Difference between revisions of "Trigeminal Nociceptive Evaluation in TMD Patients by studying CO2-Laser Evoked Potentials and Masseter Laser Silent Periods"

Trigeminal Nociceptive Evaluation in TMD Patients by studying CO2-Laser Evoked Potentials and Masseter Laser Silent Periods (view source)

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 ====Laser-Evoked Potentials (LEPs)====
 No significant differences in PTh were found between the two groups and sides (P > 0.20). However, TMD patients perceived the suprathreshold stimulus used for LEP recording as less intense on the painful side compared to the non-painful side (P < 0.05). The latency of the N and P components in patients was comparable to that of healthy controls (Figure 1).
-[[File:LEPs_and_LSP.png|thumb|right|Figure 1: A. Example of laser-evoked potentials (LEPs) from perioral stimulation (V2/V3) in a healthy subject and a TMD patient. LEP amplitude is significantly reduced in TMD patients (P < 0.001). The figure shows the overlaid average of 2 blocks of 8-12 traces each. Analysis time: 1000 ms; vertical calibration: 20 μV. B. Example of laser silent period (LSP) recorded from right (R) and left (L) masseter muscles in a healthy subject and a TMD patient with craniofacial pain on the left side. In the TMD patient, pre-stimulus EMG activity is reduced on the painful side, and no LSPs were recorded bilaterally. Analysis time: 100 ms pre-stimulus; 300 ms post-stimulus. Vertical calibration: 200 μV.]]
 Conversely, LEP amplitude was lower in patients compared to healthy subjects, by 30-50% (P < 0.001). Moreover, in patients, the reduction in LEP amplitude was more pronounced on the painful side (P < 0.001) (Figure 1A).
 ====Laser Silent Periods (LSP)====
-In all control subjects, high-intensity laser stimuli (approximately 4 x PTh) delivered to the perioral region bilaterally elicited an EMG suppression phase during masseter muscle contraction. The latency (70.2 ± 6.8 ms) and duration (50 ± 9.8 ms) of LSP were symmetrical in control subjects. In patients, LSP was absent bilaterally in 12 of them, regardless of the stimulated side (Figure 1B). In the remaining 3 patients, 2 (TMD with myofascial pain and arthralgia) presented LSP only on the non-painful side, and 1 (TMD with myofascial pain) had normal and symmetrical LSP. Additionally, pre-stimulus EMG activity in TMD patients was reduced by 50% on the painful side and by 15% on the non-painful side compared to control subjects.
+In all control subjects, high-intensity laser stimuli (approximately 4 x PTh) delivered to the perioral region bilaterally elicited an EMG suppression phase during masseter muscle contraction. The latency (70.2 ± 6.8 ms) and duration (50 ± 9.8 ms) of LSP were symmetrical in control subjects. In patients, LSP was absent bilaterally in 12 of them, regardless of the stimulated side (Figure 1B). In the remaining 3 patients, 2 (TMD with myofascial pain and arthralgia) presented LSP only on the non-painful side, and 1 (TMD with myofascial pain) had normal and symmetrical LSP. Additionally, pre-stimulus EMG activity in TMD patients was reduced by 50% on the painful side and by 15% on the non-painful side compared to control subjects.<gallery mode="slideshow">
+File:Figure 1 (Romaniello).jpg|'''Figure 1:''' A. Example of laser-evoked potentials (LEPs) from perioral stimulation (V2/V3) in a healthy subject and a TMD patient. LEP amplitude is significantly reduced in TMD patients (P < 0.001). The figure shows the overlaid average of 2 blocks of 8-12 traces each. Analysis time: 1000 ms; vertical calibration: 20 μV. B. Example of laser silent period (LSP) recorded from right (R) and left (L) masseter muscles in a healthy subject and a TMD patient with craniofacial pain on the left side. In the TMD patient, pre-stimulus EMG activity is reduced on the painful side, and no LSPs were recorded bilaterally. Analysis time: 100 ms pre-stimulus; 300 ms post-stimulus. Vertical calibration: 200 μV.
+</gallery>
 ===Discussion===