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谷氨酸诱发的颌面部肌肉疼痛作为持续性肌筋膜性颞下颌关节紊乱病疼痛的模型?

Glutamate-evoked jaw muscle pain as a model of persistent myofascial TMD pain?

作者信息

Castrillon Eduardo E, Cairns Brian E, Ernberg Malin, Wang Kelun, Sessle Barry, Arendt-Nielsen Lars, Svensson Peter

机构信息

Department of Clinical Oral Physiology, School of Dentistry, University of Aarhus, Aarhus C, Denmark.

出版信息

Arch Oral Biol. 2008 Jul;53(7):666-76. doi: 10.1016/j.archoralbio.2008.01.008. Epub 2008 Mar 4.

Abstract

OBJECTIVE

Compare pain-related measures and psychosocial variables between glutamate-evoked jaw muscle pain in healthy subjects (HS) and patients with persistent myofascial temporomandibular disorder (TMD) pain.

DESIGN

Forty-seven female HS and 10 female patients with persistent myofascial TMD pain participated. The HS received an injection of glutamate into the masseter muscle to model persistent myofascial TMD pain. Participants filled out a coping strategies questionnaire (CSQ), the symptom checklist 90 (SCL-90) and McGill pain questionnaire (MPQ). Pain intensity was assessed on an electronic visual analogue scale (VAS). Pain-drawing areas, numerical rating scale (NRS) scores of unpleasantness, pressure pain thresholds (PPTs) and pressure pain tolerance (PPTOL) were measured. Unpaired t-tests and correlation tests were used for analyses.

RESULTS

The groups were significantly different when comparing the CSQ scores of control, decrease, diverting attention, increase of behavioural activities and somatization. The peak VAS pain, NRS of unpleasantness and MPQ scores were not significantly different between groups, but PPT and PPTOL were significantly lower in the TMD patients. Significant positive correlations were found in the TMD patients between peak VAS pain and CSQ catastrophizing score and SCL-90 somatization. The scores of PPTs and PPTOLs, in patients showed positive correlations with CSQ reinterpreting pain sensations scores and PPTs correlated with CSQ praying/hoping scores.

CONCLUSIONS

Glutamate-evoked pain responses in HS and persistent myofascial TMD pain have similar sensory-discriminative and affective-unpleasantness components but differ in psychosocial features. This study suggests that experimental designs based on glutamate injection into muscle can provide an appropriate model for elucidating persistent myofascial pain conditions.

摘要

目的

比较健康受试者(HS)谷氨酸诱发的咀嚼肌疼痛与持续性肌筋膜性颞下颌关节紊乱病(TMD)疼痛患者之间与疼痛相关的指标及心理社会变量。

设计

47名女性HS和10名患有持续性肌筋膜性TMD疼痛的女性患者参与研究。HS组接受在咬肌注射谷氨酸以模拟持续性肌筋膜性TMD疼痛。参与者填写应对策略问卷(CSQ)、症状自评量表90(SCL - 90)和麦吉尔疼痛问卷(MPQ)。疼痛强度通过电子视觉模拟量表(VAS)进行评估。测量疼痛绘图区域、不愉快程度的数字评定量表(NRS)评分、压痛阈值(PPTs)和压痛耐受度(PPTOL)。采用独立样本t检验和相关性检验进行分析。

结果

在比较控制、减少、转移注意力、增加行为活动和躯体化的CSQ评分时,两组存在显著差异。两组之间的VAS疼痛峰值、不愉快程度的NRS评分和MPQ评分无显著差异,但TMD患者的PPT和PPTOL显著更低。在TMD患者中,VAS疼痛峰值与CSQ灾难化评分和SCL - 90躯体化之间存在显著正相关。患者的PPTs和PPTOLs评分与CSQ重新解释疼痛感觉评分呈正相关,PPTs与CSQ祈祷/希望评分相关。

结论

HS中谷氨酸诱发的疼痛反应与持续性肌筋膜性TMD疼痛具有相似的感觉辨别和情感不愉快成分,但在心理社会特征方面存在差异。本研究表明,基于向肌肉注射谷氨酸的实验设计可为阐明持续性肌筋膜疼痛状况提供合适的模型。

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