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Bilateral thermal hyperalgesia in trigeminal and extra-trigeminal regions in patients with myofascial temporomandibular disorders

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Abstract

Our aim was to assess thermal sensitivity in both trigeminal and extra-trigeminal regions in patients with myofascial temporomandibular disorder (TMD) but without comorbid conditions as compared to age-matched controls. Twenty women (age 24 ± 3 years) diagnosed with myofascial TMD according to the research diagnostic criteria for TMD and 20 healthy women (age 24 ± 4 years) were included. Warm and cold detection thresholds (WDT and CDT, respectively) and heat and cold pain thresholds (HPT and CPT, respectively) were bilaterally assessed over the masseter and frontalis muscles (trigeminal regions) and the wrist (extra-trigeminal region). The mean of three determinations at each site was calculated and used for analysis. The order of the test sites was randomized. A two-way ANOVA was used to test for differences between groups and sides (most painful/contra-lateral side; dominant/non-dominant). No significant differences between groups for WDT or CDT in trigeminal and extra-trigeminal regions (ANOVA, P > 0.389) were found. There were significant differences between groups, but not between sides, for HPT and CPT in both trigeminal and extra-trigeminal areas (ANOVA, P < 0.001). CPT (P < 0.001) over the trigeminal area was positively correlated with both pain intensity and duration of pain symptoms: the longer the history of pain or the greater the pain intensity, the higher the CPT (i.e., the greater cold hyperalgesia) over the trigeminal region. Our findings revealed bilateral thermal hyperalgesia (lower HPT and higher CPT) but normal WDT and CDT in trigeminal and extra-trigeminal regions in women with myofascial TMD as compared to healthy controls. Bilateral heat/cold hyperalgesia in trigeminal and extra-trigeminal areas may reflect a dysfunction of thermal channels in myofascial TMD patients as result of some combination of peripheral sensitization, facilitation of central nociceptive processing and/or decreased descending inhibition.

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Authors and Affiliations

  1. Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922, Alcorcón, Madrid, Spain

    César Fernández-de-las-Peñas, Fernando Galán-del-Río & Ricardo Ortega-Santiago

  2. Esthesiology Laboratory, Universidad Rey Juan Carlos, Alcorcón, Spain

    César Fernández-de-las-Peñas, Fernando Galán-del-Río & Ricardo Ortega-Santiago

  3. Department of Health Science and Technology, Centre for Sensory–Motor Interaction (SMI), Aalborg University, Ålborg, Denmark

    César Fernández-de-las-Peñas & Lars Arendt-Nielsen

  4. Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Madrid, Spain

    Rodrigo Jiménez-García

  5. Department of Clinical Oral Physiology, School of Dentistry, Aarhus University, Århus, Denmark

    Peter Svensson

  6. Department of Oral and Maxillofacial Surgery, Aarhus University Hospital, Århus, Denmark

    Peter Svensson

  7. Orofacial Pain Laboratory, Center for Sensory–Motor Interaction, Aalborg University, Ålborg, Denmark

    Peter Svensson

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  1. César Fernández-de-las-Peñas
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  2. Fernando Galán-del-Río
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  3. Ricardo Ortega-Santiago
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  4. Rodrigo Jiménez-García
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  5. Lars Arendt-Nielsen
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  6. Peter Svensson
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Correspondence to César Fernández-de-las-Peñas.

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Fernández-de-las-Peñas, C., Galán-del-Río, F., Ortega-Santiago, R. et al. Bilateral thermal hyperalgesia in trigeminal and extra-trigeminal regions in patients with myofascial temporomandibular disorders. Exp Brain Res 202, 171–179 (2010). https://doi.org/10.1007/s00221-009-2121-x

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  • DOI: https://doi.org/10.1007/s00221-009-2121-x

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