Key words: headache, jaw function, TMJ, TMD , temporomandibular disorders, tension-type headache
Thomas List, DDS, Odont Dr/Mike T. John, DDS, MPH, PhD/Richard Ohrbach, DDS, PhD/Eric L. Schiffman, DDS, MS/Edmond L. Truelove, DDS, MSD/Gary C. Anderson, DDS, MS
Aims: To investigate the relationship of headache frequency with patient-reported physical functioning and emotional functioning in temporomandibular disorder (TMD) subjects with concurrent temple headache.
Methods: The Research Diagnostic Criteria for TMD (RDC/TMD) Validation Project identified, as a subset of 614 TMD cases and 91 controls (n = 705), 309 subjects with concurrent TMD pain diagnoses (RDC/TMD) and temple headache. The temple headaches were subdivided into infrequent, frequent, and chronic headache according to the International Classification of Headache Disorders, second edition (ICHD–II). Study variables included self-report measures of physical functioning (Jaw Function Limitation Scale [JFLS], Graded Chronic Pain Scale [GCPS], Short Form–12 [SF–12]) and emotional functioning (depression and anxiety as measured by the Symptom Checklist–90R/SCL–90R). Differences among the three headache subgroups were characterized by increasing headache frequency. The relationship between ordered headache frequency and physical as well as emotional functioning- was analyzed using linear regression and trend tests for proportions.
Results: Physical functioning, as assessed with the JFLS (P < .001), SF-12 (P < .001), and GCPS (P < .001), was significantly associated with increased headache frequency. Emotional functioning,- reflected in depression and anxiety, was also associated with increased frequency- of headache (both P < .001).
Conclusion: Headache frequency- was substantially correlated with reduced physical functioning and emotional functioning in subjects with TMD and concurrent temple headaches. A secondary finding was that headache was precipitated by jaw activities more often in subjects with more frequent temple headaches. J OROFAC PAIN 2012;26:83–90
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