# Mechanisms of myofascial TMD pain: endogenous pain modulation and beyond

> **NIH NIH K01** · NEW YORK UNIVERSITY · 2020 · $153,846

## Abstract

PROJECT SUMMARY/ABSTRACT
Most Americans experience some form of musculoskeletal pain in their lifetime and painful myofascial
Temporomandibular Disorder (mTMD) is one condition affecting at least 10% of community women. The
causes of mTMD are poorly understood. Patients are often left with expensive or invasive treatments for which
evidence of efficacy is mixed at best. Persistent mTMD is increasingly considered a chronic pain condition,
with a presumed dysfunction in a central pain mechanisms such as in endogenous pain modulation. Despite
increasing research, including use of quantitative sensory testing, conclusive evidence of pathology has not
emerged. Given the complexity of human neurobiology, including the inherently dynamic and stimulus-
dependent nature of endogenous pain modulation, lack of progress may be due to unmeasured confounding.
This proposal will use an innovative approach to address potential confounding introduced by phenotypic
heterogeneity and nociceptive burden. First, phenotypes of mTMD based on presence of joint pain, i.e. muscle
only-based pain (M-pain) versus both muscle and joint-based pain (MJ-pain) will be refined to determine case
groups. Second, unmeasured nociceptive input from other potential sources, (i.e., nociceptive burden) will be
addressed by examining both comorbidities that represent peripheral sensitization and laboratory-based sleep
masticatory muscle activity. To conduct a more valid examination of the role of endogenous pain modulation
dysfunction in mTMD, the following aims will be examined first in a completed case-control dataset of women,
and second in planned pilot research: (1) Explore characteristics of temporomandibular joint pain to classify
mTMD patients as M-pain or MJ-pain and examine patterns of comorbid disorders; (2) Compare facilitatory
pain modulation among the M-pain, MJ-pain and control groups; and (3) Compare inhibitory pain modulation
among M-pain, MJ-pain and control groups. To accomplish the proposed research and develop a research
agenda that can uncover mechanisms of mTMD, the present application for a Mentored Research Scientist
Development Award to Promote Diversity in Dental, Oral and Craniofacial Research Workforce (K01) proposes
to advance the expertise of a trained psychiatric epidemiologist in four areas: (1) chronic pain taxonomy
(clinical and research); (2) neuroscience of pain and translational research; (3) psychophysics of pain; and
secondarily (4) systems science approaches for the study of chronic pain. The proposed research and training
will result in submission of an R01 grant proposal on mechanisms of myofascial pain onset and maintenance in
human subjects.

## Key facts

- **NIH application ID:** 9982990
- **Project number:** 5K01DE028292-02
- **Recipient organization:** NEW YORK UNIVERSITY
- **Principal Investigator:** Vivian Santiago
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $153,846
- **Award type:** 5
- **Project period:** 2019-08-01 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9982990

## Citation

> US National Institutes of Health, RePORTER application 9982990, Mechanisms of myofascial TMD pain: endogenous pain modulation and beyond (5K01DE028292-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9982990. Licensed CC0.

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