Effect of mastication on regional cerebral blood flow in humans examined by positron-emission tomography with ¹⁵O-labelled water and magnetic resonance imaging

Reflex arc of the teeth clenching-induced pressor response in rats

Although "teeth clenching" induces pressor response, the reflex tracts of the response are unknown. In this study, dantrolene administration inhibited teeth clenching generated by electrical stimulation of the masseter muscles and completely abolished the pressor response. In addition, trigeminal ganglion block or hexamethonium administration completely abolished the pressor response. Local anesthesia of molar regions significantly reduced the pressor response to 27 ± 10%. Gadolinium (mechanoreceptor blocker of group III muscle afferents) entrapment in masticatory muscles also significantly reduced the pressor response to 62 ± 7%. Although atropine methyl nitrate administration did not change the pressor response, a significant dose-dependent augmentation of heart rate was observed. These results indicate that both periodontal membrane and mechanoreceptors in masticatory muscles are the receptors for the pressor response, and that the afferent and efferent pathways of the pressor response pass through the trigeminal afferent nerves and sympathetic nerves, respectively.

Preceding functional tooth loss delays recovery from acute cerebral hypoxia and locomotor hypoactivity after murine subarachnoid haemorrhage

Tooth loss and related changes in the functionality may lead to worse outcome of stroke patients, but the effect on hemorrhagic stroke remains unclear. This study aimed to determine the impact of impaired masticatory function on acute cerebral oxygenation and locomotor activity after experimental subarachnoid haemorrhage (SAH). Twenty C57BL/6 mice with (MC-treated group) or without (control group) prior treatment of cutting off the upper molars were subjected to SAH by endovascular perforation. Grading of SAH and acute cerebral infarction were assessed by MR images. Brain tissue oxygen saturation (SbtO₂ ) by photoacoustic imaging and parameters related to locomotor activity by open-field test were analyzed serially after SAH. In all mice, global SbtO2 depression was notable immediately after SAH induction (P <.001), which recovered close to the baseline levels until day 3. However, MC-treated mice demonstrated a prolonged relative cerebral hypoxia (<40% of the baseline SbtO2) as compared to the control (3 ± 1 vs 1 ± 1 days; P <.05). The average distance travelled on day 7 and the ratio of central-area distance/total travelled distance by open-field test between days 7 and 14 were significantly lower in MC-treated mice than in the control mice (P <.05), although the occurrences of new infarction were not statistically different (P >.05). These data suggest a possible link between preceding masticatory impairment and early brain injury to deteriorate neurobehavioural function in patients after SAH.

The Effect of Number of Teeth and Chewing Ability on Cognitive Function of Elderly in UAE: A Pilot Study

Cognitive decline is one of the major causes of disability among the aging population. The aim of this study was to explore the relationship between oral health parameters (number of teeth, chewing ability, and presence of a denture) and cognitive function in the elderly across the UAE. Fifty persons (age ≥ 60; 71.26 ± 10.23) were enrolled in the study. Cognitive status was assessed using the standardized mini-mental state examination (SMMSE) and accordingly, cognitively normal subjects scoring ≥24 were considered as the control group and cognitively impaired individuals scoring ≤23 were considered as the low scoring group. Chewing ability was examined, number of teeth was noted, and demographical data was collected. The results of this pilot study showed that individuals with low SMMSE scores were significantly less educated (P < 0.01) and had fewer number of remaining teeth (P < 0.05) and impaired chewing ability (P < 0.05). These results demonstrate a significant link between the number of teeth, chewing ability, and cognitive function. However, this pilot study had its limitations and was the first of its kind in the UAE and Gulf region; therefore, future research addressing the limitations is needed to further explore this association.

Mastication and oral health-related quality of life in removable denture wearers with Alzheimer disease

STATEMENT OF PROBLEM

Alzheimer disease (AD) can affect masticatory function, affecting oral health-related quality of life (OHRQoL). Whether oral rehabilitation with conventional removable prostheses can restore masticatory function and improve OHRQoL in these individuals is unknown.

PURPOSE

The purpose of this clinical study was to evaluate the influence of oral rehabilitation with removable prostheses on masticatory efficiency and OHRQoL in elders with and without AD.

MATERIAL AND METHODS

Thirty-two elders with mild AD (n=16, mean age=76.7 ±6.3 years) or without AD (n=16, mean age=75.2 ±4.4 years) were recruited. All participants first underwent masticatory efficiency and OHRQoL evaluations, and 2 months after insertion of new removable prostheses, the variables were reassessed. Masticatory efficiency was determined using the sieving method, and OHRQoL was measured by applying the Geriatric Oral Health Assessment Index (GOHAI). The data from the baseline and after insertion of the new removable prostheses were compared by paired t test. Group differences at each time point were assessed by t test (α=.05).

RESULTS

After insertion of the new removable prostheses, masticatory efficiency and OHRQoL improved in both the elders with AD and the control. At baseline, elders with AD had lower masticatory efficiency and higher OHRQoL than controls (P<.05). After removable prosthesis insertion, elders with AD continued to show lower masticatory efficiency values than controls, but their OHRQoL was similar.

CONCLUSIONS

Oral rehabilitation with new removable prostheses improved the masticatory efficiency and OHRQoL of elders with and without AD, although masticatory efficiency did not reach control levels in elders with AD.

Brain activation patterns during unilateral premolar occlusion

OBJECTIVE

To observe the characteristics of brain activation during unilateral premolar occlusion.

METHODS

Functional magnetic resonance imaging was collected from 10 healthy volunteers during occlusion of the left first premolar (L1), left second premolar (L2), and right first premolar (R1). The brain activation patterns were analyzed, and the primary sensorimotor cortex, supplementary motor area, insula, thalamus, and prefrontal cortex were chosen as regions of interest.

RESULTS

Single premolar occlusion activated the precentral gyrus, postcentral gyrus, cerebellum, thalamus, frontal lobe, hippocampus, cingulate gyrus, and parietal lobe. The brain areas showing activation during single premolar occlusion were similar to those activated by chewing. The activation pattern of L1 was more similar to that of L2 than R1. No significant left and right hemisphere differences in signal intensity were detected within the regions of interest.

CONCLUSION

Brain activation patterns from two ipsilateral premolars were more similar than the pattern from a contralateral premolar.

Effect of chewing or compressing food on autonomic nervous activity in older adults

OBJECTIVE

To determine if autonomic nervous activity increases in older people during mastication and how this activity is related to the softness of food. We hypothesised that the coefficient of variation of R-R intervals (CVRR), high-frequency (HF) power, low-frequency (LF) power, LF/HF ratio and total power increase during chewing foods within the range of softness from moderate food to extremely soft food in older adults.

MATERIALS AND METHODS

Participants were 20 older volunteers (71-90 year old). CVRR and HF on the electrocardiogram (ECG) were used as indices of parasympathetic nervous activity. LF and the LF/HF ratio on the ECG were used as indices of sympathetic nervous activity. Total power, reflecting the level of autonomic nervous activity, was also measured. Participants were asked to chew gum with three different degrees of softness, or to compress extremely soft gum between their palate and tongue.

RESULTS

There were significant differences in HF between at resting and all chewing/compressing conditions, but no significant differences relating to food softness. There were significant differences in total power between at resting and all chewing/compressing conditions, but no significant differences relating to food softness. There were no significant differences in LF, LF/HF and CVRR among all conditions.

CONCLUSION

Autonomic nervous activity, especially parasympathetic activity in older adults, increased during chewing and compressing food when compared to activity while at rest. Within the range of food's softness from moderate to extreme soft, food's softness had no measurable effect on autonomic nervous activity.

Evaluation of lateral pterygoid muscles in painful temporomandibular joints by signal intensity on fluid-attenuated inversion recovery images

OBJECTIVES

Pathological changes of the lateral pterygoid muscle (LPM) have been investigated using various modalities, including magnetic resonance (MR) imaging and electromyography. Fluid-attenuated inversion recovery (FLAIR) is an MR sequence that we hypothesized can be used to evaluate abnormalities of the LPM. The purpose of this study was to analyze the FLAIR signal intensity of the LPM in painful temporomandibular joints (TMJs) and investigate the pathological changes of the muscle.

METHODS

The study was based on 149 TMJs of 77 patients who were referred for MR imaging of the TMJ. Patients rated their degree of pain during chewing and mouth opening using a visual analog scale (VAS). Regions of interest were placed over the superior and inferior heads of the LPM and gray matter on FLAIR sagittal images. Using the signal intensity of gray matter as a reference, the signal intensity ratio (SIR) of the LPM was calculated. Spearman's rank-correlation coefficient was used to analyze the correlation between the SIR and the VAS score (p < 0.05).

RESULTS

A significant correlation was present between the SIR on FLAIR images and the VAS score.

CONCLUSIONS

These results suggest that the FLAIR signal intensity of the superior and inferior heads of the LPM significantly increases as TMJ pain becomes more severe. Thus, FLAIR could be useful in assessing the relationship between the MR signals of the LPM and clinical symptoms.

Tooth Loss and Risk of Dementia in the Community: the Hisayama Study

OBJECTIVES

To clarify the effect of tooth loss on development of all-cause dementia and its subtypes in an elderly Japanese population.

DESIGN

Prospective cohort study.

SETTING

The Hisayama Study, Japan.

PARTICIPANTS

Community-dwelling Japanese adults without dementia aged 60 and older (N = 1,566) were followed for 5 years (2007-2012).

MEASUREMENTS

Participants were classified into four categories according to baseline number of remaining teeth (≥20, 10-19, 1-9, 0). The risk estimates of the effect of tooth loss on the development of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) were computed using a Cox proportional hazards model.

RESULTS

During follow-up, 180 (11.5%) subjects developed all-cause dementia; 127 (8.1%) had AD, and 42 (2.7%) had VaD. After adjusting for potential confounders, there was a tendency for the multivariable-adjusted hazard ratio of all-cause dementia to increase with decrease in number of remaining teeth (P for trend = .04). The risk of all-cause dementia was 1.62 times as great in subjects with 10 to 19 teeth, 1.81 times as great in those with one to nine teeth, and 1.63 times as great in those with no teeth as in those with 20 teeth or more. An inverse association was observed between number of remaining teeth and risk of AD (P for trend = .08), but no such association was observed with risk of VaD (P for trend = .20).

CONCLUSION

Tooth loss is associated with an increased risk of all-cause dementia and AD in the Japanese population.

Widespread Volumetric Brain Changes following Tooth Loss in Female Mice

Tooth loss is associated with altered sensory, motor, cognitive and emotional functions. These changes vary highly in the population and are accompanied by structural and functional changes in brain regions mediating these functions. It is unclear to what extent this variability in behavior and function is caused by genetic and/or environmental determinants and which brain regions undergo structural plasticity that mediates these changes. Thus, the overall goal of our research program is to identify genetic variants that control structural and functional plasticity following tooth loss. As a step toward this goal, here our aim was to determine whether structural magnetic resonance imaging (sMRI) is sensitive to detect quantifiable volumetric differences in the brains of mice of different genetic background receiving tooth extraction or sham operation. We used 67 adult female mice of 7 strains, comprising the A/J (A) and C57BL/6J (B) strains and a randomly selected sample of 5 of the 23 AXB-BXA strains (AXB1, AXB4, AXB24, BXA14, BXA24) that were produced from the A and B parental mice by recombinations and inbreeding. This panel of 25 inbred strains of genetically diverse inbred strains of mice is used for mapping chromosomal intervals throughout the genome that harbor candidate genes controlling the phenotypic variance of any trait under study. Under general anesthesia, 39 mice received extraction of 3 right maxillary molar teeth and 28 mice received sham operation. On post-extraction day 21, post-mortem whole-brain high-resolution sMRI was used to quantify the volume of 160 brain regions. Compared to sham operation, tooth extraction was associated with a significantly reduced regional and voxel-wise volumes of cortical brain regions involved in processing somatosensory, motor, cognitive and emotional functions, and increased volumes in subcortical sensorimotor and temporal limbic forebrain regions including the amygdala. Additionally, comparison of the 10 BXA14 and 21 BXA24 mice revealed significant volumetric differences between the two strains in several brain regions. These findings highlight the utility of high-resolution sMRI for studying tooth loss-induced structural brain plasticity in mice, and provide a foundation for further phenotyping structural brain changes following tooth loss in the full AXB-BXA panel to facilitate mapping genes that control brain plasticity following orofacial injury.

Association between mastication and cognitive status: A systematic review

PURPOSE

A substantial number of elderly people suffer from cognitive impairment and dementia, which are considered to have various risk factors, including masticatory dysfunction; however, the association between mastication and cognition is inconclusive. The objectives of this systematic review were to provide an overview of the literature on (1) the association between mastication and cognitive function and (2) the association between mastication and dementia incidence, in elderly people.

MATERIALS AND METHODS

Searches were conducted on five electronic databases (PubMed, EMBASE, CINHL, Cochrane Library, and Pro Quest) and publications were selected that met the following criteria: published between 2005 and 2015, written in English, and assessed associations between mastication and cognitive function, cognitive decline and dementia among population over 40 years old. The included publications were analyzed for study design, main conclusions, and strength of evidence by two reviewers who screened all abstracts and full-text articles, abstracted data and performed quality assessments by using a critical appraisal tool.

RESULTS

A total of 33 articles (22 cross-sectional, and 11 prospective cohort studies) were evaluated. Poorer mastication was associated with lower cognitive function in 15 of the 17 cross-sectional studies and steeper decline in 5 of the 6 prospective studies. Poorer mastication was one of significant risk factors for having dementia or mild memory impairment (MMI) in 4 of 5 cross-sectional studies and for the incidence of dementia or MMI in 4 of 5 prospective studies.

CONCLUSIONS

Most studies point to a positive association between mastication and cognitive function, including dementia among elderly people.

Effect of Gum Chewing Frequency on Oxygenation of the Prefrontal Cortex

Since increased cerebral oxygenation reflects cerebral activation, this study investigated the effect of mastication frequency on prefrontal cortex oxygenation. Eleven young volunteers (nine women, two men; M age = 20.9 years, SD = 0.9) carried out three trials in which they were asked to chew a tasteless gum for 3 min at varying (rates of mastication frequency: 30, 70, and 110). Breaks of 2 min each were interleaved between trials. The oxygenation of the left prefrontal cortex was monitored by near-infrared spectroscopy. We found a significant increase in cortical oxygenation during gum chewing in all three conditions ( p < .05), compared with a resting level; we also found a significant difference between the Fast and Slow chewing conditions, and between the Fast and Normal (70 rpm) conditions, both findings seemingly related to activation of a motor command in frontal brain regions. To our knowledge, this is the first report on the effect of mastication frequency on cerebral oxygenation. Possible implications of this finding are discussed.

Influence of Human Jaw Movement on Cerebral Blood Flow

Temporal changes in cerebral blood flow induced by jaw movement have yet to be investigated. To assess the influence of pattern and intensity of muscle contraction during jaw movement on task-induced change in cerebral blood flow, we performed bilateral transcranial Doppler ultrasound examination during clenching, gum chewing, and tooth tapping in healthy volunteers. A random-effects model analysis revealed a significant increase in middle cerebral artery blood flow velocity during clenching (high muscle activity) and gum chewing (moderate muscle activity), compared with the preceding rest period; however, such an increase was not detected during tooth tapping (low muscle activity). Cerebral blood flow was greater on the working side during the intensive isometric contraction of the masseter muscle in clenching. These results suggest that task-induced change in cerebral blood flow during jaw movement is influenced by the change in peripheral circulation evoked by muscle contraction.

Chewing-side Preference is Involved in Differential Cortical Activation Patterns during Tongue Movements after Bilateral Gum-chewing: a Functional Magnetic Resonance Imaging Study

Contralateral dominance in the activation of the primary sensorimotor cortex (S1/M1) during tongue movements (TMs) has been shown to be associated with a chewing-side preference (CSP). However, little is known about its interaction with chewing-related cortical activation. Functional magnetic resonance imaging was performed before and after gum-chewing in six subjects who exhibited a left CSP to determine the relationship between the CSP and activation patterns in the S1/M1 during TMs. Before the subjects chewed the gum, activation foci were found in the bilateral S1/M1. In the left hemisphere, both signal intensity and the area of activation significantly increased during TMs within 10 min after subjects chewed gum. Moreover, this augmented activation significantly decreased within 20 min during tongue protrusion and leftward movement. In the right hemisphere, there were no marked changes during TMs. These results suggest that bilateral gum-chewing enhances activation of the S1/M1 ipsilateral to the CSP during TMs.

Animal Models for Elucidation of the Mechanisms of Neuropsychiatric Disorders Induced by Sleep and Dietary Habits

Numerous changes in human lifestyle in modern life increase the risk of disease. Especially, modern sleep and dietary habits are crucial factors affecting lifestyle disease. In terms of sleep, decreases in total sleep time and in rapid eye movement sleep time have been observed in attention-deficit/hyperactivity disorder (ADHD) patients. From a dietary perspective, mastication during eating has several good effects on systemic, mental, and physical functions of the body. However, few animal experiments have addressed the influence of this decline in sleep duration or of long-term powdered diet feeding on parameters reflecting systemic health. In our studies, we examined both the influence of intermittent sleep deprivation (SD) treatment and long-term powdered diet feeding on emotional behavior in mice, and focused on the mechanisms underlying these impaired behaviors. Our findings were as follows: SD treatment induced hypernoradrenergic and hypodopaminergic states within the frontal cortex. Furthermore, hyperactivity and an explosive number of jumps were observed. Both the hypernoradrenergic state and the jumps were improved by treatment with ADHD therapeutic drugs. On the other hand, long-term powdered diet feeding increased social interaction behaviors. The feeding affected the dopaminergic function of the frontal cortex. In addition, the long-term powdered diet fed mice presented systemic illness signs, such as elevations of blood glucose, and hypertension. This review, describing the SD mice and long-term powdered diet fed mice can be a useful model for elucidation of the mechanism of neuropsychiatric disorders or the discovery of new therapeutic targets in combatting effects of the modern lifestyle.

Assessment of masticatory performance by means of a color-changeable chewing gum

PURPOSE

Previous research determined the relevance of masticatory performance with regard to nutritional status, cognitive functions, or stress management. In addition, the measurement of masticatory efficiency contributes to the evaluation of therapeutic successes within the stomatognathic system. However, the question remains unanswered as to what extent modern techniques are able to reproduce the subtle differences in masticatory efficiency within various patient groups. The purpose of this review is to provide an extensive summary of the evaluation of masticatory performance by means of a color-changeable chewing gum with regard to its clinical relevance and applicability.

STUDY SELECTION

A general overview describing the various methods available for this task has already been published. This review focuses in depth on the research findings available on the technique of measuring masticatory performance by means of color-changeable chewing gum. Described are the mechanism and the differentiability of the color change and methods to evaluate the color changes. Subsequently, research on masticatory performance is conducted with regard to patient age groups, the impact of general diseases and the effect of prosthetic and surgical treatment.

RESULTS

The studies indicate that color-changeable chewing gum is a valid and reliable method for the evaluation of masticatory function.

CONCLUSION

Apart from other methods, in clinical practice this technique can enhance dental diagnostics as well as the assessment of therapy outcomes.

Comparison of [(15)O] H2O Positron Emission Tomography and Functional Magnetic Resonance Imaging in Activation Studies

[(15)O] H2O positron emission tomography (PET) has long been out of use in activation studies on the brain. Indeed, it is true that blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) has better spatial resolution and temporal resolution than PET, as well as no radiation exposure. However, PET and fMRI differ in their scope. Compared to fMRI, [(15)O] H2O PET offers advantages such as being quantifiable, less deteriorated by movement, and allowing for longitudinal studies. This article aimed to reassess the merits of PET in this context.

Posterior Teeth Occlusion Associated with Cognitive Function in Nursing Home Older Residents: A Cross-Sectional Observational Study

Early detection and subsequent reduction of modifiable risk factors for cognitive decline is important for extending healthy life expectancy in the currently aging society. Although a recent increase in studies on the state or number of the teeth and cognitive function, few studies have focused on the association between posterior teeth occlusion necessary to maintain chewing function and cognitive function among older adults. This study examined the association between posterior teeth occlusion and cognitive function in nursing home older residents. In this cross-sectional study, 279 residents aged ≥60 years from eight nursing homes in Aso City, Japan participated in cognitive function and dental status assessments and completed a comprehensive questionnaire survey in 2014. Cognitive function was measured using a Mini-Mental State Examination (MMSE). Posterior teeth occlusion was assessed using a total number of functional tooth units (total-FTUs), depending on the number and location of the remaining natural and artificial teeth on implant-supported, fixed, and removable prostheses. Linear regression models were used to assess univariate and multivariate associations between total-FTUs and MMSE scores. Models were sequentially adjusted for demographic characteristics, number of natural teeth, socioeconomic status, health behaviors, comorbidities, physical function, and nutritional status. Among the 200 residents included in our analysis, mean MMSE scores and total-FTUs were 11.0 ± 8.6 and 9.3 ± 4.6, respectively. Higher total-FTUs were significantly associated with higher MMSE scores after adjustment for demographics and teeth number (B = 0.48, 95% confidence interval [CI] = 0.22-0.74). The association remained significant even after adjustment for all covariates (B = 0.25, 95% CI = 0.01-0.49). The current findings demonstrated that loss of posterior teeth occlusion was independently associated with cognitive decline in nursing home older residents in Japan. Maintenance and restoration of posterior teeth occlusion may be a preventive factor against cognitive decline in aged populations.

Multiple tooth loss is associated with vascular cognitive impairment in subjects with acute ischemic stroke

BACKGROUND AND OBJECTIVE

Emerging evidence shows that tooth loss is associated with cognitive impairment and dementia. Vascular cognitive impairment (VCI) is a common consequence of ischemic stroke. This study investigated the association of tooth loss with VCI in patients with acute stroke.

MATERIAL AND METHODS

A total of 161 subjects with acute ischemic stroke were recruited. Within 1 wk after admission, fasting blood tests were undertaken and the number of teeth present was recorded. VCI was evaluated with the Montreal Cognitive Assessment (MoCA).

RESULTS

The patients with loss of ≥ 8 teeth exhibited significantly lower MoCA values as compared to those with loss of ≤ 7 teeth (13.2 ± 6.6 vs. 17.3 ± 6.0, p < 0.001). Multivariate logistic regression analysis showed that loss of ≥ 8 teeth (OR = 3.1, 95% CI: 1.2-7.9, p = 0.02) and stroke history (OR = 3.8, 95% CI: 1.1-14.1, p = 0.04) were significantly associated with VCI (MoCA score ≤ 20.0).

CONCLUSION

Within the limitations of this study, the current findings provide the first evidence that multiple tooth loss is independently associated with VCI in patients with acute ischemic stroke.

Mastication as a Stress-Coping Behavior

Exposure to chronic stress induces various physical and mental effects that may ultimately lead to disease. Stress-related disease has become a global health problem. Mastication (chewing) is an effective behavior for coping with stress, likely due to the alterations chewing causes in the activity of the hypothalamic-pituitary-adrenal axis and autonomic nervous system. Mastication under stressful conditions attenuates stress-induced increases in plasma corticosterone and catecholamines, as well as the expression of stress-related substances, such as neurotrophic factors and nitric oxide. Further, chewing reduces stress-induced changes in central nervous system morphology, especially in the hippocampus and hypothalamus. In rodents, chewing or biting on wooden sticks during exposure to various stressors reduces stress-induced gastric ulcer formation and attenuates spatial cognitive dysfunction, anxiety-like behavior, and bone loss. In humans, some studies demonstrate that chewing gum during exposure to stress decreases plasma and salivary cortisol levels and reduces mental stress, although other studies report no such effect. Here, we discuss the neuronal mechanisms that underline the interactions between masticatory function and stress-coping behaviors in animals and humans.

Chewing and attention: a positive effect on sustained attention

Chewing is crushing food not only to aid swallowing and digestion, but also to help stress relief and regulate cognitive function, especially in attention. It is well known that chewing gum is used for sleepiness prevention during work, learning, and driving, suggesting a link between chewing and sustained attention. We hypothesized that chewing elevates attention and/or alertness, leading to improvements in cognitive performance. We carried out a systematic review of the PubMed database. We inspected the attributes of effects on attention in studies investigating the effects of chewing on attention or alertness conducted with pre-post design in healthy subjects, except elderly. We identified 151 references, 22 of which were included: 14 (64%) showed positive attributes of effects on attention, 1 (5%) showed negative attributes of effects on attention, 5 (23%) showed both positive and negative attributes of effects on attention, and 2 (9%) showed no significant attributes of effects on attention. Thus, positive attributes of effects of chewing on attention, especially on sustained attention, were shown in over half of the reports. These effects also appeared with improvement in mood and stress relief and were influenced by time-on-task effect. Further studies are needed, but chewing could be useful for modifying cognitive function.

Influence of restoration adjustments on prefrontal blood flow: A simplified NIRS preliminary study

Objective

The aim of this study was to examine, after setting several restorations, the influence of adjusted occlusal interference during gum chewing on blood flow in the prefrontal area as determined using near-infrared spectroscopy.

Material and methods

The physiological rate was assessed using a visual analog scale (VAS) questionnaire. We selected 16 patients who desired prosthetic restorative treatment on the lateral dentition, and eight healthy volunteers. Subjects were divided into three eight-person groups. One group received restorations on the premolar area (PA), another group received restorations on the molar area (MA), and the control group (CT) received no prosthetic restorations. The spectroscope was fastened to the frontal region of the head after placement of the final restoration, but before adjustment.

Results

Pre-adjustment (first gum chewing for CT) blood flow in the prefrontal cortex was measured during gum chewing. Blood flow was again measured during gum chewing after the restoration (second gum chewing for CT) had been adjusted in accordance with the subjective assessment of the patient while wearing the device. The VAS provided quantification of comfort during gum chewing before and after restoration adjustment. For the PA and MA groups, adjusting restorations decreased discomfort significantly during gum chewing. Moreover, in the MA group, prefrontal blood flow was significantly reduced, and blood flow correlated with discomfort.

Conclusions

Activation of the prefrontal area may provide an objective criterion for judging the functionality of occlusion after prosthetic occlusal reconstruction and/or orthodontics.

Effects of treadmill exercise on the LiCl-induced conditioned taste aversion in rats

Studies have shown that exercise can enhance learning and memory. Conditioned taste aversion (CTA) is an avoidance behavior induced by associative memory of the taste sensation for something pleasant or neutral with a negative visceral reaction caused by the coincident action of a toxic substance that is tasteless or administered systemically. We sought to measure the effects of treadmill exercise on CTA in rats by investigating the effects of exercise on acquisition, extinction and spontaneous recovery of CTA. We made two groups of rats: an exercise group that ran on a treadmill, and a control group that did not have structured exercise periods. To condition rats to disfavor a sweet taste, consumption of a 0.1% saccharin solution in place of drinking water was paired with 0.15M LiCl (2% body weight, i.p.) to induce visceral discomfort. We measured changes of saccharin consumption during acquisition and extinction of CTA. The exercise and no-exercise groups both acquired CTA to similar levels and showed maximum extinction of CTA around 6 days after acquisition. This result indicates that exercise affects neither acquisition nor extinction of CTA. However, in testing for preservation of CTA after much longer extinction periods that included exercise or not during the intervening period, exercising animals showed a significantly lower saccharin intake, irrespective of having exercised or not during the conditioning phase of the trial. This result suggests that exercise may help to preserve aversive memory (taste aversion in this example) as evidence by the significant spontaneous recovery of aversion in exercising animals.

Identification and adjustment of experimental occlusal interference using functional magnetic resonance imaging

BACKGROUND

The purpose of this study was to use functional magnetic resonance imaging (fMRI) to quantify changes in brain activity during experimental occlusal interference.

METHODS

Fourteen healthy volunteers performed a rhythmical tapping occlusion task with experimental occlusal interference of the right molar tooth at 0 mm (no occlusion), 0.5 mm, and 0.75 mm. The blood-oxygen-level dependent (BOLD) signal was quantified using statistical parametric mapping and compared between rest periods and task periods.

RESULTS

In tapping tasks with experimental occlusal interference of 0.75 mm or 0.5 mm, there was clear activation of the contralateral teeth-related primary sensory cortex and Brodmann's area 46. At 0 and 30 minutes after removal of the experimental occlusal interference, the activation clearly appeared in the bilateral teeth-related primary sensory cortices and Brodmann's area 46. At 60 minutes after the removal of the experimental occlusal interference, the activation of Brodmann's area 46 had disappeared, and only the bilateral teeth-related primary sensory cortices were active.

CONCLUSIONS

The present results suggest that adjustments for experimental occlusal interference can be objectively evaluated using fMRI. We expect that this method of evaluating adjustments in occlusal interference, combined with fMRI and the tapping task, could be applied clinically in the future.

Parasympathetic reflex vasodilation in the cerebral hemodynamics of rats

We investigated the role of parasympathetic reflex vasodilation in the regulation of the cerebral hemodynamics, and whether GABAA receptors modulate the response. We examined the effects of activation of the parasympathetic fibers through trigeminal afferent inputs on blood flow in the internal carotid artery (ICABF) and the cerebral blood vessels (rCBF) in parietal cortex in urethane-anesthetized rats. Electrical stimulation of the central cut end of the lingual nerve (LN) elicited intensity- and frequency-dependent increases in ICABF that were independent of changes in external carotid artery blood flow. Increases in ICABF were elicited by LN stimulation regardless of the presence or absence of sympathetic innervation. The ICABF increases evoked by LN stimulation were almost abolished by the intravenous administration of hexamethonium (10 mg kg(-1)) and were reduced significantly by atropine administration (0.1 mg kg(-1)). Although the LN stimulation alone had no significant effect on rCBF, LN stimulation in combination with a blocker of the GABAA receptor pentylenetetrazole increased the rCBF markedly. This increase in rCBF was reduced significantly by the administration of hexamethonium and atropine. These observations indicate that the increases in both ICABF and rCBF are evoked by parasympathetic activation via the trigeminal-mediated reflex. The rCBF increase evoked by LN stimulation is thought to be limited by the GABAA receptors in the central nervous system. These results suggest that the parasympathetic reflex vasodilation and its modulation mediated by GABA receptors within synaptic transmission in the brainstem are involved in the regulation of the cerebral hemodynamics during trigeminal afferent inputs.

Masticatory deficiency as a risk factor for cognitive dysfunction

Several studies have demonstrated that chewing helps to maintain cognitive functions in brain regions including the hippocampus, a central nervous system (CNS) region vital for memory and learning. Epidemiological studies suggest that masticatory deficiency is associated with development of dementia, which is related to spatial memory deficits especially in older animals. The purpose of this paper is to review recent work on the effects of masticatory impairment on cognitive functions both in experimental animals and humans. We show that several mechanisms may be involved in the cognitive deficits associated with masticatory deficiency. The epidemiological data suggest a positive correlation between masticatory deficit and Alzheimer's disease. It may be concluded that chewing has important implications for the mechanisms underlying certain cognitive abilities.

Memory-related gene expression profile of the male rat hippocampus induced by teeth extraction and occlusal support recovery

OBJECTIVES

The present study aimed to identify the effect of memory-related genes on male rats tested for spatial memory with either molar teeth extraction or its restoration by occlusal support using experimental dentures.

DESIGN

Memory-related genes were detected from hippocampi of male Wistar rats (exposed to teeth extraction with or without dentures, or no extraction (control)) (7-week old) after behavioural testing (via the radial maze task) using a DNA microarray. The time course of the expression of these genes was evaluated by quantitative real-time polymerase chain reaction (PCR) (on 49-week-old rats).

RESULTS

In preliminary experiments, to determine which memory genes are affected by spatial memory training, DNA microarray analysis revealed that thyrotropin-releasing hormone (Trh) and tenascin XA (Tnxa) were up-regulated and neuronatin (Nnat) and S100a9 were down-regulated after the maze training. The expression of Tnxa, Nnat and S100a9 of 49-week-old rats (during the time course) via quantitative real-time PCR was consistent with the results of microarrays of the preliminary experiment. Expression of Trh that was evaluated by quantitative real-time PCR did not agree with the results for this gene from the microarray for all groups. Therefore, expression of Trh may have increased in only young, trained rats. The expression of S100a9 prior to the maze task was down-regulated in only the extraction group.

CONCLUSION

These results demonstrated that Trh, Tnxa and Nnat genes were affected according to the degree of memory in male rats. This study also indicated that S100a9 is a memory-related gene, which is affected by the presence of occlusal support.

Mastication dyspraxia: a neurodevelopmental disorder reflecting disruption of the cerebellocerebral network involved in planned actions

This paper reports the longitudinal clinical, neurocognitive, and neuroradiological findings in an adolescent patient with nonprogressive motor and cognitive disturbances consistent with a diagnosis of developmental coordination disorder (DCD). In addition to prototypical DCD, the development of mastication was severely impaired, while no evidence of swallowing apraxia, dysphagia, sensorimotor disturbances, abnormal tone, or impaired general cognition was found. He suffered from bronchopulmonary dysplasia and was ventilated as a newborn for 1.5 months. At the age of 3 months, a ventriculoperitoneal shunt was surgically installed because of obstructive hydrocephalus secondary to perinatal intraventricular bleeding. At the age of 5 years, the patient's attempts to masticate were characterized by rough, effortful, and laborious biting movements confined to the vertical plane. Solid food particles had a tendency to get struck in his mouth and there was constant spillage. As a substitute for mastication, he moved the unground food with his fingers in a lateral direction to the mandibular and maxillary vestibule to externally manipulate and squeeze the food between cheek and teeth with the palm of his hand. Once the food was sufficiently soft, the bolus was correctly transported by the tongue in posterior direction and normal deglutition took place. Repeat magnetic resonance imaging (MRI) during follow-up disclosed mild structural abnormalities as the sequelae of the perinatal intraventricular bleeding, but this could not explain impaired mastication behavior. Quantified Tc-99m-ethylcysteinate dimer single-photon emission computed tomography (Tc-99m-ECD SPECT), however, revealed decreased perfusion in the left cerebellar hemisphere, as well as in both inferior lateral frontal regions, both motor cortices, and the right anterior and lateral temporal areas. Anatomoclinical findings in this patient with DCD not only indicate that the functional integrity of the cerebellocerebral network is crucially important in the planning and execution of skilled actions, but also seem to show for the first time that mastication deficits may be of true apraxic origin. As a result, it is hypothesized that "mastication dyspraxia" may have to be considered as a distinct nosological entity within the group of the developmental dyspraxias following a disruption of the cerebellocerebral network involved in planned actions.

Influence of a long-term powdered diet on the social interaction test and dopaminergic systems in mice

It is well known that the characteristics of mastication are important for the maintenance of our physical well-being. In this study, to assess the importance of the effects of food hardness during mastication, we investigated whether a long-term powdered diet might cause changes in emotional behavior tests, including spontaneous locomotor activity and social interaction (SI) tests, and the dopaminergic system of the frontal cortex and hippocampus in mice. Mice fed a powdered diet for 17 weeks from weaning were compared with mice fed a standard diet (control). The dopamine turnover and expression of dopamine receptors mRNA in the frontal cortex were also evaluated. Spontaneous locomotor activity, SI time and dopamine turnover of the frontal cortex were increased in powdered diet-fed mice. On the other hand, the expression of dopamine-4 (D4) receptors mRNA in the frontal cortex was decreased in powdered diet-fed mice. Moreover, we examined the effect of PD168077, a selective D4 agonist, on the increased SI time in powdered diet-fed mice. Treatment with PD168077 decreased the SI time. These results suggest that the masticatory dysfunction induced by long-term powdered diet feeding may cause the increased SI time and the changes in the dopaminergic system, especially dopamine D4 receptor subtype in the frontal cortex.

Flavor-Enhanced Modulation of Cerebral Blood Flow during Gum Chewing

BACKGROUND

Flavor perception, the integration of taste and odor, is a critical factor in eating behavior. It remains unclear how such sensory signals influence the human brain systems that execute the eating behavior.

METHODS

WE TESTED CEREBRAL BLOOD FLOW (CBF) IN THE FRONTAL LOBES BILATERALLY WHILE SUBJECTS CHEWED THREE TYPES OF GUM WITH DIFFERENT COMBINATIONS OF TASTE AND ODOR: no taste/no odor gum (C-gum), sweet taste/no odor gum (T-gum), and sweet taste/lemon odor gum (TO-gum). Simultaneous recordings of transcranial Doppler ultrasound (TCD) and near infrared spectrometer (NIRS) were used to measure CBF during gum chewing in 25 healthy volunteers. Bilateral masseter muscle activity was also monitored.

RESULTS

We found that subjects could discriminate the type of gum without prior information. Subjects rated the TO-gum as the most flavorful gum and the C-gum as the least flavorful. Analysis of masseter muscle activity indicated that masticatory motor output during gum chewing was not affected by taste and odor. The TCD/NIRS measurements revealed significantly higher hemodynamic signals when subjects chewed the TO-gum compared to when they chewed the C-gum and T-gum.

CONCLUSIONS

These data suggest that taste and odor can influence brain activation during chewing in sensory, cognitive, and motivational processes rather than in motor control.

Chewing gum moderates the vigilance decrement

We examine the impact of chewing gum on a Bakan-type vigilance task that requires the continual updating of short-term order memory. Forty participants completed a 30-min auditory Bakan-task either with, or without, the requirement to chew gum. Self-rated measures of mood were taken both pre- and post-task. As expected, the vigilance task produced a time-dependent performance decrement indexed via decreases in target detections and lengthened correct reaction times (RTs), and a reduction in post-task self-rated alertness scores. The declines in both performance and subjective alertness were attenuated in the chewing-gum group. In particular, correct RTs were significantly shorter following the chewing of gum in the latter stages of the task. Additionally, the gradients of decline for target detection and incline for correct RTs were both attenuated for the chewing-gum group. These findings are consistent with the data of Tucha and Simpson (2011), Appetite, 56, 299-301, who showed beneficial effects of chewing gum in the latter stages of a 30 min visual attention task, and extend their data to a task that necessitates the continuous updating of order memory. It is noteworthy that our data contradict the claim (Kozlov, Hughes, & Jones, 2012, Q. J. Exp. Psychology, 65, 501-513) that chewing gum negatively impacts short-term memory task performance.

Effects of chewing on cognitive processing speed

In recent years, chewing has been discussed as producing effects of maintaining and sustaining cognitive performance. We have reported that chewing may improve or recover the process of working memory; however, the mechanisms underlying these phenomena are still to be elucidated. We investigated the effect of chewing on aspects of attention and cognitive processing speed, testing the hypothesis that this effect induces higher cognitive performance. Seventeen healthy adults (20-34 years old) were studied during attention task with blood oxygenation level-dependent functional (fMRI) at 3.0 T MRI. The attentional network test (ANT) within a single task fMRI containing two cue conditions (no cue and center cue) and two target conditions (congruent and incongruent) was conducted to examine the efficiency of alerting and executive control. Participants were instructed to press a button with the right or left thumb according to the direction of a centrally presented arrow. Each participant underwent two back-to-back ANT sessions with or without chewing gum, odorless and tasteless to remove any effect other than chewing. Behavioral results showed that mean reaction time was significantly decreased during chewing condition, regardless of speed-accuracy trade-off, although there were no significant changes in behavioral effects (both alerting and conflict effects). On the other hand, fMRI analysis revealed higher activations in the anterior cingulate cortex and left frontal gyrus for the executive network and motor-related regions for both attentional networks during chewing condition. These results suggested that chewing induced an increase in the arousal level and alertness in addition to an effect on motor control and, as a consequence, these effects could lead to improvements in cognitive performance.

Forced mastication increases survival of adult neural stem cells in the hippocampal dentate gyrus

In this study, we examined the effect of forced mastication on neurogenesis in the hippocampal dentate gyrus (DG) of adult mice. Six-week-old mice were subjected to either a hard or normal diet for 13 weeks. They received a daily injection of bromodeoxyuridine (BrdU) for 12 consecutive days beginning at 14 weeks of age. The number of BrdU-positive cells in the DG was counted 1 day after and 5 weeks after the final BrdU injection. The number of BrdU-positive cells 1 day after injection did not differ between the 2 diet groups. However, the number of BrdU-positive cells in the group fed the hard diet was significantly increased 5 weeks after BrdU injection compared to the group fed the normal diet. The results of the Morris water maze test showed that mice fed a hard diet required significantly less time to reach the platform than the control mice when tested at 10 days. Moreover, mice in the group fed the hard diet spent significantly more time in the former platform area than the group fed the normal diet, indicating that hard diet feeding improved spatial memory compared to normal diet feeding. Real-time PCR analysis showed that the expression of glutamate receptor 1 mRNA was significantly increased in the group fed the hard diet compared with the group fed the normal diet. These results suggest that mastication increases the survival of adult neural stem cells in the hippocampal DG.

Brain activity and human unilateral chewing: an FMRI study

Brain mechanisms underlying mastication have been studied in non-human mammals but less so in humans. We used functional magnetic resonance imaging (fMRI) to evaluate brain activity in humans during gum chewing. Chewing was associated with activations in the cerebellum, motor cortex and caudate, cingulate, and brainstem. We also divided the 25-second chew-blocks into 5 segments of equal 5-second durations and evaluated activations within and between each of the 5 segments. This analysis revealed activation clusters unique to the initial segment, which may indicate brain regions involved with initiating chewing. Several clusters were uniquely activated during the last segment as well, which may represent brain regions involved with anticipatory or motor events associated with the end of the chew-block. In conclusion, this study provided evidence for specific brain areas associated with chewing in humans and demonstrated that brain activation patterns may dynamically change over the course of chewing sequences.

Stress and chewing affect blood flow and oxygen levels in the rat brain

OBJECTIVE

Mastication, including chewing, would be of great importance not only for food intake, but also for the mental, physical and physiological functioning of the body. Our study showed that mastication, especially chewing, suppresses the stress response and was regarded as a biological response to defend against various stresses. Although mastication altered brain function during stress, the underlying mechanisms have not been elucidated.

METHODS

The effects of chewing during restraint stress on blood flow and oxygen partial pressure (PO(2)) levels in the rat amygdala and hypothalamus were measured using laser Doppler flowmetry and O(2)-selective electrodes.

RESULTS

Amygdaloidal and hypothalamic blood flow were not affected by restraint stress, but PO(2) levels were significantly reduced by restraint stress for 180 min compared to unrestrained control rats. The decrease in amygdaloidal and hypothalamic PO(2) levels during restraint stress was reduced after chewing for 30 min.

CONCLUSION

These results suggested that it is possible to evaluate hypothalamic and amygdaloidal blood flow and PO(2) levels in rat brains during restraint stress. Restraint stress reduced cerebral PO(2) levels. In addition, chewing would lead to increased blood flow and to recover cerebral PO(2) levels.

Cerebro-afferent vessel and pupillary basal diameter variation induced by stomatognathic trigeminal proprioception: a case report

INTRODUCTION

A patient affected by asymmetric hemodynamics of cerebro-afferent vessels underwent duplex color scanner investigations in occlusal proprioceptive un- and rebalance conditions. Pupillometric video-oculographic examinations were performed in order to spot connected trigeminal proprioceptive motor patterns able to interfere on sympathetic autonomic activity. The aim of this case report is to verify if involuntary jaw closing during swallowing, executed in unbalance and rebalance myoelectric activity, would be able to modify cerebral hemodynamics.

CASE PRESENTATION

A 56-year-old Caucasian Italian woman affected by asymmetric blood flow of cerebro-afferent vessels underwent an electromyographic investigation of her occlusal muscles in order to assess their occlusal functional balance. The extreme asymmetry of myoelectric activity in dental occlusion evidenced by electromyographic values suggested the rebalancing of the functions of occlusal muscles through concurrent transcutaneous stimulation of the trigeminal nerve supra- and submandibular motor branches. The above-mentioned method allowed the detection of a symmetric craniomandibular muscular relation that can be kept constant through the use of a cusp bite modeled on the inferior dental arch: called orthotic-syntropic bite for its peculiar use of electrostimulation. A few days later, the patient underwent a duplex color scanner investigation and pupillometric video-oculographic examinations in occlusal unbalance and rebalance conditions.

CONCLUSIONS

A comparative data analysis showed that an unbalanced dental occlusal function may represent an interferential pattern on cerebral hemodynamics velocity and pupillometric evaluations have proved useful both in the analysis of locus coeruleus functional modalities and as a diagnostic tool in the assessment of pathologies involving locus coeruleus and autonomic systems. The inclusion of myoelectric masseter examinations can be useful in patients with asymmetric hemodynamics of cerebro-afferent vessels and dental occlusal proprioceptive rebalance can integrate the complex therapy of patients with increased chronic sympathetic activity.

The effects of a customized over-the-counter mouth guard on neuromuscular force and power production in trained men and women

Although mouth guards were originally designed for injury prevention, even elite athletes are now using performance mouth guards to improve athletic success. Both expensive custom models and over-the-counter models are available, but the efficacy is not well known. Some athletes remain wary of the perceived potential for detriments using a mouth guard to their performance. Thus, the purpose of this study was to examine various physical performance tests when using a mouth guard including a customized over-the-counter mouth guard. Twenty-six trained men (25 ± 4 years; 1.78 ± 0.07 m; 83.3 ± 11.4 kg) and 24 trained women (23 ± 3 years; 1.65 ± 0.08 m; 62.6 ± 7.8 kg) volunteered for the investigation. The subjects completed a familiarization period and then balanced and randomized treatment conditions that included: (a) a customized Power Balance performance mouth guard (PB MG); (b) a regular over the counter boil-and-bite mouth guard (Reg MG); and (c) a no mouth guard (No MG) treatment condition. At each visit, the subjects completed a testing protocol that was sequenced in the following order: sit-and-reach flexibility, medial-lateral balance, visual reaction time, vertical jump, 10-m sprint, bench throw, and plyo press power quotient (3PQ). Heart rate and rating of perceived exertion (RPE) were recorded around the 3PQ. Significance was set at p ≤ 0.05. Expected significant sex differences existed for all power, strength, and speed variables. Bench throw power (watts) and force (newtons) were significantly higher under PB MG than either Reg MG or No MG or in both men and women. The 3PQ power and force production were higher than that for the other 2 treatments for the PB MG for men only. There were no significant differences for treatment conditions in the heart rate or RPE after the 3PQ test. Men were better able to maintain significantly higher 3PQ power production under PB MG treatment condition compared with the other 2 treatment conditions. Rate of power development was significantly higher in men for the vertical jump when using the PB MG compared with that for other treatment conditions in men only. No differences were observed in flexibility, balance, visual reaction time, or sprint time. The PB MG performance mouth guard improves performance of upper-body loaded power exercises in both men and women and lower body power exercise in men without compromising performance on any other performance parameters.