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. 2025 Jun 2;25(1):881.
doi: 10.1186/s12903-025-06243-4.

Altered gray matter volume in chronic temporomandibular disorder pain with pain catastrophizing: a voxel-based morphometry study

Thi-Thu Nguyen  1 , Anh Ho-Quynh Nguyen  2 , Quang-Khang Le  3 , Thi-Kim-Anh Nguyen  4
Affiliations

Altered gray matter volume in chronic temporomandibular disorder pain with pain catastrophizing: a voxel-based morphometry study

Thi-Thu Nguyen et al. BMC Oral Health. .

Abstract

Background: Chronic temporomandibular disorder (TMD) pain with pain catastrophizing (PC) is associated with altered brain morphology; however, its neuroanatomical underpinnings remain unclear. This study aimed to investigate gray matter volume (GMV) in the brain regions of chronic TMD pain patients with PC using voxel-based morphometry.

Methods: A case-control study was conducted with 28 participants, including 14 chronic TMD pain patients with high PC and 14 age- and sex-matched healthy controls. T1-weighted magnetic resonance imaging (MRI) data were acquired using a 3-Tesla scanner and analyzed with Statistical Parametric Mapping 12 (SPM12). Whole-brain and Region-of-Interest (ROI) analyses were performed to assess GMV differences and associations between GMV with clinical variables.

Results: Whole-brain analysis revealed no significant GMV differences between groups. However, ROIs analyses showed significantly smaller GMV in the bilateral hippocampus, left parahippocampal gyrus, and right putamen in the patient group. Additionally, GMV in the orbital part of the inferior frontal gyrus was negatively associated with pain duration.

Conclusion: This study suggests that central nervous system alterations are linked to chronic TMD pain condition with pain catastrophizing. These findings contribute to understanding the neurobiological basis of chronic musculoskeletal pain and highlight the need for further research into the role of cognitive-emotional factors in pain-related neural adaptations.

Clinical trial number: Not applicable.

Keywords: Chronic pain; Pain catastrophizing; Temporomandibular disorders; Voxel-based morphometry.

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Conflict of interest statement

Declarations. Ethical approval: This study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee for Biomedical Research, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam (Approval No. 946/HĐĐĐ-ĐHYD, dated 24 November 2022). Consent to participate: Informed consent was obtained from all the participants in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Regions showing reduced GMV in patients compared to healthy controls. The color scale represents T-scores, with higher values (yellow-white) indicating stronger between-group differences and lower values (red) indicating weaker differences. Axial slices are shown at MNI coordinates z = -26, z = -27, and z = 8
Fig. 2
Fig. 2
Association between pain duration and regional gray matter volume after adjustment for age and TIV
See this image and copyright information in PMC

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