1
|
Nakamura M, Yoshimi A, Tokura T, Kimura H, Kishi S, Miyauchi T, Iwamoto K, Ito M, Sato-Boku A, Mouri A, Nabeshima T, Ozaki N, Noda Y. Duloxetine improves chronic orofacial pain and comorbid depressive symptoms in association with reduction of serotonin transporter protein through upregulation of ubiquitinated serotonin transporter protein. Pain 2024; 165:1177-1186. [PMID: 38227563 DOI: 10.1097/j.pain.0000000000003124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 10/26/2023] [Indexed: 01/18/2024]
Abstract
ABSTRACT Chronic orofacial pain (COP) is relieved by duloxetine (DLX) and frequently causes depressive symptoms. The aim of this study was to confirm effects of DLX on pain and depressive symptoms, and to associate with their effectiveness in platelet serotonin transporter (SERT) expression, which is a target molecule of DLX and plasma serotonin concentration in COP patients with depressive symptoms. We assessed for the severity of pain and depressive symptoms using the Visual Analog Scale (VAS) and 17-item Hamilton Depression Rating Scale (HDRS), respectively. Chronic orofacial pain patients were classified into 2 groups based on their HDRS before DLX-treatment: COP patients with (COP-D) and without (COP-ND) depressive symptoms. We found that the VAS and HDRS scores of both groups were significantly decreased after DLX treatment compared with those before DLX treatment. Upregulation of total SERT and downregulation of ubiquitinated SERT were observed before DLX treatment in both groups compared with healthy controls. After DLX treatment, there were no differences in total SERT of both groups and in ubiquitinated SERT of COP-D patients compared with healthy controls; whereas, ubiquitinated SERT of COP-ND patients remained downregulated. There were positive correlations between changes of serotonin concentrations and of VAS or HDRS scores in only COP-D patients. Our findings indicate that DLX improves not only pain but also comorbid depressive symptoms of COP-D patients. Duloxetine also reduces platelet SERT through upregulation of ubiquitinated SERT. As the result, decrease of plasma serotonin concentrations may be related to the efficacy of DLX in relieving pain and depression in COP patients.
Collapse
Grants
- 21H04815 Ministry of Education, Culture, Sports, Science and Technology
- 17K10325 Ministry of Education, Culture, Sports, Science and Technology
- 21K06719 Ministry of Education, Culture, Sports, Science and Technology
- 19K17108 Ministry of Education, Culture, Sports, Science and Technology
- JP21dk0307103, Japan Agency for Medical Research and Development
- JP21dk0307087 Japan Agency for Medical Research and Development
- P21wm0425007 Japan Agency for Medical Research and Development
- JP21dm0207075 Japan Agency for Medical Research and Development
- JP21ek0109498 Japan Agency for Medical Research and Development
- AS251Z03018 Adaptable and Seamless Technology Transfer Program through Target-Driven R and D
Collapse
Affiliation(s)
- Mariko Nakamura
- Division of Clinical Sciences and Neuropsychopharmacology, Faculty and Graduate School of Pharmacy, Meijo University, Nagoya, Japan
| | - Akira Yoshimi
- Division of Clinical Sciences and Neuropsychopharmacology, Faculty and Graduate School of Pharmacy, Meijo University, Nagoya, Japan
- Clinical OMICs and Translation Research Center, Meijo University, Nagoya, Japan
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tatsuya Tokura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroyuki Kimura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinichi Kishi
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoya Miyauchi
- Department of Psychiatry, KACHI Memorial Hospital, Toyohashi, Japan
| | - Kunihiro Iwamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Mikiko Ito
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Aiji Sato-Boku
- Department of Anesthesiology, School of Dentistry, Aichi Gakuin University, Nagoya Japan
| | - Akihiro Mouri
- Department of Regulatory Science for Evaluation & Development of Pharmaceuticals and Devices, Graduate School of Health Science, Fujita Health University, Aichi, Japan
- Japanese Drug Organization of Appropriate Use and Research, Nagoya, Japan
| | - Toshitaka Nabeshima
- Japanese Drug Organization of Appropriate Use and Research, Nagoya, Japan
- Laboratory of Health and Medical Science Innovation, Graduate School of Health Sciences, Fujita Health University, Aichi, Japan
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yukihiro Noda
- Division of Clinical Sciences and Neuropsychopharmacology, Faculty and Graduate School of Pharmacy, Meijo University, Nagoya, Japan
- Clinical OMICs and Translation Research Center, Meijo University, Nagoya, Japan
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Laboratory of Health and Medical Science Innovation, Graduate School of Health Sciences, Fujita Health University, Aichi, Japan
| |
Collapse
|
2
|
Kong MS, Kim MJ, Kim YY, Chang JY, Kho HS. Clinical characteristics and salivary biomarkers of burning mouth syndrome. Oral Dis 2024. [PMID: 38622964 DOI: 10.1111/odi.14959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/18/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES To investigate the clinical characteristics and salivary biomarkers in each type of burning mouth syndrome (BMS) patients. MATERIALS AND METHODS Ninety-eight postmenopausal female patients with BMS were included. Fifty and 21 patients were assigned to the primary and secondary groups, respectively. Twenty-seven patients with both primary and secondary characteristics were assigned to the intermediate group. Comprehensive clinical characteristics and salivary biomarkers were analyzed. RESULTS Significant differences in age, proportion of hyposalivator patients based on unstimulated whole saliva (UWS), symptom distribution, severties of burning sensation and effect of oral complaints in daily life (Eff-life), and positive symptom distress index (PSDI) were observed among the three groups. The primary group had significant higher UWS flow rate, fewer UWS hyposalivator proportions, and lesser severity of Eff-life than the secondary group. The intermediate group had significantly greater intensities of burning sensation and Eff-life and higher PSDI score than did the primary group. The primary group had significantly higher cortisol and dehydroepiandrosterone (DHEA) levels in stimulated whole saliva than did the secondary group. CONCLUSIONS This study's findings show that clinical characteristics differentiate each BMS type. Cortisol and DHEA levels are potential salivary biomarkers for discriminating between the primary and secondary types of BMS.
Collapse
Affiliation(s)
- Mi-Sun Kong
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Moon-Jong Kim
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
- Department of Oral Medicine, Gwanak Seoul National University Dental Hospital, Seoul, South Korea
| | - Yoon-Young Kim
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Ji-Youn Chang
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Hong-Seop Kho
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
- Institute on Aging, Seoul National University, Seoul, South Korea
| |
Collapse
|
3
|
Alajbeg IZ, Vrbanovic E, Alajbeg I, Orabovic I, Naka K, Mrla A, Boucher Y. Time-course of pain and salivary opiorphin release in response to oral capsaicin differ in burning mouth syndrome patients, temporomandibular disorders patients and control subjects. Clin Oral Investig 2024; 28:246. [PMID: 38589630 DOI: 10.1007/s00784-024-05653-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 04/03/2024] [Indexed: 04/10/2024]
Abstract
OBJECTIVES Opiorphin is an analgesic peptide released by salivary glands and capsaicin an agonist of TRPV1 receptors eliciting burning sensations. The primary objective of this study was to assess opiorphin release after stimulation of the tongue by capsaicin (STC). The secondary objectives were to compare opiorphin release after STC in 3 groups of subjects [healthy (CTRL), Burning Mouth Syndrome (BMS), painful Temporomandibular disorders (TMDp)] and pain evoked by STC in these 3 groups. MATERIALS AND METHODS Salivary opiorphin was assessed with high-performance liquid chromatography at 3 different time points (baseline, after 5 min and 20 min of STC). Pain was self-reported on a (0-10) numeric rating scale. RESULTS Three groups (N = 16) of adults were recruited at the Clinical Hospital Centre and School of Dental Medicine in Zagreb. Opiorphin levels were higher (1) in TMDp compared to CTRL in 1st (2.23 ± 1.72 pg/ul vs. 0.67 ± 0.44 pg/ul, p = 0.002) and 3rd sampling (2.44 ± 2.01 pg/ul vs. 0.74 ± 0.52 pg/ul, p = 0.020) and (2) within BMS group at 3rd sampling vs. baseline (p < 0.025). Pain scores were higher in BMS compared to TMDp (p < 0.025) and CTRL (p < 0.025). CONCLUSION This study evidenced (1) a differential basal amount of opiorphin in two pain conditions and control subjects (2) a differential kinetic of release of opiorphin after STC in CTRL, BMS and TMDp (3) a differential pain perception after STC in BMS and TMDp vs. CTRL, which can provide a readout for animal models. CLINICAL RELEVANCE The specific regulation of opiorphin release in patients with orofacial painful conditions provides valuable insights for clinicians and researchers in physiology and pathology and encourages further research in this area. TRIAL REGISTRATION ClinicalTrials.gov NCT04694274. Registered on 01/05/2021.
Collapse
Affiliation(s)
- Iva Z Alajbeg
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia.
- Department of Dental Medicine, Clinical Hospital Centre Zagreb, Zagreb, 10000, Croatia.
| | - Ema Vrbanovic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia
| | - Ivan Alajbeg
- Department of Oral Medicine, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia
- Department of Dental Medicine, Clinical Hospital Centre Zagreb, Zagreb, 10000, Croatia
| | - Ivan Orabovic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia
| | - Klara Naka
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia
| | - Antonija Mrla
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, University of Zagreb, Zagreb, 10000, Croatia
| | - Yves Boucher
- Laboratoire de Neurobiologie Orofaciale, UFR Odontologie, Université Paris Cité, Paris, 75006, France
| |
Collapse
|
4
|
Sangalli L, Prakapenka AV, Chaurasia A, Miller CS. A review of animal models for burning mouth syndrome: Mechanistic insights and knowledge gaps. Oral Dis 2024. [PMID: 38438317 DOI: 10.1111/odi.14914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/24/2024] [Accepted: 02/16/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVES The underlying mechanisms of burning mouth syndrome (BMS) remain unclear leading to challenges and unsatisfactory management. Current treatments focus primarily on symptom relief, with few consistently achieving a 50% reduction in pain. This review aims to explore animal models of BMS to gain a better understanding of the underlying mechanisms and to discuss potential and existing knowledge gaps. METHODS A comprehensive review of PubMed® , Google Scholar, and Scopus was performed to assess advances and significant gaps of existing rodent models that mimic BMS-related symptoms. RESULTS Rodent models of BMS involve reproduction of dry-tongue, chorda tympani transection, or overexpression of artemin protein. Existing preclinical models tend to highlight one specific etiopathogenesis and often overlook sex- and hormone-specific factors. CONCLUSION Combining aspects from various BMS models could prove beneficial in developing comprehensive experimental designs and outcomes encompassing the multifaceted nature of BMS.
Collapse
Affiliation(s)
- Linda Sangalli
- College of Dental Medicine-Illinois, Midwestern University, Downers Grove, Illinois, USA
| | | | - Akhilanand Chaurasia
- Department of Oral Medicine and Radiology, King George's Medical University, Lucknow, India
| | - Craig S Miller
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| |
Collapse
|
5
|
Heiliczer S, Yanko R, Sharav Y, Aframian DJ, Klutstein M, Wilensky A, Haviv Y. Oxidative stress-mediated proapoptosis signaling: A novel theory on the mechanism underlying the pathogenesis of burning mouth syndrome. J Am Dent Assoc 2024; 155:258-267. [PMID: 37966403 DOI: 10.1016/j.adaj.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 08/16/2023] [Accepted: 08/30/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Burning mouth syndrome (BMS) is a chronic oral pain disorder characterized by a generalized burning sensation in the oral mucosa without apparent medical or dental causes. Despite various hypotheses proposed to explain BMS pathogenesis, a clear understanding of the cellular-level events and associated histologic and molecular findings is lacking. Advancing our understanding of BMS pathogenesis could facilitate the development of more targeted therapeutic interventions. TYPES OF STUDIES REVIEWED The authors conducted an extensive literature search and review of cellular mechanisms, focusing on evidence-based data that support a comprehensive hypothesis for BMS pathogenesis. The authors explored novel and detailed mechanisms that may account for the characteristic features of BMS. RESULTS The authors proposed that BMS symptoms arise from the uncontrolled activation of proapoptotic transmembrane calcium permeable channels expressed in intraoral mucosal nerve fibers. Elevated levels of reactive oxygen species or dysfunctional antiapoptosis pathways may lead to uncontrolled oxidative stress-mediated apoptosis signaling, resulting in upregulation of transmembrane transient receptor potential vanilloid type 1 and P2X 3 calcium channels in nociceptive fibers. Activation of these channels can cause nerve terminal depolarization, leading to generation of action potentials that are centrally interpreted as pain. CONCLUSIONS AND PRACTICAL IMPLICATIONS The authors present a novel hypothesis for BMS pathogenesis, highlighting the role of proapoptotic transmembrane calcium permeable channels and oxidative stress-mediated apoptosis signaling in the development of BMS symptoms. Understanding these underlying mechanisms could provide new insights into the development of targeted therapeutic interventions for BMS. Additional research is warranted to validate this hypothesis and explore potential avenues for effective management of BMS.
Collapse
|
6
|
Palmer A, Hamann T, Liese J, Müller B, Kropp P, Jürgens TP, Rimmele F. Efficacy of cranial electrotherapy stimulation in patients with burning mouth syndrome: a randomized, controlled, double-blind pilot study. Front Neurol 2024; 15:1343093. [PMID: 38419716 PMCID: PMC10900232 DOI: 10.3389/fneur.2024.1343093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 01/16/2024] [Indexed: 03/02/2024] Open
Abstract
Background The Burning mouth syndrome (BMS) is a chronic pain syndrome characterized by a burning sensation in the oral mucous membranes. The etiology and pathophysiology of BMS is largely unexplained. To date, there is no evidence-based treatment strategy for BMS. Cranial electrical stimulation (CES) represents a non-invasive treatment option with a low side effect profile that is approved for the treatment of pain, depression, anxiety disorder and insomnia. It has shown efficacy in studies for chronic pain such as fibromyalgia and neuropathic pain after spinal cord injury. This study aimed to investigate the therapeutic effectiveness of CES in combination with local transcutaneous electrical nerve stimulation (TENS) as an adjunct therapy in patients with BMS compared to sham stimulation. Methods This randomized, double-blind, sham-controlled pilot study enrolled 22 patients, aged 18 years and over, with the diagnosis of BMS meeting the ICHD-3 criteria from August 2020 to June 2021. The study duration was 4 weeks (28 days) per participant. After randomization, the active group participants (n = 11) received a 100 μA CES treatment for 60 min a day whereas the devices in the Sham group did not emit electricity. Simple linear regression was used to determine whether the interventions promoted significant differences in pain intensity. Results The linear regression showed that the period of stimulation significantly predicted decrease in the intensity of pain in the active group [β = -0.036; t(26) = -7.219; p < 0.001] as in the sham group [β = -0.026; t(26) = -2.56; p < 0.017]. With the applied cutoff of 30% pain reduction within the stimulation period, both the active and sham groups had 36% responders (n = 4) (Fisher's exact test, p = 1.00). In both groups (active stimulation and sham group), a significant decrease in the intensity of pain, somatic symptoms and an improvement in sleep quality over the study period was observed. Subjects reported no adverse events during the study. Conclusion Although CES is an easily applicable and safe therapeutic option for chronic facial pain, active stimulation was not superior to sham stimulation. Among other reasons, this could be due to the short double-blinded treatment period, duration of the daily stimulation session or the small sample size.
Collapse
Affiliation(s)
- Annalena Palmer
- Department of Neurology, Headache Centre North-East, University Medical Centre Rostock, Rostock, Germany
| | - Till Hamann
- Department of Neurology, Headache Centre North-East, University Medical Centre Rostock, Rostock, Germany
| | - Jan Liese
- Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Centre Rostock, Rostock, Germany
| | - Britta Müller
- Institute of Medical Psychology and Medical Sociology, University Medical Centre Rostock, Rostock, Germany
| | - Peter Kropp
- Institute of Medical Psychology and Medical Sociology, University Medical Centre Rostock, Rostock, Germany
| | - Tim P. Jürgens
- Department of Neurology, Headache Centre North-East, University Medical Centre Rostock, Rostock, Germany
- KMG Hospital Güstrow, Güstrow, Germany
| | - Florian Rimmele
- Department of Neurology, Headache Centre North-East, University Medical Centre Rostock, Rostock, Germany
| |
Collapse
|
7
|
Okayasu I, Tachi M, Ayuse T, Wake H, Komiyama O, De Laat A. Age differences in pain sensitivity and effect of topical lidocaine on the tongue in healthy female subjects. J Oral Sci 2024; 66:26-29. [PMID: 37967923 DOI: 10.2334/josnusd.23-0167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
PURPOSE To assess the sensitivity and the effect of topical lidocaine on the tongue by quantitative sensory testing, comparing healthy middle-aged female subjects with healthy young female subjects. METHODS Sixteen healthy female subjects including eight in their fifties and eight in their twenties participated. They participated in two sessions at a 2-week interval in randomized order: lidocaine (experimental session) or placebo gel (placebo session) was applied on the tongue tip for 5min. The following parameters were taken on the tongue tip before and after application of the gel in each session: tactile detection threshold (TDT), filament-prick pain detection threshold (FPT), and numerical rating scale (NRS). RESULTS An increase of both TDT and FPT and a decrease of NRS were found after lidocaine application in both middle-aged and young female subjects. In the elder females, an increase of TDT, FPT, and NRS was also found after placebo gel application. However, the changes were not statistically significant, except for FPT in middle-aged subjects. CONCLUSION The reactions found after lidocaine application in middle-aged female subjects could be due to habituation as well as to the post-application effect of placebo gel. Placebo-induced changes appeared more pronounced in the elder females.
Collapse
Affiliation(s)
- Ichiro Okayasu
- Department of Clinical Physiology, Graduate School of Biomedical Sciences, Nagasaki University
| | - Mizuki Tachi
- Department of Clinical Physiology, Graduate School of Biomedical Sciences, Nagasaki University
| | - Takao Ayuse
- Department of Clinical Physiology, Graduate School of Biomedical Sciences, Nagasaki University
| | - Hiroyuki Wake
- Department of Clinical Education in General Dentistry, Graduate School of Biomedical Sciences, Nagasaki University
| | - Osamu Komiyama
- Department of Oral Function and Rehabilitation, Nihon University School of Dentistry at Matsudo
| | | |
Collapse
|
8
|
Pavlou IA, Spandidos DA, Zoumpourlis V, Adamaki M. Nutrient insufficiencies and deficiencies involved in the pathogenesis of bruxism (Review). Exp Ther Med 2023; 26:563. [PMID: 37954114 PMCID: PMC10632959 DOI: 10.3892/etm.2023.12262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/02/2023] [Indexed: 11/14/2023] Open
Abstract
Stress has been well-documented to have a significant role in the etiopathogenesis of bruxism. Activation of the hypothalamic-pituitary-adrenal axis (HPA) and subsequent release of corticosteroids lead to increased muscle activity. Neurological studies have demonstrated that chronic stress exposure induces neurodegeneration of important neuronal structures and destabilization of the mesocortical dopaminergic pathway. These disruptions impair the abilities to counteract the overactivity of the HPA axis and disinhibit involuntary muscle activity, while at the same time, there is activation of the amygdala. Recent evidence shows that overactivation of the amygdala under stressful stimuli causes rhythmic jaw muscle activity by over activating the mesencephalic and motor trigeminal nuclei. The present review aimed to discuss the negative effects of certain vitamin and mineral deficiencies, such as vitamin D, magnesium, and omega-3 fatty acids, on the central nervous system. It provides evidence on how such insufficiencies may increase stress sensitivity and neuromuscular excitability and thereby reduce the ability to effectively respond to the overactivation of the sympathetic nervous system, and also how stress can in turn lead to these insufficiencies. Finally, the positive effects of individualized supplementation are discussed in the context of diminishing anxiety and oxidative stress, neuroprotection and in the reversal of neurodegeneration, and also in alleviating/reducing neuromuscular symptoms.
Collapse
Affiliation(s)
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Vassilis Zoumpourlis
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation, 11635 Athens, Greece
| | - Maria Adamaki
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation, 11635 Athens, Greece
| |
Collapse
|
9
|
Zhao H, Ran S, Gan K, Du Y, Li W. Pain sensitivity and quality of life of patients with burning mouth syndrome: a preliminary study in a Chinese population. BMC Oral Health 2023; 23:951. [PMID: 38041054 PMCID: PMC10693025 DOI: 10.1186/s12903-023-03689-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND Burning mouth syndrome (BMS) is an oral-facial pain disorder involving the central and peripheral nervous systems, but the evidence for altered pain sensitivity remains inconclusive. The aim of this study was to investigate pain sensitivity and oral health-related quality of life (OHRQoL) in patients with BMS and to assess the relationship between them. METHODS Fifty Chinese patients with BMS (57.82 ± 11.2 years) and fifty age- and gender-matched healthy subjects (55.64 ± 10.1 years) participated in the study. The Pain Sensitivity Questionnaire (PSQ) was used to assess participants' pain sensitivity. The Oral Health Impact Profile (OHIP-14) was used to evaluate participants' OHRQoL. RESULTS The PSQ total score (p = 0.009), the PSQ minor score (p = 0.003) and the OHIP-14 score (p<0.05) of patients with BMS were significantly higher than those of the healthy subjects. Simple linear regression showed that the PSQ minor score was significantly associated with the OHIP-14 score in patients with BMS (β = 0.338, p = 0.016). CONCLUSION Patients with BMS have higher pain sensitivity than healthy subjects. Reducing pain sensitivity might help to improve the quality of life of patients with BMS.
Collapse
Affiliation(s)
- Hongsen Zhao
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China.
| | - Shujun Ran
- National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Kang Gan
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
| | - Yajing Du
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
| | - Wenlu Li
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Zhengzhou City, 450052, China
| |
Collapse
|
10
|
Goncalves S, Carey B, Farag AM, Kuten-Shorrer M, Natto ZS, Ariyawardana A, Mejia LM, Chmieliauskaite M, Miller CS, Ingram M, Nasri-Heir C, Sardella A, Carlson CR, Klasser GD, O'Neill F, Albuquerque R. WWOM VII: Effectiveness of topical interventions in the management of burning mouth syndrome: A systematic review. Oral Dis 2023; 29:3016-3033. [PMID: 35781729 DOI: 10.1111/odi.14297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/13/2022] [Accepted: 06/09/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the effectiveness of topical interventions in the management of burning mouth syndrome (BMS), based on the core outcome domains recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). METHODS A systematic literature review of RCTs on topical interventions for the management of BMS, published in PubMed, Web of Science, PsycInfo, Cochrane Database/Central, and Google Scholar through May 2021 was performed. RESULTS Eight RCTs (n = 358 study participants) were included in this study. Due to underreporting of IMMPACT domains, publication bias, high degree of heterogeneity between studies, meta-analysis was not undertaken. Based on changes in visual analogue pain scores (ΔVAS), the most reported outcome, the effectiveness of the topical interventions was demonstrated; however, it is low level of evidence. CONCLUSIONS High levels of variability (interventions, outcomes, outcome measurement tools, and intervention effects evaluated), heterogeneity, publication bias, and underreporting of IMMPACT domains were observed across the RCTs. This systematic review highlights the need for application of standardized outcome measures to future RCTs. At the present time, there is lack of moderate-strong evidence on short- and long-term outcomes to support or refute the use of any particular topical intervention in managing BMS. Future RCTs with standardized outcome measures are needed.
Collapse
Affiliation(s)
- Sandra Goncalves
- Department of Oral Medicine, Charles Clifford Dental Hospital, Sheffield, UK
| | - Barbara Carey
- Department of Oral Medicine, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Arwa M Farag
- Department of Oral Diagnostic Sciences, Faculty of Dentistry, King AbdulAziz University, Jeddah, Saudi Arabia
- Division of Oral Medicine, Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Michal Kuten-Shorrer
- Department of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Zuhair S Natto
- Department of Dental Public Health, Faculty of Dentistry, King AbdulAziz University, Jeddah, Saudi Arabia
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Anura Ariyawardana
- College of Medicine and Dentistry, James Cook University, Brisbane, Queensland, Australia
- Metro South Oral Health, Brisbane, Queensland, Australia
| | - Lina M Mejia
- Department of Oral Medicine and Diagnostic Sciences, College of Dental Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Milda Chmieliauskaite
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, Case Western Reserve University, School of Dental Medicine, Cleveland, Ohio, USA
| | - Craig S Miller
- Department of Oral Health Practice, University of Kentucky, College of Dentistry, Lexington, Kentucky, USA
| | - Mark Ingram
- University of Kentucky Libraries, Medical Center Library, Lexington, Kentucky, USA
| | - Cibele Nasri-Heir
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Center for Temporomandibular Disorders and Orofacial Pain, The State University of New Jersey, Newark, New Jersey, USA
| | - Andrea Sardella
- Unit of Dentistry and Stomatology, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milano, Italy
| | - Charles R Carlson
- Orofacial Pain Clinic, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA
| | - Gary D Klasser
- Department of Diagnostic Sciences, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Francis O'Neill
- Department of Oral Surgery, School of Dentistry, University of Liverpool, Liverpool, UK
| | - Rui Albuquerque
- Department of Oral Medicine, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
- Faculty of Dentistry, Oral & Craniofacial Sciences., King's College London, London, UK
| |
Collapse
|
11
|
Schwartz B, Moudgil S, Pollina F, Bhargava A. Small Fiber Neuropathy After SARS-CoV-2 Infection and Vaccination: A Case-Based Comparison. Cureus 2023; 15:e43600. [PMID: 37719518 PMCID: PMC10504057 DOI: 10.7759/cureus.43600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
COVID-19-associated neuropathies, whether post-infection or post-vaccination, have not been fully described. A variety of theories exist to explain these phenomena, many of them centering on immune dysregulation. We aim to contribute to the discussion on the similarities and differences behind the two conditions and to bolster the call for further research to be done in this area. We will discuss two different case presentations, one patient experiencing a post-COVID-19 infection neuropathy and the other experiencing a post-COVID-19 vaccination neuropathy.
Collapse
Affiliation(s)
- Beth Schwartz
- Internal Medicine, Ascension St. John Hospital, Detroit, USA
| | - Shyam Moudgil
- Neurology, Ascension St. John Hospital, Detroit, USA
| | - Frank Pollina
- Physical Medicine and Rehabilitation, Ascension St. John Hospital, Detroit, USA
| | - Ashish Bhargava
- Internal Medicine, Ascension St. John Hospital, Detroit, USA
| |
Collapse
|
12
|
Bayraktutar BN, Atocha V, Farhad K, Soto O, Hamrah P. Autoantibodies Against Trisulfated Heparin Disaccharide and Fibroblast Growth Factor Receptor-3 May Play a Role in the Pathogenesis of Neuropathic Corneal Pain. Cornea 2023; 42:821-828. [PMID: 36256257 PMCID: PMC10106522 DOI: 10.1097/ico.0000000000003142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/29/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to describe cases of patients with presumable dysimmune small-fiber neuropathy (SFN)-related neuropathic corneal pain (NCP), presenting with autoantibodies against trisulfated heparin disaccharide (TS-HDS) or fibroblast growth factor receptor-3 (FGFR-3). METHODS This study was a case series of 3 patients with NCP with positive anti-TS-HDS and/or anti-FGFR-3 autoantibodies and systemic SFN as confirmed by positive skin biopsy results. RESULTS All 3 patients were women with a mean age of 34.3± 6.1 years. They suffered from moderate to severe persistent chronic ocular discomfort (10/10, 10/10, and 9/10 on a visual analogue scale, respectively). Although 1 patient suffered from ocular pain and photophobia alone, the other 2 patients experienced additional non-ocular pain. One of the patients had pain on her face and head, and 1 patient reported neck and lower back pain. Two patients had high anti-TS-HDS IgM titers, whereas 1 patient had both high anti-TS-HDS IgM and anti-FGFR-3 IgG titers. Skin biopsy confirmed the presence of SFN in all patients by demonstrating decreased intraepidermal nerve fiber density. CONCLUSIONS The presence of anti-TS-HDS and anti-FGFR-3 autoantibodies in patients with NCP with positive skin biopsy findings for SFN highlights the potential role of dysimmune SFN in the pathogenesis of this disease.
Collapse
Affiliation(s)
- Betul N. Bayraktutar
- Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
- Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Vanessa Atocha
- Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Khosro Farhad
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Oscar Soto
- Department of Neurology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Pedram Hamrah
- Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
- Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| |
Collapse
|
13
|
Arantes DAC, Toledo ÍCD, de Arruda JAA, Mesquita RA, Castro LAD, Batista AC, Ribeiro-Rotta RF. Evaluation of peripheral nerve fibers and mast cells in burning mouth syndrome. Braz Oral Res 2023; 37:e055. [PMID: 37255075 DOI: 10.1590/1807-3107bor-2023.vol37.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 12/20/2022] [Indexed: 06/01/2023] Open
Abstract
Emerging evidence has revealed a cross-talk in the etiopathogenesis of burning mouth syndrome (BMS) related to peripheral nerve fibers (NF) and neuropeptides secreted by mast cells. Here, we investigated the S-100+ density and PGP 9.5+ integrity of peripheral NF and the tryptase+ mast cell density in the oral mucosa of BMS patients and healthy individuals. A total of 23 oral mucosa specimens (12 BMS and 11 controls) were evaluated. The clinical diagnosis of BMS was based on a careful examination, excluding other local and systemic causes. Samples were taken from an incisional biopsy of the tongue mucosa of individuals with symptomatic BMS, while the margins of the non-neoplastic tongue biopsy served as controls of healthy individuals. Immunohistochemistry was performed to determine the density/mm2 of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells. Similar densities of S-100+, PGP 9.5+ peripheral NF, and tryptase+ mast cells were found in cases of BMS, with a median value of 3.70, 0.70, and 29.24/mm2, respectively, and in the control group, with a median value of 2.60, 0.80, and 26.01/mm2, respectively (p > 0.05). Moreover, the relationship between S100+ and PGP 9.5+ peripheral NF was the same in both groups (p = 0.70). This study demonstrated that there were no alterations in the density and integrity of peripheral NF in the tongue of symptomatic BMS patients. However, the sensitization of peripheral NF in this disease may not depend on mast cell density.
Collapse
Affiliation(s)
- Diego Antonio Costa Arantes
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Oral Medicine, Goiânia, Goiás, Brazil
| | - Ítalo Cordeiro de Toledo
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Oral Medicine, Goiânia, Goiás, Brazil
| | - José Alcides Almeida de Arruda
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Departament of Oral Surgery, Pathology and Clinical Dentistry, Belo Horizonte, MG, Brazil
| | - Ricardo Alves Mesquita
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Departament of Oral Surgery, Pathology and Clinical Dentistry, Belo Horizonte, MG, Brazil
| | - Luciano Alberto de Castro
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Oral Medicine, Goiânia, Goiás, Brazil
| | - Aline Carvalho Batista
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Oral Medicine, Goiânia, Goiás, Brazil
| | - Rejane Faria Ribeiro-Rotta
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Oral Medicine, Goiânia, Goiás, Brazil
| |
Collapse
|
14
|
Sadighparvar S, Al-Hamed FS, Sharif-Naeini R, Meloto CB. Preclinical orofacial pain assays and measures and chronic primary orofacial pain research: where we are and where we need to go. FRONTIERS IN PAIN RESEARCH 2023; 4:1150749. [PMID: 37293433 PMCID: PMC10244561 DOI: 10.3389/fpain.2023.1150749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/11/2023] [Indexed: 06/10/2023] Open
Abstract
Chronic primary orofacial pain (OFP) conditions such as painful temporomandibular disorders (pTMDs; i.e., myofascial pain and arthralgia), idiopathic trigeminal neuralgia (TN), and burning mouth syndrome (BMS) are seemingly idiopathic, but evidence support complex and multifactorial etiology and pathophysiology. Important fragments of this complex array of factors have been identified over the years largely with the help of preclinical studies. However, findings have yet to translate into better pain care for chronic OFP patients. The need to develop preclinical assays that better simulate the etiology, pathophysiology, and clinical symptoms of OFP patients and to assess OFP measures consistent with their clinical symptoms is a challenge that needs to be overcome to support this translation process. In this review, we describe rodent assays and OFP pain measures that can be used in support of chronic primary OFP research, in specific pTMDs, TN, and BMS. We discuss their suitability and limitations considering the current knowledge of the etiology and pathophysiology of these conditions and suggest possible future directions. Our goal is to foster the development of innovative animal models with greater translatability and potential to lead to better care for patients living with chronic primary OFP.
Collapse
Affiliation(s)
- Shirin Sadighparvar
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
- The Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
| | | | - Reza Sharif-Naeini
- The Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
- Department of Physiology and Cell Information Systems, McGill University, Montreal, QC, Canada
| | - Carolina Beraldo Meloto
- The Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| |
Collapse
|
15
|
Shin HI, Bang JI, Kim GJ, Kim MR, Sun DI, Kim SY. Therapeutic effects of clonazepam in patients with burning mouth syndrome and various symptoms or psychological conditions. Sci Rep 2023; 13:7257. [PMID: 37142613 PMCID: PMC10160112 DOI: 10.1038/s41598-023-33983-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/21/2023] [Indexed: 05/06/2023] Open
Abstract
Burning mouth syndrome (BMS) is frequently accompanied by dysgeusia and xerostomia. Clonazepam has been widely prescribed and is effective, but it is unclear whether clonazepam also affects the symptoms that accompany BMS, or whether such symptoms affect treatment outcomes. Here, we investigated the therapeutic outcomes in BMS patients with various symptoms or comorbidities. We retrospectively reviewed 41 patients diagnosed with BMS between June 2010 and June 2021 at a single institution. Patients were instructed to take clonazepam for 6 weeks. Before the first dose, burning pain intensity was measured using a visual analog scale (VAS); the unstimulated salivary flow rate (USFR), psychologic characteristics, site(s) of pain, and any taste disturbance were evaluated. Burning pain intensity was measured again after 6 weeks. Thirty-one of the 41 patents (75.7%) exhibited a depressed mood, whereas more than 67.8% of the patients exhibited anxiety. Subjective xerostomia was reported by ten patients (24.3%). The mean salivary flow rate was 0.69 mL/min and hyposalivation (an unstimulated salivary flow rate ≤ 0.5 mL/min) was apparent in ten patients (24.3%). Dysgeusia was present in 20 patients (48.7%); a bitter taste (n = 15, 75%) was reported by the largest proportion of patients. Patients who reported a bitter taste responded best in terms of burning pain reduction after 6 weeks (n = 4, 26.6%). Overall, 32 patients (78%) reported decreased oral burning pain after clonazepam (mean VAS score changed from 6.56 to 5.34) use. Patients who reported taste disturbances exhibited a significantly greater decrease in burning pain, compared with other patients (mean VAS score changed from 6.41 to 4.58) (p = 0.02). Clonazepam significantly improved burning pain in BMS patients who had taste disturbances.
Collapse
Affiliation(s)
- Hyun-Il Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Korea
| | - Joo-In Bang
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Korea
| | - Geun-Jeon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Korea
| | - Mi Ra Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Inje University of Korea, Busan, Korea
| | - Dong-Il Sun
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Korea
| | - Sang-Yeon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, Korea.
| |
Collapse
|
16
|
Doyle ME, Premathilake HU, Yao Q, Mazucanti CH, Egan JM. Physiology of the tongue with emphasis on taste transduction. Physiol Rev 2023; 103:1193-1246. [PMID: 36422992 PMCID: PMC9942923 DOI: 10.1152/physrev.00012.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The tongue is a complex multifunctional organ that interacts and senses both interoceptively and exteroceptively. Although it is easily visible to almost all of us, it is relatively understudied and what is in the literature is often contradictory or is not comprehensively reported. The tongue is both a motor and a sensory organ: motor in that it is required for speech and mastication, and sensory in that it receives information to be relayed to the central nervous system pertaining to the safety and quality of the contents of the oral cavity. Additionally, the tongue and its taste apparatus form part of an innate immune surveillance system. For example, loss or alteration in taste perception can be an early indication of infection as became evident during the present global SARS-CoV-2 pandemic. Here, we particularly emphasize the latest updates in the mechanisms of taste perception, taste bud formation and adult taste bud renewal, and the presence and effects of hormones on taste perception, review the understudied lingual immune system with specific reference to SARS-CoV-2, discuss nascent work on tongue microbiome, as well as address the effect of systemic disease on tongue structure and function, especially in relation to taste.
Collapse
Affiliation(s)
- Máire E Doyle
- Diabetes Section/Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Hasitha U Premathilake
- Diabetes Section/Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Qin Yao
- Diabetes Section/Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Caio H Mazucanti
- Diabetes Section/Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Josephine M Egan
- Diabetes Section/Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| |
Collapse
|
17
|
Williams LD, Zis P. COVID-19-Related Burning Eye Syndrome and Burning Mouth Syndrome: A Systematic Review and Meta-analysis. Pain Ther 2023; 12:621-630. [PMID: 36917411 PMCID: PMC10012304 DOI: 10.1007/s40122-023-00492-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/20/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Previous research highlights burning eye syndrome (BES) and burning mouth syndrome (BMS) as chronic complications of COVID-19 infection. The aim of this systematic review and meta-analysis is to establish the prevalence of COVID-19-related BES and COVID-19-related BMS and describe their phenomenology. METHODOLOGY A literature search in the PubMed database was performed, and seven papers (five on BES and two on BMS) were eligible to be included in this systematic review and meta-analysis. RESULTS The pooled prevalence of COVID-19-related BES was 9.9% (95% CI 3.4-25.4%). The frequency of COVID-19-related BMS is only reported in isolated cases and ranges from 4% in mild-to-moderate cases to 15% in severe, hospitalized cases, with female patients being mostly affected. COVID-19 severity is a potential risk factor for both BES and BMS. Neither syndrome occurs in isolation. COVID-19-related BES usually appears within the first week post-infection, persisting up to 9 weeks later. COVID-19-related BMS occurs during and after initial infection, and may also persist as a chronic disease. CONCLUSIONS Both BES and BMS are neuropathic COVID-19 infection complications, still under-studied and under-investigated, despite the fact that both are prevalent. Both COVID-19-related BES and COVID-19-related BMS could potentially be initial long COVID syndrome manifestations, and further research should be carried out in this field.
Collapse
Affiliation(s)
| | - Panagiotis Zis
- Medical School, University of Sheffield, Sheffield, UK. .,Medical School, University of Cyprus, Nicosia, Cyprus. .,Second Department of Neurology, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| |
Collapse
|
18
|
Zubiate Illarramendi I, Martinez-Sahuquillo A, Monsalve Iglesias F, Sanchez Lopez JD. Innovative histological and histochemical characterization of tongue biopsies from patients with burning mouth syndrome. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:191-198. [PMID: 36201658 DOI: 10.1515/jcim-2022-0239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES The present pilot study aims to perform an innovative histological and histochemical characterization of samples from patients with burning mouth syndrome (BMS) to correlate these findings with the clinical scenario. METHODS To carry out this objective, the study samples were stained with the hematoxylin-eosin stain and later, an histochemical study was carried out to determine the composition of the extracellular matrix (ECM) using the stains of Alcian Blue, Picrosirius, Reticulin from Gomori and Verhoeff. RESULTS The results of this study revealed histological patterns compatible with cellular hypertrophy in different layers of the epithelium as well as a greater keratinization in BMS cases. On the other hand, a lower amount of proteoglycans and a greater amount of collagen fibers were observed compared to the control. In addition, older patients had fewer reticular fibers and younger patients had fewer elastic fibers compared to the control. CONCLUSIONS In conclusion, the present study shows the existence of a correlation between the histological patterns, age and symptoms of patients with BMS. Therefore, it is necessary to develop synergistic studies in order to assess and implement new classification systems that could improve the therapeutic approach of patients with BMS.
Collapse
Affiliation(s)
| | - Angel Martinez-Sahuquillo
- Oral and Maxilofacial Surgeon in Formation, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | | |
Collapse
|
19
|
Moreau C, El Habnouni C, Lecron JC, Morel F, Delwail A, Le Gall-Ianotto C, Le Garrec R, Misery L, Piver E, Vaillant L, Lefevre A, Emond P, Blasco H, Samimi M. Salivary metabolome indicates a shift in tyrosine metabolism in patients with burning mouth syndrome: a prospective case-control study. Pain 2023; 164:e144-e156. [PMID: 35916738 DOI: 10.1097/j.pain.0000000000002733] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT The pathophysiology of primary burning mouth syndrome (BMS) remains controversial. Targeted analyses or "omics" approach of saliva provide diagnostic or pathophysiological biomarkers. This pilot study's primary objective was to explore the pathophysiology of BMS through a comparative analysis of the salivary metabolome among 26 BMS female cases and 25 age- and sex-matched control subjects. Secondary objectives included comparative analyses of inflammatory cytokines, neuroinflammatory markers, and steroid hormones among cases and control subjects, and among BMS patients according to their clinical characteristics. Salivary metabolome, neuroinflammatory markers, cytokines, and steroids were, respectively, analysed by liquid chromatography coupled with mass spectrometry, ELISA and protease activity assay, and multiparametric Luminex method. Among the 166 detected metabolites, univariate analysis did not find any discriminant metabolite between groups. Supervised multivariate analysis divided patients into 2 groups with an accuracy of 60% but did not allow significant discrimination (permutation test, P = 0.35). Among the metabolites contributing to the model, 3 belonging to the tyrosine pathway ( l -dopa, l -tyrosine, and tyramine) were involved in the discrimination between cases and control subjects, and among BMS patients according to their levels of pain. Among the detectable molecules, levels of cytokines, steroid hormones, and neuroinflammatory markers did not differ between cases and control subjects and were not associated with characteristics of BMS patients. These results do not support the involvement of steroid hormones, inflammatory cytokines, or inflammatory neurogenic mediators in the pathophysiology of pain in BMS, whereas the observed shift in tyrosine metabolism may indicate an adaptative response to chronic pain or an impaired dopaminergic transmission.
Collapse
Affiliation(s)
- Charlotte Moreau
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | - Chakib El Habnouni
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | - Jean-Claude Lecron
- Laboratory Inflammation, Tissus Epithéliaux et Cytokines, Poitiers University and Immunology/inflammation Laboratory, Poitiers University Hospital, Poitiers, France
| | - Franck Morel
- Laboratory Inflammation, Tissus Epithéliaux et Cytokines, Poitiers University and Immunology/inflammation Laboratory, Poitiers University Hospital, Poitiers, France
| | - Adriana Delwail
- ImageUP, Plate-forme d'Imagerie and Laboratoire Signalisation et Transport Ioniques Membranaires ERL CNRS 7003/EA 7349, Poitiers University, Poitiers, France
| | | | - Raphaele Le Garrec
- Univ Brest, LIEN (Laboratoire Interactions Epithelium Neurones), Brest, France
| | - Laurent Misery
- Univ Brest, LIEN (Laboratoire Interactions Epithelium Neurones), Brest, France
| | - Eric Piver
- Department of Biochemistry and Molecular Biology, University Hospital of Tours, Tours Cedex, France
- Inserm UMR 1259-Morphogenèse et antigénicité du VIH et des virus des hépatites (MAVIVH)
| | - Loïc Vaillant
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | | | - Patrick Emond
- UMR 1253 iBrain, Université de Tours, Inserm, Tours, France
- Department of In Vitro Nuclear Medicine, University Hospital of Tours, Tours Cedex, France
| | - Hélène Blasco
- Department of Biochemistry and Molecular Biology, University Hospital of Tours, Tours Cedex, France
- UMR 1253 iBrain, Université de Tours, Inserm, Tours, France
| | - Mahtab Samimi
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
- BIP, 1282 INRA University of Tours, Tours, France
| |
Collapse
|
20
|
Domaneschi C, Carvalho VJG, Marotta BM, Sugaya NN, Nunes FD, Gallo CDB. Voltage-gated sodium channels gene expression in Burning Mouth Syndrome: a case-control study. Braz Oral Res 2023; 37:e005. [PMID: 36700589 DOI: 10.1590/1807-3107bor-2023.vol37.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 03/07/2022] [Indexed: 01/27/2023] Open
Abstract
Burning mouth syndrome (BMS) is a condition characterized by painful symptoms of the oral mucosa, despite the absence of any clinical signs. Its etiology is unknown, and there is still no effective treatment to date. Current evidence has shown neuropathic impairment in BMS patients. Neuropathic pain can be related to the dysfunction of voltage-gated sodium channels, considering that these receptors regulate the induction of action potentials in nociceptive neurons. This study evaluated the gene expression of voltage-gated sodium channels Na v 1.7, Na v 1.8 and Na v 1.9 in these patients. The gene expressions of these channels were assessed by real time RT-PCR analysis of fresh-frozen tongue biopsies in a case-control study composed of 12 patients with BMS, and 5 healthy control patients, proportionally matched by sex and age, and analyzed using the 2^(-Delta Delta CT) method. There was no statistically significant difference between the analyzed groups, despite the increase in Na v 1.7 (fold-change = 3.13, p = 0.52) and decrease in Na v 1.9 (fold-change = 0.45, p = 0.36) gene expression in the BMS group. The Na v 1.8 gene was not expressed in any of the samples analyzed. Although the gene expression in the voltage-gated sodium channels in BMS under study seems to be comparable with that of the normal oral mucosa, the functionality of these channels in BMS has not yet been identified, thus suggesting that further research is needed to better understand these voltage-gated sodium channels.
Collapse
Affiliation(s)
- Carina Domaneschi
- Universidade de São Paulo - USP, School of Dentistry , Department of Stomatology , Sao Paulo , SP , Brazil
| | | | - Bruno Munhoz Marotta
- Universidade de São Paulo - USP, School of Dentistry , Department of Stomatology , Sao Paulo , SP , Brazil
| | - Norberto Nobuo Sugaya
- Universidade de São Paulo - USP, School of Dentistry , Department of Stomatology , Sao Paulo , SP , Brazil
| | - Fábio Daumas Nunes
- Universidade de São Paulo - USP, School of Dentistry , Department of Oral Pathology , Sao Paulo , SP , Brazil
| | - Camila de Barros Gallo
- Universidade de São Paulo - USP, School of Dentistry , Department of Stomatology , Sao Paulo , SP , Brazil
| |
Collapse
|
21
|
Psychosocial Stress Induces Orofacial Mechanical Allodynia Due to the Enhancement of Transient Receptor Potential Ankyrin 1 Expression in Trigeminal Ganglion Neurons via the Increment of the Trace Amine-Associated Receptor 7f Expression. STRESSES 2022. [DOI: 10.3390/stresses3010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
(1) Background: Chronic psychosocial stress can lead to oral dysesthesia with tongue pain. We examined whether psychosocial stress causes orofacial pain, and analyzed the comprehensive gene expression patterns of circulating cells and transient receptor potential ankyrin 1 (TRPA1) expression in trigeminal ganglion (TG) neurons in a mouse model of psychosocial stress. (2) Methods: Mice were divided into two groups: one group was kept in confrontational housing, and the other group was kept in single housing. Blood, adrenal gland, and tongue were collected. The head withdrawal threshold (HWT) of mechanical stimulation to the whisker pad skin was measured. TRPA1-positive TG neurons were immunohistochemically examined. DNA microarray analysis and quantitative reverse transcription polymerase chain reaction analysis were performed. (3) Results: The HWT was significantly lower in mice under the psychosocial stress condition compared to non-stressed mice. In stress-loaded mice, the number of TRPA1-positive TG neurons was significantly increased. Moreover, we showed that trace amine-associated receptor 7f expression was upregulated in circulating cells in blood and downregulated in the tongue. (4) Conclusions: Our results indicated that chronic psychosocial stress induced the orofacial mechanical allodynia through enhancement of TRPA1 expression in TG neurons with changes in the levels of trace amine-associated receptor 7f.
Collapse
|
22
|
Nishizawa T, Ikenaka Y, Ichikawa G, Taguchi T. Thiamethoxam intoxication due to occupational inhalational exposure. BMJ Case Rep 2022; 15:e251110. [PMID: 36446474 PMCID: PMC9710362 DOI: 10.1136/bcr-2022-251110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Neonicotinoid is a new class of systemic insecticides that are selectively toxic to insects. However, cases of human toxicity have been reported. A man in his 60s, who worked as a pest control operator (which required the use of thiamethoxam), presented with fever and headache. We investigated the levels of thiamethoxam and clothianidin in the blood and urine. Our results suggested that chronic thiamethoxam intoxication was caused by occupational inhalation exposure and environmental pollution. After cessation of insecticide use, the patient remained asymptomatic but had persistent oral dysesthesia and postural finger tremor, even at undetectable levels of thiamethoxam and clothianidin. This case report is the first to describe human thiamethoxam intoxication after occupational inhalation exposure. When similar symptoms are encountered and a history of insecticide use is confirmed, clinicians should consider the diagnosis of neonicotinoid intoxication.
Collapse
Affiliation(s)
- Toshinori Nishizawa
- Department of General Internal Medicine, St. Luke's International Hospital, Tokyo, Japan
- Department of Global Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshinori Ikenaka
- Translational Research Unit, Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
- Laboratory of Toxicology, Department of Environmental Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Go Ichikawa
- Department of Pediatrics, Ustunomiya Cerebrospinal Center, Utsunomiya City, Japan
| | - Tomohiro Taguchi
- Department of Community Based Medicine, Fujita Health University, Toyoake, Japan
- Department of General Internal Medicine, Toyota Regional Medical Center, Toyota, Japan
| |
Collapse
|
23
|
Catalfamo LM, Marrone G, Basilicata M, Vivarini I, Paolino V, Della-Morte D, De Ponte FS, Di Daniele F, Quattrone D, De Rinaldis D, Bollero P, Di Daniele N, Noce A. The Utility of Capsicum annuum L. in Internal Medicine and In Dentistry: A Comprehensive Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11187. [PMID: 36141454 PMCID: PMC9517535 DOI: 10.3390/ijerph191811187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
Capsaicin is a chili peppers extract, genus Capsicum, commonly used as a food spice. Since ancient times, Capsaicin has been used as a "homeopathic remedy" for treating a wild range of pathological conditions but without any scientific knowledge about its action. Several studies have demonstrated its potentiality in cardiovascular, nephrological, nutritional, and other medical fields. Capsaicin exerts its actions thanks to the bond with transient receptor potential vanilloid subtype 1 (TRPV1). TRPV1 is a nociceptive receptor, and its activation starts with a neurosensitive impulse, responsible for a burning pain sensation. However, constant local application of Capsaicin desensitized neuronal cells and leads to relief from neuropathic pain. In this review, we analyze the potential adjuvant role of Capsaicin in the treatment of different pathological conditions either in internal medicine or dentistry. Moreover, we present our experience in five patients affected by oro-facial pain consequent to post-traumatic trigeminal neuropathy, not responsive to any remedy, and successfully treated with topical application of Capsaicin. The topical application of Capsaicin is safe, effective, and quite tolerated by patients. For these reasons, in addition to the already-proven beneficial actions in the internal field, it represents a promising method for the treatment of neuropathic oral diseases.
Collapse
Affiliation(s)
- Luciano Maria Catalfamo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98100 Messina, Italy
| | - Giulia Marrone
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Michele Basilicata
- UOSD Special Care Dentistry, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00100 Rome, Italy
| | - Ilaria Vivarini
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Vincenza Paolino
- UOSD Special Care Dentistry, Department of Systems Medicine, University of Rome Tor Vergata, 00100 Rome, Italy
| | - David Della-Morte
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Department of Human Sciences and Quality of Life Promotion, San Raffaele University, 00166 Rome, Italy
- Department of Neurology, Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Francesco Saverio De Ponte
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98100 Messina, Italy
| | - Francesca Di Daniele
- School of Applied Medical, Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy
- UOSD of Dermatology, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Domenico Quattrone
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98100 Messina, Italy
| | - Danilo De Rinaldis
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University Hospital of Messina, 98100 Messina, Italy
| | - Patrizio Bollero
- UOSD Special Care Dentistry, Department of Systems Medicine, University of Rome Tor Vergata, 00100 Rome, Italy
| | - Nicola Di Daniele
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Annalisa Noce
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| |
Collapse
|
24
|
Lauria G, Faber CG, Cornblath DR. Skin biopsy and small fibre neuropathies: facts and thoughts 30 years later. J Neurol Neurosurg Psychiatry 2022; 93:915-918. [PMID: 35246491 PMCID: PMC9380509 DOI: 10.1136/jnnp-2021-327742] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 01/09/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Giuseppe Lauria
- Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milan, Italy .,Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Catharina G Faber
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht, Netherlands
| | - David R Cornblath
- Department of Neurology, John Hopkins University School of Medicine, Baltimore, Maryland, USA
| |
Collapse
|
25
|
Meine Zunge brennt! – Glossodynie/orofaziales Schmerzsyndrom. DIE DERMATOLOGIE 2022; 73:701-707. [PMID: 35997968 PMCID: PMC9396595 DOI: 10.1007/s00105-022-05037-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/16/2022]
Abstract
Die Glossodynie, die besser als orofaziales Schmerzsyndrom oder Burning-Mouth-Syndrom bezeichnet wird, stellt eine therapeutische Crux dar, da eine eindeutige Ätiopathogenese bisher nicht bekannt ist. Neuere Studien weisen auf einen Zusammenhang mit neuropathischen Veränderungen hin, außerdem sind Hinweise auf Komorbiditäten mit Depression, Angst und Karzinophobie evident. Diese sind zum Teil auch Folge der Erkrankung und nicht unbedingt als ursächlich anzusehen. Da eine vielfältige Differenzialdiagnostik durch klinische Untersuchungen ausgeschlossen werden sollte, ist die Glossodynie eine diagnostische Herausforderung. In Betracht kommen neben Lichen planus, Leukoplakien, Pemphigus vulgaris und Aphthen auch internistische Erkrankungen wie Diabetes oder Anämien oder Vitaminmangel und hormonelle Einflüsse bei den überwiegend älteren und überwiegend weiblichen Patienten. Metaanalysen über durchgeführte Therapiestudien zeigen einen niedrigen Evidenzgrad der vorhandenen randomisierten kontrollierten Studien (RCTs). Nach der Literatur werden v. a. Psychotherapie und Antidepressiva zur Behandlung vorgeschlagen. Alpha-Liponsäure als Nahrungsergänzung zeigt eine kurzfristige Besserung, und auch Low-Level-Lasertherapie scheint gewisse Effekte hervorzubringen.
Collapse
|
26
|
Zhang H, Hu S, Wang Z, Li X, Wang S, Chen G. A Temporospatial Study of Sympathetic Skin Response and Electroencephalogram in Oral Mucosa Thermal Perception. Front Neurosci 2022; 16:907658. [PMID: 35911991 PMCID: PMC9337692 DOI: 10.3389/fnins.2022.907658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To investigate the temporospatial changes in sympathetic skin response (SSR) and electroencephalogram (EEG) under thermal stimuli and to draw a topographic map of SSR threshold temperature of the oral mucosa. Materials and Methods A total of 40 healthy volunteers (24 men, 16 women, mean age of 23 ± 3) were enrolled. Thermal stimuli were applied to the 35 partitions of oral mucosa starting from 36°C at the gradience of 1°C and the lowest temperature evoked SSR was defined as SSR threshold temperature. SSR and EEG signals at 45, 48, 51, and 54°C were then recorded synchronously. Results The SSR threshold temperature increased from the anterior areas to the posterior areas. No significant difference between bilateral corresponding areas or between genders was observed. The SSR amplitude value increased from 45 to 54°C in the same area, while the highest value was recorded on the tip of the tongue and decreased backwardly from the anterior area. There were significant differences in latency of SSR between the tip of the tongue and the molar areas of the oral cavity (p < 0.05). Reduction in the alpha frequency band was observed after thermal stimuli, and there were statistical differences between baseline and thermal stimuli in all four degrees of temperatures (p < 0.05). Conclusion The result of the experiment revealed that the autonomic and central nervous system (CNS) played important roles in thermal perception of oral mucosa and could be helpful for better understanding of pathological mechanism of burning mouth syndrome (BMS).
Collapse
Affiliation(s)
- Hao Zhang
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Tianjin Medical University, Tianjin, China
| | - Shengjing Hu
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin, China
| | - Zhangang Wang
- Changzhou Hospital of Traditional Chinese Medicine, Changzhou, China
| | - Xiang Li
- Department of Oral Surgery, School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - Suogang Wang
- School of Biomedical Engineering and Technology, Tianjin Medical University, Tianjin, China
- Suogang Wang,
| | - Gang Chen
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Tianjin Medical University, Tianjin, China
- *Correspondence: Gang Chen,
| |
Collapse
|
27
|
Shinoda M, Hitomi S, Iwata K, Hayashi Y. Plastic changes in nociceptive pathways contributing to persistent orofacial pain. J Oral Biosci 2022; 64:263-270. [PMID: 35840073 DOI: 10.1016/j.job.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Pain is a warning signal for the body defense mechanisms and is a critical sensation for supporting life. However, orofacial pain is not a vital sensation, but a disease. However, there are still many unclear points about the pathophysiological mechanism of orofacial pain. This situation makes it difficult for many clinicians to treat orofacial pain hypersensitivity. HIGHLIGHT Noxious information on the orofacial region received by trigeminal ganglion neurons is recognized as "orofacial pain" by being transmitted to the somatosensory cortex and limbic system via the spinal trigeminal nucleus and the thalamic sensory nuclei. Orofacial inflammation or trigeminal nerve injury causes neuropathic changes in various nociceptive signaling pathways, resulting in persistent orofacial pain. It is considered that persistent oral facial pain is triggered by plastic changes in nociceptive signaling pathways involving various cells such as satellite glial cells, astrocytes, microglia, and macrophages, as well as nociceptive neurons. CONCLUSION Recent studies have shown that hyperexcitability of nociceptive neurons in the nociceptive signaling pathways of the orofacial region caused by a variety of factors causes persistent orofacial pain. This review outlines the pathophysiology of orofacial pain along with the results of our study.
Collapse
Affiliation(s)
- Masamichi Shinoda
- Department of Physiology, Nihon University School of Dentistry, 1-8-13 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8310, Japan.
| | - Suzuro Hitomi
- Department of Physiology, Nihon University School of Dentistry, 1-8-13 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Koichi Iwata
- Department of Physiology, Nihon University School of Dentistry, 1-8-13 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
| | - Yoshinori Hayashi
- Department of Physiology, Nihon University School of Dentistry, 1-8-13 Kandasurugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
| |
Collapse
|
28
|
Guo Y, Wang B, Gao H, He C, Hua R, Gao L, Du Y, Xu J. Insight into the Role of Psychological Factors in Oral Mucosa Diseases. Int J Mol Sci 2022; 23:ijms23094760. [PMID: 35563151 PMCID: PMC9099906 DOI: 10.3390/ijms23094760] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 02/04/2023] Open
Abstract
With the development of psychology and medicine, more and more diseases have found their psychological origins and associations, especially ulceration and other mucosal injuries, within the digestive system. However, the association of psychological factors with lesions of the oral mucosa, including oral squamous cell carcinoma (OSCC), burning mouth syndrome (BMS), and recurrent aphthous stomatitis (RAS), have not been fully characterized. In this review, after introducing the association between psychological and nervous factors and diseases, we provide detailed descriptions of the psychology and nerve fibers involved in the pathology of OSCC, BMS, and RAS, pointing out the underlying mechanisms and suggesting the clinical indications.
Collapse
Affiliation(s)
- Yuexin Guo
- Department of Oral Medicine, Basic Medical College, Capital Medical University, Beijing 100069, China; (Y.G.); (Y.D.)
| | - Boya Wang
- Department of Clinical Medicine, Peking University Health Science Center, Beijing 100081, China;
| | - Han Gao
- Department of Physiology and Pathophysiology, Basic Medical College, Capital Medical University, Beijing 100069, China; (H.G.); (C.H.)
| | - Chengwei He
- Department of Physiology and Pathophysiology, Basic Medical College, Capital Medical University, Beijing 100069, China; (H.G.); (C.H.)
| | - Rongxuan Hua
- Department of Clinical Medicine, Basic Medical College, Capital Medical University, Beijing 100069, China;
| | - Lei Gao
- Department of Bioinformatics, College of Bioengineering, Capital Medical University, Beijing 100069, China;
| | - Yixuan Du
- Department of Oral Medicine, Basic Medical College, Capital Medical University, Beijing 100069, China; (Y.G.); (Y.D.)
| | - Jingdong Xu
- Department of Physiology and Pathophysiology, Basic Medical College, Capital Medical University, Beijing 100069, China; (H.G.); (C.H.)
- Correspondence: ; Tel./Fax: +86-10-8391-1469
| |
Collapse
|
29
|
Kim DK, Lee HJ, Lee IH, Lee JJ. Risk of Burning Mouth Syndrome in Patients with Migraine: A Nationwide Cohort Study. J Pers Med 2022; 12:620. [PMID: 35455736 PMCID: PMC9029595 DOI: 10.3390/jpm12040620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 12/19/2022] Open
Abstract
Migraine is a common neurological disease that causes a variety of symptoms, most notably throbbing, which is described as a pulsing headache on one side of the head. Burning mouth syndrome (BMS) is defined as an intra-oral burning sensation. Currently, no medical or dental cause has been identified for BMS. Interestingly, neuropathic pain is a characteristic feature of BMS; however, it remains unclear whether migraine can cause BMS. We aimed to identify the association of migraine with the risk of developing BMS. We used a representative nationwide cohort sample of approximately 1 million patients from 2002 to 2013 to investigate the prospective association between migraine and BMS. A total of 4157 migraine patients (migraine group) and 16,628 patients without migraine (comparison group) were enrolled after 1:4 propensity score matching. The overall incidence of BMS was significantly higher in the migraine group (0.15 per 1000 person-years) than in the comparison group (0.05 per 1000 person-years). The adjusted HR for patients with migraine who reported BMS events during the 10-year follow-up period was 2.96 (95% confidence interval, 1.02-8.56), after adjusting for other covariates. However, in the subgroup analysis, the adjusted HR for BMS events did not show a significant difference between the migraine and comparison group according to sex, age, and comorbidities. This study suggests that migraine is associated with an increased incidence of BMS. Therefore, clinicians should be attentive to detect BMS at an early stage when treating patients with migraine.
Collapse
Affiliation(s)
- Dong-Kyu Kim
- Institute of New Frontier Research, Division of Big Data and Artificial Intelligence, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea;
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea;
| | - Hyun-Joo Lee
- Institute of New Frontier Research, Division of Big Data and Artificial Intelligence, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea;
| | - Il Hwan Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea;
| | - Jae-Jun Lee
- Department of Anesthesiology and Pain Medicine, College of Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon 24253, Korea
| |
Collapse
|
30
|
Comment on scalp neuropathy in androgenetic alopecia. J Am Acad Dermatol 2022; 87:e81. [DOI: 10.1016/j.jaad.2022.03.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 11/22/2022]
|
31
|
Lee BM, Park JW, Jo JH, Oh B, Chung G. Comparative analysis of the oral microbiome of burning mouth syndrome patients. J Oral Microbiol 2022; 14:2052632. [PMID: 35341209 PMCID: PMC8942548 DOI: 10.1080/20002297.2022.2052632] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Burning mouth syndrome
(BMS) is a chronic pain condition accompanied by unpleasant burning sensations
of the oral mucosa. While multiple factors were proposed for the etiology, evidence
suggested a neuropathic pain origin while others suspected the use of
antibiotics as the underlying cause. Interestingly, several reports demonstrated
the intimate interaction of the nervous system and the microbiome. The current
study aims to elucidate the correlation of the oral microbiome with the pathophysiology
of the primary BMS. Microbiome samples obtained from the unstimulated whole
saliva of 19 primary BMS patients and 22 healthy controls were sequenced and analyzed
of the V3-V4 region of 16S rRNA gene. There was a distinct difference in the
microbial composition between the BMS and the control groups at all taxonomic levels.
Alpha diversity indexes of the oral microbiome were significantly lower in the
BMS group. The samples were readily distinguished by multidimensional scaling
analysis and linear discriminant analysis effect size. Streptococcus, Rothia, Bergeyella, and Granulicatella
genus were dominant in the BMS group, while Prevotella, Haemophilus,
Fusobacterium, Campylobacter,
and Allorevotella genus were more
abundant in the healthy group. Distinct microbiome signatures of BMS patients
suggested a diagnostic value and a potential role in the pathogenesis of BMS.
Collapse
Affiliation(s)
- Byeong-Min Lee
- Department of Oral Physiology and Program in Neurobiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ji Woon Park
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea.,Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Jung Hwan Jo
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Bumjo Oh
- Department of Family Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Gehoon Chung
- Department of Oral Physiology and Program in Neurobiology, School of Dentistry, Seoul National University, Seoul, Republic of Korea.,Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
32
|
Hanna R, Bensadoun RJ, Beken SV, Burton P, Carroll J, Benedicenti S. Outpatient Oral Neuropathic Pain Management with Photobiomodulation Therapy: A Prospective Analgesic Pharmacotherapy-Paralleled Feasibility Trial. Antioxidants (Basel) 2022; 11:533. [PMID: 35326183 PMCID: PMC8944471 DOI: 10.3390/antiox11030533] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 12/15/2022] Open
Abstract
Neuropathic pain (NP) can be challenging to treat effectively as analgesic pharmacotherapy (MED) can reduce pain, but the majority of patients do not experience complete pain relief. Our pilot approach is to assess the feasibility and efficacy of an evidence-based photobiomodulation (PBM) intervention protocol. This would be as an alternative to paralleled standard analgesic MED for modulating NP intensity-related physical function and quality of life (QoL) prospectively in a mixed neurological primary burning mouth syndrome and oral iatrogenic neuropathy study population (n = 28). The study group assignments and outcome evaluation strategy/location depended on the individual patient preferences and convenience rather than on randomisation. Our prospective parallel study aimed to evaluate the possible pre/post-benefit of PBM and to allow for a first qualitative comparison with MED, various patient-reported outcome measures (PROMs) based on Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT-II) were used for up to a nine-month follow-up period in both intervention groups (PBM and MED). The PBM protocol applied to the PBM group was as follows: λ810 nm, 200 mW, 0.088 cm2, 30 s/point, 9 trigger and affected points, twice a week for five consecutive weeks, whereas the MED protocol followed the National Institute of Clinical Excellence (NICE) guidelines. Our results showed that despite the severe and persistent nature of the symptoms of 57.50 ± 47.93 months at baseline in the PBM group, a notably rapid reduction in PISmax on VAS from 7.6 at baseline (T0) to 3.9 at one-month post-treatment (T3) could be achieved. On the other hand, mean PISmax was only reduced from 8.2 at baseline to 6.8 at T3 in the MED group. Our positive PBM findings furthermore support more patients' benefits in improving QoL and functional activities, which were considerably impaired by NP such as: eating, drinking and tasting, whereas the analgesic medication regimens did not. No adverse events were observed in both groups. To the best knowledge of the authors, our study is the first to investigate PBM efficacy as a monotherapy compared to the gold standard analgesic pharmacotherapy. Our positive data proves statistically significant improvements in patient self-reported NP, functionality, psychological profile and QoL at mid- and end-treatment, as well as throughout the follow-up time points (one, three, six and nine months) and sustained up to nine months in the PBM group, compared to the MED group. Our study, for the first time, proves the efficacy and safety of PBM as a potent analgesic in oral NP and as a valid alternative to the gold standard pharmacotherapy approach. Furthermore, we observed long-term pain relief and functional benefits that indicate that PBM modulates NP pathology in a pro-regenerative manner, presumably via antioxidant mechanisms.
Collapse
Affiliation(s)
- Reem Hanna
- Department of Oral Surgery, Dental Institute, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV,6, 16132 Genoa, Italy;
| | - René Jean Bensadoun
- Department of Radiology Oncology, Centre De Haute Energie, 10 Boulevard Pasteur, 06000 Nice, France;
| | - Seppe Vander Beken
- Bredent Medical GmbH & Co., Gewerbegebiet Gartenäcker, Weißenhorner Str. 2, 89250 Senden, Germany;
| | - Patricia Burton
- Thor Photomedicine Ltd., Water Meadow, Chesham HP5 1LF, UK; (P.B.); (J.C.)
| | - James Carroll
- Thor Photomedicine Ltd., Water Meadow, Chesham HP5 1LF, UK; (P.B.); (J.C.)
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, Laser Therapy Centre, University of Genoa, Viale Benedetto XV,6, 16132 Genoa, Italy;
| |
Collapse
|
33
|
Camolesi GCV, Marichalar-Mendía X, Padín-Iruegas ME, Spanemberg JC, López-López J, Blanco-Carrión A, Gándara-Vila P, Gallas-Torreira M, Pérez-Sayáns M. Efficacy of photobiomodulation in reducing pain and improving the quality of life in patients with idiopathic burning mouth syndrome. A systematic review and meta-analysis. Lasers Med Sci 2022; 37:2123-2133. [PMID: 35122543 PMCID: PMC9148274 DOI: 10.1007/s10103-022-03518-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/28/2022] [Indexed: 12/28/2022]
Abstract
Burning mouth syndrome is a chronic condition, which is characterised by a burning sensation or pain in the mucosa of the oral cavity. Treatment options include antidepressants, antipsychotics, anticonvulsants, analgesics, hormone replacement therapies and more recently photobiomodulation. This study aims to perform a systematic review with meta-analysis in order to determine the effect of photobiomodulation on pain relief and the oral health-related quality of life associated with this condition. A bibliographical search of the Pubmed, Embase, Web of Science and Scopus databases was conducted. Only randomised clinical trials were included. Pain and quality of life were calculated as mean difference and pooled at different treatment points (baseline = T0 and final time point = Tf) and laser modality. From a total of 103 records, 7 articles were retrieved for inclusion. PBM group had a greater decrease in pain than control group at Tf with a mean difference = − 2.536 (IC 95% − 3.662 to − 1.410; I2 = 85.33%, p < 0.001). An improvement in oral health-related quality of life was observed in both groups, although this was more significant in the photobiomodulation group mean difference = − 5.148 (IC 95% − 8.576 to − 1.719; I2 = 84.91%, p = 0.003). For the red laser, a greater improvement than infrared was observed, in pain, mean difference = − 2.498 (IC 95% − 3.942 to − 1.053; I2 = 79.93%, p < 0.001), and in quality of life, mean difference = − 8.144 (IC 95% − 12.082 to − 4.206; I2 = 64.22%, p = 0.027). Photobiomodulation, in particular, red laser protocols, resulted in improvement in pain and in quality of life of burning mouth syndrome patients.
Collapse
Affiliation(s)
- Gisela Cristina Vianna Camolesi
- Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain.,Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain
| | - Xabier Marichalar-Mendía
- Nursing I Department, University of the Basque Country (UPV/EHU), C.P. 48940, Leioa, Bizkaia, Spain
| | - Maria Elena Padín-Iruegas
- Human Anatomy and Embryology Area, Department of Functional Biology and Health Sciences, Faculty of Physiotherapy, Pontevedra, Spain.
| | - Juliana Cassol Spanemberg
- Oral Medicine and Public Health, Faculty of Dentistry, Universidad Fernando Pessoa-Canarias, Santa María de Guía, Calle de la Juventud s/n, C.P. 35450, Gran Canaria, Spain
| | - Jose López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University of Barcelona//Oral Health and Masticatory System Group-IDIBELL, C.P. 08907, Barcelona, Cataluña, Spain
| | - Andrés Blanco-Carrión
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain.,Health Research Institute of Santiago (IDIS) (ORALRES), Santiago de Compostela, Spain
| | - Pilar Gándara-Vila
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain.,Health Research Institute of Santiago (IDIS) (ORALRES), Santiago de Compostela, Spain
| | - Mercedes Gallas-Torreira
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain.,Health Research Institute of Santiago (IDIS) (ORALRES), Santiago de Compostela, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela C.P, Entrerríos s/n, 15782, Galicia, Spain.,Health Research Institute of Santiago (IDIS) (ORALRES), Santiago de Compostela, Spain
| |
Collapse
|
34
|
Seol SH, Chung G. Estrogen-dependent regulation of transient receptor potential vanilloid 1 (TRPV1) and P2X purinoceptor 3 (P2X3): Implication in burning mouth syndrome. J Dent Sci 2022; 17:8-13. [PMID: 35028015 PMCID: PMC8739235 DOI: 10.1016/j.jds.2021.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/14/2021] [Indexed: 12/20/2022] Open
Abstract
Sex differences in the nervous system have gained recent academic interest. While the prominent differences are observed in mood and anxiety disorders, growing number of evidences also suggest sex difference in pain perception. This review focuses on estrogen as the key molecule underlying such difference, because estrogen plays many functions in the nervous system, including modulation of transient receptor potential vanilloid 1 (TRPV1) and P2X purinoceptor 3 (P2X3), two important nociceptive receptors. Estrogen was shown in various studies to up-regulate TRPV1 expression through two distinct pathways, resulting in pro-nociceptive effect. However, estrogen alleviated pain in other studies, by down-regulating nerve growth factor (NGF)-activated pathways and TRPV1. Estrogen may also attenuate nociception by inhibiting P2X3 receptors and ATP-signaling. Understanding the mechanism underlying the pro- and anti-nociceptive effect of estrogen might be crucial to understand pathophysiology of the burning mouth syndrome (BMS), a common chronic orofacial pain disorder in menopausal women. The involvement of TRPV1 is strongly suspected because of burning sensation. Reduced estrogen level of the BMS patient might have caused increased activity of P2X3 receptors. Interestingly, the increased expression of TRPV1 and P2X3 in oral mucosa of BMS patients was reported. The combinational impact of differential modulation of TRPV1/P2X3 during menopause might be an important contributing factor of etiology of BMS. Understanding the estrogen-dependent regulation of nociceptive receptors may provide a valuable insight toward the peripheral mechanism of sex-difference in pain perception.
Collapse
Affiliation(s)
- Seon-Hong Seol
- College of Human Ecology, Seoul National University, Seoul, South Korea
| | - Gehoon Chung
- Department of Oral Physiology, School of Dentistry, Seoul National University, Seoul, South Korea
- Dental Research Institute, Seoul National University, Seoul, South Korea
| |
Collapse
|
35
|
Verdugo RJ, Matamala JM, Inui K, Kakigi R, Valls-Solé J, Hansson P, Bernhard Nilsen K, Lombardi R, Lauria G, Petropoulos IN, Malik RA, Treede RD, Baumgärtner U, Jara PA, Campero M. Review of techniques useful for the assessment of sensory small fiber neuropathies: Report from an IFCN expert group. Clin Neurophysiol 2022; 136:13-38. [DOI: 10.1016/j.clinph.2022.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 02/09/2023]
|
36
|
Xu R, Xie ME, Jackson CM. Trigeminal Neuralgia: Current Approaches and Emerging Interventions. J Pain Res 2021; 14:3437-3463. [PMID: 34764686 PMCID: PMC8572857 DOI: 10.2147/jpr.s331036] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 09/13/2021] [Indexed: 12/22/2022] Open
Abstract
Trigeminal neuralgia (TN) has been described in the literature as one of the most debilitating presentations of orofacial pain. This review summarizes over 150 years of collective clinical experience in the medical and surgical treatment of TN. Fundamentally, TN remains a clinical diagnosis that must be distinguished from other types of trigeminal neuropathic pain and/or facial pain associated with other neuralgias or headache syndromes. What is increasingly clear is that there is no catch-all medical or surgical intervention that is effective for all patients with trigeminal neuralgia, likely reflective of the fact that TN is likely a heterogenous group of disorders that jointly manifests in facial pain. The first-line treatment for TN remains anticonvulsant medical therapy. Patients who fail this have a range of surgical options available to them. In general, microvascular decompression is a safe and effective procedure with immediate and durable outcomes. Patients who are unable to tolerate general anesthesia or whose medical comorbidities preclude a suboccipital craniectomy may benefit from percutaneous methodologies including glycerol or radiofrequency ablation, or both. For patients with bleeding diathesis due to blood thinning medications who are ineligible for invasive procedures, or for those who are unwilling to undergo open surgical procedures, radiosurgery may be an excellent option-provided the patient understands that maximum pain relief will take on the order of months to achieve. Finally, peripheral neurectomies continue to provide an inexpensive and resource-sparing alternative to pain relief for patients in locations with limited economic and medical resources. Ultimately, elucidation of the molecular mechanisms underlying trigeminal neuralgia will pave the way for novel, more effective and less invasive therapies.
Collapse
Affiliation(s)
- Risheng Xu
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael E Xie
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christopher M Jackson
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
37
|
Hanna R, Dalvi S, Bensadoun RJ, Raber-Durlacher JE, Benedicenti S. Role of Photobiomodulation Therapy in Neurological Primary Burning Mouth Syndrome. A Systematic Review and Meta-Analysis of Human Randomised Controlled Clinical Trials. Pharmaceutics 2021; 13:1838. [PMID: 34834253 PMCID: PMC8624276 DOI: 10.3390/pharmaceutics13111838] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 10/17/2021] [Accepted: 10/26/2021] [Indexed: 12/22/2022] Open
Abstract
Mitochondrial homeostasis is crucial for energy production and neuronal survival in neurological primary burning mouth syndrome (npBMS). Photobiomodulation therapy (PBMT) has been utilised in npBMS management, however, its role of intervention remains controversial. The aim of this systematic review and meta-analysis of CRD 42020198921 PROSPERO registration reference was to oversee and determine the efficacy of PBMT in patients with npBMS, identifying the gaps and bridge them by proposing recommendations for future studies purposes. PRISMA guidelines and Cochrane Collaboration recommendations followed. Various search engines employed to analyse a total of 351 studies of which 12 were included. A wide range of utilised PBM wavelengths was between 635-980 nm and the power output ranged between 30 mW and 4000 mW. A high risk of bias (RoB) was noted in 7 out of 12 included studies (58.3%), as results of qualitative analysis. Meta-analysis findings of 4 out of 12 studies showed statistically significant intergroup differences (SSID) for visual analogue scale (VAS) values (MD = -1.47; 95% CI = -2.40 to -0.53; Z = 3.07 (p = 0.002) whereas meta-analysis on 5 out of 12 studies revealed SSID for anxiety/depression and quality of life (MD = -1.47; 95% CI = -2.40 to -0.53; Z = 3.07 (p = 0.002), favouring PBMT group to the control treatment strategies. Despite the inconsistency and diversity in PBM parameters (wavelength, power, light source, spot size, emission mode, energy per point, total energy) and treatment protocols (exposure time, number of sessions, time interval between sessions, treatment duration)-majority of the included studies showed positive PBM results. The high RoB and meta-analytical heterogeneity in the eligible studies warrant the necessity to perform well-designed and robust RCTs after acknowledging the drawbacks of the available scientific literature and addressing our suggested recommendations highlighted in our review.
Collapse
Affiliation(s)
- Reem Hanna
- Laser Therapy Centre, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy;
- Department of Oral Surgery, Dental Institute, King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK
| | - Snehal Dalvi
- Department of Periodontology, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur 441110, India;
| | - Rene Jean Bensadoun
- Centre De Haute Energie, Department of Oncology Radiology, 10 Boulevard Pasteur, 06000 Nice, France;
| | - Judith E. Raber-Durlacher
- Academic Centre for Dentistry Amsterdam, Department of Oral Medicine, University of Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands;
- Department of Oral and Maxillofacial Surgery, Amsterdam UMC, University of Amsterdam, De Boelelaan 1117, 1118, 1081 HV Amsterdam, The Netherlands
| | - Stefano Benedicenti
- Laser Therapy Centre, Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy;
| |
Collapse
|
38
|
Kishore J, Shaikh F, Zubairi AM, Mirza S, Alqutub MN, AlMubarak AM, Abduljabbar T, Vohra F. Evaluation of serum neuron specific enolase levels among patients with primary and secondary burning mouth syndrome. Cephalalgia 2021; 42:119-127. [PMID: 34644195 DOI: 10.1177/03331024211046613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Burning mouth syndrome is a painful condition of the oral cavity with ambiguous pathogenesis and diagnosis. Neuron-specific enolase is increased in several conditions including peripheral neuropathy of diabetes, ophthalmopathies, spinal cord injuries and tumors. Evidence on association of burning mouth syndrome and neuron-specific enolase is limited. AIM This study aims to evaluate neuron-specific enolase levels in primary and secondary burning mouth syndrome patients and compare the levels of neuron-specific enolase with associated conditions in secondary burning mouth syndrome. METHODS One hundred and twenty-eight patients of more than 18 years of age with no gender predilection and having clinical symptoms of burning mouth syndrome and 135 healthy subjects were included. All the patients fulfilled Scala's criteria for the diagnosis of burning mouth syndrome, including "primary" (idiopathic) and "secondary" (resulting from identified precipitating factors) burning mouth syndrome patients. Blood samples were obtained from burning mouth syndrome patients. Serum neuron-specific enolase was evaluated using enzyme-linked immunosorbent assay. To compare means and standard deviations, among primary and secondary burning mouth syndrome, data was analysed with analysis of variance and multiple comparisons test. RESULTS The mean age of the study participants for burning mouth syndrome and healthy subjects was 53.30 and 51.6 years, respectively. Amongst the secondary burning mouth syndrome group, 32 (25%) of the patients had menopause, 15 (11.7%) had diabetes, eight (6.2%) of the patients had nutritional deficiency, seven (5.4%) had combined diabetes, menopause, and depression, six (4.6%) had combined diabetes and depression, four (3.1%) were diagnosed with Sjögren's syndrome. A minor percentage of 2.3% (three) had gastroesophageal reflux disease, while the remaining three (2.3%) patients in the secondary burning mouth syndrome group were on anti-depressants. There was a statistically significant increase in the levels of neuron-specific enolase in primary burning mouth syndrome as compared to the secondary burning mouth syndrome and healthy groups. Among the subgroups of secondary burning mouth syndrome, diabetic individuals showed a significant increase in neuron-specific enolase level when compared with other conditions in the secondary burning mouth syndrome patients.Discussion and conclusion: The raised serum neuron-specific enolase levels in patients suffering from primary burning mouth syndrome highlight a possible neuropathic mechanism. It was also increased in the sub-group of secondary burning mouth syndrome patients having diabetes. Although it cannot be ascertained whether the deranged values in the diabetic group were due to burning mouth syndrome or due to diabetes, the raised quantity of neuron-specific enolase in the primary burning mouth syndrome group is a reliable diagnostic indicator. Future studies on the assessment of neuron-specific enolase levels as a diagnostic tool for onset and management of primary and secondary burning mouth syndrome are recommended.
Collapse
Affiliation(s)
- Jaimala Kishore
- Department of Oral Pathology, 37093Ziauddin University, Ziauddin University, Karachi, Pakistan
| | - Fouzia Shaikh
- Department of Pathology, Ziauddin University, Karachi, Pakistan
| | | | - Sana Mirza
- Department of Oral Pathology, 37093Ziauddin University, Ziauddin University, Karachi, Pakistan
| | - Montaser N Alqutub
- Department of Periodontics and Community Dentistry, 37850King Saud University, 37850King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman M AlMubarak
- Department of Periodontics and Community Dentistry, 37850King Saud University, 37850King Saud University, Riyadh, Saudi Arabia
| | - Tariq Abduljabbar
- Department of Prosthetic Dental Science, College of Dentistry, 37850King Saud University, Riyadh, Saudi Arabia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, 37850King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
39
|
Orliaguet M, Misery L. Neuropathic and Psychogenic Components of Burning Mouth Syndrome: A Systematic Review. Biomolecules 2021; 11:biom11081237. [PMID: 34439903 PMCID: PMC8393188 DOI: 10.3390/biom11081237] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 12/27/2022] Open
Abstract
The pathophysiology of primary burning mouth syndrome (BMS) has been extensively debated but is poorly understood despite a large number of hypotheses attempting to explain its etiopathogenic mechanisms. The aim of the present work was to systematically review papers that could provide arguments in favour of the neuropathic and psychogenic components of primary BMS for a better understanding of the disease. This systematic review (SR) was registered in PROSPERO (CRD42021224160). The search was limited to articles in English or French from 1990 to 01 December 2020. A total of 113 articles were considered for data extraction. We divided them into four subgroups: pharmacological and nonpharmacological management studies (n = 23); neurophysiological studies (n = 35); biohistopathological studies (n = 25); and questionnaire-based studies (n = 30). Several of these studies have shown neuropathic involvement at various levels of the neuraxis in BMS with the contribution of quantitative sensory testing (QST), functional brain imaging, and biohistopathological or pharmacologic studies. On the other hand, the role of psychological factors in BMS has also been the focus of several studies and has shown a link with psychiatric disorders such as anxiety and/or depression symptoms. Depending on the patient, the neuropathic and psychogenic components may exist simultaneously, with a preponderance of one or the other, or exist individually. These two components cannot be dissociated to define BMS. Consequently, BMS may be considered nociplastic pain.
Collapse
Affiliation(s)
- Marie Orliaguet
- LIEN, Department of Oral Surgery, University of Western Brittany, F-29200 Brest, France;
| | - Laurent Misery
- LIEN, Department of Dermatology, University of Western Brittany, F-29200 Brest, France
- Correspondence: ; Tel.: +33-2-9888-3527
| |
Collapse
|
40
|
Gemignani F, Bellanova MF, Saccani E, Pavesi G. Non-length-dependent small fiber neuropathy: Not a matter of stockings and gloves. Muscle Nerve 2021; 65:10-28. [PMID: 34374103 DOI: 10.1002/mus.27379] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/11/2021] [Accepted: 07/18/2021] [Indexed: 12/17/2022]
Abstract
The clinical spectrum of small fiber neuropathy (SFN) encompasses manifestations related to the involvement of thinly myelinated A-delta and unmyelinated C fibers, including not only the classical distal phenotype, but also a non-length-dependent (NLD) presentation that can be patchy, asymmetrical, upper limb-predominant, or diffuse. This narrative review is focused on NLD-SFN. The diagnosis of NLD-SFN can be problematic, due to its varied and often atypical presentation, and diagnostic criteria developed for distal SFN are not suitable for NLD-SFN. The topographic pattern of NLD-SFN is likely related to ganglionopathy restricted to the small neurons of dorsal root ganglia. It is often associated with systemic diseases, but about half the time is idiopathic. In comparison with distal SFN, immune-mediated diseases are more common than dysmetabolic conditions. Treatment is usually based on the management of neuropathic pain. Disease-modifying therapy, including immunotherapy, may be effective in patients with identified causes. Future research on NLD-SFN is expected to further clarify the interconnected aspects of phenotypic characterization, diagnostic criteria, and pathophysiology.
Collapse
Affiliation(s)
- Franco Gemignani
- Neurology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Maria F Bellanova
- Laboratory of Neuromuscular Histopathology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Elena Saccani
- Neurology Unit, Department of Specialized Medicine, University Hospital of Parma, Parma, Italy
| | - Giovanni Pavesi
- Neurology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| |
Collapse
|
41
|
Costa YM, Bonjardim LR, Conti PCR, Svensson P. Psychophysical evaluation of somatosensory function in oro-facial pain: achievements and challenges. J Oral Rehabil 2021; 48:1066-1076. [PMID: 34213796 DOI: 10.1111/joor.13223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/03/2021] [Indexed: 11/30/2022]
Abstract
AIM This critical review describes key methodological aspects for a successful oro-facial psychophysical evaluation of the somatosensory system and highlights the diagnostic value of somatosensory assessment and management perspectives based on somatosensory profiling. METHODS This topical review was based on a non-systematic search for studies about somatosensory evaluation in oro-facial pain in PubMed and Embase. RESULTS The recent progress regarding the psychophysical evaluation of somatosensory function was largely possible due to the development and application of valid, reliable and standardised psychophysical methods. Qualitative sensory testing may be useful as a screening tool to rule out relevant somatosensory abnormalities. Nevertheless, the patient should preferably be referred to a more comprehensive assessment with the quantitative sensory testing battery if confirmation of somatosensory abnormalities is necessary. Moreover, the identification of relevant somatosensory alterations in chronic pain disorders that do not fulfil the current criteria to be regarded as neuropathic has also increased the usefulness of somatosensory evaluation as a feasible method to better characterise the patients and perhaps elucidate some underpinnings of the so-called 'nociplastic' pain disorders. Finally, an additional benefit of oro-facial pain treatment based on somatosensory profiling still needs to be demonstrated and convincing evidence of somatosensory findings as predictors of treatment efficacy in chronic oro-facial pain awaits further studies. CONCLUSION Psychophysical evaluation of somatosensory function in oro-facial pain is still in its infancy but with a clear potential to continue to improve the assessment, diagnosis and management of oro-facial pain patients.
Collapse
Affiliation(s)
- Yuri M Costa
- Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil.,Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark.,Bauru Orofacial Pain Group, Bauru, Brazil
| | - Leonardo R Bonjardim
- Bauru Orofacial Pain Group, Bauru, Brazil.,Section of Head and Face Physiology, Department of Biological Sciences, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | - Paulo César R Conti
- Bauru Orofacial Pain Group, Bauru, Brazil.,Department of Prosthodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, Brazil
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark.,Faculty of Odontology, Malmo University, Malmo, Sweden
| |
Collapse
|
42
|
Is a neuropathic mechanism involved in the perception of oral dryness? Arch Oral Biol 2021; 130:105213. [PMID: 34339966 DOI: 10.1016/j.archoralbio.2021.105213] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES The aim of the present study was to review the existing phenomena which could affect subjective oral dryness and to consider the possibility that neural processing is involved in the perception of oral dryness. DESIGN A comprehensive review of scientific literatures relevant to contributing factors of dry mouth symptoms including salivary parameters related with oral dryness and role of neural mechanisms in perception of dry mouth symptoms was conducted. RESULTS Several previous reports suggested the possibility of neural processing mechanisms in perception of oral dryness. The decreased pain threshold in the oral cavity of rats with dry tongue and complaints of subjective oral dryness in patients with burning mouth syndrome, of which lacked an actual decrease in salivary output and mucosal wetness, could support this idea. Sensory changes in the oral mucosa and oral dryness may have a bi-directional influence that patients with oral dryness would be more subject to neuropathic pain in the oral mucosa, and those with neuropathic pain in the oral cavity could have complaints associated with higher levels of dry mouth symptoms. CONCLUSION A bi-directional influence between sensory change in the oral mucosa and subjective oral dryness could be assumed. We suggest the administration of neuropathic pain medications for controlling subjective oral dryness in patients without objective sign of hyposalivation.
Collapse
|
43
|
|
44
|
Acute and Chronic Pain from Facial Skin and Oral Mucosa: Unique Neurobiology and Challenging Treatment. Int J Mol Sci 2021; 22:ijms22115810. [PMID: 34071720 PMCID: PMC8198570 DOI: 10.3390/ijms22115810] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/14/2022] Open
Abstract
The oral cavity is a portal into the digestive system, which exhibits unique sensory properties. Like facial skin, the oral mucosa needs to be exquisitely sensitive and selective, in order to detect harmful toxins versus edible food. Chemosensation and somatosensation by multiple receptors, including transient receptor potential channels, are well-developed to meet these needs. In contrast to facial skin, however, the oral mucosa rarely exhibits itch responses. Like the gut, the oral cavity performs mechanical and chemical digestion. Therefore, the oral mucosa needs to be insensitive, to some degree, in order to endure noxious irritation. Persistent pain from the oral mucosa is often due to ulcers, involving both tissue injury and infection. Trigeminal nerve injury and trigeminal neuralgia produce intractable pain in the orofacial skin and the oral mucosa, through mechanisms distinct from those seen in the spinal area, which is particularly difficult to predict or treat. The diagnosis and treatment of idiopathic chronic pain, such as atypical odontalgia (idiopathic painful trigeminal neuropathy or post-traumatic trigeminal neuropathy) and burning mouth syndrome, remain especially challenging. The central integration of gustatory inputs might modulate chronic oral and facial pain. A lack of pain in chronic inflammation inside the oral cavity, such as chronic periodontitis, involves the specialized functioning of oral bacteria. A more detailed understanding of the unique neurobiology of pain from the orofacial skin and the oral mucosa should help us develop novel methods for better treating persistent orofacial pain.
Collapse
|
45
|
Abstract
Of all the oral sensations that are experienced, "metallic" is one that is rarely reported in healthy participants. So why, then, do chemotherapy patients so frequently report that "metallic" sensations overpower and interfere with their enjoyment of food and drink? This side-effect of chemotherapy-often referred to (e.g., by patients) as "metal mouth"-can adversely affect their appetite, resulting in weight loss, which potentially endangers (or at the very least slows) their recovery. The etiology of "metal mouth" is poorly understood, and current management strategies are largely unevidenced. As a result, patients continue to suffer as a result of this poorly understood phenomenon. Here, we provide our perspective on the issue, outlining the evidence for a range of possible etiologies, and highlighting key research questions. We explore the evidence for "metallic" as a putative taste, and whether "metal mouth" might therefore be a form of phantageusia, perhaps similar to already-described "release-of-inhibition" phenomena. We comment on the possibility that "metal mouth" may simply be a direct effect of chemotherapy drugs. We present the novel theory that "metal mouth" may be linked to chemotherapy-induced sensitization of TRPV1. Finally, we discuss the evidence for retronasal olfaction of lipid oxidation products in the etiology of "metal mouth." This article seeks principally to guide much-needed future research which will hopefully one day provide a basis for the development of novel supportive therapies for future generations of patients undergoing chemotherapy.
Collapse
Affiliation(s)
- Alastair J M Reith
- Oxford Medical School, Medical Sciences Division, John Radcliffe Hospital, UK
| | - Charles Spence
- Crossmodal Research Laboratory, Department of Experimental Psychology, Oxford University, UK
| |
Collapse
|
46
|
Werfalli S, Drangsholt M, Johnsen JM, Jeffrey SK, Dakhil S, Presland RB, LeResche L. Saliva flow rates and clinical characteristics of patients with burning mouth syndrome: A case-control study. Int J Oral Maxillofac Surg 2021; 50:1187-1194. [PMID: 33640241 DOI: 10.1016/j.ijom.2021.01.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 12/07/2020] [Accepted: 01/22/2021] [Indexed: 12/20/2022]
Abstract
Burning mouth syndrome (BMS) is a chronic pain condition that most commonly affects postmenopausal women older than 50 years of age. Xerostomia is a common complaint among BMS patients. However, previous studies showed inconsistent findings regarding saliva flow rate reduction. This study examined saliva flow rates, degree of mucosal hydration, xerostomia, and clinical characteristics in BMS patients compared with healthy controls. Unstimulated whole saliva (USWS) was collected through passive drooling; residual mucosal saliva (RMS) was collected using filter paper strips. Stimulated whole saliva (SWS) was collected while chewing on gum base. Oral exam and self-report data were collected. A total of 50 women (22 BMS cases and 28 healthy controls) aged 50 years or older were included in the analysis of this study. Mean age was 62 years for cases and 56 years for controls (P=0.05). Compared with controls, cases had significantly lower USWS flow rates (P<0.001) and had a higher prevalence of xerostomia (P=0.001), gastrointestinal disease (P<0.001), and vaginal dryness (P=0.01). These data show that oral and vaginal dryness are common among BMS patients. Further studies are needed to investigate potential pathophysiological mechanisms related to the quality of saliva and mucosal barrier status among these patients.
Collapse
Affiliation(s)
- S Werfalli
- Oral Medicine Department, University of Washington, Seattle, WA, USA.
| | - M Drangsholt
- Oral Medicine Department, University of Washington, Seattle, WA, USA
| | - J M Johnsen
- Oral Medicine Department, University of Washington, Seattle, WA, USA
| | - S K Jeffrey
- Oral Medicine Department, University of Washington, Seattle, WA, USA
| | - S Dakhil
- Oral Medicine Department, University of Washington, Seattle, WA, USA
| | - R B Presland
- Oral Medicine Department, University of Washington, Seattle, WA, USA
| | - L LeResche
- Oral Medicine Department, University of Washington, Seattle, WA, USA
| |
Collapse
|
47
|
Kim JY, Kim YS, Ko I, Kim DK. Association Between Burning Mouth Syndrome and the Development of Depression, Anxiety, Dementia, and Parkinson Disease. JAMA Otolaryngol Head Neck Surg 2021; 146:561-569. [PMID: 32352482 DOI: 10.1001/jamaoto.2020.0526] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Importance Burning mouth syndrome is a chronic oral pain disorder that is characterized by a generalized or localized burning sensation without the presence of any specific mucosal lesions. It remains unclear, however, whether burning mouth syndrome is associated with the development of psychoneurological conditions among patients with the syndrome. Objective To evaluate the risk of developing psychoneurological conditions, including depression, anxiety, dementia, and Parkinson disease, in patients with burning mouth syndrome. Design, Setting, and Participants This retrospective population-based cohort study was conducted using a nationwide representative cohort sample from the Korean National Health Insurance Service-National Sample Cohort, which consists of data from approximately 1 million patients in South Korea. The study included 586 patients with burning mouth syndrome (patient group) and 1172 individuals without burning mouth syndrome (comparison group). The patient group included all patients who received inpatient and outpatient care for an initial diagnosis of burning mouth syndrome between January 1, 2002, and December 31, 2012. The comparison group was selected (2 individuals without burning mouth syndrome for each patient with burning mouth syndrome) using propensity score matching for sex, age, location of residence, household income level, and comorbidities. Data were collected and analyzed from January 1, 2002, to December 31, 2013. Main Outcomes and Measures Death and the incidence of psychopathological diseases. Affective disorder events that occurred among participants during the follow-up period were investigated using survival analysis, a log-rank test, and Cox proportional hazards regression models to estimate the incidence rates, survival rates, and hazard ratios, respectively, of participants who developed psychoneurological conditions. Results Of 1758 total participants, 1086 (61.8%) were female; 701 participants (39.9%) were younger than 45 years, 667 (37.9%) were aged 45 to 64 years, and 390 (22.2%) were older than 64 years. The overall incidence of depression and anxiety was higher in patients with burning mouth syndrome (n = 586; 30.8 incidents and 44.2 incidents per 1000 person-years, respectively) than in individuals without burning mouth syndrome (n = 1172; 11.7 incidents and 19.0 incidents per 1000 person-years, respectively). The results also indicated a similar incidence of dementia and Parkinson disease between the patient group (6.5 incidents and 2.5 incidents per 1000 person-years, respectively) and the comparison group (4.9 incidents and 1.7 incidents per 1000 person-years, respectively). After adjusting for sociodemographic factors (age, location of residence, household income level, and comorbidities), the adjusted hazard ratios for the development of depression and anxiety among patients with burning mouth syndrome were 2.77 (95% CI, 2.22-3.45) and 2.42 (95% CI, 2.02-2.90), respectively. However, no association was found between burning mouth syndrome and the risk of developing dementia and Parkinson disease. Conclusions and Relevance Results of this observational study suggest that burning mouth syndrome is associated with increases in the incidence of depression and anxiety but not in the incidence of dementia and Parkinson disease among patients with the syndrome. Clinicians should be aware of this association and be prepared to make referrals to appropriate mental health care professionals.
Collapse
Affiliation(s)
- Jong-Yeup Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea.,Department of Biomedical Informatics, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Yeon Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Inseok Ko
- Department of Biomedical Informatics, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Dong-Kyu Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea.,Institute of New Frontier Research, Hallym University College of Medicine, Chuncheon, Republic of Korea
| |
Collapse
|
48
|
Roy S, Raj D, Bhattacharyya J, Das S, Goel P. Therapeutic use of alpha lipoic acid in burning mouth syndrome: A meta-analysis. SAUDI JOURNAL OF ORAL SCIENCES 2021. [DOI: 10.4103/sjos.sjoralsci_69_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
49
|
Abstract
Background:Burning mouth syndrome (BMS) is a chronic and debilitating oral pain of the normal oral mucosa. It mainly affects women in their fifth to seventh decade. Its aetiopathogenesis remains unclear and is probably of multifactorial origin, with increasing evidence that BMS may be a neuropathic disorder. BMS is classified as an idiopathic (nociplastic) orofacial pain with or without somatosensory changes by International Classification of Orofacial Pain (ICOP 2020). The diagnosis of BMS, having excluded ‘oral burning mouth symptoms’, has evolved from basic intraoral exclusion screening to extensive clinical and laboratory investigations, which include the screening of comorbidities and other chronic pains and somatosensory testing. There is no standardised treatment in managing BMS, but a proposed combination of supportive and pharmacological treatment has been recommended.Aim:To review the current concepts of BMS definitions, classifications, aetiopathogenesis, diagnosis techniques, and evidence-based treatments in managing BMS patients.Conclusion:As BMS is a diagnosis by exclusion, thus a stratified approach is required for assessment of patients presenting BMS. A BMS diagnosis protocol is desired using a standardised screening to distinguish BMS from patient’s presenting with ‘oral burning symptoms’, and evaluation of comorbid chronic pain disorders or other medical comorbidities, which will include haematological, fungal, salivary flow, and qualitative sensory testing. Axis II and other additional quantitative sensory testing may further elucidate the causes of this condition. For future BMS prediction and prevention, will be based upon research on the relationship between other chronic pain disorders and familial history, environmental and genetic information.
Collapse
Affiliation(s)
- Huann Lan Tan
- King’s College London, London, UK
- Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Tara Renton
- Dentistry, Oral & Craniofacial Science, King’s College London, London, UK
| |
Collapse
|
50
|
Currie CC, Ohrbach R, De Leeuw R, Forssell H, Imamura Y, Jääskeläinen SK, Koutris M, Nasri-Heir C, Huann T, Renton T, Svensson P, Durham J. Developing a research diagnostic criteria for burning mouth syndrome: Results from an international Delphi process. J Oral Rehabil 2020; 48:308-331. [PMID: 33155292 DOI: 10.1111/joor.13123] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/30/2020] [Accepted: 10/30/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To develop a beta version of a preliminary set of empirically derived research diagnostic criteria (RDC) for burning mouth syndrome (BMS) through expert consensus, which can then be taken into a test period before publication of a final RDC/BMS. DESIGN A 6 round Delphi process with twelve experts in the field of BMS was used. The first round formed a focus group during which the purpose of the RDC and the definition of BMS was agreed upon, as well as the structure and contents. The remaining rounds were carried out virtually via email to achieve a consensus of the beta version of the RDC/BMS. RESULTS The definition of BMS was agreed to be 'an intraoral burning or dysaesthetic sensation, recurring daily for more than 2 hours per day over more than 3 months, without evident causative lesions on clinical examination and investigation'. The RDC was based upon the already developed and validated RDC/TMD and formed three main parts: patient self-report; examination; and psychosocial self-report. A fourth additional part was also developed listing aspirational biomarkers which could be used as part of the BMS diagnosis where available, or to inform future research. CONCLUSION This Delphi process has created a beta version of an RDC for use with BMS. This will allow future clinical research within BMS to be carried out to a higher standard, ensuring only patients with true BMS are included. Further validation studies will be required alongside refinement of the RDC as trialling progresses.
Collapse
Affiliation(s)
- Charlotte C Currie
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Richard Ohrbach
- School of Dental Medicine, University at Buffalo, Buffalo, NY, USA
| | - Reny De Leeuw
- College of Dentistry, University of Kentucky, Lexington, KY, USA
| | - Heli Forssell
- Institute of Dentistry, University of Turku, Turku, Finland
| | | | | | - Michail Koutris
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Tan Huann
- King's College London Dental Institute, London, UK
| | - Tara Renton
- King's College London Dental Institute, London, UK
| | - Peter Svensson
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Justin Durham
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|