![]() A better understanding of HATMD is necessary for developing targeted strategies for its management. In contrast to primary headaches, HATMD is associated with higher headache frequency and examination-evoked masticatory muscle pain, but with surprisingly few measures of facial pain, general health, and psychological distress. HATMD is highly prevalent among patients with chronic myogenous TMD and headaches and often presents as migraine. The lasso model identified headache frequency and examination-evoked muscle pain as the most important predictors of HATMD. Few interactions were observed, demonstrating that most characteristics’ associations with HATMD were consistent in TTH and migraine groups. Multiple characteristics of facial pain, headache, general health, and psychological distress differed between TTH or migraine groups. Lowered blood pressure but not psychological or sensory characteristics was associated with HATMD. In univariate analyses, characteristics associated with HATMD included pain-free jaw opening and examination-evoked pain in masticatory muscles and temporomandibular joints (TMJ) as well as frequency and impact of headache, but not frequency or impact of facial pain. Of 185 participants, 114 (61.6%) had HATMD, while the numbers with TTH (n = 98, 53.0%) and migraine (n = 87, 47.0%) were similar. Multivariable lasso regression identified the most important predictors of HATMD. ![]() Univariate regression models quantified the associations of each characteristic with HATMD (present versus absent), headache type (TTH versus migraine), and their interaction in a factorial design. Questionnaires and examinations evaluated 42 characteristics of facial pain, headache, general health, psychological distress, and experimental pain sensitivity. ![]() HATMD was classified based on the DC/TMD. This cross-sectional study of people with both chronic myogenous TMD and primary headaches evaluated characteristics associated with HATMD.įrom a clinical trial of adults, baseline data were used from a subset with diagnoses of both TMD myalgia according to the Diagnostic Criteria for TMD (DC/TMD) and TTH or migraine according to the International Classification of Headache Disorders, 3rd edition. Headache attributed to Temporomandibular Disorder (HATMD) is a secondary headache that may have features resulting in diagnostic overlap with primary headaches, namely, tension-type (TTH) or migraine. Future studies should clarify the nature of the relationship. Magnitude of association is higher for migraine. Temporomandibular disorder symptoms are more common in migraine, ETTH, and CDH relative to individuals without headache. Differences were significant for ETTH (2.7 1.5-4.8), and were numerically but not significant for CDH (2.3 0.66-8.04). Finally, 3 or more TMD symptoms were also more common in migraine (6.2 3.8-10.2) than in no headaches. At least 2 TMD symptoms also happened more frequently in migraine (4.4, 3.0-6.3), CDH (3.4 1.5-7.6), and ETTH (2.1 1.3-3.2), relative to individuals with no headaches. Taking individuals without headache as the reference, the prevalence of at least 1 TMD symptom was increased in ETTH (prevalence ratio = 1.48, 95% confidence interval = 1.20-1.79), migraine (2.10, 1.80-2.47) and CDH (2.41, 1.84-3.17). 0001) for 3 or more symptoms, the difference was even more pronounced: 72.8% vs 37.9%. For 2 symptoms, figures were 65.1% vs 36.3% (P <. When at least 1 TMD symptom was reported, any headache happened in 56.5% vs 31.9% (P <. Primary headaches were diagnosed based on the International Classification of Headache Disorders. TMD symptoms were assessed through 5 questions, as recommended by the American Academy of Orofacial Pain, in an attempt to classify possible TMD. The potential comorbidity of headache syndromes and TMD has been established mostly based on clinic-based studies.Ī representative sample of 1230 inhabitants (51.5% women) was interviewed by a validated phone survey. A population-based cross-sectional study was conducted to estimate the prevalence of migraine, episodic tension-type headaches (ETTH), and chronic daily headaches (CDH), as well as the presence of symptoms of temporomandibular disorders (TMD) in the adult population.
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