Abstract
to analyze the frequency of different forms of temporomandibular joint dysfunction (TMJD) in episodic and chronic migraine and to study mechanisms of their comorbidity. Sixty-three patients with chronic migraine (CM) and 40 patients with episodic migraine (EM) were examined. Anxiety and depression were assessed with the HADS, quality-of-life related to headache was measured with the HIT-6. To evaluate the antinociceptive system function, we studied blink reflex (BR) and nociceptive flexion reflex (NFR). The higher frequency of TMJD was identified in patients with CM compared to those with EM (47.5 and 28.5%, respectively), CM patients more frequently had disturbances related to the myofascial pain syndrome of masticatory muscles. R3 BR and NFR thresholds were significantly decreased in CM patients as well. TMJD is a component of the pathogenesis in many patients with CM. Masticatory muscles may generate nociceptive impulses in CNS, ie be a source of peripheral sensitization, that promote pain chronification, including migraine. Dysfunction of masticatory muscles may reflect the central sensitization and disturbance of efferent pain control.
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