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Human Experimental Pain Models
Author Bios
Learning Objectives
Clinical Significance and Phenomenology
Complex Diseases: Need to Simplify
Model Requirements
Brief and Sustained Experimental Pain
Choice of the Pain Stimulus
A Model Design for Pain Experimentation
Experiential Adjustment
Choice of Stimulation Site
Currently selected section: Stimulation Site for a Study of TMJD
Experimental Design
Model Validation: Level 1
Model Validation: Level 2
Model Validation: Level 3
Model Validation: An Example
Cross-Validation with Other Model Systems
Model Systems as Tools
Sample Size Estimation
Potential Difficulties
Conclusion

 

Chapter 21: Human Experimental Pain Models: Stimulation Site for a Study of TMJD
        

Symptom research into TMJD has been guided by a dual axes taxonomy (RDC/TMJD) for the major types of TMJD (Dworkin and LeResche, 1992). Axis I distinguishes three major diagnostic subsets: (1) Group I: Masticatory myofascial pain, (2) Group II: TMJ internal derangements, and (3) Group III: TMJ arthritides. Axis II criteria serve to assess pain intensity, pain-related disability, and the presence and severity of depressive and anxiety symptoms (See: Chapters 22 Dworkin and 26 LeResche). About half of all TMJD cases are classified as masticatory myofascial pain (List and Dworkin, 1996; Maes, Lin et al., 1998). As far as the muscle-based TMJD/RDC Group I disorders are concerned, a report of pain or ache in the jaw, temples, face, preauricular area, or inside the ear at rest or during function is required for case assignment. As illustrated below, the masseter muscle appears to be the target of choice for pain induction since most clinical pain reports include this particular location.

Figure 10.1: Spatial Distribution of Pain Reports
Graphic depiction of spatial distribution of pain reports, described in text.

Spatial distribution of reports of pain reported by patients with confirmed muscle-based TMJD/RDC Group I diagnosis. As shown, the overwhelming majority of patients complain of pain in the area of the masseter muscle, indicated by red. (Unpublished data).


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