Risk Factors for Onset and Persistence of TMD

TMD 发病和持续的危险因素

• 批准号: 6984592
• 负责人: WILLIAM MAIXNER
• 金额: $ 249.71万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-15 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6984592
• 关键词: clinical research; cooperative study; disease /disorder onset; disease /disorder proneness /risk; epidemiology; human subject; oral facial pain; racial /ethnic difference; temporomandibular joint syndrome

DESCRIPTION (provided by applicant): Risk factors for onset and persistence of TMD: Myogenous temporomandibular disorder (TMD), with or without arthralgia, ranks second only to headache as the clinical condition most likely to cause craniofacial pain and dysfunction in the U.S. population. During the last decade, a small number of epidemiological studies have attempted to quantify the incidence of TMD in populations of European heritage; however, no investigative team to date has undertaken a large-scale, hypothesis-driven, prospective study designed to identify biopsychosocial and genetic risk factors for the onset and persistence of this vexing pain disorder. We propose to conduct a comprehensive, prospective cohort study of the incidence of TMD in collaboration with an internationally recognized group of epidemiologists, pain researchers, and geneticists. Participants will be enrolled and followed prospectively at four research institutions and by our Data Coordinating Center (Battelle Memorial Institute). Our three goals are to: a) undertake a five-year, prospective cohort study of 3200 initially TMD-free individuals recruited from major ethnic and racial strata at four study sites, quantifying incidence rates of first-onset-TMD; b) undertake a case-control study by recruiting 200 people with chronically symptomatic TMD identified during cohort recruitment whose history of TMD precludes them from the prospective study; c) to identify in both groups the individual and joint effects of predictors of TMD risk using a conceptual, causal model for TMD that we have developed based our own studies and other published research. Our preliminary epidemiological findings have led to the central hypothesis that pain amplification and psychological factors, both of which are influenced by genetic variants, represent causal risk factors that influence TMD onset and persistence. The outcomes of our proposed study will identify the primary socio-demographic, clinical, biological, psychological, and genetic risk factors for TMD onset and persistence. In so doing, we will obtain important and novel information regarding the etiopathogenesis of TMD, which will assist with the development of evidenced based pharmacological and behavioral interventions for TMD.

描述（由申请人提供）：TMD 发病和持续的危险因素：肌源性颞下颌关节紊乱病 (TMD)，无论是否伴有关节痛，在美国人群中都是仅次于头痛的最有可能导致颅面疼痛和功能障碍的临床疾病。在过去的十年中，少数流行病学研究试图量化欧洲后裔人群中 TMD 的发病率；然而，迄今为止，还没有调查团队进行过大规模的、以假设为驱动的前瞻性研究，旨在确定这种令人烦恼的疼痛疾病发作和持续的生物心理社会和遗传风险因素。我们建议与国际公认的流行病学家、疼痛研究人员和遗传学家小组合作，对 TMD 的发病率进行一项全面的前瞻性队列研究。参与者将在四个研究机构和我们的数据协调中心（巴特尔纪念研究所）进行前瞻性登记和跟踪。我们的三个目标是： a) 对四个研究地点的主要民族和种族阶层招募的 3200 名最初没有 TMD 的个体进行为期五年的前瞻性队列研究，量化首次发作 TMD 的发病率； b) 进行病例对照研究，招募 200 名在队列招募过程中发现的患有慢性 TMD 症状的人，这些人的 TMD 病史使他们无法参加前瞻性研究； c) 使用我们根据自己的研究和其他已发表的研究开发的 TMD 概念因果模型，确定两组中 TMD 风险预测因子的个体和联合效应。我们的初步流行病学发现得出了一个中心假设，即疼痛放大和心理因素（两者均受到遗传变异的影响）代表了影响 TMD 发作和持续的因果危险因素。我们提出的研究结果将确定 TMD 发病和持续的主要社会人口、临床、生物、心理和遗传风险因素。在此过程中，我们将获得有关 TMD 发病机制的重要且新颖的信息，这将有助于开发基于证据的 TMD 药理学和行为干预措施。