Evaluation of the influence of experimental psychological stress on the quantitative sensory testing response in temporomandibular disorders patients

• Autor(a) principal: Ferreira, Dyna Mara Araújo Oliveira
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: eng
• Título da fonte: Biblioteca Digital de Teses e Dissertações da USP
• Texto Completo: https://www.teses.usp.br/teses/disponiveis/25/25146/tde-29112021-151146/
• topic: Estresse Psicológico; Limiar de Dor; Pain Threshold; Psychological Stress; Síndrome da Disfunção da Articulação Temporomandibular; Temporomandibular Joint Dysfunction Syndrome

Background: Quantitative sensory testing (QST) is a promising method for assessing the mechanisms that contribute to the development and maintenance of painful Temporomandibular Disorders (TMD). All QST responses rely on the participant´s perception; therefore a number of cognitive and psychological factors are known to directly influence results, including psychological stress. Aims: To assess the effects of experimental psychological stress on QST response in TMD patients and healthy volunteers. Methods: 20 women with myofascial TMD and 20 healthy women underwent a standardized QST protocol, including cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT), heat pain threshold (HPT), mechanical pain threshold (MPT), pressure pain threshold (PPT) and wind up ratio (WUR) at the masseter muscle. QST was conducted before and after to the Paced Auditory Serial Addition Task (PASAT), inducing acute psychological stress. ANOVA with repeated measures was performed to assess the effect of group and time on the reported stress and absolute values of QST. The significance level was set at 5% (p=0.050). Furthermore, Z-score profiles were generated. Results: The PASAT induced a significant stress reaction (p<0.001). After exposure to experimental stress, both healthy volunteers and TMD patients showed increase in thermal detection threshold (CDT: F=4.25, p=0.017 and WDT: F=4.10, p=0.020) and decrease in thermal pain threshold (CPT: F=11.2, p<0.001 and HPT: F=8.13, p<0.001) when compared to baseline. However, stress did not induce significant changes in MPT, PPT or WUR in both groups (p>0.050). Conclusion: The experimental psychological stress induces thermal hypoesthesia and thermal hyperalgesia on masticatory muscle, regardless of the presence of TMD painful. Overall, these findings emphasize the importance of considering the psychological stress when judging QST findings.