Pain sensitivity and autonomic factors associated with development of TMD: the OPPERA prospective cohort study.
Pain sensitivity and autonomic factors associated with development of TMD: the OPPERA prospective cohort study.
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DOI：
10.1016/j.jpain.2013.06.007
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发表时间：
2013-12
期刊：
影响因子：
4
通讯作者：
Maixner, William
中科院分区：
文献类型：
--
作者：
Greenspan, Joel D.;Slade, Gary D.;Bair, Eric;Dubner, Ronald;Fillingim, Roger B.;Ohrbach, Richard;Knott, Charles;Diatchenko, Luda;Liu, Qian;Maixner, William
关键词：
多项研究报告称，慢性颞下颌关节紊乱病（TMD）患者对实验性疼痛的敏感性增强。此外，慢性TMD病例显示自主神经功能改变，包括心率升高和心率变异性降低。然而，从这些横截面观察中，无法得出关于TMD与疼痛敏感性和自主神经功能之间关联的因果推论。前瞻性OPPERA研究检查了疼痛敏感性或心脏自主功能的测量是否对TMD发生率具有预测价值。对2,737名最初无TMD的人进行了长达5.2年的随访，在此期间，260人首次发病TMD。39个实验性疼痛测量中有14个产生了显著的风险比，例如更大的疼痛敏感性与更大的TMD发病率相关。一个单一的自主神经测量-静息心率-也与更高的TMD发病率显著相关。与此相反，使用相同的疼痛敏感性和心脏自主神经功能的措施，我们以前报告了一个更大的变量组，与慢性TMD的OPPERA病例对照研究。未来的研究应该调查是否发病前疼痛敏感性或自主神经功能更具体地预测发展为慢性TMD的风险比首发TMD。
Multiple studies report that individuals with chronic temporomandibular disorder (TMD) have enhanced sensitivity to experimental pain. Additionally, chronic TMD cases show altered autonomic function, including elevated heart rate and reduced heart rate variability. However, causal inferences regarding the association between TMD and pain sensitivity and autonomic function cannot be drawn from these cross-sectional observations. The prospective OPPERA study examines whether measures of pain sensitivity or cardiac autonomic function provide predictive value in TMD incidence. A cohort of 2,737 initially TMD-free people was followed for up to 5.2 years, during which time 260 developed first-onset TMD. Fourteen of 39 experimental pain measures produced significant hazard ratios, such that greater pain sensitivity was associated with greater TMD incidence. A single autonomic measure – heart rate at rest – was also associated significantly with greater TMD incidence. In contrast, using the same measures of pain sensitivity and cardiac autonomic function, we previously reported a larger group of variables that was significantly associated with chronic TMD in the OPPERA case-control study. Future studies should investigate whether premorbid pain sensitivity or autonomic function more specifically predicts risk of developing chronic TMD than first-onset TMD.
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影响因子：
4
作者：
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影响因子：
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作者：
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