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Kong MS, Kim MJ, Kim YY, Chang JY, Kho HS. Clinical characteristics and salivary biomarkers of burning mouth syndrome. Oral Dis 2024. [PMID: 38622964 DOI: 10.1111/odi.14959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/18/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES To investigate the clinical characteristics and salivary biomarkers in each type of burning mouth syndrome (BMS) patients. MATERIALS AND METHODS Ninety-eight postmenopausal female patients with BMS were included. Fifty and 21 patients were assigned to the primary and secondary groups, respectively. Twenty-seven patients with both primary and secondary characteristics were assigned to the intermediate group. Comprehensive clinical characteristics and salivary biomarkers were analyzed. RESULTS Significant differences in age, proportion of hyposalivator patients based on unstimulated whole saliva (UWS), symptom distribution, severties of burning sensation and effect of oral complaints in daily life (Eff-life), and positive symptom distress index (PSDI) were observed among the three groups. The primary group had significant higher UWS flow rate, fewer UWS hyposalivator proportions, and lesser severity of Eff-life than the secondary group. The intermediate group had significantly greater intensities of burning sensation and Eff-life and higher PSDI score than did the primary group. The primary group had significantly higher cortisol and dehydroepiandrosterone (DHEA) levels in stimulated whole saliva than did the secondary group. CONCLUSIONS This study's findings show that clinical characteristics differentiate each BMS type. Cortisol and DHEA levels are potential salivary biomarkers for discriminating between the primary and secondary types of BMS.
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Affiliation(s)
- Mi-Sun Kong
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Moon-Jong Kim
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
- Department of Oral Medicine, Gwanak Seoul National University Dental Hospital, Seoul, South Korea
| | - Yoon-Young Kim
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Ji-Youn Chang
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
| | - Hong-Seop Kho
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, South Korea
- Institute on Aging, Seoul National University, Seoul, South Korea
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He M, Huoshen W, Li X, Sun C. Salivary and serum biomarkers to evaluate psychological disorders in burning mouth syndrome: A systematic review and meta-analysis. J Oral Pathol Med 2024; 53:182-192. [PMID: 38438274 DOI: 10.1111/jop.13526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 01/26/2024] [Accepted: 02/16/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Burning mouth syndrome is a chronic pain syndrome mainly characterized by an intensive burning sensation of tongue. Previous studies have suggested that saliva/serum biomarkers in burning mouth syndrome might be associated with psychological disorders. The aim of systematic review was to observe whether the biomarkers in serum/saliva could be an alternative method to evaluate the psychological disorders in patients with burning mouth syndrome. MATERIALS AND METHODS The PubMed, Embase, and Cochrane Library databases were searched for papers published up to March 15, 2023. Risk of bias was measured by using the Newcastle-Ottawa Scale. RevMan was used for meta-analysis. RESULTS A total of 467 articles were screened, which of 12 studies were included. These studies collected 43 different biomarkers in saliva and 35 in serum. Of these biomarkers, only three (cortisol, α-amylase, and IL-6) were analyzed in two or more studies. Only salivary cortisol levels were significantly higher in the patient group compared to the controls (Mean Difference = 1.39; 95% CI [0.80-1.97]; p < 0.001). Moreover, cortisol might be relevant to psychological scores, especially anxiety. CONCLUSION Different papers have investigated salivary and serum biomarkers in burning mouth syndrome patients with controversial results. This meta-analysis showed that cortisol levels in saliva may be a potential biomarker to assess the psychological disorders in burning mouth syndrome patients.
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Affiliation(s)
- Mei He
- Department of Stomatology, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Wuda Huoshen
- Department of Periodontics and Oral Mucosal Diseases, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
| | - Xueqing Li
- Department of Periodontics and Oral Mucosal Diseases, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
| | - Chen Sun
- Department of Periodontics and Oral Mucosal Diseases, The Affiliated Stomatology Hospital of Southwest Medical University, Luzhou, China
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Ikenouchi A, Okamoto N, Hamada S, Chibaatar E, Fujii R, Konishi Y, Igata R, Tesen H, Yoshimura R. Association between salivary mature brain-derived neurotrophic factor and psychological distress in healthcare workers. Brain Behav 2023; 13:e3278. [PMID: 37822121 PMCID: PMC10726813 DOI: 10.1002/brb3.3278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/28/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023] Open
Abstract
INTRODUCTION Previous studies have suggested association between brain-derived neurotrophic factor (BDNF) and the stress level of workers. However, no studies have investigated the potential of salivary mature BDNF (mBDNF) level as a noninvasive biomarker for psychological distress. This study aimed to explore the reliability of salivary mBDNF as a biomarker for psychological distress in healthcare workers. Furthermore, we examined the relationship between salivary and plasma mBDNF levels and their correlation with age, sex, body mass index (BMI), and exercise habits. METHODS Fifty-one healthy healthcare workers (26 men) from the University of Occupational and Environmental Health, Japan, participated in this study. In this cross-sectional study, participants provided demographic information. Psychological distress was assessed using the Kessler 6 (K6). Saliva and blood samples were collected, and mBDNF was measured by ELISA. Spearman's rank correlation coefficient was performed to analyze the relationship between mBDNF (saliva and plasma) and K6. Statistical analyses were conducted using Stata 17.0, and a significance level of p < .05 was applied. RESULTS The median K6 score was 1 (interquartile range [IQR]: 0-3). The median (IQR) salivary mBDNF was 1.36 (1.12-1.96) pg/mL, whereas the mean (standard deviation) plasma mBDNF was 1261.11 (242.98) pg/mL. No correlation was observed between salivary and plasma mBDNF concentrations or with the K6 score. Additionally, there were no associations between salivary or plasma mBDNF concentrations and age, sex, or exercise habits. Finally, an association between plasma mBDNF concentration and BMI was found only in univariate analysis. CONCLUSION Our findings indicate that salivary mBDNF can be accurately measured noninvasively in healthcare workers. Within our study sample, salivary mBDNF did not demonstrate any correlation with K6 and plasma mBDNF. Future studies with a larger study sample and a diverse study population consisting of healthy participants and patients with psychiatric disorders are warranted.
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Affiliation(s)
- Atsuko Ikenouchi
- Department of PsychiatryUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
- Medical Center for DementiaHospital of University of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Naomichi Okamoto
- Department of PsychiatryUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Shinsuke Hamada
- Department of PsychiatryUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
- Medical Center for DementiaHospital of University of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Enkhmurun Chibaatar
- Department of PsychiatryUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Rintaro Fujii
- Department of PsychiatryUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Yuki Konishi
- Department of PsychiatryUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Ryohei Igata
- Department of PsychiatryUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Hirofumi Tesen
- Department of PsychiatryUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
| | - Reiji Yoshimura
- Department of PsychiatryUniversity of Occupational and Environmental Health, JapanKitakyushuJapan
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Porporatti AL, Schroder ÂGD, Lebel A, Moreau N, Misery L, Alajbeg I, Braud A, Boucher Y. Is burning mouth syndrome associated with stress? A meta-analysis. J Oral Rehabil 2023; 50:1279-1315. [PMID: 37332081 DOI: 10.1111/joor.13536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/04/2023] [Accepted: 06/10/2023] [Indexed: 06/20/2023]
Abstract
BACKGROUND Some studies have shown burning mouth syndrome (BMS) as comorbid psychosocial and psychiatric disorders, and as well, pointed at stress as a major risk factor. OBJECTIVE The aim of this meta-analysis was to answer the following question: 'Is there an association between BMS and stress, compared to healthy controls?' METHODS Two reviewers searched for the effect of stress in BMS and published on five main databases and three from the grey literature. Various questionnaires and biomarkers were analysed. Of the 2489 selected articles, 30 met the inclusion criteria. Studies englobed questionnaires, such as Perceived Stress Questionnaire, Lipp Stress Symptoms Inventory, Holmes-Rahe scale, Depression, Anxiety, and Stress Scale (DASS-21), Recent Experience Test; and various biomarkers, such as cortisol, opiorphin, IgA, α-amylase and interleukins. RESULTS In all studies with questionnaires, stress was significantly increased in the BMS group vs. control. Patients with BMS presented 25.73% higher cortisol levels, 28.17% higher IgA levels and 40.62% higher α-amylase levels than controls. Meta-analysis found that BMS subjects presented 3.01 nmoL/L [0.53; 5.50] higher cortisol levels, 84.35 kU/L [15.00; 153.71] higher α-amylase levels, 29.25 mg/mL [9.86; 48.64] higher IgA levels and 258.59 pg/mL [59.24; 457.94] higher IL-8 levels than control. No differences were found for opiorphin concentration in ng/mL [-0.96; 2.53]. For interleukins, no differences were founded for IL-1 β, IL-2, IL-4, IL-6, IL-8, IL-10 and TNF-α. CONCLUSION Based on the available evidence, this meta-analysis suggests more stress factors in questionnaire-based studies, and higher levels of cortisol, α-amylase, IgA and IL-8 biomarkers in BMS subjects than controls.
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Affiliation(s)
- André Luís Porporatti
- Laboratoire de Neurobiologie Oro-Faciale (EA 7543), Université Paris Cité, France and GHPS Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - Ashley Lebel
- Laboratoire de Neurobiologie OroFaciale, Université Paris Cité, France and GHPS Assistance Publique Hôpitaux de Paris, Paris, France
| | - Nathan Moreau
- Laboratoire de Neurobiologie Oro-Faciale (EA 7543), Université Paris Cité and Hôpital Bretonneau (AP-HP), Paris, France
| | | | | | - Adeline Braud
- Laboratoire de Neurobiologie Oro-Faciale (EA 7543), Université Paris Cité, France and GHPS Assistance Publique Hôpitaux de Paris, Paris, France
| | - Yves Boucher
- Laboratoire de Neurobiologie Oro-Faciale (EA 7543), Université Paris Cité, France and GHPS Assistance Publique Hôpitaux de Paris, Paris, France
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Glavina A, Lugović-Mihić L, Martinović D, Cigić L, Tandara L, Lukenda M, Biočina-Lukenda D, Šupe-Domić D. Association between Salivary Cortisol and α-Amylase with the Psychological Profile of Patients with Oral Lichen Planus and Burning Mouth Syndrome: A Case-Control Study. Biomedicines 2023; 11:2182. [PMID: 37626679 PMCID: PMC10452894 DOI: 10.3390/biomedicines11082182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
The aim of our study was to assess the relationship between the concentration/activity of salivary stress biomarkers (cortisol, α-amylase) and the psychological profile of patients with oral lichen planus (OLP) and primary burning mouth syndrome (BMS). A total of 160 subjects participated in this case-control study: 60 patients with OLP; 60 patients with primary BMS; and 40 control subjects. Unstimulated whole saliva (UWS) was collected between 9 and 10 a.m. Salivary biomarkers were analyzed by enzyme-linked immunosorbent assays (ELISAs). Psychological assessment was evaluated with the Depression, Anxiety, and Stress Scale (DASS-21). The patients with primary BMS had higher salivary cortisol concentrations and α-amylase activity (0.52 vs. 0.44 µg/dL; 160,531 vs. 145,804 U/L; one-way analysis of variance (ANOVA) with post hoc Scheffe test) compared with patients with OLP. The patients with primary BMS had statistically significant higher scores for depression, anxiety, and stress compared with patients with OLP and control subjects (p < 0.001, Kruskal-Wallis test). There was a strong positive correlation between anxiety and depression, stress and depression, and stress and anxiety in patients with OLP and BMS (p < 0.001 and p < 0.001, respectively; Spearman's correlation). There was a good positive correlation between symptom intensity (pain/burning) and psychological profile (depression, anxiety, stress) in patients with primary BMS (r = 0.373, p = 0.003; r = 0.515, p < 0.001; r = 0.365, p = 0.004, respectively; Spearman's correlation). This case-control study is the first to compare the psychoendocrinological profile of patients with two different oral diseases. The patients with BMS showed a higher concentration/activity of salivary stress biomarkers (cortisol, α-amylase) and a stronger association with mental disorders compared with patients with OLP. However, an interdisciplinary psychoneuroimmunological approach is equally important in both patient groups (OLP and BMS), regardless of whether mental disorders are the cause or the consequence.
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Affiliation(s)
- Ana Glavina
- Dental Clinic Split, 21000 Split, Croatia; (A.G.); (D.B.-L.)
- Department of Oral Medicine and Periodontology, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia;
| | - Liborija Lugović-Mihić
- Department of Dermatovenereology, University Hospital Center Sestre Milosrdnice, 10000 Zagreb, Croatia;
- School of Dental Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Dinko Martinović
- Department of Maxillofacial Surgery, University Hospital of Split, 21000 Split, Croatia;
- Department of Pathophysiology, School of Medicine, University of Split, 21000 Split, Croatia
| | - Livia Cigić
- Department of Oral Medicine and Periodontology, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia;
- Department of Dental Medicine, University Hospital of Split, 21000 Split, Croatia
| | - Leida Tandara
- Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia;
| | - Marino Lukenda
- Study in English, School of Medicine, University of Split, 21000 Split, Croatia;
| | - Dolores Biočina-Lukenda
- Dental Clinic Split, 21000 Split, Croatia; (A.G.); (D.B.-L.)
- Department of Oral Medicine and Periodontology, Study of Dental Medicine, School of Medicine, University of Split, 21000 Split, Croatia;
| | - Daniela Šupe-Domić
- Department of Medical Laboratory Diagnostics, University Hospital of Split, 21000 Split, Croatia;
- Department of Health Studies, University of Split, 21000 Split, Croatia
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Gaitán-Cepeda LA, Rivera-Reza DI, Villanueva-Vilchis MDC. Neuroticism and Psychological Stress in Patients Suffering Oral Lichen Planus: Research Evidence of Psycho-Stomatology? Healthcare (Basel) 2023; 11:1738. [PMID: 37372856 DOI: 10.3390/healthcare11121738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Psychosocial factors influence the development, exacerbation, or aggravation of some oral diseases. However, the possible relationship between personality traits, affective disorders, and psychological stress in oral diseases, and their impact on oral health-related quality of life (OHRQoL), has not been fully clarified. The aim of the present study was to determine the association of neuroticism and stress with the presence of oral lichen planus (OLP), and to discover whether or not these factors impact OHRQoL. This is a case-control study matched for age and sex. The case group (OLP group) was composed of 20 patients diagnosed with OLP, while 20 people with a diagnosis of lesions not associated with stress formed the control group. Three instruments were used: the Holmes-Rahe Social Readjustment Scale, the Five Factor Personality Model, and the OHIP-49. Neuroticism obtained a score of 25.5 (±5.4) in the OLP group, which was higher than the control group value (21.7) (±5.1) (p = 0.03). The OLP group showed a worse quality of life (p < 0.05); the most affected dimensions were psychological discomfort and physical disability. It is important to include a psychological profile to establish a comprehensive treatment for these patients. We propose the recognition of a new area of clinical oral medicine: psycho-stomatology.
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Affiliation(s)
- Luis Alberto Gaitán-Cepeda
- Department of Oral and Maxillofacial Medicine and Pathology, Research and Graduate Division, Dental School, National Autonomous University of Mexico, Mexico City 04510, Mexico
| | - Diana Ivette Rivera-Reza
- Department of Oral and Maxillofacial Medicine and Pathology, Research and Graduate Division, Dental School, National Autonomous University of Mexico, Mexico City 04510, Mexico
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Moreau C, El Habnouni C, Lecron JC, Morel F, Delwail A, Le Gall-Ianotto C, Le Garrec R, Misery L, Piver E, Vaillant L, Lefevre A, Emond P, Blasco H, Samimi M. Salivary metabolome indicates a shift in tyrosine metabolism in patients with burning mouth syndrome: a prospective case-control study. Pain 2023; 164:e144-e156. [PMID: 35916738 DOI: 10.1097/j.pain.0000000000002733] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
Abstract
ABSTRACT The pathophysiology of primary burning mouth syndrome (BMS) remains controversial. Targeted analyses or "omics" approach of saliva provide diagnostic or pathophysiological biomarkers. This pilot study's primary objective was to explore the pathophysiology of BMS through a comparative analysis of the salivary metabolome among 26 BMS female cases and 25 age- and sex-matched control subjects. Secondary objectives included comparative analyses of inflammatory cytokines, neuroinflammatory markers, and steroid hormones among cases and control subjects, and among BMS patients according to their clinical characteristics. Salivary metabolome, neuroinflammatory markers, cytokines, and steroids were, respectively, analysed by liquid chromatography coupled with mass spectrometry, ELISA and protease activity assay, and multiparametric Luminex method. Among the 166 detected metabolites, univariate analysis did not find any discriminant metabolite between groups. Supervised multivariate analysis divided patients into 2 groups with an accuracy of 60% but did not allow significant discrimination (permutation test, P = 0.35). Among the metabolites contributing to the model, 3 belonging to the tyrosine pathway ( l -dopa, l -tyrosine, and tyramine) were involved in the discrimination between cases and control subjects, and among BMS patients according to their levels of pain. Among the detectable molecules, levels of cytokines, steroid hormones, and neuroinflammatory markers did not differ between cases and control subjects and were not associated with characteristics of BMS patients. These results do not support the involvement of steroid hormones, inflammatory cytokines, or inflammatory neurogenic mediators in the pathophysiology of pain in BMS, whereas the observed shift in tyrosine metabolism may indicate an adaptative response to chronic pain or an impaired dopaminergic transmission.
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Affiliation(s)
- Charlotte Moreau
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | - Chakib El Habnouni
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | - Jean-Claude Lecron
- Laboratory Inflammation, Tissus Epithéliaux et Cytokines, Poitiers University and Immunology/inflammation Laboratory, Poitiers University Hospital, Poitiers, France
| | - Franck Morel
- Laboratory Inflammation, Tissus Epithéliaux et Cytokines, Poitiers University and Immunology/inflammation Laboratory, Poitiers University Hospital, Poitiers, France
| | - Adriana Delwail
- ImageUP, Plate-forme d'Imagerie and Laboratoire Signalisation et Transport Ioniques Membranaires ERL CNRS 7003/EA 7349, Poitiers University, Poitiers, France
| | | | - Raphaele Le Garrec
- Univ Brest, LIEN (Laboratoire Interactions Epithelium Neurones), Brest, France
| | - Laurent Misery
- Univ Brest, LIEN (Laboratoire Interactions Epithelium Neurones), Brest, France
| | - Eric Piver
- Department of Biochemistry and Molecular Biology, University Hospital of Tours, Tours Cedex, France
- Inserm UMR 1259-Morphogenèse et antigénicité du VIH et des virus des hépatites (MAVIVH)
| | - Loïc Vaillant
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
| | | | - Patrick Emond
- UMR 1253 iBrain, Université de Tours, Inserm, Tours, France
- Department of In Vitro Nuclear Medicine, University Hospital of Tours, Tours Cedex, France
| | - Hélène Blasco
- Department of Biochemistry and Molecular Biology, University Hospital of Tours, Tours Cedex, France
- UMR 1253 iBrain, Université de Tours, Inserm, Tours, France
| | - Mahtab Samimi
- University François Rabelais, Tours, France
- Department of Dermatology, University Hospital of Tours, Tours Cedex, France
- BIP, 1282 INRA University of Tours, Tours, France
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Ye L, Dai Q, Hou F, Wu C, Qiu X, Yuan P, Chen F, Meng Y, Feng X, Jiang L. Salivary metabolomics of burning mouth syndrome: A cross-sectional study. Arch Oral Biol 2022; 144:105552. [DOI: 10.1016/j.archoralbio.2022.105552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/09/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022]
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Aitken-Saavedra J, Tarquinio SB, Kinalski M, Haubman D, Martins MW, Vasconcelos AC. Salivary characteristics in burning mouth syndrome: a systematic review. Minerva Dent Oral Sci 2022; 71:233-241. [PMID: 35920290 DOI: 10.23736/s2724-6329.22.04647-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Compare through case-control studies, the salivary characteristics of patients with and without BMS. EVIDENCE ACQUISITION Searches in Embase, PubMed, Web of Science, Scopus, Cochrane, and BIREME were conducted for the identification of case-controls studies reported. EVIDENCE SYNTHESIS Thirty-three studies were included, of which 26 articles evaluated OSB, 17 SRF, and 7 SE. Nineteen organic biomarkers showed higher levels in BMS patients, the two most indicated being α-amylase and cortisol. Ten organic biomarkers, including Tumor Necrosis Factor-alpha (TNF-α) and IL-6, showed lower levels in BMS patients. Regarding salivary flow rate (SFR), five articles indicated that BMS patients have less unstimulated SFR (uSRF)Two articles indicate that stimulated SFR (sSRF) is lower in BMS patients nevertheless, but eight did not show differences. Sialochemical analysis revealed that sodium (Na), chloride (Cl), potassium (K), sodium (Na), and calcium (Ca), showed higher levels in BMS patients according to three studies, but two studies did not establish any differences. Two study established that BMS patients have lower Mg salivary levels. CONCLUSIONS Qualitative salivary characteristics suggest that BMS has neuropathic, inflammatory, emotional, immune, and hormonal involvements. BMS can be associated with changes in salivary biomarkers of inflammation and oxidative stress, is related to anxiety and degree of pain.
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Affiliation(s)
- Juan Aitken-Saavedra
- Department of Oral Pathology and Medicine, Faculty of Dentistry, University of Chile, Santiago, Chile
- School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Sandra B Tarquinio
- Diagnostic Center for Oral Diseases, Federal University of Pelotas, Pelotas, Brazil
| | - Matheus Kinalski
- Faculty of Dentistry, Community University of Chapecó, Chapecó, Brazil
| | - Daniela Haubman
- School of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | | | - Ana C Vasconcelos
- Diagnostic Center for Oral Diseases, Federal University of Pelotas, Pelotas, Brazil -
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Zborowski J, Konopka T. Comparison of Clonazepam and Tongue Protector in the Treatment of Burning Mouth Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158999. [PMID: 35897370 PMCID: PMC9330819 DOI: 10.3390/ijerph19158999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023]
Abstract
Background: BMS is a chronic pain syndrome affecting the oral mucosa. It consists of experiencing a burning or dysesthetic sensation. BMS prevalence varies, with up to 15% among women. An effective treatment is still unattainable. Material and Methods: A total of 60 patients with BMS qualified for a randomised trial, divided in two groups: the clonazepam-treated and tongue protector group. Treatment was provided for 4 weeks in both groups. In the former, the oral dosage of clonazepam 0.5 mg; in the latter, a tongue protector was used. Clinical oral examination was performed, and the presence of taste disorder and pain intensity, on the visual analogues scale, were recorded. Psychological domains were explored with the Beck depression inventory (depression), Athens insomnia scale (insomnia), Eyesenck personality questionnaire-revised (personality traits), and WHO quality of life questionnaire (quality of life). Results: Complete recovery was observed in three patients after clonazepam and one patient after tongue guard treatment. A greater improvement in the VAS scores, from baseline to the control values, was demonstrated in the clonazepam group, and it was statistically significant. In women, the level of depression significantly correlated with all domains of quality of life. Conclusions: BMS is an ongoing multi-specialist challenge. The development of new pathophysiological concepts of BMS offers hope for more effective treatment. Considering the influence of BMS on the quality of life and mental disorders in most patients, further research on the possibilities of therapy seems to be very important.
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Jedel E, Elfström ML, Hägglin C. Differences in personality, perceived stress and physical activity in women with burning mouth syndrome compared to controls. Scand J Pain 2021; 21:183-190. [PMID: 33108343 DOI: 10.1515/sjpain-2020-0110] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/21/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Burning mouth syndrome (BMS) is a long-lasting pain condition which is commonly associated with anxiety symptoms and experience of adverse, stressful life events have been reported by those diagnosed with the syndrome. Stress-related biomarkers have been related to personality traits in BMS and a personality with high stress susceptibility and perceived stress may be of importance. Although biopsychosocial approaches are suggested to manage long-lasting orofacial pain, to date little is known about physical activity in women with BMS. The aim of this study was to investigate if personality, perceived stress and physical activity distinguish women with BMS from controls. METHODS Fifty-six women with BMS and 56 controls matched on age and gender completed Swedish universities Scales of Personality (SSP), Perceived Stress Questionnaire (PSQ) and a general questionnaire with an item on weekly physical activity frequency. In addition, health-related quality of life was explored by additional questionnaires and reported in a companion article (Jedel et al. Scand J Pain. 2020. PubMed PMID: 32853174). RESULTS SSP subscales Somatic Trait Anxiety, Psychic Trait Anxiety, Stress Susceptibility and Verbal Trait Aggression differed between women with BMS and controls and the personality factor scores for Neuroticism and Aggressiveness were higher. Perceived stress measured by PSQ index was higher for women with BMS compared to controls. Women with BMS reported lower physical activity frequency compared to controls and those reporting physical activity <4 days/week scored higher on PSQ compared to those with weekly physical activity ≥4 days/week. CONCLUSIONS Personality distinguished women with BMS from controls in this study. Perceived stress was higher and weekly physical activity was lower in women with BMS compared to controls. Our findings suggest physical activity should be more comprehensively measured in future BMS studies and, by extension, physical activity may be a treatment option for women with BMS. Pain management aiming to restore function and mobility with stress reduction should be considered in clinical decision making for women with BMS who have a personality with stress susceptibility, especially if reporting high perceived stress and insufficient physical activity.
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Affiliation(s)
- Elizabeth Jedel
- Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Magnus L Elfström
- Division of Psychology, School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | - Catharina Hägglin
- Public Dental Service, Region Västra Götaland, Gothenburg, Sweden.,Sahlgrenska Academy, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden
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12
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Estimating the Associations between Big Five Personality Traits, Testosterone, and Cortisol. ADAPTIVE HUMAN BEHAVIOR AND PHYSIOLOGY 2021. [DOI: 10.1007/s40750-020-00159-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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13
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Tu TTH, Watanabe M, Suga T, Hong C, Takao C, Takenoshita M, Motomura H, Toyofuku A. Personality Traits in Burning Mouth Syndrome Patients With and Without a History of Depression. Front Psychiatry 2021; 12:659245. [PMID: 34393842 PMCID: PMC8358652 DOI: 10.3389/fpsyt.2021.659245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: So far, the strong link between neuroticism, chronic pain, and depression has been well-documented in literatures. Some suggested that they might share etiological factors, thus resulting in overlapping constructs. However, such effect has never been tested in burning mouth syndrome (BMS) patients, a complex phenomenon influenced by both neuropathic and psychopathological factors. We aim to clarify how personality affects individual's pain and pain-related experiences. Methods: Two hundred forty-eight patients with BMS provided demographic information and psychiatric history; completed Ten-Item Personality Inventory, a Visual Analog Scale of pain, and McGill Pain Questionnaire; and provided adequate parameters of depressive state, catastrophizing thinking, and central sensitization. Results: BMS patients with depression history suffered more severe clinical symptoms and scored higher in neuroticism and less in openness and extraversion than did those without psychiatric diagnoses. After age, sex, and duration of pain were controlled, neuroticism in BMS patients with depression correlates with affective dimension of pain. Instead, if psychiatric history is absent, neuroticism correlates with sensory dimension and pain intensity. In both groups, higher neuroticism, unlike other personality facets, contributed to a more severe clinical condition. Conclusion: Of the five traits, neuroticism appears to be the most crucial dimension associated with the pain symptoms and patient's conditions. This study implies that management of pain must extend beyond solely providing pain-relieving medication and must require a holistic and multidisciplinary approach.
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Affiliation(s)
- Trang Thi Huyen Tu
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Motoko Watanabe
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takayuki Suga
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chaoli Hong
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Chihiro Takao
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Miho Takenoshita
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Haruhiko Motomura
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Toyofuku
- Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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14
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Škrinjar I, Lončar Brzak B, Vidranski V, Vučićević Boras V, Rogulj AA, Pavelić B. Salivary Cortisol Levels and Burning Symptoms in Patients with Burning Mouth Syndrome before and after Low Level Laser Therapy: a Double Blind Controlled Randomized Clinical Trial. Acta Stomatol Croat 2020; 54:44-50. [PMID: 32523156 PMCID: PMC7233125 DOI: 10.15644/asc54/1/5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objectives Burning mouth syndrome (BMS) is a disorder which is described as burning sensation of the oral mucosa without pathological changes. Most of the patients have some underlying stressful conditions. Stress induces an increase in secretion of different endocrine glands resulting in higher levels of glucocorticoids. One of the options for treatment of BMS includes low level laser therapy (LLLT). The aim of this research was to determine salivary cortisol levels and intensity of burning symptoms in BMS patients before and after LLLT. Materials and Methods Twenty-three participants were allocated by randomization in two groups: 12 patients in the study group and 11 patients in the placebo group. Cortisol levels in all patients were analyzed from the sample of saliva collected without stimulation. In both groups, the LLLT was performed once a day for ten consecutive days (excluding weekend) with Ga-Al-As light-emitting diode type of laser, with a wavelength of 685nm. In the control group, LLLT was done with inactive laser probe which was only emitting audio signal. The intensity of burning symptoms was measured by a visual analogue scale (VAS). The VAS and unstimulated saliva were measured at baseline and on the last day of the LLLT. A quantitative analysis of saliva was performed using competitive commercial ELISA-kit. Results VAS scores and salivary cortisol levels were significantly lower in both groups after LLLT. Conclusions LLLT can be useful in patients with BMS for reducing burning symptoms and salivary cortisol level. Future studies on a larger number of patients should clarify whether the positive results are an outcome of laser effectiveness or of placebo effect.
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Affiliation(s)
- Ivana Škrinjar
- Department of Oral Medicine, University Hospital Center Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Božana Lončar Brzak
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Valentina Vidranski
- Department of Oncology and Nuclear Medicine, University Clinical Hospital Sisters of Mercy, Vinogradska cesta 29, 10000 Zagreb, Croatia
| | - Vanja Vučićević Boras
- Department of Oral Medicine, School of Dental Medicine University of Zagreb and University Clinical Hospital Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Ana Andabak Rogulj
- Department of Oral Medicine, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
| | - Božidar Pavelić
- Department of Restorative Dentistry, School of Dental Medicine, University of Zagreb and University Hospital Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia
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15
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Campello CP, Pellizzer EP, Vasconcelos BCDE, Moraes SLD, Lemos CAA, Muniz MTC. Evaluation of IL-6 levels and +3954 polymorphism of IL-1β in burning mouth syndrome: A systematic review and meta-analysis. J Oral Pathol Med 2020; 49:961-968. [PMID: 32274841 DOI: 10.1111/jop.13018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 02/29/2020] [Accepted: 03/29/2020] [Indexed: 12/30/2022]
Abstract
This study evaluated IL-6 salivary levels as well as the +3954 polymorphism of IL-1β in patients with burning mouth syndrome and healthy individuals, through case-control studies. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We conducted this research in PubMed/MEDLINE, Cochrane Library and Web of Science databases. The risk of bias was measured based in the Newcastle-Ottawa Scale. Researches with a group of patients with burning mouth syndrome and a control group in which the presence of the +3954 polymorphism of IL-1β and/ or IL-6 salivary levels through non-stimulated saliva were evaluated to detect if this interleukin concentrations are increased in patients and if the polymorphism is a risk factor for this syndrome. We identified seven studies with total of 440 participants, 229 patients with burning mouth syndrome and 211 healthy controls, ages 24-84 years old. The female gender was predominant. Patients in the majority of studies did not present increased levels of IL-6 and the +3954 polymorphism of IL-1β is not a risk factor for this syndrome. A few studies researched biomarkers in this pathology and more investigations are required not only to identify salivary levels and the polymorphism evaluated, but also other interleukins and polymorphisms in order to clarify the etiopathogenesis of this syndrome as well as for propose new diagnostic methods and treatments.
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Affiliation(s)
- Camilla Porto Campello
- Postgraduate Program in Biotechnology, Rede Nordeste de Biotecnologia- RENORBIO, UFRPE/UPE, Recife, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Dental School, Universidade Estadual Paulista- UNESP, Araçatuba, Brazil
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16
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Paudel D, Morikawa T, Yoshida K, Uehara O, Giri S, Neopane P, Khurelchuluun A, Hiraki D, Sato J, Abiko Y. Chronic stress-induced elevation of IL-1β in the saliva and submandibular glands of mice. Med Mol Morphol 2020; 53:238-243. [PMID: 32253605 DOI: 10.1007/s00795-020-00250-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/27/2020] [Indexed: 12/16/2022]
Abstract
Psychological stress is involved in the development of various oral diseases. Alterations in the levels of cytokines in the saliva of patients with stress-related oral diseases have been reported. However, the inconsistencies in the results of these studies might be attributed to differences in the local and systemic factors in the oral cavities of the patients. We examined the effect of chronic stress on three major inflammatory cytokines Interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α in the saliva and salivary glands of chronically stressed mice. Six-week-old C57BL/6 J mice were randomly divided into a control and a stress group. The mice in stress group were exposed to 4 h of stress daily for 10 days and subsequently saliva, as well as the submandibular glands, were collected from both groups. The expression levels of cytokines in the saliva were examined by enzyme-linked immunosorbent assay. The submandibular glands were subjected to histopathological and mRNA expression analyses. IL-1β was significantly elevated in saliva of the chronic stressed mice. Furthermore, the mRNA expression levels of both IL-1β and IL-6 were significantly elevated in the submandibular gland of chronic stressed mice. IL-1β may be a potential salivary biomarker in response to chronic stress in mice.
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Affiliation(s)
- Durga Paudel
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Tetsuro Morikawa
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Koki Yoshida
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Osamu Uehara
- Division of Disease Control and Molecular Epidemiology, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Sarita Giri
- Division of Periodontology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Puja Neopane
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Ariuntsetseg Khurelchuluun
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Daichi Hiraki
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Jun Sato
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Yoshihiro Abiko
- Division of Oral Medicine and Pathology, Department of Human Biology and Pathophysiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan.
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Pereira SR, Tello Velasquez J, Duggan S, Ivanisevic B, McKenna JP, McCreary C, Downer EJ. Recent advances in the understanding of the aetiology and therapeutic strategies in burning mouth syndrome: Focus on the actions of cannabinoids. Eur J Neurosci 2020; 55:1032-1050. [DOI: 10.1111/ejn.14712] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 02/06/2020] [Accepted: 02/20/2020] [Indexed: 12/16/2022]
Affiliation(s)
- Sónia R. Pereira
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
| | - Johana Tello Velasquez
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
| | - Sarah Duggan
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
| | - Bojana Ivanisevic
- Cork University Dental School and Hospital University College Cork Cork Ireland
| | - Joseph P. McKenna
- Cork University Dental School and Hospital University College Cork Cork Ireland
| | - Christine McCreary
- Cork University Dental School and Hospital University College Cork Cork Ireland
| | - Eric J. Downer
- Discipline of Physiology School of Medicine Trinity Biomedical Sciences Institute Trinity College Dublin Dublin 2 Ireland
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18
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de Assis GG, Gasanov EV. BDNF and Cortisol integrative system - Plasticity vs. degeneration: Implications of the Val66Met polymorphism. Front Neuroendocrinol 2019; 55:100784. [PMID: 31425696 DOI: 10.1016/j.yfrne.2019.100784] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 08/12/2019] [Accepted: 08/14/2019] [Indexed: 12/12/2022]
Abstract
UNLABELLED BDNF is the neurotrophin mediating pro-neuronal survival and plasticity. Cortisol (COR), in turn, is engaged in the coordination of several processes in the brain homeostasis. Stress-responsive, both factors show an integrative role through their receptor's dynamics in neurophysiology. Furthermore, the Val66Met BDNF polymorphism may play a role in this mechanism. AIM to investigate BDNF-COR interaction in the human neurophysiology context. METHODS We collected all papers containing BDNF and COR parameters or showing COR analyses in genotyped individuals in a PubMed search - full description available on PROSPERO - CRD42016050206. DISCUSSION BDNF and COR perform distinct roles in the physiology of the brain whose systems are integrated by glucocorticoid receptors dynamics. The BDNF polymorphism appears to have an influence on individual COR responsivity to stress. BDNF and COR play complementary roles in the nervous system where COR is a regulator of positive/negative effects. Exercise positively regulates both factors, regardless of BDNF polymorphism.
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Affiliation(s)
- Gilmara Gomes de Assis
- Department of Applied Physiology, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland; Lab. of Behavioral Endocrinology, Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil.
| | - Eugene V Gasanov
- Laboratory of Neurodegeneration, International Institute of Molecular and Cell Biology in Warsaw, Poland
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19
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Kishore J, Shaikh F, Mirza S, Raffat MA, Ikram S, Akram Z. Cytokine levels and their role in the etiopathogenesis of Burning Mouth Syndrome: A systematic review. Cephalalgia 2019; 39:1586-1594. [DOI: 10.1177/0333102419854052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Introduction Burning Mouth Syndrome is characterized by variable symptoms that include pain, burning and paraguesia in an otherwise healthy-appearing oral mucosa. Although the etiopathogenesis of Burning Mouth Syndrome is unknown, some studies provide evidence of subclinical inflammation leading to disrupted cytokine levels. Aim To investigate the expression of cytokines and role in the etiopathogenesis of Burning Mouth Syndrome. Methods Online databases (MEDLINE and EMBASE) were searched from November 1986 to November 2018 for case control/cross-sectional studies comparing the levels of cytokines in patients with Burning Mouth Syndrome and healthy controls. Results A total of eight studies were included in the current review. Four studies were of high and four studies were of moderate quality. Seven studies evaluated IL-6, out of which four showed comparable results, two showed higher levels and one study reported lower levels in Burning Mouth Syndrome patients compared to controls. Four studies assessed IL-2, out of which two reported comparable results whereas one study reported higher levels and one study reported lower levels in Burning Mouth Syndrome patients compared to controls. IL-10 levels were measured in three studies that reported no significant differences in the levels between Burning Mouth Syndrome and healthy controls. Discussion and conclusion The etiopathogenesis of Burning Mouth Syndrome is multifactorial. Studies have provided scientific evidence that inflammation plays a key role in Burning Mouth Syndrome pathogenesis. However, whether up-regulation or down-regulation of specific cytokines contribute to the etiopathogenesis of Burning Mouth Syndrome remains debatable. Further high-quality studies with larger sample size and assessing a wider array of cytokines are warranted in order to obtain strong conclusions.
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Affiliation(s)
- Jaimala Kishore
- Department of Oral Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Fouzia Shaikh
- Department of General Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Sana Mirza
- Department of Oral Pathology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | | | - Sana Ikram
- Department of Oral Biology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Zohaib Akram
- Department of Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
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20
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Imamura Y, Shinozaki T, Okada-Ogawa A, Noma N, Shinoda M, Iwata K, Wada A, Abe O, Wang K, Svensson P. An updated review on pathophysiology and management of burning mouth syndrome with endocrinological, psychological and neuropathic perspectives. J Oral Rehabil 2019; 46:574-587. [PMID: 30892737 DOI: 10.1111/joor.12795] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/19/2019] [Accepted: 03/12/2019] [Indexed: 12/17/2022]
Abstract
Burning mouth syndrome (BMS) is a chronic oro-facial pain disorder of unknown cause. It is more common in peri- and post-menopausal women, and sex hormone dysregulation is believed to be an important causative factor. Psychosocial events often trigger or exacerbate symptoms, and persons with BMS appear to be predisposed towards anxiety and depression. Atrophy of small nerve fibres in the tongue epithelium has been reported, and potential neuropathic mechanisms for BMS are now widely investigated. Historically, BMS was thought to comprise endocrinological, psychosocial and neuropathic components. Neuroprotective steroids and glial cell line-derived neurotrophic factor family ligands may have pivotal roles in the peripheral mechanisms associated with atrophy of small nerve fibres. Denervation of chorda tympani nerve fibres that innervate fungiform buds leads to alternative trigeminal innervation, which results in dysgeusia and burning pain when eating hot foods. With regard to the central mechanism of BMS, depletion of neuroprotective steroids alters the brain network-related mood and pain modulation. Peripheral mechanistic studies support the use of topical clonazepam and capsaicin for the management of BMS, and some evidence supports the use of cognitive behavioural therapy. Hormone replacement therapy may address the causes of BMS, although adverse effects prevent its use as a first-line treatment. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs) may have important benefits, and well-designed controlled studies are expected. Other treatment options to be investigated include brain stimulation and TSPO (translocator protein 18 kDa) ligands.
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Affiliation(s)
- Yoshiki Imamura
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan
| | - Takahiro Shinozaki
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan
| | - Akiko Okada-Ogawa
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan
| | - Noboru Noma
- Department of Oral Diagnostic Sciences, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan.,Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan
| | - Masahiro Shinoda
- Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan.,Department of Physiology, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan
| | - Koichi Iwata
- Nihon University School of Dentistry Dental Research Center, Chiyoda-ku, Tokyo, Japan.,Department of Physiology, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan
| | - Akihiko Wada
- Department of Radiology, Faculty of Medicine, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kelun Wang
- Department of Health Science and Technology, Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
| | - Peter Svensson
- Department of Dentistry and Oral Health, Section for Orofacial Pain and Jaw Function, Aarhus University, Aarhus, Denmark
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21
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Boucher Y. Psycho-stomatodynia. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2019. [DOI: 10.1051/mbcb/2018030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction:Burning mouth syndrome is an enigmatic condition whose etiopathogenic origin remains largely unknown and whose treatment remains unsatisfactory. It is often considered to be of “psychosomatic” origin, and this etiology is frequently reported in the French medical literature.Corpus:This narrative review examines the arguments supporting this point of view, in its historical, clinical, and therapeutic aspects, in order to shed light on the patientʼs point of view.Conclusion:The etiopathogenic uncertainty does not let us give the patient an erroneous conception of the affliction.
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22
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Simultaneous measurement of salivary cortisol and alpha-amylase: Application and recommendations. Neurosci Biobehav Rev 2017; 83:657-677. [DOI: 10.1016/j.neubiorev.2017.08.015] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/16/2017] [Accepted: 08/21/2017] [Indexed: 01/20/2023]
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23
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Vrijen C, Schenk HM, Hartman CA, Oldehinkel AJ. Measuring BDNF in saliva using commercial ELISA: Results from a small pilot study. Psychiatry Res 2017; 254:340-346. [PMID: 28525789 DOI: 10.1016/j.psychres.2017.04.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 01/19/2017] [Accepted: 04/09/2017] [Indexed: 01/01/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) is a protein often studied in psychiatric populations. Commercial ELISA kits have been validated for measuring BDNF in blood plasma and serum, but blood collection is an invasive method which cannot always be used. The aim of this pilot study was to explore the noninvasive alternative of measuring BDNF in saliva. Three different commercial ELISA kits were used to analyze parallel plasma and saliva samples from six healthy adults. In total 33 plasma and 33 saliva samples were analyzed according to manufacturers' standard protocols. BDNF was successfully measured in plasma in two of the three kits, of which the results correlated highly (rs =.88). BDNF could not be measured reliably in saliva. The results of this pilot study suggest that techniques of commercial BDNF kits may not be ready for noninvasive saliva measurements, which limits the sampling frequency and settings.
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Affiliation(s)
- Charlotte Vrijen
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, CC72, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
| | - Hendrika M Schenk
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, CC72, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
| | - Catharina A Hartman
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, CC72, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
| | - Albertine J Oldehinkel
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation, CC72, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
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Abstract
Objective To review the clinical entity of primary burning mouth syndrome (BMS), its pathophysiological mechanisms, accurate new diagnostic methods and evidence-based treatment options, and to describe novel lines for future research regarding aetiology, pathophysiology, and new therapeutic strategies. Description Primary BMS is a chronic neuropathic intraoral pain condition that despite typical symptoms lacks clear clinical signs of neuropathic involvement. With advanced diagnostic methods, such as quantitative sensory testing of small somatosensory and taste afferents, neurophysiological recordings of the trigeminal system, and peripheral nerve blocks, most BMS patients can be classified into the peripheral or central type of neuropathic pain. These two types differ regarding pathophysiological mechanisms, efficacy of available treatments, and psychiatric comorbidity. The two types may overlap in individual patients. BMS is most frequent in postmenopausal women, with general population prevalence of around 1%. Treatment of BMS is difficult; best evidence exists for efficacy of topical and systemic clonazepam. Hormonal substitution, dopaminergic medications, and therapeutic non-invasive neuromodulation may provide efficient mechanism-based treatments for BMS in the future. Conclusion We present a novel comprehensive hypothesis of primary BMS, gathering the hormonal, neuropathic, and genetic factors presumably required in the genesis of the condition. This will aid in future research on pathophysiology and risk factors of BMS, and boost treatment trials taking into account individual mechanism profiles and subgroup-clusters.
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Affiliation(s)
- Satu K Jääskeläinen
- Department of Clinical Neurophysiology, University of Turku and Turku University Hospital, Turku, Finland
| | - Alain Woda
- Université Clermont Auvergne, CROC and University Hospital, Odontology department; Clermont-Ferrand, France
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Chimenos-Küstner E, de Luca-Monasterios F, Schemel-Suárez M, Rodríguez de Rivera-Campillo ME, Pérez-Pérez AM, López-López J. Burning mouth syndrome and associated factors: A case-control retrospective study. Med Clin (Barc) 2017; 148:153-157. [PMID: 27871766 DOI: 10.1016/j.medcli.2016.09.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 07/26/2016] [Accepted: 09/08/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND OBJECTIVE Burning mouth syndrome (BMS) can be defined as burning pain or dysesthesia on the tongue and/or other sites of the oral mucosa without a causative identifiable lesion. The discomfort is usually of daily recurrence, with a higher incidence among people aged 50 to 60 years, affecting mostly the female sex and diminishing their quality of life. The aim of this study was to evaluate the association between several pathogenic factors and burning mouth syndrome. PATIENTS AND METHODS 736 medical records of patients diagnosed of burning mouth syndrome and 132 medical records for the control group were studied retrospectively. The study time span was from January 1990 to December 2014. The protocol included: sex, age, type of oral discomfort and location, among other factors. RESULTS Analysis of the association between pathogenic factors and BMS diagnosis revealed that only 3 factors showed a statistically significant association: triggers (P=.003), parafunctional habits (P=.006), and oral hygiene (P=.012). There were neither statistically significant differences in BMS incidence between sex groups (P=.408) nor association of BMS with the pathogenic factors of substance abuse (P=.915), systemic pathology (P=.685), and dietary habits (P=.904). CONCLUSIONS Parafunctional habits like bruxism and abnormal movements of tongue and lips can explain the BMS main symptomatology. Psychological aspects and systemic factors should be always considered. As a multifactorial disorder, the treatment of BMS should be executed in a holistic way.
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Affiliation(s)
- Eduardo Chimenos-Küstner
- Departamento de Odontoestomatología, Campus Universitario de Bellvitge , L'Hospitalet de Llobregat, Barcelona, España.
| | | | - Mayra Schemel-Suárez
- Escuela de Odontología, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
| | | | - Alejandro M Pérez-Pérez
- Facultad de Biología, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
| | - José López-López
- Departamento de Odontoestomatología, Campus Universitario de Bellvitge , L'Hospitalet de Llobregat, Barcelona, España
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Galli F, Lodi G, Sardella A, Vegni E. Role of psychological factors in burning mouth syndrome: A systematic review and meta-analysis. Cephalalgia 2016; 37:265-277. [DOI: 10.1177/0333102416646769] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Burning mouth syndrome (BMS) is a chronic medical condition characterised by hot, painful sensations in the lips, oral mucosa, and/or tongue mucosa. On examination, these appear healthy, and organic causes for the pain cannot be found. Several studies have yielded scant evidence of the involvement of psychological and/or psychopathological factors, and several have outlined a model for the classification of BMS. Aim This review aims to provide a systematic review of research examining the psychological, psychiatric, and/or personality factors linked to BMS. Findings Fourteen controlled studies conducted between 2000 and the present were selected based on stringent inclusion/exclusion criteria. All studies but one reported at least some evidence for the involvement of psychological factors in BMS. Anxiety and depression were the most common and the most frequently studied psychopathological disorders among BMS patients. Discussion and conclusion Anxiety and depression play critical roles in this condition. Evidence on the role of personality characteristics of BMS patients has also been produced by a few studies. Further studies on the role of specific psychological factors in BMS are warranted, but the importance of a multidisciplinary approach (medical and psychological) to BMS is no matter of discussion.
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Affiliation(s)
- Federica Galli
- Department of Health Sciences, University of Milan, Italy
| | - Giovanni Lodi
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, University of Milan, Italy
| | - Andrea Sardella
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, University of Milan, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Italy
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Siqueira EC, de Souza FTA, Ferreira E, Souza RP, Macedo SC, Friedman E, Gomez MV, Gomes CC, Gomez RS. Cell phone use is associated with an inflammatory cytokine profile of parotid gland saliva. J Oral Pathol Med 2016; 45:682-686. [PMID: 26876491 DOI: 10.1111/jop.12434] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND There is controversy on the effects of the non-ionizing radiation emitted by cell phones on cellular processes and the impact of such radiation exposure on health. The purpose of this study was to investigate whether cell phone use alters cytokine expression in the saliva produced by the parotid glands. METHODS Cytokine expression profile was determined by enzyme linked immuno sorbent assay (ELISA) in the saliva produced by the parotid glands in healthy volunteers, and correlated with self-reported cell phone use and laterality. RESULTS The following parameters were determined, in 83 Brazilian individuals in saliva produced by the parotid glands comparing the saliva from the gland exposed to cell phone radiation (ipsilateral) to that from the contralateral parotid: salivary flow, total protein concentration, interleukin 1 β (IL-1 β), interleukin 6 (IL-6), interleukin 10 (IL-10), interferon γ (IFN-γ), and tumor necrosis factor α (TNF-α) salivary levels by ELISA. After multiple testing correction, decreased IL-10 and increased IL-1β salivary levels in the ipsilateral side compared with the contralateral side (P < 0.05) were detected. Subjects who used cell phones for more than 10 years presented higher differences between IL-10 levels in ipsilateral versus contralateral parotids (P = 0.0012). No difference was observed in any of the tested parameters in correlation with cell phone monthly usage in minutes. CONCLUSION The exposure of parotid glands to cell phones can alter salivary IL-10 and IL-1β levels, consistent with a pro-inflammatory microenvironment that may be related to heat production.
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Affiliation(s)
- Elisa Carvalho Siqueira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fabrício Tinôco Alvim de Souza
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Efigênia Ferreira
- Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Renan Pedra Souza
- Department of General Biology, Biological Sciences Institute, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Samuel Costa Macedo
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Eitan Friedman
- The Susanne Levy Gertner Oncogenetics Unit, Sheba Medical Center Tel Hashomer and the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Carolina Cavaliéri Gomes
- Department of Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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das Neves de Araújo Lima E, Barbosa NG, dos Santos ACS, AraújoMouraLemos TM, de Souza CM, Trevilatto PC, da Silveira EJD, de Medeiros AMC. Comparative Analysis of Psychological, Hormonal, and Genetic Factors Between Burning Mouth Syndrome and Secondary Oral Burning. PAIN MEDICINE 2016; 17:1602-11. [DOI: 10.1093/pm/pnv087] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 11/27/2015] [Indexed: 11/14/2022]
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