title: Thermal and mechanical quantitative sensory testing in Chinese patients with burning mouth syndrome--a probable neuropathic pain condition?
abstract: BACKGROUND
  To explore the hypothesis that burning mouth syndrome (BMS) probably is a neuropathic pain condition, thermal and mechanical sensory and pain thresholds were tested and compared with age- and gender-matched control participants using a standardized battery of psychophysical techniques.
  
  
  METHODS
  Twenty-five BMS patients (men: 8, women: 17, age: 49.5 ± 11.4 years) and 19 age- and gender-matched healthy control participants were included. The cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT), heat pain threshold (HPT), mechanical detection threshold (MDT) and mechanical pain threshold (MPT), in accordance with the German Network of Neuropathic Pain guidelines, were measured at the following four sites: the dorsum of the left hand (hand), the skin at the mental foramen (chin), on the tip of the tongue (tongue), and the mucosa of the lower lip (lip). Statistical analysis was performed using ANOVA with repeated measures to compare the means within and between groups. Furthermore, Z-score profiles were generated, and exploratory correlation analyses between QST and clinical variables were performed. Two-tailed tests with a significance level of 5 % were used throughout.
  
  
  RESULTS
  CDTs (P < 0.02) were significantly lower (less sensitivity) and HPTs (P < 0.001) were significantly higher (less sensitivity) at the tongue and lip in BMS patients compared to control participants. WDT (P = 0.007) was also significantly higher at the tongue in BMS patients compared to control subjects . There were no significant differences in MDT and MPT between the BMS patients and healthy subjects at any of the four test sites. Z-scores showed that significant loss of function can be identified for CDT (Z-scores = -0.9±1.1) and HPT (Z-scores = 1.5±0.4). There were no significant correlations between QST and clinical variables (pain intensity, duration, depressions scores).
  
  
  CONCLUSIONS
  BMS patients had a significant loss of thermal function but not mechanical function, supporting the hypothesis that BMS may be a probable neuropathic pain condition. Further studies including e.g. electrophysiological or imaging techniques are needed to clarify the underlying mechanisms of BMS.
authors.affiliation: Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, China.|Hangzhou ivy dental clinic Co., Limited, 156 Tianmushan road, Hangzhou, 310000, China.
authors.forename: Xueyin
authors.initials: X
authors.lastname: Mo
authors.affiliation: Orofacial Pain and TMD Research Unit, Institute of Stomatology, Affiliated Hospital of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, China.
authors.forename: Jinglu
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, China. fuanyuan65@hotmail.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Section of Orofacial Pain and Jaw Function, School of Dentistry, Aarhus University, Aarhus, Denmark.|Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Svensson
authors.affiliation: Center for Sensory-Motor Interaction (SMI) Aalborg University and Stomatological School and Hospital,Nanjing Medical University, Nanjing, PR China.
authors.forename: Kelun
authors.initials: K
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D002054:Burning Mouth Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis* / Q000453:epidemiology; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold / Q000502:physiology; D010812:Physical Stimulation / Q000379:methods; D012684:Sensory Thresholds
keywords: Burning mouth syndrome; Pathophysiology; Quantitative sensory testing