Neuroplasticity of face primary motor cortex control of orofacial movements

Masticatory Function and Bite Force in Stroke Patients

Orofacial functions are frequently affected by stroke, but little is known on the nature and extent of the impairment of mastication, which is investigated in this observational study. Thirty-one stroke patients, aged 69.0 ± 12.7 yrs, presenting with a hemi-syndrome with facial palsy, were recruited. Chewing efficiency, maximum bite and restraining lip forces were tested. Stroke severity (National Institutes of Health Stroke Scale) and dental state were recorded. The control group was similar in age, gender, and dental state (n = 24). The chewing efficiency was significantly lower in the stroke group (p ≤ 0.0001) and was related to both the dental state and the lip forces measured with small and medium-sized labial plates. The maximum bite force proved to be not significantly different between sides or groups (n.s.), whereas lip force was significantly lower in the stroke group (p ≤ 0.05). Chewing efficiency is severely affected by stroke; thus, rehabilitation protocols should aim to restore the strength and co-ordination of the orofacial muscles.

Cortical Orofacial Motor Representation

Jaw and tongue motor alterations may occur following changes in food consistency, but whether such changes are associated with re-organization of motor representations within the facial sensorimotor cortex is unclear. We used intracortical microstimulation (ICMS) and recordings of evoked electromyographic responses to determine jaw (anterior digastric) and tongue (genioglossus) motor representations within the histologically defined face primary motor cortex (face-M1) and adjacent somatosensory cortex (face-S1) of rats fed hard (N = 6) or soft (N = 6) diet for 2 to 3 weeks. ICMS evoked jaw and tongue responses from an extensive area within the face-M1 and a smaller area within the face-S1. A significant contralateral predominance was reflected in the number and latency of ICMS-evoked jaw responses (p < 0.05). There were no significant differences between the hard- and soft-diet groups in jaw and tongue motor representations, suggesting that the rat’s ability to adapt to changes in diet consistency may not be associated with significant neuroplasticity of sensorimotor cortex motor outputs.

Occlusion and brain function: mastication as a prevention of cognitive dysfunction

Research in animals and humans has shown that mastication maintains cognitive function in the hippocampus, a brain area important for learning and memory. Reduced mastication, an epidemiological risk factor for the development of dementia in humans, attenuates spatial memory and causes hippocampal neurons to deteriorate morphologically and functionally, especially in aged animals. Active mastication rescues the stress-attenuated hippocampal memory process in animals and attenuates the perception of stress in humans by suppressing endocrinological and autonomic stress responses. Active mastication further improves the performance of sustained cognitive tasks by increasing the activation of the hippocampus and the prefrontal cortex, the brain regions that are essential for cognitive processing. Abnormal mastication caused by experimental occlusal disharmony in animals produces chronic stress, which in turn suppresses spatial learning ability. The negative correlation between mastication and corticosteroids has raised the hypothesis that the suppression of the hypothalamic-pituitary-adrenal (HPA) axis by masticatory stimulation contributes, in part, to preserving cognitive functions associated with mastication. In the present review, we examine research pertaining to the mastication-induced amelioration of deficits in cognitive function, its possible relationship with the HPA axis, and the neuronal mechanisms that may be involved in this process in the hippocampus.

Circulatory response and autonomic nervous activity during gum chewing

Mastication has been proven to enhance the systemic circulation, with circulatory responses seeming to be largely regulated by autonomic nervous activity via a more complex regulatory system than those of other activities. However, few studies have examined the relationships between changes in autonomic nervous activity and the systemic circulation that are induced by masticatory movement. We investigated changes in the systemic circulation and autonomic nervous activity during gum chewing to clarify the influence of mastication. Electrocardiograms, arterial blood pressure, and masseter electromyograms were taken while chewing gum continuously as indicators of systemic circulation in 10 healthy subjects with normal dentition. Cardiac sympathetic activity and vagus nervous activity, as well as vasomotor sympathetic nervous activity, were evaluated by fluctuation analysis of heart rate and blood pressure. Repeated analysis of variance and multiple comparisons were performed to determine chronological changes in each indicator during gum chewing. Gum chewing increased the heart rate and the mean arterial pressure. Although cardiac sympathetic activity and vagus nervous activity showed significant changes, vasomotor sympathetic nervous activity did not. These results suggest that changes in the autonomic nervous activity of the heart are mainly involved in the enhancement of systemic circulation with gum chewing. This explains some characteristics of autonomic nervous regulation in masticatory movement.

Cortical input in control of swallowing

PURPOSE OF REVIEW

This review presents a current synopsis of newer research in cortical control of swallowing and its relationship to advancing knowledge in the field of human swallowing neurophysiology. The intent is to highlight recent findings and to stimulate potential research questions not yet investigated.

RECENT FINDINGS

Advances in human brain imaging have led to a wealth of newer insights into the cortical and subcortical control of human swallowing. This includes a better understanding of the hemispheric contributions to swallowing control and the mechanisms that underlie recovery or compensation after neurological injury.

SUMMARY

Through advances in imaging and neuroimaging techniques, our knowledge of the neuroanatomy and physiology of swallowing has increased dramatically over the last decade. Integration and interconnection of the diverse swallowing cortical network and how sensory input influences swallowing cortical activation has started to provide a better understanding of the physiological mechanisms that underpin this exquisite yet fundamental sensorimotor function. Experimental paradigms for swallowing neural reorganization have begun to provide evidence for their translation into clinical practice for dysphagia rehabilitation.

The effects of intra-oral pain on motor cortex neuroplasticity associated with short-term novel tongue-protrusion training in humans

To determine if short-term (15 min) training in a novel tongue-task is associated with rapid neuroplasticity of the tongue primary motor area (MI) in the human cerebral cortex, and if intra-oral tonic pain affects the tongue MI neuroplasticity and tongue-task training performance. Nine healthy volunteers (7 men, 2 women, mean age 24+/-1.1 years) participated in two cross-over training sessions in which the application to the tongue of the algesic chemical capsaicin (1%) or vehicle cream was randomized. Prior to and again immediately after 15 min of training in a tongue-protrusion task, transcranial magnetic stimulation (TMS) was applied to the MI in each session and motor evoked potentials (MEPs) were recorded in the tongue musculature and the first dorsal interosseous (FDI) muscle (as control). Neuroplasticity of the tongue MI, as reflected in a significantly enhanced TMS-MEP stimulus-response curve and reduced MEP threshold, was observed after the vehicle session but not after the capsaicin session. Subjects' overall mean performance scores were significantly higher in the vehicle session than in the capsaicin session. MI neuroplasticity may rapidly occur in association with successful performance in novel tongue-task training, but intra-oral tonic pain interferes with these effects. These findings suggest that nociceptive input modulates MI neuroplasticity associated with novel motor training and may impair the ability to learn a new motor task.