title: Tracing toothache intensity in the brain.
abstract: Identification of brain regions that differentially respond to pain intensity may improve our understanding of trigeminally mediated nociception. This report analyzed cortical responses to painless and painful electrical stimulation of a right human maxillary canine tooth. Functional magnetic resonance images were obtained during the application of five graded stimulus strengths, from below, at, and above the individually determined pain thresholds. Study participants reported each stimulus on a visual rating scale with respect to evoked sensation. Based on hemodynamic responses of all pooled stimuli, a cerebral network was identified that largely corresponds to the known lateral and medial nociceptive system. Further analysis of the five graded stimulus strengths revealed positive linear correlations for the anterior insula bilaterally, the contralateral (left) anterior mid-cingulate, as well as contralateral (left) pregenual cingulate cortices. Cerebral toothache intensity coding on a group level can thus be attributed to specific subregions within the cortical pain network.
authors.affiliation: University of Zürich, Center of Dental Medicine, Clinic for Removable Prosthodontics, Masticatory Disorders and Special Care Dentistry, Plattenstrasse 11, Zürich 8032, Switzerland. michael.bruegger@uzh.ch
authors.forename: M
authors.initials: M
authors.lastname: Brügger
authors.forename: K
authors.initials: K
authors.lastname: Lutz
authors.forename: B
authors.initials: B
authors.lastname: Brönnimann
authors.forename: M L
authors.initials: ML
authors.lastname: Meier
authors.forename: R
authors.initials: R
authors.lastname: Luechinger
authors.forename: A
authors.initials: A
authors.lastname: Barlow
authors.forename: L
authors.initials: L
authors.lastname: Jäncke
authors.forename: D A
authors.initials: DA
authors.lastname: Ettlin
mesh_terms: D000328:Adult; D000679:Amygdala / Q000502:physiology; D001921:Brain / Q000502:physiology*; D001933:Brain Stem / Q000502:physiology; D002531:Cerebellum / Q000502:physiology; D002540:Cerebral Cortex / Q000502:physiology; D003481:Cuspid / Q000294:innervation; D017352:Echo-Planar Imaging / Q000379:methods; D004558:Electric Stimulation; D005625:Frontal Lobe / Q000502:physiology; D006179:Gyrus Cinguli / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000502:physiology; D059225:Nociception / Q000502:physiology; D059226:Nociceptive Pain / Q000503:physiopathology; D009778:Occipital Lobe / Q000502:physiology; D017288:Pain Threshold / Q000502:physiology*; D010296:Parietal Lobe / Q000502:physiology; D011699:Putamen / Q000502:physiology; D012684:Sensory Thresholds / Q000502:physiology; D013702:Temporal Lobe / Q000502:physiology; D013788:Thalamus / Q000502:physiology; D014098:Toothache / Q000503:physiopathology*; D014276:Trigeminal Nerve / Q000502:physiology; D055815:Young Adult