TY - JOUR
T1 - Thermal temporal summation and decay of after-sensations in temporomandibular myofascial pain patients with and without comorbid fibromyalgia
AU - Janal, Malvin N.
AU - Raphael, Karen G.
AU - Cook, Dane B.
AU - Sirois, David A.
AU - Nemelivsky, Lena
AU - Staud, Roland
N1 - Funding Information:
The study was approved by the Institutional Review Board at the New York University (NYU) School of Medicine. This study was supported by the National Institute of Dental and Craniofacial Research, DE 18569
Publisher Copyright:
© 2016 Janal et al.
PY - 2016/9/12
Y1 - 2016/9/12
N2 - Introduction: Chronic myofascial temporomandibular disorders (TMD) may have multiple etiological and maintenance factors. One potential factor, central pain sensitization, was quantified here as the response to the temporal summation (TS) paradigm, and that response was compared between case and control groups. Objectives: As previous research has shown that fibromyalgia (FM) is diagnosed in ~20% of TMD patients, Aim 1 determined whether central sensitization is found preferentially in myofascial TMD cases that have orofacial pain as a regional manifestation of FM. Aim 2 determined if the report of after-sensations (AS) following TS varied depending on whether repeated stimuli were rated as increasingly painful. Methods: One hundred sixty-eight women, 43 controls, 100 myofascial TMD-only cases, and 25 myofascial TMD + FM cases, were compared on thermal warmth and pain thresholds, thermal TS, and decay of thermal AS. All cases met Research Diagnostic Criteria for TMD; comorbid cases also met the 1990 American College of Rheumatology criteria for FM. Results: Pain thresholds and TS were similar in all groups. When TS was achieved (~60%), significantly higher levels of AS were reported in the first poststimulus interval, and AS decayed more slowly over time, in myofascial TMD cases than controls. By contrast, groups showed similar AS decay patterns following steady state or decreasing responses to repetitive stimulation. Conclusion: In this case–control study, all myofascial TMD cases were characterized by a similar delay in the decay of AS. Thus, this indicator of central sensitization failed to suggest different pain maintenance factors in myofascial TMD cases with and without FM.
AB - Introduction: Chronic myofascial temporomandibular disorders (TMD) may have multiple etiological and maintenance factors. One potential factor, central pain sensitization, was quantified here as the response to the temporal summation (TS) paradigm, and that response was compared between case and control groups. Objectives: As previous research has shown that fibromyalgia (FM) is diagnosed in ~20% of TMD patients, Aim 1 determined whether central sensitization is found preferentially in myofascial TMD cases that have orofacial pain as a regional manifestation of FM. Aim 2 determined if the report of after-sensations (AS) following TS varied depending on whether repeated stimuli were rated as increasingly painful. Methods: One hundred sixty-eight women, 43 controls, 100 myofascial TMD-only cases, and 25 myofascial TMD + FM cases, were compared on thermal warmth and pain thresholds, thermal TS, and decay of thermal AS. All cases met Research Diagnostic Criteria for TMD; comorbid cases also met the 1990 American College of Rheumatology criteria for FM. Results: Pain thresholds and TS were similar in all groups. When TS was achieved (~60%), significantly higher levels of AS were reported in the first poststimulus interval, and AS decayed more slowly over time, in myofascial TMD cases than controls. By contrast, groups showed similar AS decay patterns following steady state or decreasing responses to repetitive stimulation. Conclusion: In this case–control study, all myofascial TMD cases were characterized by a similar delay in the decay of AS. Thus, this indicator of central sensitization failed to suggest different pain maintenance factors in myofascial TMD cases with and without FM.
KW - Central sensitization
KW - QST
KW - Temporal summation of pain
KW - Temporomandibular joint dysfunction syndrome
KW - Women
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U2 - 10.2147/JPR.S109038
DO - 10.2147/JPR.S109038
M3 - Article
AN - SCOPUS:84988918483
SN - 1178-7090
VL - 9
SP - 641
EP - 652
JO - Journal of Pain Research
JF - Journal of Pain Research
ER -