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Conditioned Pain Modulation Differences in Central and Peripheral Burning Mouth Syndrome (BMS) Patients
Guangju Yang1, Jianqiu Jin2,3, Kelun Wang4,5
1Department of Prosthodontics and Center for Oral Functional Diagnosis, Treatment and Research, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Key Laboratory of Digital Stomatology, Beijing, China.
Journal of Oral Rehabilitation
|November 4, 2024
Summary
Burning mouth syndrome (BMS) patients show impaired pain modulation, with central BMS exhibiting more significant deficits than peripheral BMS. This suggests BMS is a heterogeneous condition with distinct pain mechanisms.
Area of Science:
- Neuroscience
- Pain Research
- Oral Medicine
Background:
- Burning mouth syndrome (BMS) is a complex chronic pain condition.
- The underlying pain mechanisms in BMS are not fully understood.
- Conditioned pain modulation (CPM) reflects the integrity of endogenous pain inhibition pathways.
Purpose of the Study:
- To investigate conditioned pain modulation (CPM) capacity in patients with burning mouth syndrome (BMS).
- To differentiate CPM function between BMS patients with presumed central versus peripheral pain mechanisms.
- To compare CPM in BMS patients against healthy controls.
Main Methods:
- A randomized controlled trial involving 20 BMS patients and 22 healthy controls.
- BMS patients were categorized into central (n=11) and peripheral (n=9) subgroups based on response to a lingual nerve block.
- CPM was assessed using cold-water immersion, measuring changes in mechanical pain threshold (MPT) and wind-up ratio (WUR).
Main Results:
- BMS patients exhibited reduced CPM effectiveness compared to healthy controls.
- Central BMS patients showed significantly decreased CPM at both painful and control sites.
- Peripheral BMS patients demonstrated reduced CPM only at the painful site.
Conclusions:
- BMS is characterized by impaired central pain inhibitory processing.
- The degree of CPM impairment differs between central and peripheral BMS phenotypes.
- These findings support the concept of BMS as a heterogeneous pain disorder.
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