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Combining Neuroscience with Dental Medicine and employing different neuroimaging techniques, we study anatomical and functional aspects of sensory and pain perception in healthy subjects and in patients experiencing chronic orofacial pain.
Pain is a multidimensional experience incorporating pure sensory and psychological components closely interacting with each other. Our general understanding of this complex entity increased tremendously since neuroimaging has revolutionized the options to study the neural correlates of a pain experience in vivo. However, the specific knowledge regarding pain associated mechanisms of trigeminal mediated neural activity trails behind compared to other body sites (chronic low back pain).
Currently, we mainly use two kinds of magnetic resonance based neuroimaging methods to disentangle respective brain mechanisms, fMRI (functional magnetic resonance imaging) and MRS (magnetic resonance spectroscopy).
fMRI allows for a rather global assessment of brain responses to incoming stimuli by providing information regarding "which" brain areas are involved in coding the multi- dimensional facets of pain and other sensations. fMRS on the other hand offers insights into neurometabolic (GABA, NAA, Glutamat...) alterations associated with experimentally induced pain as well as chronic pain conditions, thus provides a more "in depth" sight of cortical pain mechanisms.
A further project investigates structure and function within the human brainstem, one of the most challenging brain areas to measure with MR technology.
Together with the Institute for Biomedical Engineering of the UZH/ETHZ (Prof. Klaas Prüssmann), we currently explore anatomical details in-vivo as well as pain related neurochemical alterations induced by experimental orofacial pain (Dr. des. Nuno DeMatos).
Matos NMP de, Hock A, Wyss M, Ettlin DA, Brügger M (2017). Neurochemical dynamics of acute orofacial pain in the human trigeminal brainstem nuclear complex. NeuroImage 162:162–172.
Brügger, M., Ettlin, D. A., Meier, M., Keller, T., Luechinger, R., Barlow, A., Palla, S., Jäncke, L., & Lutz, K. (2011). Taking Sides with Pain - Lateralization aspects Related to Cerebral Processing of Dental Pain. Frontiers in human neuroscience, 5, 12.
Brügger, M., Lutz, K., Brönnimann, B., Meier, M. L., Luechinger, R., Barlow, A., Jäncke, L., & Ettlin, D. A. (2012). Tracing toothache intensity in the brain. Journal of dental research, 91, 156–160.
Gutzeit, A., Meier, D., Meier, M. L., Weymarn, C. von, Ettlin, D. A., Graf, N., Froehlich, J. M., Binkert, C. A., & Brügger, M. (2011). Insula-specific responses induced by dental pain. A proton magnetic resonance spectroscopy study. European radiology, 21, 807–815.
Gutzeit, A., Meier, D., Froehlich, J. M., Hergan, K., Kos, S., V Weymarn, C., Lutz, K., Ettlin, D., Binkert, C. A., Mutschler, J., Sartoretti-Schefer, S., & Brügger, M. (2013). Differential NMR spectroscopy reactions of anterior/posterior and right/left insular subdivisions due to acute dental pain. European radiology, 23, 450–460.
Matos, N. M. P. de, Meier, L., Wyss, M., Meier, D., Gutzeit, A., Ettlin, D. A., & Brügger, M. (2016). Reproducibility of Neurochemical Profile Quantification in Pregenual Cingulate, Anterior Midcingulate, and Bilateral Posterior Insular Subdivisions Measured at 3 Tesla. Frontiers in Human Neuroscience, 10, 300.