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Are central sensitization symptoms and psychosocial alterations interfering in the association between painful TMD, migraine, and headache attributed to TMD?
Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil.
Malmö University, Faculty of Odontology (OD). Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark. (Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark)ORCID iD: 0000-0001-5809-8037
Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil.
Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, São Paulo, Brazil.
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2023 (English)In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 27, no 2, p. 681-690Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To determine if somatosensory function and symptoms related to central sensitization (CS) differed in individuals with painful temporomandibular disorders (TMD) according to the presence of migraine (MIG) or MIG + headache attributed to TMD (HAT).

MATERIALS AND METHODS: This study evaluated 92 adults (20-65 years), presenting painful TMD. Standard diagnostic criteria were applied to classification of painful TMD, MIG, and HAT. CS was assessed through the central sensitization inventory (CSI), wind-up ratio (WUR), pressure pain thresholds (PPT), and the conditioned pain modulation test (CPM). Psychosocial factors were evaluated by validated instruments.

RESULTS: There was a significant difference regarding gender, with more women in the group TMD + MIG + HAT (p = 0.028). TMD + MIG and TMD + MIG + HAT had significantly lower PPTs than the TMD group. No group differences were found for the WUR, CPM, or CSI. TMD + MIG + HAT had higher chronic pain intensity (p = 0.001), disability points (p = 0.045), graded chronic pain scale (p = 0.007), and higher somatization (NSPS) scores (p = 0.012), compared to the other groups.

CONCLUSION: Mechanical hyperalgesia was more pronounced in the group with the highest pain and somatization scores, while CPM and WUR did not differ between groups. Altered somatosensory function and CS may partially underlie the pathophysiology of overlapping TMD pain conditions, pointing towards additive effects of comorbid head pains.

CLINICAL RELEVANCE: Our results demonstrate the importance of considering the association of primary and secondary headaches during TMD assessment and its implications for maintaining the signs and symptoms of CS. This can influence the conduct of treatment, which must be multidisciplinary, and must include management of mechanisms related to CS.

Place, publisher, year, edition, pages
Springer, 2023. Vol. 27, no 2, p. 681-690
Keywords [en]
Headache, Migraine disorders, Sensitization of the central nervous system, Temporomandibular Disorders, Trigeminal physiology
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-56310DOI: 10.1007/s00784-022-04783-5ISI: 000885715400001PubMedID: 36383296Scopus ID: 2-s2.0-85142002287OAI: oai:DiVA.org:mau-56310DiVA, id: diva2:1714640
Available from: 2022-11-30 Created: 2022-11-30 Last updated: 2024-02-05Bibliographically approved

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Svensson, Peter

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