Dawson Andreas, Stensson Niclas, Ghafouri Bijar, Gerdle Björn, List Thomas, Svensson Peter, Ernberg Malin
Center for Oral Rehabilitation, Östergötland County Council, Linköping, Sweden.
Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden.
J Headache Pain. 2016 Dec;17(1):65. doi: 10.1186/s10194-016-0656-3. Epub 2016 Jul 7.
Dopaminergic pathways could be involved in the pathophysiology of myofascial temporomandibular disorders (M-TMD). This study investigated plasma levels of dopamine and serotonin (5-HT) in patients with M-TMD and in healthy subjects.
Fifteen patients with M-TMD and 15 age- and sex-matched healthy subjects participated. The patients had received an M-TMD diagnosis according to the Research Diagnostic Criteria for TMD. Perceived mental stress, pain intensity (0-100-mm visual analogue scale), and pressure pain thresholds (PPT, kPa) over the masseter muscles were assessed; a venous blood sample was taken.
Dopamine in plasma differed significantly between patients with M-TMD (4.98 ± 2.55 nM) and healthy controls (2.73 ± 1.24 nM; P < 0.01). No significant difference in plasma 5-HT was observed between the groups (P = 0.75). Patients reported significantly higher pain intensities (P < 0.001) and had lower PPTs (P < 0.01) compared with the healthy controls. Importantly, dopamine in plasma correlated significantly with present pain intensity (r = 0.53, n = 14, P < 0.05) and perceived mental stress (r = 0.34, n = 28, P < 0.05).
The results suggest that peripheral dopamine might be involved in modulating peripheral pain. This finding, in addition to reports in other studies, suggests that dopaminergic pathways could be implicated in the pathophysiology of M-TMD but also in other chronic pain conditions. More research is warranted to elucidate the role of peripheral dopamine in the pathophysiology of chronic pain.
多巴胺能通路可能参与了肌筋膜性颞下颌关节紊乱病(M-TMD)的病理生理过程。本研究调查了M-TMD患者和健康受试者血浆中多巴胺和5-羟色胺(5-HT)的水平。
15例M-TMD患者和15例年龄及性别匹配的健康受试者参与了研究。这些患者根据颞下颌关节紊乱病的研究诊断标准被诊断为M-TMD。评估了受试者的感知心理压力、疼痛强度(0-100毫米视觉模拟量表)以及咬肌的压痛阈值(PPT,千帕);采集了静脉血样本。
M-TMD患者血浆中的多巴胺水平(4.98±2.55纳摩尔)与健康对照组(2.73±1.24纳摩尔;P<0.01)相比有显著差异。两组间血浆5-HT水平无显著差异(P=0.75)。与健康对照组相比,患者报告的疼痛强度显著更高(P<0.001)且PPT更低(P<0.01)。重要的是,血浆中的多巴胺与当前疼痛强度显著相关(r=0.53,n=14,P<0.05)以及感知心理压力显著相关(r=0.34,n=28,P<0.05)。
结果表明外周多巴胺可能参与调节外周疼痛。这一发现,连同其他研究的报告,提示多巴胺能通路可能不仅与M-TMD的病理生理过程有关,还与其他慢性疼痛状况有关。有必要进行更多研究以阐明外周多巴胺在慢性疼痛病理生理过程中的作用。