title: Gender difference in masseteric exteroceptive suppression period and pain perception.
abstract: OBJECTIVE
  Use of brain stem reflexes in the assessment of orofacial function requires insight into the influence of demographic factors such as gender. The aim of this study was to characterize possible gender differences in the relation between quantitative measures of the masseteric exteroceptive suppression (ES) reflex response and pain perception evoked by incrementally increasing electrical stimulation.
  
  
  METHODS
  In 12 men and 12 women, the surface electromyogram was recorded from the left masseter muscle. Thirteen fixed stimulus intensities from 5 to 35 mA at 2.5 mA increments were applied to the skin above the left mental nerve. The stimulation intensity at which the late ES appeared first and the first intensity at which the subjects reported the stimulus intensity to be painful were defined as the reflex threshold (RT) and pain threshold (PT), respectively. Furthermore, data were analyzed using stimulus-response curves, and the reflex appearance levels (RAL), the saturation level, the slope from appearance to saturation of the reflex (SLP), and the pain appearance level (PAL) were determined.
  
  
  RESULTS
  The PT was equal to or higher than the RT in 9 of the 12 men, but only in 4 of the 12 women. Further, women had significantly lower PAL, RAL, and SLP (12.7 +/- 0.8, 12.9 +/- 1.4, and 3.0 +/- 0.9 mA, respectively) compared to men (20.3 +/- 1.6 mA, 16.7 +/- 1.1 T, and 4.1 +/- 0.4, respectively) (P < 0.05).
  
  
  CONCLUSIONS
  The present results document that women have a lower reflex threshold and pain threshold to cutaneous electrical stimulation than men.
  
  
  CONCLUSIONS
  These findings suggest that gender differences may exist in the sensory-motor integration of primary afferent input from the orofacial region and that these differences should be considered in the design of future reflex studies.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Belgium.
authors.forename: Osamu
authors.initials: O
authors.lastname: Komiyama
authors.forename: Kelun
authors.initials: K
authors.lastname: Wang
authors.forename: Peter
authors.initials: P
authors.lastname: Svensson
authors.forename: Lars
authors.initials: L
authors.lastname: Arendt-Nielsen
authors.forename: Antoon
authors.initials: A
authors.lastname: De Laat
mesh_terms: D000328:Adult; D004056:Differential Threshold; D004558:Electric Stimulation; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008406:Masseter Muscle / Q000502:physiology*; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D017288:Pain Threshold; D012018:Reflex / Q000502:physiology; D012677:Sensation; D012727:Sex Characteristics; D012879:Skin Physiological Phenomena; D013997:Time Factors