Wahlund Kerstin, List Thomas, Ohrbach Richard
Specialist Centre for Oral Rehabilitation, Torkelbergsgatan 11, 58185 Linköping, Sweden.
Eur J Pain. 2005 Apr;9(2):219-27. doi: 10.1016/j.ejpain.2004.06.003.
The overall purpose of this study was to determine whether adolescents with chronic temporomandibular disorder (TMD) pain are more sensitive to all types of somatic and emotional stimuli compared with a matched healthy control group. Sixty adolescents, 8 boys and 52 girls ranging from 12 to 18 years, participated in the study. Thirty of the subjects exhibited TMD, reporting pain of at least 3 months duration. The age- and gender-matched control group consisted of 30 dental recall patients who reported TMD pain less than once a week. All participants completed a 40-item questionnaire comprising 10 items each of pleasant and aversive qualities crossed with somatic and emotional forms of stimuli. The items, a selection of a broad range of familiar stimuli by a panel of experts, were rated based on intensity of experience (0-10, numerical rating scale). Well-fitting items that formed a valid construct within each of the four domains were selected using Rasch analysis. The results showed that adolescents with TMD pain reported significantly greater sensitivity (p<0.05) to aversive somatic and pleasant somatic stimuli than the controls. The differences between groups for the aversive emotional and pleasant emotional stimuli were non-significant. These findings suggest that chronic TMD pain states in adolescents are accompanied by amplification of bodily, but not purely emotional stimuli and that cognitive systems are implicated, not only an alteration of the nociceptive systems.
本研究的总体目的是确定患有慢性颞下颌关节紊乱症（TMD）疼痛的青少年与匹配的健康对照组相比，是否对所有类型的躯体和情绪刺激更敏感。60名青少年参与了该研究，其中8名男孩和52名女孩，年龄在12至18岁之间。30名受试者患有TMD，报告疼痛持续至少3个月。年龄和性别匹配的对照组由30名牙科复诊患者组成，他们报告TMD疼痛每周少于一次。所有参与者完成了一份包含40个项目的问卷，其中包括10个具有愉悦和厌恶特质的项目，这些特质与躯体和情绪形式的刺激交叉。这些项目是由专家小组从广泛的熟悉刺激中挑选出来的，根据体验强度（0 - 10，数字评分量表）进行评分。使用拉施分析选择在四个领域中每个领域内形成有效结构的拟合良好的项目。结果表明，患有TMD疼痛的青少年对厌恶的躯体刺激和愉悦的躯体刺激的敏感性显著高于对照组（p<0.05）。厌恶的情绪刺激和愉悦的情绪刺激在组间的差异不显著。这些发现表明，青少年的慢性TMD疼痛状态伴随着躯体刺激的增强，而不仅仅是情绪刺激的增强，并且认知系统也参与其中，而不仅仅是伤害感受系统的改变。
