Highlights
- •Sustained mechanical pain sensitization discriminated patients with temporomandibular disorder (TMD) and control individuals.
- •Sustained pain sensitization showed predictive validity for clinical TMD pain.
- •Sustained pain sensitization might represent 1 marker of chronic TMD pain.
Abstract
Generalized dysfunction of the nociceptive system has been hypothesized to be an important
pathophysiologic process underlying temporomandibular disorder (TMD) pain. Studies
have not identified sensitization to painful stimuli administered prospectively across
consecutive days among participants with TMD with chronic pain. We attempted to isolate
an empirically derived laboratory-based marker of sustained mechanical pain sensitization.
We examined whether this index accounted for variance in prospective assessments of
clinical TMD pain. Participants were women with a clinical diagnosis of chronic TMD
(n = 30) and healthy female controls (n = 30). Pain thresholds were assessed using
digital algometry 4 times at 12-hour intervals over 48 consecutive hours and clinical
TMD pain via follow-up telephone assessments. Sustained mechanical pain sensitization,
defined by statistically significant linear decrements in pressure pain thresholds
across the consecutive testing sessions, discriminated chronic TMD and control participants.
An index of sustained sensitization at the masseter accounted for unique variance
in clinical TMD pain over the subsequent 3-month assessment period, even controlling
for mean pain threshold and baseline pain severity. These preliminary findings highlight
discriminant and predictive validity characteristics of a novel marker of protracted
pain sensitization among women with chronic TMD pain.
Perspective
A laboratory-based and empirically defined marker of sustained mechanical pain sensitization
over the course of days with acceptable discriminant and predictive validity was identified.
This marker may represent a clinically useful marker of chronic TMD pain in women.
Key words
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Article info
Publication history
Published online: August 14, 2015
Accepted:
August 4,
2015
Received in revised form:
July 14,
2015
Received:
December 4,
2014
Footnotes
This work was supported by NIH grants NS047168, AR054871, and T32MH075884 and by grant number UL1 RR 025005 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on NCRR is available at http://www.ncrr.nih.gov/. Information on re-engineering the clinical research enterprise can be obtained from http://nihroadmap.nih.gov/clinicalresearch/overview-translational.asp. M.T.S. holds an equity stake in BMED Technologies, which is managed by the Johns Hopkins Office on Conflict of Interest. There are no additional conflicts of interest to report.
The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting true views of the Department of the Army or the Department of Defense.
Identification
Copyright
Published by Elsevier Inc.
