Predictive relationship between psychological, social, physical activity, and sleep measures and somatosensory function in individuals with musculoskeletal pain: a systematic review and meta-analysis protocol

Visual psychosocial profiling of Chinese temporomandibular disorder pain patients and correlations with somatosensory function

BACKGROUND

Psychosocial function of Chinese temporomandibular disorders (TMD) pain patients and the correlation with somatosensory function has not been sufficiently studied.

OBJECTIVE

The study aims at assessing the psychosocial function of Chinese TMD pain patients by visualisation method and evaluating the correlations with somatosensory function quantitatively.

METHODS

The Symptom Checklist 90 (SCL-90) questionnaire and standardised quantitative sensory testing (QST) were administered to 70 Chinese TMD pain patients and age- and gender-matched healthy controls (HCs). Of these, 40 TMD arthralgia patients received QST before and after medication. Psychosocial and somatosensory parameters were transformed into standardised scores. Differences within groups were assessed through t tests. Correlations between psychosocial and somatosensory profiles were explored through correlation analyses with Bonferroni correction for multiple comparisons.

RESULTS

100% of the Chinese TMD pain patients exhibited psychosocial distress in contrast to HCs. Anger and hostility showed negative correlation with the thermal nonnociceptive parameter (thermal sensory limen, p =.002) and nociceptive parameters (cold pain threshold and pain pressure threshold, p<.001). Correlation analysis indicated that cold detection threshold was negatively correlated with somatization and mechanical pain sensitivity had a negative correlation with anger and hostility through medical treatment (p <.001).

CONCLUSIONS

Visual psychosocial profiles provided an easy overview of psychosocial function in Chinese TMD pain patients. Anger and hostility was associated with increased thermal nonnociceptive and nociceptive sensitivity to stimuli. Psychosocial distress might be negatively associated with TMD treatment response which indicated a possible need for psychological intervention during treatment.

Relationships Between Psychological, Sleep, and Physical Activity Measures and Somatosensory Function in People With Peripheral Joint Pain: A Systematic Review and Meta-Analysis

OBJECTIVE

Alteration in somatosensory function has been linked to pain experience in individuals with joint pain. In this systematic review we aimed to establish the level of evidence of associations between psychological, social, physical activity, and sleep measures and somatosensory function that were assessed via quantitative sensory testing (QST) among individuals with joint pain.

METHODS

A comprehensive literature search was conducted in 6 electronic databases from their inception to July 2019. Two reviewers independently assessed the methodological quality using a modified Quality in Prognostic Studies (QUIPS) tool and supplemented with recommendations from the Critical Appraisal and Data Extraction for Systematic Review of Prediction Modelling Studies (CHARMS) checklist and the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The level of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. Data were pooled to evaluate the strength of the relationships of interest.

RESULTS

Seventeen studies related to joint pain were included. Pain catastrophizing, depression, anxiety, and physical activity level have been shown to have a significant (small to fair) association with several QST measures. Pressure pain threshold (PPT) is the only measure that was found to be consistently correlated with all the domains. The overall quality of evidence for all factors ranged from very low to moderate. Subgroup analysis revealed a stronger association for depression and pain catastrophizing and PPT and temporal pain summation in individuals with shoulder pain.

CONCLUSION

Psychological factors and physical activity levels are associated with somatosensory function in people with joint pain. These factors need to be adjusted when establishing predictive relationships between somatosensory function and pain outcomes in individuals with joint pain.

Assessment of somatosensory changes in Chinese temporomandibular disorders arthralgia patients by quantitative sensory testing

BACKGROUND

Somatosensory changes in Chinese temporomandibular disorders (TMD) arthralgia patients have not been fully studied by the latest technologies.

OBJECTIVE

This study aims at assessing somatosensory changes in Chinese TMD arthralgia patients quantitatively.

METHODS

Standardised quantitative sensory testing (QST) was performed on the pain sites and contralateral sites of 40 patients diagnosed with TMD arthralgia according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) before and after medication; similar measures were taken in 40 age- and gender-matched healthy controls. Differences within and between groups were assessed through Z-scores, two-way ANOVA and loss/gain coding system.

RESULTS

The pain sites of patients presented increased sensitivity to thermal stimuli and mechanical pain stimuli together with decreased sensitivity to mechanical tactile stimuli before medication (P < .001). Before treatment, 100% of patients had somatosensory abnormalities at the pain sites; the most frequent abnormalities were somatosensory gain to cold nociceptive, pinprick and pressure stimuli, and the most frequent loss/gain score was L0G3 (no somatosensory loss with a gain of thermal and mechanical somatosensory function; 70.0%). After treatment, although the clinical symptoms and signs of 40 patients disappeared, 80.0% of the patients' pain sites still showed multiple phenotype abnormalities. The most frequent loss/gain score was L0G2 (no somatosensory loss with a gain of mechanical somatosensory function; 35.0%).

CONCLUSIONS

Multiple phenotypes of facial somatosensory abnormalities were detected in Chinese TMD arthralgia patients before and after treatment, despite the disappearance of clinical signs and symptoms. Individual variations indicate a possible need for subgroup classification, individualised management and mechanism-based treatment.