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Influence of psychometric and sleep quality features on painful mechanical sensitivity and pain modulation in patients with temporomandibular disorders

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Abstract

Investigating the collective impact of psychometric properties and sleep quality on pain sensitivity in temporomandibular disorder (TMD) patients could improve clinical management strategies.

Objective

Assessing whether combined psychometric properties and sleep quality impact painful mechanical sensitivity and pain modulation in TMD patients.

Materials and methods

A cross-sectional study using secondary data analysis of 77 TMD patients and 101 controls. All participants completed questionnaires characterizing their psychometric profile (anxiety, depression, stress and catastrophizing) and sleep quality, alongside psychophysical tests for painful mechanical sensory (mechanical pain threshold (MPT), pressure pain threshold (PPT), and wind-up ratio (WUR)) and conditioned pain modulation (CPM). Participants were grouped into "High distress" or "Low distress" categories based on psychometric properties and sleep quality using hierarchical cluster and k-means analyses. Multiple linear regression evaluated the influence of TMD, age, and the distress cluster on MPT, WUR, PPT, and CPM in masseter and thenar muscles. Differences were statistically significant when p < 0.05.

Results

The presence of TMD was the strongest predictor of mechanical painful sensitivity in the trigeminal region (MPT[F(3,174) = 51.902;p < .001;R2 = .463]; TMD presence (β = -.682) / PPT[F(3,174) = 15.573;p < .001;R2 = .198] TMD presence (β = -.452), and extra-trigeminal (MPT[F(3,174) = 35.897;p < .001;R2 = .382] TMD (β = -.647) / CPM [F(3,174) = 4.106;p < .05;R2 = .050] TMD presence (β = .197). Furthermore, neither the high distress group nor the low distress group were able to significantly influence the variation of the values of any of the psychophysical variables evaluated (p > .05).

Conclusions

There is not a significant influence of impairment clusters based on psychological variables and sleep quality on painful mechanical sensitivity and pain modulation, regardless of the presence of TMD.

Clinical relevance

This outcome suggests that psychosocial factors and sleep quality may not play a decisive role in the sensory-discriminative aspect of pain, particularly concerning painful TMD.

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Data availability

The data that support the findings of this study will be available from the authors. The data used in the research project, whether raw, modified, groupings carried out by k-means clustering, are available through the open link:

https://docs.google.com/spreadsheets/d/12yyukoXzE0GkOKpYUEmSwj4QsX0x3vRC7KOi604zMSE/edit#gid=0

The data does not identify the volunteers, preserving their identity.

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Acknowledgements

grant 2022/13506-9, São Paulo Research Foundation (FAPESP).

Funding

Funding sources: grant 2022/13506-9, São Paulo Research Foundation (FAPESP).

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Authors and Affiliations

  1. Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil

    Rafaela Stocker Salbego, Matheus Herreira-Ferreira, Beatriz Amaral de Lima-Netto & Leonardo Rigoldi Bonjardim

  2. Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil

    Paulo César Rodrigues Conti & Dyna Mara Araújo Oliveira Ferreira

  3. Department of Dentistry, UniFTC University Center, Vitória da Conquista, Brazil

    Flávia Fonseca Carvalho Soares

  4. Faculty of Odontology, Malmø University, Malmø, Sweden

    Peter Svensson

  5. Department of Biosciences, Piracicaba School of Dentistry, University of Campinas, Piracicaba, Brazil

    Yuri Martins Costa

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Rafaela Stocker Salbego, Flávia Fonseca Carvalho Soares, Dyna Mara Araújo Oliveira Ferreira, Matheus Herreira-Ferreira, Beatriz Lima Netto, Yuri Martins Costa, Paulo César Rodrigues Conti, Peter Svensson and Leonardo Rigoldi Bonjardim. The first draft of the manuscript was written by Rafaela Stocker Salbego and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript for this submission.

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Correspondence to Rafaela Stocker Salbego.

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The study was submitted and approved by the Research Ethics Committee of the Bauru School of Dentistry, University of São Paulo (CAAE 63551122.7.0000.5417). All individuals who agreed to participate in the primary study signed an informed consent form.

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Salbego, R.S., Conti, P.C.R., Soares, F.F.C. et al. Influence of psychometric and sleep quality features on painful mechanical sensitivity and pain modulation in patients with temporomandibular disorders. Clin Oral Invest 28, 302 (2024). https://doi.org/10.1007/s00784-024-05699-y

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