Headache attributed to temporomandibular disorders and masticatory myofascial pain
Headache attributed to temporomandibular disorders and masticatory myofascial pain
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DOI：
10.2334/josnusd.15-0491
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发表时间：
2016-06-01
影响因子：
1.9
通讯作者：
Imamura, Yoshiki
中科院分区：
文献类型：
--
作者：
Hara, Kazuhiko;Shinozaki, Takahiro;Imamura, Yoshiki
我们调查了符合TMD诊断标准（DC/TMD）和国际头痛疾病分类（ICHD）-3 β中规定的TMD所致头痛诊断标准（HATMD）的患者在TMD治疗期间颞下颌关节紊乱病（TMD）相关症状与头痛之间的时间相关性。该研究招募了34名由咀嚼肌筋膜疼痛而非颞下颌关节痛引起的HATMD患者。面部疼痛的强度，压力疼痛阈值的颅周肌肉，最大的无辅助打开的下巴进行了评估，在初步检查和物理治疗前后。在干预前后还记录了头痛发作的强度和频率以及牙齿接触率。头痛的强度和频率显着下降，这些减少在时间上与改善面部疼痛强度，最大的独立开放，和压力疼痛阈值在TMD治疗。线性回归分析显示，面部疼痛强度与头痛强度之间以及牙齿接触率与压痛阈值之间存在显著相关性。在符合DC/TMD和ICHD-3 β诊断标准的HATMD患者中，TMD治疗期间头痛改善，并且改善与TMD症状的改善暂时相关。这些发现表明中枢和外周神经系统的致敏是HATMD的原因。
We investigated the temporal association between temporomandibular disorders (TMD)-related symptoms and headache during TMD treatment for patients who fulfilled the diagnostic criteria for headache attributed to TMD (HATMD) specified in the Diagnostic criteria for TMD (DC/TMD) and International classification of headache disorders (ICHD)-3 beta. The study enrolled 34 patients with HATMD induced by masticatory myofascial pain but not by temporomandibular arthralgia. Facial pain intensity, the pressure pain threshold of pericranial muscles, and maximum unassisted opening of the jaw were assessed at an initial examination and before and after physical therapy. The intensity and frequency of headache episodes and tooth contact ratio were also recorded before and after the intervention. Headache intensity and frequency significantly decreased, and these reductions were temporally related to improvements in facial pain intensity, maximum unassisted opening, and pressure pain threshold during TMD treatment. Linear regression analysis showed significant correlations between facial pain intensity and headache intensity and between tooth contact ratio and pressure pain threshold. Among patients who fulfilled the DC/TMD and ICHD-3 beta diagnostic criteria for HATMD, headache improved during TMD treatment, and the improvement was temporally related to amelioration of TMD symptoms. These findings suggest that sensitization in the central and peripheral nervous systems is responsible for HATMD.