TMJ disorders and myogenic facial pain: a discriminative analysis using the McGill Pain Questionnaire

Abstract

Our aim was to assess the discriminative capacity of the McGill Pain Questionnaire (MPQ) in patients with temporomandibular joint (TMJ) disorders or with myogenous facial pain (MP). The MPQ was administered to 57 TMJ and 28 MP patients who were also asked to assess the level of pain using the Visual Analog Scale (VAS). Weighted MPQ item scores, subscale Pain Rating Indexes (PRI), total PRI and the number of words chosen were calculated. Mean scores were tested for significant differences (Student's t-test), and the frequency with which each descriptor was chosen by the patients in both groups was analyzed. Data were also processed through two systems based on a counter-propagation neural network: the Self-Organizing Map (SOM) system, and a cluster-like analysis. In the MP group, 16 out of 20 mean MPQ item scores and all mean PRI and VAS scores were significantly higher than those in the TMJ group. There was a marked difference in descriptor choice. In the TMJ group the following descriptors were chosen by 25% or more of the patients: tiring, troublesome, nagging, sore, tender, and aching. In the MP group the descriptors most frequently chosen were: 'exhausting' (57%), 'punishing' (50%), and pulling (47%). SOM analysis distributed the two groups in the two halves of the map: only two out of 28 MP cases (7%) and 12 out of 57 TMJ cases (21%) were misplaced. The cluster-like analysis based on the 20 MPQ item scores correctly recognized 94.73% of TMJ patients and 89.28% of MP patients. In conclusion, the MPQ consistently discriminated between TMJ and MP patients. Although the higher affective scores in the MP patients may be partly induced by higher levels of anxiety in these patients, the data convincingly show that the system's discriminative capacity relates to all MPQ subscores and to the majority of the MPQ items. Moreover, within the same item, the choice of verbal descriptors varies consistently between the two groups of patients.

Psychological profile and self-administered relaxation in patients with craniofacial pain: a prospective in-office study

“…This is consistent with findings indicating that the preference of MPQ pain descriptors is associated with pain chronicity [67] as well as pain type and localization [68]. In contrast to other TMD sufferers, patients with primarily myogenic facial pain and headache choose more affective descriptors and rate the pain as more intensive [24,52,67,68]. The higher psychosomatic burden reflected by the CL scores underpins the picture of subjects who display various pain locations of similar intensity and a number of accessory complaints.…”

Signs and Symptoms of Temporomandibular Dysfunction in Fibromyalgic Patients

“…Moreover, TMJ pain, as a clinical sign, is a common finding in FM patients, also reported in a previous study, 6 but with a lower incidence than muscle pain. These findings indicated that MMP is an important factor in the coexistence of FM and TMD as reported by Leblebici et al 8 Besides, considering that TMD is classically characterized by (1) TMJ pain and/or masticatory muscles pain, (2) TMJ sound, and (3) alteration in the mandibular movements, 41,42 we found that 68.4% of the subjects presented 2 or 3 signs of TMD at the same time. Our results suggest that many FM patients have clinical characteristics of TMD, which can render FM management difficult.…”

Confirmation of the Distinction Between Chronic Migraine and Chronic Tension‐type Headache by the McGill Pain Questionnaire

“…The basic difference between SOM and traditional vector quantization techniques is that SOM is a completely data‐driven, unsupervised learning method. Details relative to the application of this methodology to MPQ data have been previously described 25 …”

“…It has been found that the MPQ satisfactorily discriminates between reversible and irreversible tooth nerve damage, 19 trigeminal neuralgia and atypical facial pain, 20 cluster headache and migraine, 21 and between various types of facial pain 22,23 . More recently, the MPQ consistently discriminated between craniomandibular joint pain and facial pain as a somatoform disorder, 24 and between temporomandibular joint (TMJ) pain and myogenic facial pain 25 …”