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Basal Circadian Cortisol Secretion in Women with Temporomandibular Disorders

¹ Department of Psychological Medicine, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK;
² Department of Psychiatry, University of Michigan, Ann Arbor, USA;
³ Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, USA; and
⁴ Department of Internal Medicine, University of Michigan, Ann Arbor, USA;

*corresponding author, akorszun{at}umich.edu

Muscular temporomandibular disorder (TMD) is a common stress-related condition showing marked comorbidity with depression and fibromyalgia (FM), both of which are associated with dysregulation of cortisol secretion. We measured cortisol levels in 15 women with well-defined TMD and 15 matched controls by sampling blood at 10-minute intervals over 24 hours in a controlled environment. TMD patients showed markedly increased daytime cortisol levels 30% to 50% higher than those of controls (p = 0.0032) and a one-hour phase delay in the timing of maximum cortisol levels (p = 0.048). Increased activation of the stress hormone axis by conscious pain perception is a likely explanation, but the magnitude of the increase could indicate that pain in the facial region acts as a greater stimulus than pain elsewhere in the body.

KEY WORDS: cortisol • temporomandibular disorders • facial pain

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