Diagnosis and treatment of intractable idiopathic orofacial pain with attention-deficit/hyperactivity disorder

Satoshi Kasahara; Kaori Takahashi; Ko Matsudaira; Naoko Sato; Ken-Ichi Fukuda; Akira Toyofuku; Tatsuya Yoshikawa; Yuichi Kato; Shin-Ichi Niwa; Kanji Uchida

doi:10.1038/s41598-023-28931-3

Diagnosis and treatment of intractable idiopathic orofacial pain with attention-deficit/hyperactivity disorder

Sci Rep. 2023 Jan 30;13(1):1678. doi: 10.1038/s41598-023-28931-3.

Authors

Satoshi Kasahara^{1

2}, Kaori Takahashi³, Ko Matsudaira^{4

5}, Naoko Sato⁶, Ken-Ichi Fukuda⁷, Akira Toyofuku⁸, Tatsuya Yoshikawa⁹, Yuichi Kato¹⁰, Shin-Ichi Niwa¹¹, Kanji Uchida¹²

Affiliations

¹ Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. namahage@king.odn.ne.jp.
² Department of Pain Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan. namahage@king.odn.ne.jp.
³ Department of Dental Anesthesiology, Tokyo Dental College, 2-9-18, Misakicho, Chiyoda-ku, Tokyo, 101-0061, Japan.
⁴ Department of Pain Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan.
⁵ Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
⁶ Nursing Department, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
⁷ Division of Special Needs Dentistry and Orofacial Pain, Tokyo Dental College, 2-9-18, Kanda-misakicho, Chiyoda-ku, Tokyo, 101-0061, Japan.
⁸ Department of Psychosomatic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
⁹ Luxia Ginza Dental Clinic, 3-7-13 Ginza, Chuo-ku, Tokyo, 104-0061, Japan.
¹⁰ Department of Pediatric Dentistry, School of Life Dentistry at Tokyo, Nippon Dental University, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan.
¹¹ Department of Psychiatry, Aizu Medical Center, Fukushima Medical University, 21-2 Maeda, Yazawa, Kawahigashi-Machi, Aizuwakamatsu, Fukushima, 969-3492, Japan.
¹² Department of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) has been reported to be associated with primary chronic pain syndromes, such as fibromyalgia, migraine, and chronic low back pain. Although idiopathic orofacial pain (IOP) is classified as burning mouth syndrome or persistent idiopathic facial or dentoalveolar pain and as a primary chronic pain, the association between IOP and ADHD has not been investigated. This retrospective cohort study investigated the severity of ADHD symptoms measured using the ADHD scale and the effects of treatment using ADHD drugs and the dopamine system stabilizer aripiprazole. The participants were 25 consecutive patients with refractory IOP referred to a psychiatrist and diagnosed with coexisting ADHD according to the Diagnostic and Statistical Manual of Mental Disorders-5. The ADHD scale scores were higher in patients with intractable IOP than those in the general population. Pharmacotherapy used in this study led to clinically significant improvements in pain, anxiety/depression, and pain catastrophizing. Intractable IOP and ADHD were shown to be associated. In the future, screening and pharmacotherapy for ADHD should be considered in the treatment of intractable IOP.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aripiprazole / therapeutic use
Attention Deficit Disorder with Hyperactivity* / complications
Attention Deficit Disorder with Hyperactivity* / diagnosis
Attention Deficit Disorder with Hyperactivity* / drug therapy
Chronic Pain* / complications
Chronic Pain* / diagnosis
Chronic Pain* / drug therapy
Facial Pain / complications
Facial Pain / diagnosis
Facial Pain / drug therapy
Humans
Retrospective Studies

Substances

Aripiprazole