Cerebral activation during thermal stimulation of patients who have burning mouth disorder: An fMRI study

Romulo J.C. Albuquerque, Reny de Leeuw, Charles R. Carlson, Jeffrey P. Okeson, Craig S. Miller, Anders H. Andersen

Research output: Contribution to journalArticlepeer-review

146 Scopus citations

Abstract

The pathophysiology of burning mouth disorder (BMD) is not clearly understood, but central neuropathic mechanisms are thought to be involved. The aim of this study was to gain insight into the pathophysiology associated with BMD by using functional magnetic resonance imaging (fMRI). Areas of brain activation following thermal stimulation of the trigeminal nerve of eight female patients with BMD (mean age 49.1 ± 10.1) were mapped using fMRI and compared with those of eight matched pain-free volunteers (mean age 50.3 ± 12.3). Qualitative and quantitative differences in brain activation patterns between the two study groups were demonstrated. BMD patients displayed greater fractional signal changes in the right anterior cingulate cortex (BA 32/24) and bilateral precuneus than did controls (p < 0.005). The control group showed larger fractional signal changes in the bilateral thalamus, right middle frontal gyrus, right pre-central gyrus, left lingual gyrus, and cerebellum than did the BMD patients (p < 0.005). In addition, BMD patients had less volumetric activation throughout the entire brain compared to the control group. Overall, BMD patients displayed brain activation patterns similar to those of patients with other neuropathic pain conditions and appear to process thermal painful stimulation to the trigeminal nerve qualitatively and quantitatively different than pain-free individuals. These findings suggest that brain hypoactivity may be an important feature in the pathophysiology of BMD.

Original languageEnglish
Pages (from-to)223-234
Number of pages12
JournalPain
Volume122
Issue number3
DOIs
StatePublished - Jun 2006

Bibliographical note

Funding Information:
The authors thank Agnes Bognar and David Powell for contributions to this paper. Funding for the MRI scans was provided by the Vice Chancellor for Research and Graduate Studies, University of Kentucky Medical Center.

Keywords

  • Brain imaging
  • Burning mouth disorder
  • Functional magnetic resonance imaging
  • Precuneus
  • Thalamic hypofunction
  • Trigeminal thermal stimulation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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