Temporomandibular disorders patients with migraine symptoms have increased disease burden due to psychological conditions

Background: Various studies have demonstrated a close link between headaches and temporomandibular disorders (TMD). However, the results are often limited to certain clinical aspects and are based on a cross-sectional study design. This study aimed to examine the clinical characteristics of patients with both TMD and migraine symptoms and to assess the long-term treatment outcomes compared to TMD patients without migraine. Methods: Sixty-four TMD patients were evaluated using the Diagnostic Criteria for TMD protocol and validated questionnaires, including Generalized Anxiety Disorder-7, Patient Health Questionnaire (PHQ)-9, PHQ-15, the Graded Chronic Pain Scale, and the Symptom Checklist-90-Revision (SCL-90-R). Patients were divided into two groups based on the presence of migraine symptoms requiring medication. The study compared psychological and clinical profiles, as well as long-term treatment outcomes. Results: The migraine group exhibited greater psychological distress, as indicated by higher scores in the SCL-90-R subscales for somatization (p = 0.035), obsessive-compulsive behavior (p = 0.015), interpersonal sensitivity (p = 0.002), depression (p = 0.035), anxiety (p = 0.042), hostility (p = 0.004), paranoid ideation (p = 0.016), and psychoticism (p = 0.044). Additionally, they scored higher on the PHQ-9 (p = 0.023) and PHQ-15 (p = 0.016). Pain levels were higher in the migraine group at 3 months post-treatment (p = 0.023) but the difference with the non-migraine group disappeared 6 months post-treatment. Younger age (odds ratio (OR) = 0.844, p = 0.001), female (OR = 0.001, p = 0.011), and more positive sites on masticatory muscle palpation (OR = 2.580, p = 0.011) were associated with a higher likelihood of experiencing migraine. Mental illness history (β = −0.465, p = 0.002), tongue ridging (β = −0.683, p < 0.001), and Oral Behavior Checklist scores (β = 0.483, p = 0.002) were associated with TMD pain intensity in the migraine group. Conclusions: TMD patients using sumatriptan for migraine symptoms had higher levels of disability and psychological distress, leading to an increased disease burden. Although the migraine group had worse short-term TMD treatment outcomes, these differences resolved after six months of treatment.

Temporomandibular disorders; Migraine; Sumatriptan; Psychological problem; Disease burden

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