scholarly journals Differences in Somatosensory Function During Premenopause and Early and Late Postmenopause in Patients With Burning Mouth Syndrome

2021 ◽  
Author(s):  
Kana Ozasa ◽  
Noboru Noma ◽  
Kosuke Watanabe ◽  
Andrew Young ◽  
Eli Eliav ◽  
...  
Keyword(s):  
Pain Threshold ◽  
Detection Threshold ◽  
Burning Mouth Syndrome ◽  
Cold Pain ◽  
Heat Pain Threshold ◽  
Z Scores ◽  
Burning Mouth ◽  
Thermal Stimuli ◽  
Burning Mouth Sensation ◽  
Somatosensory Function

Abstract Background: This study aimed to examine the association between somatosensory dysfunction and burning mouth syndrome (BMS) in premenopausal, early postmenopausal, and late postmenopausal patients, using a standardized Quantitative Sensory Testing (QST) protocol, and to determine the predictive value of thermal or mechanical perception by QST for detecting BMS.Methods: The study included 36 female participants with BMS (12 premenopausal, 10 early postmenopausal, and 14 late postmenopausal) and 42 age- and sex- matched healthy volunteers (21 premenopausal, 10 early postmenopausal, and 11 late postmenopausal). Neurophysiological tests were used to evaluate somatosensory dysfunction at the tongue.Results: Z-scores in the late postmenopausal BMS group revealed a gain of function for the cold pain threshold and heat pain threshold (Z=2.08 and 3.38, respectively). In the multiple regression analysis with the Visual Analogue Scale as the dependent variable, the vibration detection threshold predicted severity of burning mouth sensation in the premenopausal group.Conclusions: Late postmenopausal patients with BMS showed an increased response of the tongue to noxious thermal stimuli. This supports the theory that changes in sex hormones may affect trigeminal somatosensory function in particular, during the late postmenopausal stage in patients with BMS.

scholarly journals Quantitative sensory testing predicts histological small fiber neuropathy in postural tachycardia syndrome

2019 ◽  
Vol 10 (5) ◽  
pp. 428-434
Author(s):  
Sophia C.I. Billig ◽  
Joana C. Schauermann ◽  
Roman Rolke ◽  
Istvan Katona ◽  
Jörg B. Schulz ◽  
...  
Keyword(s):  
Skin Biopsy ◽  
Quantitative Sensory Testing ◽  
Pain Threshold ◽  
Detection Threshold ◽  
Small Fiber Neuropathy ◽  
Sensory Testing ◽  
Cold Pain ◽  
Noninvasive Test ◽  
Small Fiber ◽  
Heat Pain Threshold

BackgroundRetrospective investigation of the somatosensory profile and prediction of histologic small fiber neuropathy (SFN) in postural orthostatic tachycardia syndrome (POTS) was performed using quantitative sensory testing (QST) as a standardized noninvasive test.MethodsIn this investigation, full data sets from 30 patients (age: 34.03 ± 10.82 years, n = 6 males), including results of autonomic function testing, norepinephrine values, skin biopsy, and QST, were retrospectively analyzed. The QST data were compared with healthy controls (HCs) (age: 34.20 ± 10.5 years, n = 6 males, t test: 0.95).ResultsThe evaluation of all QST parameters in POTS compared with HCs yielded differences in all thermal parameters (cold detection threshold: p < 0.05, warm detection threshold: p < 0.001, thermal sensory limen: p < 0.001, cold pain threshold: p < 0.05, and heat pain threshold: p < 0.001) and in paradoxical heat sensations (p < 0.05). Differences in nonpainful stimuli (mechanical detection threshold: p < 0.05 and vibration detection threshold: p < 0.001) were also detected. All patients who had clinical signs of SFN in combination with impairment of small fibers in QST also had SFN on skin biopsy.ConclusionThese results suggest that a non–region-specific SFN in POTS compared with controls can be detected by noninvasive QST that predicts histologic small fiber pathology.

scholarly journals Pain sensitivity in men who have never experienced a headache: an observer blinded case control study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Isa Amalie Olofsson ◽  
Jeppe Hvedstrup ◽  
Katrine Falkenberg ◽  
Mona Ameri Chalmer ◽  
Henrik Winther Schytz ◽  
...  
Keyword(s):  
Pain Sensitivity ◽  
Pain Threshold ◽  
Case Control Study ◽  
Cold Pressor Test ◽  
Case Control ◽  
Pain Tolerance ◽  
Cold Pain ◽  
Primary Headache Disorders ◽  
Heat Pain Threshold ◽  
Control Study

Abstract Background Headache affects 90–99% of the population. Based on the question “Do you think that you never ever in your whole life have had a headache?” 4% of the population say that they have never experienced a headache. The rarity of never having had a headache suggests that distinct biological and environmental factors may be at play. We hypothesized that people who have never experienced a headache had a lower general pain sensitivity than controls. Methods We included 99 male participants, 47 headache free participants and 52 controls, in an observer blinded nested case-control study. We investigated cold pain threshold and heat pain threshold using a standardized quantitative sensory testing protocol, pericranial tenderness with total tenderness score and pain tolerance with the cold pressor test. Differences between the two groups were assessed with the unpaired Student’s t-test or Mann-Whitney U test as appropriate. Results There was no difference in age, weight or mean arterial pressure between headache free participants and controls. We found no difference in pain detection threshold, pericranial tenderness or pain tolerance between headache free participants and controls. Conclusion Our study clearly shows that freedom from headache is not caused by a lower general pain sensitivity. The results support the hypothesis that headache is caused by specific mechanisms, which are present in the primary headache disorders, rather than by a decreased general sensitivity to painful stimuli. Trial registration Registered at ClinicalTrials.gov (NCT04217616), 3rd January 2020, retrospectively registered.

scholarly journals Thermal Quantitative Sensory Testing in Fibromyalgia Patients / Termāla Kvantitatīva Sensora Testēšana Fibromialģijas Pacientiem

2015 ◽  
Vol 69 (5) ◽  
pp. 215-222
Author(s):  
Marija Mihailova ◽  
Ināra Logina ◽  
Santa Rasa ◽  
Svetlana Čapenko ◽  
Modra Murovska ◽  
...  
Keyword(s):  
Quantitative Sensory Testing ◽  
Pain Threshold ◽  
Fibromyalgia Impact Questionnaire ◽  
Sensory System ◽  
Thermal Stimulus ◽  
Thermal Perception ◽  
Sensory Testing ◽  
Inhibitory System ◽  
Cold Pain ◽  
Heat Pain Threshold

AbstractFibromyalgia (FM) is a chronic disorder manifested by diffuse musculoskeletal pain, fatigue, sleep, and emotional disturbance. The disorder is probably associated with dysfunction of C and A delta peripheral nerve fibres. Thermal quantitative sensory testing (QST) was used to analyse thinly myelinated A delta fibres and nonmylinated C fibres, which function in the nociceptive sensory system, and the spinothalamic pathway. The observation that FM pain has neuropathic nature increased the value of QST as an additional diagnostic tool. The research group included 51 patients. Somatic symptoms were assessed using the Fatigue Severity Score (FSS), Fibromyalgia Impact Questionnaire (FIQ) and American College of Rheumatology (ACR) 2010 year diagnostic criteria. QST was performed by using thermal stimulus at wrist and feet. QST results were compared with 20 non-FM controls matched for age and sex. FM patients showed significant alteration of thermal perception and pain threshold compared with that in healthy controls, which demonstrated possible neuropathic pain nature in FM patients. Changes were more expressed in warm perception and heat pain threshold, which probably indicates that in FM patients C fibres are more damaged and warm perception and warm pain threshold are more sensitive, which may be used as FM diagnostics. We also found statistically significant negative correlations between warm and cold perception thresholds and between heat and cold pain thresholds, reflecting central sensitization or a defective pain inhibitory system.

scholarly journals Burning Mouth Syndrome: A Review of the Etiopathologic Factors and Management

2016 ◽  
Vol 17 (2) ◽  
pp. 171-176 ◽  
Author(s):  
Sajith Vellappally
Keyword(s):  
Blood Test ◽  
Multidisciplinary Approach ◽  
Current Knowledge ◽  
Burning Mouth Syndrome ◽  
Number Of Patients ◽  
Oral Mucosal Lesions ◽  
Mucosal Lesions ◽  
Burning Mouth ◽  
Etiological Agents ◽  
Burning Mouth Sensation

ABSTRACT Burning mouth syndrome (BMS) is characterized by pain in the mouth with or with no inflammatory signs and no specific lesions. Synonyms found in literature include glossodynia, oral dysesthesia, glossopyrosis, glossalgia, stomatopyrosis, and stomatodynia. Burning mouth syndrome generally presents as a triad: Mouth pain, alteration in taste, and altered salivation, in the absence of visible mucosal lesions in the mouth. The syndrome generally manifests spontaneously, and the discomfort is typically of a continuous nature but increases in intensity during evening and at night. The etiopathogenesis seems to be complex and in a large number of patients probably involves interactions among local, systemic, and/or psychogenic factors. The differential diagnosis requires the exclusion of oral mucosal lesions or blood test alterations that can produce burning mouth sensation. Management is always based on the etiological agents involved. If burning persists after local or systemic conditions are treated, then treatment is aimed at controlling neuropathic symptoms. Treatment of BMS is still unsatisfactory, and there is no definitive cure. As a result, a multidisciplinary approach is required to bring the condition under better control. The aim of this review was to discuss several aspects of BMS, update current knowledge, and provide guidelines for patient management. How to cite this article Vellappallay S. Burning Mouth Syndrome: A Review of the Etiopathologic Factors and Management. J Contemp Dent Pract 2016;17(2):171-176.

Altered pain modulation to noxious heat thermal stimuli in burning mouth syndrome

Oral Diseases ◽  
2020 ◽  
Vol 26 (8) ◽  
pp. 1777-1782 ◽  
Author(s):  
Chisa Nishihara ◽  
Kosuke Watanabe ◽  
Kana Ozasa ◽  
Junad Khan ◽  
Eli Eliav ◽  
...  
Keyword(s):  
Burning Mouth Syndrome ◽  
Pain Modulation ◽  
Noxious Heat ◽  
Burning Mouth ◽  
Thermal Stimuli

Repeatability of cold pain and heat pain thresholds: The application of sensory testing in migraine research

Cephalalgia ◽  
2010 ◽  
Vol 30 (8) ◽  
pp. 904-909 ◽  
Author(s):  
Trond Sand ◽  
Kristian Bernhard Nilsen ◽  
Knut Hagen ◽  
Lars Jacob Stovner
Keyword(s):  
Pain Threshold ◽  
Heat Pain ◽  
Cold Pain ◽  
Pain Thresholds ◽  
Thermal Pain ◽  
Normal Limits ◽  
Normal Test ◽  
Heat Pain Threshold ◽  
The Face ◽  
Repeatability Limit

Normal heat pain threshold (HPT) and cold pain threshold (CPT) repeatability should be estimated in order to identify thermal allodynia in longitudinal studies, but such data are scarce in the literature. The aim of our study was to estimate normal HPT and CPT repeatability in the face, forehead, neck and hand. In addition, we reviewed briefly normative studies of thermal pain thresholds relevant for headache research. Thermal pain thresholds were measured on three different days in 31 healthy headache-free subjects. Coefficients of repeatability and normal limits were calculated. HPT and CPT were lowest in the face. Pooled across regions, the lower repeatability limit for the test/retest ratio was 63% for HPT and 55% for CPT. The upper normal CPT limit varied between 24.5°C and 29.7°C. Lower HPT limits ranged between 35.5°C and 40.8°C. Quantitative sensory methods provide useful information about headache and pain pathophysiology, and it is important to estimate the normal test/retest repeatability range in follow-up studies.

Spatial and Temporal Brain Responses to Noxious Heat Thermal Stimuli in Burning Mouth Syndrome

2016 ◽  
Vol 95 (10) ◽  
pp. 1138-1146 ◽  
Author(s):  
T. Shinozaki ◽  
Y. Imamura ◽  
R. Kohashi ◽  
K. Dezawa ◽  
Y. Nakaya ◽  
...  
Keyword(s):  
Burning Mouth Syndrome ◽  
Noxious Heat ◽  
Brain Responses ◽  
Burning Mouth ◽  
Thermal Stimuli

scholarly journals Low mechano-afferent fibers reduce thermal pain but not pain intensity in CRPS

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrin Habig ◽  
Gothje Lautenschläger ◽  
Hagen Maxeiner ◽  
Frank Birklein ◽  
Heidrun H. Krämer ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Pain Threshold ◽  
Glabrous Skin ◽  
Healthy Controls ◽  
Cold Pain ◽  
Pain Thresholds ◽  
Thermal Pain ◽  
C Fibers ◽  
Ct Afferents ◽  
Heat Pain Threshold

Abstract Background Human hairy (not glabrous skin) is equipped with a subgroup of C-fibers, the C-tactile (CT) fibers. Those do not mediate pain but affective aspects of touch. CT-fiber-activation reduces experimental pain if they are intact. In this pilot study we investigated pain modulating capacities of CT-afferents in CRPS. Methods 10 CRPS-patients (mean age 33 years, SEM 3.3) and 11 healthy controls (mean age 43.2 years, SEM 3.9) participated. CT-targeted-touch (brush stroking, velocity: 3 cm/s) was applied on hairy and glabrous skin on the affected and contralateral limb. Patients rated pleasantness of CT-targeted-touch (anchors: 1 “not pleasant”—4 “very pleasant”) twice daily on 10 days. Pain intensity (NRS: 0 “no pain” – 10 “worst pain imaginable”) was assessed before, 0, 30, 60 and 120 min after each CT-stimulation. To assess sensory changes, quantitative-sensory-testing was performed at the beginning and the end of the trial period. Results CT-targeted-touch was felt more pleasant on the healthy compared to the affected limb on hairy (p < 0.001) and glabrous skin (p 0.002), independent of allodynia. In contrast to healthy controls patients felt no difference between stimulating glabrous and hairy skin on the affected limb. Thermal pain thresholds increased after CT-stimulation on the affected limb (cold-pain-threshold: p 0.016; heat-pain-threshold: p 0.033). Conclusions CT-stimulation normalizes thermal pain thresholds but has no effect on the overall pain in CRPS. Therefore, pain modulating properties of CT-fibers might be too weak to alter chronic pain in CRPS. Moreover, CT-fibers appear to lose their ability to mediate pleasant aspects of touch in CRPS.

scholarly journals Time of day influences psychophysical measures in women with burning mouth syndrome

2021 ◽  
Author(s):  
Janell S. Payano Sosa ◽  
Joyce T. Da Silva ◽  
Shana A.B Burrowes ◽  
Soo Y. Yoo ◽  
Michael L. Keaser ◽  
...  
Keyword(s):  
Detection Threshold ◽  
Time Of Day ◽  
Burning Mouth Syndrome ◽  
Spontaneous Pain ◽  
Type I ◽  
Pain Thresholds ◽  
Orofacial Region ◽  
Burning Mouth ◽  
Healthy Participants

AbstractBurning mouth syndrome (BMS) is a chronic orofacial pain condition that mainly affects postmenopausal women. BMS type I patients report little to no spontaneous pain in the morning and increases in pain through the day, peaking in the afternoon. Quantitative sensory testing (QST) findings from BMS type 1 patients are inconsistent as they fail to capture this temporal variation. We examined how QST in BMS type 1 compared to healthy participants was affected by time of day. QST of the face and forearm included warmth detection threshold (WDT), cold detection threshold (CDT), and heat pain thresholds (HPT), ratings of suprathreshold heat, and pressure pain thresholds (PPT), and was performed twice: once in the morning and once in the afternoon. BMS patients reported: no differences in morning and afternoon comparisons of the orofacial region between groups and no differences in PPTs in either orofacial or arm regions between groups; lower within group PPTs of the masseter in the afternoon; higher WDTs, and lower CDTs of the forearm in the morning compared to healthy participants; lower CDTs and higher pain intensity ratings to heat stimuli at low temperatures on the forearm in the afternoon compared to healthy participants. The findings indicate that compared to healthy participants, BMS Type I patients had altered thermal sensitivity, which depended on body area tested (forearm vs orofacial region), and higher pain sensitivity, which was slightly more pronounced in the afternoon plausibly due to a hypervigilance.PerspectiveSomatosensory profiles in BMS type 1 can be affected by time of day, possibly as an effect of spontaneous burning pain that increases throughout the day. Our findings highlight the cyclical effect of BMS pathophysiology across a day, which may further help clinicians choose appropriate treatment strategies for BMS patients.

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