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Altered Regional Homogeneity and Functional Connectivity in Patients with Painful Temporomandibular Disorders: A
Xin Li1, Yujiao Jiang2, Yuqi Deng1
1Department of Nuclear Medicine, Xinqiao Hospital, Army Medical University, Chongqing 400037, China.
Introduction:
Although painful Temporomandibular Disorders (p-TMD) represent a common chronic pain condition, their central pathophysiology remains elusive. This work utilized multimodal resting-state functional MRI (rs-fMRI) to investigate functional brain alterations in patients with p-TMD.
Methods:
A total of 74 participants (41 p-TMD patients and 33 age- and gender-matched normal controls (NCs)) were enrolled in this case-control study. Each participant underwent both rs-fMRI and high-resolution structural imaging. We assessed multiple metrics, including Regional Homogeneity (ReHo), Amplitude of Low-Frequency Fluctuations (ALFF), Degree Centrality (DC), and further explored seed-based Functional Connectivity (FC). Intergroup differences were examined, and correlations between significant neuroimaging findings and clinical variables were assessed.
Results:
Relative to the NC group, p-TMD patients showed a specific increase in ReHo localized to the Left Postcentral Gyrus (L_PoG), with no concurrent changes in ALFF or DC in this region. This hyper-synchronous region demonstrated enhanced FC when the identified L_PoG cluster was used as the seed region in several brain regions, including the right caudate, left putamen, right postcentral gyrus, and right precentral gyrus. Notably, these altered ReHo and FC values showed no significant correlation with clinical variables.
Discussion:
The observed pattern of increased L_PoG ReHo in the absence of ALFF or DC changes suggests a highly localized enhancement of neuronal synchrony in the primary somatosensory cortex, rather than generalized hyperactivation or altered network hub status. The enhanced FC with the basal ganglia and contralateral sensorimotor cortex indicates aberrant integration of sensory and affective-motivational information. The lack of correlation with clinical measures suggests the brain alterations may better reflect stable disease traits than momentary pain states in p-TMD.
Conclusion:
The current study identified L_PoG neuronal hypersynchrony and enhanced sensorimotor-motivational network coupling as central features of p- TMD, which may be a manifestation of pain-related neuroplasticity. Collectively, this study provides a neuroimaging basis for developing new biomarkers and suggests potential for future targeted neuromodulation strategies in p-TMD.
