颞下颌关节紊乱病疼痛患者脑功能磁共振成像的研究进展

Advances in application of functional magnetic resonance imaging in patients with painful temporomandibular disorders

颞下颌关节紊乱病(temporomandibular disorders,TMD)是口腔颌面部最常见的慢性疼痛性疾病,目前,TMD患者疼痛的病理生理学改变及其机制尚未完全明确。功能磁共振成像(functional magnetic resonance imaging,fMRI)是目前最常用的一种无伤害性的活体脑功能检测技术,已广泛应用于慢性疼痛性疾病的研究中。本文通过对TMD相关脑功能改变的任务态和静息态fMRI研究进行综述,从神经影像学的角度探讨TMD疼痛患者所存在的疼痛异常感知和调节的神经机制,并总结咬合板治疗对TMD患者脑部的影响,以期为TMD的临床诊疗提供参考。

Temporomandibular disorders (TMD), characterized by pain and dysfunction of the temporomandibular joint, are the most common chronic orofacial pain. However, the etiologies and pathologies of TMD related chronic pain are poorly understood. Functional magnetic resonance imaging (fMRI) measures brain activity by detecting changes associated with blood flow without invasiveness, and has been widely used in chronic pain research. We reviewed recent fMRI studies exploring the brain changes of patients with painful TMD to investigate the role of central nervous system in abnormal pain perception and impaired pain modulation, and to summarize the effects of splint therapy, in the hope of facilitating the clinical diagnosis and treatment of TMD.