Abstract
BackgroundThe somatosensory phenotype of Chinese temporomandibular disorders (TMD) patients is not sufficiently studied with the use of contemporary techniques and guidelines.MethodsA standardized quantitative sensory testing (QST) battery consisting of 13 parameters with a stringent statistical protocol developed by the German Research Network on Neuropathic Pain was performed over the most painful and corresponding contralateral sites as well as the right hand of 40 Chinese patients with TMD and pain classified according to the Diagnostic Criteria for TMD (DC/TMD). The same QST protocol was performed bilaterally over the infraorbital, mental, and hand regions of 70 age- and gender-stratified healthy Chinese controls. Z-scores and loss/gain scores were computed for each TMD patient.ResultsFor patients, 82.5 % had somatosensory abnormalities in the painful facial region, while 60.0 % had abnormalities confined to the right hand. The most frequent abnormalities were somatosensory gain to pinprick (35.0 %) and pressure (35.0 %) stimuli, somatosensory loss to pinprick (25.0 %), cold (22.5 %), and heat (15.0 %) nociceptive stimuli. The most frequent loss/gain score was L0G2 (no somatosensory loss combined with a gain of mechanical somatosensory function) for both the facial (40.0 %) and hand (27.5 %) regions. Involving side-to-side differences in the evaluation increased the diagnostic sensitivity by 2.5–25.0 % across different parameters.ConclusionsSomatosensory abnormalities were commonly detected in Chinese TMD pain patients both within and outside the primary painful region, strongly indicating disturbances in the central processing of somatosensory stimuli. The individual variations in somatosensory abnormalities indicate a possible need for development of individualized TMD pain management.Electronic supplementary materialThe online version of this article (doi:10.1186/s10194-016-0632-y) contains supplementary material, which is available to authorized users.
Highlights
The somatosensory phenotype of Chinese temporomandibular disorders (TMD) patients is not sufficiently studied with the use of contemporary techniques and guidelines
The important strengths of the present study were the standardized evaluation of the phenotypes in terms of somatosensory abnormalities in Chinese TMD pain patients using loss and gain scores based on a comprehensive quantitative sensory testing (QST) protocol and Z-score transformation [9], Comparing indirectly between the results of the present study in a Chinese population and earlier studies in a mainly Caucasian patient population, it seems that gain of mechanical function is the most frequent somatosensory abnormality for both Chinese and Caucasian TMD patients [14, 15]
As the loss/gain system was not adopted by these previous studies, it is difficult to compare their results directly with the present study. It seems that the present Chinese/East Asian sample of TMD patients presented similar somatosensory abnormalities as the Caucasian/Western samples of TMD patients evaluated by same QST protocol, even though we have previously shown ethnic differences in somatosensory functions between healthy Chinese and healthy Caucasians [10]
Summary
The somatosensory phenotype of Chinese temporomandibular disorders (TMD) patients is not sufficiently studied with the use of contemporary techniques and guidelines. Despite the impact of TMD pain on the individual person and the community, studies indicate that patients with TMD pain are not sufficiently and adequately diagnosed or treated [2]. It is an open question whether the classification of pain. Just few studies have assessed somatosensory sensitivity in patients with TMD pain using the full standardized QST protocol. 21 patients with myofascial TMD pain were divided with respect to the tender point into an insensitive subgroup resembling healthy subjects and a sensitive subgroup resembling fibromyalgia syndrome patients’ QST profile [14]. The Chinese or eastern Asian populations are the biggest in the world but remain understudied using the contemporary and standardized QST protocols [7]
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