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Del Carmen Villaverde-Rodríguez M, Correa-Rodríguez M, Casas-Barragán A, Tapia-Haro RM, Aguilar-Ferrándiz ME. Orofacial Pain and Risk of Dysphagia in Women With Fibromyalgia: A Cross-Sectional Observational Study. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:883-892. [PMID: 38118459 DOI: 10.1044/2023_ajslp-23-00193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
OBJECTIVE This study aims to analyze the frequency of dysphagia risk and swallowing-associated quality of life (QoL) in a sample of women with fibromyalgia syndrome (FMS) and examine the potential relationship between risk of dysphagia and chronic orofacial pain (COP) in a sample of women with FMS. METHOD A cross-sectional observational study was conducted in 46 women with FMS. COP was assessed by mouth opening, the orofacial visual analog scale (VAS), and the craniofacial pain and disability inventory (CF-PDI). Risk of dysphagia was assessed using the Eating Assessment Tool (EAT-10) and the volume-viscosity swallowing test (V-VST). Swallowing-associated QoL was determined using the Swallowing Quality of Life (SWAL-QOL) questionnaire. RESULTS Thirty patients were identified as being at risk for dysphagia (65.21%) using the EAT-10 and, according to the SWAL-QOL, 41.30% of patients had alterations in QoL associated with swallowing. The EAT-10 correlated positively with orofacial VAS, CF-PDI-total, CF-PDI-pain and disability, and CF-PDI-jaw-functional status. In relation to SWAL-QOL, negative correlations were observed for orofacial VAS, CF-PDI-total, CF-PDI-pain and disability, and CF-PDI-jaw-functional status. Patients at risk of dysphagia (EAT-10 and V-VST) had significantly higher scores in orofacial VAS (p = .002 and p = .015), CF-PDI-total (p = .006 and p = .014), and CF-PDI-pain and disability (p = .004 and p = .013). CONCLUSIONS In this sample of women with FMS, we identified a high rate of dysphagia risk. Also, a high percentage of these women presented alterations in QoL associated with swallowing. Patients at risk for dysphagia had significantly higher orofacial VAS and CF-PDI-total scores, supporting the relationship between dysphagia risk and COP in FMS. Further research to establish the need for appropriate assessment referrals in clinical practice to determine whether dysphagia is present in this population is needed.
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Affiliation(s)
- María Del Carmen Villaverde-Rodríguez
- PhD Biomedicine Program, Faculty of Health Sciences (Granada), University of Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
| | - María Correa-Rodríguez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Nursing, Faculty of Health Sciences (Granada), University of Granada, Spain
| | - Antonio Casas-Barragán
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Physiotherapy, Faculty of Health Sciences (Granada), University of Granada, Spain
| | - Rosa María Tapia-Haro
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Physiotherapy, Faculty of Health Sciences (Granada), University of Granada, Spain
| | - María Encarnación Aguilar-Ferrándiz
- Instituto de Investigación Biosanitaria ibs.GRANADA, Spain
- Department of Physiotherapy, Faculty of Health Sciences (Granada), University of Granada, Spain
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Treister-Goltzman Y, Peleg R, Sagy I, Menashe I. Medication use and factors associated with opiate use among patients with diagnosed fibromyalgia from two ethnic sectors in southern Israel. J Pharm Policy Pract 2023; 16:78. [PMID: 37365657 DOI: 10.1186/s40545-023-00586-5] [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: 04/03/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Our aims were to compare fibromyalgia (FM) rate, drug treatment and factors associated with the use of opiates in two ethnic sectors. METHODS A retrospective cross-sectional study in southern district of Israel was performed on diagnosed FM patients in 2019-2020 [7686 members (1.50%)]. Descriptive analyses were conducted and multivariable models for the use of opiates were developed. RESULTS There were significant differences between the two ethnic groups in FM prevalence at 1.63% and 0.91% in the Jewish and Arab groups, respectively. Only 32% of the patients used recommended medications and about 44% purchased opiates. Age, BMI, psychiatric co-morbidity, and treatment with a recommended drug were similarly associated with an increased risk for opiate use in both ethnic groups. However, male gender was associated with × 2 times reduced risk to use opiates only among the Bedouins (aOR = 0.552, 95%CI = 0.333-0.911). In addition, while in both of ethnic groups the existence of another localized pain syndrome was associated with an increased risk for opiates use, this risk was 4 times higher in the Bedouin group (aOR = 8.500, 95%CI = 2.023-59.293 and aOR = 2.079, 95%CI = 1.556-2.814). CONCLUSIONS The study showed underdiagnosis of FM in the minority Arab ethnicity. Female Arab FM patients in low or high, compared to middle socio-economic status, were a risk group for excess opiate use. Increased use of opiates and very low rate of purchase of recommended drugs point to a lack of effectiveness of these drugs. Future research should assess whether the treatment of treatable factors can reduce the dangerous use of opiates.
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Affiliation(s)
- Yulia Treister-Goltzman
- Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, The Haim Doron Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84105, Beer-Sheva, Israel.
- Clalit Health Services, Southern District, Israel.
| | - Roni Peleg
- Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, The Haim Doron Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84105, Beer-Sheva, Israel
- Clalit Health Services, Southern District, Israel
| | - Iftach Sagy
- Rheumatology Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Idan Menashe
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Thomas DC, Khan J, Manfredini D, Ailani J. Temporomandibular Joint Disorder Comorbidities. Dent Clin North Am 2023; 67:379-392. [PMID: 36965938 DOI: 10.1016/j.cden.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Comorbidity is a distinct additional condition that either existed or exists during the clinical course of a patient afflicted by the condition/entity in question. The clinician attempting to manage temporomandibular joint disorder (TMD) and TMD pain must realize that recognition and management of the comorbidities are essential to the successful management of the same with optimal pain control. When TMD presents with multiple comorbidities, the task for the clinician becomes more complex. It is the hope of the authors that this condensed version of TMD-associated comorbidities acts as a primer for understanding the significance of the same in pain management.
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Affiliation(s)
- Davis C Thomas
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA; Eastman Institute of Oral Health, Rochester, NY, USA.
| | - Junad Khan
- Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, 2400 South Clinton Avenue, Building H, Suite #125, Rochester, NY 14618, USA
| | - Daniele Manfredini
- Department of Biomedical Technologies, School of Dentistry, University of Siena, Viale Bracci - 53100 Siena, Italy
| | - Jessica Ailani
- Georgetown Headache Center, Strategic Planning Neurology, Medstar Georgetown University Hospital 3800 Reservoir Road. NW, Washington, DC 20007, USA
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Accurate Diagnosis and Treatment of Painful Temporomandibular Disorders: A Literature Review Supplemented by Own Clinical Experience. Pain Res Manag 2023; 2023:1002235. [PMID: 36760766 PMCID: PMC9904928 DOI: 10.1155/2023/1002235] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 09/04/2022] [Accepted: 01/21/2023] [Indexed: 02/04/2023]
Abstract
Introduction Temporomandibular disorders (TMD) is a multifactorial group of musculoskeletal disorders often with combined etiologies that demand different treatment plans. While pain is the most common reason why patients decide to seek help, TMD is not always painful. Pain is often described by patients as a headache, prompting patients to seek the help of neurologists, surgeons, and ultimately dentists. Due to the unique characteristics of this anatomical area, appropriate diagnostic tools are needed, as well as therapeutic regimens to alleviate and/or eliminate the pain experienced by patients. Aim of the Study. The aim of this study is to collect and organize information on the diagnosis and treatment of pain in TMD, through a review of the literature supplemented by our own clinical experience. Material and Methods. The study was conducted by searching scientific databases PubMed, Scopus, and Google Scholar for documents published from 2002-2022. The following keywords were used to build the full list of references: TMD, pain, temporomandibular joint (TMJ), TMJ disorders, occlusal splint, relaxing splints, physiotherapy TMD, pharmacology TMD, natural therapy TMD, diagnostic criteria for TMD, and DC/TMD. The literature review included 168 selected manuscripts, the content of which was important for pain diagnosis and clinical treatment of TMD. Results An accurate diagnosis of TMD is the foundation of appropriate treatment. The most commonly described treatments include physiotherapy, occlusal splints therapy, and pharmacological treatment tailored to the type of TMD. Conclusions Based on the literature review and their own experience, the authors concluded that there is no single ideal form of pain therapy for TMD. Treatment of TMD should be based on a thorough diagnostic process, including the DC/TMD examination protocol, psychological evaluation, and cone beam computer tomography (CBCT) imaging. Following the diagnostic process, once a diagnosis is established, a treatment plan can be constructed to address the patient's complaints.
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Mingorance JA, Montoya P, Miranda JGV, Riquelme I. An Observational Study Comparing Fibromyalgia and Chronic Low Back Pain in Somatosensory Sensitivity, Motor Function and Balance. Healthcare (Basel) 2021; 9:1533. [PMID: 34828579 PMCID: PMC8619309 DOI: 10.3390/healthcare9111533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/08/2021] [Accepted: 11/08/2021] [Indexed: 01/07/2023] Open
Abstract
Fibromyalgia (FM) and chronic low back pain (CLBP) have shared pathophysiology and have a considerable impact on patients' daily activities and quality of life. The main objective of this study was to compare pain impact, somatosensory sensitivity, motor functionality, and balance among 60 patients with FM, 60 patients with CLBP, and 60 pain-free controls aged between 30 and 65 years. It is essential to know the possible differences existing in symptomatology of two of the major chronic pain processes that most affect the population, such as FM and CLBP. The fact of establishing possible differences in sensory thresholds, motor function, and proprioceptive measures among patients with FM and CLBP could bring us closer to a greater knowledge of the chronic pain process. Through an observational study, a comparison was made between the three groups (FM, CLBP, and pain-free controls) evaluating functional performance, postural balance, kinematic gait parameters, strength, depression, fatigue, and sensitivity to pain and vibration. Patients with chronic pain showed worse somatosensory sensitivity (p < 0.001) and motor function (p < 0.001) than pain-free controls. Moreover, patients with FM showed greater pain impact (p < 0.001) and bigger somatosensory (p < 0.001) and motor deficiencies (p < 0.001) than patients with CLBP. Further research should explore the possible reasons for the greater deterioration in patients with FM in comparison with other chronic pain conditions. Our results, showing the multiple areas susceptible of deterioration, make it necessary to adopt interdisciplinary interventions focused both on physical and emotional dysfunction.
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Affiliation(s)
- José Antonio Mingorance
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain;
- Physiotherapy Department, Son Espases Hospital, 07120 Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
| | - Pedro Montoya
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain;
- Center for Mathematics, Computing and Cognition, Federal University of ABC, São Bernardo do Campo 09606-070, Brazil
| | - José García Vivas Miranda
- Laboratory of Biosystems, Institute of Physics, Federal University of Bahia, Salvador 40170-115, Brazil;
| | - Inmaculada Riquelme
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, 07122 Palma de Mallorca, Spain;
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
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Scarola R, Montemurro N, Ferrara E, Corsalini M, Converti I, Rapone B. Temporomandibular Disorders and Fibromyalgia: A Narrative Review. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Temporomandibular disorder (TMD) and fibromyalgia (FM) have some clinical characteristics in common, for instance the chronic evolution, the pathophysiology incompletely understood and a multifactorial genesis. The incidence and the relationship between TMD and FM patients are the aims of this review. A MEDLINE and Pubmed search was performed for the key words “temporomandibular disorder” AND “fibromyalgia” from 2000 to present. A total of 19 papers were included in our review, accounting for 5449 patients. Ten studies, reporting a total of 4945 patients with TMD, showed that only 16.5% of these patients had diagnosis of FM, whereas 12 studies, reporting a total of 504 patients with FM, demonstrated that 77.0% of these patients had diagnosis of TMD. A comorbid relationship exists between TMD and FM. The complexity of both diseases shows the importance of a multimodal and interdisciplinary.
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Kim D, Ko SG, Lee EK, Jung B. The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study. BMC Musculoskelet Disord 2019; 20:631. [PMID: 31884949 PMCID: PMC6935481 DOI: 10.1186/s12891-019-3003-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 12/12/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Patients with temporomandibular joint disorder (TMD) often complain of pain in other areas. Several studies have been conducted on spinal pain in TMD patients, but have contained only limited information. Therefore, this study analyzed the relationship between TMD and spinal pain in greater detail by using nationwide data. METHODS A total of 12,375 TMD patients from the Korean National Health Insurance Review and Assessment database were analyzed. Controls were selected using propensity score-matching. The McNemar test, chi-square test, and paired t-test were used to compare the prevalence and severity of spinal pain between cases and matched controls. Logistic regression and linear regression models were used to analyze factors affecting the prevalence and severity of spinal pain in patients with TMD. RESULTS The annual period prevalence of TMD was 1.1%. The prevalence was higher in younger individuals than in individuals of other ages and was higher in women than in men. The medical expenditure for TMD per person was $86. Among TMD patients, 2.5% underwent surgical procedures and 0.3% were hospitalized. The prevalence of spinal pain in patients with TMD was 48%, whereas that in the control group was 34%. Increased severity of TMD was associated with an increased probability of spinal pain. The medical expenditure, mean number of visits, and lengths of treatment for spinal pain were greater for patients with TMD than for controls ($136 vs. $81, 4.8 days vs. 2.7 days, 5.5 days vs. 3.3 days). Higher TMD grade was associated with greater differences in average medical expenditure, number of visits, and lengths of treatment for spinal pain between cases and controls. Additionally, for women, living in a rural area and having an older age and more severe TMD were associated with a greater probability of spinal pain and higher medical expenditure related to spinal pain. CONCLUSION A strong association was observed between the presence of TMD and the presence of spinal pain. The association became stronger as the severity of TMD increased, indicating a positive correlation between the severity of TMD and spinal pain.
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Affiliation(s)
- Doori Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea
| | - Seong-Gyu Ko
- Department of Preventive Medicine, College of Korean Medicine, Graduate School, Khyung Hee University, Hoegi-dong, Dongdaemun-gu, Seoul, 02453, Republic of Korea
| | - Eun-Kyoung Lee
- Department of Preventive Medicine, College of Korean Medicine, Graduate School, Khyung Hee University, Hoegi-dong, Dongdaemun-gu, Seoul, 02453, Republic of Korea. .,Research Department, Research Institute of Korean Medicine Policy, 91, Heojun-ro, Gangseo-gu, Seoul, 07525, Republic of Korea.
| | - Boyoung Jung
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 3F, 538 Gangnam-daero, Gangnam-gu, Seoul, 06110, Republic of Korea.
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Barjandi G, Louca Jounger S, Löfgren M, Bileviciute‐Ljungar I, Kosek E, Ernberg M. Plasma tryptophan and kynurenine in females with temporomandibular disorders and fibromyalgia—An exploratory pilot study. J Oral Rehabil 2019; 47:150-157. [DOI: 10.1111/joor.12892] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 08/30/2019] [Accepted: 09/11/2019] [Indexed: 01/11/2023]
Affiliation(s)
- Golnaz Barjandi
- Department of Dental Medicine Karolinska Institutet & Scandinavian Center for Oral Neurosciences Huddinge Sweden
| | - Sofia Louca Jounger
- Department of Dental Medicine Karolinska Institutet & Scandinavian Center for Oral Neurosciences Huddinge Sweden
| | - Monika Löfgren
- Department of Clinical Sciences Karolinska Institutet Stockholm Sweden
- Department of Rehabilitation Medicine Danderyd Hospital Stockholm Sweden
| | - Indre Bileviciute‐Ljungar
- Department of Clinical Sciences Karolinska Institutet Stockholm Sweden
- Department of Rehabilitation Medicine Danderyd Hospital Stockholm Sweden
| | - Eva Kosek
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
- Department of Neuroradiology Karolinska University Hospital Stockholm Sweden
| | - Malin Ernberg
- Department of Dental Medicine Karolinska Institutet & Scandinavian Center for Oral Neurosciences Huddinge Sweden
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9
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Ayouni I, Chebbi R, Hela Z, Dhidah M. Comorbidity between fibromyalgia and temporomandibular disorders: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:33-42. [DOI: 10.1016/j.oooo.2019.02.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 02/05/2019] [Accepted: 02/23/2019] [Indexed: 01/08/2023]
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Santiago V, Raphael KG. Perceived helpfulness of treatments for myofascial TMD as a function of comorbid widespread pain. Clin Oral Investig 2019; 23:2929-2939. [PMID: 30623307 PMCID: PMC6785751 DOI: 10.1007/s00784-018-02797-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 12/20/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study examined whether patients with myofascial temporomandibular disorder (mTMD) comorbid with fibromyalgia (FM) receive different treatments or respond differently to these treatments than mTMD-only patients. MATERIALS AND METHODS A total of 125 mTMD+ women were enrolled (26 FM+ and 98 FM-). mTMD and FM were assessed via clinical research examinations. Treatment histories and self-reported treatment-related improvement were obtained via interview. RESULTS The top 3 most common treatments reported were oral appliances (59%), physical therapy (54%), and jaw exercises at home (34%). Use of alternative medicine was reported more frequently among FM+ women, but self-reported improvement did not differ by comorbid FM. Physical therapy was as likely reported by FM status but self-reported improvement scores trended higher for FM+ women. CONCLUSIONS Oral appliances were as likely to be reported by FM comorbid as FM- women. Oral appliances did not outperform self-management treatments on self-reported improvement of facial pain. CLINICAL RELEVANCE Results support the use of self-management as first-line treatment for mTMD and potential utility of inquiring about widespread pain for treatment planning.
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Affiliation(s)
- Vivian Santiago
- Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, 380 2nd Avenue, Suite 301, New York, NY, 10010, USA.
| | - Karen G Raphael
- Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, 380 2nd Avenue, Suite 301, New York, NY, 10010, USA
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Harfeldt K, Alexander L, Lam J, Månsson S, Westergren H, Svensson P, Sundgren PC, Alstergren P. Spectroscopic differences in posterior insula in patients with chronic temporomandibular pain. Scand J Pain 2019; 18:351-361. [PMID: 29794260 DOI: 10.1515/sjpain-2017-0159] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 03/06/2018] [Indexed: 11/15/2022]
Abstract
Background and aims Chronic pain including temporomandibular disorder (TMD) pain involves a complex interplay between peripheral and central sensitization, endogenous modulatory pathways, cortical processing and integration and numerous psychological, behavioral and social factors. The aim of this study was to compare spectroscopic patterns of N-Acetyl-aspartate (NAA), total creatine (tCr), choline (Cho), myo-inositol (MI), glutamate (Glu), and the combination of Glu and glutamine in the posterior insula in patients with chronic generalized or regional chronic TMD pain (gTMD and rTMD, respectively) compared to healthy individuals (HI) in relation to clinical findings of TMD pain. Methods Thirty-six female patients with chronic rTMD or gTMD with at least 3 months duration were included in the study. Ten healthy women were included as controls. All participants completed a questionnaire that comprised assessment of degrees of depression, anxiety, stress, catastrophizing, pain intensity, disability and locations. A clinical Diagnostic Criteria for Temporomandibular Disorders examination that comprised assessment of pain locations, headache, mouth opening capacity, pain on mandibular movement, pain on palpation and temporomandibular joint noises was performed. Pressure-pain threshold (PPT) over the masseter muscle and temporal summation to pressure stimuli were assessed with an algometer. Within a week all participants underwent non-contrast enhanced MRI on a 3T MR scanner assessing T1-w and T2-w fluid attenuation inversion recovery. A single-voxel 1H-MRS examination using point-resolved spectroscopy was performed. The metabolite concentrations of NAA, tCr, Cho, MI, Glu and Glx were analyzed with the LC model. Metabolite levels were calculated as absolute concentrations, normalized to the water signal. Metabolite concentrations were used for statistical analysis from the LC model if the Cramér-Rao bounds were less than 20%. In addition, the ratios NAA/tCr, Cho/tCr, Glu/tCr and MI/tCr were calculated. Results The results showed significantly higher tCr levels within the posterior insula in patients with rTMD or gTMD pain than in HI (p=0.029). Cho was negatively correlated to maximum mouth opening capacity with or without pain (rs=-0.42, n=28, p=0.031 and rs=-0.48, n=28, p=0.034, respectively) as well as pressure-pain threshold on the hand (rs=-0.41, n=28, p=0.031). Glu was positively correlated to temporal summation to painful mechanical stimuli (rs=0.42, n=26, p=0.034). Conclusions The present study found that increased concentrations of Cho and Glu in the posterior insular cortex is related to clinical characteristics of chronic TMD pain, including generalized pain. These findings provide new evidence about the critical involvement of the posterior insular cortex and the neurobiology underlying TMD pain in both regional and generalized manifestations. Implications The findings in this study have indirect implications for the diagnosis and management of TMD patients. That said, the findings provide new evidence about the critical involvement of the posterior insular cortex and the neurobiology underlying TMD pain in both regional and generalized manifestations. It is also a further step towards understanding and accepting chronic pain as a disorder in itself.
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Affiliation(s)
- Kristin Harfeldt
- Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Sweden
| | - Louise Alexander
- Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Sweden
| | - Julia Lam
- Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Sweden
| | - Sven Månsson
- Medical Radiation Physics, Department of Translational Medicine, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Hans Westergren
- Department of Pain Rehabilitation, Skåne University Hospital, Lund, Sweden.,Department of Health Sciences, Lund University, Lund, Sweden
| | - Peter Svensson
- Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark.,Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Pia C Sundgren
- Center for Imaging and function, Skåne University Hospital, Lund, Sweden.,Department of Diagnostic Radiology, Institution for Clinical Sciences, Lund University, Lund, Sweden
| | - Per Alstergren
- Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Sweden.,Department of Pain Rehabilitation, Skåne University Hospital, Lund, Sweden.,Department of Health Sciences, Lund University, Lund, Sweden.,Orofacial Pain Unit, Faculty of Odontology, Malmö University, Malmö, Sweden
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Nazeri M, Zarei MR, Pourzare AR, Ghahreh-Chahi HR, Abareghi F, Shabani M. Evidence of Altered Trigeminal Nociception in an Animal Model of Fibromyalgia. PAIN MEDICINE 2019; 19:328-335. [PMID: 28505350 DOI: 10.1093/pm/pnx114] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective Fibromyalgia (FM) is a debilitating chronic condition that significantly affects quality of life. A strong association has been demonstrated between FM and chronic pain in the trigeminal region in clinical studies. This study was performed to evaluate the response to acute and chronic noxious stimuli applied to the facial region. Methods Adult male Wistar rats (250-270 g, N = 10 for each group) were used in the current study. A subchronic swim stress model was used as the animal model of FM. Anxiety-like behaviors and response to acute and chronic noxious stimuli were assayed using the elevated plus maze, eye wiping test, and orofacial formalin test, respectively. Balance and motor function were evaluated using rotarod and wire grip tests. Results An increased anxiety-like behavior was observed in swim stress rats in comparison with control and sham subjects. Response to acute and chronic noxious stimuli in the trigeminal region was increased in the stressed rats. Motor and balance function were not altered following stress. Conclusions Results of the current study demonstrated a hyperalgesic state in the trigeminal region in a possible animal model of FM. This study provides a reliable animal model for further research on the possible mechanisms of orofacial pain in FM.
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Affiliation(s)
| | | | | | | | | | - Mohammad Shabani
- Neurophysiology and Patch Clamp Laboratory, Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
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de Souza RCV, de Sousa ET, Scudine KGO, Meira UM, de Oliveira E Silva EM, Gomes ACA, Limeira-Junior FA. Low-level laser therapy and anesthetic infiltration for orofacial pain in patients with fibromyalgia: a randomized clinical trial. Med Oral Patol Oral Cir Bucal 2018; 23:e65-e71. [PMID: 29274162 PMCID: PMC5822542 DOI: 10.4317/medoral.21965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 10/27/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To compare the analgesic effect of anesthetic infiltration of lidocaine 2% and low-level laser therapy (LLLT) by GaAlAs into tender points of patients with orofacial pain and fibromyalgia (FM). MATERIAL AND METHODS A randomized clinical trial was performed with adults (N=66) that were allocated into two groups (1:1): Group A received LLLT irradiation by Diode Laser GaAlAs (780nm) with expositions twice a week during six weeks and Group B was treated with anesthetic infiltration of lidocaine 2% without vasoconstrictor once a week for four weeks. The pain assessment included the Visual Analogic Scale (VAS) and tenderness to palpation. RESULTS No dropout and adverse effect was observed during the study. The pain decreased significantly in each group after the treatment (p=0.0001, β=1.0), even though no statistical difference was found between both treatments (p=0.46, β= 0.82). The presence of tender points decreased after both treatments, with responsively in some types of masticatory muscles (p<0.05) except posterior temporalis muscle. The patients perception showed that both treatments were effective and a few patients reported that the treatment did not improve welfare. CONCLUSIONS The LLLT by GaAlAs and anesthetic infiltration of lidocaine 2% were equally effective to control orofacial pain in FM individuals.
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Affiliation(s)
- R-C-V de Souza
- 901 Limeira Avenue, Areiao- Piracicaba-SP/Brazil, 13414-903,
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14
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Lee H, Im J, Won H, Kim JY, Kim HK, Kwon JT, Kim YO, Lee S, Cho IH, Lee SW, Kim HJ. Antinociceptive effect of Valeriana fauriei regulates BDNF signaling in an animal model of fibromyalgia. Int J Mol Med 2017; 41:485-492. [PMID: 29115388 DOI: 10.3892/ijmm.2017.3203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 09/22/2017] [Indexed: 11/06/2022] Open
Abstract
The genus Valeriana has been widely used in popular medicine for centuries, to treat sleep disorders, anxiety, epilepsy and insomnia. Recent studies have focused on the novel pharmacological effects of Valeriana fauriei Briq. (VF) species. Previous studies have attempted to determine the pharmacological functions of Valeriana in various human diseases, particularly with regards to its neuroprotective effects, and its ability to reduce pain and stress. The present study constructed an animal model of fibromyalgia (FM), which was induced by intermittent cold stress with slight modification. Subsequently, the study aimed to determine whether VF exerts antinociceptive effects on the FM‑like model following oral administration of VF extracts. The effects of VF extracts on the FM model were investigated by analyzing behavioral activity, including pain, and detecting protein expression. In the behavioral analysis, the results of a nociception assay indicated that the pain threshold was significantly decreased in the FM group. Subsequently, western blotting and immunohistochemical analyses of the hippocampus demonstrated that the protein expression levels of brain‑derived neurotrophic factor (BDNF) and phosphorylated‑cAMP response element‑binding protein were downregulated in the FM group. Conversely, VF restored these levels. These results suggested that the effects of VF extract on a model of FM may be associated with its modulatory effects on the BDNF signaling pathway in the hippocampus and medial prefrontal cortex. In conclusion, the mechanism underlying the protective effects of VF as a therapeutic agent against FM may involve the BDNF signaling pathway.
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Affiliation(s)
- Hwayoung Lee
- Department of Clinical Pharmacology, College of Medicine, Soonchunhyang University, Cheonan, Chungnam 31151, Republic of Korea
| | - Jiyun Im
- Department of Clinical Pharmacology, College of Medicine, Soonchunhyang University, Cheonan, Chungnam 31151, Republic of Korea
| | - Hansol Won
- Department of Clinical Pharmacology, College of Medicine, Soonchunhyang University, Cheonan, Chungnam 31151, Republic of Korea
| | - Jun Young Kim
- Department of Clinical Pharmacology, College of Medicine, Soonchunhyang University, Cheonan, Chungnam 31151, Republic of Korea
| | - Hyung-Ki Kim
- Department of Clinical Pharmacology, College of Medicine, Soonchunhyang University, Cheonan, Chungnam 31151, Republic of Korea
| | - Jun-Tack Kwon
- Department of Clinical Pharmacology, College of Medicine, Soonchunhyang University, Cheonan, Chungnam 31151, Republic of Korea
| | - Young Ock Kim
- Development of Ginseng and Medical Plants Research Institute, Rural Administration, Eumseong, Chungbuk 27709, Republic of Korea
| | - Sanghyun Lee
- Department of Integrative Plant Science, Chung‑Ang University, Anseong, Gyeonggi 17546, Republic of Korea
| | - Ik-Hyun Cho
- Department of Convergence Medical Science, Brain Korea 21 Plus Program, and Institute of Korean Medicine, College of Oriental Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Sang Won Lee
- Development of Ginseng and Medical Plants Research Institute, Rural Administration, Eumseong, Chungbuk 27709, Republic of Korea
| | - Hak-Jae Kim
- Department of Clinical Pharmacology, College of Medicine, Soonchunhyang University, Cheonan, Chungnam 31151, Republic of Korea
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Stocka A, Sierpinska T, Kuc J, Golebiewska M. Relationship between depression and masticatory muscles function in a group of adolescents. Cranio 2017; 36:390-395. [PMID: 28823222 DOI: 10.1080/08869634.2017.1364030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of the study is to determine association between depressive symptoms and the electrical activity of muscles in maximum voluntary clench in a group of young adults. METHODS A total of 186 volunteers (Females = 98, Males = 88), with a mean age of 19 years, were recruited to the study. All participants took a questionnaire survey stating the level of depression (Beck's scale), clinical examination, and instrumental diagnostics (EMG). RESULTS Symptoms of mild or medium depression were found in 35 of the subjects (18.82%). Average electric potentials of the masticatory muscles in maximal voluntary clench were significantly higher among the subjects with depression symptoms in comparison with subjects without those symptoms (85.96 ± 10.25 vs 78.97 ± 15.32, p < . 0.05). DISCUSSION An increase in the electrical potentials of masseter muscles in maximal voluntary clench was found in the group with depression symptoms. The study should be continued to confirm this finding.
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Affiliation(s)
- Anna Stocka
- a Department of Prosthetic Dentistry , Medical University of Bialystok , Bialystok , Poland
| | - Teresa Sierpinska
- a Department of Prosthetic Dentistry , Medical University of Bialystok , Bialystok , Poland.,b Department of Dental Techniques , Medical University of Bialystok , Bialystok , Poland
| | - Joanna Kuc
- a Department of Prosthetic Dentistry , Medical University of Bialystok , Bialystok , Poland
| | - Maria Golebiewska
- a Department of Prosthetic Dentistry , Medical University of Bialystok , Bialystok , Poland
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16
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Temporomandibular disorders and painful comorbidities: clinical association and underlying mechanisms. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:288-297. [DOI: 10.1016/j.oooo.2016.12.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 11/07/2016] [Accepted: 12/13/2016] [Indexed: 12/31/2022]
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17
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Corsalini M, Daniela DV, Biagio R, Gianluca S, Alessandra L, Francesco P. Evidence of Signs and Symptoms of Craniomandibular Disorders in Fibromyalgia Patients. Open Dent J 2017; 11:91-98. [PMID: 28357002 PMCID: PMC5345327 DOI: 10.2174/1874210601711010091] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 01/02/2017] [Accepted: 01/16/2017] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE The purpose of this study is to highlight the evidence of signs and symptoms of craniomandibular disorders (CMD) in patients suffering from fibromyalgia. MATERIALS AND METHOD The study has been carried out from May 2011 to May 2015, recruiting a sample of fibromyalgia patients at the Department of Neurophysiopathology at the hospital Policlinico in Bari. Among the 150 examined patients, 60 of them have been diagnosed to suffer from fibromyalgia and 27 accepted to be investigated with a gnathologic examination at the Dental School at the University of Bari. RESULTS 24 patients (88.9%) were women and 3 (11.1%) men; from 26 to 66 years old (average age, 39). 14 patients (51.9%) were affected by primary fibromyalgia, the remaining 13 (48.1%) by secondary fibromyalgia, mainly associated with hypothyroidism (29.6%). VAS average score was about 8 ± 1.85. The frequency of pain was daily in 15 patients (55.6%); twice a week in 10 patients (37.03%) and a few times a month in 2 patients (7.4%). 11 patients (40.7%) attributed the onset of fibromyalgia to a specific instigating event. In addition, from the gnathologic anamnesis, 11 patients (40,7%) reported a painful symptom in the head-neck region, especially in the frontal region, in the neck, in the masseter muscle and ATM. VAS average score was 3.4 ± 2.8, significantly lower than the one referring to the fibromyalgia pain. The gnathological examination found CMD signs and symptoms in 18 patients (66.7%). Concerning the prevalence of CMD, in type I fibromyalgia, myofascial pain was more frequent (5 patients), whereas in type II fibromyalgia, what was more frequent was a dislocation with reduction (3 patients). CONCLUSION Based on clinic experience, we can affirm that some patients with CMD report pain in other regions. It is difficult to distinguish the CMD forms directly correlated to fibromyalgia from those engendered by parafunctional activities; hence the need is to resolve the fibromyalgia syndrome adopting a multidisciplinary approach.
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Affiliation(s)
- Massimo Corsalini
- Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy
| | - Di Venere Daniela
- Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy
| | - Rapone Biagio
- Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy
| | | | | | - Pettini Francesco
- Dental School - University of Bari, Piazza Giulio Cesare, Bari, Italy
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18
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Moreno-Fernández AM, Jiménez-Castellanos E, Iglesias-Linares A, Bueso-Madrid D, Fernández-Rodríguez A, de Miguel M. Fibromyalgia syndrome and temporomandibular disorders with muscular pain. A review. Mod Rheumatol 2017; 27:210-216. [DOI: 10.1080/14397595.2016.1221788] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Ana Maria Moreno-Fernández
- Departamento de Citología e Histología Normal y Patológica, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain,
| | | | - Alejandro Iglesias-Linares
- Departamento de Estomatología IV, Facultad de Odontología, Universidad Complutense de Madrid, Madrid, Spain
| | - Débora Bueso-Madrid
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, Sevilla, Spain, and
| | - Ana Fernández-Rodríguez
- Departamento de Citología e Histología Normal y Patológica, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain,
| | - Manuel de Miguel
- Departamento de Citología e Histología Normal y Patológica, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain,
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19
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Okifuji A, Gao J, Bokat C, Hare BD. Management of fibromyalgia syndrome in 2016. Pain Manag 2016; 6:383-400. [PMID: 27306300 PMCID: PMC5066139 DOI: 10.2217/pmt-2016-0006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 06/02/2016] [Indexed: 12/18/2022] Open
Abstract
Fibromyalgia syndrome is a chronic pain disorder and defies definitively efficacious therapy. In this review, we summarize the results from the early treatment research as well as recent research evaluating the pharmacological, interventional and nonpharmacological therapies. We further discuss future directions of fibromyalgia syndrome management; we specifically focus on the issues that are associated with currently available treatments, such as the need for personalized approach, new technologically oriented and interventional treatments, the importance of understanding and harnessing placebo effects and enhancement of patient engagement in therapy.
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Affiliation(s)
- Akiko Okifuji
- Department of Anaesthesiology, Pain Management & Research Center, University of Utah, 615 Arapeen Drive, Suite 200, Salt Lake City, UT 84108, USA
| | - Jeff Gao
- Department of Anaesthesiology, Pain Management & Research Center, University of Utah, 615 Arapeen Drive, Suite 200, Salt Lake City, UT 84108, USA
| | - Christina Bokat
- Department of Anaesthesiology, Pain Management & Research Center, University of Utah, 615 Arapeen Drive, Suite 200, Salt Lake City, UT 84108, USA
| | - Bradford D Hare
- Department of Anaesthesiology, Pain Management & Research Center, University of Utah, 615 Arapeen Drive, Suite 200, Salt Lake City, UT 84108, USA
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20
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Fujarra FJC, Kaziyama HHS, Siqueira SRDTD, Yeng LT, Camparis CM, Teixeira MJ, Siqueira JTTD. Temporomandibular disorders in fibromyalgia patients: are there different pain onset? ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:195-200. [DOI: 10.1590/0004-282x20160017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 11/10/2015] [Indexed: 04/10/2023]
Abstract
ABSTRACT Objective To identify temporomandibular disorders (TMD) symptoms in two groups of fibromyalgia patients according to the temporal relation between the onset of facial pain (FP) and generalized body pain (GBP). Cross-sectional study design: Fifty-three consecutive women with fibromyalgia and FP were stratified according to the onset of orofacial pain: Group-A (mean age 47.30 ± 14.20 years old), onset of FP preceded GBP; Group-B (mean age 51.33 ± 11.03 years old), the FP started concomitant or after GBP. Clinical assessment Research Diagnostic Criteria for Temporomandibular Disorders and the Visual Analogue Scale. Results Myofascial pain with mouth opening limitation (p = 0.038); right disc displacement with reduction (p = 0.012) and jaw stiffness (p = 0.004) were predominant in Group A. Myofascial pain without mouth opening limitation (p = 0.038) and numbness/burning were more common in Group B. Conclusion All patients had temporomandibular joint symptoms, mainly muscle disorders. The prevalence of myofascial pain with limited mouth opening and right TMJ disc displacement with reduction were higher in Group A.
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Affiliation(s)
| | | | | | | | - Cinara M. Camparis
- Universidade Estadual de São Paulo Paulo Júlio De Mesquita Filho, Brazil
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21
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Glaros AG, Marszalek JM, Williams KB. Longitudinal Multilevel Modeling of Facial Pain, Muscle Tension, and Stress. J Dent Res 2016; 95:416-22. [PMID: 26758381 DOI: 10.1177/0022034515625216] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The role of masticatory muscle activation on pain in temporomandibular muscle and joint disorders (TMJD) is controversial. This single-group, prospective panel study examined the relationships among masticatory muscle tension, emotional distress, and TMJD pain in a sample of 7,023 observations obtained from 171 individuals using longitudinal multilevel modeling. Three main hypotheses were tested. The first posited that emotional distress and muscle tension directly influenced pain (hypothesis 1a: Distress → TMJD Pain; hypothesis 1b: Muscle Tension → TMJD Pain). The second posited that emotional distress directly influenced muscle tension (Distress → Muscle Tension), and the third posited that the effect of emotional distress on pain was mediated by muscle tension (Distress → Muscle Tension → TMJD pain). We also examined the fit of the data to possible alternative models. All the data used in this study were collected via an experience sampling methodology. The fit of the preferred models was better than that of the alternative models, with the preferred models explaining large proportions of the data, especially for level 2 variance (hypothesis 1a = 41% variance; hypothesis 1b = 69% variance; hypothesis 2 = 48% variance). In the mediation model, the addition of muscle tension to the model reduced the impact of emotional distress. The findings support a causal role for masticatory muscle tension in TMJD pain. Clinically, the results suggest that addressing tension and other oral parafunctions in those diagnosed with TMJDs should be an important part of the conservative, noninvasive care of individuals diagnosed with the myofascial pain or arthralgia of TMJD.
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Affiliation(s)
- A G Glaros
- Department of Dental Public Health and Behavioral Science, University of Missouri-Kansas City, School of Dentistry, Kansas City, MO, USA
| | - J M Marszalek
- Department of Counseling and Educational Psychology, University of Missouri-Kansas City, School of Education, Kansas City, MO, USA
| | - K B Williams
- Department of Biomedical & Health Informatics, University of Missouri-Kansas City, School of Medicine, Kansas City, MO, USA
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22
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Robinson LJ, Durham J, Newton JL. A systematic review of the comorbidity between Temporomandibular Disorders and Chronic Fatigue Syndrome. J Oral Rehabil 2015; 43:306-16. [PMID: 26549386 DOI: 10.1111/joor.12367] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2015] [Indexed: 11/29/2022]
Abstract
UNLABELLED The most common cause of chronic oro-facial pain is a group of disorders collectively termed temporomandibular disorders (TMDs). Chronic painful TMD is thought to be a 'central sensitivity syndrome' related to hypersensitivity of the nervous system, but the cause is unknown. A similar understanding is proposed for other unexplained conditions, including chronic fatigue syndrome (CFS). Exploring the comorbidity of the two conditions is a valuable first step in identifying potential common aetiological mechanisms or treatment targets. METHOD Systematic literature review. Studies were included if they recruited community or control samples and identified how many reported having both TMD and CFS, or if they recruited a sample of patients with either TMD or CFS and measured the presence of the other condition. RESULTS Six papers met inclusion criteria. In studies of patients with CFS (n = 3), 21-32% reported having TMD. In a sample of people with CFS and fibromyalgia, 50% reported having TMD. Studies in people with TMD (n = 3) reported 0-43% having CFS. Studies in samples recruited from oro-facial pain clinics (n = 2) reported a lower comorbidity with CFS (0-10%) than a study that recruited individuals from a TMD self-help organisation (43%). CONCLUSION The review highlights the limited standard of evidence addressing the comorbidity between oro-facial pain and CFS. There is a valuable signal that the potential overlap in these two conditions could be high; however, studies employing more rigorous methodology including standardised clinical assessments rather than self-report of prior diagnosis are needed.
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Affiliation(s)
- L J Robinson
- Academic Psychiatry, Newcastle University, Newcastle upon Tyne, UK.,Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - J Durham
- Centre for Oral Health Research and Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - J L Newton
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
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Arendt-Nielsen L, Skou ST, Nielsen TA, Petersen KK. Altered Central Sensitization and Pain Modulation in the CNS in Chronic Joint Pain. Curr Osteoporos Rep 2015; 13:225-34. [PMID: 26026770 DOI: 10.1007/s11914-015-0276-x] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Musculoskeletal pain disorders are the second largest contributor to global disability underlining the significance of effective treatments. However, treating chronic musculoskeletal pain, and chronic joint pain (osteoarthritis (OA)) in particular, is challenging as the underlying peripheral and central pain mechanisms are not fully understood, and safe and efficient analgesic drugs are not available. The pain associated with joint pain is highly individual, and features from radiological imaging have not demonstrated robust associations with the pain manifestations. In recent years, a variety of human quantitative pain assessment tools (quantitative sensory testing (QST)) have been developed providing new opportunities for profiling patients and reaching a greater understanding of the mechanisms involved in chronic joint pain. As joint pain is a complex interaction between many different pain mechanisms, available tools are important for patent profiling and providing the basic knowledge for development of new drugs and for developing pain management regimes.
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Affiliation(s)
- Lars Arendt-Nielsen
- Center for Sensory-Motor Interaction (SMI), Faculty of Medicine, Aalborg University, Fredrik Bajers Vej 7D3, 9220, Aalborg E, Denmark,
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The influence of emotional state on the masticatory muscles function in the group of young healthy adults. BIOMED RESEARCH INTERNATIONAL 2015; 2015:174013. [PMID: 25883942 PMCID: PMC4391487 DOI: 10.1155/2015/174013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/20/2014] [Accepted: 11/04/2014] [Indexed: 12/05/2022]
Abstract
Stress may affect the function of all the components of the masticatory system and may ultimately lead to differentiated symptoms and finally to systemic and structural dysfunctions. Objective. To determine the effect of stress on the masticatory muscles function in young healthy adults. Material and Methods. A total of 201 young, Angle's first class, healthy volunteers, 103 female and 98 male, in the age between 18 and 21 years were recruited into the study. All the participants underwent clinical examination according to the Slavicek scheme, questionnaire survey according to Perceived Stress Scale, and assessment of masticatory muscles function in central occlusion. Results. Symptoms of masticatory system dysfunction were found in the group of 86 subjects (46,24%). All the muscles activity in central occlusion was comparable in female and male groups. Mean values of masseters activities in the group of low stress subjects (75,52 µV ± 15,97) were statistically different from the groups with medium (82,43 µV ± 15,04) and high (81,33 ± 12,05) perceived stress (P < 0.05). Conclusion. Chronic stress may reveal or exacerbate symptoms of masticatory dysfunction.
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25
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Alpaslan C. Orofacial pain and fibromyalgia pain: Being aware of comorbid conditions. World J Rheumatol 2015; 5:45-49. [DOI: 10.5499/wjr.v5.i1.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/17/2014] [Accepted: 12/01/2014] [Indexed: 02/06/2023] Open
Abstract
Orofacial pain originating from myofascial pain of temporomandibular disorders is the second most common source of pain, after tooth pain. However, diagnosis of myofascial pain is challenging due to its characteristic referral pattern. Furthermore, pain arising from structures in the orofacial region may be a presentation of fibromyalgia and treatment directed at temporomandibular disorders fails to alleviate the pain. Similarly, patients with fibromyalgia may present with pain in the orofacial region. The physician in this case should be aware of temporomandibular disorders, its characteristic findings and treatment approaches that might be included in the treatment plan.
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Gui MS, Pimentel MJ, Rizzatti-Barbosa CM. Temporomandibular disorders in fibromyalgia syndrome: a short-communication. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.rbre.2014.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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27
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Gui MS, Pimentel MJ, Rizzatti-Barbosa CM. Disfunção temporomandibular na síndrome da fibromialgia: comunicação breve. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 55:189-94. [DOI: 10.1016/j.rbr.2014.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 06/26/2014] [Accepted: 07/18/2014] [Indexed: 11/28/2022] Open
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Di Venere D, Corsalini M, Stefanachi G, Tafuri S, De Tommaso M, Cervinara F, Re A, Pettini F. Quality of life in fibromyalgia patients with craniomandibular disorders. Open Dent J 2015; 9:9-14. [PMID: 25674166 PMCID: PMC4319208 DOI: 10.2174/1874210601509010009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 12/11/2014] [Accepted: 12/15/2014] [Indexed: 12/30/2022] Open
Abstract
Fibromyalgia (FM) is a rheumatic disease which affects fibrous tissues and muscles; it is characterized by chronic pain and it is often associated with craniomandibular disorders (CMD). 31 patients were assessed from March 2012 to October 2012 through the administration of specific questionnaires and following neurologic and gnatologic assessment. A relevant corre-lation between FM and CMD emerges from the present study, as 80.6% of our patients report CMD symptoms with high prevalence of myofascial pain (84%). Multivariate regression analysis revealed that the patients in the present study did not differ in score of quality of life questionnaires from patients with fibromyalgia. The neuropathic pain diagnostic question-naire (DN4) scores were positively affected by belonging to group II of Research Diagnostic Criteria of Temporomandibular Disorders (RDC/ TDM) classification, suggesting the possibility of a neuropathic component in chronic pain in this CMD group, as already speculated in our study on the correlation between burning mouth syndrome and CMD and by other au-thors in studies on chronic low back pain. However, further clinic and instrumental studies are needed in order to test this as-sumption.
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Affiliation(s)
- D Di Venere
- Dental School, University of Bari, Bari, Italy
| | - M Corsalini
- Dental School, University of Bari, Bari, Italy
| | | | - S Tafuri
- Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - M De Tommaso
- Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - F Cervinara
- Dental School, University of Bari, Bari, Italy
| | - A Re
- Dental School, University of Bari, Bari, Italy
| | - F Pettini
- Dental School, University of Bari, Bari, Italy
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Abstract
It is evident that chronic pain can modify the excitability of central nervous system which imposes a specific challenge for the management and for the development of new analgesics. The central manifestations can be difficult to quantify using standard clinical examination procedures, but quantitative sensory testing (QST) may help to quantify the degree and extend of the central reorganization and effect of pharmacological interventions. Furthermore, QST may help in optimizing the development programs for new drugs.Specific translational mechanistic QST tools have been developed to quantify different aspects of central sensitization in pain patients such as threshold ratios, provoked hyperalgesia/allodynia, temporal summation (wind-up like pain), after sensation, spatial summation, reflex receptive fields, descending pain modulation, offset analgesia, and referred pain areas. As most of the drug development programs in the area of pain management have not been very successful, the pharmaceutical industry has started to utilize the complementary knowledge obtained from QST profiling. Linking patients QST profile with drug efficacy profile may provide the fundamentals for developing individualized, targeted pain management programs in the future. Linking QST-assessed pain mechanisms with treatment outcome provides new valuable information in drug development and for optimizing the management regimes for chronic pain.
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Affiliation(s)
- Lars Arendt-Nielsen
- Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, School of Medicine, Aalborg University, Fredrik Bajers Vej 7-D3, 9220, Aalborg, Denmark,
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30
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Systematic review of the Multidimensional Fatigue Symptom Inventory-Short Form. Support Care Cancer 2014; 23:191-212. [DOI: 10.1007/s00520-014-2389-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 08/05/2014] [Indexed: 12/18/2022]
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31
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Pimentel MJ, Gui MS, Reimão R, Rizzatti-Barbosa CM. Sleep quality and facial pain in fibromyalgia syndrome. Cranio 2014; 33:122-8. [DOI: 10.1179/2151090314y.0000000014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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32
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Pimentel MJ, Gui MS, de Aquino LMM, Rizzatti-Barbosa CM. Features of Temporomandibular Disorders in Fibromyalgia Syndrome. Cranio 2014; 31:40-5. [DOI: 10.1179/crn.2013.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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33
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Abstract
SUMMARY Chronic widespread pain (CWP) represents pain involving several regions of the body. Various psychological and social risk factors such as poor general health status, sleep disturbance, fatigue and high psychological distress have been identified for the development of CWP. Numerous chronic pain conditions are comorbid, resulting in the development of CWP in many of these patients. Temporomandibular disorder is one of the most extensively studied chronic musculoskeletal pain condition in terms of its comorbidity with CWP and fibromyalgia. It has been proposed that these comorbid pain disorders share common denominators, including exposure to certain environmental events, elevated psychological distress, pain amplification and genetic predisposition. Increased awareness of CWP is important for improved diagnoses and more effective pain management. Patients with CWP can be effectively managed in multidisciplinary pain clinics.
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Affiliation(s)
- Pei Feng Lim
- Center for Neurosensory Disorders, University of North Carolina at Chapel Hill, 2054 Old Dental Building, CB 7455, Chapel Hill, NC 27599, USA
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34
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Shephard MK, Macgregor EA, Zakrzewska JM. Orofacial pain: a guide for the headache physician. Headache 2013; 54:22-39. [PMID: 24261452 DOI: 10.1111/head.12272] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2013] [Indexed: 12/19/2022]
Abstract
Orofacial pain represents a significant burden in terms of morbidity and health service utilization. It includes very common disorders such as toothache and temporomandibular disorders, as well as rare orofacial pain syndromes. Many orofacial pain conditions have overlapping presentations, and diagnostic uncertainty is frequently encountered in clinical practice. This review provides a clinically orientated overview of common and uncommon orofacial pain presentations and diagnoses, with an emphasis on conditions that may be unfamiliar to the headache physician. A holistic approach to orofacial pain management is important, and the social, cultural, psychological and cognitive context of each patient needs to be considered in the process of diagnostic formulation, as well as in the development of a pain management plan according to the biopsychosocial model. Recognition of psychological comorbidities will assist in diagnosis and management planning.
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Affiliation(s)
- Martina K Shephard
- Oral Medicine Unit, Eastman Dental Hospital, UCLH NHS Foundation Trust, London, UK
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35
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Zakrzewska JM. Differential diagnosis of facial pain and guidelines for management. Br J Anaesth 2013; 111:95-104. [PMID: 23794651 DOI: 10.1093/bja/aet125] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The diagnosis and management of facial pain below the eye can be very different dependant on whether the patient visits a dentist or medical practitioner. A structure for accurate diagnosis is proposed beginning with a very careful history. The commonest acute causes of pain are dental and these are well managed by dentists. Chronic facial pain can be unilateral or bilateral and continuous or episodic. The commonest non-dental pains are temporomandibular disorders (TMDs), especially musculoskeletal involving the muscles of mastication either unilaterally or bilaterally; they may be associated with other chronic pains. A very wide range of treatments are used but early diagnosis, reassurance and some simple physiotherapy is often effective in those with good coping strategies. Dentists will often make splints to wear at night. Neuropathic pain is usually unilateral and of the episodic type; the most easily recognized is trigeminal neuralgia. This severe electric shock like pain, provoked by light touch, responds best to carbamazepine, and neurosurgery in poorly controlled patients. Trauma, either major or because of dental procedures, results in neuropathic pain and these are then managed as for any other neuropathic pain. Red flags include giant cell arteritis which much be distinguished from temporomandibular disorders (TMD), especially in >50 yr olds, and cancer which can present as a progressive neuropathic pain. Burning mouth syndrome is rarely recognized as a neuropathic pain as it occurs principally in peri-menopausal women and is thought to be psychological. Chronic facial pain patients are best managed by a multidisciplinary team.
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Affiliation(s)
- J M Zakrzewska
- Facial Pain Unit, Division of Diagnostic, Surgical and Medical Sciences, Eastman Dental Hospital, UCLH NHS Foundation Trust, 256 Grays Inn Road, London WC1X 8LD, UK.
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36
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Facial pain associated with fibromyalgia can be marked by abnormal neuromuscular control: a cross-sectional study. Phys Ther 2013; 93:1092-101. [PMID: 23599350 DOI: 10.2522/ptj.20120338] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Temporomandibular disorder (TMD) development in fibromyalgia syndrome (FMS) is not yet fully understood, but altered neuromuscular control in FMS may play a role in triggering TMD. OBJECTIVE The purpose of this study was to verify the association between neuromuscular control and chronic facial pain in groups of patients with FMS and TMD. DESIGN A cross-sectional study was conducted. METHODS This study involved an analysis of facial pain and electromyographic activity of the masticatory muscles in patients with FMS (n=27) and TMD (n=28). All participants were evaluated according to Research Diagnostic Criteria for Temporomandibular Disorders and surface electromyography (SEMG). Myoelectric signal calculations were performed using the root mean square and median frequency of signals. RESULTS The data revealed premature interruption of masticatory muscle contraction in both patient groups, but a significant correlation also was found between higher median frequency values and increased facial pain. This correlation probably was related to FMS because it was not found in patients with TMD only. Facial pain and increased SEMG activity during mandibular rest also were positively correlated. LIMITATIONS Temporal conclusions cannot be drawn from the study. Also, the study lacked a comparison group of patients with FMS without TMD as well as a control group of individuals who were healthy. CONCLUSIONS Altered neuromuscular control in masticatory muscles may be correlated with perceived facial pain in patients with FMS.
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Haas J, Eichhammer P, Traue HC, Hoffmann H, Behr M, Crönlein T, Pieh C, Busch V. Alexithymic and somatisation scores in patients with temporomandibular pain disorder correlate with deficits in facial emotion recognition. J Oral Rehabil 2012; 40:81-90. [PMID: 23137311 DOI: 10.1111/joor.12013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2012] [Indexed: 01/05/2023]
Abstract
Current studies suggest dysfunctional emotional processing as a key factor in the aetiology of temporomandibular disorder (TMD). Investigating facial emotion recognition (FER) may offer an elegant and reliable way to study emotional processing in patients with TMD. Twenty patients with TMD and the same number of age-, sex- and education-matched controls were measured with the Facially Expressed Emotion Labelling (FEEL) test, the 26-item Toronto Alexithymia Scale (TAS-26), the Screening for Somatoform Symptoms (SOMS-2a), the German Pain Questionnaire and the 21-item Hamilton Depression Rating Scale (HAMD). The patients had significantly lower Total FEEL Scores (P = 0·021) as compared to the controls, indicating a lower accuracy of FER. Furthermore, we were able to demonstrate significant group differences with respect to the following issues: patients were more alexithymic (P = 0·006), stated more somatoform symptoms (P < 0·004) and had higher depressive scores in the HAMD (P < 0·003). The factors alexithymia and somatisation could explain 31% (adjusted 27%) of the variance of the FEEL Scores in the sample. The estimation of the standardised regression coefficients suggests an equivalent influence of TAS-26 and SOMS-2a on the FEEL Scores, whereas 'group' (patients versus healthy controls) and depressive symptoms did not contribute significantly to the model. Our findings highlight FER deficits in patients with TMD, which are partially explained by concomitant alexithymia and somatisation. As suggested previously, impaired FER in patients with TMD may further point to probable aetiological proximities between TMD and somatoform disorders.
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Affiliation(s)
- J Haas
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany.
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38
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Kulshreshtha P, Deepak KK. Autonomic nervous system profile in fibromyalgia patients and its modulation by exercise: a mini review. Clin Physiol Funct Imaging 2012; 33:83-91. [DOI: 10.1111/cpf.12000] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 08/20/2012] [Indexed: 01/24/2023]
Affiliation(s)
- Poorvi Kulshreshtha
- Department of Physiology; Kalinga Institute of Medical Sciences; KIIT University; Bhubaneswar; Odisha; India
| | - Kishore K. Deepak
- Department of Physiology; All India Institute of Medical Sciences; New Delhi; India
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High prevalence of orofacial complaints in patients with fibromyalgia: a case–control study. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:e29-34. [DOI: 10.1016/j.oooo.2012.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 03/19/2012] [Accepted: 04/02/2012] [Indexed: 11/19/2022]
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41
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Mayer TG, Neblett R, Cohen H, Howard KJ, Choi YH, Williams MJ, Perez Y, Gatchel RJ. The development and psychometric validation of the central sensitization inventory. Pain Pract 2011; 12:276-85. [PMID: 21951710 DOI: 10.1111/j.1533-2500.2011.00493.x] [Citation(s) in RCA: 491] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Central sensitization (CS) has been proposed as a common pathophysiological mechanism to explain related syndromes for which no specific organic cause can be found. The term "central sensitivity syndrome (CSS)" has been proposed to describe these poorly understood disorders related to CS. The goal of this investigation was to develop the Central Sensitization Inventory (CSI), which identifies key symptoms associated with CSSs and quantifies the degree of these symptoms. The utility of the CSI, to differentiate among different types of chronic pain patients who presumably have different levels of CS impairment, was then evaluated. Study 1 demonstrated strong psychometric properties (test-retest reliability = 0.817; Cronbach's alpha = 0.879) of the CSI in a cohort of normative subjects. A factor analysis (including both normative and chronic pain subjects) yielded 4 major factors (all related to somatic and emotional symptoms), accounting for 53.4% of the variance in the dataset. In Study 2, the CSI was administered to 4 groups: fibromyalgia (FM); chronic widespread pain without FM; work-related regional chronic low back pain (CLBP); and normative control group. Analyses revealed that the patients with FM reported the highest CSI scores and the normative population the lowest (P < 0.05). Analyses also demonstrated that the prevalence of previously diagnosed CSSs and related disorders was highest in the FM group and lowest in the normative group (P < 0.001). Taken together, these 2 studies demonstrate the psychometric strength, clinical utility, and the initial construct validity of the CSI in evaluating CS-related clinical symptoms in chronic pain populations.
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Affiliation(s)
- Tom G Mayer
- Department of Orthopedic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA
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42
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Benoliel R, Svensson P, Heir GM, Sirois D, Zakrzewska J, Oke-Nwosu J, Torres SR, Greenberg MS, Klasser GD, Katz J, Eliav E. Persistent orofacial muscle pain. Oral Dis 2011; 17 Suppl 1:23-41. [PMID: 21382137 DOI: 10.1111/j.1601-0825.2011.01790.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The pathophysiology of persistent orofacial myalgia has been the centre of much controversy. In this article we suggest a novel descriptive term; 'persistent orofacial muscle pain' (POMP) and review current evidence that supports the hypothesis that the induction of POMP involves the interplay between a peripheral nociceptive source in muscle, a faulty central nervous system component and decreased coping ability. In this context it is widely accepted that a complex interaction of variable intrinsic and extrinsic factors act to induce POMP and dysfunction.
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Affiliation(s)
- R Benoliel
- Department of Oral Medicine, The Faculty of Dentistry, Hebrew University-Hadassah, Jerusalem, Israel.
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Ferré-Corominas J, Chimenos-Küstner E, López-López J. Consideraciones odontológicas en la fibromialgia. Med Clin (Barc) 2011; 137:27-9. [DOI: 10.1016/j.medcli.2009.11.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 11/12/2009] [Accepted: 11/24/2009] [Indexed: 11/28/2022]
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Green PG, Alvarez P, Gear RW, Mendoza D, Levine JD. Further validation of a model of fibromyalgia syndrome in the rat. THE JOURNAL OF PAIN 2011; 12:811-8. [PMID: 21481648 DOI: 10.1016/j.jpain.2011.01.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2010] [Revised: 01/06/2011] [Accepted: 01/19/2011] [Indexed: 12/17/2022]
Abstract
UNLABELLED We have recently developed an animal model of fibromyalgia syndrome in the rat. In this model, rats exposed to unpredictable sound stress develop a delayed onset enhancement and prolongation of cytokine-induced mechanical hyperalgesia in muscle and skin. In this study, we tested the hypothesis that our model also manifests symptoms of common comorbid diagnoses: irritable bowel syndrome, temporomandibular disorder, and anxiety. Both visceral sensitivity and cytokine hyperalgesia in masseter muscle were present in the stressed rats. Furthermore, in an established model of irritable bowel syndrome-water avoidance-we observed significant muscle hyperalgesia. Finally, using the elevated plus maze to assess for anxiety level, we observed a significantly higher anxiety level in sound stress-exposed rats. Thus, unpredictable sound stress produces a condition in the rat with several features-delayed onset visceral and temporomandibular hyperalgesia and increased anxiety, as well as cutaneous and muscle hyperalgesia-commonly found in patients with fibromyalgia syndrome. PERSPECTIVE A stress model-unpredictable sound-in the rat exhibits several features (cutaneous, musculoskeletal, and visceral hyperalgesia, as well as anxiety) that are found in patients with fibromyalgia syndrome. Thus, this model may be used to test hypotheses about the underlying mechanisms and response to therapy in patients with fibromyalgia.
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Affiliation(s)
- Paul G Green
- Department of Oral and Maxillofacial Surgery, University of California San Francisco, San Francisco, California 94143-0440, USA
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45
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Acupuncture for Treating Temporomandibular Disorder: Retrospective Study on Safety and Efficacy. J Acupunct Meridian Stud 2010; 3:260-6. [DOI: 10.1016/s2005-2901(10)60046-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Accepted: 10/11/2010] [Indexed: 11/23/2022] Open
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46
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Fibromyalgia Syndrome in Chronic Disabling Occupational Musculoskeletal Disorders. J Occup Environ Med 2010; 52:1186-91. [DOI: 10.1097/jom.0b013e3181fc838d] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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47
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48
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Lindenmeyer A, Sutcliffe P, Eghtessad M, Goulden R, Speculand B, Harris M. Oral and maxillofacial surgery and chronic painful temporomandibular disorders--a systematic review. J Oral Maxillofac Surg 2010; 68:2755-64. [PMID: 20822845 DOI: 10.1016/j.joms.2010.05.056] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 05/12/2010] [Accepted: 05/21/2010] [Indexed: 11/19/2022]
Abstract
PURPOSE To provide a systematic review of the best available research literature investigating the relation of oral and maxillofacial surgical procedures to the onset or relief of chronic painful temporomandibular disorder (TMD). MATERIALS AND METHODS A comprehensive review of the databases CINAHL, Cochrane Library, Embase, Medline, NHS Evidence--Oral Health, PsycINFO, Web of Knowledge, and MetaLib was undertaken by 2 authors (P.S., M.H.) up to June 2009 using search terms appropriate to establishing a relation between orofacial surgical procedures and TMD. The search was restricted to English-language publications. RESULTS Of the 1,777 titles reviewed, 35 articles were critically appraised but only 32 articles were considered eligible. These were observational studies that fell into 2 groups; 9 were seeking to establish a surgical cause for TMD. Of these, only 2 of a series of 3 claimed that there was a significant link, but this claim was based on weak data (health insurance records) and was abandoned in a subsequent report. Twenty-three studies were seeking to achieve relief by orthognathic surgical intervention. These were also negative overall, with 7 articles showing varying degrees of mostly nonsignificant improvement, whereas 16 showed no change or a worse outcome. No published report on the putative effect of implant insertion was found. CONCLUSION These apparently contradictory approaches underline a belief that oral surgical trauma or gross malocclusion has a causative role in the onset of TMD. However, there was no overall evidence of a surgical causal etiology or orthognathic therapeutic value. This review emphasizes that it is in the patients' best interest to carry out prospective appropriately controlled randomized trials to clarify the situation.
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Affiliation(s)
- Antje Lindenmeyer
- Postgraduate Dental Education Unit, Warwick Medical School, Coventry, UK
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49
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Subgrouping patients with fibromyalgia according to the results of the fibromyalgia impact questionnaire: a replication study. Rheumatol Int 2010; 31:1555-9. [DOI: 10.1007/s00296-010-1521-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2010] [Accepted: 05/01/2010] [Indexed: 12/28/2022]
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50
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Leonard G, Goffaux P, Mathieu D, Blanchard J, Kenny B, Marchand S. Evidence of descending inhibition deficits in atypical but not classical trigeminal neuralgia. Pain 2009; 147:217-23. [DOI: 10.1016/j.pain.2009.09.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Revised: 09/04/2009] [Accepted: 09/09/2009] [Indexed: 01/09/2023]
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