Payano Sosa Janell S, Da Silva Joyce T, Burrowes Shana A B, Yoo Soo Y, Keaser Michael L, Meiller Timothy F, Seminowicz David A
Program in Neuroscience, University of Maryland, Baltimore, Baltimore, MD, United States.
Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, United States.
Front Neurosci. 2021 Oct 1;15:698164. doi: 10.3389/fnins.2021.698164. eCollection 2021.
Burning mouth syndrome (BMS) is a chronic orofacial pain condition that mainly affects postmenopausal women. BMS type I patients report little to no spontaneous pain in the morning and increases in pain through the day, peaking in the afternoon. Quantitative sensory testing (QST) findings from BMS type 1 patients are inconsistent as they fail to capture this temporal variation. We examined how QST in BMS type 1 ( = 18) compared to healthy participants ( = 33) was affected by time of day. QST of the face and forearm included warmth detection threshold (WDT), cold detection threshold (CDT), and heat pain thresholds (HPT), ratings of suprathreshold heat, and pressure pain thresholds (PPT), and was performed twice: once in the morning and once in the afternoon. Compared to healthy participants, BMS patients had higher pain sensitivity to phasic heat stimuli at most temperatures (35°C U = 126.5, = 0.0006, 39°C U = 186.5, = 0.0386, 41°C U = 187.5, = 0.0412, 43°C U = 171, = 0.0167, 45°C U = 168.5, = 0.0146) on the forearm, but no differences in pain thresholds (HPT and PPT) regardless of time of day or body area tested. BMS patients had higher WDT (U = 123, = 0.0172), and lower CDT (U = 98, = 0.0021) of the forearm and lower WDT of the face (U = 55, = 0.0494). The differences in forearm WDT (U = 71.5, = 0.0113) and CDT (U = 70, = 0.0096) were most pronounced in the morning. In summary, BMS type I patients had increased pain sensitivity on the forearm, but no differences in pain thresholds on the face or forearm. Patients also showed altered thermal sensitivity, which depended on body area tested (heightened in the orofacial region but blunted on the forearm), and was more pronounced in the morning plausibly due to hypervigilance.
灼口综合征（BMS）是一种主要影响绝经后女性的慢性口面部疼痛病症。I型BMS患者报告称，早晨几乎没有或没有自发疼痛，疼痛在一天中逐渐增加，在下午达到峰值。I型BMS患者的定量感觉测试（QST）结果不一致，因为它们未能捕捉到这种时间变化。我们研究了I型BMS患者（n = 18）与健康参与者（n = 33）相比，QST如何受到一天中不同时间的影响。面部和前臂的QST包括热觉检测阈值（WDT）、冷觉检测阈值（CDT）和热痛阈值（HPT）、阈上热觉评分以及压痛阈值（PPT），并进行了两次：一次在早晨，一次在下午。与健康参与者相比，BMS患者在前臂大多数温度下对阶段性热刺激的疼痛敏感性更高（35°C时U = 126.5，p = 0.0006；39°C时U = 186.5，p = 0.0386；41°C时U = 187.5，p = 0.0412；43°C时U = 171，p = 0.0167；45°C时U = 168.5，p = 0.0146），但无论一天中的时间或测试的身体部位如何，疼痛阈值（HPT和PPT）均无差异。BMS患者前臂的WDT较高（U = 123，p = 0.0172），CDT较低（U = 98，p = 0.0021），面部的WDT较低（U = 55，p = 0.0494）。前臂WDT（U = 71.5，p = 0.0113）和CDT（U = 70，p = 0.0096）的差异在早晨最为明显。总之，I型BMS患者前臂的疼痛敏感性增加，但面部或前臂的疼痛阈值无差异。患者还表现出热敏感性改变，这取决于测试的身体部位（口面部区域增强，但前臂减弱），并且由于过度警觉，在早晨更为明显。
