Enhanced Pain Facilitation Rather Than Impaired Pain Inhibition in Burning Mouth Syndrome Female Patients

Overview

Journal J Headache Pain

Publisher Biomed Central

Date 2022 Nov 19

PMID 36401169

Authors

Christelle Gremeau-Richard

Paul Pionchon

Aurelien Mulliez

Christian Duale

Radhouane Dallel

Affiliations

Soon will be listed here.

Abstract

Background: Deficient endogenous pain modulation has been implicated in the development and exacerbation of chronic orofacial pain. To date, relatively little is known regarding the function of the endogenous pain modulation in patients with burning mouth syndrome (BMS). This case-control study investigated endogenous pain modulation in women with BMS.

Methods: Conditioned pain modulation (CPM) was assessed upon temporal summation (TSP) of thermal pain. Forty female subjects, 20 BMS patients and 20 age-matched control subjects, were included in a 2 session-protocol. Mechanical and thermal pain thresholds were measured on the forearm and hand. TSP was obtained using repetitive laser-evoked thermal stimuli applied on the non-dominant hand, at an intensity yielding to moderate pain. During TSP, CPM was produced by immersing the contralateral foot in a water bath at painful cold (8 °C) temperature. In control conditions, the foot was immersed in a water bath at not painful (30 °C) temperature.

Results: BMS was not associated with any impairment in thermal as well as mechanical extracephalic pain thresholds. TSP and CPM efficacy were similar in BMS patients and control subjects. However, BMS patients exhibited enhanced extracephalic heat hyperalgesia.

Conclusion: This study reveals that there is no impairment of endogenous pain inhibition mechanisms in BMS patients, but rather an increase in pain facilitation.

Citing Articles

The enigma of burning mouth syndrome: Insights into dual pain mechanisms.

Pinto-Pardo N J Dent Sci. 2024; 19(2):1231-1232.

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Time-course of pain and salivary opiorphin release in response to oral capsaicin differ in burning mouth syndrome patients, temporomandibular disorders patients and control subjects.

Alajbeg I, Vrbanovic E, Alajbeg I, Orabovic I, Naka K, Mrla A Clin Oral Investig. 2024; 28(5):246.

PMID: 38589630 DOI: 10.1007/s00784-024-05653-y.

References

Coombes B, Bisset L, Vicenzino B . Thermal hyperalgesia distinguishes those with severe pain and disability in unilateral lateral epicondylalgia. Clin J Pain. 2012; 28(7):595-601. DOI: 10.1097/AJP.0b013e31823dd333. View

Yarnitsky D . Conditioned pain modulation (the diffuse noxious inhibitory control-like effect): its relevance for acute and chronic pain states. Curr Opin Anaesthesiol. 2010; 23(5):611-5. DOI: 10.1097/ACO.0b013e32833c348b. View

Ribeiro-Dasilva M, Goodin B, Fillingim R . Differences in suprathreshold heat pain responses and self-reported sleep quality between patients with temporomandibular joint disorder and healthy controls. Eur J Pain. 2012; 16(7):983-93. PMC: 3628618. DOI: 10.1002/j.1532-2149.2011.00108.x. View

Pfau D, Rolke R, Nickel R, Treede R, Daublaender M . Somatosensory profiles in subgroups of patients with myogenic temporomandibular disorders and Fibromyalgia Syndrome. Pain. 2009; 147(1-3):72-83. DOI: 10.1016/j.pain.2009.08.010. View

Greenspan J, Slade G, Bair E, Dubner R, Fillingim R, Ohrbach R . Pain sensitivity risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case control study. J Pain. 2011; 12(11 Suppl):T61-74. PMC: 3249228. DOI: 10.1016/j.jpain.2011.08.006. View

Raphael K, Janal M, Anathan S, Cook D, Staud R . Temporal summation of heat pain in temporomandibular disorder patients. J Orofac Pain. 2009; 23(1):54-64. PMC: 2652673. View

Nishihara C, Watanabe K, Ozasa K, Khan J, Eliav E, Imamura Y . Altered pain modulation to noxious heat thermal stimuli in burning mouth syndrome. Oral Dis. 2020; 26(8):1777-1782. DOI: 10.1111/odi.13486. View

Garrett P, Sarlani E, Grace E, Greenspan J . Chronic temporomandibular disorders are not necessarily associated with a compromised endogenous analgesic system. J Orofac Pain. 2013; 27(2):142-50. PMC: 4627641. DOI: 10.11607/jop.943. View

Honda M, Iida T, Kamiyama H, Masuda M, Kawara M, Svensson P . Mechanical sensitivity and psychological factors in patients with burning mouth syndrome. Clin Oral Investig. 2018; 23(2):757-762. DOI: 10.1007/s00784-018-2488-9. View

10.

Staud R, Weyl E, Price D, Robinson M . Mechanical and heat hyperalgesia highly predict clinical pain intensity in patients with chronic musculoskeletal pain syndromes. J Pain. 2012; 13(8):725-35. PMC: 3581857. DOI: 10.1016/j.jpain.2012.04.006. View

11.

Baad-Hansen L, List T, Kaube H, Jensen T, Svensson P . Blink reflexes in patients with atypical odontalgia and matched healthy controls. Exp Brain Res. 2006; 172(4):498-506. DOI: 10.1007/s00221-006-0358-1. View

12.

Sato H, Saisu H, Muraoka W, Nakagawa T, Svensson P, Wajima K . Lack of temporal summation but distinct aftersensations to thermal stimulation in patients with combined tension-type headache and myofascial temporomandibular disorder. J Orofac Pain. 2012; 26(4):288-95. View

13.

King C, Wong F, Currie T, Mauderli A, Fillingim R, Riley 3rd J . Deficiency in endogenous modulation of prolonged heat pain in patients with Irritable Bowel Syndrome and Temporomandibular Disorder. Pain. 2009; 143(3):172-178. PMC: 3629692. DOI: 10.1016/j.pain.2008.12.027. View

14.

Mignogna M, Pollio A, Fortuna G, Leuci S, Ruoppo E, Adamo D . Unexplained somatic comorbidities in patients with burning mouth syndrome: a controlled clinical study. J Orofac Pain. 2011; 25(2):131-40. View

15.

Latremoliere A, Woolf C . Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain. 2009; 10(9):895-926. PMC: 2750819. DOI: 10.1016/j.jpain.2009.06.012. View

16.

Yunus M . Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness. Semin Arthritis Rheum. 2008; 37(6):339-52. DOI: 10.1016/j.semarthrit.2007.09.003. View

17.

Jaaskelainen S, Woda A . Burning mouth syndrome. Cephalalgia. 2017; 37(7):627-647. DOI: 10.1177/0333102417694883. View

18.

Guy N, Voisin D, Mulliez A, Clavelou P, Dallel R . Medication overuse reinstates conditioned pain modulation in women with migraine. Cephalalgia. 2017; 38(6):1148-1158. DOI: 10.1177/0333102417727545. View

19.

Moana-Filho E, Herrero Babiloni A, Theis-Mahon N . Endogenous pain modulation in chronic orofacial pain: a systematic review and meta-analysis. Pain. 2018; 159(8):1441-1455. DOI: 10.1097/j.pain.0000000000001263. View

20.

Hackett J, Naugle K, Naugle K . The Decline of Endogenous Pain Modulation With Aging: A Meta-Analysis of Temporal Summation and Conditioned Pain Modulation. J Pain. 2019; 21(5-6):514-528. DOI: 10.1016/j.jpain.2019.09.005. View