Impact of temporomandibular disorder comorbidity on pain, quality of life, sleep, and functional outcomes in chronic migraine patients not using preventive treatment: a cross-sectional study.

Abstract

Objectives: To investigate pain, quality of life, sleep, and functional outcomes between chronic migraine (CM) patients with temporomandibular disorder (TMD) and patients with CM alone.

Methods: Thirty one patients with CM and thirty one patients with CM+TMD were recruited in the study. All patients had not been on preventive treatment for CM or TMD in the previous three months. TMD was examined by physical examination, guided by the subdomains of the Helkimo Clinical Dysfunction Index (HCDI). All patients were evaluated for allodynia using the Allodynia Symptom Checklist (ASC-12), quality of life using the 36-item Short Form Health Survey (SF-36), headache-related disability using the Migraine Disability Assessment Scale (MIDAS) and the Headache Impact Test (HIT-6), and sleep quality using the Pittsburgh Sleep Quality Index (PSQI).

Results: The average pain intensity was higher in patients with CM+TMD (p < 0.001). The number of patients with a migraine attack duration of more than 3 days were significantly higher in the same group (p = 0.001). ASC-12 scores were significantly elevated in patients with CM+TMD (p < 0.001). MIDAS and HIT-6 scores were significantly higher in the CM+TMD patient group (p = 0.010, p < 0.001, respectively). HCDI score was significantly positively correlated with age, BMI, average number of headache days in a month, ASC-12 score, PSQI sleep disturbance domain score, and PSQI total score (r = 0.625, 0.406, 0.417, 0.484, 0.499, and 0.487, respectively).

Conclusion: In patients with CM, TMD comorbidity significantly associated with high average pain intensity, migraine attack duration, and allodynia. Physicians managing headaches should not overlook TMD symptoms in CM and should benefit from collaborating with TMD specialists to address TMD symptoms effectively.