Treatment of comorbid migraine and temporomandibular disorders: a factorial, double-blind, randomized, placebo-controlled study.

Daniela A G Goncalves, Cinara M. Camparis, José G. Speciali, Sabrina M. Castanharo, Liliana T. Ujikawa, Richard B. Lipton, Marcelo E. Bigal

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

To investigate the effectiveness of single and concomitant treatment of migraine and temporomandibular disorders (TMD) in women with the comorbidity. Eligible female patients met International Classification of Headache Disorders, second edition (ICHD-2) criteria for migraine with or without aura and the Research Diagnostic Criteria for myofascial TMD (Grade ll or lll). After a run-in period (30 days), women with both migraine and TMD were enrolled into a four-arm, double-blind, placebo-controlled, factorial study testing the separate and joint effects of a migraine treatment (propranolol 90 mg) and a TMD treatment (stabilization splint [SS]) in four groups of patients. The four treatment groups were propranolol and SS (n = 22); propranolol placebo and SS (n = 23); propranolol and non-occlusal splint (NOS) (n = 23); and propranolol placebo and NOS (n = 21). The primary endpoint for migraine was change in headache days from baseline to the third month, and the secondary endpoint was change in days with at least moderate headache in the same period. The TMD endpoints included pain threshold and mandibular vertical range of motion. Data were analyzed using analysis of variance (ANOVA, Dunn's post-hoc test) or Kruskal-Wallis test. For the primary endpoint, in intention-to-treat (ITT) analyses (n = 94), propranolol and SS were associated with a nonsignificant reduction in the number of headache days, relative to all other groups. For per-protocol (PP) Completer analyses (n = 89), differences in the number of headache days reached significance (P < .05). The propranolol and SS group was significantly superior to the other groups on all other headache endpoints and in disability, in both ITT and PP analyses. No significant differences among groups were seen for the TMD parameters. In women with TMD and migraine, migraine significantly improved only when both conditions were treated. The best treatment choice for TMD pain in women with migraine is yet to be defined.

Original languageEnglish (US)
Pages (from-to)325-335
Number of pages11
JournalJournal of Orofacial Pain
Volume27
Issue number4
StatePublished - Sep 2013

Fingerprint

Temporomandibular Joint Disorders
Splints
Migraine Disorders
Propranolol
Placebos
Headache
Therapeutics
Analysis of Variance
Migraine without Aura
Migraine with Aura
Headache Disorders
Intention to Treat Analysis
Pain Threshold
Articular Range of Motion
Comorbidity
Pain

ASJC Scopus subject areas

  • Dentistry(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine
  • Medicine(all)

Cite this

Goncalves, D. A. G., Camparis, C. M., Speciali, J. G., Castanharo, S. M., Ujikawa, L. T., Lipton, R. B., & Bigal, M. E. (2013). Treatment of comorbid migraine and temporomandibular disorders: a factorial, double-blind, randomized, placebo-controlled study. Journal of Orofacial Pain, 27(4), 325-335.

Treatment of comorbid migraine and temporomandibular disorders : a factorial, double-blind, randomized, placebo-controlled study. / Goncalves, Daniela A G; Camparis, Cinara M.; Speciali, José G.; Castanharo, Sabrina M.; Ujikawa, Liliana T.; Lipton, Richard B.; Bigal, Marcelo E.

In: Journal of Orofacial Pain, Vol. 27, No. 4, 09.2013, p. 325-335.

Research output: Contribution to journalArticle

Goncalves, DAG, Camparis, CM, Speciali, JG, Castanharo, SM, Ujikawa, LT, Lipton, RB & Bigal, ME 2013, 'Treatment of comorbid migraine and temporomandibular disorders: a factorial, double-blind, randomized, placebo-controlled study.', Journal of Orofacial Pain, vol. 27, no. 4, pp. 325-335.
Goncalves, Daniela A G ; Camparis, Cinara M. ; Speciali, José G. ; Castanharo, Sabrina M. ; Ujikawa, Liliana T. ; Lipton, Richard B. ; Bigal, Marcelo E. / Treatment of comorbid migraine and temporomandibular disorders : a factorial, double-blind, randomized, placebo-controlled study. In: Journal of Orofacial Pain. 2013 ; Vol. 27, No. 4. pp. 325-335.
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AU - Speciali, José G.

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