Looking at Burning Mouth Syndrome Brain: The Prevalence of Idiopathic Intracranial Hypertension Radiologic Signs in BMS Patients

IF 4 3区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of oral rehabilitation Pub Date : 2025-07-21 DOI:10.1111/joor.70017

Michele Davide Mignogna, Noemi Coppola, Stefania Leuci, Mattia Sansone, Federica Canfora, Daniela Adamo, Roberto De Simone

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引用次数: 0

Abstract

Background

Idiopathic intracranial hypertension (IIH), a disorder characterised by an elevation of intracranial pressure, has implications in chronic pain syndromes, especially in the cranial territory, and has been a matter of discussion. This study explores an association between burning mouth syndrome (BMS) and cerebrospinal fluid dynamic disturbances, as in IIH, by analysing the prevalence of MRI signs of impaired intracranial pressure control in BMS patients.

Methods

This was a case–control with a cross-section design study carried out at the Oral Medicine Unit, Federico II University of Naples, between September 2022 and March 2023. The observer was blinded on MRI measurements. Patients were recruited sequentially in the BMS referral centre of the Oral Medicine Unit. Thirty-seven BMS patients and 37 healthy controls were consecutively enrolled during their first visit with an oral medicine specialist and a general dentist respectively. A non-contrast brain MRI including an MRI venography of the intracranial venous vessels and a fundus oculi in order to evaluate the presence of papilloedema (an ophthalmological sign of raised intracranial pressure) was performed on all participants. The radiologic diagnostic criteria of IIH to include the patient in the study were at least 3 out of 4 indirect signs on the neuroimaging (empty sella, enlargement of the optic nerve sheets, bulb flattening and dural sinus stenosis).

Results

Thirty-seven patients with BMS and 37 HCs were included in the study with a female predominance in the BMS group. The prevalence of enlargement of the optic nerve sheath diameter (6.0 vs. 5.3; p < 0.001), the prevalence of empty sella (54.1% vs. 13.5%; p < 0.001), and the prevalence of dural sinus stenosis/hypoplasia (97.3% vs. 27%; p < 0.001) were statistically significantly higher in the BMS group than in HCs.

Conclusions

The higher prevalence of IIH signs on neuroimaging (empty sella, enlargement of the optic nerve sheets and dural sinus stenosis) in BMS patients compared to HCs highlights that BMS should be considered a chronic neurological disorder. The investigation of CSF dynamics in BMS patients could reveal new perspectives on the diagnosis and pathogenesis of the disease.

Abstract Image

查看原文本刊更多论文

观察灼口综合征脑：特发性颅内高压放射学征象在BMS患者中的流行。

背景：特发性颅内高压（Idiopathic intracranial hypertension， IIH）是一种以颅内压升高为特征的疾病，它与慢性疼痛综合征，特别是颅区疼痛有关，一直是一个讨论的问题。本研究通过分析灼口综合征（BMS）患者颅内压控制受损的MRI体征的患病率，探讨了灼口综合征（BMS）与脑脊液动力学紊乱（如IIH）之间的关系。方法：这是一项横断面设计的病例对照研究，于2022年9月至2023年3月在那不勒斯费代里科二世大学口腔医学部进行。观察者在MRI测量上是盲的。患者依次在BMS转诊中心的口腔医学单位招募。37名BMS患者和37名健康对照者分别在口腔医学专家和普通牙医的首次就诊期间连续入组。对所有参与者进行非对比脑MRI，包括颅内静脉血管和眼底的MRI静脉造影，以评估乳头状水肿（颅内压升高的眼科征象）的存在。将患者纳入本研究的IIH放射学诊断标准为神经影像学上4个间接征象中的至少3个（鞍空、视神经片扩大、球扁平和硬脑膜窦狭窄）。结果：37例BMS患者和37例hcc患者纳入研究，BMS组以女性为主。视神经鞘直径增大的患病率(6.0 vs. 5.3；结论：与hc相比，BMS患者在神经影像学上出现IIH体征（鞍空、视神经片扩大和硬脑膜窦狭窄）的比例更高，这表明BMS应被视为一种慢性神经系统疾病。BMS患者脑脊液动力学的研究可以为该病的诊断和发病机制提供新的视角。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of oral rehabilitation 医学-牙科与口腔外科

CiteScore

5.60

自引率

10.30%

发文量

116

审稿时长

4-8 weeks

期刊介绍： Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.