Feasibility and reliability of intraorally evoked “nociceptive-specific” blink reflexes

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  • Rajath Sasidharan Pillai
  • Cung May Thai, Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VrijeUniversiteit Amsterdam, The Netherlands, Holland
  • Laura Zweers, Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VrijeUniversiteit Amsterdam, The Netherlands, Holland
  • Michail Koutris, Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VrijeUniversiteit Amsterdam, The Netherlands, Holland
  • Frank Lobbezoo, Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VrijeUniversiteit Amsterdam, The Netherlands, Holland
  • Yuri Martins Costa, Department of Physiological Sciences, Piracicaba Dental School,University of Campinas, Piracicaba, Brazil, Brasilien
  • Maria Pigg, Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Department of Endodontics, Faculty of Odontology, Malmӧ University, Sweden, Sverige
  • Thomas List, Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmӧ University, Sweden, Sverige
  • Peter Svensson
  • Lene Baad-Hansen
Objectives: The “nociceptive-specific” blink reflex (nBR) evoked by extraoral stimulation has been used to assess trigeminal nociceptive processing in patients with trigeminal nerve damage regardless of the site of damage. This study aimed to test the feasibility of nBR elicited by intraoral stimulation, compare intraoral and extraoral nBR and assess the intrarater and interrater reliability of the intraoral nBR for the maxillary (V2) and mandibular (V3) branches of the trigeminal nerve.Materials and methods: In 17 healthy participants, nBR was elicited by stimulation of two extraoral and two intraoral sites by two operators and repeated intraorally by one operator. Main outcome variables were intraoral stimulus-evoked pain scores and nBR R2 responses at different stimulus intensities. Intraclass correlation coefficients (ICC) were used to assess reliability.Results: Dependent on the stimulus intensity, intraoral stimulation evoked R2 responses in up to 12/17 (70.6%) participants for V2 and up to 8/17 (47.1%) participants for V3. Pain scores (p < 0.003) and R2 responses (p < 0.004) increased with increasing intensities for V2, but not V3. The R2 responses were significantly smaller with intraoral stimulation compared to extraoral stimulation (p < 0.014). Overall, ICCs were fair to excellent for V2 but poor for V3.Conclusion: Intraorally evoked nBR was feasible in a subset of healthy participants and was less responsive than nBR with extraoral stimulation. The V2 nBR showed better reliability than V3.Clinical relevance: The nBR can be used to assess nerve damage to the maxillary intraoral regions, though other measures may need to be considered for the mandibular intraoral regions.
OriginalsprogEngelsk
TidsskriftClinical Oral Investigations
Vol/bind24
Nummer2
Sider (fra-til)883-896
Antal sider14
ISSN1432-6981
DOI
StatusUdgivet - feb. 2020

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