Who is more prone to experimentally-induced central sensitization amongst subjects with temporomandibular disorders and healthy individuals?

Cayrol, Timothée;Roussel, Nathalie;Mouraux, André;Pitance, Laurent;van den Broeke, Emanuel
(2019) Pain Science in Motion III: International and Interdisciplinary colloqium on Research Methods in Pain Sciences — Location: Savona (31.May.2019)

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Authors
  • Cayrol, TimothéeUCLouvain
    Author
  • Roussel, NathalieUCLouvain
    Author
  • Mouraux, Andréorcid-logoUCLouvain
    Author
  • Pitance, Laurentorcid-logoUCLouvain
    Author
  • van den Broeke, Emanuelorcid-logoUCLouvain
    Author
Abstract
Title Who is more prone to experimentally-induced central sensitization amongst subjects with temporomandibular disorders and healthy individuals? Introduction Central sensitization (CS) is increasingly understood as a main contributor to temporomandibular disorders (TMD). Furthermore, a predisposition to develop more CS in response to nociceptive input may play a role in the maintenance of pain. The aim of this study is to assess the response of TMD subjects and healthy individuals to high frequency stimulation (HFS). HFS is an experimental procedure inducing CS manifesting itself by secondary hyperalgesia, a large area skin surrounding the stimulated site becoming more sensitive to mechanical pinprick stimuli. Methods To be included TMD subjects will have to fulfil the DC/TMD criteria; they may present with other musculoskeletal disorders but TMD will have to be their main complain. Exclusion criteria will include a history of orofacial surgery and any coexisting psychiatric, inflammatory, neurological or metabolic comorbidities. HFS will be used to induce CS in subjects with TMD and healthy controls. The spatial extent and the duration of secondary hyperalgesia will be measured. Pain ratings, spontaneous pain and allodynia in the area of secondary hyperalgesia will also be assessed. These parameters will be used to compare participants and identify potential clusters. Correlations between the response to HFS and a range of secondary outcomes will be assessed in subjects with TMD, including pain distribution, conditioned pain modulation, pressure pain thresholds and physical symptoms (Central Sensitization Inventory, Symptom Severity Scale, Widespread Pain Index, Graded Chronic Pain Scale and Patient Health Questionnaire-15), functional limitations (Jaw Functional Limitation Scale), and psychological factors (Generalized Anxiety Disorder-7, patient health questionnaire-9). Discussion It is expected that some individuals in both groups will develop more CS in response to nociceptive input. Characteristics of secondary hyperalgesia may be correlated with the secondary outcomes in subjects with TMD. HFS has the potential to be a new, safe, and well-controlled technique assessing the tendency to develop CS in TMD, which could later be taken into account for patient management. Process evaluation The protocol is about to be submitted to an ethical committee. In parallel, the validity of measuring the area and the extent of secondary hyperalgesia induced by HFS is being studied in healthy subjects. The success of these steps is mandatory before conducting a power analysis and launching the study.
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Cayrol, T., Roussel, N., Mouraux, A., Pitance, L., & van den Broeke, E. (2019). Who is more prone to experimentally-induced central sensitization amongst subjects with temporomandibular disorders and healthy individuals? Pain Science in Motion III: International and Interdisciplinary colloqium on Research Methods in Pain Sciences, Savona. https://hdl.handle.net/2078.5/31323