Altered structural connectivity of pain-related brain network in burning mouth syndrome—investigation by graph analysis of probabilistic tractography

Akihiko Wada, Takashi Shizukuishi, Junko Kikuta, Haruyasu Yamada, Yusuke Watanabe, Yoshiki Imamura, Takahiro Shinozaki, Ko Dezawa, Hiroki Haradome, Osamu Abe

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


Purpose: Burning mouth syndrome (BMS) is a chronic intraoral pain syndrome featuring idiopathic oral pain and burning discomfort despite clinically normal oral mucosa. The etiology of chronic pain syndrome is unclear, but preliminary neuroimaging research has suggested the alteration of volume, metabolism, blood flow, and diffusion at multiple brain regions. According to the neuromatrix theory of Melzack, pain sense is generated in the brain by the network of multiple pain-related brain regions. Therefore, the alteration of pain-related network is also assumed as an etiology of chronic pain. In this study, we investigated the brain network of BMS brain by using probabilistic tractography and graph analysis. Methods: Fourteen BMS patients and 14 age-matched healthy controls underwent 1.5T MRI. Structural connectivity was calculated in 83 anatomically defined regions with probabilistic tractography of 60-axis diffusion tensor imaging and 3D T1-weighted imaging. Graph theory network analysis was used to evaluate the brain network at local and global connectivity. Results: In BMS brain, a significant difference of local brain connectivity was recognized at the bilateral rostral anterior cingulate cortex, right medial orbitofrontal cortex, and left pars orbitalis which belong to the medial pain system; however, no significant difference was recognized at the lateral system including the somatic sensory cortex. A strengthened connection of the anterior cingulate cortex and medial prefrontal cortex with the basal ganglia, thalamus, and brain stem was revealed. Conclusion: Structural brain network analysis revealed the alteration of the medial system of the pain-related brain network in chronic pain syndrome.

Original languageEnglish
Pages (from-to)525-532
Number of pages8
Issue number5
Publication statusPublished - 1 May 2017


  • Burning mouth syndrome
  • Chronic pain
  • Diffusion tensor imaging
  • Probabilistic tractography
  • Structural brain connectivity: graph theory network analysis


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