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.