Academic Journal
Myofascial pain with referral: Role of nociceptive drive and central pain mechanisms.
| Τίτλος: | Myofascial pain with referral: Role of nociceptive drive and central pain mechanisms. |
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| Συγγραφείς: | Zebda H; Department of Oral Diagnostic Sciences, University at Buffalo School of Dental Medicine, Buffalo, NY, United States; Faculty of Dentistry, Ibn Sina University for Medical Science, Amman, Jordan. Electronic address: hosam.zebda@isums.edu.jo., Gonzalez Y; Department of Oral Diagnostic Sciences, University at Buffalo School of Dental Medicine, Buffalo, NY, United States., Crow H; Department of Oral Diagnostic Sciences, University at Buffalo School of Dental Medicine, Buffalo, NY, United States., Ohrbach R; Department of Oral Diagnostic Sciences, University at Buffalo School of Dental Medicine, Buffalo, NY, United States. |
| Πηγή: | The journal of pain [J Pain] 2026 Feb; Vol. 39, pp. 105629. Date of Electronic Publication: 2025 Dec 05. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Churchill Livingstone Country of Publication: United States NLM ID: 100898657 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-8447 (Electronic) Linking ISSN: 15265900 NLM ISO Abbreviation: J Pain Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : Churchill Livingstone, c2000- |
| Ιατρικοί όροι (MeSH): | Referred Pain*/physiopathology , Nociception*/physiology , Myofascial Pain Syndromes*/physiopathology , Nociceptive Pain*/physiopathology, Central Nervous System Sensitization/physiology ; Humans ; Male ; Female ; Adult ; Middle Aged ; Young Adult ; Pain Measurement |
| Περίληψη: | Referred pain frequently occurs in musculoskeletal pain disorders. The differential role of peripheral (nociceptive drive) and central (pain processing) domains associated with referred pain was investigated. Utilizing TMJ IMPACT Project data, 293 participants were classified into 2 groups: referred pain (n=118) and local pain (n=175). Each domain of nociceptive drive and central processing was comprised of 7 observed variables as predictors based on face validity. Latent variables for each domain were constructed using confirmatory factor analysis (CFA). Univariate associations of predictors and multivariate associations of latent variables were tested with logistic models. Referred pain, compared to local pain, was associated with each of 6 nociceptive drive predictors (odds ratios (ORs) ranging 1.03-1.41), and 4 central processing predictors (ORs ranging 1.03-1.8); confidence limits (95%) were appropriately narrow. The latent variable model indicated that nociceptive drive was comprised of non-specific orofacial symptoms, pain-free opening, mobility assessment-based hyperalgesia, pain sensitivity (trigeminal), joint sounds, and painful body-manikin sites above the neck. Central processing was comprised of non-specific body symptoms, perceived stress, pain-catastrophizing, and painful body-manikin sites below the neck. The CFA model fit was marginally acceptable. Using latent variables, referred pain was univariately associated with nociceptive drive (OR=2.5; 95%CL=1.8-3.3) and central processing (OR=1.7; 95%CL=1.3-2.2). In the multivariate model, nociceptive drive remained significant (OR=2.4; 95%CL=1.7-3.3), whereas central processing did not. While nociceptive drive and central mechanisms are distinct but overlapping contributors based on multiple indicators, the processes associated with the nociceptive drive indicators may be primary for activation of pain referral. PERSPECTIVE: Both nociceptive drive and central pain processing are involved with the report of referred pain. Using a latent variable model, nociceptive drive indicators reflecting masticatory system sensory changes dominate and point to the need for a broad, peripherally oriented therapeutic approach to restore normal function of the masticatory system. (Copyright © 2025 United States Association for the Study of Pain, Inc. Published by Elsevier Inc. All rights reserved.) |
| Grant Information: | U01 DE019784 United States DE NIDCR NIH HHS |
| Contributed Indexing: | Keywords: Central pain mechanism; Myofascial pain; Nociceptive drive; Referred pain |
| Entry Date(s): | Date Created: 20251207 Date Completed: 20260122 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC12770823 |
| DOI: | 10.1016/j.jpain.2025.105629 |
| PMID: | 41354129 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1528-8447 |
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| DOI: | 10.1016/j.jpain.2025.105629 |