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Wang J, Novick S. Peptide set test: a peptide-centric strategy to infer differentially expressed proteins. BIOINFORMATICS (OXFORD, ENGLAND) 2024; 40:btae270. [PMID: 38632081 DOI: 10.1093/bioinformatics/btae270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 03/20/2024] [Accepted: 04/16/2024] [Indexed: 04/19/2024]
Abstract
MOTIVATION The clinical translation of mass spectrometry-based proteomics has been challenging due to limited statistical power caused by large technical variability and inter-patient heterogeneity. Bottom-up proteomics provides an indirect measurement of proteins through digested peptides. This raises the question whether peptide measurements can be used directly to better distinguish differentially expressed proteins. RESULTS We present a novel method called the peptide set test, which detects coordinated changes in the expression of peptides originating from the same protein and compares them to the rest of the peptidome. Applying our method to data from a published spike-in experiment and simulations demonstrates improved sensitivity without compromising precision, compared to aggregation-based approaches. Additionally, applying the peptide set test to compare the tumor proteomes of tamoxifen-sensitive and tamoxifen-resistant breast cancer patients reveals significant alterations in peptide levels of collagen XII, suggesting an association between collagen XII-mediated matrix reassembly and tamoxifen resistance. Our study establishes the peptide set test as a powerful peptide-centric strategy to infer differential expression in proteomics studies. AVAILABILITY AND IMPLEMENTATION Peptide set test (PepSetTest) is publicly available at https://github.com/JmWangBio/PepSetTest.
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Affiliation(s)
- Junmin Wang
- Data Sciences and Quantitative Biology, Discovery Sciences, Biopharmaceuticals R&D, AstraZeneca, Gaithersburg, MD 20878, United States
| | - Steven Novick
- Global Statistical Sciences, Eli Lilly, Indianapolis, IN 46285, United States
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Shu H, Liu S, Crawford J, Tao F. A female-specific role for trigeminal dynorphin in orofacial pain comorbidity. Pain 2023; 164:2801-2811. [PMID: 37463238 PMCID: PMC10790138 DOI: 10.1097/j.pain.0000000000002980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/01/2023] [Indexed: 07/20/2023]
Abstract
ABSTRACT Migraine is commonly reported in patients with temporomandibular disorders (TMDs), but little is known about the mechanisms underlying the comorbid condition. Here, we prepared a mouse model to investigate this comorbidity, in which masseter muscle tendon ligation (MMTL) was performed to induce a myogenic TMD, and the pre-existing TMD enabled a subthreshold dose of nitroglycerin (NTG) to produce migraine-like pain in mice. RNA sequencing followed by real-time quantitative polymerase chain reaction confirmation showed that MMTL plus NTG treatment increased prodynorphin ( Pdyn ) mRNA expression in the spinal trigeminal nucleus caudalis (Sp5C) of female mice but not in male mice. Chemogenetic inhibition of Pdyn -expressing neurons or microinjection of antidynorphin antiserum in the Sp5C alleviated MMTL-induced masseter hypersensitivity and diminished the MMTL-enabled migraine-like pain in female mice but not in male mice. Moreover, chemogenetic activation of Pdyn -expressing neurons or microinjection of dynorphin A (1-17) peptide in the Sp5C enabled a subthreshold dose of NTG to induce migraine-like pain in female mice but not in male mice. Taken together, our results suggest that trigeminal dynorphin has a female-specific role in the modulation of comorbid TMDs and migraine.
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Affiliation(s)
- Hui Shu
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
| | - Sufang Liu
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
| | - Joshua Crawford
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
| | - Feng Tao
- Department of Biomedical Sciences, Texas A&M University
School of Dentistry, Dallas, Texas, USA
- Center for Craniofacial Research and Diagnosis, Texas
A&M University School of Dentistry, Dallas, Texas, USA
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Heikkala E, Oura P, Paananen M, Ho E, Ferreira P, Tanguay-Sabourin C, Karppinen J. Chronic disease clusters are associated with prolonged, bothersome, and multisite musculoskeletal pain: a population-based study on Northern Finns. Ann Med 2023; 55:592-602. [PMID: 36773018 PMCID: PMC9930817 DOI: 10.1080/07853890.2023.2177723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Chronic diseases often accumulate with musculoskeletal (MSK) pain. However, less evidence is available on idiosyncratic patterns of chronic diseases and their relationships with the severity of MSK pain in general MSK pain populations. MATERIAL AND METHODS Questionnaire-based data on physician-diagnosed chronic diseases, MSK pain and its dimensions (frequency, intensity, bothersomeness, and the number of pain sites), and confounders were collected from the Northern Finland Birth Cohort 1966 at the age of 46. Latent Class Analysis (LCA) was used to identify chronic disease clusters among individuals who reported any MSK pain within the previous year (n = 6105). The associations between chronic disease clusters, pain dimensions, and severe MSK pain, which was defined as prolonged (over 30 d within the preceding year), bothersome (Numerical Rating Scale >5), and multisite (two or more pain sites) pain, were analyzed using logistic regression and general linear regression models, adjusted for sex and educational level (n for the full sample = 4768). RESULTS LCA resulted in three clusters: Metabolic (10.8% of the full sample), Psychiatric (2.9%), and Relatively Healthy (86.3%). Compared to the Relatively Healthy cluster, the Metabolic and Psychiatric clusters had higher odds for daily pain and higher mean pain intensity, bothersomeness, and the number of pain sites. Similarly, the odds for severe MSK pain were up to 75% (95% confidence interval: 44%-113%) and 155% (81%-259%) higher in the Metabolic and Psychiatric clusters, respectively, after adjustments for sex and educational level. CONCLUSIONS Distinct patterns of chronic disease accumulation can be identified in the general MSK pain population. It seems that mental and metabolic health are at interplay with severe MSK pain. These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.Key messagesThis large study on middle-aged people with musculoskeletal pain aimed to examine the idiosyncratic patterns of chronic diseases and their relationships with the severity of musculoskeletal pain. Latent class cluster analysis identified three chronic disease clusters: Psychiatric, Metabolic, and Relatively Healthy. People with accumulated mental (Psychiatric cluster) or metabolic diseases (Metabolic cluster) experienced more severe pain than people who were relatively healthy (Relatively Healthy cluster). These findings suggest a potential need to screen for psychiatric and metabolic entities of health when treating working-aged people with MSK pain.
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Affiliation(s)
- Eveliina Heikkala
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Rovaniemi Health Center, Rovaniemi, Finland
| | - Petteri Oura
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Markus Paananen
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Western Uusimaa Wellbeing Services County, Social and Health Care Services, Espoo, Finland
| | - Emma Ho
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia.,Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, University of Sydney, Sydney, Australia
| | - Paulo Ferreira
- Sydney Musculoskeletal Health, School of Health Sciences, Charles Perkins Centre, University of Sydney, Sydney, Australia
| | - Christophe Tanguay-Sabourin
- Alan Edwards Pain Centre for Research on Pain, McGill University, Montreal, Canada.,Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Jaro Karppinen
- Research Unit of Population Health, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland
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Piekartz HV, van der Meer H, Olivo SA. Craniofacial disorders and headaches. A narrative review. Musculoskelet Sci Pract 2023; 66:102815. [PMID: 37419842 DOI: 10.1016/j.msksp.2023.102815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/09/2023]
Abstract
OBJECTIVES Craniofacial- and headache disorders are common co-morbid disorders. The aim of this review is to provide an overview of the research discussing craniofacial pain, especially temporomandibular disorders, and its relationship and impact on headaches, as well as suggestions for diagnostic assessment tools and physical therapeutic management strategies. METHOD A narrative structured review was performed. A search was conducted in MEDLINE using terms related to craniofacial pain and headaches. Additionally, papers regarding this topic were also extracted from the authors' personal libraries. Any study design (i.e., RCT, observational studies, systematic review, narrative review) that reported the concepts of interest was included, using Covidence. Results were narratively synthesized and described. RESULTS From an epidemiological perspective, craniofacial pain and headaches are strongly related and often co-existing. This may be due to the neuroanatomical connection with the trigeminal cervical complex, or due to shared predisposing factors such as age, gender, and psychosocial factors. Pain drawings, questionnaires, and physical tests can be used to determine the cause of pain, as well as other perpetuating factors in patients with headaches and craniofacial pain. The evidence supports different forms of exercise and a combination of hands-on and hands-off strategies aimed at both the craniofacial pain as well as the headache. CONCLUSION Headaches may be caused or aggravated by different disorders in the craniofacial region. Proper use of terminology and classification may help in understanding these complaints. Future research should look into the specific craniofacial areas and how headaches may arise from problems from those regions. (249 words).
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Affiliation(s)
- Harry von Piekartz
- University of Applied Sciences Osnabrück, Department of Physical Therapy and Rehabilitation Science, Germany; Cranial Facial Therapy Academy (CRAFTA), Hamburg, Germany.
| | - Hedwig van der Meer
- Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, the Netherlands; SOMT University of Physiotherapy, Amersfoort, Netherlands
| | - Susan Armijo Olivo
- University of Applied Sciences Osnabrück, Department of Physical Therapy and Rehabilitation Science, Germany; Faculty of Rehabilitation Medicine, Faculty of Medicine and Dentistry Rehabilitation Research Center, University of Alberta, Edmonton, Canada
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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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Focus Groups to Inform the Development of a Patient-Reported Outcome Measure (PROM) for Temporomandibular Joint Disorders (TMDs). THE PATIENT 2023; 16:265-276. [PMID: 36840915 PMCID: PMC9961303 DOI: 10.1007/s40271-023-00618-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/30/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Understanding symptoms of temporomandibular joint disorders (TMDs) can help doctors and patients document, monitor, and manage the disease and help researchers evaluate interventions. Patients with TMDs experience symptoms ranging from mild to severe, primarily in the head and neck region. This study describes findings from formative patient focus groups to capture, categorize, and prioritize symptoms of TMDs towards the development of a patient-reported outcome measure (PROM). METHODS We conducted ten focus groups with 40 men and women with mild, moderate, and severe TMD. Focus groups elicited descriptions of symptoms and asked participants to review a list of existing patient-reported outcomes (PROs) from the literature and patient advisor input and speak to how those PROs reflect their own experience, including rating their importance. RESULTS We identified 52 distinct concepts across six domains: somatic, physical, social, sexual, affective, and sleep. Focus groups identified the ability to chew and eat; clicking, popping, and other jaw noises; jaw pain and headaches; jaw misalignment or dislocation; grinding, clenching, or chewing, including at night; and ear sensations as most important. Participants with severe TMDs more often reported affective concepts like depression and shame than did participants with mild or moderate TMDs. CONCLUSION Findings support PROM item development for TMDs, including selecting existing PROMs or developing new ones that reflect patients' lived experiences, priorities, and preferred terminology. Such measures are needed to increase understanding of TMDs, promote accurate diagnosis and effective treatment, and help advance research on TMDs.
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Vale Braido GVD, Svensson P, Dos Santos Proença J, Mercante FG, Fernandes G, de Godoi Gonçalves DA. Are central sensitization symptoms and psychosocial alterations interfering in the association between painful TMD, migraine, and headache attributed to TMD? Clin Oral Investig 2023; 27:681-690. [PMID: 36383296 DOI: 10.1007/s00784-022-04783-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 11/06/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine if somatosensory function and symptoms related to central sensitization (CS) differed in individuals with painful temporomandibular disorders (TMD) according to the presence of migraine (MIG) or MIG + headache attributed to TMD (HAT). MATERIALS AND METHODS This study evaluated 92 adults (20-65 years), presenting painful TMD. Standard diagnostic criteria were applied to classification of painful TMD, MIG, and HAT. CS was assessed through the central sensitization inventory (CSI), wind-up ratio (WUR), pressure pain thresholds (PPT), and the conditioned pain modulation test (CPM). Psychosocial factors were evaluated by validated instruments. RESULTS There was a significant difference regarding gender, with more women in the group TMD + MIG + HAT (p = 0.028). TMD + MIG and TMD + MIG + HAT had significantly lower PPTs than the TMD group. No group differences were found for the WUR, CPM, or CSI. TMD + MIG + HAT had higher chronic pain intensity (p = 0.001), disability points (p = 0.045), graded chronic pain scale (p = 0.007), and higher somatization (NSPS) scores (p = 0.012), compared to the other groups. CONCLUSION Mechanical hyperalgesia was more pronounced in the group with the highest pain and somatization scores, while CPM and WUR did not differ between groups. Altered somatosensory function and CS may partially underlie the pathophysiology of overlapping TMD pain conditions, pointing towards additive effects of comorbid head pains. CLINICAL RELEVANCE Our results demonstrate the importance of considering the association of primary and secondary headaches during TMD assessment and its implications for maintaining the signs and symptoms of CS. This can influence the conduct of treatment, which must be multidisciplinary, and must include management of mechanisms related to CS.
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Affiliation(s)
- Guilherme Vinícius do Vale Braido
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil.
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Faculty of Odontology, Malmø University, Malmö, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Juliana Dos Santos Proença
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Fernanda Gruninger Mercante
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Giovana Fernandes
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
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Sahbaz T, Karacay BC. Investigation of temporomandibular disorders in patients with fibromyalgia syndrome: A case-control study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101296. [PMID: 36152974 DOI: 10.1016/j.jormas.2022.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION The aim of this study is to compare the frequency of temporomandibular disorders and to examine the temporomandibular pain and functionality levels between healthy female participants and female patients diagnosed with fibromyalgia. MATERIALS AND METHODS Our study included 300 participants. Patients were evaluated according to the Diagnostic Criteria for Temporomandibular Disorders: Assessment Instruments (DC/TMD). While evaluating the patients using DC/TMD, TMD Pain Screener and Symptom questionnaire were used within the scope of Axis I, and Graded Chronic Pain Scale, Jaw Functional Limitation Scale-8 (JFLS-8), Patient Health Questionnaire (PHQ-4) and Oral Behaviors Checklist were applied. RESULTS Bruxism, tooth grinding and masseter hypertrophy were found to be significantly higher in fibromyalgia patients compared to healthy volunteers (p<0.001). The pain screener, JFLS-8, PHQ-4 and OBC scores and GCPS levels were found to be increased in the fibromyalgia group compared to healthy individuals (p<0.001). Considering the post-examination diagnoses of the participants, the diagnoses of myalgia (p=0.022) and disc displacement with reduction (p<0.001) were significantly higher than healthy individuals. CONCLUSIONS Fibromyalgia is a common pathology, therefore, TMD symptoms, which are more difficult to diagnose and often missed, should be questioned in fibromyalgia patients and should be kept in mind in the management of fibromyalgia patients.
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Affiliation(s)
- Tugba Sahbaz
- Department of Physical Medicine and Rehabilitation, Health Sciences University, Kanuni Sultan Suleyman Research Hospital, Istanbul, Turkey.
| | - Basak Cigdem Karacay
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey
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Kang JH, Lee JK. Does risk of obstructive sleep apnea have interaction with chronic facial pain? J Korean Assoc Oral Maxillofac Surg 2022; 48:277-283. [PMID: 36316185 PMCID: PMC9639246 DOI: 10.5125/jkaoms.2022.48.5.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES The main purpose of the present study was to investigate the associations between the risk of obstructive sleep apnea (OSA) and chronic orofacial pain in a nationally representative sample of the Korean population. MATERIALS AND METHODS Data from the 8th wave Korean national health and nutrition examination survey, which was conducted from 2019 to 2020 were analyzed. This study included 5,780 Koreans (2,503 males, 3,277 females) over 40 years of age. The presence of subjective chronic facial pain lasting more than 3 months was evaluated based on a self-reported questionnaire. The risk of OSA was determined using the STOP-BANG questionnaire. Data related to anthropometric and sociodemographic factors; diagnostic history of hypertension, depression, and OSA; level of health-related quality of life and stress awareness; health-related behaviors, including smoking and alcohol drinking; and sleep duration were collected. The participants were classified into two groups according to the presence of chronic facial pain. RESULTS The level of health-related quality of life and stress awareness showed significant differences between the two groups. The sleep duration on weekends also presented significant differences. No significant differences were observed in the presence of snoring and observed apnea, while participants with chronic facial pain showed significantly higher levels of tiredness between the groups. The risk of OSA evaluated by STOP-BANG questionnaire showed significant differences between groups; however, the risk of OSA seemed to be higher in participants without chronic facial pain. CONCLUSION The participants with chronic facial pain demonstrated decreased sleep duration, lower health-related quality of life, and increased stress and tiredness. Even though, the role of OSA in the development of chronic facial pain was inconclusive from the study, it is possible that ethnicity play a role in relationship between OSA and chronic facial pain.
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Affiliation(s)
- Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Jeong Keun Lee
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
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10
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Kang JH, Lee JK. Associations between obstructive sleep apnea and painful temporomandibular disorder: a systematic review. J Korean Assoc Oral Maxillofac Surg 2022; 48:259-266. [PMID: 36316183 PMCID: PMC9639245 DOI: 10.5125/jkaoms.2022.48.5.259] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/29/2022] Open
Abstract
The relationship between obstructive sleep apnea (OSA) and diverse types of pain conditions have been proposed. However, no consensus on the relationship between OSA and painful temporomandibular disorders (TMDs) has been established. Therefore, this systematic review has been conducted to review the existing literatures and provide comprehensive synthesis of such literatures about OSA and painful TMDs using the evidence-based methodology. A literature search was conducted using two electronic databases, Scopus, and PubMed. Risk of bias was assessed using the risk-ofbias assessment tool for non-randomized study version 2.0. A total of 158 articles were screened from the initial search and eventually, 5 articles were included in this systematic review. One study adopted both the longitudinal prospective cohort and case-control designs and other 4 articles adopted the cross-sectional design. Two studies employed polysomnography (PSG) for the diagnosis of OSA and mentioned the results from the PSG. All crosssectional studies demonstrated higher OSA prevalence among patients with TMD, and one cohort study suggested OSA as a risk factor for TMD. OSA appears to have potential influences on the development of TMD; however, the role of TMD in the development of OSA remains to be unknown owing to the lack of high-quality evidences.
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Affiliation(s)
- Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea
| | - Jeong Keun Lee
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea,Jeong Keun Lee, Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, 164 WorldCup-ro, Yeongtong-gu, Suwon 16499, Korea, TEL: +82-31-219-5333, E-mail: , ORCID: https://orcid.org/0000-0002-5561-6297
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11
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Pain Management and Rehabilitation for Central Sensitization in Temporomandibular Disorders: A Comprehensive Review. Int J Mol Sci 2022; 23:ijms232012164. [PMID: 36293017 PMCID: PMC9602546 DOI: 10.3390/ijms232012164] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 11/24/2022] Open
Abstract
Temporomandibular disorders (TMD) are a group of musculoskeletal diseases affecting masticatory muscles and temporomandibular joints (TMJ). In this context, the chronic TMD could be considered as a condition with chronic primary orofacial pain, presenting as myofascial TMD pain or TMJ arthralgia. In this context, myogenous TMD may present overlapping features with other disorders, such as fibromyalgia and primary headaches, characterized by chronic primary pain related to dysfunction of the central nervous system (CNS), probably through the central sensitization. This phenomenon could be defined as an amplified response of the CNS to sensory stimuli and peripheral nociceptive, characterized by hyperexcitability in the dorsal horn neurons in the spinal cord, which ascend through the spinothalamic tract. The main objectives of the management of TMD patients are: decreasing pain, increasing TMJ function, and reducing the reflex masticatory muscle spasm/pain. The first-line treatments are physical therapy, pharmacological drugs, occlusal splints, laser therapy, extracorporeal shockwave therapy, transcutaneous electrical nerve stimulation, and oxygen–ozone therapy. Although all these therapeutic approaches were shown to have a positive impact on the central sensitization of TMD pain, there is still no agreement on this topic in the scientific literature. Thus, in this comprehensive review, we aimed at evaluating the evidence on pain management and rehabilitation for the central sensitization in TMD patients.
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12
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Smith SJ, Sichlau M, Sewall LE, Smith BH, Chen B, Khurana N, Rowe PC. An online survey of pelvic congestion support group members regarding comorbid symptoms and syndromes. Phlebology 2022; 37:596-601. [PMID: 35831253 DOI: 10.1177/02683555221112567] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives Patients with pelvic congestion syndrome (PCS) often report overlapping somatic symptoms and syndromes. The objective of this study was to explore the prevalence of co-existing symptoms and self-reported syndrome diagnoses among women with PCS and to inform future research hypotheses. Methods A brief online survey was offered to members of a PCS support group website. Responses were assessed for self-reported co-existing symptoms and formal diagnoses, including: chronic fatigue syndrome, fibromyalgia, postural tachycardia syndrome, irritable bowel syndrome, migraines, interstitial cystitis, and temporomandibular joint dysfunction. Results Of a total of 6000 members, there were 398 respondents; 232 (59%) had not yet been treated for PCS. Among these, the most prevalent co-existing symptoms were as follows: severe fatigue (72%), dizziness (63%), IBS symptoms (61%), brain fog (33%), migraines (49%), polyuria or dysuria (41%), excessive sweating (31%), TMJ pain (31%), and loose skin or lax joints (18%). These are much higher than reported for the general female population. The most commonly self-reported comorbid syndrome diagnoses for the overall group of 398 were: irritable bowel syndrome (29%), fibromyalgia (13%), spinal nerve problems (18%), interstitial cystitis (10%), postural tachycardia syndrome (9%), hypertension (11%), chronic fatigue syndrome (10%), and Ehlers-Danlos syndrome (6%). Other than with hypertension, these rates are variably higher than in the general population. Conclusion Several self-reported co-existing symptoms and syndromes are more prevalent in members of a PCS support group relative to the reported prevalence in the general population. More formal investigation is warranted to evaluate this finding and to investigate potential etiologic links. Ehlers-Danlos Syndrome appears to be common in self identifying PCS women.
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Affiliation(s)
- Steven J Smith
- Vascular and Interventional Professionals, LLC, Hinsdale, IL, USA
| | - Michael Sichlau
- Vascular and Interventional Professionals, LLC, Hinsdale, IL, USA
| | - Luke E Sewall
- Vascular and Interventional Professionals, LLC, Hinsdale, IL, USA
| | - B Holly Smith
- Center for the Advanced Study of Human Paleobiology, George Washington University, Washington, DC, USA
| | - Brenda Chen
- University of California, Los Angeles, CA, USA
| | - Neal Khurana
- Vascular and Interventional Specialists of Siouxland, Dakota Dunes, ND, USA
| | - Peter C Rowe
- Dept of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
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Boggero IA, Pickerill HM, King CD. Fatigue in Adults with Chronic Arthralgia/Myalgia in the Temporomandibular Region: Associations with Poor Sleep Quality, Depression, Pain Intensity, and Future Pain Interference. J Oral Facial Pain Headache 2022; 36:155-163. [PMID: 35943326 PMCID: PMC10586567 DOI: 10.11607/ofph.2944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 11/08/2021] [Indexed: 11/16/2023]
Abstract
AIMS To examine associations between fatigue and poor sleep quality, depression symptoms, and pain intensity in an adult population with chronic arthralgia/myalgia in the temporomandibular region and to test whether fatigue predicted future pain-related interference above and beyond these other constructs. METHODS The sample included 40 participants with chronic arthralgia and/or myalgia in the temporomandibular region and 21 healthy controls. Participants self-reported fatigue (PROMIS fatigue score), sleep quality (PSQI), depression symptoms (PROMIS depression score), and average pain intensity and completed four weekly surveys of pain-related interference with daily activities. RESULTS The chronic arthralgia/myalgia group reported greater fatigue than healthy controls (t = 4.85, P < .001). Fatigue was significantly correlated with poor sleep quality (r = .46), higher depression symptoms (r = .41), and higher pain intensity (r = .46) in the chronic arthralgia/myalgia group, and these three variables together explained 39% of variance in fatigue. Greater fatigue-above and beyond sleep quality, depression symptoms, and average pain intensity-was associated with a higher average level of pain-related interference (β = 0.56, t score = 3.30, P = .002) over the following month. Depression symptoms, poor sleep quality, and pain intensity did not significantly predict pain interference above and beyond fatigue (all P > .05). CONCLUSION The results suggest that fatigue is a clinically relevant symptom distinct from depression, poor sleep quality, or pain intensity and may be related to worse pain outcomes over the following month in adults with chronic temporomandibular arthralgia/myalgia. Clinicians should assess, monitor, and treat fatigue to the best of their abilities when working with this population.
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Staniszewski K, Willassen L, Berge T, Johansson A, Schjødt B, Rosen A. High Pain Intensity is a Risk Factor of Non-Resolving TMD: A Three-Year Follow-Up of a Patient Group in a Norwegian Interdisciplinary Evaluation Program. J Pain Res 2022; 15:1283-1296. [PMID: 35529313 PMCID: PMC9075908 DOI: 10.2147/jpr.s341861] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/10/2022] [Indexed: 12/17/2022] Open
Abstract
Purpose To investigate the outcome of patients with long-term refractory temporomandibular disorders (TMD) three years after a Norwegian interdisciplinary evaluation program with attention to patient satisfaction, function, pain, and psychosocial variables. Patients and Methods The study population consisted of 60 long-term refractory TMD patients who were investigated by a Norwegian interdisciplinary team. A questionnaire that covered medical history, function, pain, lifestyle factors, TMD-status and follow-up from their general medical practitioner (GMP) was sent to the patients three years after the evaluation. Questionnaires that assessed function (Mandibular Functional Index Questionnaire [MFIQ] and Roland Morrison Scale [RMS]), pain intensity (General Pain Intensity questionnaire [GPI]) and psychosocial factors (Hospital Anxiety and Depression scale [HADS]); a 2-item version of the Coping Strategies Questionnaire [CSQ]) were included in the package. Results Thirty-nine out of 60 TMD patients completed the questionnaires. Improvements in TMD symptoms were reported in 10 patients (26%), were unchanged in 16 patients (41%) and worsened in 13 patients (33%). Only 8 patients (21%) were satisfied with the follow-up of the suggested treatments from their GMP. Significant improvements of symptoms were noted in MFIQ (jaw function), GPI (including pain intensity at maximum and suffering from pain), and CSQ (pain related catastrophizing), in all 39 TMD patients as one group. However, a subgroup analysis showed that the significant improvements were mostly within patients who reported improvement of TMD symptoms. A high pain intensity at baseline was a significant risk factor (OR = 5.79, 95% CI: 1.34, 24.96) for patients who reported worsening of TMD symptoms at follow-up. Conclusion High pain intensity at baseline was a significant risk factor for poorer recovery three years after an interdisciplinary evaluation. Our data support the notion that improved coping with TMD pain includes both decreased pain intensity, CSQ and MFIQ scores.
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Affiliation(s)
- Kordian Staniszewski
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Correspondence: Kordian Staniszewski, Department of Clinical Dentistry University of Bergen, Årstadveien 19, Bergen, 5009, Norway, Tel +47 47602632, Email
| | - Lisa Willassen
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Trond Berge
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Anders Johansson
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - Borrik Schjødt
- Centre for Pain Management and Palliative Care, Haukeland University Hospital, Bergen, Norway
| | - Annika Rosen
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
- Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
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Kleykamp BA, Ferguson MC, McNicol E, Bixho I, Arnold LM, Edwards RR, Fillingim R, Grol-Prokopczyk H, Ohrbach R, Turk DC, Dworkin RH. The prevalence of comorbid chronic pain conditions among patients with temporomandibular disorders: A systematic review. J Am Dent Assoc 2022; 153:241-250.e10. [PMID: 34952681 DOI: 10.1016/j.adaj.2021.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/23/2021] [Accepted: 08/19/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND This systematic review was designed to evaluate the presence of comorbid conditions among patients with temporomandibular disorders (TMDs). TYPES OF STUDIES REVIEWED The authors reviewed studies that reported the prevalence or incidence of chronic pain conditions or psychiatric disorders (anxiety, mood, personality disorders) among patients with any type of TMD. The authors calculated sample size-weighted prevalence estimates when data were reported in 2 or more studies for the same comorbid condition. RESULTS A total of 9 prevalence studies and no incidence studies were eligible for review; 8 of the studies examined chronic pain comorbidities. Weighted estimates showed high prevalence of pain comorbidities across studies, including current chronic back pain (66%), myofascial syndrome (50%), chronic stomach pain (50%), chronic migraine headache (40%), irritable bowel syndrome (19%), and fibromyalgia (14%). A single study examined psychiatric disorders and found that current depression was the most prevalent disorder identified (17.5%). CONCLUSIONS AND PRACTICAL IMPLICATIONS There is a high prevalence of comorbid chronic pain conditions among patients with TMDs, with more than 50% of patients reporting chronic back pain, myofascial syndrome, and chronic stomach pain. Psychiatric disorders among patients with different types of TMDs were studied less commonly in this pain population. Knowledge of the distribution of these and other comorbid disease conditions among patients with different types of TMDs can help dentists and other health care providers to identify personalized treatment strategies, including the coordination of care across medical specialties.
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Deutsch G, Deshpande H, Lai HH, Kutch JJ, Ness TJ. Cerebral Perfusion and Sensory Testing Results Differ in Interstitial Cystitis/Bladder Pain Syndrome Patients with and without Fibromyalgia: A Site-Specific MAPP Network Study. J Pain Res 2022; 14:3887-3895. [PMID: 34992450 PMCID: PMC8711634 DOI: 10.2147/jpr.s343695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 12/04/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Fibromyalgia is a common co-morbidity in patients with interstitial cystitis/bladder pain syndrome. Quantitative sensory testing measures and regional cerebral blood flow measures have been noted to differ from healthy controls in both subjects with fibromyalgia and those with interstitial cystitis when studied independently. The present study examined such measures in subjects with the diagnosis of interstitial cystitis both with and without the co-diagnosis of fibromyalgia to determine whether differences in these measures may be associated with co-morbidity. Patients and Methods Female subjects with the diagnosis of interstitial cystitis with (n = 15) and without (n = 19) the co-diagnosis of fibromyalgia as well as healthy control subjects (n = 41) underwent quantitative sensory testing. A subset of these patients (9 with and 9 without fibromyalgia) underwent brain perfusion studies using arterial spin labeled functional magnetic resonance imaging. An analysis was performed of absolute regional cerebral blood flow of regions-of-interest when experiencing a full bladder compared with an empty bladder. Results Subjects with both interstitial cystitis and fibromyalgia were more hypersensitive than those without fibromyalgia as well as healthy controls in most sensory measures except heat. Subjects with interstitial cystitis, but no fibromyalgia, differed from healthy controls only in toleration of the ischemic forearm task. Other co-morbidities were more common in those subjects with both interstitial cystitis and fibromyalgia. Bladder fullness was associated with significantly greater whole brain gray matter blood flow in subjects with interstitial cystitis and fibromyalgia when compared with that of subjects with interstitial cystitis without fibromyalgia. Examination of regional cerebral blood flow in individual regions-of-interest demonstrated statistically significant differences between the subjects with interstitial cystitis with and those without fibromyalgia bilaterally in the thalamus, amygdala and hippocampus, as well as the right prefrontal cortex and greater responsiveness to changes in bladder fullness in the insula. Conclusion Quantitative sensory testing and brain perfusion data support that there are two phenotypes of interstitial cystitis patients, which can be differentiated by a co-diagnosis of fibromyalgia. This may affect responsiveness to treatment and suggest the utility of stratifying interstitial cystitis patients according to their co-morbidities.
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Affiliation(s)
- Georg Deutsch
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hrishikesh Deshpande
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - H Henry Lai
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Jason J Kutch
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Timothy J Ness
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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17
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Bach E, Sigaux N, Fauvernier M, Cousin AS. Reasons for failure of total temporomandibular joint replacement: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2022; 51:1059-1068. [PMID: 35012826 DOI: 10.1016/j.ijom.2021.12.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/10/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the revision rate after total alloplastic temporomandibular joint replacement (TMJR) and determine whether there is a higher risk of revision surgery with stock or custom-fitted prostheses (the two most current TMJR prosthesis types). A systematic review was performed, with a search of PubMed, Google Scholar, and the Cochrane Library in November 2020. Overall, 27 articles were included in this study, describing Biomet and TMJ Concepts prostheses and including postoperative data on complications requiring a return to the operating room. A total of 2247 prostheses were analysed: 1350 stock Biomet prostheses and 897 custom-fitted TMJ Concepts and custom-fitted Biomet prostheses. The global revision rate was 1.19 per 100 prosthesis-years. The most common reason for revision was heterotopic bone formation. Stock prostheses appeared to have a lower risk of revision compared to custom prostheses: rate ratio 0.52 (95% confidence interval 0.33-0.81, P-value 0.003). Regarding causes of revision, the only significant difference between the types of devices was a higher rate of heterotopic bone formation for custom-made prostheses (P = 0.001). The results of this study revealed a low revision rate post TMJR revision, with stock devices even less prone to such risk. Nevertheless, these results can be explained by the fact that custom-made prostheses are more likely to be used for cases in which the anatomy is significantly abnormal or there is a history of multiple joint surgeries, which carry a greater risk of complications and heterotopic bone formation.
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Affiliation(s)
- E Bach
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France.
| | - N Sigaux
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France
| | - M Fauvernier
- Department of Biostatistics, Lyon Sud Hospital, University of Lyon 1, Lyon, France
| | - A-S Cousin
- Department of Maxillofacial and Facial Plastic Surgery, Lyon Sud Hospital, Hospices Civils de Lyon, Pierre-Bénite, Lyon, France
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18
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Shiha MG, Aziz I. Review article: Physical and psychological comorbidities associated with irritable bowel syndrome. Aliment Pharmacol Ther 2021; 54 Suppl 1:S12-S23. [PMID: 34927759 DOI: 10.1111/apt.16589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 12/11/2022]
Abstract
Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders encountered by physicians in primary and secondary care. Patients with IBS commonly present with various extraintestinal complaints, which account for a substantial clinical and economic burden. The common extraintestinal comorbidities associated with IBS include anxiety, depression, somatisation, fibromyalgia, chronic fatigue syndrome, chronic pelvic pain, interstitial cystitis, sexual dysfunction and sleep disturbance. The presence of comorbidity in IBS poses a diagnostic and therapeutic challenge with patients frequently undergoing unnecessary investigations and interventions, including surgery. This review discusses the different physical and psychological comorbidities associated with IBS, the shared pathophysiological mechanisms and potential management strategies.
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Affiliation(s)
- Mohamed G Shiha
- Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK
| | - Imran Aziz
- Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK.,Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
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19
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Chang SJ, Kim HJ, Juon HS, Park H, Choi SW, Lee KE, Ryu H. A comparison of the influencing factors of chronic pain and quality of life between older Koreans and Korean-Americans with chronic pain: a correlational study. Qual Life Res 2021; 31:1179-1189. [PMID: 34462905 PMCID: PMC8960560 DOI: 10.1007/s11136-021-02983-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Chronic pain is one of the most common health problems for older adults worldwide and is likely to result in lower quality of life. Living in a different culture may also influence chronic pain and quality of life in older adults. The purpose of this study was to explore how multifaceted elements affect chronic pain and quality of life in older Koreans living in Korea and in older Korean-Americans (KAs) living in the USA. METHODS We conducted a secondary data analysis of data from 270 adults aged 65 years or over (138 Koreans and 132 KAs). We compared the effects of multifaceted elements on pain and quality of life by testing structural equation models (SEMs) for each group, using a maximum likelihood estimation and bootstrapping. RESULTS SEMs for both Korean and KAs showed that age and depressive symptoms directly affected quality of life. The number of comorbidities and depressive symptoms had mediating effects on quality of life through chronic pain in both groups. In older Koreans only, perceived financial status directly affected quality of life. In older KAs only, sleep quality indirectly affected quality of life through chronic pain. CONCLUSION The data showed that multimorbidity and depressive symptoms play critical roles for explaining chronic pain in older Koreans and KAs and ultimately negatively influence quality of life. Future intervention program to improve quality of life in older adults with chronic pain should consider the different cultural aspects affecting quality of life for Koreans and KAs.
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Affiliation(s)
- Sun Ju Chang
- College of Nursing and The Research Institute of Nursing Science, Seoul National University, Daehak-ro 103, Jongro-gu, Seoul, 406-799, Republic of Korea
| | - Hee Jun Kim
- College of Nursing and Research Institute of Nursing Science, Ajou University, 206 World cup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, Republic of Korea.
| | - Hee-Soon Juon
- Department of Medical Oncology, Thomas Jefferson University, Benjamin Franklin House, 834 Chestnut Street, Philadelphia, PA, 19107, USA
| | - Hyunjeong Park
- Department of Nursing, Towson University, 8000 York Road, Towson, MD, 21252, USA
| | - Seung Woo Choi
- Department of Nursing, College of Medicine, Inha University, 100 Inha-ro Bldg 5S-322, Michuhol-gu, Incheon, Republic of Korea
| | - Kyung-Eun Lee
- College of Nursing, Seoul National University, Daehak-ro 103, Jongro-gu, Seoul, 406-799, Republic of Korea
| | - Hyunju Ryu
- College of Nursing, Seoul National University, Daehak-ro 103, Jongro-gu, Seoul, 406-799, Republic of Korea
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20
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Barjandi G, Kosek E, Hedenberg-Magnusson B, Velly AM, Ernberg M. Comorbid Conditions in Temporomandibular Disorders Myalgia and Myofascial Pain Compared to Fibromyalgia. J Clin Med 2021; 10:3138. [PMID: 34300304 PMCID: PMC8306531 DOI: 10.3390/jcm10143138] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 12/12/2022] Open
Abstract
The impact of comorbidities in fibromyalgia (FM) and temporomandibular disorders (TMD) have been well documented, but whether TMD sub-diagnoses myalgia (MYA) and myofascial pain with referral (MFP) differ regarding comorbidity is unclear. We aimed to elucidate this by studying the presence and associations of comorbidities in FM, MFP and MYA. An extended version of the Diagnostic Criteria for TMD axis II questionnaire was used to examine demographics, pain and comorbidities in 81 patients with FM, 80 with MYA, and 81 with MFP. Patients with MFP and FM reported a higher percentage of irritable bowel syndrome (IBS), depression, anxiety, somatic symptoms, perceived stress, and insomnia compared to MYA. Patients with FM had more IBS, depression, and somatic symptom disorder versus MFP. After adjusting for confounding variables, participants with anxiety, somatic symptoms disorder, pain catastrophizing, and perceived stress, as well as a greater number of comorbidities, were more likely to have MFP than MYA, whereas FM participants were more associated with IBS, somatic symptoms and insomnia compared to MFP. The number of comorbidities was significantly associated with widespread pain but not pain duration, body mass index or being on sick leave. In conclusion, patients with MFP were more similar to those with FM regarding comorbidity and should be differentiated from MYA in clinical settings and pain management.
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Affiliation(s)
- Golnaz Barjandi
- Scandinavian Center for Orofacial Neuroscience (SCON), Department of Dental Medicine, Karolinska Institute, SE141 04 Huddinge, Sweden; (B.H.-M.); (M.E.)
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institute, SE17 165 Stockholm, Sweden;
- Department of Surgical Sciences, Uppsala University, SE751 85 Uppsala, Sweden
| | - Britt Hedenberg-Magnusson
- Scandinavian Center for Orofacial Neuroscience (SCON), Department of Dental Medicine, Karolinska Institute, SE141 04 Huddinge, Sweden; (B.H.-M.); (M.E.)
- Department of Orofacial Pain and Jaw Function, Eastman Institute, SE113 24 Stockholm, Sweden
| | - Ana Miriam Velly
- Faculty of Dentistry, McGill University, Montreal, QC H3T 1E2, Canada;
- Department of Dentistry, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Malin Ernberg
- Scandinavian Center for Orofacial Neuroscience (SCON), Department of Dental Medicine, Karolinska Institute, SE141 04 Huddinge, Sweden; (B.H.-M.); (M.E.)
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21
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Manrriquez SL, Robles K, Pareek K, Besharati A, Enciso R. Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis. J Dent Anesth Pain Med 2021; 21:183-205. [PMID: 34136641 PMCID: PMC8187022 DOI: 10.17245/jdapm.2021.21.3.183] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/21/2021] [Accepted: 04/24/2021] [Indexed: 12/20/2022] Open
Abstract
This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA frequency in patients with temporomandibular disorders (TMD)-HA comorbidity. Randomized controlled trials (RCTs) using full-arch coverage, hard resin, and maxillary SS therapy were included. Electronic databases, including Cochrane Library, MEDLINE through PubMed, Web of Science, and EMBASE, were searched. The risk of bias was analyzed based on Cochrane's handbook. The search yielded 247 references up to January 28, 2020. Nine RCTs were included at a high risk of bias. The comparison groups included other splints, counseling, jaw exercises, medications, neurologic treatment, and occlusal equilibration. Four studies reported a statistically significant reduction in HA intensity, and five studies reported significant improvement in HA frequency from baseline at 2-12 months in patients with TMD-HA comorbidity treated with a full-arch hard maxillary SS. HA frequency in tension-type HA (TTH) comorbid with TMD diagnoses of myofascial pain (MFP) or capsulitis/synovitis improved significantly with SS than that with full-arch maxillary non-occluding splint (NOS) in two studies. Comparison groups receiving hard partial-arch maxillary splint nociceptive trigeminal inhibition (NTI) showed statistically significant improvements in HA intensity in patients with mixed TMD phenotypes of MFP and disc displacement comorbid with “general HA.” Comparison groups receiving partial-arch maxillary resilient/soft splint (Relax) showed significant improvements in both HA intensity and frequency in patients with HA concomitant with MFP. The meta-analysis showed no statistically significant difference in the improvement of pain intensity at 2-3 months with comparison of the splints (partial-arch soft [Relax], hard [NTI], and full-arch NOS) or splint use compliance at 6-12 months with comparison of the splints (partial-arch Relax and full-arch NOS) versus the SS groups in patients with various TMD-HA comorbidities. In conclusion, although SS therapy showed a statistically significant decrease in HA intensity and HA frequency when reported, the evidence quality was low due to the high bias risk and small sample size. Therefore, further studies are required.
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Affiliation(s)
- Salvador L Manrriquez
- Orofacial Pain and Oral Medicine Clinic, Division of Diagnostic Sciences, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
| | - Kenny Robles
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
| | - Kam Pareek
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA.,Department of Diagnostic Sciences, University of the Pacific-Arthur A. Dugoni School of Dentistry, San Francisco, California, USA
| | - Alireza Besharati
- Master of Science Program in Orofacial Pain and Oral Medicine, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
| | - Reyes Enciso
- Division of Dental Public Health and Pediatric Dentistry, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, California, USA
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22
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Proença JDS, Baad-Hansen L, Braido GVDV, Mercante FG, Campi LB, Gonçalves DADG. Lack of correlation between central sensitization inventory and psychophysical measures of central sensitization in individuals with painful temporomandibular disorder. Arch Oral Biol 2021; 124:105063. [PMID: 33529837 DOI: 10.1016/j.archoralbio.2021.105063] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 01/07/2021] [Accepted: 01/10/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess the correlation between the Central Sensitization Inventory (CSI) scores and the results of psychophysical tests and psychosocial questionnaires according to the presence of painful temporomandibular disorder (TMD). DESIGN It was a cross-sectional study involving 146 participants, aged 20-65 years. Painful TMD was classified using the Research Diagnostic Criteria for Temporomandibular Disorders. CSI was applied to assess "central sensitization-related symptoms", as has been suggested. Wind-up ratio, pressure pain threshold and conditioned pain modulation were used as psychophysical tests to evaluate signs and symptoms of central sensitization. Psychosocial factors were assessed by the presence of non-specific physical symptoms, depressive and anxiety symptoms. The sample was divided into two groups: Control (n = 31); Painful TMD (n = 115). Descriptive statistics characterized the sample. Correlation analysis were performed using Pearson's and Spearman's correlation coefficients (α = 5%). RESULTS Of the total sample, 78.8 % presented painful TMD, and the mean (standard deviation) age was 37.4 (±11.5) years. Anxiety symptoms (p = 0.028) and non-specific physical symptoms (p < 0.001) were more frequent in the painful TMD group than in controls. Painful TMD patients presented higher scores of the CSI (p < 0.001) and lower pressure pain thresholds (p ≤ 0.020) compared to controls. CSI scores were significantly correlated with psychosocial measures (p < 0.001) but not with psychophysical tests (p ≥ 0.089). CONCLUSION The CSI scores did not correlate with psychophysical measures of central sensitization but were positively correlated with the results of psychosocial questionnaires.
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Affiliation(s)
- Juliana Dos Santos Proença
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil.
| | - Lene Baad-Hansen
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Guilherme Vinícius do Vale Braido
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Fernanda Gruninger Mercante
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
| | - Letícia Bueno Campi
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil
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23
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Kang JH. Neck associated factors related to migraine in adolescents with painful temporomandibular disorders. Acta Odontol Scand 2021; 79:43-51. [PMID: 32529877 DOI: 10.1080/00016357.2020.1774649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Migraine is a comorbidity of painful temporomandibular disorders (TMDs). Both migraine and painful TMD have associations with neck pain and head posture. The aim of this study was to clarify the role of neck pain and head posture on the association between migraine and painful TMD in adolescents. MATERIALS AND METHOD In total 314 adolescents were included: 235 adolescents with only painful TMD (pTMD) and 79 adolescents with painful TMD and migraine (TMDMIG). Adolescents were diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders and International Classification of Headache Disorders, 3rd edition. Head postures were identified using lateral cephalograms. Myofascial trigger points (TrPs) were evaluated in the temporalis, masseter, trapezius, sternocleidomastoid, sub-occipitalis, and splenius capitis muscles. RESULTS Multivariate logistic regression analysis confirmed the associations among the orofacial pain duration, number of active TrPs in the trapezius muscles, intensity of neck pain, and distance between the occiput and atlas and migraine in adolescents with TMD. The relationships among intensity of neck pain, number of TrPs in the cervical muscles, and head posture were more prominent in the TMDMIG than those in the pTMD. CONCLUSION Neck associated factors seemed to have relevance with migraine in adolescents with painful TMD.
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Affiliation(s)
- Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea (ROK)
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Kleykamp BA, Ferguson MC, McNicol E, Bixho I, Arnold LM, Edwards RR, Fillingim R, Grol-Prokopczyk H, Turk DC, Dworkin RH. The Prevalence of Psychiatric and Chronic Pain Comorbidities in Fibromyalgia: an ACTTION systematic review. Semin Arthritis Rheum 2020; 51:166-174. [PMID: 33383293 DOI: 10.1016/j.semarthrit.2020.10.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/21/2020] [Accepted: 10/16/2020] [Indexed: 02/07/2023]
Abstract
Fibromyalgia (FM) is a chronic widespread pain condition that overlaps with multiple comorbid health conditions and contributes to considerable patient distress. The aim of this review was to provide a systematic overview of psychiatric and chronic pain comorbidities among patients diagnosed with FM and to inform the development of recommendations for the design of clinical trials. Thirty-one, cross-sectional, clinical epidemiology studies that evaluated patients diagnosed with FM were included for review. None of the reviewed studies reported on the incidence of these comorbidities. Sample size-weighted prevalence estimates were calculated when prevalence data were reported in 2 or more studies for the same comorbid condition. The most prevalent comorbidity across all studies reviewed was depression/major depressive disorder (MDD) with over half of the patients included having this diagnosis in their lifetime (weighted prevalence up to 63%). In addition, nearly one-third of FM patients examined had current or lifetime bipolar disorder, panic disorder, or post-traumatic stress disorder. Less common psychiatric disorders reported included generalized anxiety disorder, obsessive compulsive disorder, and specific phobias (agoraphobia, social phobia). There were fewer studies that examined chronic pain comorbidities among FM patients, but when evaluated, prevalence was also high ranging from 39% to 76% (i.e., chronic tension-type or migraine headache, irritable bowel syndrome, myofascial pain syndrome, and temporomandibular disorders). The results of the review suggest that depression and chronic pain conditions involving head/jaw pain and IBS were elevated among FM patients compared to other conditions in the clinic-based studies. In contrast, anxiety-related disorders were much less common. Addressing the presence of these comorbid health conditions in clinical trials of treatments for FM would increase the generalizability and real-world applicability of FM research.
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Affiliation(s)
- Bethea A Kleykamp
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
| | - McKenzie C Ferguson
- Southern Illinois University Edwardsville, School of Pharmacy, Edwardsville, IL, USA
| | | | - Ida Bixho
- MCPHS University, Boston, MA, USA; Sanofi Genzyme, Cambridge, MA, USA
| | - Lesley M Arnold
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | - Roger Fillingim
- University of Florida, College of Dentistry, and Pain Research and Intervention Center of Excellence, Gainesville, FL, USA
| | | | | | - Robert H Dworkin
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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Erdrich S, Hawrelak JA, Myers SP, Harnett JE. A systematic review of the association between fibromyalgia and functional gastrointestinal disorders. Therap Adv Gastroenterol 2020; 13:1756284820977402. [PMID: 33343707 PMCID: PMC7727037 DOI: 10.1177/1756284820977402] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/09/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Fibromyalgia and functional gastrointestinal disorders (FGID) including irritable bowel syndrome (IBS) are common conditions presenting in clinical settings and are more prevalent in women. While the relationship between IBS and fibromyalgia has been demonstrated, a review of the prevalence of the broader group of FGID in adults with fibromyalgia has not been undertaken. The aim of this review was to systematically review the published literature, identifying the comorbidity of FGID in people with fibromyalgia, and to discuss the clinical implications, limitations of current research and areas of interest for future research. METHODS Medline, Embase, CINAHL and Web of Science were searched during June 2019. Results were screened for original research articles meeting established criteria for identification of FGID in adults diagnosed with fibromyalgia. RESULTS A total of 14 studies involving 1340 adults with fibromyalgia, 363 healthy controls and 441 adults with other pathologies were included in this review. Only 1 of the 14 studies included surveyed the full range of FGID . Functional gut disorders were matched to Rome II criteria for reporting and comparison. In addition to increased abdominal pain and functional bloating or gas, IBS of mixed-pattern and constipation-types appear to be more prevalent than diarrhoea-predominant IBS in adults with fibromyalgia. CONCLUSION This review confirms previous reports that IBS is common in people living with fibromyalgia and suggests that IBS-mixed and constipation types predominate. An association with a range of FGID other than IBS is suggested, but data are limited. Research exploring the association between fibromyalgia and functional gastrointestinal dysfunction beyond IBS are warranted.
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Affiliation(s)
- Sharon Erdrich
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Science Road, Camperdown, Sydney, New South Wales 2006, Australia
| | - Jason A. Hawrelak
- College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Stephen P. Myers
- NatMed Research Unit, Office of the Deputy Vice Chancellor (Research), Southern Cross University, Lismore, New South Wales, Australia
| | - Joanna E. Harnett
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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Fong LX, Veerabhadrappa SK, Yadav S, Bin Zamzuri AT, Talib RB. Evaluation of orofacial pain and psychological comorbidities in health sciences university students. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2020. [DOI: 10.1051/mbcb/2020055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Introduction: Orofacial pain (OP) is a common public health problem among the general population however, its distribution among the young population like students has not been evaluated so far. The objectives of this study were to investigate the self-reported prevalence, and characteristics of OP, and to evaluate its association with psychological comorbidities such as anxiety and depression. Materials and Methods: A questionnaire-based study was conducted on students studying health sciences programs at SEGi University, Malaysia. A well-designed, structured questionnaire was utilized to assess the prevalence and characteristics of OP. Hospital Anxiety and Depression (HAD) scale was used to evaluate the psychological status of the students. The collected data was subject to statistical analysis by using the SPSS version 22 software. Results: Overall 494 university students had participated in the study of which, 78% (n = 375) of students had suffered from OP and it was significantly higher among the female students (p < 0.03). Headache was the most common type of OP (66.2%) followed by pain in temple region (47.2%), in and around eyes (29.1%), facial region (23.3%), and tooth/gingival pain (20.9%). The association between the prevalence of OP and anxiety was statistically significant (p < 0.019). About 35.4% of the health sciences students had first OP episode started three months ago, 4.2% had daily pain, 14.3% suffered from continuous pain, and only 14% of the students had consulted professionals and 36.1% of them took medication. Conclusion: A significantly higher prevalence of self-reported OP was evident among the health sciences university students and students with different types of OP had higher anxiety and depression scores. Early recognition of OP symptoms and associated comorbidities must be considered for the prevention and successful management of these conditions to circumvent its negative academic impact on the students.
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Rodrigues-de-Souza DP, Paz-Vega J, Fernández-de-las-Peñas C, Cleland JA, Alburquerque-Sendín F. Is Irritable Bowel Syndrome Considered in Clinical Trials on Physical Therapy Applied to Patients with Temporo-Mandibular Disorders? A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228533. [PMID: 33213056 PMCID: PMC7698821 DOI: 10.3390/ijerph17228533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023]
Abstract
The aim of the current scoping review was to identify if the presence of irritable bowel syndrome was included as eligibility criteria of participants included in clinical trials investigating the effects of physical therapy in individuals with temporomandibular pain disorders (TMDs). A systematic electronic literature search in the Web of Science database was conducted. Scientifically relevant, randomized clinical trials (those cited in other studies at least 5 times, or clinical trials published in high-impact journals, i.e., first and second quartiles (Q1-Q2) of any category of the Journal Citation Report (JCR)) evaluating the effects of any physical therapy intervention in patients with TMDs were included. The Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality of the selected trials. Authors affiliated to a clinical or non-clinical institution, total number of citations, objective, sex/gender, age, and eligibility criteria in each article were extracted and analyzed independently by two authors. From a total of 98 identified articles, 12 and 19 clinical trials were included according to the journal citation criterion or JCR criterion, respectively. After removing duplicates, a total of 23 trials were included. The PEDro score ranged from 4 to 8 (mean: 6.26, SD: 1.48). Based on the eligibility criteria of the trials systematically reviewed, none considered the presence of comorbid irritable bowel syndrome in patients with TMDs. The comorbidity between TMDs and irritable bowel syndrome is not considered within the eligibility criteria of participants in highly cited clinical trials, or published in a high-impact journal, investigating the effects of physical therapy in TMDs.
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Affiliation(s)
- Daiana P. Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (D.P.R.-d.-S.); (J.P.-V.); (F.A.-S.)
| | - Javier Paz-Vega
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (D.P.R.-d.-S.); (J.P.-V.); (F.A.-S.)
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Madrid, Spain
- Correspondence: ; Tel.: +34-914-888-884
| | - Joshua A. Cleland
- Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA 02155, USA;
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (D.P.R.-d.-S.); (J.P.-V.); (F.A.-S.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
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van der Wal A, Van de Heyning P, Gilles A, Jacquemin L, Topsakal V, Van Rompaey V, Braem M, Visscher CM, Truijen S, Michiels S, De Hertogh W. Prognostic Indicators for Positive Treatment Outcome After Multidisciplinary Orofacial Treatment in Patients With Somatosensory Tinnitus. Front Neurosci 2020; 14:561038. [PMID: 33041758 PMCID: PMC7525007 DOI: 10.3389/fnins.2020.561038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/18/2020] [Indexed: 01/12/2023] Open
Abstract
Introduction Subjective tinnitus that is influenced by the somatosensory system is called somatosensory tinnitus (ST). When ST is related to the temporomandibular area, multidisciplinary orofacial treatment can reduce tinnitus severity. It is, however, unknown if we can predict this positive outcome. The aim of this study is to look for prognostic indicators that can predict a positive outcome after multidisciplinary orofacial treatment in patients with ST. Methods Patients were included when they were diagnosed with temporomandibular-related ST and received a maximum of 18 sessions of orofacial treatment during a 9-week program. Predictors for positive treatment outcome were identified using univariate and multiple logistic regression analyses with the Tinnitus Questionnaire (TQ) and the Tinnitus Functional Index (TFI) as dependent variables. Results The results of 101 patients were included in the analysis. Immediately after multidisciplinary orofacial treatment, a clinically relevant decrease in TQ score was significantly associated with “shorter duration of tinnitus” [odds ratio (OR) 0.99], “higher initial score on the TQ somatic subscale” (OR 1.52), and “painful palpation of the temporomandibular joint (TMJ)” (OR 2.46). After 9 weeks of follow-up, the “higher initial score on the TQ somatic subscale” remained as the sole predictor (OR 1.44). A clinically relevant decrease on TFI after 9 weeks of follow-up was predicted by “female gender” (OR 2.70), “younger age” (OR 0.96), “shorter duration of the tinnitus” (OR 0.99), “lower pressure pain thresholds (PPT) on TMJ” (OR 0.99), “lower PPT on sternocleidomastoid origin” (OR 0.99), and “better speech in noise perception” (OR 0.88). A multivariate model comprising “shorter duration of tinnitus” and “higher initial score on the somatic subscale of the TQ” correctly predicts the clinically relevant decrease in TQ score after treatment in 68.5%. A second multivariate model comprising “female gender,” “younger age,” and “shorter duration of the tinnitus” correctly predicts a clinically significant decrease on TFI after follow-up in 68.1%. Conclusion We were able to identify various prognostic indicators. “Younger female patients” with a “shorter duration of tinnitus” and a “higher initial score on the TQ somatic subscale” appear to have the best prognosis after multimodal orofacial therapy.
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Affiliation(s)
- Annemarie van der Wal
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Multidisciplinary Motor Centre Antwerp, University of Antwerp, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Annick Gilles
- Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Human and Social Welfare, University College Ghent, Ghent, Belgium
| | - Laure Jacquemin
- Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vedat Topsakal
- Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Marc Braem
- Lab Dental Materials, University of Antwerp, Antwerp, Belgium.,Special Care Dentistry, University Hospital Antwerp, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Corine Mirjam Visscher
- Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam, Research Institute MOVE Amsterdam, University of Amsterdam, VU University Amsterdam, Amsterdam, Netherlands
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Sarah Michiels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Willem De Hertogh
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Al-Huraishi HA, Meisha DE, Algheriri WA, Alasmari WF, Alsuhaim AS, Al-Khotani AA. Newly graduated dentists' knowledge of temporomandibular disorders compared to specialists in Saudi Arabia. BMC Oral Health 2020; 20:272. [PMID: 33028397 PMCID: PMC7542860 DOI: 10.1186/s12903-020-01259-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 09/22/2020] [Indexed: 11/30/2022] Open
Abstract
Background General dentists are often the first healthcare professionals to see patients with orofacial pain (OFP). OFP conditions associated with the temporomandibular joint are often confused with dentoalveolar disorders, which leads to mismanagement. The objective of this study was to evaluate the level of knowledge of temporomandibular disorders (TMD) among newly graduated dentists compared to OFP specialists in Saudi Arabia. Methods This was a descriptive cross-sectional study utilizing an anonymous validated questionnaire assessing professional knowledge regarding TMDs in newly qualified dentists and OFP specialists. The questionnaire interrogated four domains including chronic pain/pain behavior, etiology, diagnosis/classification, and treatment/prognosis. OFP specialists were used as the reference group. Results A total of 393 dentists participated, a response rate of 67.6% in newly graduated dentists and 77.3% in OFP specialists. The degree of agreement between newly graduated general dentists and OFP specialists was highest for the “chronic pain and pain behavior” domain. The consensus among specialists was highest for the “treatment and prognosis” domain and the least for the “chronic pain and pain behavior” domain. Conclusion Newly graduated general dentists have limited knowledge of TMD in almost all domains compared to specialists. Given that a lack of knowledge of TMD can lead to clinical mismanagement, dental school curricula must address this important knowledge gap.
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Affiliation(s)
- Haila A Al-Huraishi
- Department of Orofacial Pain and Jaw Function, Riyadh Specialized Dental Center, Riyadh, Saudi Arabia.,Scandinavian Center for Orofacial Neurosciences (SCON), Malmö/Huddinge, Sweden
| | - Dalia E Meisha
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Wafa A Algheriri
- Department of Dentistry, John Hopkins Aramco Health Care Hospital, Dhahran, Saudi Arabia
| | | | | | - Amal A Al-Khotani
- Scandinavian Center for Orofacial Neurosciences (SCON), Malmö/Huddinge, Sweden.,East Jeddah Hospital, Ministry of Health, Jeddah, Saudi Arabia
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Blanchard L, Goostree S, Duncombe A. Graded exposure and orthopedic manual physical therapy for kinesiophobia and function in chronic temporomandibular dysfunction: A case report. Cranio 2020; 40:454-467. [PMID: 32552574 DOI: 10.1080/08869634.2020.1779483] [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: 10/24/2022]
Abstract
BACKGROUND This case report describes the successful use of multi-modal physical therapy (PT), including orthopedic manual physical therapy (OMPT) and graded exposure, in a patient with chronic temporomandibular dysfunction (TMD). CLINICAL PRESENTATION A 41-yr old female presented with a five-year history of bilateral chronic myofascial TMD and comorbid neck/right arm pain. The patient was treated for 12 weeks with a focus on OMPT and graded exposure. The patient demonstrated clinically significant improvements on the Tampa Scale of Kinesiophobia-TMD, maximal mouth opening, Global Rating of Change, and Jaw Functional Limitation Scale. CLINICAL RELEVANCE Mechanisms underlying chronic TMD are complex. Current evidence supports PT management of physical impairments; however, neglecting central drivers or psychosocial factors may result in suboptimal outcomes. Physical therapists are able to address both peripheral and central mechanisms of pain, and future research should examine the utilization of multi-modal PT to improve kinesiophobia and function in patients with chronic TMD.
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Affiliation(s)
- Leanna Blanchard
- Department of Rehabilitation Services, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | | | - Alison Duncombe
- Department of Rehabilitation Services, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
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A Pre-Existing Myogenic Temporomandibular Disorder Increases Trigeminal Calcitonin Gene-Related Peptide and Enhances Nitroglycerin-Induced Hypersensitivity in Mice. Int J Mol Sci 2020; 21:ijms21114049. [PMID: 32516986 PMCID: PMC7313473 DOI: 10.3390/ijms21114049] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 05/31/2020] [Accepted: 06/03/2020] [Indexed: 12/14/2022] Open
Abstract
Migraine is commonly reported among patients with temporomandibular disorders (TMDs), especially myogenic TMD. The pathophysiologic mechanisms related to the comorbidity of the two conditions remain elusive. In the present study, we combined masseter muscle tendon ligation (MMTL)-produced myogenic TMD with systemic injection of nitroglycerin (NTG)-induced migraine-like hypersensitivity in mice. Facial mechanical allodynia, functional allodynia, and light-aversive behavior were evaluated. Sumatriptan, an FDA-approved medication for migraine, was used to validate migraine-like hypersensitivity. Additionally, we examined the protein level of calcitonin gene-related peptide (CGRP) in the spinal trigeminal nucleus caudalis using immunohistochemistry. We observed that mice with MMTL pretreatment have a prolonged NTG-induced migraine-like hypersensitivity, and MMTL also enabled a non-sensitizing dose of NTG to trigger migraine-like hypersensitivity. Systemic injection of sumatriptan inhibited the MMTL-enhanced migraine-like hypersensitivity. MMTL pretreatment significantly upregulated the protein level of CGRP in the spinal trigeminal nucleus caudalis after NTG injection. Our results indicate that a pre-existing myogenic TMD can upregulate NTG-induced trigeminal CGRP and enhance migraine-like hypersensitivity.
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Effects on migraine, neck pain, and head and neck posture, of temporomandibular disorder treatment: Study of a retrospective cohort. Arch Oral Biol 2020; 114:104718. [DOI: 10.1016/j.archoralbio.2020.104718] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 03/23/2020] [Accepted: 04/01/2020] [Indexed: 12/26/2022]
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De Stefano R, Bruno A, Muscatello MRA, Cedro C, Cicciù A, Rullo R, Gaeta M, Fiorillo L. Oral Health and Fibromyalgia Syndrome: A Systemic Review. J Funct Morphol Kinesiol 2020; 5:E7. [PMID: 33467223 PMCID: PMC7739237 DOI: 10.3390/jfmk5010007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 01/13/2020] [Accepted: 01/17/2020] [Indexed: 12/12/2022] Open
Abstract
Fibromyalgia is a syndrome currently considered idiopathic and multifactorial rheumatic that causes an increase in muscle tension and is characterized by muscle pain and chronic fibrous tissues-widespread, fluctuating and migrating-associated with stiffness, asthenia, cognitive disorders, insomnia or sleep disorders, alterations in sensitivity to stimuli. In affected patients, there may be anxiety or depressive disorder development. The aim of this study is, with the help of an interdisciplinary team, to evaluate the correlations between this syndrome and oral health. A literature review was conducted, analyzing the most common scientific databases, more than 200 studies were obtained. Subsequently to the application of filters and revision by the authors, only 18 articles were considered eligible for this review. From the results, it is clear that the correlations between fibromyalgia and oral health mainly concern pain in the oro-maxillofacial district, especially in the temporomandibular joint. This certainly could help for faster diagnosis of the syndrome, which is currently difficult to identify.
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Affiliation(s)
- Rosa De Stefano
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina ME, Italy; (R.D.S.); (A.B.); (M.R.A.M.); (C.C.); (M.G.)
| | - Antonio Bruno
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina ME, Italy; (R.D.S.); (A.B.); (M.R.A.M.); (C.C.); (M.G.)
| | - Maria Rosaria Anna Muscatello
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina ME, Italy; (R.D.S.); (A.B.); (M.R.A.M.); (C.C.); (M.G.)
| | - Clemente Cedro
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina ME, Italy; (R.D.S.); (A.B.); (M.R.A.M.); (C.C.); (M.G.)
| | - Alessandra Cicciù
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, 98100 Messina ME, Italy;
| | - Rosario Rullo
- Department of Biomedical and Surgical and Biomedical Sciences Naples University, 80100 Naples, Italy;
| | - Michele Gaeta
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, University of Messina, 98100 Messina ME, Italy; (R.D.S.); (A.B.); (M.R.A.M.); (C.C.); (M.G.)
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences, Morphological and Functional Images, School of Dentistry, University of Messina, 98100 Messina ME, Italy;
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Mobilio N, Iovino P, Bruno V, Catapano S. Severity of irritable bowel syndrome in patients with temporomandibular disorders: A case-control study. J Clin Exp Dent 2019. [PMID: 31636872 DOI: 10.4317/jced.55649.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background To assess the risk and severity of IBS in a population of TMD patients. Material and Methods Subjects for the study group were recruited from patients attending the Dental Clinic. Health controls (HC) were recruited among patients' friends and clinic staff. All subjects filled in the RDC/TMD questionnaire and the ROME III questionnaire for the diagnosis of IBS. The IBS Severity Scoring System (IBS-SSS) was used to evaluate the severity of each case of IBS. Categorical variables were compared through the Chi square test. The risk of having abdominal pain was analysed using logistic regression. Results Twenty-two (46.8%) cases of IBS were diagnosed among TMD patients, whereas only 4 (11.4%) were in the HC group. This difference was statistically significant (χ2(1)=11.6; p<.01). The differences in the distribution of IBS-SSS were statistically significant (χ2(3)=12.49; p<.05). The regression model resulted statistically significant (χ2(5)=24.08; p<.001, R2=.37): abdominal pain was significantly related to nonspecific physical symptoms independent of the other variables. Conclusions TMD patients had a greater risk of having IBS compared to HC. TMD patients presented also more severe form of IBS than HC. Key words:Temporomandibular disorders, irritable bowel syndrome, facial pain, case-control study.
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Affiliation(s)
- Nicola Mobilio
- DDS, Research Assistant, Dental School, Dental Clinic, University of Ferrara, c.so Giovecca, 203, 44121 Ferrara, Italy
| | - Paola Iovino
- MD, Associate Professor, Functional GI Disorders Center at Gastrointestinal Unit, AOU S. Giovanni di Dio e Ruggi d'Aragona, Department of Medicine and Surgery, University of Salerno, v. S. Allende, Baronissi, 84084 Salerno, Italy
| | - Vincenzo Bruno
- MD, DDS, Lecturer, Dental School, Dental Clinic, University of Ferrara, c.so Giovecca, 203, 44121 Ferrara, Italy
| | - Santo Catapano
- MD, DDS, Associate Professor, Dental School, Dental Clinic, University of Ferrara, c.so Giovecca, 203, 44121 Ferrara, Italy
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Mobilio N, Iovino P, Bruno V, Catapano S. Severity of irritable bowel syndrome in patients with temporomandibular disorders: A case-control study. J Clin Exp Dent 2019; 11:e802-e806. [PMID: 31636872 PMCID: PMC6797452 DOI: 10.4317/jced.55649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/13/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To assess the risk and severity of IBS in a population of TMD patients. MATERIAL AND METHODS Subjects for the study group were recruited from patients attending the Dental Clinic. Health controls (HC) were recruited among patients' friends and clinic staff. All subjects filled in the RDC/TMD questionnaire and the ROME III questionnaire for the diagnosis of IBS. The IBS Severity Scoring System (IBS-SSS) was used to evaluate the severity of each case of IBS. Categorical variables were compared through the Chi square test. The risk of having abdominal pain was analysed using logistic regression. RESULTS Twenty-two (46.8%) cases of IBS were diagnosed among TMD patients, whereas only 4 (11.4%) were in the HC group. This difference was statistically significant (χ2(1)=11.6; p<.01). The differences in the distribution of IBS-SSS were statistically significant (χ2(3)=12.49; p<.05). The regression model resulted statistically significant (χ2(5)=24.08; p<.001, R2=.37): abdominal pain was significantly related to nonspecific physical symptoms independent of the other variables. CONCLUSIONS TMD patients had a greater risk of having IBS compared to HC. TMD patients presented also more severe form of IBS than HC. Key words:Temporomandibular disorders, irritable bowel syndrome, facial pain, case-control study.
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Affiliation(s)
- Nicola Mobilio
- DDS, Research Assistant, Dental School, Dental Clinic, University of Ferrara, c.so Giovecca, 203, 44121 Ferrara, Italy
| | - Paola Iovino
- MD, Associate Professor, Functional GI Disorders Center at Gastrointestinal Unit, AOU S. Giovanni di Dio e Ruggi d'Aragona, Department of Medicine and Surgery, University of Salerno, v. S. Allende, Baronissi, 84084 Salerno, Italy
| | - Vincenzo Bruno
- MD, DDS, Lecturer, Dental School, Dental Clinic, University of Ferrara, c.so Giovecca, 203, 44121 Ferrara, Italy
| | - Santo Catapano
- MD, DDS, Associate Professor, Dental School, Dental Clinic, University of Ferrara, c.so Giovecca, 203, 44121 Ferrara, Italy
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Sahdev R, Wu BW, Anderson N, Khawaja SN, Kim S, Keith DA. A Retrospective Study of Patient Outcomes After Temporomandibular Joint Replacement With Alloplastic Total Joint Prosthesis at Massachusetts General Hospital. J Oral Maxillofac Surg 2019; 77:280-288. [DOI: 10.1016/j.joms.2018.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/06/2018] [Accepted: 09/07/2018] [Indexed: 11/24/2022]
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Vivaldi D, Di Giosia M, Tchivileva IE, Jay GW, Slade GD, Lim PF. Headache attributed to TMD Is Associated With the Presence of Comorbid Bodily Pain: A Case-Control Study. Headache 2018; 58:1593-1600. [DOI: 10.1111/head.13404] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 06/24/2018] [Accepted: 06/25/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Daniela Vivaldi
- Department of Endodontics and Department of Dental Ecology, School of Dentistry; UNC-CH; Chapel Hill NC USA
| | | | - Inna E. Tchivileva
- Department of Endodontics, School of Dentistry; UNC-CH; Chapel Hill NC USA
| | - Gary W. Jay
- Department of Neurology, School of Medicine; UNC-CH; Chapel Hill NC USA
| | - Gary D. Slade
- Department of Dental Ecology, School of Dentistry; UNC-CH; Chapel Hill NC USA
| | - Pei F. Lim
- Department of Endodontics, School of Dentistry; UNC-CH; Chapel Hill NC USA
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Mitrirattanakul S, Jariyasakulroj S. Dental treatment as perceived etiology of temporomandibular disorders. Cranio 2018; 38:109-114. [DOI: 10.1080/08869634.2018.1495304] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Maulén-Yáñez M, Meeder-Bella W, Videla-Jiménez PJ, González-Arriagada WA. Assessment of association between muscular diagnosis in temporomandibular disorders with mandibular kinematics. Cranio 2018; 37:365-373. [PMID: 29734882 DOI: 10.1080/08869634.2018.1465513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective: To study the association between mandibular kinematics and muscular diagnoses in temporomandibular disorders (TMD). Method: Retrospective, descriptive clinical study based on an analysis of 370 clinical records of muscle diagnoses in TMD. Statistical analysis was performed with the SPSS program. Results: Five different muscle diagnoses were considered. Myospasm and centrally mediated myalgia were discarded from the statistical analysis because of their low incidences. The diagnoses included in the analysis were protective co-contraction, myofascial pain, and myalgia. Decreased mandibular kinematics in the frontal and horizontal planes were related to myofascial pain. Mandibular kinematics with deflection in opening values decreased in the frontal plane, but intermediate or increased values in the horizontal plane were related to the protective co-contraction. Muscle pain with normal or increased mandibular kinematics was associated with a diagnosis of myalgia. Conclusion: Values of mandibular kinematics are correlated with the muscular diagnoses in TMD and are useful for diagnosis.
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Affiliation(s)
- Miguel Maulén-Yáñez
- Facultad de Odontología, Universidad de Valparaíso , Valparaíso , Chile.,Clinic of Temporomandibular Disorders and Orofacial Pain, Department of Dentistry, Gustavo Fricke Hospital , Viña del Mar , Chile
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Visscher CM, Baad-Hansen L, Durham J, Goulet JP, Michelotti A, Roldán Barraza C, Häggman-Henrikson B, Ekberg E, Raphael KG. Benefits of implementing pain-related disability and psychological assessment in dental practice for patients with temporomandibular pain and other oral health conditions. J Am Dent Assoc 2018; 149:422-431. [PMID: 29653670 DOI: 10.1016/j.adaj.2017.12.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 12/15/2017] [Accepted: 12/20/2017] [Indexed: 10/17/2022]
Abstract
BACKGROUND Evidence in the field of dentistry has demonstrated the importance of pain-related disability and psychological assessment in the development of chronic symptoms. The Diagnostic Criteria for Temporomandibular Disorders offer a brief assessment for the diagnostic process in patients with orofacial pain (Axis II). The authors describe relevant outcomes that may guide general oral health care practitioners toward tailored treatment decisions and improved treatment outcomes and provide recommendations for the primary care setting. METHODS The authors conducted a review of the literature to provide an overview of knowledge about Axis II assessment relevant for the general oral health care practitioner. RESULTS The authors propose 3 domains of the Axis II assessment to be used in general oral health care: pain location (pain drawing), pain intensity and related disability (Graded Chronic Pain Scale [GCPS]), and psychological distress (Patient Health Questionnaire-4 [PHQ-4]). In the case of localized pain, low GCPS scores (0-II), and low PHQ-4 scores (0-5), patients preferably receive treatment in primary care. In the case of widespread pain, high GCPS scores (III-IV), and high PHQ-4 scores (6-12), the authors recommend referral to a multidisciplinary team, especially for patients with temporomandibular disorder (TMD) pain. CONCLUSIONS The authors recommend psychological assessment at first intake of a new adult patient or for patients with persistent TMD pain. The authors recommend the pain-related disability screening tools for all TMD pain symptoms and for dental pain symptoms that persist beyond the normal healing period. PRACTICAL IMPLICATIONS A brief psychological and pain-related disability assessment for patients in primary care may help the general oral health care practitioner make tailored treatment decisions.
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Pagé MG, Fortier M, Ware MA, Choinière M. As if one pain problem was not enough: prevalence and patterns of coexisting chronic pain conditions and their impact on treatment outcomes. J Pain Res 2018; 11:237-254. [PMID: 29416373 PMCID: PMC5790081 DOI: 10.2147/jpr.s149262] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The presence of multiple coexisting chronic pain (CP) conditions (eg, low-back pain and migraines) within patients has received little attention in literature. The goals of this observational longitudinal study were to determine the prevalence of coexisting CP conditions, identify the most frequent ones and patterns of coexistence, investigate the relationships among patients' biopsychosocial characteristics and number of CP conditions, and determine the impact of coexisting CP conditions on treatment response. PATIENTS AND METHODS A total of 3,966 patients attending multidisciplinary pain-treatment centers who were enrolled in the Quebec Pain Registry were included. Patients completed self-report and nurse-administered questionnaires before their first visit and 6 months later. Results were analyzed using descriptive statistics, factor and cluster analyses, negative binomials with log-link generalized linear models, and linear mixed-effect models. RESULTS A third of patients reported coexisting CP conditions. No specific patterns of comorbidities emerged. The presence of coexisting CP conditions was associated with longer pain duration, older age, being female, and poorer quality of life. The presence of more than one CP condition did not have a clinically significant impact on treatment responses. DISCUSSION The novelty of the study results relate to the heterogeneity that was found in the patterns of coexistence of CP conditions and the fact that having multiple CP conditions did not clinically impact treatment response. These results highlight the need for future research that examines causes of coexistence among CP conditions across the spectrum of CP, as opposed to focusing on specific conditions, and to examine whether multiple CP conditions impact on additional domains, such as treatment satisfaction. These results highlight the importance of studying the pathophysiological mechanisms underlying the development of coexisting CP conditions, in order eventually to prevent/minimize their occurrence and/or develop optimal treatment and management approaches.
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Affiliation(s)
- M Gabrielle Pagé
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM)
- Department of Biomedical Sciences, Faculty of Medicine, Université de Montréal
| | - Maude Fortier
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM)
| | - Mark A Ware
- Department of Family Medicine
- Department of Anesthesia, Faculty of Medicine
- Alan Edwards Centre for Research on Pain, McGill University
| | - Manon Choinière
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CRCHUM)
- Department of Anesthesiology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
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Mercuri LG. Temporomandibular Joint Disorder Management in Oral and Maxillofacial Surgery. J Oral Maxillofac Surg 2017; 75:927-930. [DOI: 10.1016/j.joms.2016.10.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 11/28/2022]
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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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Diverse Physiological Roles of Calcitonin Gene-Related Peptide in Migraine Pathology: Modulation of Neuronal-Glial-Immune Cells to Promote Peripheral and Central Sensitization. Curr Pain Headache Rep 2017; 20:48. [PMID: 27334137 DOI: 10.1007/s11916-016-0578-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The neuropeptide calcitonin gene-related peptide (CGRP) is implicated in the underlying pathology of migraine by promoting the development of a sensitized state of primary and secondary nociceptive neurons. The ability of CGRP to initiate and maintain peripheral and central sensitization is mediated by modulation of neuronal, glial, and immune cells in the trigeminal nociceptive signaling pathway. There is accumulating evidence to support a key role of CGRP in promoting cross excitation within the trigeminal ganglion that may help to explain the high co-morbidity of migraine with rhinosinusitis and temporomandibular joint disorder. In addition, there is emerging evidence that CGRP facilitates and sustains a hyperresponsive neuronal state in migraineurs mediated by reported risk factors such as stress and anxiety. In this review, the significant role of CGRP as a modulator of the trigeminal system will be discussed to provide a better understanding of the underlying pathology associated with the migraine phenotype.
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Gallotta S, Bruno V, Catapano S, Mobilio N, Ciacci C, Iovino P. High risk of temporomandibular disorder in irritable bowel syndrome: Is there a correlation with greater illness severity? World J Gastroenterol 2017; 23:103-109. [PMID: 28104985 PMCID: PMC5221272 DOI: 10.3748/wjg.v23.i1.103] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/12/2016] [Accepted: 12/08/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the prevalence and the risk of temporomandibular disorders (TMDs) in patients with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhoea, and mixed) compared to the general population.
METHODS Between January 2014 and December 2015 we enrolled consecutively adult patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy controls (HC) without IBS. At enrollment, we analyzed all patients for the presence of TMDs according to the Research Diagnostic Criteria for TMD.
RESULTS We enrolled 91 IBS patients (23 IBS-D, 30 IBS-C and 38 IBS-M) and 57 HC in the study. We found a higher risk of having TMD (OR = 3.41, 95%CI: 1.66-7.01) compared to the HC. The risk of having TMD was independent of IBS-subtype. Multiple regression analysis showed that facial pain was positively related to abdominal pain and higher level of depression.
CONCLUSION IBS patients had a more than three times greater risk of TMD compared to HC. The risk of having TMD was similar in different IBS subtypes. IBS patients that also fulfilled criteria for TMD seem to share along with chronic facial and abdominal pain a significant co-occurrence with psychiatric disorders and female preponderance.
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46
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Gallotta S, Bruno V, Catapano S, Mobilio N, Ciacci C, Iovino P. High risk of temporomandibular disorder in irritable bowel syndrome: Is there a correlation with greater illness severity? World J Gastroenterol 2017. [PMID: 28104985 DOI: 10.3748/wjg.v23.i1.103.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/29/2022] Open
Abstract
AIM To investigate the prevalence and the risk of temporomandibular disorders (TMDs) in patients with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhoea, and mixed) compared to the general population. METHODS Between January 2014 and December 2015 we enrolled consecutively adult patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy controls (HC) without IBS. At enrollment, we analyzed all patients for the presence of TMDs according to the Research Diagnostic Criteria for TMD. RESULTS We enrolled 91 IBS patients (23 IBS-D, 30 IBS-C and 38 IBS-M) and 57 HC in the study. We found a higher risk of having TMD (OR = 3.41, 95%CI: 1.66-7.01) compared to the HC. The risk of having TMD was independent of IBS-subtype. Multiple regression analysis showed that facial pain was positively related to abdominal pain and higher level of depression. CONCLUSION IBS patients had a more than three times greater risk of TMD compared to HC. The risk of having TMD was similar in different IBS subtypes. IBS patients that also fulfilled criteria for TMD seem to share along with chronic facial and abdominal pain a significant co-occurrence with psychiatric disorders and female preponderance.
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Affiliation(s)
- Serena Gallotta
- Serena Gallotta, Carolina Ciacci, Paola Iovino, Functional GI Disorders Center at Gastrointestinal Unit, AOU S. Giovanni di Dio e Ruggi d'Aragona, Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
| | - Vincenzo Bruno
- Serena Gallotta, Carolina Ciacci, Paola Iovino, Functional GI Disorders Center at Gastrointestinal Unit, AOU S. Giovanni di Dio e Ruggi d'Aragona, Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
| | - Santo Catapano
- Serena Gallotta, Carolina Ciacci, Paola Iovino, Functional GI Disorders Center at Gastrointestinal Unit, AOU S. Giovanni di Dio e Ruggi d'Aragona, Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
| | - Nicola Mobilio
- Serena Gallotta, Carolina Ciacci, Paola Iovino, Functional GI Disorders Center at Gastrointestinal Unit, AOU S. Giovanni di Dio e Ruggi d'Aragona, Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
| | - Carolina Ciacci
- Serena Gallotta, Carolina Ciacci, Paola Iovino, Functional GI Disorders Center at Gastrointestinal Unit, AOU S. Giovanni di Dio e Ruggi d'Aragona, Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
| | - Paola Iovino
- Serena Gallotta, Carolina Ciacci, Paola Iovino, Functional GI Disorders Center at Gastrointestinal Unit, AOU S. Giovanni di Dio e Ruggi d'Aragona, Department of Medicine and Surgery, University of Salerno, 84084 Salerno, Italy
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Bonato LL, Quinelato V, De Felipe Cordeiro PC, De Sousa EB, Tesch R, Casado PL. Association between temporomandibular disorders and pain in other regions of the body. J Oral Rehabil 2016; 44:9-15. [DOI: 10.1111/joor.12457] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2016] [Indexed: 01/14/2023]
Affiliation(s)
- L. L. Bonato
- TMD and Orofacial Pain; School of Medicine of Petropolis; Rio de Janeiro RJ Brazil
- Department of Dentistry; Fluminense Federal University; Niteroi RJ Brazil
| | - V. Quinelato
- Department of Dentistry; Fluminense Federal University; Niteroi RJ Brazil
| | | | - E. B. De Sousa
- Program of Cell and Developmental Biology; Institute of Biomedical Sciences; Rio de Janeiro Federal University; Rio de Janeiro RJ Brazil
- Research Division; National Institute of Traumatology and Orthopedics Jamil Haddad; Rio de Janeiro RJ Brazil
| | - R. Tesch
- School of Medicine of Petropo-lis; Metropolis RJ Brazil
- Brazilian Dental Association - Petropolis and Duque de Caxias; Rio de Janeiro RJ Brazil
- Pontificia Universi-dad Catolica Madre y Maestra; Santo Domingo Dominican Republic
| | - P. L. Casado
- Periodontology Department; Fluminense Federal University; Niteroi RJ Brazil
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Cornelison LE, Hawkins JL, Durham PL. Elevated levels of calcitonin gene-related peptide in upper spinal cord promotes sensitization of primary trigeminal nociceptive neurons. Neuroscience 2016; 339:491-501. [PMID: 27746346 DOI: 10.1016/j.neuroscience.2016.10.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 09/27/2016] [Accepted: 10/03/2016] [Indexed: 01/08/2023]
Abstract
Orofacial pain conditions including temporomandibular disorder (TMD) and migraine are characterized by peripheral and central sensitization of trigeminal nociceptive neurons. The goal of this study was to investigate the role of calcitonin gene-related peptide (CGRP) in promoting bidirectional signaling within the trigeminal system to mediate sensitization of primary nociceptive neurons. Adult male Sprague-Dawley rats were injected intercisternally with CGRP or co-injected with the receptor antagonist CGRP8-37 or KT 5720, a protein kinase A (PKA) inhibitor. Nocifensive head withdrawal response to mechanical stimulation was investigated using von Frey filaments. Expression of PKA, glial fibrillary acidic protein (GFAP), and ionized calcium-binding adapter molecule 1 (Iba1) in the spinal cord and phosphorylated extracellular signal-regulated kinase (P-ERK) in the ganglion was studied using immunohistochemistry. Some animals were co-injected with CGRP and Fast Blue dye and the ganglion was imaged using fluorescent microscopy. CGRP increased nocifensive responses to mechanical stimulation when compared to control. Co-injection of CGRP8-37 or KT 5720 with CGRP inhibited the nocifensive response. CGRP stimulated PKA and GFAP expression in the spinal cord, and P-ERK in ganglion neurons. Seven days post injection, Fast Blue was observed in ganglion neurons and satellite glial cells. Our results demonstrate that elevated levels of CGRP in the upper spinal cord promote sensitization of primary nociceptive neurons via a mechanism that involves activation of PKA centrally and P-ERK in ganglion neurons. Our findings provide evidence of bidirectional signaling within the trigeminal system that facilitate increased neuron-glia communication within the ganglion associated with trigeminal sensitization.
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Affiliation(s)
- Lauren E Cornelison
- Center for Biomedical and Life Sciences, Missouri State University, Springfield, MO, USA
| | - Jordan L Hawkins
- Center for Biomedical and Life Sciences, Missouri State University, Springfield, MO, USA
| | - Paul L Durham
- Center for Biomedical and Life Sciences, Missouri State University, Springfield, MO, USA.
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Campi LB, Jordani PC, Tenan HL, Camparis CM, Gonçalves DAG. Painful temporomandibular disorders and central sensitization: implications for management-a pilot study. Int J Oral Maxillofac Surg 2016; 46:104-110. [PMID: 27553896 DOI: 10.1016/j.ijom.2016.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 05/12/2016] [Accepted: 07/25/2016] [Indexed: 10/21/2022]
Abstract
The objective was to investigate the presence of cutaneous allodynia and hyperalgesia in the trigeminal and extra-trigeminal areas, as a surrogate for central sensitization (CS), in women with a painful temporomandibular disorder (TMD) and without other painful conditions. Painful TMDs, depression, and non-specific physical symptoms (NSPS) were classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The amount of pain in the trigeminal and extra-trigeminal areas was determined using a visual analogue scale (0-100mm) after the application of a vibrotactile stimulus and assessment of the pressure pain threshold (PPT). Statistical tests (Fisher's, χ2, and Mann-Whitney) were performed, with a significance level of 5%. The sample comprised 45 women (mean age 37.5 years; 16 with a painful TMD) who were free of any headache, fibromyalgia, or other painful condition. Painful TMD was associated with higher pain sensitivity and lower PPT values in the trigeminal (P<0.01) and extra-trigeminal regions (P<0.01). The presence of depression contributed significantly to increased pain sensitivity. The presence of hyperalgesia and allodynia in both the trigeminal and extra-trigeminal regions among women with a painful TMD indicated the presence of CS. Changes involving the central nervous system should be considered during the evaluation and management of patients with a painful TMD.
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Affiliation(s)
- L B Campi
- Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil.
| | - P C Jordani
- Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil
| | - H L Tenan
- Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil
| | - C M Camparis
- Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil
| | - D A G Gonçalves
- Araraquara School of Dentistry, Universidade Estadual Paulista - UNESP, Araraquara, Sao Paulo, Brazil
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Moghaddassi M, Togha M, Shahram F, Hanif H, Dadkhah S, Jahromi SR, Mozafari M. Headache in Behcet's disease: types and characteristics. SPRINGERPLUS 2016; 5:1077. [PMID: 27462525 PMCID: PMC4943913 DOI: 10.1186/s40064-016-2721-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 06/30/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Behcet's disease involves several systems in the body. Neurological involvement is identified by different symptoms. Headache is one of the common complaints of patients with Behcet's disease. It might be a part of neurological involvement or may arise independently in the course of disease. Studies with small sample size have resulted in various findings in this field. Since the prevalence of Behcet's disease is relatively high in Iran, this study was carried out to compare the features of headache between an acceptable number of patients with this rare disease and a control group. METHODS The current case-control study was performed to compare the features of headache between 312 patients with definite Behcet's disease who referred to a Behcet's clinic and healthy individuals. Patients with Behcet's disease were randomly selected. Controls were matched for age and sex. They were personally examined and interviewed meticulously using a questionnaire that met the standards of the International Headache Society classification for different types of headache. RESULTS The incidence of headache in the case and control groups was 28.3 % (n = 120) and 18.6 % (n = 59), respectively (p < 0.05; OR 2.73). Tension-type headache was observed in 12.2 % (n = 38) of cases which was significantly higher than control group (n = 6.3 %) (p = 0.011; OR 2.05). The most frequent type of headache in the case group was tension-type headache (12.2 %). In the control group, however, migraine without aura was the most common type (9.1 %). A correlation between ophthalmological involvement and headache was observed in 11 patients in the case group. In addition, a significantly higher systolic blood pressure was found in the case group compared to the controls (125.1 vs. 121.7 mmHg; p = 0.007). There was no major correlation between prednisolone consumption in patients with Behcet's disease and the type and frequency of headache. CONCLUSIONS Headache, especially tension-type headache, is more common in patients with Behcet's disease. This might be the result of specific types of uveitis-related and non-structural headaches seen in Behcet's disease.
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Affiliation(s)
- Maryam Moghaddassi
- />Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoureh Togha
- />Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- />Department of Neurology, Neurology Ward, Sina Hospital, Tehran University of Medical Sciences, Hassan Abad Square, Tehran, 1136746911 Iran
| | - Farhad Shahram
- />Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Hanif
- />Department of Neurosurgery, Birjand University of Medical Sciences, Birjand, Iran
| | - Sahar Dadkhah
- />Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soodeh Razeghi Jahromi
- />Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid-Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Mozafari
- />Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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