title: Effect of contingent electrical stimulation  on masticatory muscle activity and pain  in patients with a myofascial temporomandibular disorder and sleep bruxism.
abstract: OBJECTIVE
  To determine whether an intervention reduces oromotor activity and masticatory muscle pain in myofascial temporomandibular disorder (M/TMD) patients with high levels of masticatory muscle activity associated with sleep bruxism.
  
  
  METHODS
  Fourteen women with M/TMD and prior polysomnographic evidence consistent with sleep bruxism participated in a 10-week single-group pre-test/ post-test mechanistic clinical trial. A 2-week period of baseline monitoring of individually biocalibrated electromyographic (EMG) events associated with sleep bruxism was followed by 6 weeks of EMG-event-contingent treatment via an innocuous electrical pulse to the skin overlying the temporalis muscle. Treatment was discontinued during 2-week follow-up monitoring. Each night before sleep, subjects recorded their average daily pain.
  
  
  RESULTS
  Mixed-model analysis of variance showed a reliable reduction of EMG events during contingent stimulation treatment periods, but frequency of EMG events returned to baseline levels during follow-up (linear term, P = .002; quadratic term, P = .001). In contrast, nightly pain reports failed to show any systematic changes during treatment (linear and quadratic trends, both P > .10).
  
  
  CONCLUSIONS
  Spontaneous pain severity and nighttime oromotor activity vary independently over nights, even in M/TMD patients selected for relatively high levels of both characteristics.
authors: Department of Oral & Maxillofacial Pathology, New York University College of Dentistry, New York, NY, USA. kgr234@nyu.edu
authors: Karen G
authors: KG
authors: Raphael
authors: Malvin N
authors: MN
authors: Janal
authors: David A
authors: DA
authors: Sirois
authors: Peter
authors: P
authors: Svensson
mesh_terms: D000339:Affect / Q000502:physiology; D002138:Calibration; D004599:Electric Stimulation Therapy / Q000379:methods*; D004576:Electromyography / Q000379:methods; D005157:Facial Pain / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008499:Medical Records; D008991:Monitoring, Physiologic; D010147:Pain Measurement / Q000379:methods; D057566:Self Report; D012815:Signal Processing, Computer-Assisted; D012890:Sleep / Q000502:physiology; D020186:Sleep Bruxism / Q000628:therapy*; D013703:Temporal Muscle / Q000503:physiopathology*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome