Altered brain responses to noxious dentoalveolar stimuli in high-impact temporomandibular disorder pain patients

Research output: Contribution to journalArticlepeer-review


High-impact temporomandibular disorder (TMD) pain may involve brain mechanisms related to maladaptive central pain modulation. We investigated brain responses to stimulation of trigeminal sites not typically associated with TMD pain by applying noxious dentoalveolar pressure to high- and low-impact TMD pain cases and pain-free controls during functional magnetic resonance imaging (fMRI). Fifty female participants were recruited and assigned to one of three groups based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and Graded Chronic Pain Scale: controls (n = 17), low-impact (n = 17) and high-impact TMD (n = 16). Multimodal whole-brain MRI was acquired following the Human Connectome Project Lifespan protocol, including stimulus-evoked fMRI scans during which painful dentoalveolar pressure was applied to the buccal gingiva of participants. Group analyses were performed using non-parametric permutation tests for parcellated cortical and subcortical neuroimaging data. There were no significant between-group differences for brain activations/deactivations evoked by the noxious dentoalveolar pressure. For individual group mean activations/deactivations, a gradient in the number of parcels surviving thresholding was found according to the TMD pain grade, with the highest number seen in the high-impact group. Among the brain regions activated in chronic TMD pain groups were those previously implicated in sensory-discriminative and motivational-affective pain processing. These results suggest that dentoalveolar pressure pain evokes abnormal brain responses to sensory processing of noxious stimuli in high-impact TMD pain participants, which supports the presence of maladaptive brain plasticity in chronic TMD pain.

Original languageEnglish (US)
Article numbere0266349
Pages (from-to)e0266349
JournalPloS one
Issue number10 October
StatePublished - Oct 2022

Bibliographical note

Funding Information:
Research reported in this publication was supported by the National Institute of Dental & Craniofacial Research of the National Institutes of Health ( under Award Number R00 DE027414 (E.J.M.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additional support was provided by the Office of the Vice President for Research, University of Minnesota. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors wish to thank Ms. Patt Carlson for her efforts in screening potential study participants. We would also like to acknowledge the following for their significant roles in in the earlier stages of this research project: Alberto Herrero Babiloni DDS, MS (McGill University) and Flavia P. Kapos DDS, MS (University of Washington). The authors acknowledge the Minnesota Supercomputing Institute (MSI) at the University of Minnesota for providing resources that contributed to the research results reported within this paper. URL: http://www.msi.umn. edu.

Publisher Copyright:
© 2022 Peck et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


  • Brain/diagnostic imaging
  • Chronic Pain
  • Female
  • Humans
  • Magnetic Resonance Imaging/methods
  • Pain Measurement/methods
  • Temporomandibular Joint Disorders/complications

Center for Magnetic Resonance Research (CMRR) tags

  • ANDI
  • BFC

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't


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