Referred sensations in the orofacial region are associated with a decreased descending pain inhibition and modulated by remote noxious stimuli and local anesthesia.
Journal
Pain
ISSN: 1872-6623
Titre abrégé: Pain
Pays: United States
ID NLM: 7508686
Informations de publication
Date de publication:
01 10 2023
01 10 2023
Historique:
received:
26
05
2022
accepted:
03
01
2023
medline:
18
9
2023
pubmed:
8
6
2023
entrez:
8
6
2023
Statut:
ppublish
Résumé
Referred sensation (RS) as a specific clinical phenomenon has been known for a long time, although the underlying mechanisms remain unclear. The aims of this study were to assess if (1) healthy individuals who experienced RS had a less active endogenous pain system when compared with those who did not; (2) activation of descending pain inhibition mechanisms can modulate RS parameters; and finally, (3) a transient decrease in peripheral afferent input because of a local anesthetic (LA) block in the masseter muscle can modulate RS parameters. To assess these, 50 healthy participants were assessed in 3 different sessions. In the first session, conditioned pain modulation (CPM) as well as mechanical sensitivity and RS at the masseter muscle were assessed. In the same session, participants who experienced RS had their mechanical sensitivity and RS assessed again while undergoing a CPM protocol. In the second and third sessions, participants had their mechanical sensitivity and RS assessed before and after receiving an injection of 2 mL of LA and isotonic saline into the masseter muscle. The main findings of this study were (1) participants who experienced RS during standardized palpation exhibited increased mechanical sensitivity ( P < 0.05, Tukey post hoc test) and decreased CPM ( P < 0.05, Tukey post hoc test) when compared with those who did not; RS incidence ( P < 0.05, Cochran Q test), frequency ( P < 0.05; Friedman test), intensity ( P < 0.05, Tukey post hoc test), and area ( P < 0.05, Tukey post hoc test) were all significantly reduced when assessed (2) during a painful conditioning stimulus and (3) after LA block. These novel findings highlight that RS in the orofacial region are strongly modified by both peripheral and central nervous system factors.
Identifiants
pubmed: 37289580
doi: 10.1097/j.pain.0000000000002921
pii: 00006396-990000000-00319
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2228-2238Informations de copyright
Copyright © 2023 International Association for the Study of Pain.
Références
Castrillon EE, Cairns BE, Wang K, Arendt-Nielsen L, Svensson P. Comparison of glutamate-evoked pain between the temporalis and masseter muscles in men and women. PAIN 2012;153:823–29.
Castrillon EE, Exposto FG, Sato H, Tanosoto T, Arima T, Baad-Hansen L, Svensson P. Entropy of masseter muscle pain sensitivity: a new technique for pain assessment. J Oral Facial Pain Headache 2017;31:87–94.
Coghill RC, Price DD, Hayes RL, Mayer DJ. Spatial distribution of nociceptive processing in the rat spinal cord. J Neurophysiol 1991;65:133–40.
Coghill RC. The distributed nociceptive system: a framework for understanding pain. Trends Neurosci 2020;43:780–94.
Costa YM, Exposto FG, Castrillon EE, Conti PCR, Bonjardim LR, Svensson P. Local anaesthesia decreases nerve growth factor induced masseter hyperalgesia. Sci Rep 2020;10:15458.
Cummins TM, Kucharczyk MM, Graven-Nielsen T, Bannister K. Activation of the descending pain modulatory system using cuff pressure algometry: back translation from man to rat. Eur J Pain 2020;24:1330–8.
Domenech-Garcia V, Palsson TS, Herrero P, Graven-Nielsen T. Pressure-induced referred pain is expanded by persistent soreness. PAIN 2016;157:1164–72.
Exposto FG, Masuda M, Castrillon EE, Svensson P. Effects of nerve growth factor experimentally-induced craniofacial muscle sensitization on referred pain frequency and number of headache days: a double-blind, randomized placebo-controlled study. Cephalalgia 2018;38:2006–16.
Exposto FG, Udagawa G, Naganawa T, Svensson P. Comparison of masseter muscle referred sensations after mechanical and glutamate stimulation: a randomized, double-blind, controlled, cross-over study. PAIN 2018;159:2649–57.
Exposto FG, Bendixen KH, Ernberg M, Bach FW, Svensson P. Characterization and predictive mechanisms of experimentally induced tension-type headache. Cephalalgia 2019;39:1207–18.
Exposto FG, Bendixen KH, Ernberg M, Bach FW, Svensson P. Assessment of pain modulatory and somatosensory profiles in chronic tension-type headache patients. Pain Med 2021;22:2356–65.
Feinstein B, Langton JNK, Jameson RM, Schiller F. Experiments on pain referred from deep somatic tissues. J Bone Joint Surg 1954;36:981–97.
Futarmal S, Kothari M, Ayesh E, Baad-Hansen L, Svensson P. New palpometer with implications for assessment of deep pain sensitivity. J Dent Res 2011;90:918–22.
GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1211–59.
Gerdle B, Rivano Fischer M, Cervin M, Ringqvist Å. Spreading of pain in patients with chronic pain is related to pain duration and clinical presentation and weakly associated with outcomes of interdisciplinary pain rehabilitation: a cohort study from the Swedish Quality Registry for Pain Rehabilitation (SQRP). J Pain Res 2021;14:173–87.
Graven-Nielsen T, Arendt-Nielsen L. Assessment of mechanisms in localized and widespread musculoskeletal pain. Nat Rev Rheumatol 2010;6:599–606.
Graven-Nielsen T, Kendall SA, Henriksson KG, Bengtsson M, Sörensen J, Johnson A, Gerdle B, Arendt-Nielsen L. Ketamine reduces muscle pain, temporal summation, and referred pain in fibromyalgia patients. PAIN 2000;85:483–91.
Graven-Nielsen T. Mechanisms and manifestations in musculoskeletal pain: from experimental to clinical pain settings. PAIN 2022;163:S29–45.
Guan Y, Borzan J, Meyer RA, Raja SN. Windup in dorsal horn neurons is modulated by endogenous spinal mu-opioid mechanisms. J Neurosci 2006;26:4298–307.
Haviv Y, Rettman A, Aframian D, Sharav Y, Benoliel R. Myofascial pain: an open study on the pharmacotherapeutic response to stepped treatment with tricyclic antidepressants and gabapentin. J Oral Facial Pain Headache 2015;29:144–51.
Hilgenberg-Sydney PB, Kowacs PA, Conti PCR. Somatosensory evaluation in dysfunctional syndrome patients. J Oral Rehabil 2016;43:89–95.
Hoheisel U, Mense S, Simons DG, Yu XM. Appearance of new receptive fields in rat dorsal horn neurons following noxious stimulation of skeletal muscle: a model for referral of muscle pain? Neurosci Lett 1993;153:9–12.
Hoheisel U, Koch K, Mense S. Functional reorganization in the rat dorsal horn during an experimental myositis. PAIN 1994;59:111–8.
Kellgren J. Observations on referred pain arising from muscles. Clin Sci 1938;3:175–90.
Kellgren J. On the distribution of pain from deep somatic structures with charts of segmental pain areas. Clin Sci 1939;4:35–46.
Kennedy DL, Kemp HI, Ridout D, Yarnitsky D, Rice AS. Reliability of conditioned pain modulation: a systematic review. PAIN 2016;157:2410–9.
King CD, Wong F, Currie T, Mauderli AP, Fillingim RB, Riley JL III. Deficiency in endogenous modulation of prolonged heat pain in patients with irritable bowel syndrome and temporomandibular disorder. PAIN 2009;143:172–8.
Kothari SF, Kothari M, Zambra RF, Baad-Hansen L, Svensson P. Standardization of muscle palpation- methodological considerations. Clin J Pain 2014;30:174–82.
Kothari SF, Baad-Hansen L, Oono Y, Svensson P. Somatosensory assessment and conditioned pain modulation in temporomandibular disorders pain patients. PAIN 2015;156:2545–55.
Le Bars D. The whole body receptive field of dorsal horn multireceptive neurones. Brain Res Rev 2002;40:29–44.
Lövgren A, Visscher CM, Lobbezoo F, Yekkalam N, Vallin S, Wänman A, Häggman-Henrikson B. The association between myofascial orofacial pain with and without referral and widespread pain. Acta Odontol Scand 2022;80:481–6.
Masuda M, Iida T, Exposto FG, Baad-Hansen L, Kawara M, Komiyama O, Svensson P. Referred pain and sensations evoked by standardized palpation of the masseter muscle in healthy participants. J Oral Facial Pain Headache 2018;32:159–66.
Masuda M, Iida T, Exposto FG, Baad-Hansen L, Kawara M, Komiyama O, Svensson P. Spatio-temporal effects of standardized palpation on referred sensations and pain from the masseter muscle in healthy individuals. Int J Oral Med Sci 2018;17:9–17.
Ohrbach R, Gonzalez Y, List T, Michelotti A, Schiffman E. Diagnostic criteria for temporomandibular disorders (DC/TMD) clinical examination protocol: version January 6, 2014. Available at: http://www.rdc-tmdinternational.org . Accessed November 19, 2017. http://www.rdc-tmdinternational.org :Accessed on
Oono Y, Wang K, Baad-Hansen L, Futarmal S, Kohase H, Svensson P, Arendt-Nielsen L. Conditioned pain modulation in temporomandibular disorders (TMD) pain patients. Exp Brain Res 2014;232:3111–9.
Palsson TS, Doménech-García V, Boudreau SS, Graven-Nielsen T. Pain referral area is reduced by remote pain. Eur J Pain 2021;25:1804–14.
Pielsticker A, Haag G, Zaudig M, Lautenbacher S. Impairment of pain inhibition in chronic tension-type headache. PAIN 2005;118:215–23.
Rolke R, Baron R, Maier C, Tolle TR, Treede DR, Beyer A, Binder A, Birbaumer N, Birklein F, Botefur IC, Braune S, Flor H, Huge V, Klug R, Landwehrmeyer GB, Magerl W, Maihofner C, Rolko C, Schaub C, Scherens A, Sprenger T, Valet M, Wasserka B. Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values. PAIN 2006;123:231–43.
Rubin TK, Gandevia SC, Henderson LA, Macefield VG. Effects of intramuscular anesthesia on the expression of primary and referred pain induced by intramuscular injection of hypertonic saline. J Pain 2009;10:829–35.
Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, List T, Svensson P, Gonzalez Y, Lobbezoo F, Michelotti A, Brooks SL, Ceusters W, Drangsholt M, Ettlin D, Gaul C, Goldberg LJ, Haythornthwaite JA, Hollender L, Visscher CM, Zakrzewska J, Dworkin SF, Smith B, Maixner W, van der Meulen M, Murray GM, Nixdorf DR, Palla S, Petersson A, Pionchon P, Smith B, Visscher CM, Zakrzewska J, Dworkin SF. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache 2014;28:6–27.
Schneider CA, Rasband WS, Eliceiri KW. NIH Image to ImageJ: 25 years of image analysis. Nat Methods 2012;9:671–5.
Svensson P, Graven-Nielsen T, Arendt-Nielsen L. Mechanical hyperesthesia of human facial skin induced by tonic painful stimulation of jaw muscles. PAIN 1998;74:93–100.
Szikszay TM, Adamczyk WM, Carvalho GF, May A, Luedtke K. Offset analgesia: somatotopic endogenous pain modulation in migraine. PAIN 2020;161:557–64.
Waller R, Smith AJ, O'Sullivan PB, Slater H, Sterling M, Alexandra McVeigh J, Straker LM. Pressure and cold pain threshold reference values in a large, young adult, pain-free population. Scand J Pain 2016;13:114–22.
Wright EF. Referred craniofacial pain patterns in patients with temporomandibular disorder. J Am Dent Assoc 2000;131:1307–15.
Yarnitsky D, Bouhassira D, Drewes AM, Fillingim RB, Granot M, Hansson P, Landau R, Marchand S, Matre D, Nilsen KB, Stubhaug A, Treede RD, Wilder-Smith OH. Recommendations on practice of conditioned pain modulation (CPM) testing. Eur J Pain 2015;19:805–6.
You HJ, Lei J, Sui MY, Huang L, Tan YX, Tjolsen A, Arendt-Nielsen L. Endogenous descending modulation: spatiotemporal effect of dynamic imbalance between descending facilitation and inhibition of nociception. J Physiol 2010;588:4177–88.