Psychoneuroimmunological evaluation of chronic muscle pain and joint pain in TMD patients

慢性肌肉疼痛可因疲劳、焦虑、神经官能症和慢性口腔功能障碍等心理和生理压力而加重。然而，这些压力与TMD患者临床症状表现之间的关系尚不清楚。此外，咀嚼肌疼痛不仅有局部因素的影响，也有心理状态等普遍因素的影响。在两年期间，发表了两篇期刊文章、21次口头报告（其中7次在国际会议上发表）和一份出版物。以下是本研究的简要总结。在TMD症状的处理中，生物心理社会因素发挥了重要作用，约85%的患者在没有牙科干预的情况下在两个月内症状得到改善。为了定量和定性地评估疼痛，多维疼痛量表（MPI）被翻译成日语，并证实了足够的内部、理论、标准相关和建设性的效度。三叉神经区感知和痛觉阈值受生理因素影响，各亚组的心理特征影响临床症状的表现。皮质醇作为反映心理免疫状态的应激标志物，唾液中皮质醇浓度依次为关节障碍组、咀嚼障碍组和咀嚼/关节障碍组。

Chronic muscle pain is enhanced by psychological and physical stressor such as fatigue, anxiety, neurosis, and chronic oral parafunction.However, the relation between these stresses and the manifestation of clinical symptoms is not clear in TMD patients.In addition, masticatory muscles' pain tends to follows chronic course not only because of local factors but also general factors such as psychological status.In a two-year period, two journal articles, 21 oral presentations (seven of which were presented at the international meeting), and one publication were presented. The followings are the brief summary of this research.1.In the management of symptoms of TMD, a biopsychosocial factor played an important role, and symptoms of about 85% patients improved in two months with no dental intervention.2.To evaluate pain quantitatively and qualitatively, Multidimensional Pain Inventory (MPI) was translated into Japanese and sufficient internal, theoretical, criterion-related, and constructive validities were confirmed.3.The perception and pain thresholds of trigeminal nerve area were influenced by physical factor, and that the psychological character of each TMD subgroup affects the manifestation of clinical symptoms. The cortisol was evaluated as the stress marker that reflect psychoimmunological status and it was revealed that the cortisol concentration in saliva showed higher value in order of joint disorder group, masticatory disorder group, and masticatory/joint disorder group.