Summary of Findings From the OPPERA Prospective Cohort Study of Incidence of First-Onset Temporomandibular Disorder: Implications and Future Directions

JOURNAL OF PAIN

卷:14

Article

Slade, Gary D.^1,2,3  Fillingim, Roger B.^7,8  Sanders, Anne E.^1,2  Bair, Eric^1,4,5  Greenspan, Joel D.^9,10,11  Ohrbach, Richard¹²  Dubner, Ronald^9,10,11  Diatchenko, Luda^1,4,13,14,15  Smith, Shad B.^1,4  Knott, Charles¹⁶  Maixner, William^1,4,6 

[1] Univ N Carolina, Reg Ctr Neurosensory Disorders, Chapel Hill, NC USA

[2] Univ N Carolina, Dept Dent Ecol, Chapel Hill, NC USA

[3] Univ N Carolina, Dept Epidemiol, Chapel Hill, NC USA

[4] Univ N Carolina, Dept Endodont, Chapel Hill, NC USA

[5] Univ N Carolina, Dept Biostat, Chapel Hill, NC USA

[6] Univ N Carolina, Dept Pharmacol, Chapel Hill, NC USA

[7] Univ Florida, Coll Dent, Dept Community Dent & Behav Sci, Gainesville, FL USA

[8] Pain Res & Intervent Ctr Excellence, Gainesville, FL USA

[9] Univ Maryland, Sch Dent, Dept Oral & Maxillofacial Surg, Baltimore, MD 21201 USA

[10] Univ Maryland, Sch Dent, Dept Neural & Pain Sci, Baltimore, MD 21201 USA

[11] Univ Maryland, Sch Dent, Brotman Facial Pain Ctr, Baltimore, MD 21201 USA

[12] SUNY Buffalo, Dept Oral Diagnost Sci, Buffalo, NY 14260 USA

[13] Univ N Carolina, Carolina Ctr Genome Sci, Chapel Hill, NC USA

[14] McGill Univ, Dept Anesthesia, Montreal, PQ, Canada

[15] McGill Univ, Alan Edwards Ctr Res Pain, Montreal, PQ, Canada

[16] Battelle Mem Inst, Durham, NC USA

关键词: Temporomandibular disorder;    cohort studies;    epidemiology;    psychological factors;    clinical pain;    comordid conditions;    pain sensitivity;    genetics;   

DOI  :  10.1016/j.jpain.2013.09.010

来源: Elsevier

【 摘 要 】

Papers in this issue investigate when and how putative risk factors influence development of first-onset, painful temporomandibular disorder (TMD). The results represent first findings from the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) prospective cohort study that monitored 2,737 men and women aged 18 to 44 years recruited at 4 U.S. study sites. During a median 2.8-year follow-up period, 260 participants developed TMD. The average incidence rate of 4% per annum was influenced by a broad range of phenotypic risk factors including sociodemographic characteristics, health status, clinical orofacial factors, psychological functioning, pain sensitivity, and cardiac autonomic responses. A novel method of multivariable analysis used random forest models to simultaneously evaluate contributions of all 202 phenotypic variables. Variables from the health status domain made the greatest contribution to TMD incidence, followed closely by psychological and clinical orofacial domains. However, only a few measures of pain sensitivity and autonomic function contributed to TMD incidence, and their effects were modest. Meanwhile, age and study site were independent predictors of TMD incidence, even after controlling for other phenotypes. Separate analysis of 358 genes that regulate pain found several novel genetic associations with intermediate phenotypes that, themselves, are risk factors for TMD, suggesting new avenues to investigate biological pathways contributing to TMD. (C) 2013 by the American Pain Society

【 授权许可】

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