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The following is a summary of “AN EXPLORATORY DATA-DRIVEN APPROACH TO CLASSIFY SUBGROUPS OF PATIENTS WITH TEMPOROMANDIBULAR DISORDERS BASED ON PAIN MECHANISMS,” published in the October 2024 issue of Pain by Asquini et al. 

Temporomandibular disorders (TMDs) are common musculoskeletal conditions with non-specific presentations, often challenges the targeted treatments, categorizing patients on neurobiological pain mechanisms could be a potential solution.  

Researchers conducted a retrospective study to assess the complexity of TMDs using network analysis (NA) and to validate potential TMD subgroups based on mechanism-specific pain categories.  

They included 102 patients with TMD and covered biopsychosocial variables encompassing general health, psychosocial features, TMD pain, and TMD characteristics. The NA assessed the relationships between variables and identified the role of each feature within the network. Hierarchical clustering was employed to classify the TMD subgroups.  

The results showed that NA revealed significant correlations primarily within the same feature domains, indicating a solid interplay between symptoms and psychological factors. Cluster analysis identified 2 subgroups: nociceptive and nociplastic. The nociplastic group exhibited higher levels of anxiety, depression, pain catastrophization, central sensitization, pain duration, more pain locations, poorer sleep quality, QoL, and health status. In contrast, the nociceptive group exhibited restricted maximal mouth opening (MMO), heightened pain during temporomandibular joints (TMJ) palpation and mouth opening, and a more significant positive response to manual therapy. Across all features, psychological factors, pain locations, and MMO primarily contributed to subgroup separation.  

Investigators concluded that adopting a data-driven approach emphasized the significance in the patient classification of the neurobiological based on pain and facilitating clinical reasoning and personalized treatments. 

Source: jpain.org/article/S1526-5900(24)00697-7/fulltext