Venopunction of the cubital vein as an alternative approach for CGRP plasma level evaluation in tmd patients

Abstract

Calcitonin gene-related peptide is an important vasodilator. It plays an important role in the metabolism of chewing muscles. The aim of the study was to evaluate the plasma level of CGRP in patients with myofascial pain (RDC/TMD Ia) and myofascial pain with limited opening (RDC/TMD Ib) before and after occlusal splint therapy (Michigan splint). A randomised trial was performed including 39 patients (males = 3, females = 36). Blood samples were taken from the external jugular vein (JUG) and cubital vein (CUB) before and after 30 days of occlusal splint therapy. Plasma levels of CGRP were measured with ELISA KIT for Human Calcitonin Gene Related Peptide (CGRP) 96T (USCNK Business Co. Ltd.). The results of the study show that the plasma CGRP level was higher in the external jugular vein (JUG1 = 5.07pg/mL [SD = 1.99]) than in cubital vein (CUB1 = 4.3 pg/mL [SD = 1.6]). After 30 days of the occlusal splint therapy the levels in both veins increased: JUG2 = 6.07 pg/mL (SD = 2.19), and CUB2 = 4.9 pg/mL (SD = 1.4). The CGRP plasma level increase was statistically significant only in the external jugular vein (JUG) (p < 0.05). Statistically significant pain intensity reduction was observed: VAS1 = 5.4 (SD = 2.08) decreased to VAS2 = 1.7 (SD = 2.07) after splint therapy (p < 0.05). Venepuncture of an external jugular vein is more precise, than venepuncture of a cubital vein in evaluating CGRP plasma level changes in patients with TMD.