Spatial and Temporal Brain Responses to Noxious Heat Thermal Stimuli in Burning Mouth Syndrome. (September 2016)

• Record Type: Journal Article
• Authors: Shinozaki, T.; Imamura, Y.; Kohashi, R.; Dezawa, K.; Nakaya, Y.; Sato, Y.; Watanabe, K.; Morimoto, Y.; Shizukuishi, T.; Abe, O.; Haji, T.; Tabei, K.; Taira, M.
• Other Names: Dubner Ronald guest-editor.
• Is Part Of: Journal of dental research. Volume 95:Number 10(2016)
• Page Start: 1138
• Page End: 1146
• Publication Date: 2016-09
• Subjects: functional MRI -- pain habituation -- anterior cingulate cortex -- parahippocampal gyrus -- neuropathic orofacial pain -- chronic primary pain; Dentistry -- Periodicals; Dentistry -- Social aspects -- Periodicals; Dentistry -- Periodicals; Research -- Periodicals; 617.6005
• DOI: 10.1177/0022034516653580
• Languages: English
• ISSNs: 0022-0345

Abstract

Burning mouth syndrome (BMS) is an idiopathic orofacial pain condition. Although the pathophysiology of BMS is not clearly understood, central and peripheral neuropathic mechanisms are thought to be involved. The authors compared brain response to noxious heat stimuli in 16 right-handed women with primary BMS and 15 sex- and age-matched right-handed healthy female controls. A thermal stimulus sequence of 32 °C to 40 °C to 32 °C to 49 °C was repeated 4 times in a cycle. Warm and noxious heat stimuli were delivered with a Peltier thermode placed on the right palm or right lower lip for 32 s each in a session. Functional magnetic resonance imaging data were obtained by recording echoplanar images with a block design. Statistical Parametric Mapping 8 software was used to analyze the data. Patients and controls both reported feeling more pain during palm stimulation than during lip stimulation. Repetition of noxious heat stimulus on the lower lip but not on the palm induced habituation in brain activity in the cingulate cortex without reduction in pain perception. Multiple regression analysis revealed a correlation between perceived pain intensity and suppression of brain activity in the anterior cingulate cortex when the repeated thermal sequence was applied at the lower lip. Furthermore, the response of the parahippocampal area differed in BMS patients and controls when the same repeated thermal sequence was applied at the palm. The authors' findings indicate that BMS patients show specific brain responses due to impaired function of the central and peripheral nervous systems (clinical trial registration: UMIN000015002).