Changes in cognitive functioning as an effect of complex treatment of myofascial pain in temporomandibular disorders

Introduction
Pain reduction is a benefit that comprehensive treatment of myalgic temporomandibular disorders can provide. Myalgic pain reduction is associated with a series of changes at the neurophysiological level, which are inseparably connected with psychoemotional and cognitive changes. It has not been established if the course of these changes is the same for chronic myofascial pain in temporomanibular disorders as it is for other types of chronic pain.

Objectives
The present study examined changes in cognitive functioning among patients with myofascial pain before and after three months of prosthetic treatment supplemented with psychoeducational and physiotherapeutic therapy.

Material and methods
Participants were 45 patients, 23 were people with painful myofascial temporomandibular disorders and 22 were people with disorders of the same type who did not complain about pain symptoms. Statistical analysis included group comparisons of verbal learning, perceptiveness, attention, verbal fluency, immediate and working memory as well as selected executive functions measured with a number of psychological tests and neuropsychological clinical trials.

Results
Analyses based on two-sided dependent samples t-tests as well as the Fisher’s LSD tests conducted in the analysis of variances showed therapeutic effects, both, with reference to chosen spheres of cognitive functioning, which initially differentiated the control and research groups, as well as the ones which did not differentiate these two groups.

Conclusions
The results of this study indicate that cognitive functioning undergoes dynamic changes in the initial phase of treatment. Some of these changes may be specific for myofascial pain. The awareness about those changes may appear to be essential for planning therapeutic procedures and beneficial to maintain patient’s engagement in the process of treatment.