Garrett Pauline H, Sarlani Eleni, Grace Edward G, Greenspan Joel D
Department of Endodontics, Prosthodontics and Operative Dentistry, University of Maryland School of Dentistry, Baltimore, Maryland, USA.
J Orofac Pain. 2013 Spring;27(2):142-50. doi: 10.11607/jop.943.
To test whether temporomandibular disorders (TMD) case-control differences in conditioned pain modulation (CPM) exist, using a mechanically evoked temporal summation (TS) model.
A series of 10 repetitive, mildly noxious, mechanical stimuli were applied to the fingers of 30 women with TMD, who had a primary diagnosis of masticatory myofascial pain, and 30 age-matched healthy women. The subjects rated the pain intensity caused by the 1st, 5th, and 10th stimuli in the series. To evaluate CPM, the same series of mechanical stimulations were applied with concomitant exposure of the other hand to a painfully cold water bath. Statistical inferences were based on t tests, chi-square tests, or analysis of variance (ANOVA), as appropriate.
Pain ratings increased significantly with stimulus repetition (P < .01) and CPM significantly reduced TS of pain (P < .01). Of particular note, both groups showed very similar degrees of CPM, with no significant group difference.
Painful TMD is not necessarily associated with a compromised ability to engage the endogenous analgesic system in an experimental setting.
使用机械诱发的时间总和（TS）模型，测试颞下颌关节紊乱病（TMD）病例组与对照组在条件性疼痛调制（CPM）方面是否存在差异。
对30名初步诊断为咀嚼肌筋膜疼痛的TMD女性患者和30名年龄匹配的健康女性的手指施加一系列10次重复性轻度有害机械刺激。受试者对该系列中第1次、第5次和第10次刺激所引起的疼痛强度进行评分。为评估CPM，在对另一只手进行冷水浴致痛刺激的同时，施加相同系列的机械刺激。根据情况，统计推断基于t检验、卡方检验或方差分析（ANOVA）。
疼痛评分随刺激重复显著增加（P <.01），CPM显著降低疼痛的TS（P <.01）。特别值得注意的是，两组显示出非常相似的CPM程度，无显著组间差异。
在实验环境中，疼痛性TMD不一定与内源性镇痛系统参与能力受损有关。
