Sleep Bruxism and Central Sensitization in Myofascial Face Pain

最常见的颞下颌关节紊乱病--肌筋膜面部疼痛的发病机制 (TMD)，仍然存在争议。其中一个关键的争议是关于睡眠磨牙症的作用； 相对较弱的Sb措施支持了Sb在至少一些MFP患者中的作用，而不是 为了彻底解决这个问题，已经开展了基于睡眠的研究。此应用程序建议将其作为其 主要目的是对SB在MFP维护中的作用进行权威性研究，其中 研磨和咬合将被检查。我们还将探索某人和压力之间的关系- 诱发性磨牙症，以及基因异常在调节患者疼痛风险中的作用 某人。第二个目标是评估中枢敏化(CS)在MFP维持中的作用。 支持CS在MFP中的作用的证据受到患者和患者样本中的偏差的限制 解剖位置。因此，我们将在一个更具代表性的MFP样本中检验CS在MFP中的作用 患者和对照组，以及进行三叉神经外区和三叉神经区CS的评估。 这两个区域CS的差异可能暗示了不同的疼痛维持机制。收集的数据 在这两个目标的服务下，然后允许实现第三个目标，理解关系 MFP中SB和CS之间的关系，包括SB和CS中的高程定义子组的可能性 哪些不同的疼痛维持机制是有效的。这些目标可以在一个 120例MFP患者和60例人口学匹配对照的病例对照研究追求这些目标将 提供关于某人在MFP中的作用的确凿证据，并将促进对关系的理解 在某人和CS之间。这一理解有望支持我们改善临床状况的长期目标 通过靶向治疗潜在的疼痛维持机制来治疗MFP。

The pathogenesis of myofascial face pain (MFP), the most prevalent type of temporomandibular disorder (TMD), remains controversial. One of the key controversiesconcerns the role of sleep bruxism (SB); While relatively weak measures of SB have supported a role of SB in at least some MFP patients, nolaboratory- based sleep study has been undertaken to resolvethis issue definitively. This application proposesas its main aim the conduct of the definitive study of SB in MFP maintenance, in which the separate role of grinding and clenching would be examined. We would also explore the relationship between SB andstress- induced bruxism, as well as the role of genetic anomaliesin modulating the risk of pain among thosewith SB. A second aim would evaluate the role of central sensitization (CS) in the maintenanceof MFP. Evidence supporting a role for CS in MFP has been limited by biases in the sampling of both patientsand anatomic sites. Therefore, we would examine the role of CS in MFP in a more representative sample of MFP patients and controls, as well as conduct an evaluationof CS in both extratrigeminal and trigeminal regions. Differences in CS in these two areas might suggest different pain maintenance mechanisms. Data collected in the service of these two aims then allows the achievement a third aim, understanding the relationships between SB and CS in MFP, including the possibility that elevations in SB and CS may define subgroupsin which different pain maintenance mechanisms are operative. These aims can be achieved in the context of a case-control study of 120 MFP patients and 60 demographically-matchedcontrols. Pursuit of these aims will provide firm evidence regarding the role of SB in MFP and will advance understanding of the relationship between SB and CS. This understanding is expectedto support our long-term goal of improving clinical treatment of MFP by targeting treatment to underlying pain-maintenenance mechanisms.