Ernberg M, Hedenberg-Magnusson B, Alstergren P, Kopp S
Department of Clinical Oral Physiology, Faculty of Odontology, Karolinska Institute, Huddinge, Sweden.
Acta Odontol Scand. 1998 Jun;56(3):129-34. doi: 10.1080/000163598422857.
The aim of this study was to compare the effects on the level of serotonin (5-HT) in the masseter muscle by intramuscular glucocorticoid (GC) administration in patients with fibromyalgia (FM) and localized myalgia (LM), as well as to determine associated changes in pain, tenderness, and microcirculation. The study comprised 22 patients with pain and tenderness in the masseter muscle region. Ten patients (all women) had FNI, and 12 (1 man and 11 women) had LM involving the temporomandibular system. The patients were examined clinically and by microdialysis at 2 visits 2-3 weeks apart and received local glucocorticoid treatment at the first visit. The ratio (S1/S2) between the initial level of 5-HT (S1) and steady state level (S2) was used as a relative measure of the intramuscular release of 5-HT. This ratio decreased significantly after treatment in the FM group. In the FM group there was also a negative correlation regarding changes between visits of 5-HT and changes of intramuscular temperature. In the LM group there was a negative correlation regarding changes between visits of 5-HT and changes of pressure pain threshold and pressure pain tolerance level. This study indicates that there is a reduction of the ratio between initial 5-HT and steady state level in the painful masseter muscle after intramuscular GC administration to FM patients, a reduction not present in the LM patients. In addition, 5-HT seems to be involved in the modulation of local muscle microcirculation in FM patients and in hyperalgesia in LM patients.
本研究的目的是比较肌内注射糖皮质激素（GC）对纤维肌痛（FM）和局限性肌痛（LM）患者咬肌中血清素（5-HT）水平的影响，并确定疼痛、压痛和微循环的相关变化。该研究纳入了22名咬肌区域有疼痛和压痛的患者。10名患者（均为女性）患有FM，12名患者（1名男性和11名女性）患有累及颞下颌系统的LM。在相隔2 - 3周的两次就诊时对患者进行临床检查和微透析，并在首次就诊时给予局部糖皮质激素治疗。5-HT初始水平（S1）与稳态水平（S2）的比值用作5-HT肌内释放的相对指标。FM组治疗后该比值显著下降。在FM组中，5-HT就诊间变化与肌内温度变化之间也存在负相关。在LM组中，5-HT就诊间变化与压力痛阈和压力痛耐受水平变化之间存在负相关。本研究表明，对FM患者肌内注射GC后，疼痛咬肌中5-HT初始水平与稳态水平的比值降低，而LM患者中不存在这种降低。此外，5-HT似乎参与了FM患者局部肌肉微循环的调节以及LM患者的痛觉过敏。
