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Functional Magnetic Resonance Connectivity in Patients With Temporomadibular Joint Disorders

Myofascial pain in the masticatory region, generally referred to as headache, is a common temporomandibular disorder (TMD) characterized by the hypersensitive regions of the contracted skeletal muscle fibers. A correct clinical treatment of myofascial pain has the potential to modify the functional...

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Autores principales: Festa, Felice, Rotelli, Chiara, Scarano, Antonio, Navarra, Riccardo, Caulo, Massimo, Macrì, Monica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072218/
https://www.ncbi.nlm.nih.gov/pubmed/33912123
http://dx.doi.org/10.3389/fneur.2021.629211
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author Festa, Felice
Rotelli, Chiara
Scarano, Antonio
Navarra, Riccardo
Caulo, Massimo
Macrì, Monica
author_facet Festa, Felice
Rotelli, Chiara
Scarano, Antonio
Navarra, Riccardo
Caulo, Massimo
Macrì, Monica
author_sort Festa, Felice
collection PubMed
description Myofascial pain in the masticatory region, generally referred to as headache, is a common temporomandibular disorder (TMD) characterized by the hypersensitive regions of the contracted skeletal muscle fibers. A correct clinical treatment of myofascial pain has the potential to modify the functional activation of cerebral networks associated with pain and unconscious teeth clenching, specifically the pain network (PN) and default mode network (DMN). In this study, research is presented as a case series of five patients with myofascial pain: three were diagnosed with intra- and extra-articular disorders, and two were diagnosed with only extra-articular disorders. All five patients received gnathological therapy consisting of passive splints and biofeedback exercises for tongue–palatal vault coordination. Before and after treatment, patients underwent pain assessments (through measures of visual analog scales and muscular palpation tests), nuclear magnetic resonance of the temporomandibular joint, and functional nuclear magnetic resonance of the brain. In each patient, temporomandibular joint nuclear magnetic resonance results were similar before and after the gnathological treatment. However, the treatment resulted in a considerable reduction in pain for all patients, according to the visual analog scales and the palpation test. Furthermore, functional nuclear magnetic resonance of the brain clearly showed a homogeneous modification in cerebral networks associated with pain (i.e., PN and DMN), in all patients. In conclusion, gnathological therapy consisting of passive aligners and biofeedback exercises improved myofascial pain in all five patients. Most importantly, this study showed that all five patients had a homogeneous functional modification of pain and default mode networks. Using passive splints in combination with jaw exercises may be an effective treatment option for patients with TMD. This research could be a starting point for future investigations and for clinicians who want to approach similar situations.
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spelling pubmed-80722182021-04-27 Functional Magnetic Resonance Connectivity in Patients With Temporomadibular Joint Disorders Festa, Felice Rotelli, Chiara Scarano, Antonio Navarra, Riccardo Caulo, Massimo Macrì, Monica Front Neurol Neurology Myofascial pain in the masticatory region, generally referred to as headache, is a common temporomandibular disorder (TMD) characterized by the hypersensitive regions of the contracted skeletal muscle fibers. A correct clinical treatment of myofascial pain has the potential to modify the functional activation of cerebral networks associated with pain and unconscious teeth clenching, specifically the pain network (PN) and default mode network (DMN). In this study, research is presented as a case series of five patients with myofascial pain: three were diagnosed with intra- and extra-articular disorders, and two were diagnosed with only extra-articular disorders. All five patients received gnathological therapy consisting of passive splints and biofeedback exercises for tongue–palatal vault coordination. Before and after treatment, patients underwent pain assessments (through measures of visual analog scales and muscular palpation tests), nuclear magnetic resonance of the temporomandibular joint, and functional nuclear magnetic resonance of the brain. In each patient, temporomandibular joint nuclear magnetic resonance results were similar before and after the gnathological treatment. However, the treatment resulted in a considerable reduction in pain for all patients, according to the visual analog scales and the palpation test. Furthermore, functional nuclear magnetic resonance of the brain clearly showed a homogeneous modification in cerebral networks associated with pain (i.e., PN and DMN), in all patients. In conclusion, gnathological therapy consisting of passive aligners and biofeedback exercises improved myofascial pain in all five patients. Most importantly, this study showed that all five patients had a homogeneous functional modification of pain and default mode networks. Using passive splints in combination with jaw exercises may be an effective treatment option for patients with TMD. This research could be a starting point for future investigations and for clinicians who want to approach similar situations. Frontiers Media S.A. 2021-04-12 /pmc/articles/PMC8072218/ /pubmed/33912123 http://dx.doi.org/10.3389/fneur.2021.629211 Text en Copyright © 2021 Festa, Rotelli, Scarano, Navarra, Caulo and Macrì. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Festa, Felice
Rotelli, Chiara
Scarano, Antonio
Navarra, Riccardo
Caulo, Massimo
Macrì, Monica
Functional Magnetic Resonance Connectivity in Patients With Temporomadibular Joint Disorders
title Functional Magnetic Resonance Connectivity in Patients With Temporomadibular Joint Disorders
title_full Functional Magnetic Resonance Connectivity in Patients With Temporomadibular Joint Disorders
title_fullStr Functional Magnetic Resonance Connectivity in Patients With Temporomadibular Joint Disorders
title_full_unstemmed Functional Magnetic Resonance Connectivity in Patients With Temporomadibular Joint Disorders
title_short Functional Magnetic Resonance Connectivity in Patients With Temporomadibular Joint Disorders
title_sort functional magnetic resonance connectivity in patients with temporomadibular joint disorders
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072218/
https://www.ncbi.nlm.nih.gov/pubmed/33912123
http://dx.doi.org/10.3389/fneur.2021.629211
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