Lu Chenghui, Jiang Mengyu, Li Xin, Du Qing, Tang Guoyao
Department of Stomatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Core Unit of National Clinical Research Center for Oral Diseases, Shanghai, China.
Department of Oral Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China.
J Oral Rehabil. 2025 Jul 22. doi: 10.1111/joor.70020.
Burning mouth syndrome (BMS) is a chronic pain disorder affecting the oral mucosa, primarily characterised by a burning sensation in otherwise healthy-appearing tissues. Due to the absence of specific clinical manifestations and identifiable pathological changes, BMS is often misdiagnosed, leading to persistent pain and significant impacts on patients' emotional and psychological well-being.
The present review aims to elucidate the neurobiological mechanisms underlying BMS and explore potential neuromodulation therapies for its management.
We analysed current research on the pathophysiology of BMS, focusing on peripheral sensory transmission abnormalities and central pain modulation dysfunctions, employing methodologies such as quantitative sensory testing, neuroimaging and molecular biomarker analysis to support diagnostic assessments.
The pathological mechanisms of neuropathic pain in BMS involve complex interactions at various levels of the sensory neural axis, along with significant biomarkers associated with chronic pain. Patients often experience comorbid conditions, including emotional disturbances, sleep disorders and cognitive dysfunction. Early recognition and proactive intervention are essential for managing pain symptoms and rehabilitating associated comorbidities.
While pharmacological approaches remain better supported by current evidence, peripheral neuromodulation therapies like photobiomodulation (PBM) have shown promise for pain management. Initial studies on central neuromodulation techniques like repetitive transcranial magnetic stimulation (rTMS) indicate potential benefits though further trials are needed to validate their effectiveness. Future research integrating neurobiological mechanisms with intervention strategies holds promise for optimising treatment strategies for BMS.
灼口综合征（BMS）是一种影响口腔黏膜的慢性疼痛疾病，主要特征是在外观正常的组织中出现烧灼感。由于缺乏特异性临床表现和可识别的病理变化，BMS常被误诊，导致疼痛持续存在，并对患者的情绪和心理健康产生重大影响。
本综述旨在阐明BMS潜在的神经生物学机制，并探索其管理的潜在神经调节疗法。
我们分析了目前关于BMS病理生理学的研究，重点关注外周感觉传导异常和中枢疼痛调节功能障碍，采用定量感觉测试、神经影像学和分子生物标志物分析等方法来支持诊断评估。
BMS中神经性疼痛的病理机制涉及感觉神经轴各水平的复杂相互作用，以及与慢性疼痛相关的重要生物标志物。患者常伴有情绪障碍、睡眠障碍和认知功能障碍等共病情况。早期识别和积极干预对于管理疼痛症状和恢复相关共病至关重要。
虽然目前证据对药物治疗方法的支持力度更大，但光生物调节（PBM）等外周神经调节疗法已显示出在疼痛管理方面的潜力。对重复经颅磁刺激（rTMS）等中枢神经调节技术的初步研究表明有潜在益处，不过还需要进一步试验来验证其有效性。将神经生物学机制与干预策略相结合的未来研究有望优化BMS治疗策略。
