Alexithymic and somatisation scores in patients with temporomandibular pain disorder correlate with deficits in facial emotion recognition

Abstract

Current studies suggest dysfunctional emotional processing as a key factor in the aetiology of temporomandibular disorder (TMD). Investigating facial emotion recognition (FER) may offer an elegant and reliable way to study emotional processing in patients with TMD. Twenty patients with TMD and the same number of age-, sex- and education-matched controls were measured with the Facially Expressed Emotion Labelling (FEEL) test, the 26-item Toronto Alexithymia Scale (TAS-26), the Screening for Somatoform Symptoms (SOMS-2a), the German Pain Questionnaire and the 21-item Hamilton Depression Rating Scale (HAMD). The patients had significantly lower Total FEEL Scores (P = 0·021) as compared to the controls, indicating a lower accuracy of FER. Furthermore, we were able to demonstrate significant group differences with respect to the following issues: patients were more alexithymic (P = 0·006), stated more somatoform symptoms (P < 0·004) and had higher depressive scores in the HAMD (P < 0·003). The factors alexithymia and somatisation could explain 31% (adjusted 27%) of the variance of the FEEL Scores in the sample. The estimation of the standardised regression coefficients suggests an equivalent influence of TAS-26 and SOMS-2a on the FEEL Scores, whereas 'group' (patients versus healthy controls) and depressive symptoms did not contribute significantly to the model. Our findings highlight FER deficits in patients with TMD, which are partially explained by concomitant alexithymia and somatisation. As suggested previously, impaired FER in patients with TMD may further point to probable aetiological proximities between TMD and somatoform disorders.

Alexithymia partly predicts pain, poor health and social difficulties in patients with temporomandibular disorders

“…When facets of alexithymia were considered, 10% of pain was predicted by DIF, DDF and age; 38% of poor health was predicted by DIF and age; finally, 13% of social difficulty was predicted by DIF. These results are line with recent findings highlighting facial emotion recognition deficits in patients with TMD (21).…”

Effect of brain training through visual mirror feedback, action observation and motor imagery on orofacial sensorimotor variables: A single‐blind randomized controlled trial

“…The data employed for the analysis consisted of 3 consecutive measurements of the PPT at the 2 locations taken at 30‐second intervals, using the mean of these measurements. Chesterton et al (2007) showed that the reliability of pressure algometry is high (intraclass correlation coefficient [ICC], 0.91; 95% confidence interval [CI] 0.82‐0.97) …”

“…Brain representation training‐based interventions such as MI, AO and VMF have been proposed as novel therapeutic tools to facilitate motor cortex activity, with or without the actual exercise, for patients who are unable to perform the movements . In this regard, this type of intervention could have a favourable effect on patients with temporomandibular disorders and those with dysphagia in whom pain sensitivity, tongue weakness or motor and emotional processing could be disrupted and related to the maintenance and appearance of the pathologic condition . The combination of motor control exercises and MI has also shown statistically significant changes in sensorimotor function variables of the craniocervical region and in the subjective perception of fatigue, when compared with exercises performed in isolation .…”

Reduction of head and face pain by challenging lateralization and basic emotions: a proposal for future assessment and rehabilitation strategies

“…21,22 The ability to recognize faces and facial expressions and participate directly, is required for a perfect intercommunicative relationship. 23 Research studies have shown that diminished quality and quantity of facial expression is associated with chronic face pain, temporomandibular dysfunction, facial asymmetries, and neurological disorders, such as facial paresis and Parkinson's disease; however, it can also be influenced by affective dysfunctions such as depression. 13,24,25 To understand one's own feelings and display them is closely connected with the ability to recognize and interpret them through mimicry and gestures to other human beings.…”

“…13,24,25 To understand one's own feelings and display them is closely connected with the ability to recognize and interpret them through mimicry and gestures to other human beings. 23,26 When a person recognizes an emotion in another's face, it stimulates a response to mimic the facial expression with their own facial muscles; this has been called the facial reflex. (Fig.…”