1. Investigación

Background: We aimed to determine the presence of alexithymia in patients with craniofacial pain (CFP) compared with asymptomatic individuals. Our secondary aims were to assess the relationship of alexithymia with anxiety and depression levels, as well as to assess the presence of facial emotion recognition deficit. Methods: Medline, Scielo and Google Scholar were searched, with the last search performed in 8 September 2021. Standardized mean differences (SMDs) and 95% CIs were calculated for relevant outcomes and were pooled in a meta-analysis using the random effects model. In addition, meta-analyses of correlations and a metaregression of alexithymia with depression and anxiety were performed. Results: Regarding alexithymia, assessed through the Toronto Alexithymia Scale (TAS), the results showed significant differences, with higher values in patients compared with asymptomatic individuals, with a large clinical effect (SMD 0.46; 95% CI [0.22–0.71]; heterogeneity-Q 66.86; p < 0.001; inconsistency (I2) = 81%). We found statistically significant correlations with a small clinical effect of alexithymia with anxiety and depression. The meta-regression showed no significant association between the TAS and anxiety or depression. With respect to facial emotion recognition, the results showed statistically significant differences, with greater recognition difficulty in patients compared with asymptomatic individuals, with a large clinical effect (SMD −1.17; 95% CI [−2.01 to −0.33]; heterogeneity-Q 2.97; p = 0.080; I2 = 66%). Conclusions: Patients with CFP showed alexithymia with moderate evidence. There was also moderate evidence indicating that these patients had significant deficits in facial emotion recognition compared with asymptomatic individuals. Furthermore, alexithymia showed statistically significant correlations with anxiety and depression levels.

The aim of the present study was to explore the pain modulation effects of motor imagery(MI) and action observation (AO) of specific neck therapeutic exercises both locally, in the cervicalregion, and remotely. A single-blind, placebo clinical trial was designed. A total of 30 patients withchronic neck pain (CNP) were randomly assigned to an AO group, MI group, or placebo observation(PO) group. Pain pressure thresholds (PPTs) of C2/C3, trapezius muscles, and epicondyle werethe main outcome variables. Secondary outcomes included heart rate measurement. Statistically significant differences were observed in PPTs of the cervical region in the AO and MI groups betweenthe preintervention and first postintervention assessment. Significant differences were found inthe AO group in the epicondyle between the preintervention, first and second post-intervention assessments. Regarding heart rate response, differences were found in the AO and MI groups betweenthe preintervention and average intervention measurements. AO and MI induce immediate painmodulation in the cervical region and AO also induces remote hypoalgesia. OA appears to lead togreater pain modulation as well as a greater heart rate response, however, both should be clinicallyconsidered in patients with CNP.