Temporomandibular Disorders (TMD) are characterised by pain and limited jaw movement and are a significant issue. Current management is influenced by the view of a simple association between pain and limited movement. This study will test a new theory that an individual's motor response to pain is influenced by the complexity of the jaw motor system as well as the individual's pain experience. This project will point towards individualised recommendations for effective management of TMD.
An FMRI Analysis Of The Functional Organization Within The Brain Of Experimental Superficial And Deep Orofacial Pain
Funder
National Health and Medical Research Council
Funding Amount
$307,526.00
Summary
This project will investigate how the human brain processes a number of important aspects of human jaw muscle pain that are clinically relevant but poorly understood. For example, we do not understand why jaw muscle pain has such different behavioural effects to skin pain. Jaw muscle pain is associated with a significant emotional component not seen in with skin pains. Also, skin pain usually has a sharp or burning quality, is well-localized and is readily treated, while jaw muscle pain is a dee ....This project will investigate how the human brain processes a number of important aspects of human jaw muscle pain that are clinically relevant but poorly understood. For example, we do not understand why jaw muscle pain has such different behavioural effects to skin pain. Jaw muscle pain is associated with a significant emotional component not seen in with skin pains. Also, skin pain usually has a sharp or burning quality, is well-localized and is readily treated, while jaw muscle pain is a deep pain that has a dull, aching quality that may be referred to related sites of the face, head and neck. It is also not known why jaw muscle pain is more common in females in comparison to males. Chronic jaw muscle pain is a major symptom of patients with Temporomandibular Disorders, the most common form of non-dental orofacial pain and that involves pain in or about the jaw joint and-or jaw muscles, and often limitation of jaw movement. Chronic jaw muscle pain can have a severe effect on quality of life but its diagnosis and management is difficult. Despite the widespread prevalence of chronic orofacial pains, we have little information on the central processing of chronic human orofacial pain. This proposal will improve our fundamental understanding of how jaw muscle pain is processed in the brain. The way that the central nervous system processes and represents jaw muscle pain will help explain why these pains present differently in the clinic and should provide important information on the differences between females and males in the representation of jaw muscle pain. This information on the central processing of chronic orofacial pain is crucial to inform the direction of novel or specific management strategies. Our long-term goal is to improve the diagnosis and management of patients with Temporomandibular Disorders, and the present application represents a major new direction of research.Read moreRead less
Effects Of Jaw Muscle Pain On Jaw Muscle Activity And Jaw Movement In Humans
Funder
National Health and Medical Research Council
Funding Amount
$337,770.00
Summary
Chronic facial muscle pain is a significant community health problem that is poorly understood. Current treatments are based on the idea that structural or stress-related factors result in increased jaw muscle activity which then generates pain that in turn leads to more muscle activity - the so-called Vicious Cycle Theory. Treatments therefore aim to break the cycle by focussing on reducing muscle activity and thereby alleviate the pain. There is currently, however, little scientific evidence f ....Chronic facial muscle pain is a significant community health problem that is poorly understood. Current treatments are based on the idea that structural or stress-related factors result in increased jaw muscle activity which then generates pain that in turn leads to more muscle activity - the so-called Vicious Cycle Theory. Treatments therefore aim to break the cycle by focussing on reducing muscle activity and thereby alleviate the pain. There is currently, however, little scientific evidence for this Theory. Another theory has been recently proposed in the Pain Adaptation Model. This model says that changes in muscle activity and movement are protective against further pain rather than the cause of the pain. The evidence, however, for this model is limited and conflicting. The current lack of understanding of facial muscle pain limits advancement in its management. Our long-term goal is to improve the management of patients with facial pain. The present application aims to determine whether muscle pain alters jaw muscle activity and jaw movement. Our preliminary clinical data provide compelling evidence for the Pain Adaptation Model. We are confident of a better understanding of what goes wrong in the jaw muscles in chronic facial pain and this will have implications for muscle pains elsewhere in the body. The outcome may help to refute the Vicious Cycle Theory, and help shift the focus away from signs and symptoms associated with the jaw muscles, and re-direct the focus to the alleviation of pain as the primary management goal. The information obtained should also provide a solid basis on which treatments can be tested for optimal resolution of symptoms, and an evidence-based approach in the management of facial pain.Read moreRead less
Understanding Persistent Low Back Pain Where It Resides, In The Brain
Funder
National Health and Medical Research Council
Funding Amount
$848,972.00
Summary
Low back pain is a leading cause of disability amongst Australians. A critical question is why some people get better after hurting their back while others do not. This project examines whether changes in the brain predict low back pain outcome. This information will rapidly advance our understanding of low back pain and has the potential to facilitate the development of novel therapies.
Exploring The Role Of Nitrogen Metabolism, Energy Metabolism And Mitochondrial Function In The Pathophysiological Mechanisms Of Paediatric ME/CFS.
Funder
National Health and Medical Research Council
Funding Amount
$784,064.00
Summary
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a disease diagnosed by symptoms. Our extensive research has led to a hypothesis that ME/CFS results from toxic by-products of energy production in their cells. This problem can be caused by many unique ways, which could explain the diversity of the ME/CFS patient population. We propose to test this hypothesis with a novel personalised experimental design to simultaneously produce a plethora of new knowledge for the field of ME/CFS.
The Comparative Health System Efficiency For Treating Chronic Physical And Mental Disorders
Funder
National Health and Medical Research Council
Funding Amount
$58,500.00
Summary
Mental disorders account for 15% of the burden of disease in Australia, and are the largest cause of disability. Effective treatments are available for all mental disorders, however the majority of sufferers in Australia do not receive these treatments that work. Hence the burden of disease due to mental disorders in Australia persists. Why is this so? Is there something unique about mental disorders that means little can be done with direct treatment? The feasibility and affordability of mental ....Mental disorders account for 15% of the burden of disease in Australia, and are the largest cause of disability. Effective treatments are available for all mental disorders, however the majority of sufferers in Australia do not receive these treatments that work. Hence the burden of disease due to mental disorders in Australia persists. Why is this so? Is there something unique about mental disorders that means little can be done with direct treatment? The feasibility and affordability of mental health treatment can only be truly understood in comparison with other chronic disorders. Such comparisons are particularly significant as mental health remains a stigmatised area of the health sector. Without comparative data it would be easy for critics to argue for decreased funding for people with mental disorders. Project Outcomes: For three chronic physical disorders in Australia (osteoarthritis, rheumatoid arthritis, asthma) this project will define the cost-effectiveness of current care, the cost-effectiveness of optimal care (everyone getting treatments that work), and the amount of disease burden that can be averted with high-quality health care. These findings will be compared to similar calculations we have produced for mental disorders, to determine if it is mental disorders or chronic disorders per se that require much more effort by the health care system in Australia.Read moreRead less
An Integrated, Multi-system Approach To Understanding Persistent Pain
Funder
National Health and Medical Research Council
Funding Amount
$419,180.00
Summary
Musculoskeletal pain is a major health problem in Australia, with an economic burden second only to cancer. Despite the scale of the problem, there are few effective treatments. This project examines a range of biological mechanisms that could explain why some people get better over time while others experiencing pain do not. The findings of this research will contribute to the development of new treatments that can be targeted to each individual to improve pain and disability.
National Centre For Research Excellence In Neuromuscular Disorders: Transforming The Management Of Neuromuscular Disorders From Compassionate Assistance To Targeted Therapy And Prevention
Funder
National Health and Medical Research Council
Funding Amount
$2,805,509.00
Summary
Neuromuscular disorders affect 1 in 1,000 people, often result in progressive muscle weakness and can cause early death. At present not enough is being done to ensure translation of research into improved outcomes for patients. For the first time in Australia, the CRE-NMD will establish an integrated, comprehensive program to investigate diagnosis, prevention and treatment of neuromuscular disorders from infancy to adulthood.
Cognitive-behaviour Therapy For Tinnitus: Dismantling Study To Maximise Treatment Efficacy
Funder
National Health and Medical Research Council
Funding Amount
$230,220.00
Summary
Tinnitus (ringing in the ears) is a problem which affects a large number of people and for which there is no generally successful medical treatment. People are usually told that they will have to learn to live with the problem. Cognitive-behaviour therapy (CBT) has emerged as the principle means of helping people to cope with tinnitus. The proposed study aims to: (a) enhance the efficacy of CBT interventions for tinnitus, (b) identify the active components of CBT that mediate treatment gains, an ....Tinnitus (ringing in the ears) is a problem which affects a large number of people and for which there is no generally successful medical treatment. People are usually told that they will have to learn to live with the problem. Cognitive-behaviour therapy (CBT) has emerged as the principle means of helping people to cope with tinnitus. The proposed study aims to: (a) enhance the efficacy of CBT interventions for tinnitus, (b) identify the active components of CBT that mediate treatment gains, and (c) specify the mechanisms by which change occurs. The study is designed to dismantle the multi-component CBT tinnitus management protocol to investigate the relative efficacy of the individual components of treatment. The need to identify the types of psychological therapies which work best for potentially different kinds of tinnitus patients is important on both practical and theoretical grounds. Identifying and including only those components of treatment that are beneficial, and eliminating those that are not, is crucial to matching specific treatments to specific patients, which represents a major endeavour in contemporary psychotherapy research. Whether there are individual differences in response to the different components of the treatment or whether there is a single most potent component is of considerable theoretical interest. It is expected that subjects who receive the full treatment will display the largest immediate and long-term gains. Treatments which involve cognitive restructuring will produce better effects than those that do not. This project will contribute to enhanced functioning among tinnitus patients and increase the proportion of those who can benefit from empirically supported therapies.Read moreRead less
A Randomised Controlled Trial Of A Promising New Treatment For Chronic Whiplash
Funder
National Health and Medical Research Council
Funding Amount
$620,556.00
Summary
Following a whiplash injury about one third of people develop persisting pain and disability i.e. chronic whiplash. In a series of pilot trials we have developed a new physiotherapy treatment for chronic whiplash. Initial results are very promising. We now propose to definitively establish the effectiveness of this new treatment in a large clinical trial. At the same time we will evaluate the cost-effectiveness of the treatment.