Lack of temporal summation but distinct aftersensations to thermal stimulation in patients with combined tension-type headache and myofascial temporomandibular disorder.

Hitoshi Sato, Hironori Saisu, Wataru Muraoka, Taneaki Nakagawa, Peter Svensson, Koichi Wajima

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

To compare patients with combined tension-type headache and myofascial temporomandibular disorder (TMD) with control subjects on two measures of central processing-ie, temporal summation and aftersensations to heat stimulation in the trigeminal nerve and spinal nerve territories. A novel heat stimulation protocol was used in which 13 females with tension-type headache/TMD and 20 female controls were exposed to 11 painful heat stimuli at a rate of 0.33 Hz. Two temperature ranges (low, 44°C to 46°C; high, 45°C to 47°C) were tested on the cheek and arm in separate trials. Perceived pain was rated on a 100-mm visual analog scale after the second, sixth, and eleventh stimulus presentation and every 15 seconds after the final stimulus presentation (aftersensations) for up to 3 minutes. The duration of aftersensations was compared using the student unpaired t test with Welch correction. Temporal summation was not observed in any of the groups, but aftersensations were consistently reported. The aftersensations lasted longer in tension-type headache/TMD patients (right cheek, 100.4 ± 62.0 seconds; right arm, 115.4 ± 64.0 seconds) than in controls (right cheek, 19.5 ± 2.5 seconds; right arm, 20.3 ± 2.7 seconds) (P < .05). A cutoff value (right cheek, 44.6 seconds; right arm, 41.5 seconds) provided a sensitivity and specificity of 0.77 and 0.95, respectively, with the high stimulus protocol. The results from this pilot study suggest that aftersensations to painful heat stimulation can appear without temporal summation. Furthermore, the developed test protocol has a good predictive value and may have the potential to discriminate between tension-type headache/TMD patients and control subjects.

Original languageEnglish
Pages (from-to)288-295
Number of pages8
JournalJournal of Orofacial Pain
Volume26
Issue number4
Publication statusPublished - 2012 Sep

Fingerprint

Tension-Type Headache
Temporomandibular Joint Disorders
Cheek
Headache Disorders
Arm
Hot Temperature
Spinal Nerves
Trigeminal Nerve
Patient Rights
Visual Analog Scale
Students
Sensitivity and Specificity
Pain
Temperature

ASJC Scopus subject areas

  • Dentistry(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Lack of temporal summation but distinct aftersensations to thermal stimulation in patients with combined tension-type headache and myofascial temporomandibular disorder. / Sato, Hitoshi; Saisu, Hironori; Muraoka, Wataru; Nakagawa, Taneaki; Svensson, Peter; Wajima, Koichi.

In: Journal of Orofacial Pain, Vol. 26, No. 4, 09.2012, p. 288-295.

Research output: Contribution to journalArticle

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