Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
Clin J Pain. 2013 Apr;29(4):362-5. doi: 10.1097/AJP.0b013e31826232f6.
To evaluate the influence of myofascial pain on the Pressure Pain Threshold (PPT) of masticatory muscles in women with migraine.
The sample comprised 101 women, ages ranging from 18 to 60 years, with an episodic migraine diagnosis previously confirmed by a neurologist. All patients were evaluated using Research Diagnostic Criteria for Temporomandibular Disorders to determine the presence of myofascial pain and were divided into 2 groups: group I (n=56), comprising women with a migraine, and group II (n=45), comprising women with a migraine and myofascial pain. Two more groups (49 asymptomatic women and 50 women with myofascial pain), matched for sex and race, obtained from a previous study, were added to this study. The PPT values of masseter and temporalis (anterior, middle, and posterior regions) muscles were recorded bilaterally using a pressure algometer. One-way analysis of variance and the Tukey test for pairwise comparisons were used in statistical analysis with a 5% significance level.
We found that all groups had significantly lower PPT values compared with asymptomatic women, with lower values seen in group II (women with migraine and myofascial pain). Women with a migraine and myofascial pain showed significantly lower PPT values compared with women with a migraine only, and also when compared with women with myofascial pain only.
Migraine, especially when accompanied by myofascial pain, reduces the PPT of masticatory muscles, suggesting the importance of masticatory muscle palpation during examination of patients with migraine.
评估肌筋膜疼痛对偏头痛女性咀嚼肌压力疼痛阈值（PPT）的影响。
该样本包括 101 名年龄在 18 至 60 岁之间的女性，均经神经科医生确诊为发作性偏头痛。所有患者均采用颞下颌关节紊乱研究诊断标准进行评估，以确定是否存在肌筋膜疼痛，并分为 2 组：组 I（n=56），包括偏头痛患者；组 II（n=45），包括偏头痛合并肌筋膜疼痛的患者。另外还从先前的研究中增加了两组（49 名无症状女性和 50 名肌筋膜疼痛女性），这些女性在性别和种族上与组 I 和组 II 匹配。使用压力测痛计记录双侧咀嚼肌和颞肌（前、中、后区域）的 PPT 值。采用单因素方差分析和 Tukey 检验进行两两比较，统计分析的显著性水平为 5%。
我们发现所有组的 PPT 值均明显低于无症状女性组，其中组 II（偏头痛合并肌筋膜疼痛的女性）的 PPT 值最低。偏头痛合并肌筋膜疼痛的女性与仅患有偏头痛的女性相比，以及与仅患有肌筋膜疼痛的女性相比，其 PPT 值明显较低。
偏头痛，尤其是伴有肌筋膜疼痛时，会降低咀嚼肌的 PPT，这表明在检查偏头痛患者时，咀嚼肌触诊很重要。
