Project Summary / Abstract The long-term goal of our Interdisciplinary Clinical Advances and Research Excellence in Temporomandibular Disorders (ICARE 4 TMDs) Collaborative is to provide a robust framework to undertake a cohesive and comprehensive national interdisciplinary exploration into TMDs and comorbid conditions. TMDs are a constellation of heterogenous disorders involving the masticatory musculature, the TMJ, and associated structures, afflicting 5 to 10% of US population with annual healthcare costs of ~$4 billion. A substantial proportion of patients also present with systemic comorbidities such as headaches and fibromyalgia. Because of their unknown etiopathogenesis, the diagnosis and therapies for TMDs remain non-specific. Consequently, patients often tolerate debilitating pain and their inability to undertake essential functions such as eating and speech impacts quality of life and contributes to psychological distress. Identifying factors that cause or predispose individuals to TMDs will enable early recognition and guide the design of rational therapies, but achieving this goal requires research and clinical applications across traditional boundaries. The boundaries that limit progress in understanding or treating TMDs encompass the translational gap between discovery science and clinical applications, and between the several scientific disciplines - from musculoskeletal to pain science to regenerative medicine. To address these major gaps in knowledge and clinical care, ICARE 4 TMDs Collaborative will establish research priorities and funding and workforce development mechanisms that intentionally integrate these scientific and patient care domains. Given this primary goal, we have developed a sound conceptual model for a national Collaborative that will be further refined, detailed, and structured during the planning phase. The outcome of this planning grant is to establish a responsive administrative and operational structure; engage scholars and mentors to utilize their expertise for integrated research and workforce development; and define criteria and protocols for funding of interdisciplinary projects and career development programs. These objectives will be achieved by (1) planning the implementation of integrated bridging science from basic to clinical in pain and neurology, musculoskeletal disorders, regenerative medicine, and biomarkers; and (2) map and launch a robust and innovative workforce development program for training diverse multi-faceted scholars and clinicians with capabilities of integrating novel technologies and approaches towards accelerating discoveries and delivery of individualized interdisciplinary patient care. This application leverages multi-institutional intellectual talent and expertise of funded investigators / mentors from within and outside the field, established infrastructure and core facilities, and training programs. The application is highly responsive to the FOA due to its truly encompassing, interdisciplinary and integrated approach to dissecting TMDs for improved and targeted patient care, and because it provides a compelling forward-looking framework for a comprehensive and vibrant TMD Collaborative.

Project Narrative Temporomandibular Disorders (TMD) and associated chronic overlapping pain conditions (COPCs) represent a spectrum of painful disorders that afflict approximately 5 to 10% of the US population with approximate annual healthcare costs of ~$4 billion. No definitive etiopathology-based diagnostics are currently available, and treatments are non-specific and largely palliative. We propose an Interdisciplinary Clinical Advances and Research Excellence in TMDs (ICARE 4 TMDs) Collaborative that will plan the: (1) implementation of integrated bridging science from basic to clinical in pain and neurology, musculoskeletal disorders, regenerative medicine, and biomarkers; and (2) launch of a robust and innovative workforce development program with the goal of training and developing diverse and multi-faceted scholars and clinicians. We believe that this multi-institutional interdisciplinary Collaborative will nucleate highly beneficial collaborations to accelerate discoveries for individualized novel interdisciplinary patient care for TMDs and COPCs.