Pain-sensorimotor interactions: New perspectives and a new model.

How pain and sensorimotor behavior interact has been the subject of research and debate for many decades. This article reviews theories bearing on pain-sensorimotor interactions and considers their strengths and limitations in the light of findings from experimental and clinical studies of pain-sensorimotor interactions in the spinal and craniofacial sensorimotor systems. A strength of recent theories is that they have incorporated concepts and features missing from earlier theories to account for the role of the sensory-discriminative, motivational-affective, and cognitive-evaluative dimensions of pain in pain-sensorimotor interactions.

Pterygoid muscle activity in speech: A preliminary investigation.

Background: Speaking depends on refined control of jaw opening and closing movements. The medial pterygoid muscle (MPT), involved in jaw closing, and the lateral pterygoid muscle (LPT), involved in jaw opening, are two key mandibular muscles in mastication and are likely to be recruited for controlled movements in speech.

Objectives: Three hypotheses were investigated, that during speech the MPT and LPT: (1) were both active, (2) but exhibited different patterns of activity, (3) which fluctuated with the vowels and consonants in speech.

Threshold variations of medial pterygoid single motor units during vertical or horizontal force tasks.

Objectives: To test the hypotheses that (a) the force thresholds at onset of medial pterygoid muscle single motor unit (SMU) activity do not decrease with an increase in the rate of force generation in standardised vertical or horizontal jaw-force tasks, and (b) there is evidence for functional heterogeneity within the medial pterygoid muscle.

Methods: In 14 healthy participants, electromyographic recordings of the right medial pterygoid muscle were performed with intramuscular fine-wire electrodes during four isometric force tasks: vertical, horizontal contralateral, horizontal protrusion and horizontal ipsilateral, performed at two rates of force development (slow ramp, fast ramp). Computer tomography scans confirmed electrode location within the muscle, which was divided into medial and lateral parts.

Functional properties of single motor units in the human medial pterygoid muscle: Thresholds.

Background: Little is known regarding the functional properties of single motor units (SMUs) in the medial pterygoid muscle (MPt) during jaw movements.

Objectives: The aims are (a) to report the thresholds of onset of MPt SMUs during 4 goal-directed jaw movement tasks, and (b) to determine whether the threshold of onset of SMU activation varies with the velocity of jaw movement and the location within the muscle.

Methods: Intra-muscular electrodes were inserted in the right MPt of 18 participants performing ipsilateral (right), contralateral, protrusive and opening-closing jaw movements recorded at 2 velocities.

Altered Brainstem Pain Modulating Circuitry Functional Connectivity in Chronic Painful Temporomandibular Disorder.

There is evidence from preclinical models of chronic pain and human psychophysical investigations to suggest that alterations in endogenous brainstem pain-modulation circuit functioning are critical for the initiation and/or maintenance of pain. Whilst preclinical models have begun to explore the functioning of this circuitry in chronic pain, little is known about such functioning in humans with chronic pain. The aim of this investigation was to determine whether individuals with chronic non-neuropathic pain, painful temporomandibular disorders (TMD), display alterations in brainstem pain-modulating circuits.

Effect of Expectation on Pain Processing: A Psychophysics and Functional MRI Analysis.

Pain is a complex phenomenon that is highly modifiable by expectation. Whilst the intensity of incoming noxious information plays a key role in the intensity of perceived pain, this intensity can be profoundly shaped by an individual's expectations. Modern brain imaging investigations have begun to detail the brain regions responsible for placebo and nocebo related changes in pain, but less is known about the neural basis of stimulus-expectancy changes in pain processing.

Simultaneous Noxious Stimulation of the Human Anterior Temporalis and Masseter Muscles. Part II: Effects on Jaw Muscle Electromyographic Activity.

Aims: To test the hypotheses that, in comparison to control, the effects of simultaneous noxious stimulation of the right masseter and anterior temporalis muscles on jaw muscle activity (1) vary with the task; (2) are different between different agonist or antagonist muscles involved in a task; and (3) are correlated with mood or pain-related cognition scores.

Methods: In 15 asymptomatic participants, recordings were made of jaw movement and electromyographic (EMG) activity of the right digastric and bilateral masseter and anterior temporalis muscles during standardized open/close and free and standardized chewing tasks. The tasks were repeated in three blocks: block 1 (baseline), block 2 (during simultaneous infusion of 5% hypertonic or 0.

Reorganization of Masseter and Temporalis Muscle Single Motor Unit Activity During Experimental Masseter Muscle Pain.

Aims: To test the hypothesis that experimental noxious stimulation of the right masseter muscle results in a reorganization of motor unit activity within the right temporalis and right masseter muscles during jaw closing tasks.

Methods: A total of 20 healthy participants received hypertonic saline (5% sodium chloride) infusion into the right masseter muscle, and pain intensity was maintained at 40-60/100 mm on a visual analog scale. Standardized isometric biting tasks were performed with an intraoral force transducer while single motor units (SMUs) were recorded from the right masseter and temporalis muscles.

Simultaneous Noxious Stimulation of the Human Anterior Temporalis and Masseter Muscles. Part I: Effects on Jaw Movements.

Aims: To test the hypotheses that, in comparison to control (isotonic saline), simultaneous noxious stimulation (hypertonic saline) of the masseter and anterior temporalis muscles would result in (1) reductions in amplitude and velocity of jaw movements during standardized open/close jaw movements and during free and standardized chewing and (2) changes in amplitude and velocity of jaw movements that relate to higher levels of negative mood or pain-related thoughts.

Methods: Standardized open/close and free and standardized chewing were recorded in 15 asymptomatic participants in three blocks: block 1 (baseline), block 2 (during 5% hypertonic or 0.9% isotonic saline infusion into the right masseter and anterior temporalis muscles simultaneously), and block 3 (infusion sequence reversed).

Single motor units from the medial pterygoid muscle can be active during isometric horizontal and vertical forces.

Objectives: To determine (a) whether the medial pterygoid muscle is active in an isometric vertical force task and in isometric horizontal force tasks in the contralateral, protrusion and ipsilateral directions; (b) whether the same single motor units (SMUs) could be active across different directions of isometric force generation; and (c) whether different regions of the medial pterygoid muscle exhibit different patterns of SMU activation during the generation of any one direction of isometric force.

Methods: Intramuscular electromyographic (EMG) recordings were made from the right medial pterygoid muscle in 15 healthy participants during isometric force tasks: vertical and horizontal contralateral, protrusion and ipsilateral. A computed tomography scan divided the EMG recording site into a medial or lateral part in each participant.

The three-axial gyroscope sensor detects the turning point between opening and closing phases of chewing.

Most devices measuring the kinematics of masticatory function are cumbersome to setup and not portable. Data collection would be facilitated, particularly in the elderly, if the device used for the objective measurement of mastication was easily transportable and simple to setup. Accelerometers and gyroscope sensors are lightweight and portable and may be useful alternatives.

Reorganization of motor unit activity at different sites within the human masseter muscle during experimental masseter pain.

The aims were to test the hypotheses that experimental masseter muscle pain leads to recruitment and/or derecruitment of motor units at different sites within the masseter and that the patterns of change in motor unit activity differ between sites. Single motor unit (SMU) activity was recorded at two sites within the right masseter [superior/anterior, inferior/posterior (IP)] during isometric biting tasks (ramp, step level) on an intraoral force transducer in 17 participants during three experimental blocks comprising no infusion (baseline), 5% hypertonic saline infusion (pain), or isotonic saline infusion (control). A visual analog scale (VAS) was used to score pain intensity.

Experimental noxious stimulation of the right masseter muscle does not affect bilateral masseter and temporalis muscle activity and force parameters during standardised isometric biting tasks.

Aim: To determine if the electromyographic (EMG) activity of the left and right masseter and anterior temporalis muscles is altered by experimental right masseter muscle noxious stimulation during goal-directed isometric biting tasks in asymptomatic humans.

Methods: Isometric biting tasks (slow and fast ramp biting tasks, 2-step biting task) were performed on an intraoral force transducer in 18 participants during the following blocks: baseline block, hypertonic saline infusion into the right masseter muscle (painful block) and isotonic saline infusion into the right masseter (control block). Bipolar surface electrodes recorded EMG activity from the bilateral masseter and anterior temporalis muscles.

The Effects of Experimental Temporalis Muscle Pain on Jaw Muscle Electromyographic Activity During Jaw Movements and Relationships with Some Psychological Variables.

Aims: To determine if the effects of experimental temporalis muscle pain on jaw muscle activity vary with the jaw task performed, jaw displacement magnitude, participant being studied, and with psychological measures.

Methods: Jaw movement was tracked, and electromyographic (EMG) activity was recorded from the masseter and anterior temporalis and digastric muscles in 14 asymptomatic participants during standardized opening/closing jaw movement, free chewing, and standardized chewing tasks. Tasks were repeated in three blocks: Block 1 (baseline), Block 2 (during 5% hypertonic or 0.

Brainstem Pain-Control Circuitry Connectivity in Chronic Neuropathic Pain.

Preclinical investigations have suggested that altered functioning of brainstem pain-modulation circuits may be crucial for the maintenance of some chronic pain conditions. While some human psychophysical studies show that patients with chronic pain display altered pain-modulation efficacy, it remains unknown whether brainstem pain-modulation circuits are altered in individuals with chronic pain. The aim of the present investigation was to determine whether, in humans, chronic pain following nerve injury is associated with altered ongoing functioning of the brainstem descending modulation systems.

Effect of a brief episode of experimental muscle pain on jaw movement and jaw-muscle activity during chewing.

The aims of this study were to determine whether: (i) the jaw motor system develops a new pattern of jaw movement and/or jaw-muscle activity after resolution of an acute episode of jaw-muscle pain; and (ii) if jaw-muscle activity and jaw-movement features change progressively with repetition of a chewing sequence. Jaw movement and jaw muscle (masseter, anterior temporalis, and digastric) activity were recorded during free and rate-standardized chewing in eight asymptomatic participants (pain infusion group), before and at three time blocks up to 45 min after a single 0.2-ml bolus infusion of 5% hypertonic saline into the right masseter muscle.

Chronic Neuropathic Pain: It's about the Rhythm.

The neural mechanisms underlying the development and maintenance of chronic neuropathic pain remain unclear. Evidence from human investigations suggests that neuropathic pain is associated with altered thalamic burst firing and thalamocortical dysrhythmia. Additionally, experimental animal investigations show that neuropathic pain is associated with altered infra-slow (<0.

Pain and Personality: Do Individuals with Different Forms of Chronic Pain Exhibit a Mutual Personality?

The role of personality in the experience of chronic pain is a growing field, with endless debate regarding the existence of a "pain personality". This study aims to compare different chronic pain types and consolidate the existence of a common personality. Thirty-two females with chronic orofacial pain and 37 age-matched healthy females were assessed with the Temperament and Character Inventory-Revised.

Anatomical changes at the level of the primary synapse in neuropathic pain: evidence from the spinal trigeminal nucleus.

Accumulated evidence from experimental animal models suggests that neuronal loss within the dorsal horn is involved in the development and/or maintenance of peripheral neuropathic pain. However, to date, no study has specifically investigated whether such neuroanatomical changes also occur at this level in humans. Using brain imaging techniques, we sought to determine whether anatomical changes were present in the spinal trigeminal nucleus in subjects with chronic orofacial neuropathic pain.

Subtle alterations in brain anatomy may change an individual's personality in chronic pain.

It is well established that gross prefrontal cortex damage can affect an individual's personality. It is also possible that subtle prefrontal cortex changes associated with conditions such as chronic pain, and not detectable until recent advances in human brain imaging, may also result in subtle changes in an individual's personality. In an animal model of chronic neuropathic pain, subtle prefrontal cortex changes including altered basal dendritic length, resulted in altered decision making ability.

Experimental jaw muscle pain increases pain scores and jaw movement variability in higher pain catastrophizers.

Aims: To investigate differences between higher and lower pain catastrophizers in the effects of hypertonic saline-evoked jaw muscle pain on pain perception and jaw movement.

Methods: Repetitive open/close jaw movements were recorded in 28 asymptomatic participants (20 men, 8 women; ages 25 to 62 years) during continuous infusion of 5% hypertonic saline or isotonic saline into the right masseter muscle. All participants completed the McGill Pain Questionnaire; the Depression, Anxiety and Stress Scales; and the Jaw Function Limitation Scale.

Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†.

Aims: The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.

Unraveling the effects of plasticity and pain on personality.

Unlabelled: Chronic pain resulting from physical stressors is often accompanied by psychological disorders such as depression. Although depressive disorders are associated with changes in brain anatomy, it remains unknown if changes in brain anatomy associated with increased state depression levels also occur in patients with chronic pain. When individuals are experiencing physical stressors such as ongoing pain, depressive personality traits may predispose them to develop depressive states.

Differential brain activity in subjects with painful trigeminal neuropathy and painful temporomandibular disorder.

Human brain imaging investigations have revealed that acute pain is associated with coactivation of numerous brain regions, including the thalamus, somatosensory, insular, and cingulate cortices. Surprisingly, a similar set of brain structures is not activated in all chronic pain conditions, particularly chronic neuropathic pain, which is associated with almost exclusively decreased thalamic activity. These inconsistencies may reflect technical issues or fundamental differences in the processing of acute compared with chronic pain.

Association between resting jaw muscle electromyographic activity and mandibular advancement splint outcome in patients with obstructive sleep apnea.

Introduction: The muscles of mastication are important in positioning the mandible and can therefore affect the patency of the upper airway. The aim of this study was to determine whether resting masticatory muscle activity influences the response to mandibular advancement splint treatment in patients with obstructive sleep apnea.

Methods: Thirty-eight adult patients with obstructive sleep apnea were recruited for the study.