Kothari Mohit, Odgaard Lene, Nielsen Jørgen Feldbæk, Kothari Simple Futarmal
Department of Clinical Medicine, Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark.
Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark.
Clin Oral Investig. 2024 Dec 2;28(12):678. doi: 10.1007/s00784-024-06086-3.
Studies assessing the presence of painful temporomandibular disorders (TMD) in post-traumatic headache (PTH) attributed to mild traumatic brain injury are lacking. We aimed to (1) measure the prevalence of painful TMD and assess its association with demographic and trauma-related factors in patients with PTH and (2) compare the headache characteristics and post-concussion burden between the PTH patients with and without painful TMD.
This study embedded in a population-based epidemiologic cohort study (N = 2,832) assessed mild traumatic brain injury patients (18-60 years) 2-4 months after their trauma. PTH patients (n = 382) were identified and invited to fill out questionnaires assessing post-concussion symptoms and burden, headache characteristics, presence of painful TMD and demographics.
The prevalence of painful TMD was 22.5%. Living with a partner/spouse (OR = 0.31, 95% CI: 0.13-0.75, P = 0.010) and having a secondary education (OR = 0.28, 95% CI: 0.08-0.99, P = 0.048) was significantly associated with decreased risk of having painful TMD. PTH patients with painful TMD reported significantly higher headache intensity (P < 0.042), increased symptom burden (P = 0.007), reduced workability after trauma (P = 0.019) and were frequently on full-time sick leave compared to those without painful TMD.
PTH patients had a high prevalence of painful TMD. Living with a partner/spouse and having a secondary education decreased the risk of having painful TMD. Patients with painful TMD were significantly heavily burdened compared to those without painful TMD.
Presence of painful TMD in PTH patients may compromise the rehabilitation plan and complicate the management of these patients.
缺乏评估归因于轻度创伤性脑损伤的创伤后头痛（PTH）中疼痛性颞下颌关节紊乱病（TMD）存在情况的研究。我们旨在（1）测量疼痛性TMD的患病率，并评估其与PTH患者的人口统计学和创伤相关因素的关联，以及（2）比较有和没有疼痛性TMD的PTH患者之间的头痛特征和脑震荡后负担。
本研究纳入一项基于人群的流行病学队列研究（N = 2,832），评估轻度创伤性脑损伤患者（18 - 60岁）创伤后2 - 4个月的情况。识别出PTH患者（n = 382），并邀请他们填写问卷，评估脑震荡后症状和负担、头痛特征、疼痛性TMD的存在情况以及人口统计学信息。
疼痛性TMD的患病率为22.5%。与伴侣/配偶共同生活（OR = 0.31，95% CI：0.13 - 0.75，P = 0.010）和接受中等教育（OR = 0.28，95% CI：0.08 - 0.99，P = 0.048）与疼痛性TMD风险降低显著相关。与没有疼痛性TMD的患者相比，有疼痛性TMD的PTH患者报告的头痛强度显著更高（P < 0.042）、症状负担增加（P = 0.007）、创伤后工作能力下降（P = 0.019），并且经常休全薪病假。
PTH患者中疼痛性TMD的患病率较高。与伴侣/配偶共同生活和接受中等教育可降低疼痛性TMD的风险。与没有疼痛性TMD的患者相比，有疼痛性TMD的患者负担明显更重。
PTH患者中疼痛性TMD的存在可能会影响康复计划，并使这些患者的管理复杂化。
