Pain Catastrophizing and Functional Activation During Occlusion in TMD Patients-An Interventional Study

Area of Science:

• Neuroscience
• Pain Research
• Dental Medicine

Background:

• Temporomandibular disorder (TMD) interventions, like occlusal splints, have unclear effects on pain relief and pain catastrophizing.
• Previous research suggests the insula plays a key role in pain relief associated with occlusal splint treatment.

Purpose of the Study:

• To investigate the impact of occlusal splint therapy on brain activity related to pain processing and pain catastrophizing in TMD patients.
• To explore the relationship between insula activation, pain relief, and pain catastrophizing during splint intervention.

Main Methods:

• A placebo-controlled, longitudinal functional magnetic resonance imaging (fMRI) study involving 20 TMD patients.
• Patients underwent fMRI during repetitive occlusal movements at baseline and after approximately 7 weeks of splint therapy.
• Occlusion force measures were used to balance performance, and self-reported pain catastrophizing was collected.

Main Results:

• fMRI activation in pain processing areas, including the insula and somatosensory cortex, decreased after intervention.
• A positive correlation between left anterior insula activation and pain catastrophizing was observed at baseline.
• Both insula activation and pain catastrophizing decreased with treatment, especially in patients with milder TMD.

Conclusions:

• Occlusal splint therapy effectively reduces brain activity associated with pain processing and pain catastrophizing in TMD patients.
• The left anterior insula's role in pain catastrophizing is highlighted, with its activation decreasing alongside reported catastrophizing.
• Findings suggest splint therapy is beneficial, particularly for individuals with less severe TMD symptoms.