Advertisement

Association of somatosensory dysfunction with symptom duration in burning mouth syndrome

  • Kosuke Watanabe
  • Noboru NomaEmail author
  • Naohiko Sekine
  • Daiki Takanezawa
  • Chisa Hirota
  • Eli Eliav
  • Yoshiki Imamura
Original Article

Abstract

Objectives

A standardized battery of quantitative sensory tests developed by the German Research Network on Neuropathic Pain (DFNS) was used to assess the association between somatosensory dysfunction and disease duration in patients with burning mouth syndrome (BMS).

Materials and methods

The 28 female participants with BMS were classified according to disease duration: ≤ 6 months (subchronic BMS, n = 15) and > 6 months (chronic BMS, n = 13); 29 age- and sex-matched healthy volunteers (control group) were recruited from staff of a dental hospital. The DFNS quantitative sensory testing protocol was applied at the ulnar surface of the right forearm and the tip of the tongue. Values for BMS patients and controls were compared and analyzed.

Results

The mechanical detection threshold (MDT) was significantly higher (i.e., loss of sensation) at the tongue tip in the chronic BMS group than in the control group (p = 0.011), whereas mechanical pain sensitivity (MPS) at the forearm was significantly higher (i.e., gain of sensation) in the chronic BMS group than in the control group (Z score = − 2.13 and 1.99, respectively). Multivariate analyses revealed that BMS patients could be discriminated from controls by using pressure pain threshold at the tongue (79.3%) (in the subchronic BMS group) and by MDT and MPS at the tongue tip and MPS at the forearm (96.6 and 89.7%, respectively) (in the chronic BMS group).

Conclusions

In BMS patients with long disease duration, MDT showed loss of sensation.

Clinical relevance

Increased MPS suggests that a neuropathic mechanism in the peripheral and central nervous systems is involved in BMS development.

Keywords

Burning mouth syndrome Quantitative sensory testing German Research Network on Neuropathic Pain 

Notes

Funding

This study was supported in part by research grants from the Sato and Uemura funds, Dental Research Center from the Nihon University School of Dentistry, and a Nihon University Multi-disciplinary Research Grant.

Compliance with ethical standards

Conflict of interest

The author declares that they have no conflict of interest.

Ethical approval

This study was approved by the Ethical Committee of Nihon University School of Dentistry (EP16 D021).

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Eliav E, Gracely RH, Nahlieli O, Benoliel R (2004) Quantitative sensory testing in trigeminal nerve damage assessment. J Orofac Pain 18(4):339–344PubMedGoogle Scholar
  2. 2.
    Eliav E, Kamran B, Schaham R, Czerninski R, Gracely RH, Benoliel R (2007) Evidence of chorda tympani dysfunction in patients with burning mouth syndrome. J Am Dent Assoc 138(5):628–633PubMedGoogle Scholar
  3. 3.
    Forssell H, Jääskeläinen S, Tenovuo O, Hinkka S (2002) Sensory dysfunction in burning mouth syndrome. Pain 99(1–2):41–47PubMedGoogle Scholar
  4. 4.
    Grushka M, Epstein JB (2002) Burning mouth syndrome. Am Fam Physician 65(4):615–620PubMedGoogle Scholar
  5. 5.
    Jääskeläinen SK (2004) Clinical neurophysiology and quantitative sensory testing in the investigation of orofacial pain and sensory function. J Orofac Pain 18:85–107PubMedGoogle Scholar
  6. 6.
    Lauria G, Majorana A, Borgna M, Lombardi R, Penza P, Padovani A, Sapelli P (2005) Trigeminal small-fiber sensory neuropathy causes burning mouth syndrome. Pain 115(3):332–337PubMedGoogle Scholar
  7. 7.
    Femiano F, Gombos F, Scully C (2004) Burning mouth syndrome: the efficacy of lipoic acid on subgroups. J Eur Acad Dermatology Venereol 18(6):676–678Google Scholar
  8. 8.
    Grushka M, Epstein JB, Gorsky M (2003) Burning mouth syndrome and other oral sensory disorders: a unifying hypothesis. Pain Res Manag 8(3):133–135PubMedGoogle Scholar
  9. 9.
    Hershkovich O, Nagler RM (2004) Biochemical analysis of saliva and taste acuity evaluation in patients with burning mouth syndrome, xerostomia and/or gustatory disturbances. Arch Oral Biol 49(7):515–522PubMedGoogle Scholar
  10. 10.
    Hagelberg N, Forssell H, Rinne JO, Scheinin H, Taiminen T, Aalto S, Luutonen S, Någren K, Jääskeläinen S (2003) Striatal dopamine D1 and D2 receptors in burning mouth syndrome. Pain 101(1–2):149–154PubMedGoogle Scholar
  11. 11.
    Jääskeläinen SK (2012) Pathophysiology of primary burning mouth syndrome. Clin Neurophysiol 123(1):71–77PubMedGoogle Scholar
  12. 12.
    Nasri-Heir C, Gomes J, Heir GM, Ananthan S, Benoliel R, Teich S, Eliav E (2011) The role of sensory input of the chorda tympani nerve and the number of fungiform papillae in burning mouth syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112(1):65–72PubMedGoogle Scholar
  13. 13.
    Merskey H, Bogduk N (1994) Classification of chronic pain: descriptions of chronic painsyndrome and definitions of pain terms, 2nd edn. IASP Press, SeattleGoogle Scholar
  14. 14.
    Loeser JD, Butler SH, Chapman CR, Turk DC (eds) (2001) Bonica's management of pain, 3rd edn. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  15. 15.
    Berry PH, Chapman CR, Covington EC, et al (2001) Pain: current understanding of assessment, management and treatments. National Pharmaceutical Council, INCGoogle Scholar
  16. 16.
    Tighe P, Buckenmaier CC, Boezaart AP et al (2015) Acute pain medicine in the United States: a status report. Pain Med (United States) 16(9):1806–1826Google Scholar
  17. 17.
    IHS (2018) ICHD-3: the international classification of headache disorders 3rd edition. Int Headache Soc 38(1):1–211Google Scholar
  18. 18.
    Rolke R, Baron R, Maier C, Tölle TR, Treede DR, Beyer A, Binder A, Birbaumer N, Birklein F, Bötefür IC, Braune S, Flor H, Huge V, Klug R, Landwehrmeyer GB, Magerl W, Maihöfner C, Rolko C, Schaub C, Scherens A, Sprenger T, Valet M, Wasserka B (2006) Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values. Pain 123(3):231–243PubMedGoogle Scholar
  19. 19.
    Rolke R, Magerl W, Campbell KA, Schalber C, Caspari S, Birklein F, Treede RD (2006) Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain 10(1):77–88PubMedGoogle Scholar
  20. 20.
    Yilmaz Z, Egbuniwe O, Renton T (2016) The detection of small-fiber neuropathies in burning mouth syndrome and iatrogenic lingual nerve injuries: use of quantitative sensory testing. J Oral Facial Pain Headache 30(2):87–98PubMedGoogle Scholar
  21. 21.
    Hartmann A, Seeberger R, Bittner M, Rolke R, Welte-Jzyk C, Daubländer M (2017) Profiling intraoral neuropathic disturbances following lingual nerve injury and in burning mouth syndrome. BMC Oral Health 17(1):68PubMedPubMedCentralGoogle Scholar
  22. 22.
    Svensson P, Bjerring P, Arendt-Nielsen L, Kaaber S (1993) Sensory and pain thresholds to orofacial argon laser stimulation in patients with chronic burning mouth syndrome. Clin J Pain 9(3):207–215PubMedGoogle Scholar
  23. 23.
    Mo X, Zhang J, Fan Y et al (2015) Thermal and mechanical quantitative sensory testing in Chinese patients with burning mouth syndrome—a probable neuropathic pain condition? J Headache Pain 16:84PubMedPubMedCentralGoogle Scholar
  24. 24.
    Kaplan I, Levin T, Papoiu ADP, Patel N, Patel T, Calderon S, Littner M, McGlone F, Yosipovitch G (2011) Thermal sensory and pain thresholds in the tongue and chin change with age, but are not altered in burning mouth syndrome. Skin Res Technol 17(2):196–200PubMedGoogle Scholar
  25. 25.
    Jaaskelainen SK, Forssell H, Tenovuo O (1997) Abnormalities of the blink reflex in burning mouth syndrome. Pain 73(3):455–460PubMedGoogle Scholar
  26. 26.
    Puhakka A, Forssell H, Soinila S, Virtanen A, Röyttä M, Laine M, Tenovuo O, Teerijoki-Oksa T, Jääskeläinen SK (2016) Peripheral nervous system involvement in primary burning mouth syndrome—results of a pilot study. Oral Dis 22(4):338–344PubMedGoogle Scholar
  27. 27.
    Escolano-Lozano F, Barreiros AP, Birklein F, Geber C (2018) Transthyretin familial amyloid polyneuropathy (TTR-FAP): parameters for early diagnosis. Brain Behav 8(1):e00889PubMedGoogle Scholar
  28. 28.
    Just T, Steiner S, Pau HW (2010) Oral pain perception and taste in burning mouth syndrome. J Oral Pathol Med 39(1):22–27PubMedGoogle Scholar
  29. 29.
    Grushka M, Sessle BJ, Howley TP (1987) Psychophysical assessment of tactile, pain and thermal sensory functions in burning mouth syndrome. Pain 28(2):169–184PubMedGoogle Scholar
  30. 30.
    Ito M, Kurita K, Ito T, Arao M (2002) Pain threshold and pain recovery after experimental stimulation in patients with burning mouth syndrome. Psychiatry Clin Neurosci 56(2):161–168PubMedGoogle Scholar
  31. 31.
    Gremeau-Richard C, Dubray C, Aublet-Cuvelier B et al (2010) Effect of lingual nerve block on burning mouth syndrome (stomatodynia): a randomized crossover trial. Pain 149(1):27–32PubMedGoogle Scholar
  32. 32.
    Albuquerque RJCC, de Leeuw R, Carlson CR, Okeson JP, Miller CS, Andersen AH (2006) Cerebral activation during thermal stimulation of patients who have burning mouth disorder: an fMRI study. Pain 122(3):223–234PubMedGoogle Scholar
  33. 33.
    Khan SA, Keaser ML, Meiller TF et al (2014) Altered structure and function in the hippocampus and medial prefrontal cortex in patients with burning mouth syndrome. Pain 155(8):1472–1480PubMedGoogle Scholar
  34. 34.
    Shinozaki T, Imamura Y, Kohashi R, Dezawa K, Nakaya Y, Sato Y, Watanabe K, Morimoto Y, Shizukuishi T, Abe O, Haji T, Tabei K, Taira M (2016) Spatial and temporal brain responses to noxious heat thermal stimuli in burning mouth syndrome. J Dent Res 95(10):1138–1146PubMedGoogle Scholar
  35. 35.
    Sinding C, Gransjoen AM, Schlumberger G et al (2016) Grey matter changes of the pain matrix in patients with burning mouth syndrome. Eur J Neurosci 43(8):997–1005PubMedGoogle Scholar
  36. 36.
    Wada A, Shizukuishi T, Kikuta J, Yamada H, Watanabe Y, Imamura Y, Shinozaki T, Dezawa K, Haradome H, Abe O (2017) Altered structural connectivity of pain-related brain network in burning mouth syndrome—investigation by graph analysis of probabilistic tractography. Neuroradiology 59(5):525–532PubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Kosuke Watanabe
    • 1
    • 2
  • Noboru Noma
    • 1
    • 2
    Email author
  • Naohiko Sekine
    • 1
    • 2
  • Daiki Takanezawa
    • 1
    • 2
  • Chisa Hirota
    • 1
    • 2
  • Eli Eliav
    • 3
  • Yoshiki Imamura
    • 1
    • 2
  1. 1.Department of Oral Diagnostic SciencesNihon University School of DentistryTokyoJapan
  2. 2.Clinical Research Division, Dental Research InstituteNihon University School of DentistryTokyoJapan
  3. 3.Eastman Institute for Oral HealthUniversity of Rochester Medical CenterRochesterUSA

Personalised recommendations