Fillingim R B, Maixner W, Kincaid S, Sigurdsson A, Harris M B
Department of Dental Ecology, University of North Carolina at Chapel Hill 27599-7455, USA.
Clin J Pain. 1996 Dec;12(4):260-9. doi: 10.1097/00002508-199612000-00005.
We have previously reported that patients with temporomandibular disorders (TMD) exhibit enhanced sensitivity to experimentally evoked pain (1); however, the clinical relevance of this increased pain sensitivity remains unclear. The purpose of this study was to investigate the relationship of experimental pain sensitivity to clinical and psychosocial variables among patients with TMD.
Thirty-six TMD patients were studied, half of whom were pain sensitive (PS) and the other half pain tolerant (PT), based on their ability to tolerate an ischemic pain task. Responses to painful thermal and nonpainful visual stimuli as well as clinical/diagnostic symptoms and psychosocial variables were compared for the two groups (i.e., PS vs. PT).
Results indicated that, compared with PT patients, the PS group exhibited greater sensitivity to thermal pain and rated innocuous visual stimuli as more intense. PS patients also reported greater clinical pain, but in general the groups did not differ on diagnostic and psychosocial measures.
The results suggest that ischemic pain tolerance is a clinically relevant marker of pain sensitivity in TMD patients. These findings are consistent with the hypothesis that impairments in CNS inhibitory pathways may contribute to the pain associated with TMD.
我们之前曾报道颞下颌关节紊乱症（TMD）患者对实验诱发的疼痛表现出更高的敏感性（1）；然而，这种疼痛敏感性增加的临床相关性仍不明确。本研究的目的是调查TMD患者实验性疼痛敏感性与临床及心理社会变量之间的关系。
对36名TMD患者进行研究，根据他们耐受缺血性疼痛任务的能力，其中一半为疼痛敏感型（PS），另一半为疼痛耐受型（PT）。比较两组（即PS组与PT组）对疼痛性热刺激和非疼痛性视觉刺激的反应以及临床/诊断症状和心理社会变量。
结果表明，与PT患者相比，PS组对热痛表现出更高的敏感性，并且将无害视觉刺激评定为更强烈。PS患者也报告有更严重的临床疼痛，但总体而言，两组在诊断和心理社会指标上没有差异。
结果表明，缺血性疼痛耐受性是TMD患者疼痛敏感性的一个临床相关指标。这些发现与中枢神经系统抑制通路受损可能导致与TMD相关的疼痛这一假设一致。
