Factors implicated in the effect of mindfulness-based intervention in chronic painful TMD: the role of inflammatory markers and oxidative stress, and cognitive-behavioral-emotional involvement

• Grant number: 22/05658-3
• Support Opportunities: Regular Research Grants
• Start date: March 01, 2023
• End date: February 28, 2025
• Field of knowledge: Health Sciences - Nursing - Psychiatric Nursing
• Principal Investigator: Edilaine Cristina da Silva Gherardi Donato
• Grantee: Edilaine Cristina da Silva Gherardi Donato
• Host Institution: Escola de Enfermagem de Ribeirão Preto (EERP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Associated researchers: Christie Ramos Andrade Leite Panissi ; Laís Valencise Magri ; Riccardo Lacchini
• Associated scholarship(s): 24/02489-1 - Assistance in a clinical-experimental project on TMD and mindfulness from scientific and procedural perspectives, BP.TT

Abstract

The multidimensional understanding of chronic painful TMD has implications for clinical practice, postulating the need to produce evidence that evaluates the various components (biological, cognitive, behavioral and emotional) involved in the response to the therapeutic interventions studied, with a view to achieving greater effectiveness in the treatment. treatment of affected people. Evidence on mindfulness-based interventions indicates these practices as strong allies in the treatment of chronic pain and, potentially, for painful TMD. There are no studies produced that have evaluated, in a joint and controlled manner, response parameters that integrate biochemical markers and cognitive, behavioral and emotional components. This project aims to fill this gap, evaluating the role of inflammatory blood biochemical markers and oxidative stress in conjunction with variables from the cognitive-behavioral-emotional model of women with chronic painful TMD undergoing mindfulness-based intervention. Objective: To identify blood biochemical markers related to inflammation and oxidative stress (MMP2, MMP9, TIMP1, TIMP2, alpha 2 macroglobulin, IL6, IL10, TNF alpha, 8-isoprostane, TBARS, FRAP, CAT, SOD), and the components cognitive-behavioral-emotional implications for the effect of mindfulness therapy in women with chronic painful TMD.Materials and methods: The experiments will be carried out with a sample of 84 women divided into 4 groups, 2 clinical groups and 2 healthy control groups. The mindfulness intervention, according to the MBSR protocol (Mindfulness Based Stress Reduction), will be applied in one of the clinical groups and one of the healthy groups. Biochemical, clinical, cognitive, behavioral and emotional variables will be evaluated before and after the intervention, and at the same time points in the randomized control groups for the waiting list. The sociodemographic and cognitive-behavioral-emotional profile variables will be collected through the application of instruments, psychometric scales and clinical assessment. Biochemical markers will be measured from blood samples, using ELISA to measure TIMP1, TIMP2, alpha 2 macroglobulin, IL6, IL10, TNF alpha, 8-isoprostane; zymography for MMP2 and MMP9; and specific kits with absorbance readings in a spectrophotometer for TBARS, FRAP, CAT and SOD. Statistical analysis will be performed using univariate (T test, ANOVA, Mann-Whitney, Kruskal-Wallis) and multivariate methods. The significance level adopted will be less than 0.05. Project approved by the Research Ethics Committee, CAAE: 98129918.6.0000.5407. (AU)