The National Institutes of Health’s National Institute of Dental and Craniofacial Research has awarded Duke Anesthesiology Katherine Martucci, PhD, a two-year $444,125 R21 grant for her project titled, “Toward CNS Correlates of Autonomic Dysfunction in Painful TMD.”
“Temporomandibular disorder, or TMD, is a very prevalent painful jaw condition but treatment options are trial-and-error,” says Martucci, associate professor in anesthesiology and director of the Human Affect and Pain Neuroscience Laboratory. “This project will allow us to launch an important new line of research on how autonomic tone influences central nervous system function in persons with TMD, which will help with identifying the right treatment for the right persons.”
Painful temporomandibular disorders are a prevalent form of chronic craniofacial pain. While chronic TMD pain affects up to 12% of US adults, current clinical treatment selection remains trial-and-error with modest efficacy. Assessment of both the autonomic and central nervous systems offers a promising pathway for refining treatment selection.
To clarify autonomic/central nervous system (CNS) contributions to painful TMD, Martucci and investigators will study how alterations in the CNS (ie, brain and brainstem) interact with autonomic dysfunction and clinical symptoms. Among normotensive patients with TMD (N=20) and age- / BMI- matched pain-free controls (N=20), autonomic function will be evaluated using cardiac and beat-to-beat blood pressure measurements. Using novel fMRI sequences to evaluate brain and brainstem function, researchers will test how altered CNS activity relates to autonomic dysfunction and pain (surveys & quantitative sensory tests).
Martucci’s project will generate ample pilot data for a longitudinal investigation delineating how neuroimaging and biobehavioral endpoints relate to patient prognosis. Ultimately, this study will lay the groundwork for innovative, dual-targeted CNS and autonomic interventions, advancing personalized treatment selection for patients with TMD.