Contribution of chronic pain and neuroticism to abnormal forebrain gray matter in patients with temporomandibular disorder

Massieh Moayedi, Irit Weissman-Fogel, Adrian P. Crawley, Michael B. Goldberg, Bruce V. Freeman, Howard C. Tenenbaum, Karen D. Davis

Research output: Contribution to journalArticlepeer-review


Cortical plasticity is thought to occur following continuous barrage of nociceptive afferent signals to the brain. Hence, chronic pain is presumed to induce anatomical and physiological changes in the brain over time. Inherent factors, some pre-dating the onset of chronic pain, may also contribute to brain abnormalities present in patients. In this study we used structural MRI to examine whether patients with chronic temporomandibular (TMD) pain have abnormalities in gray matter (GM) within brain areas implicated in pain, modulation and sensorimotor function. We found that patients with TMD have cortical thickening in the primary somatosensory cortex (S1), frontal polar and the ventrolateral prefrontal cortex (PFC). These findings provide a structural basis for previous findings of TMD pain and cognitive sluggishness in TMD. We then examined the contribution of TMD characteristics to GM abnormalities. We found that 1) GM in the sensory thalamus positively correlated to TMD duration, 2) cortical thickness in the primary motor (M1) and the anterior mid-cingulate cortices (aMCC) were negatively correlated to pain intensity, and 3) pain unpleasantness was negatively correlated to cortical thickness in the orbitofrontal cortex (OFC). These findings suggest that an individual's TMD pain history contributes to GM in the brain. Lastly, we examined the contribution of a potential pre-existing vulnerability due to neuroticism. In the TMD patients, we found that there was an abnormal positive correlation between neuroticism and OFC thickness, in contrast to the negative correlation found in the healthy controls. Therefore, neuroticism may contribute to TMD pathophysiology. In sum, our data suggest that GM in the brain of patients with chronic TMD pain can be shaped by both personality and pain characteristics.

Original languageEnglish
Pages (from-to)277-286
Number of pages10
Issue number1
StatePublished - 1 Mar 2011
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by the Canadian Institute of Health Research (Grant Number MOP 53304 ). MM is funded by a CIHR Banting and Best Canada Graduate Scholarship, an Ontario Graduate Scholarship, and the CIHR Pain: M2C and Cell Signals Strategic Training in Health Research grants. KDD is a Canada Research Chair in Brain and Behaviour.


  • Chronic pain
  • Cingulate cortex
  • Cortical thickness analysis
  • MRI
  • Neuroticism
  • Prefrontal cortex
  • Sensorimotor cortex
  • TMD
  • Thalamus
  • Voxel-based morphometry

ASJC Scopus subject areas

  • Neurology
  • Cognitive Neuroscience


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