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高疼痛强度和灾难化是否会干扰与 TMD 相关的慢性疼痛女性的认知表现?一项横断面研究。

Can high pain intensity and catastrophizing interfere with the cognitive performance of women with chronic pain related TMD? A cross-sectional study.

机构信息

Universidade de São Paulo, Faculdade de Odontologia de Ribeirão Preto, Ribeirão Preto, SP, Brasil.

Universidade de Ribeirão Preto, UNAERP, Ribeirão Preto, SP, Brasil.

出版信息

J Appl Oral Sci. 2023 Mar 27;31:e20220384. doi: 10.1590/1678-7757-2022-0384. eCollection 2023.

Abstract

OBJECTIVE

Interventions based on pain education and self-management are dependent on factors such as attention, memory, concentration, and executive function. To explore the relationship between cognitive performance and the variables pain intensity, central sensitization, catastrophizing, and hypervigilance in women diagnosed with chronic pain-related TMD.

METHODOLOGY

This is a cross-sectional study. A total of 33 women (mean age: 38±4.6 years; range: 18 to 66 years) with chronic pain-related TMD (myalgia and/or arthralgia) diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Specific questionnaires were used to evaluate cognitive performance, overall pain intensity, central sensitization, hypervigilance, and pain catastrophizing. The data were analyzed using Pearson's correlation coefficient and backward stepwise multiple linear regression (statistical significance at 5% alpha).

RESULTS

Approximately 53% of the study sample showed decreased cognitive performance. High central sensitization, hypervigilance, and pain catastrophizing were observed. A significant negative correlation was observed between cognitive performance and hypervigilance (p=.003, r=-.49), cognitive performance and catastrophizing (p<.001, r=-.58), and cognitive performance and pain intensity (p<.001, r=-.58). Regarding the partial regression coefficients, only catastrophizing and pain intensity showed statistical significance (t=-2.12, p=.043; t=-2.64, p=.014, respectively), indicating a significant role in explaining cognitive performance at the sample.

CONCLUSION

High pain intensity and the presence of catastrophic thoughts regarding pain can predict impaired cognitive performance in women with chronic pain-related TMD. Management strategies addressing psychosocial dimensions such as reducing catastrophizing and ensuring complete understanding of the condition are important.

摘要

目的

基于疼痛教育和自我管理的干预措施依赖于注意力、记忆、集中力和执行功能等因素。本研究旨在探讨女性慢性疼痛相关颞下颌关节紊乱症患者的认知表现与疼痛强度、中枢敏化、灾难化和过度警觉等变量之间的关系。

方法

这是一项横断面研究。共纳入 33 名慢性疼痛相关颞下颌关节紊乱症(肌痛和/或关节痛)女性患者(平均年龄:38±4.6 岁;年龄范围:18-66 岁),这些患者均根据颞下颌关节紊乱症诊断标准(DC/TMD)进行诊断。使用特定的问卷评估认知表现、整体疼痛强度、中枢敏化、过度警觉和疼痛灾难化。使用 Pearson 相关系数和逐步向后多元线性回归分析(统计显著性水平为 5% alpha)对数据进行分析。

结果

研究样本中约有 53%的人认知表现下降。高中枢敏化、过度警觉和疼痛灾难化现象明显。认知表现与过度警觉(p=.003,r=-.49)、认知表现与灾难化(p<.001,r=-.58)以及认知表现与疼痛强度(p<.001,r=-.58)之间存在显著负相关。关于偏回归系数,只有灾难化和疼痛强度具有统计学意义(t=-2.12,p=.043;t=-2.64,p=.014),表明它们在样本中对解释认知表现具有显著作用。

结论

高疼痛强度和对疼痛的灾难性思维可以预测慢性疼痛相关颞下颌关节紊乱症女性的认知表现受损。管理策略应注重解决心理社会维度的问题,如减少灾难化和确保对病情的全面理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/80f0/10065759/d906111d1fb3/1678-7757-jaos-31-e20220384-gf01.jpg

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