ELUCIDATE: Exploring pain and autonomic dysfunction in ME/CFS and temporomandibular disorders

Principal investigator

Mr James Allison

Institution

School of Dental Sciences, Newcastle University

Start date

August 2021

Funding

This project is funded by ME Research UK with the financial support of the Fred and Joan Davies Bequest.

Background and aim

Widespread pain affecting the muscles and joints is a significant problem for people with ME/CFS, and has a huge impact on their everyday activities and quality of life. While central sensitisation in the brain and dysfunction of the autonomic nervous system (ANS) are thought to play a role, the precise mechanisms involved are not yet known.

Temporomandibular disorders (TMDs) are a group of musculoskeletal conditions affecting the muscles that move the jaw. They cause pain in the face and jaw, and are more common in ME/CFS than in the general population. Research from Prof. Julia Newton’s group at Newcastle University suggests that the link between ME/CFS and TMDs may be due to a common underlying problem affecting the ANS.

The ANS controls many of the unconscious activities of the body such as breathing, heart rate and the circulation of blood. It is known to work less well in ME/CFS, and is worse still when TMD is also present.

James Allison

Mr James Allison is an oral surgeon at Newcastle University, and the aim of his study is to explore the contribution of the ANS to the painful symptoms experienced by people with ME/CFS and/or TMDs.

He will use electroencephalography (which measures the electrical activity of the brain non-invasively) to assess the brain’s response to painful pressure applied to the finger and jaw in four groups of people:

  • Patients with ME/CFS only,
  • Patients with both ME/CFS and TMD,
  • Patients with TMD only, and
  • Healthy participants without ME/CFS or TMD.

The idea is that these responses will help to determine how pain differs in ME/CFS and in other people. In addition, low-resolution brain electromagnetic tomography will be used to identify where in the brain these differences are located.

Another part of the study involves using non-invasive stimulation of the vagus nerve to potentially ‘calm’ the ANS, and to measure the effect this has on both brain activity and levels of pain.

Mr Allison’s hope is that the findings of his study will help inform future treatments for pain in ME/CFS by identifying where in the brain these differences in pain response occur, and what part the ANS plays, and by understanding why some people might differ in their response to treatment.