We assessed the trigeminal nociceptive pathways in patients with painful temporomandibular disorders (TMD) and control subjects using a CO2-laser stimulator which provides a predominant activation of the nociceptive system. Fifteen patients with unilateral pain were examined in accordance with the Research Diagnostic Criteria for TMD and 30 gender- and age-matched individuals were included as a control group. Laser-evoked potentials (LEPs) and laser silent periods (LSPs) after stimulation of the perioral region (V2/V3) on the painful and non-painful sides were recorded in all subjects. LEPs were evoked by low-intensity pulses (1.5 x perception threshold (PTh)) and recorded from scalp electrodes at the vertex. LSPs were evoked by high-intensity pulses (4 X PTh) and recorded bilaterally from masseter muscles with surface electromyogram (EMG) electrodes. Subjects also assessed the stimulus intensity on a 0-10 rating scale. LEPs had normal latency but smaller amplitude in TMD patients compared to the control group (P < 0.001). Side-to-side comparison within patients showed that LEP amplitude was even more reduced after stimulation on the painful than the non-painful side (P < 0.001). TMD patients showed a significant side-asymmetry of the pre-stimulus EMG activity, with a smaller value in the muscle on the painful side (P < 0.001). LSPs were completely absent bilaterally in 12 TMD patients and unilaterally in two patients; only one patient had normal and bilateral LSPs. TMD patients perceived the laser stimulus less intense on the painful than the non-painful side (P < 0.05). We found suppression of cortical responses and brainstem reflexes elicited by a predominantly nociceptive input in TNM patients. These findings are consistent with recent experimental pain studies and suggest that chronic craniofacial pain in TMD patients may be associated with a dysfunction of the trigeminal nociceptive system. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.

Assessment of nociceptive trigeminal pathways by laser-evoked potentials and laser silent periods in patients with painful temporomandibular disorders / A., Romaniello; Cruccu, Giorgio; G., Frisardi; L., Arendt Nielsen; P., Svensson. - In: PAIN. - ISSN 0304-3959. - 103:1-2(2003), pp. 31-39. [10.1016/s0304-3959(02)00347-0]

Assessment of nociceptive trigeminal pathways by laser-evoked potentials and laser silent periods in patients with painful temporomandibular disorders

CRUCCU, Giorgio;
2003

Abstract

We assessed the trigeminal nociceptive pathways in patients with painful temporomandibular disorders (TMD) and control subjects using a CO2-laser stimulator which provides a predominant activation of the nociceptive system. Fifteen patients with unilateral pain were examined in accordance with the Research Diagnostic Criteria for TMD and 30 gender- and age-matched individuals were included as a control group. Laser-evoked potentials (LEPs) and laser silent periods (LSPs) after stimulation of the perioral region (V2/V3) on the painful and non-painful sides were recorded in all subjects. LEPs were evoked by low-intensity pulses (1.5 x perception threshold (PTh)) and recorded from scalp electrodes at the vertex. LSPs were evoked by high-intensity pulses (4 X PTh) and recorded bilaterally from masseter muscles with surface electromyogram (EMG) electrodes. Subjects also assessed the stimulus intensity on a 0-10 rating scale. LEPs had normal latency but smaller amplitude in TMD patients compared to the control group (P < 0.001). Side-to-side comparison within patients showed that LEP amplitude was even more reduced after stimulation on the painful than the non-painful side (P < 0.001). TMD patients showed a significant side-asymmetry of the pre-stimulus EMG activity, with a smaller value in the muscle on the painful side (P < 0.001). LSPs were completely absent bilaterally in 12 TMD patients and unilaterally in two patients; only one patient had normal and bilateral LSPs. TMD patients perceived the laser stimulus less intense on the painful than the non-painful side (P < 0.05). We found suppression of cortical responses and brainstem reflexes elicited by a predominantly nociceptive input in TNM patients. These findings are consistent with recent experimental pain studies and suggest that chronic craniofacial pain in TMD patients may be associated with a dysfunction of the trigeminal nociceptive system. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.
2003
adult; brain; carbon dioxide; case-control studies; chronic craniofacial pain; chronic disease; complications/physiopathology/psychology; dose-response relationship; electromyography; etiology/physiopathology; evoked potentials; female; humans; instrumentation; laser silent periods; laser-evoked potentials; lasers; male; masseter muscle; methods; middle aged; neural pathways; pain; pain measurement; pain threshold; physiology; physiopathology; radiation; radiation effects; temporomandibular disorders; temporomandibular joint disorders; trigeminal nerve diseases
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Assessment of nociceptive trigeminal pathways by laser-evoked potentials and laser silent periods in patients with painful temporomandibular disorders / A., Romaniello; Cruccu, Giorgio; G., Frisardi; L., Arendt Nielsen; P., Svensson. - In: PAIN. - ISSN 0304-3959. - 103:1-2(2003), pp. 31-39. [10.1016/s0304-3959(02)00347-0]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/405247
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