Vibrotactile threshold is elevated in temporomandibular disorders

Abstract

Experimental pain can elevate vibrotactile threshold, a phenomenon attributed in the literature to the operation of a 'touch gate.' It is not known, however, whether clinical pain produces similar effects. To explore this possibility, we measured vibrotactile threshold in patients with temporomandibular disorders (TMD) whose pain had a prominent myalgic component. Two-interval forced-choice tracking was used to determine threshold for a 25-Hz vibratory stimulus presented on the cheek. Threshold was found to be significantly elevated in the TMD group, compared to an age- and gender-matched control group of pain-free individuals. Within the TMD group, those with a supra-median level of muscle tenderness (corrected for background levels of spontaneous pain) had significantly higher threshold than those with lower levels of palpation pain. These findings are consistent with the idea of a touch gate, and suggest the usefulness of further research in this area with clinical pain populations. The effects of an adapting stimulus (25 Hz, 20 dB SL) were also studied, and found to produce parallel elevations in vibrotactile threshold in the TMD and pain-free groups. This result indicates that at least some adaptation occurs at a higher (subsequent) level of somatosensory information processing than does the touch gating implied by the unadapted thresholds.

Tactile Perception in Adults with Autism: a Multidimensional Psychophysical Study

“…Using the adaptation protocol of Hollins et al (1996), there was a main effect of the block of 20 trials (corresponding to pre-adaptation, adaptation, or post-adaptation phases), with thresholds increasing during the adaptation phase, as expected (F = 51.41; p < 0.0001, Fig. 3B).…”

“…In Experiment 1, we tested participants' ability to detect constant pressure using thin nylon, "von Frey" filaments. Since another possibility for hypersensitivity in autism is that sensory neurons fail to adapt normally, we measured adaptation to the detection of vibrotactile stimuli in Experiment 2, using a paradigm known to produce adaptation in non-autistic participants (Hollins, Sigurdsson, Fillingim, & Goble, 1996). In Experiment 3, we obtained magnitude estimates for the perceived hedonic value (pleasantness/unpleasantness) of textured surfaces; in Experiment 4, we measured thresholds for thermal sensations of cool and warmth, and in Experiment 5, we obtained thermal pain thresholds.…”

Interpreting Joint Pain: Quantitative Sensory Testing in Musculoskeletal Management

“…However, increased vibration detection threshold (ie, less sensitivity) has been demonstrated in knee OA, 53 hip OA, 55 and temporomandibular joint disorders. 26 It has been proposed that vibration detection threshold may be an indicator of aberrant joint proprioception and, consequently, joint pathology 56 ; however, proprioception was not assessed in this study. Interestingly, a subsequent study found a correlation between improvement in pain and improvement in proprioception in persons with knee OA.…”

“…1 While both of these studies investigated cutaneous pain, hypoesthesia has been demonstrated in subjects with experimentally induced muscle pain 65 and in individuals with chronic musculoskeletal dysfunction, in particular, temporomandibular joint dysfunction. 26 The mechanisms behind these findings require further clarification. Nonetheless, clinical findings of hypoesthesia, dysesthesia, and/ or mechanical allodynia in the region of a chronic musculoskeletal condition are suggestive of altered central nociceptive mechanisms.…”

“…12,13,27,36 Mechanical Allodynia and Mechanical Detection Threshold Recent research has identified hypoesthesia and/ or dysesthesia in relation to chronic joint injury. 16,22,26 In healthy individuals, intra-articular joint stimulation of the temoromandibular joint, designed to experimentally induce nociceptive sensitization, resulted in hypoesthesia of the skin in the region of the joint. 3 Clinical studies appear to support these findings.…”