Cortical plasticity in patients with persistent idiopathic dentoalveolar pain: A case-control study

Aim Persistent idiopathic dentoalveolar pain (PIDAP) is a chronic pain syndrome involving central sensitization; however, the underlying brain mechanisms remain poorly understood. This study was conducted using voxel-based morphometry (VBM) analysis in a magnetic resonance imaging (MRI) with the aim of investigating cortical plasticity (brain structural changes) in patients with PIDAP. Methods High-resolution T1-weighted MRI data were acquired from 24 patients with PIDAP and 25 age- and sex-matched healthy controls. Before treatment, patients underwent scanning and psychological assessments (Pain Catastrophizing Scale: PCS). VBM analysis was used to assess the between-group difference in gray matter volume. Results On VBM analysis, patients with PIDAP, compared with the controls, had significantly reduced gray matter volume in the right primary somatosensory cortex (S1), which corresponds to the oral area in the S1 region. Furthermore, the gray matter volume in this region was negatively correlated with the PCS scores. Conclusions These results highlight the association between cortical plasticity in the S1 (which may reflect altered somatosensory processing) and the PCS scores in patients with PIDAP, which suggests the involvement of central mechanisms in PIDAP pathophysiology. Clinical Trial Registration UMIN000029226.