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- Baad-Hansen, Lene, et al.
(författare)
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Somatosensory sensitivity in patients with persistent idiopathic orofacial pain is associated with pain relief from hypnosis and relaxation
- 2013
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Ingår i: The Clinical Journal of Pain. - : Lippincott Williams & Wilkins. - 0749-8047 .- 1536-5409. ; 29:6, s. 518-526
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: In a recent study hypnosis has been found to relieve persistent idiopathic orofacial pain. Quantitative sensory testing (QST) is widely used to evaluate somatosensory sensitivity, which has been suggested as a possible predictor of management outcome. The objectives of this study were to examine: (1) possible associations between clinical pain relief and baseline somatosensory sensitivity and (2) the effect of hypnosis management on QST parameters. METHODS: Forty-one patients with persistent idiopathic orofacial pain completed this randomized controlled study in 1 of 2 groups: hypnosis (hypnotic analgesia suggestions) or control (relaxation). QST at 2 intraoral (pain region and contralateral mirror image region) and 3 extraoral (hand and both cheeks) sites was performed at baseline and after the hypnosis/control management, together with pressure pain thresholds and pressure pain tolerance thresholds determined bilaterally at the masseter and temporalis muscles, the temporomandibular joints, and the third finger. RESULTS: Degree of pain relief was negatively correlated with a summary statistic of baseline somatosensory sensitivity (summed z-score), that is, high baseline somatosensory sensitivity was associated with low pain relief (r=-0.372, P=0.020). Hypnosis had no major effect on any QST measure compared with relaxation (P>0.063). CONCLUSIONS: High pain sensitivity at baseline may predict poor pain management outcome. In addition, despite clear clinical pain relief, hypnosis did not significantly or specifically influence somatosensory sensitivity. Future studies should further explore QST measures as possible predictors of different management response in orofacial pain conditions.
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| 2. |
- Pillai, Rajath S, et al.
(författare)
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Assessment of Somatosensory and Psychosocial Function of Patients With Trigeminal Nerve Damage
- 2020
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Ingår i: Clinical Journal of Pain. - : Lippincott Williams & Wilkins. - 1536-5409 .- 0749-8047. ; 36:5, s. 321-335
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The present study assessed somatosensory changes related to trigeminal nerve damage using extensive evaluation tools and assessed the effect of such damage on the patients' psychosocial status and quality of life compared with healthy participants.METHODS: In 37 patients with intraorally or extraorally presenting trigeminal nerve damage diagnosed as painful or nonpainful posttraumatic trigeminal neuropathy, psychophysical tests like quantitative sensory testing (QST) and qualitative sensory testing and the electrophysiological "nociceptive-specific" blink reflex were performed. The patients and 20 healthy participants completed a set of questionnaires assessing their psychosocial status and quality of life.RESULTS: A loss or gain of somatosensory function was seen in at least 1 QST parameter in >88.9% of the patients. Patients in whom extraoral QST was performed showed an overall loss of somatosensory function, whereas intraoral QST showed a general gain of somatosensory function. Qualitative sensory testing identified a side-to-side difference in the tactile and pinprick stimulation in >77% of the patients. An abnormal "nociceptive-specific" blink reflex response was seen in 42.1% to 71.4% of patients dependent on the trigeminal branch stimulated, though comparisons with healthy reference values showed ambiguous results. Compared with the healthy participants, patients showed higher scores for pain catastrophizing, symptoms of depression and anxiety, limited jaw function, more somatic symptoms, and significantly impaired oral health-related quality of life (all P<0.038).DISCUSSION: The results from the present study showed presence of varied somatosensory abnormalities when assessed using psychophysical and electrophysiological investigations and a significantly impaired psychosocial status.
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