Professor & patients' paper on the solvable biological challenge of ME/CFS: reader-friendly version
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Autonomic function, CFS and temporomandibular disorder

Discussion in 'Latest ME/CFS Research' started by MeSci, Oct 28, 2015.

  1. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    I couldn't find this here, to my surprise.

    Lucy J. Robinsonab, Justin Durhamc, Laura L. MacLachland & Julia L. Newtonde

    Published online: 05 Oct 2015

    Abstract

    Background: Chronic fatigue syndrome (CFS) is heterogeneous in nature, yet no clear subclassifications currently exist. There is evidence of dysautonomia in almost 90% of patients and CFS is often co-morbid with conditions associated with autonomic nervous system (ANS) dysfunction, such as temporomandibular disorders (TMD). The present study examined the point prevalence of TMD in a sample of people with CFS and explored whether co-morbidity between the conditions is associated with greater ANS dysfunction than CFS alone.

    Method:
    Fifty-one patients and 10 controls underwent screening for TMD. They completed a self-report measure of ANS function (COMPASS-31) and objective assessment of heart rate variability during rest and standing (derived using spectral analysis). Frequency densities in the high-frequency (HF) and low-frequency (LF) band were calculated.

    Results:
    Patients with CFS were divided into those who screened positive for TMD (n = 16, 31%; CFS + TMD) and those who did not (n  = 35, 69%; CFS − TMD). Both CFS groups had significantly higher self-rated ANS dysfunction than controls. CFS + TMD scored higher than CFS − TMD on the orthostatic and vasomotor subscales. The CFS + TMD group had significantly higher HF and significantly lower LF at rest than the other two groups. In discriminant function analysis, self-report orthostatic intolerance and HF units correctly classified 75% of participants.

    Conclusions:
    Almost one-third of CFS patients screened positive for TMD and this was associated with greater evidence of parasympathetic dysfunction. The presence of TMD shows potential as an effective screen for patients with CFS showing an autonomic profile and could help identify subgroups to target for treatment.

    http://www.tandfonline.com/doi/full/10.1080/21641846.2015.1091152
     
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  2. Scarecrow

    Scarecrow Annie Gsampel

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    I've never see it reported before that TMD is associated with ANS dysfunction.

    @MeSci do you have access to the full text? Any idea what the citation for that would be?
     
    Valentijn likes this.
  3. eafw

    eafw Senior Member

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    Interesting, I have had TMJ a long while, though it does come and go a bit. Is the speculation that the jaw muscles don't switch off properly in people with parasympathetic/autonomic problems OR the other way round, that TMJ exacerbates autonomic dysregulation ?
     
  4. Research 1st

    Research 1st Severe ME, POTS & MCAS.

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    TMD isn't associated to ANS dysfunction in terms of pathology of course. TMD is, however, common in ME 'CFS' and ME sufferers have POTS.

    To many, it's now patently obvious, it's the pathogens we have that damage our CNS, leading to ANS dysfunction and ME via chronic inflammation/autoimmunity.

    It should also be noted that Lyme, is associated to all 3: ANS Dysfunction, ME 'CFS' & TMJ.
     
    msf likes this.
  5. Jonathan Edwards

    Jonathan Edwards Senior Member

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    I cannot work out why there should be a relation, or why anyone should look for it, but maybe I am missing something.
     
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  6. Strawberry

    Strawberry Senior Member

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    I definitely agree, but want to see the full paper. I have had severe TMJD for nearly 35 years (age 15) while my fatigue/stamina/allergy issues started in early to mid 20s, and chronic sore throat late 20s. Now partially disabling fatigue in the last 3 years. I fell and split my chin open two times as a child, and TMJ set in after having my wisdom teeth removed at 15. I'm not quite understanding how that could have caused my CFS. To me it would be unrelated.

    Yet I am curious as all get out!
     
  7. Mark

    Mark Acting CEO

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    I was recently tested for TMD when being fitted with a maxillofacial device for my sleep apnea. The specialists said that the shape of my jaw - typical of the people they treat - could explain why the classical treatment for the sleep apnea (CPAP mask) hadn't been effective, and the maxillofacial device has indeed been much more effective and his improved the quality of my sleep significantly. I have had minor problems with my jaw clicking in the past, but they said I didn't have TMD. Nevertheless, it seems interesting that there may be this association between TMD (and perhaps in my case a somewhat TMD-like jaw) and atypical sleep apnea...perhaps there is a clue here to a subset of the CFS population (under broad CFS definitions) where TMD and resulting sleep problems may be particularly significant. N=1 but I thought I should post my experience in case it offers any clues as to the connections this research may be pointing at.
     
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  8. Scarecrow

    Scarecrow Annie Gsampel

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    TMJ is listed as one of the co-morbid entities in the CCC.

    I can tick off a few of the following and all of the ones that apply to me don't require too much of a stretch to connect them to ANS dysfunction but TMD/TMJ has always stood out as being different. I don't doubt that there is an association between ME and TMD but what is the basis of it? I never imagined that the connection would be ANS dysfunction but the abstract implies more than simple correlation.

    Is eafw's first suggestion plausible? It can't be the whole story. My jaw is only sporadically painful but I can never open my mouth smoothly - it always partially dislocates. I can't see it as a purely muscular problem.

     
  9. Strawberry

    Strawberry Senior Member

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    Actually, just to update my post, I would think the only connection would be inflammation in the joints. If there is inflammation of the joints, TMJD issues should almost be expected. But I fully do not agree that my TMJD is linked to or caused my CFS. Nor do I think it would be effective for screening for CFS.

    But still wanting to see the full article...
     
  10. Hip

    Hip Senior Member

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    Substance P might be the connection between a temporomandibular disorder (TMD) and the autonomic nervous system.

    I believe the neurotransmitter substance P is elevated in TMD (though at the moment I cannot find a reference for this, except here where it says: "serum levels of substance P levels are known to increase by over tenfold with bite dysfunction").

    Now this rat study found that on injection of substance P, both cardiac sympathetic nervous system activity and parasympathetic nervous system activity increase.
     
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  11. Marco

    Marco Grrrrrrr!

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  12. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    Sorry - forgot to include the title - it's 'Autonomic function in chronic fatigue syndrome with and without painful temporomandibular disorder.' (I found it by clicking on Julia's name.)

    I don't know if the full text is freely available - you could try a search using some of the text in double quotes.
     
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  13. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    Another article by the same authors:
    A systematic review of the comorbidity between Temporomandibular Disorders and Chronic Fatigue Syndrome
    Full text is behind a paywall, but this page has further info about the study (I think).
     
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  14. Strawberry

    Strawberry Senior Member

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    Once again, hoping somebody has access to the full paper? Or the one above? I am not understanding (as stated earlier) the link. CFS sufferers have inflammation. The temporal mandibular joint is a small and complex joint, if there is any inflammation in the system this joint will understandably have issues.

    IMHO this is like saying "people with caries/cavities seem to all have teeth."

    Can anyone access the paper(s)?
     
    jimells likes this.
  15. sillysocks84

    sillysocks84 Senior Member

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    This is weird. I noticed my left jaw joint started clicking and popping when I had my onset. Some days it doesn't click. The days it clicks my whole illness is more symptomatic. Still I don't understand why.
     

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