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Somatosensory abnormalities in Chinese patients with painful temporomandibular disorders.

Yang G, Baad-Hansen L, Wang K, Fu K, Xie QF, Svensson P - J Headache Pain (2016)

Bottom Line: The most frequent abnormalities were somatosensory gain to pinprick (35.0 %) and pressure (35.0 %) stimuli, somatosensory loss to pinprick (25.0 %), cold (22.5 %), and heat (15.0 %) nociceptive stimuli.The most frequent loss/gain score was L0G2 (no somatosensory loss combined with a gain of mechanical somatosensory function) for both the facial (40.0 %) and hand (27.5 %) regions.The individual variations in somatosensory abnormalities indicate a possible need for development of individualized TMD pain management.

View Article: PubMed Central - PubMed

Affiliation: Department of Prosthodontics and Center for Oral Functional Diagnosis, Treatment and Research, Peking University School and Hospital of Stomatology, Zhongguancun Nandajie 22, 100081, Beijing, China.

ABSTRACT

Background: The somatosensory phenotype of Chinese temporomandibular disorders (TMD) patients is not sufficiently studied with the use of contemporary techniques and guidelines.

Methods: A standardized quantitative sensory testing (QST) battery consisting of 13 parameters with a stringent statistical protocol developed by the German Research Network on Neuropathic Pain was performed over the most painful and corresponding contralateral sites as well as the right hand of 40 Chinese patients with TMD and pain classified according to the Diagnostic Criteria for TMD (DC/TMD). The same QST protocol was performed bilaterally over the infraorbital, mental, and hand regions of 70 age- and gender-stratified healthy Chinese controls. Z-scores and loss/gain scores were computed for each TMD patient.

Results: For patients, 82.5 % had somatosensory abnormalities in the painful facial region, while 60.0 % had abnormalities confined to the right hand. The most frequent abnormalities were somatosensory gain to pinprick (35.0 %) and pressure (35.0 %) stimuli, somatosensory loss to pinprick (25.0 %), cold (22.5 %), and heat (15.0 %) nociceptive stimuli. The most frequent loss/gain score was L0G2 (no somatosensory loss combined with a gain of mechanical somatosensory function) for both the facial (40.0 %) and hand (27.5 %) regions. Involving side-to-side differences in the evaluation increased the diagnostic sensitivity by 2.5-25.0 % across different parameters.

Conclusions: Somatosensory abnormalities were commonly detected in Chinese TMD pain patients both within and outside the primary painful region, strongly indicating disturbances in the central processing of somatosensory stimuli. The individual variations in somatosensory abnormalities indicate a possible need for development of individualized TMD pain management.

No MeSH data available.


Related in: MedlinePlus

Examples of somatosensory z-score profiles of 2 patients with painful temporomandibular disorders indicating abnormalities involving different peripheral or central pain mechanisms [10–13]. Open symbols indicate patient A (loss of function to tactile, pinprick, and thermal non-nociceptive stimuli), and closed symbols indicate patient B (gain of function to painful pinprick and pressure stimuli). The zone between the two lines (−1.96 < z < 1.96) is the normal range based on the healthy material. CDT: cold detection threshold; WDT: warmth detection threshold; TSL: thermal sensory limen; CPT: cold pain threshold; HPT: heat pain threshold; MDT: mechanical detection threshold; MPT: mechanical pain threshold; MPS: mechanical pain sensitivity; WUR: windup ratio; VDT: vibration detection threshold; PPT: pressure pain threshold
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Fig2: Examples of somatosensory z-score profiles of 2 patients with painful temporomandibular disorders indicating abnormalities involving different peripheral or central pain mechanisms [10–13]. Open symbols indicate patient A (loss of function to tactile, pinprick, and thermal non-nociceptive stimuli), and closed symbols indicate patient B (gain of function to painful pinprick and pressure stimuli). The zone between the two lines (−1.96 < z < 1.96) is the normal range based on the healthy material. CDT: cold detection threshold; WDT: warmth detection threshold; TSL: thermal sensory limen; CPT: cold pain threshold; HPT: heat pain threshold; MDT: mechanical detection threshold; MPT: mechanical pain threshold; MPS: mechanical pain sensitivity; WUR: windup ratio; VDT: vibration detection threshold; PPT: pressure pain threshold

Mentions: There was no PHS or DMA in the patient group. The most frequent somatosensory absolute abnormalities at the painful site of the TMD pain group was (in order of frequency): somatosensory gain with regard to MPS, PPT, WUR, and WDT; and somatosensory loss with regard to CPT, HPT, MDT, MPT, CDT, TSL, VDT, and WDT (Table 1, Fig. 2).Fig. 2


Somatosensory abnormalities in Chinese patients with painful temporomandibular disorders.

Yang G, Baad-Hansen L, Wang K, Fu K, Xie QF, Svensson P - J Headache Pain (2016)

Examples of somatosensory z-score profiles of 2 patients with painful temporomandibular disorders indicating abnormalities involving different peripheral or central pain mechanisms [10–13]. Open symbols indicate patient A (loss of function to tactile, pinprick, and thermal non-nociceptive stimuli), and closed symbols indicate patient B (gain of function to painful pinprick and pressure stimuli). The zone between the two lines (−1.96 < z < 1.96) is the normal range based on the healthy material. CDT: cold detection threshold; WDT: warmth detection threshold; TSL: thermal sensory limen; CPT: cold pain threshold; HPT: heat pain threshold; MDT: mechanical detection threshold; MPT: mechanical pain threshold; MPS: mechanical pain sensitivity; WUR: windup ratio; VDT: vibration detection threshold; PPT: pressure pain threshold
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4829566&req=5

Fig2: Examples of somatosensory z-score profiles of 2 patients with painful temporomandibular disorders indicating abnormalities involving different peripheral or central pain mechanisms [10–13]. Open symbols indicate patient A (loss of function to tactile, pinprick, and thermal non-nociceptive stimuli), and closed symbols indicate patient B (gain of function to painful pinprick and pressure stimuli). The zone between the two lines (−1.96 < z < 1.96) is the normal range based on the healthy material. CDT: cold detection threshold; WDT: warmth detection threshold; TSL: thermal sensory limen; CPT: cold pain threshold; HPT: heat pain threshold; MDT: mechanical detection threshold; MPT: mechanical pain threshold; MPS: mechanical pain sensitivity; WUR: windup ratio; VDT: vibration detection threshold; PPT: pressure pain threshold
Mentions: There was no PHS or DMA in the patient group. The most frequent somatosensory absolute abnormalities at the painful site of the TMD pain group was (in order of frequency): somatosensory gain with regard to MPS, PPT, WUR, and WDT; and somatosensory loss with regard to CPT, HPT, MDT, MPT, CDT, TSL, VDT, and WDT (Table 1, Fig. 2).Fig. 2

Bottom Line: The most frequent abnormalities were somatosensory gain to pinprick (35.0 %) and pressure (35.0 %) stimuli, somatosensory loss to pinprick (25.0 %), cold (22.5 %), and heat (15.0 %) nociceptive stimuli.The most frequent loss/gain score was L0G2 (no somatosensory loss combined with a gain of mechanical somatosensory function) for both the facial (40.0 %) and hand (27.5 %) regions.The individual variations in somatosensory abnormalities indicate a possible need for development of individualized TMD pain management.

View Article: PubMed Central - PubMed

Affiliation: Department of Prosthodontics and Center for Oral Functional Diagnosis, Treatment and Research, Peking University School and Hospital of Stomatology, Zhongguancun Nandajie 22, 100081, Beijing, China.

ABSTRACT

Background: The somatosensory phenotype of Chinese temporomandibular disorders (TMD) patients is not sufficiently studied with the use of contemporary techniques and guidelines.

Methods: A standardized quantitative sensory testing (QST) battery consisting of 13 parameters with a stringent statistical protocol developed by the German Research Network on Neuropathic Pain was performed over the most painful and corresponding contralateral sites as well as the right hand of 40 Chinese patients with TMD and pain classified according to the Diagnostic Criteria for TMD (DC/TMD). The same QST protocol was performed bilaterally over the infraorbital, mental, and hand regions of 70 age- and gender-stratified healthy Chinese controls. Z-scores and loss/gain scores were computed for each TMD patient.

Results: For patients, 82.5 % had somatosensory abnormalities in the painful facial region, while 60.0 % had abnormalities confined to the right hand. The most frequent abnormalities were somatosensory gain to pinprick (35.0 %) and pressure (35.0 %) stimuli, somatosensory loss to pinprick (25.0 %), cold (22.5 %), and heat (15.0 %) nociceptive stimuli. The most frequent loss/gain score was L0G2 (no somatosensory loss combined with a gain of mechanical somatosensory function) for both the facial (40.0 %) and hand (27.5 %) regions. Involving side-to-side differences in the evaluation increased the diagnostic sensitivity by 2.5-25.0 % across different parameters.

Conclusions: Somatosensory abnormalities were commonly detected in Chinese TMD pain patients both within and outside the primary painful region, strongly indicating disturbances in the central processing of somatosensory stimuli. The individual variations in somatosensory abnormalities indicate a possible need for development of individualized TMD pain management.

No MeSH data available.


Related in: MedlinePlus