{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T12:22:30Z","timestamp":1787746950674,"version":"build-2784847793"},"reference-count":80,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Botulinum neurotoxin type A (BoNT-A) is used across coexisting craniocervical conditions, and therapeutic response is often overinterpreted as evidence of a shared generator. The bruxism literature shows why. Across six controlled studies with event-level outcome measurement, reported effects on event frequency track not dose or injection field but whether the rule used to detect an event could follow the amplitude the toxin had just reduced; none yet combines a placebo arm with an amplitude-independent event definition. This targeted critical narrative review interprets representative evidence mechanistically rather than assessing efficacy. It examines chronic migraine, tension-type headache, myogenous temporomandibular disorders, and bruxism, with somatosensory tinnitus as a cross-modal boundary case. Efficacy is protocol-specific in chronic migraine and uncertain elsewhere. Tracing studies locate somatosensory routes to the cochlear nucleus in the spinal trigeminal and dorsal column nuclei; a direct mesencephalic-trigeminal-to-cochlear projection has not been demonstrated in the tracing literature reviewed, so somatic\u2013auditory plausibility does not establish the masticatory proprioceptive route invoked by muscle-targeted rationales. Because BoNT-A affects motor output, peripheral nociceptive signaling, and muscle spindle input\u2014the last of these probably differing in availability across injection fields\u2014we frame it as a site-dependent, multi-output perturbation. That pharmacology is established; what is offered here is the inferential framing and the anatomical constraint following from it.<\/jats:p>","DOI":"10.3390\/toxins18090358","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:07:53Z","timestamp":1787566073000},"page":"358","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["One Molecule, Different Circuits? What Botulinum Toxin Can and Cannot Reveal About Craniocervical Comorbidity"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8139-9169","authenticated-orcid":false,"given":"Andrea Felice","family":"Armenti","sequence":"first","affiliation":[{"name":"LA VISION Training Institute, Via Magenta, 5, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7336-154X","authenticated-orcid":false,"given":"Giovanni","family":"Salti","sequence":"additional","affiliation":[{"name":"Medlight Institute, Via Monteverdi, 2, 50144 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1111\/joor.70110","article-title":"Exploring the Bidirectional Association Between Migraine and Temporomandibular Disorders: A Systematic Review and Meta-Analysis","volume":"53","author":"Dias","year":"2026","journal-title":"J. Oral Rehabil."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"129","DOI":"10.11607\/ofph.2745","article-title":"Association Between Primary Headache and Bruxism: An Updated Systematic Review","volume":"35","author":"Polmann","year":"2021","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1080\/08869634.2024.2404270","article-title":"Associations Between Temporomandibular Disorders and Tinnitus\u2014A Systematic Review","volume":"43","author":"Christidis","year":"2025","journal-title":"CRANIO"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1177\/10454411000110010401","article-title":"Acute and Chronic Craniofacial Pain: Brainstem Mechanisms of Nociceptive Transmission and Neuroplasticity, and Their Clinical Correlates","volume":"11","author":"Sessle","year":"2000","journal-title":"Crit. Rev. Oral Biol. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/j.1460-9568.2007.05608.x","article-title":"Convergence of Cutaneous, Musculoskeletal, Dural and Visceral Afferents onto Nociceptive Neurons in the First Cervical Dorsal Horn","volume":"26","author":"Hu","year":"2007","journal-title":"Eur. J. Neurosci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3213","DOI":"10.1097\/00001756-199810050-00015","article-title":"Convergence of Nociceptive and Non-Nociceptive Input onto the Medullary Dorsal Horn in Man","volume":"9","author":"Ellrich","year":"1998","journal-title":"NeuroReport"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.anorl.2024.09.008","article-title":"Trigeminal cervical complex: A neural network affecting the head and neck","volume":"142","author":"Hosri","year":"2025","journal-title":"Eur. Ann. Otorhinolaryngol. Head. Neck Dis."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Gardellin, J., D\u2019Angelo, M., Spadotto, L., Checchin, G., Gaetti, G., Gambol\u00f2, L., Stirparo, G., and Merli, N. (2026). Masseter Muscle in Somatosensory Tinnitus and Potential Therapeutic Role for Botulinum Toxin Type A: A Scoping Review. Toxins, 18.","DOI":"10.3390\/toxins18070310"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Farazpey, M., Bellitto, V., Ricci, G., and Nittari, G. (2026). The Effects of Botulinum Toxin on Sleep Bruxism: An Electromyographic Study with the Portable Bruxoff Holter System. J. Clin. Med., 15.","DOI":"10.3390\/jcm15093275"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1124\/pr.116.012658","article-title":"Botulinum Neurotoxins: Biology, Pharmacology, and Toxicology","volume":"69","author":"Pirazzini","year":"2017","journal-title":"Pharmacol. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Matak, I., B\u00f6lcskei, K., Bach-Rojecky, L., and Helyes, Z. (2019). Mechanisms of Botulinum Toxin Type A Action on Pain. Toxins, 11.","DOI":"10.3390\/toxins11080459"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1111\/head.13849","article-title":"Mechanism of Action of OnabotulinumtoxinA in Chronic Migraine: A Narrative Review","volume":"60","author":"Burstein","year":"2020","journal-title":"Headache"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3689","DOI":"10.1523\/JNEUROSCI.0375-08.2008","article-title":"Long-Distance Retrograde Effects of Botulinum Neurotoxin A","volume":"28","author":"Antonucci","year":"2008","journal-title":"J. Neurosci."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Restani, L., Giribaldi, F., Manich, M., Bercsenyi, K., Menendez, G., Rossetto, O., Caleo, M., and Schiavo, G. (2012). Botulinum Neurotoxins A and E Undergo Retrograde Axonal Transport in Primary Motor Neurons. PLoS Pathog., 8.","DOI":"10.1371\/journal.ppat.1003087"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.neuroscience.2011.04.026","article-title":"Behavioral and Immunohistochemical Evidence for Central Antinociceptive Activity of Botulinum Toxin A","volume":"186","author":"Matak","year":"2011","journal-title":"Neuroscience"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Nemani\u0107, D., \u0160o\u0161tari\u0107, P., Megli\u0107, P., Matak, I., and Bach-Rojecky, L. (2025). Botulinum Toxin Type A Exerts Direct Trans-Synaptic Action at Bilateral Spinal Nociceptive Circuits. Toxins, 17.","DOI":"10.3390\/toxins17030140"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Nemani\u0107, D., Grdunac, M., \u0160o\u0161tari\u0107 Mu\u017ei\u0107, P., Megli\u0107, P., Matak, I., and Bach-Rojecky, L. (2026). Regional Brain Localization of Botulinum Toxin Type A-Truncated SNAP-25 After Injection into the Rat Hind Paw. Toxins, 18.","DOI":"10.3390\/toxins18060261"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1042\/BJ20111117","article-title":"Extravesicular Intraneuronal Migration of Internalized Botulinum Neurotoxins Without Detectable Inhibition of Distal Neurotransmission","volume":"441","author":"Lawrence","year":"2012","journal-title":"Biochem. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.neuroscience.2017.03.049","article-title":"Botulinum Neurotoxin Type A-Cleaved SNAP25 Is Confined to Primary Motor Neurons and Localized on the Plasma Membrane Following Intramuscular Toxin Injection","volume":"352","author":"Cai","year":"2017","journal-title":"Neuroscience"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1113\/jphysiol.2012.239178","article-title":"Beyond Muscular Effects: Depression of Spinal Recurrent Inhibition After Botulinum Neurotoxin A","volume":"591","author":"Aymard","year":"2013","journal-title":"J. Physiol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Weise, D., Weise, C.M., and Naumann, M. (2019). Central Effects of Botulinum Neurotoxin\u2014Evidence from Human Studies. Toxins, 11.","DOI":"10.3390\/toxins11010021"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"400","DOI":"10.3109\/00016489309135834","article-title":"Botulinum A Toxin Effects on Rat Jaw Muscle Spindles","volume":"113","author":"Filippi","year":"1993","journal-title":"Acta Oto-Laryngol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1002\/(SICI)1097-4598(199604)19:4<488::AID-MUS9>3.0.CO;2-8","article-title":"Extrafusal and Intrafusal Muscle Effects in Experimental Botulinum Toxin-A Injection","volume":"19","author":"Rosales","year":"1996","journal-title":"Muscle Nerve"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1016\/0006-8993(86)91148-0","article-title":"The Distribution of Muscle Primary Afferents from the Masseter Nerve to the Trigeminal Sensory Nuclei","volume":"372","author":"Nishimori","year":"1986","journal-title":"Brain Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1002\/ar.20712","article-title":"Peripheral Muscle Targets and Central Projections of the Mesencephalic Trigeminal Nucleus in Macaque Monkeys","volume":"291","author":"Wang","year":"2008","journal-title":"Anat. Rec."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1002\/cne.902790302","article-title":"Distribution and Central Projections of Primary Afferent Neurons That Innervate the Masseter Muscle and Mandibular Periodontium: A Double-Label Study","volume":"279","author":"Capra","year":"1989","journal-title":"J. Comp. Neurol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.neubiorev.2013.11.002","article-title":"The Facial Motor System","volume":"38","author":"Cattaneo","year":"2014","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jpra.2017.01.005","article-title":"Connections Between the Facial and Trigeminal Nerves: Anatomical Basis for Facial Muscle Proprioception","volume":"12","author":"Cobo","year":"2017","journal-title":"JPRAS Open"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.neulet.2017.01.016","article-title":"Searching for Proprioceptors in Human Facial Muscles","volume":"640","author":"Cobo","year":"2017","journal-title":"Neurosci. Lett."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1002\/ar.25324","article-title":"Proprioceptive Innervation of the Human Lips","volume":"307","author":"Cuendias","year":"2024","journal-title":"Anat. Rec."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2562","DOI":"10.1002\/ar.25172","article-title":"Mammalian Facial Muscles Contain Muscle Spindles","volume":"306","author":"Omstead","year":"2023","journal-title":"Anat. Rec."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1177\/0333102410364676","article-title":"OnabotulinumtoxinA for Treatment of Chronic Migraine: Results from the Double-Blind, Randomized, Placebo-Controlled Phase of the PREEMPT 1 Trial","volume":"30","author":"Aurora","year":"2010","journal-title":"Cephalalgia"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1177\/0333102410364677","article-title":"OnabotulinumtoxinA for Treatment of Chronic Migraine: Results from the Double-Blind, Randomized, Placebo-Controlled Phase of the PREEMPT 2 Trial","volume":"30","author":"Diener","year":"2010","journal-title":"Cephalalgia"},{"key":"ref_34","first-page":"CD011616","article-title":"Botulinum toxins for the prevention of migraine in adults","volume":"2018","author":"Herd","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Chamani, G., Jasim, H., Minston, A., Dias, M.F., Poluha, R.L., Gon\u00e7alves, D.A.G., Christidis, M., Al-Moraissi, E.A., Christidis, N., and De la Torre Canales, G. (2026). Botulinum Toxin Type A for the Prevention of Migraines: An Umbrella Review of Systematic Reviews. Toxins, 18.","DOI":"10.3390\/toxins18010033"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/s10194-018-0921-8","article-title":"Guideline on the use of onabotulinumtoxinA in chronic migraine: A consensus statement from the European Headache Federation","volume":"19","author":"Bendtsen","year":"2018","journal-title":"J. Headache Pain"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1136\/jnnp-2013-307149","article-title":"Per cent of patients with chronic migraine who responded per onabotulinumtoxinA treatment cycle: PREEMPT","volume":"86","author":"Silberstein","year":"2015","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Wieckiewicz, M., Grychowska, N., Zietek, M., Wieckiewicz, G., and Smardz, J. (2017). Evidence to Use Botulinum Toxin Injections in Tension-Type Headache Management: A Systematic Review. Toxins, 9.","DOI":"10.3390\/toxins9110370"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"K\u0119pczy\u0144ska, K., and Domitrz, I. (2022). Botulinum Toxin\u2014A Current Place in the Treatment of Chronic Migraine and Other Primary Headaches. Toxins, 14.","DOI":"10.3390\/toxins14090619"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1046\/j.1468-2982.1996.1603175.x","article-title":"Initiating Mechanisms of Experimentally Induced Tension-Type Headache","volume":"16","author":"Jensen","year":"1996","journal-title":"Cephalalgia"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1007\/s11916-011-0216-0","article-title":"The Role of Muscles in Tension-Type Headache","volume":"15","author":"Bendtsen","year":"2011","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"6","DOI":"10.11607\/jop.1151","article-title":"Diagnostic Criteria for Temporomandibular Disorders (DC\/TMD) for Clinical and Research Applications: Recommendations of the International RDC\/TMD Consortium Network and Orofacial Pain Special Interest Group","volume":"28","author":"Schiffman","year":"2014","journal-title":"J. Oral Facial Pain Headache"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Saini, R.S., Ali Abdullah Almoyad, M., Binduhayyim, R.I.H., Quadri, S.A., Gurumurthy, V., Bavabeedu, S.S., Kuruniyan, M.S., Naseef, P.P., Mosaddad, S.A., and Heboyan, A. (2024). The effectiveness of botulinum toxin for temporomandibular disorders: A systematic review and meta-analysis. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0300157"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"4112","DOI":"10.1097\/MS9.0000000000002183","article-title":"Effects of botulinum toxin type A in patients with painful temporomandibular joint disorders: A systematic review and meta-analysis","volume":"86","author":"Zhu","year":"2024","journal-title":"Ann. Med. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1007\/s40265-024-02048-x","article-title":"Botulinum Toxin-A for the Treatment of Myogenous Temporomandibular Disorders: An Umbrella Review of Systematic Reviews","volume":"84","author":"Ernberg","year":"2024","journal-title":"Drugs"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1111\/joor.13915","article-title":"Effect on Pain Following One Session of Botulinum Toxin Type A in Patients with Jaw Myalgia: A Randomised Double-Blind Controlled Multicentre Pilot Study","volume":"52","author":"Minston","year":"2025","journal-title":"J. Oral Rehabil."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Chaudhry, B.A., Robinson, C.L., Caronna, E., Dodd-Glover, F., Virk, A.S., Prieto Peres, M.F., O\u2019Brien, H.L., Romero-Reyes, M., and Ashina, S. (2026). Central and Peripheral Sensitization in Temporomandibular Disorders: Proposed Mechanisms of Botulinum Toxin Therapy. Toxins, 18.","DOI":"10.3390\/toxins18010028"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1179\/crn.2008.017","article-title":"Efficacy of Botulinum Toxin in Treating Myofascial Pain in Bruxers: A Controlled Placebo Pilot Study","volume":"26","author":"Manfredini","year":"2008","journal-title":"CRANIO"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1111\/joor.12663","article-title":"International consensus on the assessment of bruxism: Report of a work in progress","volume":"45","author":"Lobbezoo","year":"2018","journal-title":"J. Oral Rehabil."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1111\/joor.13985","article-title":"Updating the Bruxism Definitions: Report of an International Consensus Meeting","volume":"52","author":"Verhoeff","year":"2025","journal-title":"J. Oral Rehabil."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/joor.13411","article-title":"Standardised Tool for the Assessment of Bruxism","volume":"51","author":"Manfredini","year":"2024","journal-title":"J. Oral Rehabil."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/PHM.0b013e3181bc0c78","article-title":"Effect of Botulinum Toxin Injection on Nocturnal Bruxism: A Randomized Controlled Trial","volume":"89","author":"Lee","year":"2010","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e000328","DOI":"10.1136\/bmjno-2022-000328","article-title":"Efficacy of Botulinum Toxin Type A in the Targeted Treatment of Sleep Bruxism: A Double-Blind, Randomised, Placebo-Controlled, Cross-Over Study","volume":"4","author":"Cruse","year":"2022","journal-title":"BMJ Neurol. Open"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e559","DOI":"10.1212\/WNL.0000000000004951","article-title":"Onabotulinum Toxin-A Injections for Sleep Bruxism: A Double-Blind, Placebo-Controlled Study","volume":"90","author":"Ondo","year":"2018","journal-title":"Neurology"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"291","DOI":"10.5664\/jcsm.3532","article-title":"Effects of Botulinum Toxin on Jaw Motor Events during Sleep in Sleep Bruxism Patients: A Polysomnographic Evaluation","volume":"10","author":"Shim","year":"2014","journal-title":"J. Clin. Sleep Med."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Shim, Y.J., Lee, H.J., Park, K.J., Kim, H.T., Hong, I.H., and Kim, S.T. (2020). Botulinum Toxin Therapy for Managing Sleep Bruxism: A Randomized and Placebo-Controlled Trial. Toxins, 12.","DOI":"10.3390\/toxins12030168"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Foscaldo, T.F., dos Santos Belo Junior, P.H., Ribeiro, G.R., de Proen\u00e7a, L.S., De la Torre Canales, G., and Senna, P.M. (2025). Comparing Botulinum Toxin and Biofeedback Therapies for Awake Bruxism: A Randomized Clinical Trial. BMC Oral Health, 25.","DOI":"10.1186\/s12903-025-07133-5"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Buzatu, R., Luca, M.M., Castiglione, L., and Sinescu, C. (2024). Efficacy and Safety of Botulinum Toxin in the Management of Temporomandibular Symptoms Associated with Sleep Bruxism: A Systematic Review. Dent. J., 12.","DOI":"10.3390\/dj12060156"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Coelho, M.S., de Oliveira, J.M.D., Polmann, H., Pauletto, P., Stefani, C.M., Maciel, L.C.D.L., and Canto, G.D.L. (2025). Botulinum Toxin for Bruxism: An Overview. Toxins, 17.","DOI":"10.3390\/toxins17050249"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"De Luca Canto, G., Pauletto, P., Stefani, C.M., Gon\u00e7alves, T.M.S.V., Junior, N.C., Flores-Mir, C., Pinto, A.C.P.N., and Trevisani, V.F.M. (2025). Spin bias in randomized controlled trials of botulinum toxin for bruxism management: A meta-epidemiologic study. BMC Med. Res. Methodol., 25.","DOI":"10.1186\/s12874-025-02547-9"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2331216518796403","DOI":"10.1177\/2331216518796403","article-title":"Diagnostic Criteria for Somatosensory Tinnitus: A Delphi Process and Face-to-Face Meeting to Establish Consensus","volume":"22","author":"Michiels","year":"2018","journal-title":"Trends Hear."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1055\/s-0028-1095895","article-title":"Head, Neck, and Eye Movements That Modulate Tinnitus","volume":"29","author":"Simmons","year":"2008","journal-title":"Semin. Hear."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"213","DOI":"10.5152\/iao.2020.8067","article-title":"Somatic Modulation in Tinnitus: Clinical Characteristics and Treatment Outcomes","volume":"16","author":"Lee","year":"2020","journal-title":"J. Int. Adv. Otol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.otohns.2005.02.015","article-title":"Evaluation of Botulinum Toxin A in Treatment of Tinnitus","volume":"132","author":"Stidham","year":"2005","journal-title":"Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"133","DOI":"10.5935\/0946-5448.20210024","article-title":"Botulinum Toxin Can Abolish and\/or Quiet Tinnitus Associated with Chronic Migraine: Serendipitous Observations","volume":"25","author":"Ranoux","year":"2021","journal-title":"Int. Tinnitus J."},{"key":"ref_66","unstructured":"ClinicalTrials.gov (2022). The Efficacy of Incobotulinum Toxin A Injections for Treatment of Tinnitus: A Randomized Controlled Trial, Clinical Study ID: NCT05650645."},{"key":"ref_67","unstructured":"EU Clinical Trials Information System (2024). TINNITOX: Botulinum Toxin A in Tinnitus Patients with Concurrent Bruxism and\/or Jaw Muscle Myalgia: A Triple-Blind, Randomized, Placebo-Controlled Crossover Trial, Clinical Trial Registration. EUCT 2024-518256-23-00."},{"key":"ref_68","unstructured":"Brazilian Registry of Clinical Trials (2020). Botox Study and Facial Anesthetic Infiltration on the Tinnitus Intensity in Patients with Temporomandibular Disorders, RBR-73jdz5."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"3334","DOI":"10.1111\/j.1460-9568.2005.04142.x","article-title":"Multisensory Integration in the Dorsal Cochlear Nucleus: Unit Responses to Acoustic and Trigeminal Ganglion Stimulation","volume":"21","author":"Shore","year":"2005","journal-title":"Eur. J. Neurosci."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1002\/jnr.20343","article-title":"Projections from the Trigeminal Nuclear Complex to the Cochlear Nuclei: A Retrograde and Anterograde Tracing Study in the Guinea Pig","volume":"78","author":"Zhou","year":"2004","journal-title":"J. Neurosci. Res."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1002\/cne.20466","article-title":"Projections from the Spinal Trigeminal Nucleus to the Cochlear Nucleus in the Rat","volume":"484","author":"Haenggeli","year":"2005","journal-title":"J. Comp. Neurol."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Balmer, T.S., and Trussell, L.O. (2021). Trigeminal Contributions to the Dorsal Cochlear Nucleus in Mouse. Front. Neurosci., 15.","DOI":"10.3389\/fnins.2021.715954"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.heares.2006.01.006","article-title":"Somatosensory Influence on the Cochlear Nucleus and Beyond","volume":"216\u2013217","author":"Shore","year":"2006","journal-title":"Hear. Res."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/S0301-0082(01)00021-1","article-title":"Comparative Analysis of the Chemical Neuroanatomy of the Mammalian Trigeminal Ganglion and Mesencephalic Trigeminal Nucleus","volume":"66","author":"Lazarov","year":"2002","journal-title":"Prog. Neurobiol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1159\/000351685","article-title":"Prevalence and Factors Associated with Neck and Jaw Muscle Modulation of Tinnitus","volume":"18","author":"Won","year":"2013","journal-title":"Audiol. Neurotol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"325","DOI":"10.11607\/jop.1096","article-title":"Treatment of Comorbid Migraine and Temporomandibular Disorders: A Factorial, Double-Blind, Randomized, Placebo-Controlled Study","volume":"27","author":"Camparis","year":"2013","journal-title":"J. Orofac. Pain"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1177\/0333102418758283","article-title":"Guidelines of the International Headache Society for Controlled Trials of Preventive Treatment of Chronic Migraine in Adults","volume":"38","author":"Tassorelli","year":"2018","journal-title":"Cephalalgia"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Balanta-Melo, J., Toro-Ibacache, V., Kupczik, K., and Buvinic, S. (2019). Mandibular Bone Loss after Masticatory Muscles Intervention with Botulinum Toxin: An Approach from Basic Research to Clinical Findings. Toxins, 11.","DOI":"10.3390\/toxins11020084"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1111\/joor.13087","article-title":"Effect of multiple injections of botulinum toxin into painful masticatory muscles on bone density in the temporomandibular complex","volume":"47","author":"Raphael","year":"2020","journal-title":"J. Oral Rehabil."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1111\/joor.13590","article-title":"Adverse effect of botulinum toxin-A injections on mandibular bone: A systematic review and meta-analysis","volume":"51","author":"Moussa","year":"2024","journal-title":"J. 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