Author:
Blumenfeld Andrew M.,Boyd James P.
Abstract
Abstract
Objective
To assess the nocioceptive input of habitual nocturnal jaw clenching that acts as a contributing factor in migraine pathogenesis.
Background
Habitual nocturnal jaw clenching has been implicated as a trigger, particularly in those whose headaches are present upon waking or shortly thereafter. Nocturnal EMG studies of patients diagnosed with migraine show nearly twice the temporalis clenching EMG levels and double the bite force as matched asymptomatic controls, leading to the speculation that parafunctional clenching activity may have some role in headache pathogenesis. The NTI (Nociceptive Trigeminal Inhibition) oral device is a dental splint designed to reduce nocturnal jaw clenching intensity and is FDA approved for the prevention of medically diagnosed migraine pain based on open label studies. There are no prior placebo-controlled trials to assess the migraine prevention efficacy of the NTI splint. This is the first placebo-controlled cross-over study to assess the efficacy of the NTI splint in patients with Chronic Migraine.
Method
A placebo controlled, single-blinded cross-over study was done with IRB oversight assessing the efficacy of the NTI splint compared to placebo using the change in the HIT-6 score as the outcome measure.
Results
68% of refractory chronic migraine sufferers using the NTI as measured by sequential HIT 6 scores had at least a one-category improvement (severe to substantial, or substantial to some, or some to none) compared to 12% when using a placebo device. 36% of subjects using the NTI device reported a two-category improvement in their HIT-6 score, compared to 0% when using placebo.
Conclusion
The improvement in HIT-6 scores produced by the NTI device, suggests that patients with Chronic Migraine may have intense nocturnal jaw clenching as a contributing factor to their headache related disability. An NTI device is one method of assessing whether jaw-clenching is a contributing factor to ongoing migraine.
Trial registration
Current Controlled Trials NCT04871581. 04/05/2021. Retrospectively registered.
Publisher
Springer Science and Business Media LLC
Subject
Neurology (clinical),General Medicine
Reference29 articles.
1. Castillo J, Munoz P, Guitera V, Pascual J. Epidemiology of chronic daily headache in the general population. Headache. 1999;39:190–6.
2. Silberstein SD, Lipton RB. Chronic daily headache. Curr Opin Neurol. 2000;13:277–83.
3. Pascual J, Colas R, Castillo J. Epidemiology of chronic daily headache. Curr Pain Headache Rep. 2001;5:529–36.
4. SD Silberstein 2005 Transformed and chronic migraine Goadsby, Silberstein, S,Dodic D, eds. Chronic Daily Headache for Clinicians. Hamilton, Ontario: BC Decker,Inc.::21–56
5. Rozen TD. Migraine prevention: What patients want from medication and theirphysicians (a headache specialty clinic perspective). Headache. 2006;46(5):750–3.
Cited by
5 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献