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Autonomic Dysfunction and the Trajectory of TMD with Multisystem Manifestations

Award Number: R03DE035161
ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/01/2026
PERIOD OF PERFORMANCE END DATE: 06/30/2028

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Autonomic Dysfunction and the Trajectory of TMD with Multisystem Manifestations - PROJECT SUMMARY Temporomandibular disorders (TMD) affect over 12 million U.S. adults and often co-occur with overlapping bodily pain, anxiety, depression, and sleep disturbances - a cluster termed multisystem TMD. This phenotype is associated with poor outcomes and high individual burden. Despite its prevalence, the mechanisms underlying multisystem TMD and strategies for early intervention remain unclear. Cardiovascular autonomic nervous system (ANS) regulation of heart rate and blood pressure plays a key role in the modulation of pain, emotion, and sleep. Our prior work using the high-quality multicenter Orofacial Pain Prospective Evaluation and Risk Assessment (OPPERA) study data found that ANS dysfunction, combined with multisystem symptoms, predicts a more than 10-fold risk of first-onset TMD. This suggests ANS dysfunction is a key pathophysiological factor in TMD development. This R03 project aims to: (1) Improve the identification of cardiovascular ANS dysfunction phenotypes that contribute to multisystem TMD risk, and (2) develop and validate a practical chairside symptom screening tool to identify high-risk individuals. Using the longitudinal-prospective and cross-sectional OPPERA datasets, Aim 1 will characterize patterns of cardiovascular ANS dysfunction at rest and during orthostatic stress, and link these patterns to multisystem symptom trajectories. Aim 2 will develop a brief symptom screening tool incorporating multisystem symptoms, and test its predictive validity for TMD onset and persistence. This study leverages unique, rich datasets and multidisciplinary expertise. It is expected to provide novel insights into ANS dysfunction in multisystem TMD and deliver a clinically useful screening tool for early identification. The findings will lay the foundation for future studies targeting pathophysiology-based early intervention and prevention of multisystem TMD.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $315,000 )
2026	2026	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Oral Diseases and Disorders Research	000	1	6/23/2026	NEW	$315,000
														Subtotal = $315,000

Grand Total All Awards = $315,000

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Autonomic Dysfunction and the Trajectory of TMD with Multisystem Manifestations

Award Number: R03DE035161

ORGANIZATION: NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/01/2026

PERIOD OF PERFORMANCE END DATE: 06/30/2028

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