Individuals with chronic migraine (CM) and temporomandibular disorder (TMD) may have mechanical hyperalgesia in the trigeminal and extra-trigeminal regions, according to a study published in Acta Odontologica Scandinavica.
A total of 52 patients with CM and TMD and 30 asymptomatic individuals were recruited from a neurology department in a hospital in Spain. Participants were asked to complete questionnaires on demographic and pain-related data (ie, pain, pain catastrophizing, pain related to disability, impact and severity of headache, and signs and symptoms of depression and anxiety). In addition, pain pressure thresholds (PPTs) and maximal mouth opening were measured.
PPTs were found to be lower in patients with CM and TMD vs asymptomatic participants both in the trigeminal and extra-trigeminal regions (P <.01). The presence of depression symptoms (assessed with the Spanish version of the Hospital Anxiety and Depression Scale) was found to predict PPTs in the masseter muscle (P =.001; accounting for 18% of the variance) and in the control point (P =.011; 10% of the variance). The PPT in the temporal muscle was found to be predicted by results on the Craniofacial and Disability Inventory (P =.001; accounting for 20% of the variance). The Craniofacial and Disability Inventory was found to predict pain-free maximal mouth opening (P <.001; 24% of the variance).
Study limitations include a high percentage of women in the cohort (87.8%), study participants from a single center, and a small cohort.
“It has been proposed that the pathophysiology of migraine may be associated with a central sensitization process… Migraine-related allodynia develops at the site where headache occurs, normally in the ophthalmic region of the trigeminal nerve, and propagates throughout the face, scalp, body, and upper and lower limbs. There is now evidence that patients with TMD present with generalized hyperalgesia. This finding supports the view that central sensitization mechanisms govern both conditions,” concluded the study authors.
Garrigós-Pedrón M, La Touche R, Navarro-Desentre P, Gracia-Naya M, Segura-Ortí E. Widespread mechanical pain hypersensitivity in patients with chronic migraine and temporomandibular disorders: relationship and correlation between psychological and sensorimotor variables [published online January 10, 2019]. Acta Odontol Scand. doi: 10.1080/00016357.2018