Assessment of Variations of Pressure Sensitivity Within and Between Chronic Painful Jaw Muscles—A Case–Control Clinical Study

IF 3.8 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2026-10-23 DOI:10.1002/ejp.70423

Juan Fernando Oyarzo, Manolis Jusakos, Paula Zamora, Eduardo Castrillón, Fernando G. Exposto, Peter Svensson

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引用次数: 0

Abstract

Background

Orofacial myofascial pain shows variable muscle sensitivity, referred pain, and complex spatiotemporal pressure processing profiles.

Methods

This participant-, examiner- and data analyst-blinded case–control study compared masticatory muscle sensitivity and entropy patterns between 28 chronic myofascial TMD pain patients and 28 age- and sex-matched controls, introducing a comprehensive approach for ‘topoalgesia’ assessment. Mechanical pain sensitivity (MPS) was assessed at nine sites on the masseter and temporalis muscles bilaterally using a palpometer with 0.5, 1.0 and 2.0 kgf for 2 s. Participants rated MPS on a 0–50–100 numeric rating scale after each palpation and reported referred sensations. Entropy and center of gravity (COG) were analysed.

Results

Chronic myofascial TMD pain patients reported significantly greater MPS scores than controls across all force levels and muscles (p < 0.05). Both groups showed increased MPS with higher applied forces. TMD patients exhibited significantly greater entropy in the masseter muscle at 0.5 and 1.0 kgf, and in the temporalis muscle at 2.0 kgf (p < 0.001). TMD patients also reported more referred sensations than controls across all force levels (p < 0.001). COG analysis showed myofascial TMD patients presented more centrally located COG within the masseter muscle than controls particularly at lower forces.

Conclusions

Results suggest that chronic myofascial TMD patients present greater muscle sensitivity, differing entropy profiles across muscles and force levels, and distinct spatiotemporal patterns compared to controls, associated with more frequent referred sensations. These findings contribute to understanding chronic muscle pain manifestations, and topoalgesia may help better track disease progression or remission over time.

Significance Statement

Quantification of spatial variation in pressure sensitivity (topoalgesia) showed that chronic myofascial TMD patients diverge from healthy controls at 0.5 kg and 2.0 kg palpation forces, but not at 1.0 kg, identifying force-specific parameters that could sharpen diagnostic sensitivity for orofacial pain.

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慢性疼痛颌骨肌肉内部和之间压力敏感性变化的评估-一项病例对照临床研究

口面部肌筋膜疼痛表现为可变的肌肉敏感性、牵涉性疼痛和复杂的时空压力处理特征。该研究采用参与者、检查者和数据分析双盲方法，比较了28名慢性肌筋膜TMD疼痛患者和28名年龄和性别匹配的对照组的咀嚼肌敏感性和熵模式，引入了一种全面的“拓扑痛觉”评估方法。采用0.5、1.0和2.0 kg / gf的压力计测量双侧咬肌和颞肌9个部位的机械痛敏感性（MPS），持续2 s。参与者在每次触诊后对MPS进行0-50-100的数值评定，并报告所指的感觉。对熵和重心进行了分析。结果慢性肌筋膜TMD疼痛患者在所有力量水平和肌肉上的MPS评分均显著高于对照组（p < 0.05）。两组的MPS都随着施加力的增加而增加。TMD患者在0.5和1.0 kgf时咬肌和2.0 kgf时颞肌熵值显著增加（p < 0.001）。TMD患者在所有力水平上也报告了比对照组更多的参考感觉（p < 0.001）。COG分析显示肌筋膜TMD患者在咬肌中心位置的COG比对照组更多，特别是在较低的力时。结果表明，与对照组相比，慢性肌筋膜TMD患者表现出更大的肌肉敏感性，不同肌肉和力水平的熵分布和不同的时空模式，并伴有更频繁的参考感觉。这些发现有助于理解慢性肌肉疼痛的表现，并且拓扑痛觉可以帮助更好地跟踪疾病的进展或缓解。压力敏感性（拓扑痛觉）的空间变化量化表明，慢性肌筋膜TMD患者在0.5 kg和2.0 kg触诊力时与健康对照组存在差异，但在1.0 kg时则没有差异，从而确定了可以提高对口面部疼痛诊断敏感性的力特异性参数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.