Differential diagnosis of temporomandibular disorders and other orofacial pain disorders.
Jeffrey P Okeson, Reny de Leeuw
https://pubmed.ncbi.nlm.nih.gov/21094721Actively Recruiting
Phase Not Applicable
Age: 18Years +
All Genders
ID06813040
Efficacy of Repetitive Transcranial Magnetic Stimulation in Chronic Pain in Patients with Temporomandibular Disorders
Led by University of Coimbra · Updated on 2025-02-13
40
Participants Needed
1
Research Sites
21 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Temporomandibular disorder (TMD) includes musculoskeletal conditions affecting the jaw joint, chewing muscles, and nearby structures. About 30 to 40% of acute painful TMD cases become chronic, causing ongoing pain that affects daily life, emotional well-being, and quality of life. Chronic orofacial pain involves complex biological and psychological factors, making treatment challenging. This trial investigates the effectiveness of transcranial magnetic stimulation (TMS), a non-invasive brain stimulation method, in treating chronic TMD pain and aims to identify predictors of treatment success using brain connectivity and psychosocial assessments. Participants receive either active or sham repetitive transcranial magnetic stimulation (rTMS) over the motor cortex. The active rTMS is applied at 10Hz with 2000 pulses per session at 90% of the resting motor threshold, using a figure-8 coil. Ten sessions are conducted, spaced between 24 to 72 hours apart. The sham treatment mimics the look and sound of rTMS without delivering magnetic pulses. This randomized, triple-blinded trial compares these two groups to assess rTMS effects on chronic TMD. Participants will be assessed for pain intensity and jaw function before and after all rTMS sessions, with follow-ups at one week, two weeks, and one month post-treatment. Additional evaluations include pain-related disability, depression, anxiety, central sensitization, quality of life, and brain functional connectivity at various time points during and after treatment. The study tracks changes across these measures to understand the impact and safety of rTMS in chronic TMD over the course of treatment and follow-up periods.
CONDITIONS
Brief Title
Efficacy of Repetitive Transcranial Magnetic Stimulation in Temporomandibular Disorders.
Who Can Participate
Age: 18Years +
All Genders
Eligibility Criteria
You may qualify if you...
- Individuals of both sexes, literate, aged over 18 years with a diagnosis of muscular and/or joint TMD by the Diagnostic Criteria for Temporomandibular Disorders (DC-TMD)
- Orofacial pain lasting longer than 6 months
- Orofacial pain intensity greater than 5 on the visual analogue scale (VAS)
You will not qualify if you...
- Verbal communication impairment due to neurological disorder, previous illness sequelae, or psychiatric condition
- Pregnant women
- Presence of any impediment to MRI such as pacemaker, cochlear implant, ferromagnetic clips, deep brain stimulation electrodes, ocular implants, Swan-Ganz catheter, orthopedic prostheses, or metal near the area of interest
- Contraindications for transcranial magnetic stimulation including focal or generalized encephalopathies, increased intracranial pressure, severe heart disease, history of head trauma or epilepsy, family history of idiopathic epilepsy, use of drugs lowering seizure threshold, chronic alcohol or epileptogenic drug use
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
screening and enrollment visit
Implementation
Duration - 10 sessions with a minimum interval of 24 hours and a maximum of 72 hours between sessions
Participants receive repetitive transcranial magnetic stimulation (rTMS) over the motor cortex with either active or sham device sessions.
10 visits (in-person) for device sessions
Follow-up
Duration - 1 month after treatment completion
Participants are monitored for changes in pain intensity, functional limitation, and other secondary outcomes after treatment.
3 visits at 1 week, 2 weeks, and 1 month after treatment
Trial Site Locations
Total: 1 location
1
University of Coimbra
Coimbra, Portugal, 3000-548
Actively Recruiting
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Research Team
M
Miguel Castelo-Branco
C
Catarina Duarte
How is the study designed?
Study Type
INTERVENTIONAL
Masking
TRIPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Published Research Related To This Trial
Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†.
Eric Schiffman, Richard Ohrbach, Edmond Truelove...
https://pubmed.ncbi.nlm.nih.gov/24482784Temporomandibular pain and jaw dysfunction at different ages covering the lifespan--A population based study.
A Lövgren, B Häggman-Henrikson, C M Visscher...
https://pubmed.ncbi.nlm.nih.gov/26311138Longitudinal outcome of temporomandibular disorders: a 5-year epidemiologic study of muscle disorders defined by research diagnostic criteria for temporomandibular disorders.
Peter Rammelsberg, Linda LeResche, Samuel Dworkin...
https://pubmed.ncbi.nlm.nih.gov/12756926Neuropathic pain: mechanisms and their clinical implications.
Steven P Cohen, Jianren Mao
https://pubmed.ncbi.nlm.nih.gov/24500412The neuro-pathophysiology of temporomandibular disorders-related pain: a systematic review of structural and functional MRI studies.
Yuanyuan Yin, Shushu He, Jingchen Xu...
https://pubmed.ncbi.nlm.nih.gov/32560622Interventions for the management of temporomandibular joint osteoarthritis.
Raphael Freitas de Souza, Claudia H Lovato da Silva, Mona Nasser...
https://pubmed.ncbi.nlm.nih.gov/22513948Transitioning to chronic temporomandibular disorder pain: A combination of patient vulnerabilities and iatrogenesis.
Charles S Greene, Daniele Manfredini
https://pubmed.ncbi.nlm.nih.gov/33966303Non-invasive brain stimulation techniques for chronic pain.
Neil E O'Connell, Louise Marston, Sally Spencer...
https://pubmed.ncbi.nlm.nih.gov/29547226The efficacy of transcranial direct current stimulation and transcranial magnetic stimulation for chronic orofacial pain: A systematic review.
Natália R Ferreira, Ygor N Junqueira, Nathália B Corrêa...
https://pubmed.ncbi.nlm.nih.gov/31415654