Temporomandibular Dysfunction (TMD) Clinical Trial
Official title:
Effect of Noninvasive Neuromodulation on Chronic Pain and Anxiety Levels in Individuals With Temporomandibular Disorders
1. BACKGROUND: Temporomandibular Dysfunction (TMD) is a disease characterized by a set of
signs and symptoms that may include joint noise, pain in the mastication muscles,
limitation of mandibular movements, facial pain, joint pain and / or dental wear. Pain
appears as a very present and striking symptom, with a tendency to chronicity. This is a
difficult treatment condition often associated with psychological factors such as
anxiety. Chronic pain involved modifications in the neuronal excitability, therefore,
the neuromodulation withTranscranial direct current stimulation (tDCS) appears as a
possible strategy for the treatment. Some studies have shown improvement in subjects
with chronic pain using tDCS, however, it needs further investigation of its therapeutic
effect.
2. PROBLEM: Despite the wide range of strategies used to treat patients with TMD, some
patients have a temporary and / or unsatisfactory relief response, which generates
hypotheses that emotional components often underlie treatment refractoriness, and
development of a memory for pain. Thus, it is evident the need for a therapy that acts
directly on the central nervous system (CNS). This action can occur through medications,
however, many individuals are refractory or have side effects such as dependence and /
or tolerance. In this way, the importance of new treatments involving neuromodulation
and neuroplasticity mechanisms, such as tDCS, is highlighted, which may become a
complementary alternative to the different types of treatment already in use. Besides
corroborating with the need to give preference to reversible and non-invasive
procedures.
3. HYPOTHESIS: The investigators believe that the use of anodic tDCS in the treatment of
patients with TMD presenting with chronic pain will have a positive effect, promoting a
decrease in painful symptoms through a Central Nervous System (neuromodulation) action
in comparison to placebo stimulation. Because of the mutual influence between pain and
psychological factors, it is expected that the analgesic effect will have a positive
effect on anxiety levels. In addition, it is believed that a more intense analgesic
effect occurs in the DLPF stimulation group of the cortex compared to the M1 stimulation
group, since this region demonstrates to be responsible for the processing of the
emotional component of the pain, often underlying the refractoriness to treatment
4. AIM: To evaluate and compare the efficacy of anodic tDCS, applied in different cortical
regions (M1 and DLPFC), in the pain and anxiety levels in individuals with chronic pain
due muscular TMD.
n/a
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT03555201 -
Efficacy of Physiotherapy in Patients With Temporomandibular Disorders.
|
N/A | |
| Not yet recruiting |
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N/A |