MRI-Based Neuroimaging of Chronic Orofacial Pain in Temporomandibular Joint Dysfunction Comorbid with Anxiety and Depression

A study of the brain using magnetic resonance morphometry and diffusion tensor imaging in patients with chronic orofacial pain syndrome associated with temporomandibular joint pain dysfunction syndrome revealed changes in regional gray matter volume, namely a decrease in the volume of the primary somatosensory cortex, an increase in gray matter volume in the thalamus, and an increase in both volume and microstructural alterations in the brainstem (in the dorsal horn of the midbrain) accompanied by changes in diffusion properties, specifically an increase in mean diffusivity; in the projection of structures of the descending pain modulation system, including the periaqueductal gray matter of the midbrain and the nucleus raphe magnus, as well as in the integrity of ascending pain pathways (a reduction of fractional anisotropy in the trigeminal root entry zone, the spinal trigeminal tract, and the ventral trigemino-thalamic tract); as well as bilateral increases in the gray matter volume of the pons corresponding to the principal sensory nucleus of the trigeminal nerve. The aim of this study is to analyze current data concerning MRI neuroimaging methods of the central nervous system in patients with chronic orofacial pain syndrome in temporomandibular joint pain dysfunction syndrome comorbid with anxiety and depression. We analyzed more than 60 articles in English devoted to neuroimaging studies using voxel-based morphometry of the central nervous system in patients with chronic orofacial pain syndrome in temporomandibular joint pain dysfunction syndrome comorbid with anxiety and depression. The rapid development of imaging in recent decades has led to an increase in the number of identified causes of dysfunction in the trigeminal nerve system, which are amenable to specific treatment and functional recovery. A clinically oriented segmental approach to trigeminal nerve pathology is important for conducting specialized high-resolution imaging studies, which are a powerful tool in the examination of patients with trigeminal nerve dysfunction.