Schmidt John E, Carlson Charles R
Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
J Orofac Pain. 2009 Summer;23(3):230-42.
To investigate (1) differences in heart rate variability (HRV) indices between masticatory muscle pain (MMP) patients and pain-free controls at rest, during a stressor condition, and during a post-stressor recovery period, and (2) factors including psychological distress, social environment, and family-of-origin characteristics in the MMP sample compared to a pain-free matched control sample.
Physiological activation and emotional reactivity were assessed in 22 MMP patients and 23 controls during baseline, stressor, and recovery periods. Physiological activity was assessed with frequency domain HRV indices. Emotional reactivity was assessed with the Emotional Assessment Scale. Analytic strategy began with overall 2 x 3 multivariate analyses of variance on physiological data followed by focused contrasts to test specific hypotheses regarding physiological and emotional status. Hypothesized differences between study groups on psychological and social-environmental variables were compared with univariate analyses of variance.
The MMP patients showed physiological activation during the baseline period and significantly more physiological activation during the recovery period compared to the controls. This pattern was also present in emotional reactivity between the groups. The emotional and physiological differences between the groups across study periods were more pronounced in pain patients reporting a traumatic stressor.
These results provide further evidence of physiological activation and emotional responding in MMP patients that differentiates them from matched pain-free controls. The use of HRV indices to measure physiological functioning quantifies the degree of sympathetic and parasympathetic activation. Study results suggest the use of these HRV indices may improve understanding of the role of excitatory and inhibitory mechanisms in patients with MMP conditions.
研究(1)咀嚼肌疼痛(MMP)患者与无疼痛对照组在静息状态、应激状态及应激后恢复期的心率变异性(HRV)指标差异;(2)与无疼痛匹配对照组相比,MMP样本中的心理困扰、社会环境和原生家庭特征等因素。
对22例MMP患者和23例对照组在基线期、应激期和恢复期进行生理激活和情绪反应评估。生理活动通过频域HRV指标进行评估。情绪反应通过情绪评估量表进行评估。分析策略首先对生理数据进行总体的2×3多变量方差分析,然后进行聚焦对比以检验关于生理和情绪状态的特定假设。研究组在心理和社会环境变量上的假设差异通过单变量方差分析进行比较。
与对照组相比,MMP患者在基线期表现出生理激活,在恢复期生理激活显著更多。这种模式在两组的情绪反应中也存在。在报告有创伤性应激源的疼痛患者中,各研究阶段两组之间的情绪和生理差异更为明显。
这些结果进一步证明了MMP患者的生理激活和情绪反应,使其与匹配的无疼痛对照组有所区别。使用HRV指标来测量生理功能可量化交感神经和副交感神经激活的程度。研究结果表明,使用这些HRV指标可能有助于更好地理解兴奋性和抑制性机制在MMP患者中的作用。