# Mechanistic Characterization of Pain in Temporomandibular Disorders: Does Pain Centralization Influence Responsiveness to Peripherally Targeted Treatments?

> **NIH NIH R00** · EMORY UNIVERSITY · 2020 · $246,352

## Abstract

Project Summary / Abstract
Temporomandibular disorders (TMD), characterized by persistent pain in the cheek and jaw area of the face,
affect approximately 1 in 10 women at some point in their lives. TMD treatments primarily focus on peripheral
factors; however, many patients with TMD show no signs of peripheral damage. It is now known that many
chronic pain conditions, including TMD, involve pain centralization, meaning the pain is generated and
maintained by central, rather than peripheral, nervous system processes. There are currently no well accepted
means through which centralized TMD pain can be identified in the clinic, and the failure to properly identify
these centralized cases means that ineffective peripheral treatments are administered. The specific aims of
this project are to 1) Demonstrate that structural, functional, and neurochemical abnormalities exist in TMD that
are similar to those reported in other centralized pain conditions, 2) Utilize questionnaire and quantitative
sensory testing measures that can accurately detect centralized pain to place patients on a continuum from
peripheral to centralized, and show that the brains of centralized, but not peripheral, patients differ significantly
from healthy controls, and 3) Determine the measures of centralization and brain morphology, function, and
chemistry that predict lack of improvement from a peripherally targeted treatment regimen, to show that
centralized TMD patients do not respond as well to treatments that fail to target their pathology. The primary
goal of the mentored (K99) portion of the award is to give the candidate the additional training in neuroimaging
necessary for him to obtain a tenure track faculty position and successfully run his own independent research
program. The K99 phase will take place at the University of Michigan, under the mentorship of Drs. Daniel
Clauw, Richard Harris, and David Williams, who are world-renowned experts in centralized pain conditions,
pain neuroimaging, and pain psychometrics, respectively. Dr. William Maixner (Duke University), a world-
leading expert on TMD, will also serve as a mentor; he will advise the candidate on the clinically relevant
aspects of TMD and help the candidate network with other more established TMD researchers. The University
of Michigan is ideal for the K99 phase of the project because of the available resources, including faculty who
are committed to clinical pain research and mentoring, research-devoted magnetic resonance imaging (MRI)
scanners and state-of-the-art pain testing equipment, and ample laboratory and office space at the Chronic
Pain and Fatigue Research Center. Upon completing the K99 portion of the award, the candidate will be well
suited to make the transition to tenure-track faculty.

## Key facts

- **NIH application ID:** 10101757
- **Project number:** 4R00DE026810-03
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Daniel Elliott Harper
- **Activity code:** R00 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $246,352
- **Award type:** 4N
- **Project period:** 2020-07-08 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10101757

## Citation

> US National Institutes of Health, RePORTER application 10101757, Mechanistic Characterization of Pain in Temporomandibular Disorders: Does Pain Centralization Influence Responsiveness to Peripherally Targeted Treatments? (4R00DE026810-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10101757. Licensed CC0.

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