Analysis of thermal pain sensitivity and psychological profiles in different subgroups of TMD patients |
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| Authors: | JW Park GT Clark YK Kim JW Chung |
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| Institution: | 1. TMD and Orofacial Pain Clinic, Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea;2. Orofacial Pain and Oral Medicine Center, School of Dentistry, University of Southern California, Los Angeles, USA;1. Department of Obstetrics and Gynecology, NorthShore University HealthSystem, Evanston, IL;2. Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL;3. Department of Obstetrics and Gynecology, University of Chicago Pritzker School of Medicine, Chicago, IL;4. Center for the Psychology of Learning and Experimental Psychopathology, Katholieke Universiteit Leuven, Leuven, Belgium;1. Orofacial Pain Team of Dentistry, Division of Hospital das Clínicas, Medical School of Universidade de São Paulo (USP), Brazil;2. Pain Center of Neurology, Department of Medical School of Universidade de São Paulo (USP), Brazil;3. Araraquara Dentistry School, Universidade Estadual Paulista (UNESP), Brazil;4. Psychobiology Department and Sleep Institute, Universidade Federal de São Paulo (UNIFESP), Brazil;1. School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia;2. School of Physiotherapy, The University of Notre Dame Australia, Fremantle, Australia;3. School of Biomedical Sciences and CHIRI Biosciences Research Precinct, Curtin University, Perth, Australia;1. Departments of Oral and Maxillofacial Surgery and Neural and Pain Sciences, and Brotman Facial Pain Center, University of Maryland School of Dentistry, Baltimore, Maryland;2. Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;3. Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;5. Department of Endodontics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;9. Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;4. Regional Center for Neurosensory Disorders, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;7. Department of Community Dentistry and Behavioral Science, University of Florida, College of Dentistry, and Pain Research and Intervention Center of Excellence, Gainesville, Florida;11. Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, New York;12. Battelle Memorial Institute, Durham, North Carolina;8. Carolina Center for Genome Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina;1. Headache & Orofacial Pain Effort (H.O.P.E.), Biological & Materials Sciences Department, University of Michigan School of Dentistry, USA;2. Department of Orthodontics & Pediatric Dentistry, School of Dentistry, University of Michigan, USA;3. Department of Biomedical Engineering, The City College of New York, City University of New York, New York, NY, USA;4. Soterix Medical, New York, NY, USA;5. Department of Biostatistics, School of Public Health, University of Michigan, USA;6. Molecular & Behavioral Neuroscience Institute (MBNI), University of Michigan, USA;1. Center for Pain Research and Innovation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;2. Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;3. Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;4. Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, NY, USA;5. Department of Community Dentistry & Behavioral Science, University of Florida, Gainesville, FL, USA;6. Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA;7. Brotman Facial Pain Center, University of Maryland School of Dentistry, Baltimore, MD, USA;8. Department of Endodontics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;9. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA |
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| Abstract: | This study evaluated differences in pain sensitivities and psychological profiles among different temporomandibular disorder (TMD) pain subtypes. Evaluation was done on 36 normal subjects and 39 TMD patients with high Graded Chronic Pain scale scores. TMD patients were placed in three pain subgroups (myogenous, arthrogenous, mixed) using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I guidelines. RDC/TMD axis II profiles including depression and somatization were analysed. Cold pain threshold (CPT), heat pain threshold (HPT), and heat pain tolerance threshold (HPTT) were measured on three facial regions (anterior temporalis, masseter, TMJ) and a leg region (anterior tibialis). The arthrogenous pain subgroup showed significantly higher CPT and lower HPT and HPTT in the facial region, and lower HPTT in the anterior tibialis region compared with normal and myogenous pain subgroups. The myogenous pain subgroup had significantly higher somatization scores than normal and arthrogenous pain subgroups, and higher depression scores than normal subjects. The results suggest that peripheral and/or central sensitization are present in chronic arthrogenous pain more so than in myogenous pain, and this phenomenon appears to take place regardless of the patient's psychological profiles. These results may explain the underlying mechanism that aggravates TMD pain. |
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