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Deprecated: Implicit conversion from float 282.79999999999995 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Pain 2015 ; 16 (3): 247-57 Nephropedia Template TP
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Parasympathetic Reactivity in Fibromyalgia and Temporomandibular Disorder: Associations with Sleep Problems, Symptom Severity, and Functional Impairment #MMPMID25542636
Eisenlohr-Moul TA; Crofford LJ; Howard T; Yepes JF; Carlson CR; de Leeuw R
J Pain 2015[Mar]; 16 (3): 247-57 PMID25542636show ga
Despite evidence of autonomic disturbances in chronic multi-symptom illnesses such as temporomandibular joint disorder (TMD) and fibromyalgia (FM), additional work is needed to characterize the role of parasympathetic reactivity in these disorders. Given the high levels of comorbidity with psychiatric disorders characterized by stronger parasympathetic reductions than controls in safe contexts (leading to higher arousal), it was hypothesized that individuals with TMD and FM would respond similarly. In this preliminary investigation, 43 women with TMD (n = 17), TMD + FM (n = 11), or neither (controls; n = 15) completed a baseline assessment of respiratory sinus arrhythmia (RSA; a measure of parasympathetic activity) followed by ongoing parasympathetic assessment during a questionnaire period. As predicted, patients showed greater parasympathetic decline in response to the questionnaire period, suggesting an autonomic stance that supports defensive rather than engagement behaviors. Individual differences in parasympathetic reduction during the questionnaire period were related to a variety of physical and psychosocial variables. Although this study has a number of key limitations, including a convenience sampling approach and the small group sizes, if replicated in larger samples, the findings would have important implications for the treatment of patients with these disorders.Perspective: Compared to controls, individuals with temporomandibular disorders or temporomandibular disorder and fibromyalgia demonstrated greater parasympathetic reduction during psychosocial assessment, and individual differences in parasympathetic reduction predicted negative patient outcomes. Such parasympathetic reductions may betray a tendency to readily perceive danger in safe environments.