Physiology And Pathophysiology Of Disorders Of The Musculoskelatal System
Funder
National Health and Medical Research Council
Funding Amount
$926,980.00
Summary
This application for a Senior Principal Research Fellowship is to enable me to address the enormous burden of musculoskeletal conditions - an important, but understudied and underfunded area of health/medical research. My focus is the most costly and prevalent musculoskeletal conditions of low back pain and osteoarthritis, and other neuromuscular conditions such as incontinence. My aim is to improve outcomes by discovering how to apply the right treatment to the right person at the right time.
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.
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
I will use non-invasive brain stimulation to study the operation of the corticospinal pathway in humans while they perform tasks requiring precise control of fingers and thumb. This pathway from brain to spinal cord is important for independent finger movements, and these experiments will provide insight into the cortical mechanisms by which independent finger movements are produced. I will also investigate relationships between patterns of corticospinal activation (which I have shown differ bet ....I will use non-invasive brain stimulation to study the operation of the corticospinal pathway in humans while they perform tasks requiring precise control of fingers and thumb. This pathway from brain to spinal cord is important for independent finger movements, and these experiments will provide insight into the cortical mechanisms by which independent finger movements are produced. I will also investigate relationships between patterns of corticospinal activation (which I have shown differ between subjects and hands) and digital dexterity. While it seems reasonable to assume that digital dexterity is dependent on the operation of the corticospinal system, the relationship is obscure, even at a gross level. Digital dexterity can vary considerably between subjects, and even between hands in the same subject. Are people more skilled with their hands because they are better able to engage the corticospinal system in control of the digits? The present study will address this fundamental question. The brain stimulation techniques that I will use are the only techniques presently available which can answer these questions in humans. This information will assist us to understand how normal subjects perform skilled tasks with their hands, as well as helping us to understand how damage to the nervous system (e.g., stroke, multiple sclerosis, Parkinson's disease) produces deficits in movement control. The information gained may suggest training regimes for skill acquisition in normal subjects, and to promote recovery of function in patients with neurological damage or disease.Read moreRead less