{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T19:57:35Z","timestamp":1767211055577,"version":"3.40.5"},"reference-count":72,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T00:00:00Z","timestamp":1560816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The <jats:italic>International Classification of Headache Disorders, 3rd Edition<\/jats:italic>, accepted \u201cheadache attributed to temporomandibular disorders\u201d as a valid headache. The neurophysiologic interplay between cervical structures and the temporomandibular joint, however, might also suggest that a temporomandibular disorder could develop in patients with cervicogenic headache.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the presence of preclinical temporomandibular signs between female patients with episodic cervicogenic headache and a control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Case\u2010controlled cross\u2010sectional design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Institutional setting: Hasselt University.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Twenty\u2010two women (mean age \u00b1 SD: 20.7\u2009\u00b1\u20092.5\u2009years) with episodic cervicogenic headache, without temporomandibular signs and 22 matched (gender, age, level of education, occupation) asymptomatic controls (21\u2009\u00b1\u20092.3\u2009years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>(Un)assisted temporomandibular range of motion, pressure pain thresholds, painful palpations were examined and the level of perceived stress was measured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measurements<\/jats:title><jats:p>Temporomandibular range of motion (mm), pressure pain thresholds (kPa\/cm\u00b2), painful palpations (yes\/no), and level of perceived stress (Perceived Stress Scale).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Maximal mouth\u2010opening was significantly smaller in the headache group (<jats:italic>P<\/jats:italic> &lt;.05; effect size [ES] \u22120.45). Palpation of the masseter resulted in significantly more positive pain responses in the headache group at the left (<jats:italic>P<\/jats:italic>\u2009=\u2009.009; ES \u221e) and right (<jats:italic>P<\/jats:italic>\u2009=\u2009.002;ES 17.5) origin, left (<jats:italic>P<\/jats:italic>\u2009=\u2009.004; ES 14.54) and right (<jats:italic>P<\/jats:italic>\u2009=\u2009.03; ES 5.71) body and left (<jats:italic>P<\/jats:italic>\u2009&lt; .001; ES 12) insertion. Significantly lower pressure pain thresholds on the left and right anterior (<jats:italic>P<\/jats:italic>\u2009=\u2009.03; ES \u22120.33 resp. <jats:italic>P<\/jats:italic>\u2009=\u2009.02; ES \u22120.35), central (<jats:italic>P<\/jats:italic>\u2009=\u2009.003; ES 1.02 resp. <jats:italic>P<\/jats:italic>\u2009=\u2009.02; ES 0.79) and right posterior (<jats:italic>P<\/jats:italic>\u2009=\u2009.03; ES 0.62) temporalis and right tibialis anterior (<jats:italic>P<\/jats:italic>\u2009=\u2009.03; ES \u22120.33) were measured in the headache group. The level of perceived stress was significantly higher (<jats:italic>P<\/jats:italic>\u2009=\u2009.02) in the headache group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with episodic cervicogenic headache present with signs of a preclinical temporomandibular disorder and sensitization. The smaller range of motion, lower pressure pain thresholds, and higher levels of stress accentuate the multidimensionality of the problem.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>IV<\/jats:p><\/jats:sec>","DOI":"10.1002\/pmrj.12156","type":"journal-article","created":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T09:00:56Z","timestamp":1552381256000},"page":"1287-1295","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Preclinical Signs of a Temporomandibular Disorder in Female Patients With Episodic Cervicogenic Headache Versus Asymptomatic Controls: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9024-2377","authenticated-orcid":false,"given":"Sarah","family":"Mingels","sequence":"first","affiliation":[{"name":"REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of 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