Influence of psychosocial clusters on painful mechanical sensitivity and pain modulation in patients with Temporomandibular Disorder

Author(s)

Rafaela Stocker Salbego

• Document type: Master's Dissertation
• Press: Bauru.
• Institution: Universidade de São Paulo (USP). Faculdade de Odontologia de Bauru (FOB/SDB)
• Defense date: 2023-10-30

Examining board members

Leonardo Rigoldi Bonjardim; Yuri Martins Costa; Daniela Disconzi Seitenfus Rehm; Rodrigo Ricci Vivan

• Advisor: Leonardo Rigoldi Bonjardim

Abstract

The aim of this study was to assess the combined impact of psychological factors and sleep quality on mechanical pain sensitivity and pain modulation in women with painful Temporomandibular Disorder (TMD) and asymptomatic controls. This was a cross-sectional study with secondary data analysis involving 77 women diagnosed with myalgia according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and 101 asymptomatic controls. All study participants completed a set of questionnaires to characterize their psychological profile (anxiety, depression, stress and catastrophizing) and sleep quality. Additionally, they underwent quantitative tests of mechanical sensory pain thresholds (mechanical pain threshold - MPT, pressure pain threshold - PPT, and temporal summation ratio), as well as conditioned pain modulation (CPM). The psychological and sleep quality parameters from each instrument were transformed into T-scores, and the sample underwent hierarchical clustering and k-means analyses to categorize individuals into two groups: non-compromised or compromised based on their similarities. Multiple linear regression was performed to evaluate the influence of TMD presence, age, and the cluster of psychological compromise and sleep quality on MPT, PPT, WUR, and CPM values in masseter and thenar muscles. Statistical significance was considered when p < 0.05. The presence of TMD emerged as the strongest predictor of mechanical pain sensitivity in both the trigeminal (MPT [F(3,174)=51.902; p<0.001; adjusted R2= 0.463], TMD presence ( = -0.682) and age ( = 0.118) / PPT [F(3,174)=15.573; p<0.001; adjusted R2= 0.198], TMD presence ( = -0.452) and age ( = 0.356)) and extra-trigeminal (MPT [F(3,174)=35.897; p<0.001; adjusted R2= 0.382], TMD ( = -0.647) / PPT [F(3,174)=4.843; p<0.05; adjusted R2= 0.061], TMD presence ( = -0.227) and age ( = 0.259)) regions. Similarly, for CPM [F(3,174)=4.106; p<0.05; adjusted R2= 0.050], TMD presence ( = 0.197) and age ( = -0.192) were the main contributors. Notably, the results did not demonstrate a significant influence of compromise clusters based on psychological variables and sleep quality on mechanical pain sensitivity and pain modulation in women, regardless of the presence of TMD. (AU)

• FAPESP's process: 22/13506-9 - INFLUENCE OF PSYCHOSOCIAL CLUSTERS ON MECHANICAL PAIN SENSITIVITY AND PAIN MODULATION IN TEMPOROMANDIBULAR DISORDERS PATIENTS
• Grantee: Rafaela Stocker Salbego
• Support Opportunities: Scholarships in Brazil - Master