Current Perceptlon Thresholds and Pain Tolerance Thresholds in Temporomandibular Disorders Patients

측두하악장애 환자에서의 전류인지역치와 동통내성역치

Yi, Young-Chul;Ahn, Yong-Woo;Ko, Myung-Yun;Park, June-Sang
이영철;안용우;고명연;박준상

  • Published : 20040300

Abstract

This article has attempted to characterize current perception thresholds(CPT) and pain tolerance thresholds(PTT) valuesusing the new electrodiagnostjc device in TMD Patients. Thirty one patients(female 22, male 9, mean age 29.5$\pm$14.0 years),were diagnosed as having TMD in the Department of Oral Medicine at the Pusan National University Hospital, and thirtyhealthy subjects(fema1e 19, male 11, mean age 24.3$\pm$6.4 years) participated in this studv. The CPT and PTT measureswere performed using the $Neurometer^{\circledR}$ CPT/C electrodiagnostic device with fully automated mode. The CPT and the PTI test site were trigeminal nerve, located anterior to the tragus of the ear (approximately 1 cm). Results were as follows: The female in the control group have lower PTT of all fiber than male. 2. There were no significant differences in the CPT and PTT between the affected side and non-affected side in the patient group and there Were no significant differences in the CPT and PTT between the female and the male in the patient group except CPT of A-$\beta$ fiber. 3. In the female, the patient group have higher CPT of C fiber than those of the control group but there were no significant differences in PTT of all fiber. 4. In the male, the patient group have lower PTT of all fiber than those of the control group but there were no significant differences in CPT of all fiber. 5. CPT of A-$\delta$ and C fiber of patient group were higher than those of control group. But PTT of all fiber of patient group were lower than those of the control group. 6. There is no correlation between VAS and CPT and PTT in the affected side in the patient group.

Keywords

References

  1. 기우천, 최재갑, 고명연 역 : 측두하악장애, 서울, 1993, 지성출판사, pp12-84.
  2. 정성창, 김영구, 한경수 역 : 악관절장애와 두개안면통증, 서울, 1995, 지성출판사, pp 89-270
  3. 고명연, 박준상 역 : 측두하악장애의 실제, 서울, 1994, 지성출판사. pp15-44.
  4. 정성창외 역 : 악관절장애와 교합,5판, 서울, 1999, 고문사, pp 169-286, 379-422
  5. Okeson J.P. : Bell's Orofacial Pains, 5th ed., Chicago, 1995, Quintessence Publishing Co, Inc., pp5
  6. Patrick D.W., Ronald M. : Textbook of Pain, 3rd ed., Newyork, 1994. Churchill livingstone, pp 338-39
  7. Dotson R.M. : Clinical neurophysiology laboratory tests to assess the nociceptive system in human. J. Clin. Neurophys., 14:32-45, 1997.
  8. Katims J.J. : Electrodiagnostic functional sensory evaluation of the patient with pain: A review of the neuroselective current perception threshold (CPT) and pain tolerance threshold (PTT). Pain Digest., 8:219-230, 1998.
  9. Takekuma K., Ando F., Niino N. et al : Age and gender differences in skin sensory threshold assessed by current perception in community-dwelling Japanese. J. Epidemiol., 10:S33-S:38, 2000.
  10. Katims J.J., Long D.M., Ng L.K.Y. : Transcutaneous nerve stimulation (TNS): frequency and waveform specificity in humans. Appl. Neurophysiol., 49:86-91, 1986.
  11. Veves A., Malik R., Townsend C., Thompson S., Boulton A.J.M. : Unmyelinated fibre pathology in diabetic patients with mild neuropathy. Diabetologia., 35(supp l) :A16, 1992.
  12. Sung C.H. : Changes of trigeminal current perception threshold measures in the facial paralysis patient with stellate ganglion blokcade. J.Korean Pain Res. Soc., 7:144, 1997.
  13. Chung J.W. : The effects of transcutaneous electrical nerve stimulation and electroacupuncture stimulation therapy on the current perception threshold of orofacial region. Korean J Oral Med. 24(3):301-313, 1999.
  14. Kim J.H., Park J.S., Ko M.Y. : The effects of low level laser therapy on current perception threshold in orofacial region. Korean J Oral Med, 27(3):391-400, 2002.
  15. Kim H.S., Kho H.S., Kim Y.K., Lee S.W., Chung S.C.: Reliability and Characteristics of Current Perception Thresholds in the Territory of the Infraorbital and Inferior aveolar Nerves. J orofacial pain, 14(4):286-292, 2000.
  16. Raj P.P., Chado H.N., Angst M., Heavner J., et al. : Painless electrodiagnostic current perception threshold and pain tolerance threshold values in CRPS subjects and healthy controls: A multicenter study. Pain Practice., 1:53-60, 2001.
  17. Angst M.S., Ramaswamy B, Riley E.T., et al. : Lumbar epidural morphine in humans and supraspinal analgesia to experimental heat pain. Anesthesiology., 92:312-324, 2000.
  18. Mironer Y.E., Somerville, J.J., Pain tolerance threshold: The first objective measurement of spinal cord stimulator trial results. Pain Med., In press.
  19. Alo' KM, Chado HN. : Effect of spinal cord stimulation on sensory nerve conduction threshold functional measures. Neuromodulation,. In press.
  20. Liu S,Gerancher J. Bainton B. : Effects of electrical stimulation at different frequencies on perception and pain in humam volunteers:epidural versus intravenous administration of fentanyl. Anesth and Analog., 82:98-102, 1996.
  21. Wong D., Baker C. : Reference manual for the Wong-Baker FACES pain rating scale. Tulsa, 1995.
  22. Neurometer CPT/C Operating Manual, : Neurotron, Inc., Baltimore, Maryland, U.S.A.; 1999.
  23. Ganong WF : Review of Medical Physiology. Los Altos, 1981, Lange Medical Publishers; and Meyer RA : Mechanically insensitive afferents(MIAs) in cutaneous nerve of monkey. Brain Res, 561(2):252-261, 1991. https://doi.org/10.1016/0006-8993(91)91601-V
  24. McMahon S.B., Koltzenburg M. : Silent afferent and visceral pain. In Fields H.I., Liebeskind J.C. (eds.) : Pharmacological Approaches to the treatment of chronic pain : New concepts and critical issues. Seattle, IASP Press, pp 11-30, 1994.
  25. Merrill R. L. : Orofacial pain mechanisms and their clinical application. Dental Clinics of North America., 41(2):167-188, 1997.
  26. Travell J.G., Simmons D.G. : Background and principles. In Myofascial Pain and Dysfunction. The Trigger Point Manual. Baltimore. Williams & Wilkins, pp 5-44, 1983.
  27. Levy D et al. : A comparison of two methods for measuring thresholds in diabetic neuropathy. J Neurol Neurosurg Psychiatry, 52: 1072-1077, 1989. https://doi.org/10.1136/jnnp.52.9.1072
  28. Hagberg C, Hellsing G. Hagberg M. : Perception of cutaneous electrical stimulation in patients with craniomandibular disorders. J Craniomandib Disord., Spring;4(2):120-125, 1990.
  29. Xie Q., Hampt G. : Sensibility threshold in patient with masticatory muscle pain. Acta. Odontol. Scand., 52:33-35, 1994.