J Oral Facial Pain Headache. 2018;32(2):113-122. doi: 10.11607/ofph.1819.
To investigate, in individuals with pain-related temporomandibular disorder (TMD), the association of long-term pain intensity with baseline health-related quality of life (HRQoL) and jaw functional limitation.
Of 513 cases with baseline pain-related TMD (masticatory muscle and/or temporomandibular joint [TMJ] pain), 273 were reevaluated after 8 years, and 258 of them had complete baseline data for Jaw Functional Limitation Scale (JFLS) scores and HRQoL measured by the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the 12-item Short Form Health Survey and follow-up data for Characteristic Pain Intensity (CPI) from the Graded Chronic Pain Scale. Secondary analyses of existing data quantified the effects of primary (PCS, MCS) and secondary (JFLS) predictors on follow-up CPI by using multivariable linear regression. Sensitivity analyses considered differences between the included participants (n = 258) and those who were not included (n = 255) by using inverse probability weighting. Interactions of baseline predictors with age, sex, and baseline CPI were evaluated using multivariable linear regression.
The score for baseline PCS, but not MCS or JFLS, was associated with follow-up CPI (P = .012). One standard deviation (SD = 9.0)-higher baseline PCS score predicted an overall 3.2-point-lower follow-up CPI (95% confidence interval -5.8 to -0.7) after adjusting for age, sex, MCS, JFLS, and baseline CPI scores. However, the effect of PCS score was not uniform: the association between PCS and follow-up CPI scores was statistically significant for participants with baseline CPI ≥ 51.3/100 and clinically significant for participants with baseline CPI ≥ 68.7/100. Adjustment for TMD treatments and sensitivity analyses had negligible effect.
In participants with moderate to severe baseline TMD pain intensity, higher baseline physical HRQoL predicted lower TMD pain intensity at 8 years follow-up. PCS score could contribute to a multifactorial long-term TMD pain prediction model.
在与疼痛相关的颞下颌关节紊乱（TMD）患者中，研究长期疼痛强度与基线健康相关生活质量（HRQoL）和下颌功能受限的关系。
在 513 例基线与疼痛相关的 TMD（咀嚼肌和/或颞下颌关节 [TMJ] 疼痛）患者中，273 例在 8 年后进行了重新评估，其中 258 例有完整的基线 Jaw Functional Limitation Scale（JFLS）评分和通过 12 项短表健康调查的身体成分综合评分（PCS）和精神成分综合评分（MCS）以及特征性疼痛强度（CPI）的分级慢性疼痛量表的随访数据。对现有数据的二次分析通过使用多变量线性回归量化了主要（PCS、MCS）和次要（JFLS）预测因素对随访 CPI 的影响。敏感性分析通过使用逆概率加权考虑了纳入参与者（n=258）与未纳入参与者（n=255）之间的差异。使用多变量线性回归评估了基线预测因子与年龄、性别和基线 CPI 的交互作用。
基线 PCS 评分，但不是 MCS 或 JFLS，与随访 CPI 相关（P=.012）。在调整年龄、性别、MCS、JFLS 和基线 CPI 评分后，基线 PCS 评分每增加一个标准差（SD=9.0），随访 CPI 总体降低 3.2 分（95%置信区间为-5.8 至-0.7）。然而，PCS 评分的效果并不均匀：PCS 与随访 CPI 评分之间的关联在基线 CPI≥51.3/100 的参与者中具有统计学意义，在基线 CPI≥68.7/100 的参与者中具有临床意义。调整 TMD 治疗和敏感性分析几乎没有影响。
在基线 TMD 疼痛强度为中度至重度的参与者中，较高的基线身体 HRQoL 预测了 8 年随访时 TMD 疼痛强度的降低。PCS 评分可能有助于建立 TMD 疼痛的多因素长期预测模型。
