{"doi":"10.17615/k720-mb84","title":"Pressure pain thresholds fluctuate with, but do not usefully predict, the clinical course of painful temporomandibular disorder","abstract":"Central sensitization elicits pain hypersensitivity and is thought to be causally implicated in painful temporomandibular disorder (TMD). This causal inference is based on cross-sectional evidence that people with TMD have greater sensitivity than controls to noxious stimuli. We tested this inference in the OPPERA prospective cohort study of 3,258 adults with no lifetime history of TMD when enrolled (Visit 1). During five years of follow-up, one group labelled “persistent TMD cases” (n=72) developed first-onset TMD by Visit 2 that persisted ≥6 months until Visit 3. Another group labelled “transient TMD cases” (n=75) developed first-onset TMD at Visit 2 which resolved by Visit 3. Randomly sampled “controls” (n=126) remained TMD-free throughout all three visits. At each visit, pressure pain thresholds (PPTs) were measured by algometry at 10 cranial and bodily sites. In persistent TMD cases, mean PPTs reduced 43 kPa (P<0.0001) between Visits 1 and 2 and thereafter did not change significantly. In transient TMD cases, mean PPTs reduced 41 kPa (P<0.001) between Visits 1 and 2, and then increased 20 kPa (P<0.001) by Visit 3. These patterns were similar after excluding cranial sites symptomatic for TMD. Importantly, Visit 1 PPTs had no clinically useful prognostic value in predicting first-onset TMD (odds ratio [OR] 1.07, P=0.15). Among first-onset cases, Visit 2 PPTs were modest predictors of persistent TMD (OR=1=.36, P=0.002). In this longitudinal study, PPTs reduced when TMD developed then rebounded when TMD resolved. However, pre-morbid PPTs poorly predicted TMD incidence, countering the hypothesis that they signify mechanisms causing first-onset TMD.","journal":"UNC Libraries","year":2020,"id":136353,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9545,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":301592,"name":"Roger B. Fillingim","orcid":"0000-0002-7699-8183","position":1,"is_corresponding":false},{"id":301595,"name":"Anne E. Sanders","orcid":"0000-0003-2607-9514","position":2,"is_corresponding":false},{"id":301594,"name":"Joel D. Greenspan","orcid":"0000-0003-4062-9797","position":3,"is_corresponding":false},{"id":595430,"name":"Ron Dubner","orcid":null,"position":4,"is_corresponding":false},{"id":79748,"name":"Eric Bair","orcid":"0000-0001-8733-7869","position":5,"is_corresponding":false},{"id":301593,"name":"Richard Ohrbach","orcid":"0000-0002-9266-9734","position":6,"is_corresponding":false},{"id":547651,"name":"Richard H. Gracely","orcid":null,"position":7,"is_corresponding":false},{"id":130820,"name":"William Maixner","orcid":null,"position":8,"is_corresponding":false},{"id":301597,"name":"Gary D. Slade","orcid":"0000-0002-4065-6341","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-18T23:16:48.793683Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}