Temporomandibular disorder in chronic migraine

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Abstract

Rationale: For many years, temporomandibular disorder (TMD) has been studied primarily by dentists and maxillofacial surgeons. However, new data is emerging that TMD is comorbid with various types of headache; however this association has not been studied in detail. Aim: To analyze TMD prevalence and clinical structure in patients with migraine. Materials and methods: We assessed 84 patients with chronic migraine (CM) and 42 patients with episodic migraine (EM). TMD was diagnosed according to the Diagnostic Criteria for Temporomandibular Disorders: Clinical Protocol and Assessment Instruments 2014. We also performed subgroup analysis for low-frequency EM (less than 4 headache days per month, LFEM) vs. high-frequency EM and CM (over 10 headache days per month, HFEM + CM). Results: In both groups, myofascial pain was the most prevalent form of TMD. The prevalence of TMD was higher in CM as compared to EM (52.4% vs. 28.6%, correspondingly, р = 0.02). Even more evident differences were observed between LFEM and HFEM + CM (18.2% vs. 51.6%, correspondingly, р < 0.009). The difference was significant for painrelated TMD only. The prevalence of bruxism was comparable across LFEM and HFEM + CM (18% vs. 30.5%, correspondingly, р = 0.3) and significantly lower than TMD prevalence in HFEM + CM (30.5% vs. 51.6%, correspondingly, p = 0.005). The anxiety level in patients with and without TMD was also comparable (8.1 ± 4.1 vs. 8.3 ± 4.7, correspondingly, р = 0.8). Conclusion: CM patients have a high prevalence of pain-related TMD (52.4%). The prevalence of TMD in LFEM is comparable to that in the general population. The presence of bruxism or anxiety cannot be associated with a high TMD prevalence in our patients. In CM, pain in the masticatory muscles may be caused by anti-nociceptive dysfunction, mirroring central sensitization and disrupted descending modulation of pain.

About the authors

N. V. Latysheva

I.M. Sechenov First Moscow State Medical University

Author for correspondence.
Email: ninalat@gmail.com

Latysheva Nina V. – MD, PhD, Associate Professor, Chair of Neurology, Institute for Professional Education 

10b Staropetrovsky proezd, Moscow, 125040

Россия

E. G. Filatova

I.M. Sechenov First Moscow State Medical University

Email: fake@neicon.ru

Filatova Elena G. – MD, PhD, Professor, Chair of Neurology, Institute for Professional Education 

10b Staropetrovsky proezd, Moscow, 125040

Россия

A. S. Platonova

I.M. Sechenov First Moscow State Medical University

Email: fake@neicon.ru

Platonova Aleksandra S. – MD, Postgraduate Student, Chair of Neurology, Institute for Professional Education

10b Staropetrovsky proezd, Moscow, 125040

Россия

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Copyright (c) 2017 Latysheva N.V., Filatova E.G., Platonova A.S.

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