO - Journal of Oral Rehabilitation
JF - Journal of Oral Rehabilitation
IS - 11
ER -