Anxiety has a great influence on the painful experience related to Temporomandibular Disorder (TMD), but the association between clusters of anxiety phenotypes and the subjective perception of signs and symptoms was few explored in the scientific literature. The aim of this study was to analyze the impact of anxiety level on the pain perception experience and fatigue of masticatory muscles in subjects with chronic TMD according to clusters of anxiety phenotypes.
26 patients with a diagnosis of TMD (DC/TMD) were assessed: Anxiety level (BAI), emotional, sensory and affective aspects of the pain experience (SF-MPQ), pain catastrophizing, presence of referred pain and perception of TMD signs and symptoms (ProTMDMulti). The fatigue (masseter/temporalis) was also analyzed by surface electromyography, and the TMD patients were compared with 13 controls paired by age and gender.
Patients with moderate/severe anxiety showed higher scores for all pain indexes and pain catastrophization, besides a higher association with DC/TMD diagnoses, self-perception of TMD-related signs and symptoms, and higher muscle fatigue mastication (p < 0.05) when compared with minimum/low anxiety. Temporalis muscle showed higher fatigue compared with masseter.
The level of anxiety directly impacts the perception of painful experience and other signs and symptoms of TMD as well as the fatigue response of masticatory muscles. Clusters based on anxiety phenotypes show different clinical manifestations of painful TMD, such results emphasize the need to specific strategies to identify these subgroups in order to increase clinical assertiveness in pain management.