Center for Biosciences Applied to Patients with Special Needs (CEBAPE), Institute of Science and Technology, São José dos Campos Campus, São Paulo State University (UNESP), São Paulo, Brazil.
Hospital of the State Public Servant of São Paulo (IAMSPE), São Paulo, Brazil.
Sleep. 2022 Nov 9;45(11). doi: 10.1093/sleep/zsac181.
The aim of the present study was to investigate orofacial pain in individuals with Down syndrome (DS) and determine possible associations with masticatory muscle hypotonia (MMH), maximum mouth opening (MMO), and sleep disorders. Twenty-three individuals with DS underwent a standardized clinical examination using Axis I of the Diagnostic Criteria for Temporomandibular Disorders, for the diagnosis of pain in the masseter and temporal muscles and temporomandibular joint (TMJ). MMH was investigated using electromyography of the temporal and masseter muscles and the measurement of maximum bite force (MBF). MMO was measured using an analog caliper. Sleep disorders (obstructive sleep apnea [OSA], snoring index [SI], and sleep bruxism index [SBI]) were investigated using type II polysomnography. Statistical analysis was performed. Nonsignificant differences were found in muscle and TMJ pain between the sexes. However, myalgia and referred myofascial pain in the left masseter muscle were more frequent in males (69%) than females (40%). Electrical activity of the temporal (left: p = .002; right: p = .004) and masseter (left: p = .008) muscles was significantly lower in males than in females. MBF range was lower in males than females, indicating the highest MMH among males. OSA, SI, and SBI were identified in both sexes, but with no statistically significant differences. We concluded that myalgia and referred myofascial pain were found in some individuals with DS, especially in males. Arthralgia was found mainly in females. Temporal and masseter myalgia may have exerted an influence on the severity of MMH in males, particularly on the left side.
本研究旨在调查唐氏综合征（Down syndrome，DS）患者的口腔颌面部疼痛，并确定其与咀嚼肌张力减退症（masticatory muscle hypotonia，MMH）、最大张口度（maximum mouth opening，MMO）和睡眠障碍的可能相关性。23 名 DS 患者接受了轴 I 下的颞下颌关节紊乱病诊断标准的标准化临床检查，以诊断咀嚼肌和颞下颌关节的疼痛。使用颞肌和咀嚼肌肌电图以及最大咬合力（maximum bite force，MBF）测量来检查 MMH。使用模拟卡尺测量 MMO。使用 II 型多导睡眠图检查睡眠障碍（阻塞性睡眠呼吸暂停 [obstructive sleep apnea，OSA]、打鼾指数 [snoring index，SI]和睡眠磨牙指数 [sleep bruxism index，SBI]）。进行了统计分析。未发现男女之间肌肉和 TMJ 疼痛有显著差异。然而，男性（69%）比女性（40%）更常出现左侧咀嚼肌的肌痛和牵涉性肌筋膜痛。男性颞肌（左侧：p =.002；右侧：p =.004）和咀嚼肌（左侧：p =.008）的电活动明显低于女性。男性的 MBF 范围低于女性，表明男性的 MMH 最高。在两性中均发现 OSA、SI 和 SBI，但无统计学差异。我们得出结论，一些 DS 患者存在肌痛和牵涉性肌筋膜痛，尤其是男性。关节痛主要发生在女性中。颞肌和咀嚼肌肌痛可能对男性 MMH 的严重程度产生影响，尤其是左侧。
