Skip to main content
Erschienen in: Experimental Brain Research 1/2010

01.04.2010 | Research Article

Bilateral thermal hyperalgesia in trigeminal and extra-trigeminal regions in patients with myofascial temporomandibular disorders

verfasst von: César Fernández-de-las-Peñas, Fernando Galán-del-Río, Ricardo Ortega-Santiago, Rodrigo Jiménez-García, Lars Arendt-Nielsen, Peter Svensson

Erschienen in: Experimental Brain Research | Ausgabe 1/2010

Einloggen, um Zugang zu erhalten

Abstract

Our aim was to assess thermal sensitivity in both trigeminal and extra-trigeminal regions in patients with myofascial temporomandibular disorder (TMD) but without comorbid conditions as compared to age-matched controls. Twenty women (age 24 ± 3 years) diagnosed with myofascial TMD according to the research diagnostic criteria for TMD and 20 healthy women (age 24 ± 4 years) were included. Warm and cold detection thresholds (WDT and CDT, respectively) and heat and cold pain thresholds (HPT and CPT, respectively) were bilaterally assessed over the masseter and frontalis muscles (trigeminal regions) and the wrist (extra-trigeminal region). The mean of three determinations at each site was calculated and used for analysis. The order of the test sites was randomized. A two-way ANOVA was used to test for differences between groups and sides (most painful/contra-lateral side; dominant/non-dominant). No significant differences between groups for WDT or CDT in trigeminal and extra-trigeminal regions (ANOVA, P > 0.389) were found. There were significant differences between groups, but not between sides, for HPT and CPT in both trigeminal and extra-trigeminal areas (ANOVA, P < 0.001). CPT (P < 0.001) over the trigeminal area was positively correlated with both pain intensity and duration of pain symptoms: the longer the history of pain or the greater the pain intensity, the higher the CPT (i.e., the greater cold hyperalgesia) over the trigeminal region. Our findings revealed bilateral thermal hyperalgesia (lower HPT and higher CPT) but normal WDT and CDT in trigeminal and extra-trigeminal regions in women with myofascial TMD as compared to healthy controls. Bilateral heat/cold hyperalgesia in trigeminal and extra-trigeminal areas may reflect a dysfunction of thermal channels in myofascial TMD patients as result of some combination of peripheral sensitization, facilitation of central nociceptive processing and/or decreased descending inhibition.
Literatur
Zurück zum Zitat Ayesh E, Baad-Hansen L, Svensson P (2008) Hypersensitivity to menthol in temporo-mandibular joint arthralgia patients In: Proceedings from 12th World Congress on Pain, IASP Press, abstract 373 Ayesh E, Baad-Hansen L, Svensson P (2008) Hypersensitivity to menthol in temporo-mandibular joint arthralgia patients In: Proceedings from 12th World Congress on Pain, IASP Press, abstract 373
Zurück zum Zitat Beck AT, Steer RA, Brown GK (1996) Beck depression inventory, 2nd edn. The Psychological Corporation, San Antonio, Texas Beck AT, Steer RA, Brown GK (1996) Beck depression inventory, 2nd edn. The Psychological Corporation, San Antonio, Texas
Zurück zum Zitat Bengtsson A, Henriksson KG, Jorfeldt L, Kagedal B, Lennmarken C, Lindström F (1986) Primary fibromyalgia: a clinical and laboratory study of 55 patients. Scand J Rheumatol 15:340–347CrossRefPubMed Bengtsson A, Henriksson KG, Jorfeldt L, Kagedal B, Lennmarken C, Lindström F (1986) Primary fibromyalgia: a clinical and laboratory study of 55 patients. Scand J Rheumatol 15:340–347CrossRefPubMed
Zurück zum Zitat Berglund B, Harju E, Kosek E, Lindblom U (2002) Quantitative and qualitative perceptual analysis of cold dysesthesia and hyperalgesia in fibromyalgia. Pain 96:177–187CrossRefPubMed Berglund B, Harju E, Kosek E, Lindblom U (2002) Quantitative and qualitative perceptual analysis of cold dysesthesia and hyperalgesia in fibromyalgia. Pain 96:177–187CrossRefPubMed
Zurück zum Zitat Bragdon EE, Light KC, Costello NL, Sigurdsson A, Bunting S, Bhalang K, Maixner W (2002) Group differences in pain modulation: pain-free women compared to pain-free men and to women with TMD. Pain 96:227–237CrossRefPubMed Bragdon EE, Light KC, Costello NL, Sigurdsson A, Bunting S, Bhalang K, Maixner W (2002) Group differences in pain modulation: pain-free women compared to pain-free men and to women with TMD. Pain 96:227–237CrossRefPubMed
Zurück zum Zitat Chien A, Eliav E, Sterling M (2009) Hypoesthesia occurs with sensory hypersensitivity in chronic whiplash: further evidence of a neuropathic condition. Man Ther 14:138–146CrossRefPubMed Chien A, Eliav E, Sterling M (2009) Hypoesthesia occurs with sensory hypersensitivity in chronic whiplash: further evidence of a neuropathic condition. Man Ther 14:138–146CrossRefPubMed
Zurück zum Zitat De Medinaceli L, Hurpeau J, Merle M, Begorre H (1997) Cold and post-traumatic pain: modelling of the peripheral nerve message. Biosystems 43:145–167CrossRefPubMed De Medinaceli L, Hurpeau J, Merle M, Begorre H (1997) Cold and post-traumatic pain: modelling of the peripheral nerve message. Biosystems 43:145–167CrossRefPubMed
Zurück zum Zitat Drangsholt M, LeResche L (1999) Temporomandibular disorder pain. In: Crombie IK, Croft PR, Linton SJ et al (eds) Epidemiology of pain. IASP Press, Seattle, pp 203–233 Drangsholt M, LeResche L (1999) Temporomandibular disorder pain. In: Crombie IK, Croft PR, Linton SJ et al (eds) Epidemiology of pain. IASP Press, Seattle, pp 203–233
Zurück zum Zitat Dworkin SF, LeResche L (1992) Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Cranio mandib Disord 6:301–355 Dworkin SF, LeResche L (1992) Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Cranio mandib Disord 6:301–355
Zurück zum Zitat Edwards RR, Sarlani E, Wesselmann U, Fillingim RB (2005) Quantitative assessment of experimental pain perception: multiple domains of clinical relevance. Pain 114:315–319CrossRefPubMed Edwards RR, Sarlani E, Wesselmann U, Fillingim RB (2005) Quantitative assessment of experimental pain perception: multiple domains of clinical relevance. Pain 114:315–319CrossRefPubMed
Zurück zum Zitat Etöz OA, Ataoglu H (2007) Evaluation of pain perception in patients with temporo-mandibular disorders. J Oral Maxillofac Surg 65:2475–2478CrossRefPubMed Etöz OA, Ataoglu H (2007) Evaluation of pain perception in patients with temporo-mandibular disorders. J Oral Maxillofac Surg 65:2475–2478CrossRefPubMed
Zurück zum Zitat Fillingim RB, Maixner W, Kincaud S, Silva S (1998) Sex differences in temporal summation but not sensory-discriminative processing of thermal pain. Pain 75:121–127CrossRefPubMed Fillingim RB, Maixner W, Kincaud S, Silva S (1998) Sex differences in temporal summation but not sensory-discriminative processing of thermal pain. Pain 75:121–127CrossRefPubMed
Zurück zum Zitat Gracely R, Grant M, Giesecke T (2003) Evoked pain measures in fibromyalgia. Clin Rheumatol 17:593–609 Gracely R, Grant M, Giesecke T (2003) Evoked pain measures in fibromyalgia. Clin Rheumatol 17:593–609
Zurück zum Zitat Granot M, Sprecher E, Yarnitsky D (2003) Psychophysics of phasic and tonic heat pain stimuli by quantitative sensory testing in healthy subjects. Eur J Pain 7:139–143CrossRefPubMed Granot M, Sprecher E, Yarnitsky D (2003) Psychophysics of phasic and tonic heat pain stimuli by quantitative sensory testing in healthy subjects. Eur J Pain 7:139–143CrossRefPubMed
Zurück zum Zitat Hollins M, Harper D, Gallagher S, Owings EW, Lim PF, Miller V et al (2009) Perceived intensity and unpleasantness of cutaneous and auditory stimuli: an evaluation of the generalized hypervigilance hypothesis. Pain 141:215–221CrossRefPubMed Hollins M, Harper D, Gallagher S, Owings EW, Lim PF, Miller V et al (2009) Perceived intensity and unpleasantness of cutaneous and auditory stimuli: an evaluation of the generalized hypervigilance hypothesis. Pain 141:215–221CrossRefPubMed
Zurück zum Zitat Isong U, Gansky SA, Plesh O (2008) Temporomandibular joint and muscle disorder-type pain in US adults: the National Health Interview Survey. J Orofac Pain 22:317–322PubMed Isong U, Gansky SA, Plesh O (2008) Temporomandibular joint and muscle disorder-type pain in US adults: the National Health Interview Survey. J Orofac Pain 22:317–322PubMed
Zurück zum Zitat Jensen MP, Turbner JA, Romano JM, Fisher L (1999) Comparative reliability and validity of chronic pain intensity measures. Pain 83:157–162CrossRefPubMed Jensen MP, Turbner JA, Romano JM, Fisher L (1999) Comparative reliability and validity of chronic pain intensity measures. Pain 83:157–162CrossRefPubMed
Zurück zum Zitat King CD, Wong F, Currie T, Mauderli AP, Fillingim RB, Riley JL III (2009) Deficiency in endogenous modulation of prolonged heat pain in patient with irritable bowel syndrome and temporomandibular disorder. Pain 143:172–178CrossRefPubMed King CD, Wong F, Currie T, Mauderli AP, Fillingim RB, Riley JL III (2009) Deficiency in endogenous modulation of prolonged heat pain in patient with irritable bowel syndrome and temporomandibular disorder. Pain 143:172–178CrossRefPubMed
Zurück zum Zitat Lambertz D, Hoheisel U, Mense S (2008) Influence of a chronic myositis on rat spinal field potentials evoked by TTX-resistant unmyelinated skin and muscle afferents. Eur J Pain 12:686–695CrossRefPubMed Lambertz D, Hoheisel U, Mense S (2008) Influence of a chronic myositis on rat spinal field potentials evoked by TTX-resistant unmyelinated skin and muscle afferents. Eur J Pain 12:686–695CrossRefPubMed
Zurück zum Zitat LeResche L (1997) Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med 8:291–305CrossRefPubMed LeResche L (1997) Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med 8:291–305CrossRefPubMed
Zurück zum Zitat Maixner W, Fillingim R, Booker D, Sigurdsson A (1995) Sensitivity of patients with painful temporomandibular disorders to experimentally evoked pain. Pain 63:341–351CrossRefPubMed Maixner W, Fillingim R, Booker D, Sigurdsson A (1995) Sensitivity of patients with painful temporomandibular disorders to experimentally evoked pain. Pain 63:341–351CrossRefPubMed
Zurück zum Zitat Maixner W, Fillingim R, Sigurdsson A, Kincaid S, Silva S (1998) Sensitivity of patients with painful temporomandibular disorders to experimentally evoked pain: evidence for altered temporal summation of pain. Pain 76:71–81CrossRefPubMed Maixner W, Fillingim R, Sigurdsson A, Kincaid S, Silva S (1998) Sensitivity of patients with painful temporomandibular disorders to experimentally evoked pain: evidence for altered temporal summation of pain. Pain 76:71–81CrossRefPubMed
Zurück zum Zitat Mendell LM, Wall PD (1965) Responses of single dorsal cord cells to peripheral cutaneous unmyelinated fibres. Nature 206:97–99CrossRefPubMed Mendell LM, Wall PD (1965) Responses of single dorsal cord cells to peripheral cutaneous unmyelinated fibres. Nature 206:97–99CrossRefPubMed
Zurück zum Zitat Mohn C, Vassend O, Knardahl S (2008) Experimental pain sensitivity in women with temporomandibular disorders and pain-free controls: the relationship to orofacial muscular contraction and cardiovascular responses. Clin J Pain 24:343–352CrossRefPubMed Mohn C, Vassend O, Knardahl S (2008) Experimental pain sensitivity in women with temporomandibular disorders and pain-free controls: the relationship to orofacial muscular contraction and cardiovascular responses. Clin J Pain 24:343–352CrossRefPubMed
Zurück zum Zitat Park R, Wallace M, Schuheis G (2001) Relative sensitivity to alfentanil and reliability of current perception threshold vs. von Frey tactile stimulation and thermal sensory testing. J Peripher Nerv Syst 6:232–240CrossRefPubMed Park R, Wallace M, Schuheis G (2001) Relative sensitivity to alfentanil and reliability of current perception threshold vs. von Frey tactile stimulation and thermal sensory testing. J Peripher Nerv Syst 6:232–240CrossRefPubMed
Zurück zum Zitat Pfau DB, Rolke R, Treede RD, Daublaender M (2009) Somatosensory profiles in subgroups of patients with myogenic temporomandibular disorders and fibromyalgia syndrome. Pain 147:72–83CrossRefPubMed Pfau DB, Rolke R, Treede RD, Daublaender M (2009) Somatosensory profiles in subgroups of patients with myogenic temporomandibular disorders and fibromyalgia syndrome. Pain 147:72–83CrossRefPubMed
Zurück zum Zitat Price DD, Harkins SW (1987) Combined use of experimental pain and visual analogue scales in providing standardized measurement of clinical pain. Clin J Pain 3:1–8CrossRef Price DD, Harkins SW (1987) Combined use of experimental pain and visual analogue scales in providing standardized measurement of clinical pain. Clin J Pain 3:1–8CrossRef
Zurück zum Zitat Raja SN, Campbell JN, Meyer RA (1984) Evidence for different mechanisms of primary and secondary hyperalgesia following heat injury to the glabrous skin. Brain 107:1179–1188CrossRefPubMed Raja SN, Campbell JN, Meyer RA (1984) Evidence for different mechanisms of primary and secondary hyperalgesia following heat injury to the glabrous skin. Brain 107:1179–1188CrossRefPubMed
Zurück zum Zitat Rakel B, Barr JO (2003) Physical modalities in chronic pain management. Nurs Clin North Am 38:477–494CrossRefPubMed Rakel B, Barr JO (2003) Physical modalities in chronic pain management. Nurs Clin North Am 38:477–494CrossRefPubMed
Zurück zum Zitat Raphael KG (2009) Temporal summation of heat pain in temporomandibular disorder patients. J Orofac Pain 23:54–64PubMed Raphael KG (2009) Temporal summation of heat pain in temporomandibular disorder patients. J Orofac Pain 23:54–64PubMed
Zurück zum Zitat Rolke R, Magerl W, Campbell KA, Schalber C, Caspari S, Birklein F, Treede RD (2006) Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain 10:77–88CrossRefPubMed Rolke R, Magerl W, Campbell KA, Schalber C, Caspari S, Birklein F, Treede RD (2006) Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain 10:77–88CrossRefPubMed
Zurück zum Zitat Sarlani E, Greenspan J (2003) Evidence for generalized hyperalgesia in temporo-mandibular disorders patients. Pain 10:221–226CrossRef Sarlani E, Greenspan J (2003) Evidence for generalized hyperalgesia in temporo-mandibular disorders patients. Pain 10:221–226CrossRef
Zurück zum Zitat Sarlani E, Grace EG, Reynolds MA, Greenspan JD (2004) Evidence for up-regulated central nociceptive processing in patients with masticatory myofascial pain. J Orofac Pain 18:41–55PubMed Sarlani E, Grace EG, Reynolds MA, Greenspan JD (2004) Evidence for up-regulated central nociceptive processing in patients with masticatory myofascial pain. J Orofac Pain 18:41–55PubMed
Zurück zum Zitat Scott D, Jull G, Sterling M (2005) Widespread sensory hypersensitivity is a feature of chronic whiplash-associated disorder but not chronic idiopathic neck pain. Clin J Pain 21:175–181CrossRefPubMed Scott D, Jull G, Sterling M (2005) Widespread sensory hypersensitivity is a feature of chronic whiplash-associated disorder but not chronic idiopathic neck pain. Clin J Pain 21:175–181CrossRefPubMed
Zurück zum Zitat Sherman JJ, LeResche L, Mancl LA, Huggins K, Sage JC, Dworkin SF (2005) Cyclic effects on experimental pain response in women with temporomandibular disorders. J Orofac Pain 19:133–143PubMed Sherman JJ, LeResche L, Mancl LA, Huggins K, Sage JC, Dworkin SF (2005) Cyclic effects on experimental pain response in women with temporomandibular disorders. J Orofac Pain 19:133–143PubMed
Zurück zum Zitat Sluka KA, Kalra A, Moore SA (2001) Unilateral intramuscular injections of acidic saline produce a bilateral, long-lasting hyperalgesia. Muscle Nerve 24:37–46CrossRefPubMed Sluka KA, Kalra A, Moore SA (2001) Unilateral intramuscular injections of acidic saline produce a bilateral, long-lasting hyperalgesia. Muscle Nerve 24:37–46CrossRefPubMed
Zurück zum Zitat Svensson P, Sessle BJ (2004) Orofacial pain. In: Miles TS, Nauntofte B, Svensson P (eds) Clinical oral physiology: quintessence, pp 93–139 Svensson P, Sessle BJ (2004) Orofacial pain. In: Miles TS, Nauntofte B, Svensson P (eds) Clinical oral physiology: quintessence, pp 93–139
Zurück zum Zitat Svensson P, List T, Hector G (2001) Analysis of stimulus-evoked pain in patients with myofascial temporomandibular pain disorders. Pain 92:399–409CrossRefPubMed Svensson P, List T, Hector G (2001) Analysis of stimulus-evoked pain in patients with myofascial temporomandibular pain disorders. Pain 92:399–409CrossRefPubMed
Zurück zum Zitat Torsten J, Miglioretti DL, Leresche L, Von Korff M, Critchlow CW (2003) Widespread pain as a risk factor for dysfunctional temporomandibular disorder pain. Pain 102:257–263CrossRef Torsten J, Miglioretti DL, Leresche L, Von Korff M, Critchlow CW (2003) Widespread pain as a risk factor for dysfunctional temporomandibular disorder pain. Pain 102:257–263CrossRef
Zurück zum Zitat VanVoorhis WCR, Blumentritt TL (2007) Psychometric properties of the Beck depression inventory-II in a clinically-identified sample of Mexican American adolescents. J Child Fam Stud 16:789–798CrossRef VanVoorhis WCR, Blumentritt TL (2007) Psychometric properties of the Beck depression inventory-II in a clinically-identified sample of Mexican American adolescents. J Child Fam Stud 16:789–798CrossRef
Zurück zum Zitat Wasner G, Schwarz K, Schattschneider J, Binder A, Jensen TS, Baron R (2004) Interaction between histamine-induced itch and experimental muscle pain. Pain 8:179–185 Wasner G, Schwarz K, Schattschneider J, Binder A, Jensen TS, Baron R (2004) Interaction between histamine-induced itch and experimental muscle pain. Pain 8:179–185
Zurück zum Zitat Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM (1990) The American College of Rheumatology 1990 criteria for classification of fibromyalgia: report of the multicenter criteria committee. Arthritis Rheum 33:160–170CrossRefPubMed Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM (1990) The American College of Rheumatology 1990 criteria for classification of fibromyalgia: report of the multicenter criteria committee. Arthritis Rheum 33:160–170CrossRefPubMed
Zurück zum Zitat Woolf CJ, Bennett GJ, Doherty M, Dubner R, Kidd B, Koltzenburg M et al (1998) Towards a mechanism-based classification of pain? Pain 77:227–229CrossRefPubMed Woolf CJ, Bennett GJ, Doherty M, Dubner R, Kidd B, Koltzenburg M et al (1998) Towards a mechanism-based classification of pain? Pain 77:227–229CrossRefPubMed
Zurück zum Zitat Wright EF, Des Rosier KF, Clark MK, Bifano SL (1997) Identifying undiagnosed rheumatic disorders among patients with TMD. J Am Dent Assoc 128:738–744PubMed Wright EF, Des Rosier KF, Clark MK, Bifano SL (1997) Identifying undiagnosed rheumatic disorders among patients with TMD. J Am Dent Assoc 128:738–744PubMed
Zurück zum Zitat Yamazaki Y, Ren K, Shimada M, Iwata K (2008) Modulation of paratrigeminal nociceptive neurons following temporomandibular joint inflammation in rats. Exp Neurol 214:209–218CrossRefPubMed Yamazaki Y, Ren K, Shimada M, Iwata K (2008) Modulation of paratrigeminal nociceptive neurons following temporomandibular joint inflammation in rats. Exp Neurol 214:209–218CrossRefPubMed
Metadaten
Titel
Bilateral thermal hyperalgesia in trigeminal and extra-trigeminal regions in patients with myofascial temporomandibular disorders
verfasst von
César Fernández-de-las-Peñas
Fernando Galán-del-Río
Ricardo Ortega-Santiago
Rodrigo Jiménez-García
Lars Arendt-Nielsen
Peter Svensson
Publikationsdatum
01.04.2010
Verlag
Springer-Verlag
Erschienen in
Experimental Brain Research / Ausgabe 1/2010
Print ISSN: 0014-4819
Elektronische ISSN: 1432-1106
DOI
https://doi.org/10.1007/s00221-009-2121-x

Weitere Artikel der Ausgabe 1/2010

Experimental Brain Research 1/2010 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Sozialer Aufstieg verringert Demenzgefahr

24.05.2024 Demenz Nachrichten

Ein hohes soziales Niveau ist mit die beste Versicherung gegen eine Demenz. Noch geringer ist das Demenzrisiko für Menschen, die sozial aufsteigen: Sie gewinnen fast zwei demenzfreie Lebensjahre. Umgekehrt steigt die Demenzgefahr beim sozialen Abstieg.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Thrombektomie auch bei großen Infarkten von Vorteil

16.05.2024 Ischämischer Schlaganfall Nachrichten

Auch ein sehr ausgedehnter ischämischer Schlaganfall scheint an sich kein Grund zu sein, von einer mechanischen Thrombektomie abzusehen. Dafür spricht die LASTE-Studie, an der Patienten und Patientinnen mit einem ASPECTS von maximal 5 beteiligt waren.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.