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Females with painful temporomandibular disorders present higher intracortical facilitation relative to pain-free controls

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Abstract

Objectives

This study aimed to investigate cortical excitability differences in the primary motor cortex (M1) hand representation between individuals with temporomandibular disorders (TMD) and healthy controls. We assessed resting motor thresholds, motor-evoked potentials (MEPs), intracortical inhibition, and intracortical facilitation and explored potential associations with clinical and psychosocial characteristics in the TMD group.

Materials and methods

We recruited 36 female participants with TMD and 17 pain-free controls. Transcranial magnetic stimulation (TMS) was used to assess M1 cortical excitability. Correlations between clinical and psychosocial factors and cortical excitability measures were also evaluated.

Results

Patients with TMD showed significantly higher intracortical facilitation at 12 ms (z = 1.98, p = 0.048) and 15 ms (z = 2.65, p = 0.008) when compared to controls. Correlations revealed associations between intracortical facilitation and pain interference, sleep quality, depressive symptoms, and pain catastrophizing in the TMD group.

Conclusions

Females with TMD exhibit heightened motor cortex intracortical facilitation in the hand representation, potentially indicating altered cortical excitability beyond the motor face area. This suggests a role for cortical excitability in TMD pathophysiology, influenced by psychosocial factors.

Clinical relevance

Understanding cortical excitability in TMD may inform targeted interventions. Psychosocial variables may play a role in cortical excitability, emphasizing the multidimensional nature of TMD-related pain. Further research is needed to confirm and expand upon these findings, with potential implications for the management of TMD and related pain conditions.

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Data availability

The data of this study will be available upon reasonable request.

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Acknowledgements

The authors would like to acknowledge the work of Dr Sehrish Saghir in the development of Fig. 1.

Funding

GJL received research support from a Canadian Institutes of Health Research Canada Research Chair. LDB received research support from Foundation Caroline Durand Research Chair in Acute Traumatology of Université de Montréal. AHB was funded by a Vanier Scholarship and the CPS.

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Authors and Affiliations

  1. Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada

    Alberto Herrero Babiloni & Gilles J. Lavigne

  2. Sacre-Coeur Hospital, CIUSSS NIM Research Center, CEAMS, 5400 Boul Gouin O, Montreal, QC, H4J 1C5, Canada

    Alberto Herrero Babiloni, Marianne Jodoin, Catherine Provost, Camille Charlebois-Plante, Beatrice P. De Koninck, Amelie Apinis-Deshaies, Gilles J. Lavigne & Louis De Beaumont

  3. Department of Psychology, University of Montreal, Montreal, Quebec, Canada

    Marianne Jodoin, Camille Charlebois-Plante, Beatrice P. De Koninck & Louis De Beaumont

  4. Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada

    Gilles J. Lavigne

Authors
  1. Alberto Herrero Babiloni
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  2. Marianne Jodoin
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  8. Louis De Beaumont
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Contributions

AHB participated in the conception of the idea and wrote the main manuscript, text, and tables. MJ participated in the conception of the idea and reviewed the manuscript. CP, CCP, BDK, and AAD participated in data collection, and data curation. GL and LDB supervised the conception of the project and the writing of the manuscript. All authors reviewed the manuscript.

Corresponding author

Correspondence to Alberto Herrero Babiloni.

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The authors declare no competing interests.

Ethical approval

The study procedures were approved by The Human Subjects Research Ethics Board of Hôpital du Sacré-Cœur de Montréal. Written informed consent was obtained from every participant.

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The authors declare no competing interests.

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Herrero Babiloni, A., Jodoin, M., Provost, C. et al. Females with painful temporomandibular disorders present higher intracortical facilitation relative to pain-free controls. Clin Oral Invest 28, 12 (2024). https://doi.org/10.1007/s00784-023-05412-5

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