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- Al-Khotani, A, et al.
(author)
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The Association Between Psychological Symptoms and Self-Reported Temporomandibular Disorders Pain Symptoms in Children and Adolescents
- 2021
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In: Frontiers in oral health. - : Frontiers Media SA. - 2673-4842. ; 2, s. 675709-
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Journal article (peer-reviewed)abstract
- Background: Several studies have reported an association between temporomandibular disorder pain (TMD-P) and emotional disorders in children and adolescents. However, no studies have reported if self-reported TMD-P in Saudi Arabia is associated with psychosocial symptoms. Therefore, the current study aimed to evaluate the association between self-reported TMD-P with depression, anxiety and somatic problems in children and adolescents in Saudi Arabia. The hypothesis was that there is an association between self-reported TMD-P and psychological symptoms among children and adolescents.Materials and Methods: The included participants were randomly selected boys and girls aged between 10 and 18 years, with a mean (SD) age of 14.0 (2.3) years. Out of 633 children and adolescents that were invited to participate, 509 voluntarily agreed to participate, and 466 completed all questionnaires. The questionnaires included items retrieved from the Youth Self Report (YSR) and Axis II of the Research Diagnostic Criteria for TMD (RDC/TMD) besides demographic data, medical history, and presence of oral parafunctions. To assess the presence of self-reported TMD-Pain, each participant was verbally asked two validated questions regarding the presence of TMD-P and dysfunction (2Q-TMD).Results: Self-reported TMD-P in children and adolescents was significantly associated with anxiety, depression, somatic symptoms, and social problems (P < 0.0001). Further, the frequencies of anxiety, depression, and somatic disorders were more evident among children and adolescents who suffered from TMD-P (P < 0.0001). The odds of reporting TMD-P in children and adolescents was 1.4 times for border line and clinical diagnosis scores for anxiety and withdrawal depression domains, and 2.6 times for the somatic symptoms' domains. However, in the multiple regression model after controlling for possible confounders, only somatic symptoms and social scores were significant. Moreover, self-reported TMD-P was twice as prevalent among girls compared to boys.Conclusion: This study reports a significant association between psychosocial burden and presence of self-reported TMD-Pain, with a stronger impact on girls than boys. There were significantly higher number of participants with self-reported TMD-P reporting a poor oral and general health. In addition, self-reported TMD-P was higher among those with borderline and clinically diagnosed anxiety/depression scores. Based on this finding, the current study supports that an early approach and recognition of children and adolescents with anxiety, depression, somatic symptoms, and TMD problems. This could result in a lesser burden for these children and adolescents both in regard to pain and psychosocial implications with increased quality of life.
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- Alhilou, AM, et al.
(author)
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Nerve growth factor and glutamate increase the density and expression of substance P-containing nerve fibers in healthy human masseter muscles
- 2021
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In: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 11:1, s. 15673-
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Journal article (peer-reviewed)abstract
- Nocifensive behavior induced by injection of glutamate or nerve growth factor (NGF) into rats masseter muscle is mediated, in part, through the activation of peripheral NMDA receptors. However, information is lacking about the mechanism that contributes to pain and sensitization induced by these substances in humans. Immunohistochemical analysis of microbiopsies obtained from human masseter muscle was used to investigate if injection of glutamate into the NGF-sensitized masseter muscle alters the density or expression of the NMDA receptor subtype 2B (NR2B) or NGF by putative sensory afferent (that express SP) fibers. The relationship between expression and pain characteristics was also examined. NGF and glutamate administration increased the density and expression of NR2B and NGF by muscle putative sensory afferent fibers (P < 0.050). This increase in expression was greater in women than in men (P < 0.050). Expression of NR2B receptors by putative sensory afferent fibers was positively correlated with pain characteristics. Results suggest that increased expression of peripheral NMDA receptors partly contributes to the increased pain and sensitivity induced by intramuscular injection of NGF and glutamate in healthy humans; a model of myofascial temporomandibular disorder (TMD) pain. Whether a similar increase in peripheral NMDA expression occurs in patients with painful TMDs warrants further investigation.
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- Alhilou, AM, et al.
(author)
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Sex-related differences in response to masseteric injections of glutamate and nerve growth factor in healthy human participants
- 2021
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In: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 11:1, s. 13873-
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Journal article (peer-reviewed)abstract
- The neurophysiological mechanisms underlying NGF-induced masseter muscle sensitization and sex-related differences in its effect are not well understood in humans. Therefore, this longitudinal cohort study aimed to investigate the effect of NGF injection on the density and expression of substance P, NMDA-receptors and NGF by the nerve fibers in the human masseter muscle, to correlate expression with pain characteristics, and to determine any possible sex-related differences in these effects of NGF. The magnitude of NGF-induced mechanical sensitization and pain during oral function was significantly greater in women than in men (P < 0.050). Significant positive correlations were found between nerve fiber expression of NMDA-receptors and peak pain intensity (rs = 0.620, P = 0.048), and expression of NMDA-receptors by putative nociceptors and change in temporal summation pain after glutamate injection (rs = 0.561, P = 0.003). In women, there was a significant inverse relationship between the degree of NGF-induced mechanical sensitization and the change in nerve fiber expression of NMDA-receptors alone (rs = − 0.659, P = 0.013), and in combination with NGF (rs = − 0.764, P = 0.001). In conclusion, women displayed a greater magnitude of NGF-induced mechanical sensitization that also was associated with nerve fibers expression of NMDA-receptors, when compared to men. The present findings suggest that, in women, increased peripheral NMDA-receptor expression could be associated with masseter muscle pain sensitivity.
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- Almqvist, J, et al.
(author)
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Functional interaction of Oct transcription factors with the family of repeats in Epstein-Barr virus oriP.
- 2005
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In: The Journal of general virology. - : Microbiology Society. - 0022-1317 .- 1465-2099. ; 86:Pt 5, s. 1261-7
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Journal article (peer-reviewed)abstract
- The family of repeats (FR) is a major upstream enhancer of the Epstein-Barr virus (EBV) latent C promoter (Cp) that controls transcription of six different latent nuclear proteins following interaction with the EBV nuclear protein EBNA1. Here, it was shown that Cp could also be activated by octamer-binding factor (Oct) proteins. Physical binding to the FR by the cellular transcription factors Oct-1 and Oct-2 was demonstrated by using an electrophoretic mobility-shift assay. Furthermore, Oct-1 in combination with co-regulator Bob.1, or Oct-2 alone, could drive transcription of a heterologous thymidine kinase promoter linked to the FR in both B cells and epithelial cells. Cp controlled by the FR was also activated by binding of Oct-2 to the FR. This may have direct implications for B cell-specific regulation of Cp.
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- Andersen, Oluf, 1941, et al.
(author)
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Treatment Options for Epstein-Barr Virus-Related Disorders of the Central Nervous System.
- 2023
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In: Infection and drug resistance. - 1178-6973. ; 16, s. 4599-4620
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Research review (peer-reviewed)abstract
- Epstein-Barr virus (EBV), a causative agent for several types of lymphomas and mucosal cancers, is a human lymphotropic herpesvirus with the capacity to establish lifelong latent infection. More than 90% of the human population worldwide is infected. The primary infection is usually asymptomatic in childhood, whereas infectious mononucleosis (IM) is common when the infection occurs in adolescence. Primary EBV infection, with or without IM, or reactivation of latent infection in immunocompromised individuals have been associated with a wide range of neurologic conditions, such as encephalitis, meningitis, acute disseminated encephalomyelitis, and cerebellitis. EBV is also involved in malignant lymphomas in the brain. An increasing number of reports on EBV-related disorders of the central nervous system (CNS) including the convincing association with multiple sclerosis (MS) have put in focus EBV-related conditions beyond its established link to malignancies. In this review, we present the clinical manifestations of EBV-related CNS-disorders, put them in the context of known EBV biology and focus on available treatment options and future therapeutic approaches.
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- Baad-Hansen, L, et al.
(author)
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Effect of systemic monosodium glutamate (MSG) on headache and pericranial muscle sensitivity
- 2010
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In: Cephalalgia : an international journal of headache. - : SAGE Publications. - 1468-2982. ; 30:1, s. 68-76
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Journal article (peer-reviewed)abstract
- We conducted a double-blinded, placebo-controlled, crossover study to investigate the occurrence of adverse effects such as headache as well as pain and mechanical sensitivity in pericranial muscles after oral administration of monosodium glutamate (MSG). In three sessions, 14 healthy men drank sugar-free soda that contained either MSG (75 or 150 mg/kg) or NaCl (24 mg/kg, placebo). Plasma glutamate level, pain, pressure pain thresholds and tolerance levels, blood pressure (BP), heart rate and reported adverse effects were assessed for 2 h. No muscle pain or robust changes in mechanical sensitivity were detected, but there was a significant increase in reports of headache and subjectively reported pericranial muscle tenderness after MSG. Systolic BP was elevated in the high MSG session compared with low MSG and placebo. These findings add new information to the concept of MSG headache and craniofacial pain sensitivity.
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- Barjandi, Golnaz, et al.
(author)
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Comorbid Conditions in Temporomandibular Disorders Myalgia and Myofascial Pain Compared to Fibromyalgia
- 2021
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In: Journal of Clinical Medicine. - : MDPI. - 2077-0383. ; 10:14
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Journal article (peer-reviewed)abstract
- The impact of comorbidities in fibromyalgia (FM) and temporomandibular disorders (TMD) have been well documented, but whether TMD sub-diagnoses myalgia (MYA) and myofascial pain with referral (MFP) differ regarding comorbidity is unclear. We aimed to elucidate this by studying the presence and associations of comorbidities in FM, MFP and MYA. An extended version of the Diagnostic Criteria for TMD axis II questionnaire was used to examine demographics, pain and comorbidities in 81 patients with FM, 80 with MYA, and 81 with MFP. Patients with MFP and FM reported a higher percentage of irritable bowel syndrome (IBS), depression, anxiety, somatic symptoms, perceived stress, and insomnia compared to MYA. Patients with FM had more IBS, depression, and somatic symptom disorder versus MFP. After adjusting for confounding variables, participants with anxiety, somatic symptoms disorder, pain catastrophizing, and perceived stress, as well as a greater number of comorbidities, were more likely to have MFP than MYA, whereas FM participants were more associated with IBS, somatic symptoms and insomnia compared to MFP. The number of comorbidities was significantly associated with widespread pain but not pain duration, body mass index or being on sick leave. In conclusion, patients with MFP were more similar to those with FM regarding comorbidity and should be differentiated from MYA in clinical settings and pain management.
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22. |
- Barjandi, Golnaz, et al.
(author)
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Plasma tryptophan and kynurenine in females with temporomandibular disorders and fibromyalgia-An exploratory pilot study.
- 2020
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In: Journal of Oral Rehabilitation. - : Wiley. - 1365-2842 .- 0305-182X. ; 47:2, s. 150-157
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Journal article (peer-reviewed)abstract
- BACKGROUND: Both temporomandibular disorders myalgia (TMDM) and fibromyalgia (FM) have been linked to central and peripheral changes in serotonin availability. The precursor of serotonin, tryptophan (TRP), is mainly catabolised via another pathway to produce kynurenine (KYN), but whether changes of this pathway are present in TMDM and FM are still unclear.OBJECTIVE: The aim was to explore blood plasma concentrations of TRP and KYN in TMDM and FM in an attempt to identify novel associations for future research.METHODS: Plasma of 113 female participants (17 TMDM, 40 FM and 56 healthy pain-free controls) were analysed for TRP and KYN concentrations. The degradation of TRP via the KYN pathway was indicated by the KYN to TRP ratio (KYN/TRP). Pain intensities were assessed with the Graded Chronic Pain Scale (GCPS) and Visual Analogue Scale (VAS). Psychological symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder scale (GAD-7).RESULTS: In TMDM there was a negative correlation between TRP and pain intensity (rs = -0.55 P = .023) and positive correlations between KYN/TRP and pain intensity (rs = 0.59 P = .013). In FM, KYN/TRP was negatively correlated with anxiety symptoms (rs = -0.36 P = .022) and a trend towards significantly lower TRP levels was found compared to controls (P = .05).CONCLUSION: The association between KYN/TRP and pain intensity as well as anxiety ratings in this small exploratory study may indicate that KYN/TRP could be a relevant indicator for symptom severity in TMDM and FM. Further investigations of the KYN pathway in chronic myalgia are warranted.
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- Bergius, My, et al.
(author)
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Are judges influenced by legally irrelevant circumstances?
- 2020
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In: Law, Probability and Risk. - : Oxford University Press (OUP). - 1470-8396 .- 1470-840X. ; 19:2, s. 157-164
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Journal article (peer-reviewed)abstract
- Judges should not be influenced by legally irrelevant circumstances in their legal decision making and judges generally believe that they manage legally irrelevant circumstances well. The purpose of this experimental study was to investigate whether this self-image is correct. Swedish judges (N = 256) read a vignette depicting a case of libel, where a female student had claimed on her blog that she had been sexually harassed by a named male professor. The professor had sued the student for libel and the student retracted her claim during the hearing. Half of the judges received irrelevant information - that the professor himself had been convicted of libel a year earlier, while the other half did not receive this information. For the outcome variable, the judges were asked to state how much compensation the student should pay the professor. Those judges who received information about the professor himself having been convicted of libel stated that he should be given significantly less compensation than those who did not receive the irrelevant information. The results show that the judges’ decision was affected by legally irrelevant circumstances. Implications for research and practice are discussed
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29. |
- Bergius, M., et al.
(author)
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Are judges influenced by legally irrelevant circumstances?
- 2020
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In: Law, Probability and Risk. - 1470-8396. ; 19:2, s. 157-164
-
Journal article (peer-reviewed)abstract
- Judges should not be influenced by legally irrelevant circumstances in their legal decision making and judges generally believe that they manage legally irrelevant circumstances well. The purpose of this experimental study was to investigate whether this self-image is correct. Swedish judges (N = 256) read a vignette depicting a case of libel, where a female student had claimed on her blog that she had been sexually harassed by a named male professor. The professor had sued the student for libel and the student retracted her claim during the hearing. Half of the judges received irrelevant information - that the professor himself had been convicted of libel a year earlier, while the other half did not receive this information. For the outcome variable, the judges were asked to state how much compensation the student should pay the professor. Those judges who received information about the professor himself having been convicted of libel stated that he should be given significantly less compensation than those who did not receive the irrelevant information. The results show that the judges' decision was affected by legally irrelevant circumstances. Implications for research and practice are discussed. © The Author(s) [2020].
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30. |
- Berglund, Mattias, 1972-
(author)
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Molecular Characterization of Diffuse Large B-cell Lymphoma and Aspects of Transformation
- 2004
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Doctoral thesis (other academic/artistic)abstract
- Lymphomas are a heterogeneous group of neoplasias originating from B- or T-lymphocytes. In this thesis, we determined the genetic and immunophenotypic characterization of DLBCL and their prognostic impact. Moreover, genomic alterations associated with the transformation to DLBCL from Hodgkin lymphoma (HL) and follicular lymphoma (FL) were elucidated. In order to outline the impact of cytogenetic as well as immunophenotypic prognostic markers in DLBCL, we firstly studied a series of 54 DLBCL tumors using comparative genomic hybridization (CGH) and we identified several frequently occurring chromosomal imbalances. Loss of 22q was more often found in the diagnostic tumors with a more advanced clinical stage, while gain of 18q21 was more commonly identified in relapses. Secondly, we correlated the expression patterns of CD10, bcl-6, IRF-4 and bcl-2 with clinical parameters in a series of 173 de novo DLBCL patients. Patients with a germinal center (GC) phenotype displayed a better survival than the non-GC group. Expression of bcl-6 and CD10 was correlated with a better survival while bcl-2 expression was associated with a poor prognosis.In approaching the HL transformation, two novel B-cell lines (U-2932 and U-2940), derived from patients with DLBCL following HL, were characterized. Interestingly, a translocation with materials from 2q and 7q as well as loss of material on 6q was found in both cell lines. For FL transformation, we assessed chromosomal alterations in a panel of 28 DLBCL patients with a previous history of FL. The DLBCL tumors displayed more chromosomal imbalances compared to FL tumors. Loss of 6q16-21 and gain of 7pter-q22 were more commonly found in the DLBCL counterparts, suggesting the chromosomal location of putative genes that may be involved in the transformation process.
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- Bjersing, Jan, 1966, et al.
(author)
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Benefits of resistance exercise in lean women with fibromyalgia: involvement of IGF-1 and leptin
- 2017
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In: Bmc Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 18:106
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Journal article (peer-reviewed)abstract
- Background: Chronic pain and fatigue improves by exercise in fibromyalgia (FM) but underlying mechanisms are not known. Obesity is increased among FM patients and associates with higher levels of pain. Symptom improvement after aerobic exercise is affected by body mass index (BMI) in FM. Metabolic factors such as insulin-like growth factor 1 (IGF1) and leptin may be involved. In this study, the aim was to evaluate the role of metabolic factors in lean, overweight and obese women during resistance exercise, in relation to symptom severity and muscle strength in women with FM. Methods: Forty-three women participated in supervised progressive resistance exercise, twice weekly for 15-weeks. Serum free and total IGF-1, IGF-binding protein 3 (IGFBP3), adiponectin, leptin and resistin were determined at baseline and after 15-weeks. Level of current pain was rated on a visual analogue scale (0-100 mm). Level of fatigue was rated by multidimensional fatigue inventory (MFI-20) subscale general fatigue (MFIGF). Knee extension force, elbow flexion force and handgrip force were assessed by dynamometers. Results: Free IGF-1 (p = 0.047), IGFBP3 (p = 0.025) and leptin (p = 0.008) were significantly decreased in lean women (n = 18), but not in the overweight (n = 17) and the obese (n = 8). Lean women with FM benefited from resistance exercise with improvements in current pain (p= 0.039, n = 18), general fatigue (MFIGF, p = 0.022, n = 18) and improved elbow-flexion force (p = 0.017, n = 18). In overweight and obese women with FM there was no significant improvement in pain or fatigue but an improvement in elbow flexion (p = 0.049; p = 0.012) after 15 weeks of resistance exercise. Conclusion: The clearest clinical response to resistance exercise was found in lean patients with FM. In these individuals, individualized resistance exercise was followed by changes in IGF-1 and leptin, reduced pain, fatigue and improved muscular strength. In overweight and obese women FM markers of metabolic signaling and clinical symptoms were unchanged, but strength was improved in the upper limb. Resistance exercise combined with dietary interventions might benefit patients with FM and overweight.
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37. |
- Bojmar, Linda
(author)
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Metastatic Mechanisms in Malignant Tumors
- 2015
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Doctoral thesis (other academic/artistic)abstract
- The ultimate cause of cancer related deaths is metastasis. This thesis is about three of the main human cancers; breast, colorectal and pancreatic cancer, that together account for more than 25% of the cancer-related deaths worldwide. The focus of the thesis is the spread of cancer, metastasis, and the aim was to investigate mechanisms that can be of importance for this process. We analyzed patient samples to validate the role of epithelialto-mesenchymal transition in vivo and found regulations of many related factors. However, these changes tend to fluctuate along the metastatic process, something which makes targeting complicated. We, moreover, focused on the influence of the tumor microenvironment for metastatic spread. In pancreatic cancer, the stroma constitutes the main part of many tumors. We analyzed the crosstalk between tumor and stromal cell and focused on the mediating inflammatory factor interleukin-1 (IL-1) and regulation of microRNAs. The results showed that the most commonly mutated factor in pancreatic cancer, KRAS, associates with the expression of IL-1 and subsequent activation of stromal cells. Blocking KRAS signaling together with IL-1 blockage give a more pronounced effect on in vitro proliferation and migration of cancer cells and suggests the use of a combination therapy. The cancer-associated activation of the stroma was found to be related to changes in microRNA expression. microRNA was analyzed separately in epithelial cells and stromal cells after microdissection of matched samples of primary and secondary tumors of breast and colorectal cancers. miR-214 and miR-199a were upregulated in stroma associated with progressive tumors and in pancreatic cancer stroma we could show that their expression alters the activation of stromal cells and thereby the growth and migratory ability of associated pancreatic tumor cells. In breast and colorectal cancers we found several common microRNAs to be up- or downregulated in line with progression. We could show that one of these candidates, miR-18a, had a prognostic value in metastatic breast cancer. To further develop these studies we analyzed this microRNA in circulating microvesicles, i.e. exosomes, and investigated their role in the preparation of a pre-metastatic niche. MicroRNAs are stable biomarkers in the circulation, especially protected in exosomes, which can moreover specifically deliver their message to recipient cells. These studies facilitate the understanding of metastatic behavior and suggest new targets to stop cancer metastasis.
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- Bozoky, Benedek, et al.
(author)
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Stabilization of the classical phenotype upon integration of pancreatic cancer cells into the duodenal epithelium
- 2021
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In: Neoplasia. - : Elsevier. - 1522-8002 .- 1476-5586. ; 23:12, s. 1300-1306
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Journal article (peer-reviewed)abstract
- Introduction: Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive solid tumors. Based on transcriptomic classifiers, basal-like and classical PDAC subtypes have been defined that differ in prognosis. Cells of both subtypes can coexist in individual tumors; however, the contribution of either clonal heterogeneity or microenvironmental cues to subtype heterogeneity is unclear. Here, we report the spatial tumor phenotype dynamics in a cohort of patients in whom PDAC infiltrated the duodenal wall, and identify the duodenal epithelium as a distinct PDAC microniche. Materials and methods: We used serial multiplex quantitative immunohistochemistry (smq-IHC) for 24 proteins to phenotypically chart PDAC tumor cells in patients whose tumors infiltrated the duodenal epithelium. Additionally, we used a genetically engineered mouse model to study the PDAC cell phenotype in the small intestinal epithelium in a controlled genetic background. Result: We show that pancreatic cancer cells revert to non-destructive growth upon integration into the duodenal epithelium, where they adopt traits of intestinal cell differentiation, associated with phenotypical stabilization of the classical subtype. The integrated tumor cells replace epithelial cells in an adenoma-like manner, as opposed to invasive growth in the submucosa. Finally, we show that this phenomenon is shared between species, by confirming duodenal integration and phenotypic switching in a genetic PDAC mouse model. Discussion: Our results identify the duodenal epithelium as a distinct PDAC microniche and tightly link microenvironmental cue to cancer transcriptional subtypes. The phenomenon of "intestinal mimicry" provides a unique opportunity for the systematic investigation of microenvironmental influences on pancreatic cancer plasticity.
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- Buckley, Patrick G., et al.
(author)
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Identification of genetic aberrations on chromosome 22 outside the NF2 locus in schwannomatosis and neurofibromatosis type 2
- 2005
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In: Human Mutation. - : Hindawi Limited. - 1059-7794 .- 1098-1004. ; 26:6, s. 540-9
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Journal article (peer-reviewed)abstract
- Schwannomatosis is characterized by multiple peripheral and cranial nerve schwannomas that occur in the absence of bilateral 8th cranial nerve schwannomas. The latter is the main diagnostic criterion of neurofibromatosis type 2 (NF2), which is a related but distinct disorder. The genetic factors underlying the differences between schwannomatosis and NF2 are poorly understood, although available evidence implicates chromosome 22 as the primary location of the gene(s) of interest. To investigate this, we comprehensively profiled the DNA copy number in samples from sporadic and familial schwannomatosis, NF2, and a large cohort of normal controls. Using a tiling-path chromosome 22 genomic array, we identified two candidate regions of copy number variation, which were further characterized by a PCR-based array with higher resolution. The latter approach allows the detection of minute alterations in total genomic DNA, with as little as 1.5 kb per measurement point of nonredundant sequence on the array. In DNA derived from peripheral blood from a schwannomatosis patient and a sporadic schwannoma sample, we detected rearrangements of the immunoglobulin lambda (IGL) locus, which is unlikely to be due to a B-cell specific somatic recombination of IGL. Analysis of normal controls indicated that these IGL rearrangements were restricted to schwannomatosis/schwannoma samples. In the second candidate region spanning GSTT1 and CABIN1 genes, we observed a frequent copy number polymorphism at the GSTT1 locus. We further describe missense mutations in the CABIN1 gene that are specific to samples from schwannomatosis and NF2 and make this gene a plausible candidate for contributing to the pathogenesis of these disorders.
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- Canales, GD, et al.
(author)
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Efficacy of Botulinum Toxin Type-A I in the Improvement of Mandibular Motion and Muscle Sensibility in Myofascial Pain TMD Subjects: A Randomized Controlled Trial
- 2022
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In: Toxins. - : MDPI AG. - 2072-6651. ; 14:7
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Journal article (peer-reviewed)abstract
- This study assessed the effects of botulinum toxin type A (BoNT-A) in mandibular range of motion and muscle tenderness to palpation in persistent myofascial pain (MFP) patients (ReBEC RBR-2d4vvv). Eighty consecutive female subjects with persistent MFP, were randomly divided into four groups (n = 20): three BoNT-A groups with different doses and a saline solution group (placebo control group). Treatments were injected bilaterally in the masseter and anterior temporalis muscle in a single session. Clinical measurements of mandibular movements included: pain-free opening, maximum unassisted and assisted opening, and right and left lateral excursions. Palpation tests were performed bilaterally in the masseter and temporalis muscle. Follow-up occurred 28 and 180 days after treatment. For the statistical analysis the Mann–Whitney U-test with Bonferroni correction was used for groups comparisons. Regardless of dose, all parameters of mandibular range of motion significantly improved after 180 days in all BoNT-A groups, compared with the control group. Palpation pain over the masseter and temporalis muscles were significantly reduced in all BoNT-A groups regardless of dose, compared with the control group, after 28 and 180 days of treatment. Independent of doses, BoNT-A improved mandibular range of motion and muscle tenderness to palpation in persistent MFP patients.
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46. |
- Canales, GD, et al.
(author)
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Long-Term Effects of a Single Application of Botulinum Toxin Type A in Temporomandibular Myofascial Pain Patients: A Controlled Clinical Trial
- 2022
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In: Toxins. - : MDPI AG. - 2072-6651. ; 14:11
-
Journal article (peer-reviewed)abstract
- This study assessed the long-term effects of botulinum toxin type A (BoNT-A) in subjective pain, pain sensibility, and muscle thickness in persistent myofascial temporomandibular-disorder pain (MFP-TMD) patients. Fourteen female subjects with persistent MFP received BoNT-A treatment with different doses (10U-25U for temporalis muscle and 30U-75U for masseter muscle). The treatment was injected bilaterally in the masseter and anterior temporalis muscles in a single session. Clinical measurements included: self-perceived pain (VAS), pain sensibility (PPT), and muscles thickness (ultrasonography). Follow-up occurred 1, 3, 6, and 72 months after treatment for VAS and PPT and 1, 3, and 72 months for ultrasonography. For statistical analysis, the Friedman test with the Bonferroni test for multiple comparisons as a post hoc test was used for non-parametric repeated measures comparisons among the evaluation times. A 5% probability level was considered significant in all tests. VAS values presented a significant decrease throughout the study (p < 0.05). Regarding PPT values, a significant increase was found when comparing baseline data with post-treatment follow-ups (p < 0.05), and even though a significant decrease was found in muscle thickness when baseline values were compared with the 1- and 3-months assessments, no differences were found when compared with the 72 months follow-up (p > 0.05). A single injection of BoNT-A presents long-term effects in reducing pain in persistent MFP-TMD patients, and a reversibility of adverse effects on masticatory-muscle thickness.
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49. |
- Castrillon, Eduardo, et al.
(author)
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ACIDIC SALINE-INDUCED PAIN AS A MODEL FOR EXPERIMENTAL MASSETER MYALGIA IN HEALTHY SUBJECTS : PRELIMINARY RESULTS
- 2010
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In: Abstracts of the 13th World Congress of Pain. - : IASP (International Association for the Study of Pain and Omnipress).
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Conference paper (other academic/artistic)abstract
- Repeated intramuscular injections of acidic saline in rats are reported to induce a chronic type of muscle sensitization without causing significant tissue damage in this model two repeated injections of acidic saline (pH 4) into the gastrocnemius muscle produce short-lasting pain, but allodynia that lasts for 4 week with pain spread to the contralateral side. This may indicate that central sensitization occurs and this model is thus believed to more accurately mimic chronic myalgia. Our aim was to find out if repeated injection of buffered acidic saline into the masseter muscle causes pain and hyperalgesia and if so this would be a valid experimental model for orofacial myalgia / myofascial TMD in humans. Twenty healthy and pain-free subjects (10 male + 10 female: 25.1 ± 0.9 years) were included. Pain levels were assessed on a 0-10 numerical rating scale (NRS) and pressure pain thresholds (PPTs) were recorded using an electronic pressure algometer. The subjects received a unilateral intramuscular injection (0.5 ml) of acidic saline (pH 3) or placebo (isotonic saline, pH 6) into the masseter muscle (randomized and double-blind). Two days thereafter the injection was repeated with the same substance. Pain was assessed 5 min before the injection and at 5, 15, 30, 45 min, 1, 3, 24 hours after both injections and then at 4 and 7 days after the second injection and PPTs at 5, 15, 30, 45 min, 1 hrs after both injections and at 1, 4 and 7 days after the second injection. The experiment was repeated with the other substance after at least one week. There was no difference between substances in NRS pain scores after the injections. One way ANOVA indicated a time effect but no substance effect on PPTs. These preliminary results do not support acidic saline injections as a valid pain model for experimental masseter myalgia in healthy subjects.
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- Castrillon, Eduardo E, et al.
(author)
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Acidic saline-induced pain as a model for experimental masseter myalgia in healthy subjects
- 2013
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In: European Journal of Pain. - : John Wiley & Sons. - 1090-3801 .- 1532-2149. ; 17:10, s. 1438-1446
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Journal article (peer-reviewed)abstract
- BACKGROUND: Repeated injection of acidic saline into skeletal muscles of the leg in rodents induces a prolonged bilateral mechanical hyperalgesia that persists for up to 30 days and may be useful to model widespread muscle pain conditions. In this study, repeated injection of acidic (pH 3.3) saline solution into the masseter muscle of healthy human subjects was undertaken to determine if these injections are painful and whether they would induce a prolonged period of muscle sensitization to artificial and/or natural mechanical stimulation of the masseter and temporalis muscles. METHODS: Eighteen subjects (10 male, 8 female) participated in the study. Subjects received two injections of 0.5 mL acidic or regular isotonic saline 2 days apart, in a randomized, double blind, crossover design. RESULTS: There was no significant difference in pain intensity ratings when acidic saline injections were compared with regular saline injections. Pain area drawings were, however, significantly larger in response to the first injection of acidic saline than to the second injection of acidic saline or to either the first or second injection of regular saline. Repeated injection of acidic saline did not significantly alter pressure pain thresholds from the masseter or temporalis muscles on either the injected side or the opposite side over the 10-day post injection monitoring period. There was also no effect of injections on chewing. CONCLUSION: These findings indicate that, unlike in some rodent models, repeated injection of low pH solutions into jaw muscles of humans fails to induce a period of prolonged muscle hyperalgesia.
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