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Biomedical subjects

S F Dworkin

Publications and source records attributed to S F Dworkin.

At least 55 records · Page 3Linked to original sources
PubMed1986

Correspondence between subjective report of temporomandibular disorder symptoms and clinical findings.

Correspondence between subjective reports of temporomandibular disorder symptoms and clinical findings was examined in 65 volunteers. Significant relationships showed that the greater the number of reported symptoms, the greater the likelihood that positive signs would be found during examination. The symptom survey questionnaires served as a valid method for screening patients for temporomandibular disorder-related signs.

Adult↗
PubMed1984

A pain microcomputer system for clinical and laboratory investigation.

This report describes the design and use of a mobile "Pain Microcomputer System" (PMS). As a mobile clinical and laboratory research tool the PMS integrates four functions: (1) psychophysical measurement of behavioral pain responses; (2) psychophysiologic recording, including brain evoked potentials, cortical power spectrum analysis, EKG and EMG; (3) data acquisition, analysis and display; (4) peripheral communications via modem allows interaction with larger computers for more complex data analyses, extensive graphics, etc. A word processor disk facilitates writing of scientific and clinical reports. Present and future capabilities of the system for comprehensive pain research and patient care are discussed.

Animals↗
PubMed1984

Facial expression accompanying pain.

The study of facial expression accompanying pain is of both practical and theoretical importance. It has been suggested that nonverbal behavior may provide accurate information on pain states to supplement self-report and that perhaps facial expressions could even serve as accurate measures of pain in the absence of verbal report. Recent studies of specific facial expressions accompanying pain have benefited greatly from the techniques and findings of earlier research on facial expressions of emotion. These research findings also raise a number of questions concerning relationships between pain and emotion expressions, and provide some tools (e.g. direct facial measurement systems) for answering them. A review of empirical research indicates that there are distinct facial expressions which accompany acute painful experiences with some regularity, and that these expressions occur in both infants and adults, at least in Western cultures. Important areas for future research include cross-cultural studies, investigations of the circumstances under which these facial expressions occur and the possibilities for masking or falsifying them and research into facial behaviors related to chronic pain.

Facial Expression↗
PubMed1984

Cognitive modification of pain: information in combination with N2O.

The present study sought to discover whether information clarifying how the analgesic/sedative drug nitrous oxide (N2O) works would result in increased analgesic responses to painful stimuli when various concentrations of N2O were administered. Subjects were provided with high and low levels of information regarding the action and use of N2O as an analgesic and sedative. Absolute sensation threshold (AST), pain threshold (PTh), and pain tolerance (PTo) to tooth pulp shock were measured in microamperes during administration of each of 3 concentrations of N2O (15%, 30%, and 45%, with oxygen). Subjects rated stimulus intensity and stimulus aversiveness in response to a fixed painful stimulus, and completed questionnaires regarding the perceived efficacy of N2O and their subjective mood state throughout the session. The marked differences observed in pain reports between the high information group and the control group confirm that providing information to people receiving a drug for pain relief yields higher sensation thresholds, pain thresholds, and tolerance of pain. In addition, we observed that in the presence of N2O an equivalent fixed painful stimulus will be perceived as less painful after appropriate information is provided. These findings suggest that experimentally influencing thought processes, in combination with an analgesic, can have the effect of increasing analgesia.

Adult↗
PubMed1984

Intraligamentary anesthesia: a double-blind comparative study.

Three local anesthetic agents (Xylocaine 2%, Xylocaine 2% with epinephrine 1:50,000, and Marcaine 0.5 with epinephrine 1:200,000) were injected intraorally using an intraligamentary injection technique. The study used a double-blind design and electrical tooth pulp stimulation to examine the duration of pulpal anesthesia. Patterns of recovery from each drug, subjective discomfort associated with each drug, pain of injection, and pain in comparison with local infiltration were also measured. The extent and duration of adjacent soft tissue anesthesia were recorded. Xylocaine 2% with epinephrine 1:50,000 produced the longest pulpal anesthesia. The decay pattern of this particular drug was less abrupt than that of the two others. No difference in discomfort or pain was found across the various drugs. There was no significant difference in pain at injection when intraligamentary anesthesia was compared with local infiltration. Post-injection pain was slightly lower with local infiltration. The extent of soft tissue anesthesia was significantly related to vasoconstrictor levels in the drugs. The study shows that duration of pulpal and soft tissue anesthesia can be tightly controlled by the operator and tailored specifically to planned dental procedures.

Adult↗
PubMed1983

Benign chronic orofacial pain. Clinical criteria and therapeutic approaches.

Trigeminal neuralgia and temporomandibular joint (TMJ) pain-dysfunction syndrome are the most common benign orofacial pain disorders. Because orofacial pain can arise from many sources and can be exacerbated by emotional stress, diagnosis is complex. Primary trigeminal neuralgia (tic douloureux) is characterized by severe paroxysms of pain often initiated by stimuli applied to trigger zones. Atypical facial neuralgia is a more loosely defined collection of orofacial neuralgias with variable distribution of pain and age of onset. Treatment (ie, pharmacologic and surgical procedures, nerve blocks, alcohol injection) is often based on the theoretical biases of clinicians. The most common clinical findings in TMJ pain-dysfunction syndrome are localized facial pain, mandibular dysfunction, and joint sounds. Therapy includes use of drugs to relieve pain and relax muscles, elimination of occlusal discrepancies, and surgical procedures. Psychologic referral is usually considered a last resort.

Biofeedback, Psychology↗
PubMed1983

Analgesic effects of nitrous oxide with controlled painful stimuli.

This study was designed to provide statistical estimates of the effects of N2O on pain and anxiety associated with tooth-pulp shock in a clinical and in a laboratory setting. Amounts of electric stimulation needed to first feel sensation, amounts to feel pain, and pain tolerance were measured. N2O had a significant effect on raising levels of absolute sensation, pain threshold, and pain tolerance in response to increasing electrical stimulation of teeth. These effects were noted when N2O and pulp stimulation were delivered in a clinical dental setting or in a pain-research laboratory. Subjects also decreased their evaluation of the intensity of the same stimulus as N2O was inhaled at various concentrations; their aversion to the same stimulus tended to be influenced by N2O to a greater extent than perceived intensity. Anxiety levels were reduced to a statistically significant degree.

Adolescent↗
PubMed1983

Cortical power spectral analysis of acute pathophysiological pain.

In the past decade, advances in quantitative EEG methods, such as the analysis of cortical power spectrum, have proven a useful tool for observing changes in brain activity as a function of physiological and behavioral states. The cortical power spectrum (CPS) is a computer-derived analysis of brain electrical activity using mathematical principles of Fast Fourier Transform function. The total energy output of specific cortical areas can be estimated over time, as a function of EEG spectral frequencies. This report describes the study of CPS in pathophysiological pain patients, using acute dental pain as a model. Seven "walk-in" acute pain patients in an emergency dental clinic were recorded during 10 min of pain, before treatment. Approximately one week later, 10 min recordings during nonpain states were obtained as control. Subjective pain scales and other psychological measures were administered to all subjects before and after recording on each visit. Each 10 min stage of continuous CPS recording consisted of 10 spectra per stage, 6 epochs/spectrum, and 10.24 sec/epoch; each spectrum was stored, averaged, transformed, displayed, printed, and plotted by the Pain Microcomputer System. Results show significant cortical power reduction along all frequency bands (0.5-50 Hz) when pain-states are compared to nonpain states. The magnitude of reduction also appears to correspond to subjective pain report. Analysis for rank order may be inversely related to subjective painfulness, indicating that pain and alpha-desynchronization are closely associated. This study demonstrates that the brain activity of clinical pain patients can be measured. The feasibility of developing a pathophysiological objective pain measuring system is discussed.

Acute Disease↗
PubMed1983

Cognitive reversal of expected nitrous oxide analgesia for acute pain.

In a laboratory experiment, the expected analgesic action of 33% nitrous oxide was reversed by creating the expectancy of heightened awareness of bodily sensations. Pain threshold and tolerance of electrical tooth-pulp stimulation were significantly reduced. Results from a control study gave us a basis for comparison of changes in the verbal expression of pain when nitrous oxide was administered without introducing expectancies beyond those already held by the subjects. Contrasting results from the experimental and control studies confirm the powerful role of mental processes in mediating pain experience.

Adult↗
PubMed1982

Pain in clinical and laboratory contexts.

Subjects served as their own control when tooth pulp shock was delivered in laboratory and clinical situations. Significantly heightened pain was observed in the clinical dental setting. The dental setting proved more anxiety-provoking and associated with reduced tolerance for pain, suggesting that cognitive contexts of a dental setting may elicit heightened subjective pain responses.

Adult↗
PubMed1981

Cortical power spectrum analysis of hypnotic pain control in surgery.

Cortical power spectrum (CPS) of brain potentials was recorded from the scalp between prefrontal and parietal regions in both right hemisphere (RH) and left hemisphere (LH). A pattern of laterality shift in CPS occurred at different stages during an extensive oral surgery, performed under hypnosis, in a young female patient. Video and audio recordings as well as psychophysiological recordings were obtained through the following 6 stages: Baseline, Hypnosis, Surgery (1 hr, no cortical recording), Immediate Postsurgery Procedure, Hypnotic Re-experience, Hypnotic Rest, and Posthypnotic Baseline. Indications of anxiety and pain scores were reported in writing by the patient through verbal command by the hypnotist. In each stage, 10 min of CPS (10 spectrum/stage, 8 epochs/spectrum, 6 seconds/epoch) were analyzed by a PDP-11 computer. The results of CPS analysis demonstrated significant large total power reduction at different stages. There was significant correlation between both hemispheres at baseline, but dissociation of hemispheric power output occurred during hypnosis stages. LH was more dominant than RH during baseline and presurgery hypnosis, but both were leveled-off immediately following the surgery procedure. However, RH became more dominant during all postsurgery hypnosis stages. Interestingly, this pattern shifted back to the original relationship during the posthypnotic baseline stage. Specific changes of spectral power in theta and alpha of EEG activities in both hemispheres also occurred in conjunction with hypnosis.

Adult↗
PubMed1975

Chronic MPD, group therapy and psychodynamics.

Three groups of patients with myofascial pain-dysfunction syndrome received 12 eclectic group psychotherapy sessions. The principal reason for selecting this mode of treatment was to observe the group dynamics for the operation of intra and interpersonal variables that might support the psychophysiologic hypothesis for myofascial pain-dysfunction syndrome and validate the existence of personality characteristics that are associated with patients who have myofascial pain-dysfunction.

Attitude↗