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Quintessence Publishing: Journals: OFPH
Journal of Oral & Facial Pain and Headache

Edited by Barry J. Sessle, BDS, MDS, BSc, PhD, FRSC

Official Journal of the American Academy of Orofacial Pain,
the European, Asian, and Ibero-Latin Academies of Craniomandibular
Disorders, and the Australian Academy of Orofacial Pain

ISSN 2333-0384 (print) • ISSN 2333-0376 (online)

Publication:
Summer 2011
Volume 25 , Issue 3

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Nocturnal Heart Rate Variability Is Lower in Temporomandibular Disorder Patients Than in Healthy, Pain-free Individuals

Chete M. Eze-Nliam, MD, MPH/Phillip J. Quartana, PhD/Angela M. Quain, RPSGT/Michael T. Smith, PhD, CBSM

Pages: 232239
PMID: 21837290

Aims: To determine whether patients with a painful myofascial temporomandibular disorder (TMD) have diminished nocturnal heart rate variability (HRV), a marker of autonomic nervous system (ANS) dysfunction, relative to healthy, pain-free controls. Methods: Participants with myofascial TMD and healthy, pain-free volunteers underwent nocturnal polysomnography studies during which HRV indices were measured. Multiple linear regression analyses were used to determine whether TMD status exerted unique effects on HRV. Results: Ninety-five participants (n = 37 TMD; n = 58 controls) were included in the analyses. The TMD group had a lower standard deviation of R-R intervals (89.81 23.54 ms versus 107.93 34.42 ms, P ≤ .01), a lower root mean squared successive difference (RMSSD) of R-R intervals (54.78 27.37 ms versus 81.88 46.43 ms, P < .01), and a lower high frequency spectral power (2336.89 1224.64 ms2 versus 2861.78 1319 ms2, P = .05) than the control group. The ratio of the low-frequency (LF) to the high-frequency (HF) spectral power was higher in the TMD group (2.47 2 versus 1.38 0.65, P < .01). The differences in RMSSD (91.21 ms versus 112.03 ms, P = .05) and LF:HF ratio (0.71 versus 0.32, P < .01) remained significant after controlling for age and psychological distress. Conclusion: Myofascial TMD patients revealed lower nocturnal HRV than healthy, pain-free controls. Further research should focus on processes that address this ANS imbalance, which may potentially lead to effective therapeutic interventions. J Orofac Pain 2011;25:232239

Key words: autonomic dysfunction, chronic pain syndrome, heart rate variability, sympathetic hyperactivity, temporomandibular disorder

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