Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20190027
Brazilian Journal of Pain
Original Article

Use of non-invasive neuromodulation in the treatment of pain in temporomandibular dysfunction: preliminary study

Uso da neuromodulação não invasiva no tratamento da dor em disfunção temporomandibular: um estudo preliminar

Tatyanne dos Santos Falcão Silva; Melyssa Kellyane Cavalcanti Galdino; Suellen Mary Marinho dos Santos Andrade; Luciana Barbosa Sousa de Lucena; Renata Emanuela Lyra de Brito Aranha; Evelyn Thais de Almeida Rodrigues

http://dx.doi.org/10.5935/2595-0118.20190027 BrJP, vol.2, n2, p.147-154, 2019
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Abstract

BACKGROUND AND OBJECTIVES: In temporomandibular disorder, the pain is a very present and striking symptom, with a tendency to chronicity, through mechanisms of maladaptive neuroplasticity. In the face of this, transcranial direct current stimulation appears as a possible strategy for the treatment of chronic pain in the temporomandibular disorder. This study aimed to evaluate the efficacy of anodal transcranial direct current stimulation in the pain symptoms and anxiety levels in individuals with chronic myofascial temporomandibular disorder.

METHODS: The participants received three different types of intervention in a randomized order: anodic in the primary motor cortex, in the dorsolateral prefrontal cortex and sham stimulation.

RESULTS: There were significant improvements in clinical pain in all stimulation protocols, with a relief of approximately 40% (p=0.001). There was no significant difference in the effect of the transcranial direct current stimulation between the different types of stimulation (p=0.14). There was a positive impact on anxiety symptoms, leading to a significant decrease in state anxiety levels (p=0.035) and trait (p=0.009).

CONCLUSION: The use of the transcranial direct current stimulation improved the health status of patients with chronic myofascial temporomandibular disorder, promoting pain relief, decreased level of anxiety, and quality of life.

Keywords

Orofacial pain, Rehabilitation, Transcranial stimulation by continuous current

Resumo

JUSTIFICATIVA E OBJETIVOS: Na disfunção temporomandibular, a dor aparece de forma frequente e marcante, com tendência à cronicidade, através de mecanismos de neuroplasticidade mal adaptativo. Diante disso, a estimulação transcraniana por corrente contínua surge como uma possível estratégia de tratamento da dor crônica em disfunção temporomandibular. O presente estudo objetivou avaliar a eficácia da estimulação transcraniana por corrente contínua anódica nos sintomas dolorosos e, por conseguinte, nos níveis de ansiedade em indivíduos com disfunção temporomandibular muscular crônica.

MÉTODOS: Os participantes receberam três tipos diferentes de intervenção cuja ordem foi randomizada: anódica no córtex motor primário, na região cortical dorsolateral pré-frontal e estimulação simulada.

RESULTADOS: Houve melhorias significativas para a dor clínica em todos os protocolos de estimulação, com um alívio de aproximadamente 40% (p=0,001). Não houve diferença significativa no efeito da estimulação transcraniana por corrente contínua entre os diferentes tipos de estimulação (p=0,14). Ocorreu impacto positivo sobre os sintomas de ansiedade, com diminuição significativa nos níveis de ansiedade estado (p=0,035) e traço (p=0,009).

CONCLUSÃO: O uso da estimulação transcraniana por corrente contínua melhorou a condição de saúde dos portadores de disfunção temporomandibular muscular crônica, promovendo um alívio do quadro álgico, diminuição do nível de ansiedade, além de gerar qualidade de vida.

Palavras-chave

Dor orofacial, Estimulação transcraniana por corrente contínua, Reabilitação

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Submitted date:
09/30/2018

Accepted date:
03/11/2019

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