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慢性偏头痛和颞下颌关节紊乱症患者中广泛存在的机械性疼痛超敏反应:心理和感觉运动变量之间的关系及相关性

Widespread mechanical pain hypersensitivity in patients with chronic migraine and temporomandibular disorders: relationship and correlation between psychological and sensorimotor variables.

作者信息

Garrigós-Pedrón Miriam, La Touche Roy, Navarro-Desentre Pablo, Gracia-Naya Manuel, Segura-Ortí Eva

机构信息

a Departamento de Fisioterapia , Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid , Madrid , Spain.

b Instituto de Neurociencia y Dolor Craneofacial (INDCRAN), Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ) , Madrid , Spain.

出版信息

Acta Odontol Scand. 2019 Apr;77(3):224-231. doi: 10.1080/00016357.2018.1538533. Epub 2019 Jan 10.

Abstract

OBJECTIVE

This study aimed to assess mechanical hyperalgesia in the trigeminal and extra-trigeminal regions in patients with chronic migraine (CM) and temporomandibular disorders (TMD) in comparison to asymptomatic subjects and to determine the association between sensorimotor variables and psychological and disability variables and evaluate the prediction of a sensorimotor variables though psychological and disability variables in patients with CM and TMD.

MATERIAL AND METHODS

A total of 52 subjects with concomitant CM and TMD and 30 asymptomatic subjects were included in the study. The pressure pain threshold (PPT), maximal mouth opening (MMO) and a series of self-reported factors were compared.

RESULTS

There were 52 CM and TMD (92.3% women and 7.7% men; age = 46.2 ± 9.5) and 30 asymptomatic subjects (80% women and 20% men; age = 47.4 ± 10). Differences were found between patients with CM and TMD and asymptomatic participants (p < .01) when comparing the PPTs in the trigeminal and extra-trigeminal regions. The PPT for the trigeminal region was predicted by depressive symptoms (variance of 18%) as well as disability and craniofacial pain (variance of 20%). The extra-trigeminal region PPT was predicted by depressive symptoms (variance of 10%), and pain-free MMO was predicted by disability and craniofacial pain (variance of 24%).

CONCLUSIONS

This study suggests that patients with CM and TMD present with generalized mechanical hyperalgesia. In addition, an association between sensorimotor, psychological and disability variables was observed.

摘要

目的

本研究旨在评估慢性偏头痛(CM)和颞下颌关节紊乱症(TMD)患者三叉神经及三叉神经外区域的机械性痛觉过敏情况,并与无症状受试者进行比较,确定感觉运动变量与心理及残疾变量之间的关联,并评估CM和TMD患者中感觉运动变量通过心理及残疾变量的预测情况。

材料与方法

本研究共纳入52例同时患有CM和TMD的受试者以及30例无症状受试者。比较了压力疼痛阈值(PPT)、最大开口度(MMO)及一系列自我报告因素。

结果

共有52例CM和TMD患者(女性占92.3%,男性占7.7%;年龄=46.2±9.5)和30例无症状受试者(女性占80%,男性占20%;年龄=47.4±10)。比较三叉神经及三叉神经外区域的PPT时,发现CM和TMD患者与无症状参与者之间存在差异(p<0.01)。三叉神经区域的PPT可由抑郁症状(方差为18%)以及残疾和颅面疼痛(方差为20%)预测。三叉神经外区域的PPT可由抑郁症状(方差为10%)预测,无痛MMO可由残疾和颅面疼痛(方差为24%)预测。

结论

本研究表明,CM和TMD患者存在全身性机械性痛觉过敏。此外,还观察到感觉运动、心理和残疾变量之间存在关联。

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