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Sustained and Repeated Mouth Opening Leads to Development of Painful Temporomandibular Disorders Involving Macrophage/Microglia Activation in Mice

Temporomandibular disorder (TMD) is a set of heterogeneous musculoskeletal conditions involving the temporomandibular joint (TMJ) and/or the masticatory muscles. Up to 33% of the population has had at least one symptom of TMD with 5-10% of them requiring treatment. Common symptoms include limited jaw movement, joint sound, and pain in the orofacial area. Once TMD becomes chronic, it can be debilitating with comorbidities that greatly reduce one's overall quality of life. However, the underlying mechanism of TMD is unclear due to the multicausative nature of the disease.

Prevalence of TMD in Sjӧgren Syndrome Patients

Sjӧgren's Syndrome seems to play a role in temporomandibular joint disorders.

Early Molecular Response and Microanatomical Changes in the Masseter Muscle and Mandibular Head After Botulinum Toxin Intervention in Adult Mice

The Botox-injected masseters had greatly increased expression of genes involved in muscle atrophy at the 1 week time point compared to the control side muscles. At the end of the study, 2 weeks after injection, the Botox-injected masseters were about 20% smaller than the control side masseters, and the Botox-side condyles had lost about 40% of relative bone area compared to the control side condyles.

Centralized Pain in TMD: Is It All in the Head?

We are pleased to introduce Sophia Stone, a new contributor to The TMJ Association, whose passion is to separate TMD fact from TMD fiction. Sophia has a background in medicine and research and can draw on her personal experience as a TMD patient.

Why Head and Face Pain Cause More Suffering

  • Dec 14, 2017

Hate headaches? The distress you feel is not all in your -- well, head. People consistently rate pain of the head, face, eyeballs, ears and teeth as more disruptive, and more emotionally draining, than pain elsewhere in the body.

Duke University scientists have discovered how the brain's wiring makes us suffer more from head and face pain. The answer may lie not just in what is reported to us by the five senses, but in how that sensation makes us feel emotionally.

The team found that sensory neurons that serve the head and face are wired directly into one of the brain's principal emotional signaling hubs. Sensory neurons elsewhere in the body are also connected to this hub, but only indirectly.

The results may pave the way toward more effective treatments for pain mediated by the craniofacial nerve, such as chronic headaches and neuropathic face pain.

"Usually doctors focus on treating the sensation of pain, but this shows the we really need to treat the emotional aspects of pain as well," said Fan Wang, a professor of neurobiology and cell biology at Duke, and senior author of the study. The results appear online Nov. 13 in Nature Neuroscience.

Pain signals from the head versus those from the body are carried to the brain through two different groups of sensory neurons, and it is possible that neurons from the head are simply more sensitive to pain than neurons from the body.

But differences in sensitivity would not explain the greater fear and emotional suffering that patients experience in response to head-face pain than body pain, Wang said.

Personal accounts of greater fear and suffering are backed up by functional Magnetic Resonance Imaging (fMRI), which shows greater activity in the amygdala -- a region of the brain involved in emotional experiences -- in response to head pain than in response to body pain.

"There has been this observation in human studies that pain in the head and face seems to activate the emotional system more extensively," Wang said. "But the underlying mechanisms remained unclear."

To examine the neural circuitry underlying the two types of pain, Wang and her team tracked brain activity in mice after irritating either a paw or the face. They found that irritating the face led to higher activity in the brain's parabrachial nucleus (PBL), a region that is directly wired into the brain's instinctive and emotional centers.

Then they used methods based on a novel technology recently pioneered by Wang's group, called CANE, to pinpoint the sources of neurons that caused this elevated PBL activity.

"It was a eureka moment because the body neurons only have this indirect pathway to the PBL, whereas the head and face neurons, in addition to this indirect pathway, also have a direct input," Wang said. "This could explain why you have stronger activation in the amygdala and the brain's emotional centers from head and face pain."

Source: Duke Today, Why Head and Face Pain Causes More Suffering, 11/13/17.

https://today.duke.edu/2017/11/why-head-and-face-pain-causes-more-suffering 

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