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Titolo:
Analysis of stimulus-evoked pain in patients with myofascial temporomandibular pain disorders
Autore:
Svensson, P; List, T; Hector, G;
Indirizzi:
Univ Aalborg, Orofacial Pain Lab, Ctr Sensory Motor Interact, DK-9220 Aalborg S, Denmark Univ Aalborg Aalborg Denmark S otor Interact, DK-9220 Aalborg S, Denmark Univ Aarhus, Royal Dent Coll, Dept Prosthet Dent & Stomatognath Physiol, Aarhus, Denmark Univ Aarhus Aarhus Denmark Dent & Stomatognath Physiol, Aarhus, Denmark Aalborg Hosp, Dept Maxillofacial Surg, Aalborg, Denmark Aalborg Hosp Aalborg Denmark Dept Maxillofacial Surg, Aalborg, Denmark Specialist Ctr Oral Rehabil, TMD Unit, Linkoping, Sweden Specialist Ctr Oral Rehabil Linkoping Sweden MD Unit, Linkoping, Sweden
Titolo Testata:
PAIN
fascicolo: 3, volume: 92, anno: 2001,
pagine: 399 - 409
SICI:
0304-3959(200106)92:3<399:AOSPIP>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
TENSION-TYPE HEADACHE; JAW MUSCLE PAIN; TEMPORAL SUMMATION; FACIAL-PAIN; FIBROMYALGIA; THRESHOLDS; SENSITIVITY; CLASSIFICATION; STIMULATION; RELIABILITY;
Keywords:
human experimental muscle pain; pressure pain thresholds; thermal heat pain thresholds; trigeminal pain mechanisms; temporomandibular disorders;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
57
Recensione:
Indirizzi per estratti:
Indirizzo: Svensson, P Univ Aalborg, Orofacial Pain Lab, Ctr Sensory Motor Interact, Fredrik Bajers Vej 7, DK-9220 Aalborg S, Denmark Univ Aalborg Fredrik Bajers Vej 7 Aalborg Denmark S , Denmark
Citazione:
P. Svensson et al., "Analysis of stimulus-evoked pain in patients with myofascial temporomandibular pain disorders", PAIN, 92(3), 2001, pp. 399-409

Abstract

The pathophysiological mechanisms of myofascial temporomandibular disorders (TMD) are still under investigation. The hypothesis that TMD pain is caused by a generalized sensitization of higher order neurons in the nociceptive pathways combined with a decreased efficacy of endogenous inhibitory systems has recently gained support in the literature. This study was designed to further investigate the somatosensory sensibility within and outside thecraniofacial region. Twenty-two patients fulfilled the research diagnosticcriteria for TMD for myofascial pain (Dworkin and LeResche, J CraniomandibDisord Facial Oral Pain 6 (1992) 301) and 21 age- and sex-matched subjectsserved as a control group. The somatosensory sensibility to a deep tonic input was tested by standardized infusions of hypertonic saline into the masseter and anterior tibialis muscle. Furthermore, pressure pain thresholds (PPTs) and heat pain thresholds (HPTs) were assessed with phasic stimuli at the same sites before and following the infusions. Myofascial TMD patients reported infusion of hypertonic saline to be more painful on 10 cm visual analogue scales (peak pain 8.8 +/- 0.4 cm) than control subjects (6.8 +/- 0.5 cm, t-test: P = 0.003) in the masseter but not in the anterior tibialis (7.4 +/- 0.5 vs. 6.6 +/- 0.5 cm, P = 0.181). The perceived area of experimental masseter pain measured on drawings was marginally larger in TMD patients (2.6 +/- 0.5 arbitrary units (a.u.)) than in control subjects (1.4 +/- 0.2 a.u., Mann-Whitney: P = 0.048) but no differences were observed for the anterior tibialis (P = 0.771). The PPTs were lower in the myofascial TMD patients compared to the control group, both in the masseter (analysis of variance (ANOVA): P = 0.002) and in the anterior tibialis (P = 0.005), whereas there were no significant differences in HPT (ANOVAs: P = 0.357, P = 0.101). There were no significant correlations between measures of somatosensory sensibility and measures of clinical pain intensity, pain duration, graded chronic pain scores or somatization or depression scores (Pearson: R < 0.304, P > 0.172). The present study in a well-defined group of myofascial TMD patients found that the responsiveness to both tonic and phasic deep stimuli, but not to phasic superficial inputs at the pain threshold level, in thecraniofacial region was higher compared with a control group. These findings suggest that myofascial TMD pain is associated with a facilitation of stimulus-evoked pain primarily, but not exclusively related to the painful region. (C) 2001 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.

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Documento generato il 02/12/20 alle ore 15:08:09