1
|
Oh JC. Changes in the Activation Level of the Floor of the Mouth Muscles during Pressing and Swallowing Tasks According to the Degree of Tongue Pressure. Dysphagia 2024:10.1007/s00455-024-10691-5. [PMID: 38466426 DOI: 10.1007/s00455-024-10691-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/26/2024] [Indexed: 03/13/2024]
Abstract
The suprahyoid muscles play an important role in protecting the airway by elevating both the hyoid bone and larynx superior-anteriorly during swallowing. However, providing systematic external resistance when performing exercises to improve suprahyoid muscle strength is practically difficult. This study attempted to confirm whether systematic resistance can be provided to the suprahyoid muscles using the Iowa Oral Performance Instrument (IOPI)-a representative tongue pressure measurement device. Thirty-one healthy adults participated in this study (20.6 ± 0.96 y, 19 females). The participants performed 16 exercise tasks using the IOPI three times each in random order (Anterior/posterior tongue × pressing/swallowing task × 40/60/80/100% maximum tongue pressure). Furthermore, the floor of the mouth (FOM) muscle activity during exercise was simultaneously measured using surface electromyography. During the pressing task, there were significant differences in FOM maximal muscle activity among the four exercise intensities for both the anterior and posterior oral tongue. For the swallowing task, a significant difference was found in FOM muscle activity among the four exercise intensities for the anterior tongue. For the posterior tongue, significant differences were identified among all conditions except for the comparison between 80% and 100% maximum tongue pressure. Significant correlations between the degree of tongue pressure and maximal FOM muscle activity were found in both the pressing and swallowing tasks at the anterior and posterior oral tongue. Overall, these results indicate that objective and systematic external resistance can be applied using the IOPI-a standard tongue pressure measurement device-during the program to improve suprahyoid muscle function.
Collapse
Affiliation(s)
- Jong-Chi Oh
- Department of Occupational Therapy, Cheongju University, 298 Daesung-ro, Cheongwon-gu, Cheongju, Chungcheongbuk-do, 28503, Republic of Korea.
| |
Collapse
|
2
|
Poncin W, Correvon N, Tam J, Borel J, Berger M, Liistro G, Mwenge B, Heinzer R, Contal O. The effect of tongue elevation muscle training in patients with obstructive sleep apnea: A randomised controlled trial. J Oral Rehabil 2022; 49:1049-1059. [PMID: 36081312 PMCID: PMC9826101 DOI: 10.1111/joor.13369] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 08/23/2022] [Accepted: 09/05/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Oropharyngeal myofunctional therapy is a multi-component therapy effective to reduce the severity of obstructive sleep apnoea (OSA). However, existing protocols are difficult to replicate in the clinical setting. There is a need to isolate the specific effectiveness of each component of the therapy. OBJECTIVE To assess the effects of a 6 weeks tongue elevation training programme in patients with OSA. METHODS We conducted a multicentre randomised controlled trial. Eligible participants were adults diagnosed with moderate OSA who presented low adherence to continuous positive airway pressure therapy (mean use <4 h per night). The intervention group completed a 6 weeks tongue elevation training protocol that consisted in anterior tongue elevation strength and endurance tasks with the Iowa Oral Performance Instrument. The control group completed a 6 weeks sham training protocol that involved expiratory muscle training at very low intensity. Polygraphy data, tongue force and endurance, and OSA symptoms were evaluated pre- and post-intervention. The primary outcome was apneoa-hypopnea index (AHI). RESULTS Twenty-seven patients (55 ± 11 years) were recruited. According to modified intention-to-treat analysis (n = 25), changes in AHI and c did not significantly differ between groups. Daytime sleepiness (Epworth Sleepiness Scale) and tongue endurance significantly improved in the intervention group compared to the control group (p = .015 and .022, respectively). In the intervention group, 75% of participants had a decrease in daytime sleepiness that exceeded the minimal clinically important difference. CONCLUSION Six weeks of tongue elevation muscle training had no effect on OSA severity.
Collapse
Affiliation(s)
- William Poncin
- School of Health Sciences (HESAV)HES‐SO University of Applied Sciences and Arts Western SwitzerlandLausanneSwitzerland,Institute of Experimental and Clinical Research (IREC), pôle de Pneumologie, ORL et DermatologieUniversité Catholique de LouvainBrusselsBelgium,Service de Pneumologie, Cliniques universitaires Saint‐LucBrusselsBelgium
| | - Nils Correvon
- School of Health Sciences (HESAV)HES‐SO University of Applied Sciences and Arts Western SwitzerlandLausanneSwitzerland
| | - Jonathan Tam
- HES‐SO University of Applied Sciences and Arts Western SwitzerlandLausanneSwitzerland,Service de Physiothérapie cardio‐respiratoire, département de chirurgie, cœur‐vaisseau et centre interdisciplinaireCentre Hospitalier Universitaire VaudoisLausanneSwitzerland
| | | | - Mathieu Berger
- Center for Investigation and Research in SleepCentre Hospitalier Universitaire Vaudois and Université de LausanneLausanneSwitzerland
| | - Giuseppe Liistro
- Service de Pneumologie, Cliniques universitaires Saint‐LucBrusselsBelgium
| | - Benny Mwenge
- Service de Pneumologie, Cliniques universitaires Saint‐LucBrusselsBelgium
| | - Raphael Heinzer
- Center for Investigation and Research in SleepCentre Hospitalier Universitaire Vaudois and Université de LausanneLausanneSwitzerland
| | - Olivier Contal
- School of Health Sciences (HESAV)HES‐SO University of Applied Sciences and Arts Western SwitzerlandLausanneSwitzerland
| |
Collapse
|
3
|
Li WY, Jin H, Zou Y, Huang H, Wei Z, Kang J, Xue Y, Wang W. The Different Effect of Tongue Motor Task Training (TTT) and Strength Training (ST) on the Modulation of Genioglossus Corticomotor Excitability and upper airway stability in Rats. Sleep 2022; 45:6648555. [PMID: 35867628 DOI: 10.1093/sleep/zsac170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES the mechanical efficiency of upper airway (UA) muscles are pivotal in maintaining UA stability. We aimed to investigate if different tongue training approaches could differently induce signs of neuroplastic in the corticomotor pathways and upper airway stability changes. METHODS 36 Sprague-Dawley rats were trained daily for eight weeks to lick an isotonic force-sensing disc at targeting forces using 30-50% of maximal achieved lick force (MALF) for tongue task training (TTT) or targeting force set above 50%, 60% and 70% of MALF progressively for tongue strength training (TST). Corticomotor excitability was dynamically assessed by GG response to transcortical magnetic stimulation (TMS) at different sessions. GG EMG activity, GG ultrastructure and myosin heavy chain (MHC), UA dynamics were assessed after eight weeks. RESULTS After 4 weeks, GG TMS latencies decreased in both tongue training groups when compared with the control group (p<0.05) and this excitability was more stable in TTT group. After 8 weeks, both GG TMS response and EMG activity revealed increased excitability in TTT and TST groups. The apoptotic pathological morphology changes of GG ultrastructure were observed in TST group, but not TTT. Percentage of GG MHC type I fibers in TST group was higher than the control and TTT groups (p<0.05). The UA Pcrit decreased significantly in TTT group (p<0.05) and tend to decrease in TST group (p=0.09). CONCLUSION TTT could improve the UA stability and induce the neuroplastic changes more efficiently without training-induced muscle injury, while TST revealed a fatigue-resistance change in GG.
Collapse
Affiliation(s)
- Wen-Yang Li
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Hongyu Jin
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Ying Zou
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Hong Huang
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Zhijing Wei
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Jian Kang
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Yixue Xue
- Neurobiology department, College of Life Science, China Medical University, Shenyang, China
| | - Wei Wang
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| |
Collapse
|
4
|
Boscato N, Hayakawa H, Iida T, Costa YM, Kothari SF, Kothari M, Svensson P. Impact of oral motor task training on corticomotor pathways and diadochokinetic rates in young healthy participants. J Oral Rehabil 2022; 49:924-934. [PMID: 35722734 PMCID: PMC9543743 DOI: 10.1111/joor.13349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/11/2022] [Accepted: 06/11/2022] [Indexed: 11/27/2022]
Abstract
Background Studies addressing the training‐induced neuroplasticity and interrelationships of the lip, masseter, and tongue motor representations in the human motor cortex using single syllable repetition are lacking. Objective This study investigated the impact of a repeated training in a novel PaTaKa diadochokinetic (DDK) orofacial motor task (OMT) on corticomotor control of the lips, masseter, and tongue muscles in young healthy participants. Methods A total of 22 young healthy volunteers performed 3 consecutive days of training in an OMT. Transcranial magnetic stimulation was applied to elicit motor evoked potentials (MEPs) from the lip, masseter, tongue, and first dorsal interosseous (FDI, internal control) muscles. MEPs were assessed by stimulus–response curves and corticomotor mapping at baseline and after OMT. The DDK rate from PaTaKa single syllable repetition and numeric rating scale (NRS) scores were also obtained at baseline and immediately after each OMT. Repeated‐measures analysis of variance was used to detect differences at a significance level of 5%. Results There was a significant effect of OMT and stimulus intensity on the lips, masseter, and tongue MEPs compared to baseline (p < .001), but not FDI MEPs (p > .05). OMT increased corticomotor topographic maps area (p < .001), and DDK rates (p < .01). Conclusion Our findings suggest that 3 consecutive days of a repeated PaTaKa training in an OMT can induce neuroplastic changes in the corticomotor pathways of orofacial muscles, and it may be related to mechanisms underlying the improvement of orofacial fine motor skills due to short‐term training. The clinical utility should now be investigated.
Collapse
Affiliation(s)
- Noéli Boscato
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Hidetoshi Hayakawa
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Division of Oral Function and Rehabilitation, Department of Oral Health Science, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - Takashi Iida
- Division of Oral Function and Rehabilitation, Department of Oral Health Science, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - Yuri M Costa
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Department of Biosciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Simple Futarmal Kothari
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Mohit Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Department of Clinical Medicine, Aarhus University, Hammel, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark.,JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, India
| | - Peter Svensson
- Section for Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark.,Faculty of Odontology, Malmö University, Malmö, Sweden
| |
Collapse
|
5
|
Kumar A, Munirji L, Nayif S, Almotairy N, Grigoriadis J, Grigoriadis A, Trulsson M. Motor Performance and Skill Acquisition in Oral Motor Training With Exergames: A Pilot Study. Front Aging Neurosci 2022; 14:730072. [PMID: 35309890 PMCID: PMC8924593 DOI: 10.3389/fnagi.2022.730072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/11/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To investigate the effects of oral-motor training with exergames on motor performance and motor skill acquisition in two different age groups. Methods Thirty-two healthy participants were recruited in the current pilot study and divided equally into two groups (Gen Z and Baby Boomers) according to their age. A pair of electromyographic (EMG) electrodes were placed on the participants’ masseter muscles. The EMG device communicated via Bluetooth with a mobile video game in response to the electromyographic activity of the masseter muscles during clenching. During the experimental session, participants were asked to play a video game in five blocks of 5 min each, with a 3-min break between each time block. The goal of the game was to collect as many coins (game points) as possible and to dodge/avoid upcoming obstacles (game life). Motor performance was assessed by performance scores and the number of game lives. Skill acquisition was measured by task efficiency (ratio of performance scores and number of game lives) across time blocks. Results The results of the study showed significantly lower performance scores (p < 0.001), a higher number of game lives (p < 0.001), and lower task efficiency in the Baby Boomer group compared to the Gen Z group. Specifically, the results showed that there was a significant difference in task efficiency between the first and second, third and fourth, fourth- and fifth-time blocks in the Gen Z group (p < 0.002). However, there was only a significant difference between first- and second-time blocks in the Baby Boomer group (p = 1.012), suggesting that skill acquisition in the Baby Boomer group did not change significantly over the course of the time blocks. Conclusion The study showed higher motor performance and superior motor skill acquisition with novel exergame training in the Gen Z group compared to the Baby Boomer group. The results of the study indicate that there is an improvement in oral motor skills with short-term training, yet the differences in oral motor skills between the two groups are still evident. The Baby Boomer group, unlike the Gen Z group, did not show robust improvement in task efficiency over the course of the series.
Collapse
Affiliation(s)
- Abhishek Kumar
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
- *Correspondence: Abhishek Kumar,
| | - Linda Munirji
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Sam Nayif
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Nabeel Almotairy
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
| | - Joannis Grigoriadis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Anastasios Grigoriadis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Mats Trulsson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
6
|
Liu W, Cui C, Hu Z, Li J, Wang J. Changes of neuroplasticity in cortical motor control of human masseter muscle related to orthodontic treatment. J Oral Rehabil 2021; 49:258-264. [PMID: 34921434 DOI: 10.1111/joor.13298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 12/01/2021] [Accepted: 12/12/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Orthodontic treatment is a common clinical method of malocclusion. Studies have found that neurons in the sensorimotor cortex of the brain undergo adaptive remodeling in response to changes in oral behavior or occlusion. OBJECTIVE To explore whether orthodontic treatment could be sufficient to cause neuroplastic changes in the corticomotor excitability of the masseter muscle. METHODS Fifteen Angle Class II malocclusion patients who were receiving orthodontic treatment participated in the study. Cortical excitability was assessed by electromyographic activity changes evoked by transcranial magnetic stimulation. Four orthodontic time points were recorded, including baseline, day 1, day 7, and day 30. Motor evoked potentials (MEPs) were recorded in the masseter muscle and the first dorsal interosseous muscle (FDI) serving as a control. The data were analysed by stimulus-response curves and corticomotor mapping. Statistical analyses involved repeated measures analysis of variance, two-way ANOVA, and Tukey's post hoc tests. RESULTS Motor evoked potentials (MEPs) of the masseter muscle were significantly decreased during orthodontic treatment compared with those of the baseline (p < .001). MEPs of the masseter muscle were dependent on session and stimulus intensity (p < .001), whereas MEPs of FDI were only dependent on stimulus intensity (p = .091). Finally, Tukey's post hoc tests demonstrated that MEPs of the masseter muscle on days 1 and 7, with 70%-90% stimulus intensities, were higher than those of baseline values (p < .001). CONCLUSIONS The present study suggested that orthodontic treatment can lead to neuroplastic changes in the corticomotor control of the masseter muscle, which may add to our understanding of the adaptive response of subjects to changes of oral environment during the orthodontic treatment.
Collapse
Affiliation(s)
- Weicai Liu
- Department of Prosthodontics, School & Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
| | - Congcong Cui
- Department of Prosthodontics, School & Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
| | - Zhonglin Hu
- Department of Prosthodontics, School & Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
| | - Juan Li
- Department of Prosthodontics, School & Hospital of Stomatology, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Tongji University, Shanghai, China
| | - Jijun Wang
- Shanghai Mental Health Center, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| |
Collapse
|
7
|
Stipancic KL, Kuo YL, Miller A, Ventresca HM, Sternad D, Kimberley TJ, Green JR. The effects of continuous oromotor activity on speech motor learning: speech biomechanics and neurophysiologic correlates. Exp Brain Res 2021; 239:3487-3505. [PMID: 34524491 PMCID: PMC8599312 DOI: 10.1007/s00221-021-06206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/25/2021] [Indexed: 11/26/2022]
Abstract
Sustained limb motor activity has been used as a therapeutic tool for improving rehabilitation outcomes and is thought to be mediated by neuroplastic changes associated with activity-induced cortical excitability. Although prior research has reported enhancing effects of continuous chewing and swallowing activity on learning, the potential beneficial effects of sustained oromotor activity on speech improvements is not well-documented. This exploratory study was designed to examine the effects of continuous oromotor activity on subsequent speech learning. Twenty neurologically healthy young adults engaged in periods of continuous chewing and speech after which they completed a novel speech motor learning task. The motor learning task was designed to elicit improvements in accuracy and efficiency of speech performance across repetitions of eight-syllable nonwords. In addition, transcranial magnetic stimulation was used to measure the cortical silent period (cSP) of the lip motor cortex before and after the periods of continuous oromotor behaviors. All repetitions of the nonword task were recorded acoustically and kinematically using a three-dimensional motion capture system. Productions were analyzed for accuracy and duration, as well as lip movement distance and speed. A control condition estimated baseline improvement rates in speech performance. Results revealed improved speech performance following 10 min of chewing. In contrast, speech performance following 10 min of continuous speech was degraded. There was no change in the cSP as a result of either oromotor activity. The clinical implications of these findings are discussed in the context of speech rehabilitation and neuromodulation.
Collapse
Affiliation(s)
- Kaila L Stipancic
- Department of Communicative Disorders and Sciences, University at Buffalo, Buffalo, NY, USA
| | - Yi-Ling Kuo
- Department of Physical Therapy, Upstate Medical University, Syracuse, NY, USA
| | - Amanda Miller
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA, USA
| | - Hayden M Ventresca
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Building 79/96, 2nd Floor 13th Street, Boston, MA, 02129, USA
| | - Dagmar Sternad
- Department of Biology, Northeastern University, Boston, MA, USA
| | - Teresa J Kimberley
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Building 79/96, 2nd Floor 13th Street, Boston, MA, 02129, USA
| | - Jordan R Green
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Building 79/96, 2nd Floor 13th Street, Boston, MA, 02129, USA.
| |
Collapse
|
8
|
Cheng I, Sasegbon A, Hamdy S. A systematic review and meta-analysis of the effects of intraoral treatments for neurogenic oropharyngeal dysphagia. J Oral Rehabil 2021; 49:92-102. [PMID: 34800341 DOI: 10.1111/joor.13274] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/01/2021] [Accepted: 10/25/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Rehabilitative treatments for oropharyngeal dysphagia, including oromotor exercises and sensory stimulation, have been widely adopted into clinical practice. However, the effects of these treatments are mainly supported by exploratory studies. As such, their clinical efficacy remains uncertain. OBJECTIVE Our systematic review and meta-analysis aimed to evaluate the efficacy of intraoral treatments for neurogenic oropharyngeal dysphagia based on evidence from randomised controlled trials (RCTs). METHODS Six electronic databases were systematically searched between January 1970 and July 2021. Data were extracted and analysed by two independent reviewers. The outcome measure was changes in (any) relevant clinical swallowing-related characteristics. RESULTS Data from 285 dysphagic patients were collected from 8 RCT studies across a range of intraoral dysphagia treatments. The pooled effect size of all intraoral dysphagia treatments was non-significant compared to control comparators (SMD [95%CI] = 0.23 [-0.22, 0.69], p = .31; I2 = 73%). Subgroup analysis revealed that the pooled effect sizes were also non-significant for oromotor exercises (device-facilitated lip resistance exercises and tongue exercises) (SMD [95%CI] = 0.11 [-0.76, 0.97]; p = .81; I2 = 88%) and sensory stimulation (thermal-tactile, thermo-chemical and electrical stimulation) (SMD [95%CI] = 0.35 [-0.03, 0.72]; p = .07; I2 = 0%). CONCLUSIONS Our results showed that overall, intraoral dysphagia treatments, including oromotor exercises and sensory stimulation, do not show beneficial effects for neurogenic oropharyngeal dysphagia. The evidence for these treatments remains weak and currently inadequate to support clinical use. Large-scale, multi-centre RCTs are warranted to fully explore their clinical efficacy.
Collapse
Affiliation(s)
- Ivy Cheng
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Centre for Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Ayodele Sasegbon
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Centre for Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Shaheen Hamdy
- Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Centre for Gastrointestinal Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| |
Collapse
|
9
|
Schimmel M, Aarab G, Baad-Hansen L, Lobbezoo F, Svensson P. A conceptual model of oro-facial health with an emphasis on function. J Oral Rehabil 2021; 48:1283-1294. [PMID: 34462948 PMCID: PMC9292770 DOI: 10.1111/joor.13250] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/14/2021] [Accepted: 08/24/2021] [Indexed: 11/29/2022]
Abstract
The individual inclination to lead an autonomous life until death is associated with requirements that may be of physiological, psychosocial and environmental nature. We aim to describe a conceptual oro‐facial health model with an emphasis on oro‐facial function, taking the domains of quality of life and patient‐centred values into account. In the context of oro‐facial function, the requirements of life are met when the oro‐facial system is in a fit state. ‘Fitness of the oro‐facial system, that is oro‐facial health, is a state that is characterised by an absence of, or positive coping with physical disease, mental disease, pain and negative environmental and social factors. It will allow natural oro‐facial functions such as sensing, tasting, touching, biting, chewing, swallowing, speaking, yawning, kissing and facial expression’. In the presented conceptual model of oro‐facial health, it is postulated that each individual has present and future potentials related to biological prerequisites and resources that are developed by an individual through the course of life. These potentials form the oro‐facial functional capacity. When the individual potentials together do not meet the requirements of life anymore, dysfunction and disease result. The oro‐facial system is subject to physiological ageing processes, which will inevitably lead to a decrease in the oro‐facial functional capacity. Furthermore, comorbid medical conditions might hamper oro‐facial function and, alongside with the ageing process, may lead to a state of oral hypofunction. Currently, there is a lack of widespread, validated, easy‐to‐use instruments that help to distinguish between states of oro‐facial fitness as opposed to oral hypofunction. Clearly, research is needed to establish adequate, validated instruments alongside with functional rehabilitation procedures.
Collapse
Affiliation(s)
- Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - Ghizlane Aarab
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lene Baad-Hansen
- Department of Dentistry and Oral Health, Section for Orofacial Pain and Jaw Function, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Peter Svensson
- Department of Dentistry and Oral Health, Section for Orofacial Pain and Jaw Function, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark.,Faculty of Odontology, Malmø University, Sweden
| |
Collapse
|
10
|
Glöggler JC, Hellmann D, Von Manstein M, Jäger R, Repky S, Beyersmann J, Lapatki BG. Motor learning might contribute to a therapeutic anterior shift of the habitual mandibular position-An exploratory study. J Oral Rehabil 2021; 48:891-900. [PMID: 33983634 DOI: 10.1111/joor.13183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 05/07/2021] [Accepted: 05/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Passive mandibular advancement with functional appliances is commonly used to treat juvenile patients with mandibular retrognathism. OBJECTIVE The aim of this study was to investigate whether active repetitive training of the mandible into an anterior position would result in a shift of the habitual mandibular position (HMP). METHODS Twenty adult healthy subjects were randomly assigned to one of two groups: a training group receiving six supervised functional training sessions of 10 min each and a control group without training. Bonded lateral biteplates disengaged occlusion among both groups throughout the 15-day experiment. Customised registration-training appliances consisted of a maxillary component with an anterior plane and a mandibular component with an attached metal sphere. Training sessions consisted of repeated mouth-opening/closing cycles (frequency: 30/min) to hit an anteriorly positioned hemispherical target notch with this metal sphere. The HMP was registered at defined times during the experiment. RESULTS The HMP in the training group showed a statistically significant anterior shift of 1.6 mm (interquartile range [IQR]: 1.2 mm), compared with a significant posterior shift of -0.8 mm (IQR: 2.8 mm) in the control group (p < .05). Although the anterior shift among the training group showed a partial relapse 4 days after the first training block, it then advanced slightly in the 4-day interval after the second training block, which might indicate neuroplasticity of the masticatory motor system. CONCLUSIONS Motor learning by repetitive training of the mandible into an anterior position might help to improve the results of functional appliance therapy among patients with mandibular retrognathism.
Collapse
Affiliation(s)
| | - Daniel Hellmann
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | | | - Rudolph Jäger
- Department of Orthodontics, Ulm University, Ulm, Germany
| | - Stefan Repky
- Institute of Statistics, Ulm University, Ulm, Germany
| | | | | |
Collapse
|
11
|
Matsuzaki S, Shimada A, Tanaka J, Kothari M, Castrillon E, Iida T, Svensson P. Effect of mandibular advancement device on plasticity in corticomotor control of tongue and jaw muscles. J Clin Sleep Med 2021; 17:1805-1813. [PMID: 33904391 DOI: 10.5664/jcsm.9284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES This study aims to investigate if the use of a mandibular advancement device (MAD) is associated with neuroplasticity in corticomotor control of tongue and jaw muscles. METHODS Eighteen healthy individuals participated in a randomized crossover study with 3 conditions for 2 weeks each: baseline, wearing an oral appliance (OA: sham MAD) or MAD during sleep. The custom-made MAD was constructed by positioning the mandible to 50% of its maximal protrusion limit. Transcranial magnetic stimulation (TMS) was applied to elicit motor evoked potentials (MEPs). The MEPs were assessed by constructing stimulus-response curves at four stimulus intensities: 90%, 100%, 120%, and 160% of the motor threshold (MT) from the right tongue and right masseter, and the first dorsal interosseous muscles (FDI, control) at baseline, after the first and the second intervention. RESULTS There was a significant effect of condition and stimulus intensity both on the tongue and as well as on masseter MEPs (P < 0.01). Tongue and masseter MEPs were significantly higher at 120% and 160% following the MAD compared to the OA (P < 0.05). There were no effects of condition on FDI MEPs (P = 0.855). CONCLUSIONS The finding suggests that MAD induces neuroplasticity in the corticomotor pathway of the tongue and jaw muscles associated with the new jaw position. Further investigations are required in patients with obstructive sleep apnea (OSA) to see if this cortical neuroplasticity may contribute or perhaps predict treatment effects with MADs in OSA.
Collapse
Affiliation(s)
- Satoshi Matsuzaki
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON).,Department of Fixed Prosthodontics and Occlusion, Osaka Dental University, Japan
| | - Akiko Shimada
- Department of Geriatric Dentistry, Osaka Dental University, Japan
| | - Junko Tanaka
- Department of Fixed Prosthodontics and Occlusion, Osaka Dental University, Japan
| | - Mohit Kothari
- Hammel Neurorehabilitation and University Research Clinic, Department of Clinic Medicine, Aarhus University, Hammel, Denmark.,JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, India
| | - Eduardo Castrillon
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON)
| | - Takashi Iida
- Division of Oral Function and Rehabilitation, Department of Oral Health Science, Nihon University School of Dentistry at Matsudo
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON).,Faculty of Odontology, Malmø University, Sweden
| |
Collapse
|
12
|
Hellmann D, Glöggler JC, Plaschke K, Jäger R, Eiglsperger U, Schindler HJ, Lapatki BG. Effects of preventing intercuspation on the precision of jaw movements. J Oral Rehabil 2021; 48:392-402. [PMID: 33368502 DOI: 10.1111/joor.13137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Closing movements are among the jaw's basic physiological motor actions. During functional movements, the jaw changes position continually, which requires appropriate proprioception. However, the significance of the various proprioceptive receptors involved and how they interact is not yet fully clear. OBJECTIVES This study's main objective was to test whether preventing intercuspation (IC) for 1 week would affect the precision of jaw-closing movements into IC and the functional space of habitual chewing movements (HCM). A secondary objective was to compare precision of jaw-closing movements into IC with the precision of movements into a target position (TP) far from IC. METHODS Fourteen participants' HCM and jaw-closing movements into IC were recorded on two sessions (T1 and T2) 1 week apart. Between sessions, participants wore posterior bite plates to prevent IC. They also received a 10-minute training session at T1 to guide their jaw-closing movements into TP. The precision of the closing movements into IC and TP was analysed. For HCM, the vertical amplitude, lateral width and area of chewing cycles were evaluated. RESULTS The precision of jaw movements into IC increased as the jaw gap decreased, but precision did not differ significantly between T1 and T2. For HCM, the vertical amplitude and area of chewing cycles increased significantly between T1 and T2. The precision of the closing trajectory into TP increased significantly during the training session. CONCLUSION Our results confirm the excellent adaptability of the craniomandibular system, controlled by stringent motor programmes that are supported by continuous peripheral sensory input.
Collapse
Affiliation(s)
- Daniel Hellmann
- Dental Academy for Continuing Professional Development Karlsruhe, Karlsruhe, Germany.,Department of Prosthodontics, University of Würzburg, Würzburg, Germany
| | | | | | - Rudolf Jäger
- Department of Orthodontics, University of Ulm, Ulm, Germany
| | | | - Hans J Schindler
- Department of Prosthodontics, University of Würzburg, Würzburg, Germany.,Biomechanics Research Group, Institute for Mechanics, Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
| | | |
Collapse
|
13
|
Plasticity in corticomotor pathways linked to a jaw protrusion training task: Potential implications for management of patients with obstructive sleep apnea. Brain Res 2020; 1749:147124. [DOI: 10.1016/j.brainres.2020.147124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/20/2020] [Accepted: 09/08/2020] [Indexed: 12/13/2022]
|
14
|
Kameda T, Sakamoto M, Terada K. Semi-powered exoskeleton that regulates the muscular activity of jaw movement for oral functional rehabilitation/training. Dent Mater J 2020; 40:101-109. [PMID: 32863379 DOI: 10.4012/dmj.2019-400] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The sequential oral functions of mastication and swallowing are well tuned in humans. To prevent oral hypofunction as a risk factor for systemic frailty by oral motor training, semi-powered exoskeleton was developed and evaluated its loading/assist effects by monitoring electromyography signals and saliva secretion in healthy persons. The actuator of the driving unit combined mechanical and powered mechanics and was driven alternatively by an unpowered stainless-steel spring system for jaw-opening training by loading and a powered shape-memory alloy spring system to assist jaw closing. Sequential device movement was controlled by two electronic circuits with two magnetic switching systems to match human jaw movement. This exoskeleton realized a 25% increase of jaw-opening muscular activity for training, 15% saving of jaw-closing muscular activity for assistance, and 15% enhancement of saliva secretion, which could contribute to the prevention of oral frailty by maintenance and strengthening of oral function in the upcoming super-aging society.
Collapse
Affiliation(s)
- Takashi Kameda
- Department of Orthodontics, Nippon Dental University School of Life Dentistry at Niigata
| | - Makoto Sakamoto
- Department of Health Sciences, Niigata University School of Medicine
| | - Kazuto Terada
- Orthodontic Dentistry, Nippon Dental University Niigata Hospital
| |
Collapse
|
15
|
Moscatelli F, Messina G, Valenzano A, Triggiani AI, Sessa F, Carotenuto M, Tartaglia N, Ambrosi A, Cibelli G, Monda V. Effects of twelve weeks' aerobic training on motor cortex excitability. J Sports Med Phys Fitness 2020; 60:1383-1389. [PMID: 32536109 DOI: 10.23736/s0022-4707.20.10677-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Regular physical activity or aerobic exercise is well known to increase brain plasticity. Recent studies have reported that aerobic exercise enhances neuroplasticity and motor learning. The aim of this study was to investigate if 12 weeks' aerobic training can modify cortical excitability and motor evoked potential (MEP) responses. METHODS Fifteen untrained males were recruited. Cortical excitability was investigated using TMS. VO2<inf>max</inf> was estimated using Cooper's test. Aerobic intervention lasted 12 weeks. The subjects performed a 6-week supervised aerobic workout, 3 times a week, at 60-75% of their maximum heart rate (HR<inf>max</inf>). Over the following 6 weeks, they performed a supervised aerobic workout 3 times a week at 70-75% of FC<inf>max</inf>. RESULTS After 8 weeks of aerobic training there was a significant increase of distance covered during Cooper's test (P<0.001) and a significant increase of VO2<inf>max</inf> (P<0.001); there was also an improvement in resting motor threshold (rMT decreased from 60.5±6.6% [T0] to 55.8±5.9% [T2]; P<0.001), motor evoked potential latency decreased (from 25.3±0.8 ms [T0] to 24.1±0.8 ms [T2]; P<0.001), and motor evoked potential amplitude increased (from 0.58±0.09 mV [T0] to 0.65±0.08 mV [T2]; P<0.001). Furthermore, after 12 weeks' aerobic training there were improvements in all parameters. CONCLUSIONS This study shows that aerobic activity seems to induce changes in cortical excitability if performed for a period longer than 4 weeks, in addition to typical cardiorespiratory benefits in previously untrained males.
Collapse
Affiliation(s)
- Fiorenzo Moscatelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy -
| | - Anna Valenzano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio I Triggiani
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marco Carotenuto
- Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Nicola Tartaglia
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Antonio Ambrosi
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giuseppe Cibelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Vincenzo Monda
- Unit of Dietetic and Sport Medicine, Section of Human Physiology, Department of Experimental Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| |
Collapse
|
16
|
Montuelle SJ, Olson RA, Curtis H, Williams SH. Unilateral lingual nerve transection alters jaw-tongue coordination during mastication in pigs. J Appl Physiol (1985) 2020; 128:941-951. [PMID: 32191597 DOI: 10.1152/japplphysiol.00398.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
During chewing, movements and deformations of the tongue are coordinated with jaw movements to manage and manipulate the bolus and avoid injury. Individuals with injuries to the lingual nerve report both tongue injuries due to biting and difficulties in chewing, primarily because of impaired bolus management, suggesting that jaw-tongue coordination relies on intact lingual afferents. Here, we investigate how unilateral lingual nerve (LN) transection affects jaw-tongue coordination in an animal model (pig, Sus scrofa). Temporal coordination between jaw pitch (opening-closing) and 1) anteroposterior tongue position (i.e., protraction-retraction), 2) anteroposterior tongue length, and 3) mediolateral tongue width was compared between pre- and post-LN transection using cross-correlation analyses. Overall, following LN transection, the lag between jaw pitch and the majority of tongue kinematics decreased significantly, demonstrating that sensory loss from the tongue alters jaw-tongue coordination. In addition, decrease in jaw-tongue lag suggests that, following LN transection, tongue movements and deformations occur earlier in the gape cycle than when the lingual sensory afferents are intact. If the velocity of tongue movements and deformations remains constant, earlier occurrence can reflect less pronounced movements, possibly to avoid injuries. The results of this study demonstrate that lingual afferents participate in chewing by assisting with coordinating the timing of jaw and tongue movements. The observed changes may affect bolus management performance and/or may represent protective strategies because of altered somatosensory awareness of the tongue.NEW & NOTEWORTHY Chewing requires coordination between tongue and jaw movements. We compared the coordination of tongue movements and deformation relative to jaw opening-closing movements pre- and post-lingual nerve transection during chewing in pigs. These experiments reveal that the timing of jaw-tongue coordination is altered following unilateral disruption of sensory information from the tongue. Therefore, maintenance of jaw-tongue coordination requires bilateral sensory information from the tongue.
Collapse
Affiliation(s)
- Stéphane J Montuelle
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Warrensville Heights, Ohio
| | - Rachel A Olson
- Department of Biological Sciences, Ohio University, Athens, Ohio
| | - Hannah Curtis
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio
| | - Susan H Williams
- Department of Biomedical Sciences, Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio
| |
Collapse
|
17
|
Kheirkhah M, Brodoehl S, Leistritz L, Götz T, Baumbach P, Huonker R, Witte OW, Volk GF, Guntinas-Lichius O, Klingner CM. Abnormal Emotional Processing and Emotional Experience in Patients with Peripheral Facial Nerve Paralysis: An MEG Study. Brain Sci 2020; 10:E147. [PMID: 32143383 PMCID: PMC7139433 DOI: 10.3390/brainsci10030147] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/27/2020] [Accepted: 03/02/2020] [Indexed: 11/16/2022] Open
Abstract
Abnormal emotional reactions of the brain in patients with facial nerve paralysis have not yet been reported. This study aims to investigate this issue by applying a machine-learning algorithm that discriminates brain emotional activities that belong either to patients with facial nerve paralysis or to healthy controls. Beyond this, we assess an emotion rating task to determine whether there are differences in their experience of emotions. MEG signals of 17 healthy controls and 16 patients with facial nerve paralysis were recorded in response to picture stimuli in three different emotional categories (pleasant, unpleasant, and neutral). The selected machine learning technique in this study was the logistic regression with LASSO regularization. We demonstrated significant classification performances in all three emotional categories. The best classification performance was achieved considering features based on event-related fields in response to the pleasant category, with an accuracy of 0.79 (95% CI (0.70, 0.82)). We also found that patients with facial nerve paralysis rated pleasant stimuli significantly more positively than healthy controls. Our results indicate that the inability to express facial expressions due to peripheral motor paralysis of the face might cause abnormal brain emotional processing and experience of particular emotions.
Collapse
Affiliation(s)
- Mina Kheirkhah
- Biomagnetic Center, Jena University Hospital, 07747 Jena, Germany; (M.K.); (S.B.); (T.G.); (R.H.)
| | - Stefan Brodoehl
- Biomagnetic Center, Jena University Hospital, 07747 Jena, Germany; (M.K.); (S.B.); (T.G.); (R.H.)
- Hans Berger Department of Neurology, Jena University Hospital, 07747 Jena, Germany;
| | - Lutz Leistritz
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, 07740 Jena, Germany;
| | - Theresa Götz
- Biomagnetic Center, Jena University Hospital, 07747 Jena, Germany; (M.K.); (S.B.); (T.G.); (R.H.)
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, 07740 Jena, Germany;
| | - Philipp Baumbach
- Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, 07747 Jena, Germany;
| | - Ralph Huonker
- Biomagnetic Center, Jena University Hospital, 07747 Jena, Germany; (M.K.); (S.B.); (T.G.); (R.H.)
| | - Otto W. Witte
- Hans Berger Department of Neurology, Jena University Hospital, 07747 Jena, Germany;
| | - Gerd Fabian Volk
- Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany; (G.F.V.); (O.G.-L.)
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany; (G.F.V.); (O.G.-L.)
| | - Carsten M. Klingner
- Biomagnetic Center, Jena University Hospital, 07747 Jena, Germany; (M.K.); (S.B.); (T.G.); (R.H.)
- Hans Berger Department of Neurology, Jena University Hospital, 07747 Jena, Germany;
| |
Collapse
|
18
|
Suso-Martí L, Paris-Alemany A, La Touche R, Cuenca-Martínez F. Effects of mental and physical orofacial training on pressure pain sensitivity and tongue strength: A single-blind randomized controlled trial. Physiol Behav 2020; 215:112774. [PMID: 31838148 DOI: 10.1016/j.physbeh.2019.112774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/07/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The main objective of this study was to analyze differences on pain pressure thresholds, tongue strength and perceived effort between various orofacial motor exercise training dosages of mental representation training through motor imagery (MI) and action observation (AO), first in isolation and then in combination with real exercise performance. METHODS A single-blind randomized controlled trial was designed. 48 asymptomatic individuals were randomized into two groups: Intensive training group (IG) and Moderate training group (MG). Both groups performed a first session of MI and AO of orofacial exercises training and a second session of actual orofacial exercises combined with mental representation training, but with different dosage in terms of series and repetitions. Pain pressure thresholds (PPTs) in the masseter and temporal muscles and tongue muscle strength were the main variables. RESULTS Regarding the PPT, ANOVA revealed significant between-group differences, where MG showed a significantly higher PPT than IG at post-day2, with a medium effect size. Both groups showed with-in group differences between pre and post intervention measures in the first session, but only the IG showed differences in the second. Regarding tongue muscle strength, ANOVA revealed significant within-group differences only in MG between the pre-day and post-day first intervention. CONCLUSION The results of the present study suggest that movement representation training performed in isolation may have a positive effect on PPTs and tongue muscle strength. In addition, the combination with the actual execution of the exercises could be considered effective, but it is necessary to take into account the training dosage to avoid fatigue responses.
Collapse
Affiliation(s)
- Luis Suso-Martí
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Departament of Physiotherapy, Universidad CEU Cardenal Herrera, CEU Universities, Valencia, Spain
| | - Alba Paris-Alemany
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, España; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España
| | - Roy La Touche
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), Madrid, España; Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ), Madrid, España.
| | - Ferran Cuenca-Martínez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España; Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España
| |
Collapse
|
19
|
Cullins MJ, Wenninger JM, Cullen JS, Russell JA, Kleim JA, Connor NP. Tongue Force Training Induces Plasticity of the Lingual Motor Cortex in Young Adult and Aged Rats. Front Neurosci 2019; 13:1355. [PMID: 31920514 PMCID: PMC6931318 DOI: 10.3389/fnins.2019.01355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/02/2019] [Indexed: 11/24/2022] Open
Abstract
Tongue exercise programs are used clinically for dysphagia in aged individuals and have been shown to improve lingual strength. However, the neural mechanisms of age-related decline in swallowing function and its association with lingual strength are not well understood. Using an established rat model of aging and tongue exercise, we hypothesized that the motor cortex of aged rats would have a smaller lingual motor map area than young adult rats and would increase in size as a function of tongue exercise. Over 8 weeks, rats either underwent a progressive resistance tongue exercise program (TE), learned the task but did not exercise (trained controls, TC), or were naïve untrained controls (UC). Cortical motor map areas for tongue and jaw were determined using intracortical microstimulation (ICMS). Rats in the TE and TC groups had a significantly larger motor cortex region for the tongue than the UC group. Lingual cortical motor area was not correlated with protrusive tongue force gains and did not differ significantly with age. These results suggest that learning a novel tongue force skill was sufficient to induce plasticity of the lingual motor cortex yet increasing tongue strength with progressive resistance exercise did not significantly expand the lingual motor area beyond the gains that occurred through the skilled learning component.
Collapse
Affiliation(s)
- Miranda J. Cullins
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
- *Correspondence: Miranda J. Cullins,
| | - Julie M. Wenninger
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
| | - Jared S. Cullen
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
| | - John A. Russell
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
| | - Jeffrey A. Kleim
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - Nadine P. Connor
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
| |
Collapse
|
20
|
Pitts LL, Rogers L, Wang X, Bahia MM, Cherney LR. Functionally navigated transcranial magnetic stimulation to evoke lingual pressure in stroke survivors with dysphagia and healthy adults: a proof of concept trial. Top Stroke Rehabil 2019; 27:241-250. [PMID: 31838961 DOI: 10.1080/10749357.2019.1701175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Post-stroke dysphagia is characterized by reduced corticolingual excitability and lingual pressure; however, it remains unknown if transcranial magnetic stimulation (TMS) directly facilitates lingual pressure generation.Objectives: To explore optimal procedures for single pulse TMS using neuronavigation to evoke lingual pressure in intact and disrupted neural networks.Methods: Using co-registered functional magnetic resonance imaging, stimulation sites were determined for five healthy adults (Mage = 67) and four stroke survivors with dysphagia and reduced tongue strength (Mage = 66). Evoked lingual pressures were sampled across 45-65% of maximum stimulator output. Healthy participants repeated TMS with a bite block to isolate lingual pressure from off-target stimulation of mandibular elevators.Results: Only one functionally-guided stimulation site fell within previously reported optimal lateral (8-11cm) and anterior (2-4.25cm) coordinates. Lingual pressure was stable prior to pulse and increased linearly with intensity for both groups (p = .005). Post-stroke active motor thresholds were elevated compared to healthy adults (p = .025). Lingual pressure latency remained stable across intensities (p > .05). Jaw stabilization via bite block reduced the mean magnitude of evoked lingual pressure by approximately 16%.Conclusions: Single pulse TMS directly evokes higher lingual pressure and can define motor thresholds in intact and disordered corticolingual pathways. Stimulation sites using neuronavigation in healthy adults and stroke survivors largely differed from external coordinates in the literature that were predominantly established in young adults. Procedures to investigate motor thresholds for lingual pressure generation are proposed. The therapeutic role of TMS to address post-stroke deficits in lingual pressure and corticolingual excitability warrants continued investigation.
Collapse
Affiliation(s)
- Laura L Pitts
- Communication Sciences and Disorders, University of Northern Iowa, Cedar Falls, IA, USA.,Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Think and Speak Lab, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Lynn Rogers
- Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Think and Speak Lab, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Xue Wang
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mariana M Bahia
- Communication Sciences and Disorders, University of Northern Iowa, Cedar Falls, IA, USA
| | - Leora R Cherney
- Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Think and Speak Lab, Shirley Ryan AbilityLab, Chicago, IL, USA
| |
Collapse
|
21
|
Abstract
The current literature on peripheral cranial nerve stimulation for the purpose of achieving therapeutic effects via altering brain activity is reviewed. Vagus nerve stimulation, which is approved for use in refractory epilepsy, is the most extensively studied cranial nerve stimulator that has direct impact on the central nervous system. Despite the recognized central effects of peripheral cranial nerve stimulation, the mechanism of action for all indications remains incompletely understood. Further research on both mechanisms and indications of central effects of cranial nerve stimulation has the potential to alleviate burden of disease in a large array of conditions.
Collapse
Affiliation(s)
- Gavriel D Kohlberg
- Division of Otology and Neurotology, Department of Otolaryngology - Head and Neck Surgery, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356161, Seattle, WA 98195 - 6161, USA
| | - Ravi N Samy
- Division of Otology/Neurotology, Neurotology Fellowship, Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, Neurosensory Disorders Center at University of Cincinnati Gardner Neuroscience Institute, Cincinnati Children's Hospital Medical Center, 213 Albert Sabin, Way, MSB 6009C, Cincinnati, OH 45267-0528, USA.
| |
Collapse
|
22
|
Guilleminault C, Huang YS, Quo S. Apraxia in children and adults with obstructive sleep apnea syndrome. Sleep 2019; 42:5580770. [DOI: 10.1093/sleep/zsz168] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 05/20/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study Objectives
Early in life impairment of orofacial growth leads to sleep-disordered breathing (SDB). Normal lingual gnosis and praxis are part of this early development related to the normal sensorimotor development of the tongue and surrounding oral musculature. The aim of this retrospective study was to explore if lingual praxia is impaired in both SDB children and adults and if there is an association to craniofacial morphology.
Methods
The ability to perform simple tongue maneuvers was investigated in 100 prepubertal SDB children and 150 SDB adults (shown with polysomnography). All individuals had a clinical investigation by specialists to assess any orofacial growth impairment and the elements potentially behind this impairment. In a subgroup of individuals both able and unable to perform the maneuvers, we also performed a blind recognition of forms placed in the mouth.
Results
A subgroup of pediatric and adult SDB patients presented evidence not only of orofacial growth impairment, but also apraxia independent of age and severity of OSA.
Conclusions
By 3 years of age, children should be able to perform requested tongue maneuvers and have oral form recognition. Abnormal gnosis–praxis was noted, independent of age in SDB children and adults, demonstrating that an abnormal functioning of the tongue in the oral cavity during early development can be detected. Both children and adults with SDB may present similar absences of normal oral development very early in life and a similar presentation of apraxia, suggesting that the distinction of SDB in children versus adults may not be relevant.
Collapse
Affiliation(s)
| | - Yu-Shu Huang
- Pediatric Psychiatry and Sleep Center, Chang Gung Hospital and Medical College, Taoyuan, Taiwan
| | - Stacey Quo
- Division of Orthodontics, University of California San Francisco School of Dentistry, CA
| |
Collapse
|
23
|
Vitali C, Baldanzi C, Crispiatico V, Polini F, Ammenti P, Montesano A, Cattaneo D. Effect of Impairment-Oriented and Function-Oriented Exercises on Mouth Function in Subjects with Systemic Sclerosis. Folia Phoniatr Logop 2019; 72:389-401. [PMID: 31550704 DOI: 10.1159/000502643] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 08/09/2019] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The aim of this study was to develop an exercise protocol to improve maximal mouth opening (MMO), tongue protrusion (Tprot), tongue strength (Tstren), and lip strength (Lstren), and to assess its effects on subjects with scleroderma. METHODS We performed four replicated single-system studies in a consecutive sample of subjects with scleroderma. An instrumented assessment measured MMO, Tprot, Tstren, and Lstren. Each day, subjects were assessed and performed orofacial exercises conducted by speech therapists. Treatments were first aimed at improving mouth physical characteristics by impairment-oriented exercises and then to improve skills with function-oriented exercises. RESULTS The mean phase differences between assessment and treatment phases across subjects were from 0.88 to 9.56 mm in MMO, from 2.03 to 12.3 mm in Tprot, from -0.12 to 5.35 N in Tstren, and from -0.84 to 5.19 N in Lstren. After treatment, 3 subjects crossed the 5th percentile discriminating normal from abnormal performances for both Tstren and Tprot, while this occurred in 2 subjects for MMO and Lstren. CONCLUSIONS The results of this study suggest that rehabilitation appears to be useful in reducing tongue and lip impairments and in improving oral functions in subjects with scleroderma.
Collapse
|
24
|
Södersten P, Brodin U, Zandian M, Bergh CEK. Verifying Feighner's Hypothesis; Anorexia Nervosa Is Not a Psychiatric Disorder. Front Psychol 2019; 10:2110. [PMID: 31607977 PMCID: PMC6756277 DOI: 10.3389/fpsyg.2019.02110] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 08/30/2019] [Indexed: 12/17/2022] Open
Abstract
Mental causation takes explanatory priority over evolutionary biology in most accounts of eating disorders. The evolutionary threat of starvation has produced a brain that assists us in the search for food and mental change emerges as a consequence. The major mental causation hypothesis: anxiety causes eating disorders, has been extensively tested and falsified. The subsidiary hypothesis: anxiety and eating disorders are caused by the same genotype, generates inconsistent results because the phenotypes are not traits, but vary along dimensions. Challenging the mental causation hypothesis in Feighner et al. (1972) noted that anorexic patients are physically hyperactive, hoarding for food, and they are rewarded for maintaining a low body weight. In 1996, Feighner's hypothesis was formalized, relating the patients' behavioral phenotype to the brain mechanisms of reward and attention (Bergh and Södersten, 1996), and in 2002, the hypothesis was clinically verified by training patients how to eat normally, thus improving outcomes (Bergh et al., 2002). Seventeen years later we provide evidence supporting Feighner's hypothesis by demonstrating that in 2012, 20 out of 37 patients who were referred by a psychiatrist, had a psychiatric diagnosis that differed from the diagnosis indicated by the SCID-I. Out of the 174 patients who were admitted in 2012, most through self-referral, there was significant disagreement between the outcomes of the SCID-I interview and the patient's subjective experience of a psychiatric problem in 110 of the cases. In addition, 358 anorexic patients treated to remission scored high on the Comprehensive Psychopathological Rating Scale, but an item response analysis indicated one (unknown) underlying dimension, rather than the three dimensions the scale can dissociate in patients with psychiatric disorders. These results indicate that psychiatric diagnoses, which are reliable and valid in patients with psychiatric disorders, are less well suited for patients with anorexia. The results are in accord with the hypothesis of the present Research Topic, that eating disorders are not always caused by disturbed psychological processes, and support the alternative, clinically relevant hypothesis that the behavioral phenotype of the patients should be addressed directly.
Collapse
Affiliation(s)
- Per Södersten
- Karolinska Institutet, Mandometer Clinics, Huddinge, Sweden
| | | | | | | |
Collapse
|
25
|
Kumar A, Koullia N, Jongenburger M, Koutris M, Lobbezoo F, Trulsson M, Svensson P. Behavioral learning and skill acquisition during a natural yet novel biting task. Physiol Behav 2019; 211:112667. [PMID: 31479681 DOI: 10.1016/j.physbeh.2019.112667] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 08/05/2019] [Accepted: 08/30/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the effect of short-term training on behavioral learning and skill acquisition during a natural yet novel biting task. METHODS Thirty (18 women) healthy volunteers in the age range of 18-32 years were divided into a naive (n = 17) and expert (n = 13) groups based on the self-reported familiarity to perform a complex behavioral biting task. The volunteers participated in a single experimental session divided into three sets with three series, each with ten trials of a standardized biting task. The task was to position, split and retrieve a sunflower seed from its shell without crushing the seed. The two consecutive sets were separated by fifteen minutes of short-term training. During the short-term training, the participants repeatedly performed the biting task for about fifteen minutes. A five-point grading system was devised to determine the performance and video registrations were made to determine the duration of the task. RESULTS There was a significant main effect of training on the task performance scores (P < .001). The performance scores of the naive group before training was significantly lower than all the sets of the expert group (P < .010). The performance scores of the naive group were also significantly better after training than before (P = .001). However, the expert group took significantly shorter time to complete the task than the naive group. CONCLUSION The results of the present study show a significant effect of training on the performance of a complex behavioral biting task. Training resulted in improved performance scores and a subtle decrease in the duration of the task.
Collapse
Affiliation(s)
- Abhishek Kumar
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Sweden; SCON
- Scandinavian Center for Orofacial Neurosciences, Sweden.
| | - Nomiki Koullia
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Marcella Jongenburger
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Michail Koutris
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, the Netherlands
| | - Mats Trulsson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Sweden; SCON
- Scandinavian Center for Orofacial Neurosciences, Sweden
| | - Peter Svensson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Sweden; Section of Orofacial Pain and Jaw Function, Department of Dentistry, Aarhus University, Denmark; SCON
- Scandinavian Center for Orofacial Neurosciences, Sweden
| |
Collapse
|
26
|
Combination of jaw and tongue movement training influences neuroplasticity of corticomotor pathways in humans. Exp Brain Res 2019; 237:2559-2571. [PMID: 31346648 DOI: 10.1007/s00221-019-05610-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 07/18/2019] [Indexed: 01/30/2023]
Abstract
Since humans in daily life perform multiple motor behaviors that often involve the simultaneous activation of both jaw and tongue muscles, it is essential to understand the effects of combined orofacial sensorimotor tasks on plasticity in corticomotor pathways. Moreover, to establish novel rehabilitation programs for patients, it is important to clarify the possible interrelationships in corticomotor excitability between jaw and tongue motor control. The aim of this study was to examine the effect of a combination of a repetitive tooth bite task (TBT) and a repetitive tongue lift task (TLT) on corticomotor excitability of the tongue and jaw muscles as assessed by transcranial magnetic stimulation (TMS). Sixteen healthy individuals participated in three kinds of training tasks consisting of 41-min TBT, 41-min TLT, and 82-min TBT + TLT. Motor-evoked potentials (MEPs) from the tongue muscle, masseter muscle, and first dorsal interosseous muscle were measured before and after the training tasks. The amplitude of tongue MEPs after training with TLT and TLT + TBT, and masseter MEPs after training with TBT and TLT + TBT, were significantly higher than before training (P < 0.05). Tongue MEPs and masseter MEPs were significantly higher after TLT + TBT than after TBT or TLT (P < 0.05). The present results suggest that a task combining both jaw and tongue movement training is associated with a greater degree of neuroplasticity in the corticomotor control of jaw and tongue muscles than either task alone.
Collapse
|
27
|
Sessle BJ. Can you be too old for oral implants? An update on ageing and plasticity in the oro‐facial sensorimotor system. J Oral Rehabil 2019; 46:936-951. [DOI: 10.1111/joor.12830] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/06/2019] [Accepted: 05/26/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Barry J. Sessle
- Faculty of Dentistry University of Toronto Toronto Ontario Canada
- Department of Physiology, Faculty of Medicine University of Toronto Toronto Ontario Canada
| |
Collapse
|
28
|
The role of EEG and EMG combined virtual reality gaming system in facial palsy rehabilitation - A case report. J Bodyw Mov Ther 2019; 23:425-431. [PMID: 31103130 DOI: 10.1016/j.jbmt.2019.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND The recovery rates for facial palsy are usually excellent; however, regularly patients present with problems with their fine facial movements that affect their emotional expressions. OBJECTIVE To discover the viability and ease of using an Electroencephalogram (EEG) and Electromyography (EMG) combined Virtual Reality (VR) gaming system - the 'Oculus Rift' device in the evaluation and rehabilitation of facial palsy. DESIGN Single case study. PATIENT INFORMATION A young 23-year-old female with facial palsy. CLINICAL FINDINGS Most of the patient's facial features were re-established within the recovery time frame, except for her right forehead and eyebrow movements. INTERVENTION A 10 day exercise program (Day 2-11) with an immersive virtual reality device, which randomly shoots virtually animated white balls in an unpredictable and testing pattern. OUTCOME MEASURES EEG and EMG patterns corresponding to the facial upper quadrant were taken at baseline, post-intervention, and at follow up. RESULTS EMG and EEG investigation revealed a progressive improvement in the muscle activation in response to the impulsive and unpredictable activities in the virtual environment provided through the immersive VR device. CONCLUSION The case report found a positive relationship between VR, facial upper quadrant EMG activation and EEG pattern changes following the intervention.
Collapse
|
29
|
Ikuta M, Iida T, Kothari M, Shimada A, Komiyama O, Svensson P. Impact of sleep bruxism on training-induced cortical plasticity. J Prosthodont Res 2019; 63:277-282. [PMID: 30704929 DOI: 10.1016/j.jpor.2018.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To investigate if sleep bruxism (SB) influences training-induced cortical plasticity and performance in terms of accuracy and precision of a tooth-clenching task (TCT). METHODS Thirty-eight participants were allocated into SB group (N=19) and control group (N=19) according to presence of SB based on a 2-week screening. The participants were instructed to perform a standardized TCT for 58min at three different force levels (10%, 20% and 40% of maximum voluntary contraction; MVC) in three series (first and third without visual-feedback and second with visual-feedback). Accuracy and precision of the TCT were calculated from actual bite force values. Transcranial magnetic stimulation was applied to elicit motor evoked potentials (MEPs) from the masseter and first dorsal interosseous muscle (FDI) before the TCT (pre-TCT-session) and 5-min after the TCT (post-TCT-session). RESULTS Accuracy was significantly dependent on the series and target force level (P<0.001), however, there was a significant decrease only in the control group at 10% MVC from first to third session (P<0.001). No significant differences between groups were observed for the precision of the TCT. Masseter MEPs in the SB group in the pre-TCT-session at 120% and 160% motor threshold were significantly lower than in the control group (P<0.05). Masseter MEPs of the control group in the post-TCT-session were significantly higher than the pre-TCT-session (P<0.05) but not SB. FDI MEPs were only dependent on stimulus intensity (P<0.001). CONCLUSIONS SB is associated with significant changes not only in excitability of corticomotor control but also motor learning of jaw movements and force control.
Collapse
Affiliation(s)
- Mai Ikuta
- Division of Oral Function and Rehabilitation, Department of Oral Health Science, Nihon University School of Dentistry at Matsudo, Matsudo, Japan; Section of Orofacial Pain and Jaw Function, Aarhus University, Department of Dentistry, Aarhus, Denmark
| | - Takashi Iida
- Division of Oral Function and Rehabilitation, Department of Oral Health Science, Nihon University School of Dentistry at Matsudo, Matsudo, Japan.
| | - Mohit Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark; Department of Clinic Medicine, Aarhus University, Aarhus, Denmark
| | - Akiko Shimada
- Section of Orofacial Pain and Jaw Function, Aarhus University, Department of Dentistry, Aarhus, Denmark; Osaka Dental University Hospital, Osaka, Japan
| | - Osamu Komiyama
- Division of Oral Function and Rehabilitation, Department of Oral Health Science, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function, Aarhus University, Department of Dentistry, Aarhus, Denmark; Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark; Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| |
Collapse
|
30
|
What is the functional relevance of reorganization in primary motor cortex after spinal cord injury? Neurobiol Dis 2019; 121:286-295. [DOI: 10.1016/j.nbd.2018.09.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 09/10/2018] [Indexed: 01/15/2023] Open
|
31
|
Fougeront N, Fleiter B. Temporomandibular disorder and comorbid neck pain: facts and hypotheses regarding pain-induced and rehabilitation-induced motor activity changes. Can J Physiol Pharmacol 2018; 96:1051-1059. [PMID: 30067068 DOI: 10.1139/cjpp-2018-0100] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
According to the "pain adaptation model", temporomandibular disorder (TMD)-related pain induces a paradoxical activity of masticatory muscles: an agonistic hypoactivity during jaw closing and an antagonistic activity during jaw opening (agonist/antagonist co-activation). However, this model suffers several weaknesses; notably, it does not explain all types of neck muscle activities in neck pain (NP), which is a very prevalent TMD comorbid condition. In NP, neck muscle antagonistic activity is increased, and agonistic activity is decreased as postulated by the pain adaptation model. However, synergistic and compensatory activity may occur and agonistic activity may be unchanged or even increased as postulated within the "vicious cycle theory". Thus, both theories would apply partly as outlined currently in musculoskeletal disorders (MSD). Besides pain, psychological stress may also induce motor dysfunction in TMD and NP. In NP, rehabilitation may increase agonistic activity and decrease compensatory activity and antagonistic activity, thus inducing a switch from agonist/antagonist co-activation towards reciprocal inhibition. Thus, rehabilitation-induced motor activity changes constitute a new research field that should improve MSD therapeutics. Additionally, immature tongue function (so-called infantile swallow) might be connected to TMD where low agonistic activity of masticatory muscles would be compensated by facial muscle hyperactivity during oropharyngeal phase of deglutition.
Collapse
Affiliation(s)
- Nicolas Fougeront
- a Consultation de troubles fonctionnels oro-faciaux, service de médecine bucco-dentaire/odontologie, groupe hospitalier Pitié-Salpétrière Charles-Foix, 94200 Ivry-sur-Seine, France
| | - Bernard Fleiter
- a Consultation de troubles fonctionnels oro-faciaux, service de médecine bucco-dentaire/odontologie, groupe hospitalier Pitié-Salpétrière Charles-Foix, 94200 Ivry-sur-Seine, France.,b Faculté de chirurgie dentaire, Université René Descartes, Paris, France
| |
Collapse
|
32
|
Wang CM, Shieh WY, Ho CS, Hu YW, Wu YR. Home-Based Orolingual Exercise Improves the Coordination of Swallowing and Respiration in Early Parkinson Disease: A Quasi-Experimental Before-and-After Exercise Program Study. Front Neurol 2018; 9:624. [PMID: 30104999 PMCID: PMC6077208 DOI: 10.3389/fneur.2018.00624] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 07/10/2018] [Indexed: 01/04/2023] Open
Abstract
Introduction: The coordination of swallowing and respiration is important for safety swallowing without aspiration. This coordination was affected in Parkinson disease (PD). A noninvasive assessment tool was used to investigate the effect of an easy-to-perform and device-free home-based orolingual exercise (OLE) program on swallowing and respiration coordination in patients with early-stage PD. Materials and Methods: This study had a quasi-experimental before-and-after exercise program design. Twenty six patients with early-stage PD who were aged 62.12 ± 8.52 years completed a 12-week home-based OLE program. A noninvasive assessment tool was used to evaluate swallowing and respiration. For each patient, we recorded and analyzed 15 swallows (3 repeats of 5 water boluses: 1, 3, 5, 10, and 20 mL) before and after the home-based OLE program. Oropharyngeal swallowing and its coordination with respiration were the outcome measures. The frequency of piecemeal deglutition, pre- and post-swallowing respiratory phase patterns, and parameters of oropharyngeal swallowing and respiratory signals (swallowing respiratory pause [SRP], onset latency [OL], total excursion time [TET], excursion time [ET], second deflexion, amplitude, and duration of submental sEMG activity, and amplitude of laryngeal excursion) were examined. Results: The rate of piecemeal deglutition decreased significantly when swallowing 10- and 20-mL water boluses after the program. In the 1-mL water bolus swallowing trial, the rate of protective pre- and post-swallowing respiratory phase patterns was significantly higher after the program. For the parameters of oropharyngeal swallowing and respiratory signals, only the amplitude of laryngeal excursion was significantly lower after the program. Moreover, the volume of the water bolus significantly affected the SRP and duration of submental sEMG when patients swallowed three small water bolus volumes (1, 3, and 5 mL). Conclusion: The home-based OLE program improved swallowing and its coordination with respiration in patients with early-stage PD, as revealed using a noninvasive method. This OLE program can serve as a home-based program to improve swallowing and respiration coordination in patients with early-stage PD.
Collapse
Affiliation(s)
- Chin-Man Wang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taipei, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wann-Yun Shieh
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Chan-Shien Ho
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Yu-Wei Hu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Yih-Ru Wu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taipei, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|
33
|
Deng H, Gao S, Lu S, Kumar A, Zhang Z, Svensson P. Alteration of occlusal vertical dimension induces signs of neuroplastic changes in corticomotor control of masseter muscles: Preliminary findings. J Oral Rehabil 2018; 45:710-719. [PMID: 29920731 DOI: 10.1111/joor.12682] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE To investigate the effect of altering occlusal vertical dimension (OVD) in patients with severe attrition on corticomotor control of the masseter muscles as assessed by navigated transcranial magnetic stimulation (nTMS). METHODS Seven patients (58.6 ± 8.4 years) with decreased OVD due to severe attrition were given mandibular occlusal splints to alter the OVD with the instruction to wear during the whole awake time for a period of four weeks. Motor-evoked potentials (MEPs) and the motor cortex maps of the masseter muscles and first dorsal interosseous (FDI) muscles as control were recorded by nTMS at baseline and at least 4 weeks after the alteration of OVD. The stimulus-response curves of MEPs were analysed with two-way repeated-measures ANOVA, and the numerical rating scale scores, motor thresholds, onset latencies, motor cortex maps and centre of gravity (COG) were analysed with paired t tests. RESULTS There was a significant increase in the amplitude of the masseter muscle MEPs (P = 0.036), but no change in the motor cortex map areas (P = 0.111) four weeks after the alteration of OVD. Furthermore, there was no significant difference in either the amplitude of the FDI muscle MEPs (P = 0.466) or the motor cortex map areas (P = 0.230) before and after OVD alteration. CONCLUSION The results suggest that alteration of OVD in patients with severe attrition was associated with signs of neuroplastic changes in the corticomotor control of the masseter muscles. The results of the study may add to our understanding of the putative mechanisms related to cortical changes in response to OVD alterations.
Collapse
Affiliation(s)
- Hongyan Deng
- Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Shang Gao
- Capital Medical University, Beijing, China
| | - Shengyi Lu
- Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Abhishek Kumar
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - Zhenting Zhang
- Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Peter Svensson
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark.,Section of Orofacial Pain and Jaw Function, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
34
|
Effect of short-term training on fine motor control in trigeminally innervated versus spinally innervated muscles. Hum Mov Sci 2018; 58:132-139. [PMID: 29426038 DOI: 10.1016/j.humov.2018.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 01/24/2018] [Accepted: 01/28/2018] [Indexed: 11/21/2022]
|
35
|
Yao D, Sessle BJ. Face sensorimotor cortex undergoes neuroplastic changes in a rat model of trigeminal neuropathic pain. Exp Brain Res 2018. [PMID: 29520443 DOI: 10.1007/s00221-018-5226-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Trigeminal nerve injury can result in neuropathic pain behavior and alterations in motor function, but it is unclear if such injury produces neuroplastic alterations in face sensorimotor cortex that could contribute to the alterations in motor function. Therefore, this study aimed to determine if trigeminal nerve injury in a rat neuropathic pain model induces neuroplastic changes in jaw and tongue motor representations in face sensorimotor cortex in association with facial nociceptive behavior. Right infraorbital nerve transection was performed in adult male Sprague-Dawley rats; sham-operated rats served as controls. Nociceptive behavior was assessed by testing facial mechanical sensitivity pre-operatively and post-operatively (1-28 days). Intracortical microstimulation was also applied post-operatively in a series of microelectrode penetrations to map jaw and tongue motor representations in the face sensorimotor cortex by analyzing anterior digastric and genioglossus electromyographic activities evoked by microstimulation at histologically verified sites in face primary somatosensory cortex (face-SI) as well as face primary motor cortex (face-MI). Compared to sham, infraorbital nerve injury induced a significant (2-way repeated-measures analysis of variance, P < 0.001) bilateral decrease in facial mechanical threshold that lasted up to 28 days post-operatively. Nerve injury also induced a significant bilateral decrease compared to sham (P < 0.05) in the number of anterior digastric and/or genioglossus sites in face-MI and in face-SI. These findings indicate that trigeminal nerve injury induces neuroplastic alterations in jaw and tongue motor representations in face sensorimotor cortex that are associated with facial nociceptive behavior and that may contribute to sensorimotor changes following trigeminal nerve injury.
Collapse
Affiliation(s)
- Dongyuan Yao
- School of Pharmaceutical Science and Jiangxi Mental Hospital, Nanchang University, 461 Bayi Road, Nanchang, 330006, Jiangxi, China. .,Department of Physiology, Faculty of Dentistry, and Faculty of Medicine, University of Toronto, 124 Edward St., Toronto, ON, M5G 1G6, Canada.
| | - Barry J Sessle
- Department of Physiology, Faculty of Dentistry, and Faculty of Medicine, University of Toronto, 124 Edward St., Toronto, ON, M5G 1G6, Canada
| |
Collapse
|
36
|
Improving Upper Extremity Function and Quality of Life with a Tongue Driven Exoskeleton: A Pilot Study Quantifying Stroke Rehabilitation. Stroke Res Treat 2018; 2017:3603860. [PMID: 29403672 PMCID: PMC5748322 DOI: 10.1155/2017/3603860] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 04/29/2017] [Accepted: 11/13/2017] [Indexed: 01/17/2023] Open
Abstract
Stroke is a leading cause of long-term disability around the world. Many survivors experience upper extremity (UE) impairment with few rehabilitation opportunities, secondary to a lack of voluntary muscle control. We developed a novel rehabilitation paradigm (TDS-HM) that uses a Tongue Drive System (TDS) to control a UE robotic device (Hand Mentor: HM) while engaging with an interactive user interface. In this study, six stroke survivors with moderate to severe UE impairment completed 15 two-hour sessions of TDS-HM training over five weeks. Participants were instructed to move their paretic arm, with synchronized tongue commands to track a target waveform while using visual feedback to make accurate movements. Following TDS-HM training, significant improvements in tracking performance translated into improvements in the UE portion of the Fugl-Meyer Motor Assessment, range of motion, and all subscores for the Stroke Impact Scale. Regression modeling found daily training time to be a significant predictor of decreases in tracking error, indicating the presence of a potential dose-response relationship. The results of this pilot study indicate that the TDS-HM system can elicit significant improvements in moderate to severely impaired stroke survivors. This pilot study gives preliminary insight into the volume of treatment time required to improve outcomes.
Collapse
|
37
|
Kumar A, Kothari M, Grigoriadis A, Trulsson M, Svensson P. Bite or brain: Implication of sensorimotor regulation and neuroplasticity in oral rehabilitation procedures. J Oral Rehabil 2018; 45:323-333. [DOI: 10.1111/joor.12603] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2017] [Indexed: 02/04/2023]
Affiliation(s)
- A. Kumar
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
| | - M. Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - A. Grigoriadis
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
| | - M. Trulsson
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
| | - P. Svensson
- Division of Oral Diagnostics and Rehabilitation; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
- Scandinavian Center for Orofacial Neurosciences (SCON); Huddinge Sweden
- Section of Orofacial Pain and Jaw Function; Institute for Odontology and Oral Health; Aarhus University; Aarhus Denmark
| |
Collapse
|
38
|
Avivi-Arber L, Sessle BJ. Jaw sensorimotor control in healthy adults and effects of ageing. J Oral Rehabil 2017; 45:50-80. [DOI: 10.1111/joor.12554] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2017] [Indexed: 12/22/2022]
Affiliation(s)
- L. Avivi-Arber
- Faculty of Dentistry; University of Toronto; Toronto ON Canada
| | - B. J. Sessle
- Faculty of Dentistry; University of Toronto; Toronto ON Canada
| |
Collapse
|
39
|
Monda V, Valenzano A, Moscatelli F, Salerno M, Sessa F, Triggiani AI, Viggiano A, Capranica L, Marsala G, De Luca V, Cipolloni L, Ruberto M, Precenzano F, Carotenuto M, Zammit C, Gelzo M, Monda M, Cibelli G, Messina G, Messina A. Primary Motor Cortex Excitability in Karate Athletes: A Transcranial Magnetic Stimulation Study. Front Physiol 2017; 8:695. [PMID: 28955250 PMCID: PMC5600924 DOI: 10.3389/fphys.2017.00695] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 08/29/2017] [Indexed: 12/03/2022] Open
Abstract
Purpose: The mechanisms involved in the coordination of muscle activity are not completely known: to investigate adaptive changes in human motor cortex Transcranial magnetic stimulation (TMS) was often used. The sport models are frequently used to study how the training may affect the corticospinal system excitability: Karate represents a valuable sport model for this kind of investigations for its high levels of coordination required to athletes. This study was aimed at examining possible changes in the resting motor threshold (rMT) and in the corticospinal response in karate athletes, and at determining whether athletes are characterized by a specific value of rMT. Methods: We recruited 25 right-handed young karate athletes and 25 matched non-athletes. TMS was applied to primary motor cortex (M1). Motor evoked potential (MEP) were recorded by two electrodes placed above the first dorsal interosseous (FDI) muscle. We considered MEP latencies and amplitudes at rMT, 110% of rMT, and 120% of rMT. Results: The two groups were similar for age (p > 0.05), height (p > 0.05) and body mass (p > 0.05). The TMS had a 70-mm figure-of-eight coil and a maximum output of 2.2 T, placed over the left motor cortex. During the stimulation, a mechanical arm kept the coil tangential to the scalp, with the handle at 45° respect to the midline. The SofTaxic navigator system (E.M.S. Italy, www.emsmedical.net) was used in order to correctly identifying and repeating the stimulation for every subject. Compared to non-athletes, athletes showed a lower resting motor threshold (p < 0.001). Furthermore, athletes had a lower MEP latency (p < 0.001) and a higher MEP amplitude (p < 0.001) compared to non-athletes. Moreover, a ROC curve for rMT was found significant (area: 0.907; sensitivity 84%, specificity 76%). Conclusions: As the main finding, the present study showed significant differences in cortical excitability between athletes and non-athletes. The training can improve cortical excitability inducing athletes' modifications, as demonstrated in rMT and MEP values. These finding support the hypothesis that the sport practice determines specific brain organizations in relationship with the sport challenges.
Collapse
Affiliation(s)
- Vincenzo Monda
- Department of Experimental Medicine, Università degli Studi della Campania "Luigi Vanvitelli"Naples, Italy
| | - Anna Valenzano
- Department of Clinical and Experimental Medicine, University of FoggiaFoggia, Italy
| | - Fiorenzo Moscatelli
- Department of Clinical and Experimental Medicine, University of FoggiaFoggia, Italy
| | - Monica Salerno
- Department of Clinical and Experimental Medicine, University of FoggiaFoggia, Italy
| | - Francesco Sessa
- Department of Clinical and Experimental Medicine, University of FoggiaFoggia, Italy
| | - Antonio I Triggiani
- Department of Clinical and Experimental Medicine, University of FoggiaFoggia, Italy
| | - Andrea Viggiano
- Department of Medicine and Surgery, University of SalernoSalerno, Italy
| | - Laura Capranica
- Department of Motor, Human and Health Science, University of Rome, "Foro Italico"Rome, Italy
| | - Gabriella Marsala
- Struttura Complessa di Farmacia, Azienda Ospedaliero-UniversitariaFoggia, Italy
| | - Vincenzo De Luca
- Department of Psychiatry, University of TorontoToronto, ON, Canada
| | - Luigi Cipolloni
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Università degli Studi di Roma La SapienzaRome, Italy
| | - Maria Ruberto
- Department of Medical-Surgical and Dental Specialties, Università degli Studi della Campania "Luigi Vanvitelli"Naples, Italy
| | - Francesco Precenzano
- Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Università degli Studi della Campania "Luigi Vanvitelli"Naples, Italy
| | - Marco Carotenuto
- Department of Mental Health, Physical and Preventive Medicine, Clinic of Child and Adolescent Neuropsychiatry, Università degli Studi della Campania "Luigi Vanvitelli"Naples, Italy
| | - Christian Zammit
- Anatomy Department, Faculty of Medicine and Surgery, University of MaltaMsida, Malta
| | - Monica Gelzo
- Department of Molecular Medicine and Medical Biotechnology, Università degli Studi di Napoli Federico IINaples, Italy
| | - Marcellino Monda
- Department of Experimental Medicine, Università degli Studi della Campania "Luigi Vanvitelli"Naples, Italy
| | - Giuseppe Cibelli
- Department of Clinical and Experimental Medicine, University of FoggiaFoggia, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of FoggiaFoggia, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, Università degli Studi della Campania "Luigi Vanvitelli"Naples, Italy
| |
Collapse
|
40
|
Kothari M, Stubbs PW, Pedersen AR, Jensen J, Nielsen JF. Reliability of surface electromyography measurements from the suprahyoid muscle complex. J Oral Rehabil 2017. [PMID: 28644567 DOI: 10.1111/joor.12537] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Assessment of swallowing musculature using motor evoked potentials (MEPs) can be used to evaluate neural pathways. However, recording of the swallowing musculature is often invasive, uncomfortable and unrealistic in normal clinical practice. To investigate the possibility of using the suprahyoid muscle complex (SMC) using surface electromyography (sEMG) to assess changes to neural pathways by determining the reliability of measurements in healthy participants over days. Seventeen healthy participants were recruited. Measurements were performed twice with one week between sessions. Single-pulse (at 120% and 140% of the resting motor threshold (rMT)) and paired-pulse (2 ms and 15 ms paired pulse) transcranial magnetic stimulation (TMS) were used to elicit MEPs in the SMC which were recorded using sEMG. ≈50% of participants (range: 42-58%; depending on stimulus type/intensity) had significantly different MEP values between day 1 and day 2 for single-pulse and paired-pulse TMS. A large stimulus artefact resulted in MEP responses that could not be assessed in four participants. The assessment of the SMC using sEMG following TMS was poorly reliable for ≈50% of participants. Although using sEMG to assess swallowing musculature function is easier to perform clinically and more comfortable to patients than invasive measures, as the measurement of muscle activity using TMS is unreliable, the use of sEMG for this muscle group is not recommended and requires further research and development.
Collapse
Affiliation(s)
- M Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - P W Stubbs
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - A R Pedersen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - J Jensen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - J F Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| |
Collapse
|
41
|
Guilleminault C, Huang YS. From oral facial dysfunction to dysmorphism and the onset of pediatric OSA. Sleep Med Rev 2017; 40:203-214. [PMID: 29103943 DOI: 10.1016/j.smrv.2017.06.008] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/21/2017] [Accepted: 06/26/2017] [Indexed: 01/01/2023]
Abstract
The upper airway is a collapsible tube, and its collapsibility increases during sleep. Extrinsic factors such as atypical craniofacial features may increase the risks of airway collapse. We review early development of oral-facial structures and the anatomical variants that may be present at birth and can impact nasal breathing. After birth, there is a continuous interaction between orofacial functions and growth of anatomic features. We review the dysfunctions identified to date that may impact orofacial development leading to sleep-disordered-breathing through changes in the orofacial growth. The identification of risk-factors, ultimately leading to full-blown obstructive sleep apnea, may allow early recognition of these factors and the development of treatments to eliminate early problems or at least decrease their impact.
Collapse
Affiliation(s)
- Christian Guilleminault
- Stanford University Sleep Medicine Division, CA, USA; Pediatric Sleep Laboratory Division of Child Psychiatry Chang Gung Memorial Hospital and Medical College, Linkou, Taiwan.
| | - Yu-Shu Huang
- Stanford University Sleep Medicine Division, CA, USA; Pediatric Sleep Laboratory Division of Child Psychiatry Chang Gung Memorial Hospital and Medical College, Linkou, Taiwan
| |
Collapse
|
42
|
Kothari M, Stubbs PW, Figlewski K, Pedersen AR, Jensen J, Baad-Hansen L, Svensson P, Nielsen JF. Effect of transcranial direct current stimulation on neuroplasticity in corticomotor pathways of the tongue muscles. J Oral Rehabil 2017; 44:691-701. [DOI: 10.1111/joor.12529] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M. Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - P. W. Stubbs
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - K. Figlewski
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - A. R. Pedersen
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - J. Jensen
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - L. Baad-Hansen
- Section of Orofacial Pain and Jaw Function, Department of Odontology and Oral Health; Aarhus University; Hammel
- Scandinavian Center for Orofacial Neurosciences (SCON); Aarhus Denmark
| | - P. Svensson
- Section of Orofacial Pain and Jaw Function, Department of Odontology and Oral Health; Aarhus University; Hammel
- Scandinavian Center for Orofacial Neurosciences (SCON); Aarhus Denmark
- Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - J. F. Nielsen
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| |
Collapse
|
43
|
de Felício CM, da Silva Dias FV, Folha GA, de Almeida LA, de Souza JF, Anselmo-Lima WT, Trawitzki LVV, Valera FCP. Orofacial motor functions in pediatric obstructive sleep apnea and implications for myofunctional therapy. Int J Pediatr Otorhinolaryngol 2016; 90:5-11. [PMID: 27729152 DOI: 10.1016/j.ijporl.2016.08.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/22/2016] [Accepted: 08/24/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The purposes of this study were (1) to identify possible differences in muscular and orofacial functions between children with obstructive sleep apnea (OSA) and with primary snoring (PS); (2) to examine the standardized difference between normal values of myofunctional scores and those of subjects with OSA or PS; and (3) to identify the features associated with OSA. METHODS Participants were 39 children (mean age 8 ± 1.2 years) of which, 27 had a diagnosis of OSA and 12 had PS. All participants were examined by an otorhinolaryngologist and underwent overnight polysomnography. Orofacial characteristics were determined through a validated protocol of orofacial myofunctional evaluation with scores (OMES), surface electromyography of masticatory muscles, and measurements of maximal lip and tongue strength. Reference values in the OMES were included to quantify the standardized difference (effect size = ES) relative to the groups studied and in the regression analysis. RESULTS The OSA group had lower scores in breathing and deglutition, more unbalanced masticatory muscle activities than PS group (P < 0.05), but both groups had similar reductions in orofacial strength. OSA had a large ES (Cohen's d > 0.8) in all analysed OMES scores, while PS group showed small and medium differences in breathing and mastication scores, respectively. The mobility of the stomatognathic components score was the most important to contribute for group status (57%, P < 0.0001) in the regression analysis. CONCLUSION Children with tonsillar hypertrophy and OSA had relevant impairments in orofacial functions and lesser muscular coordination than children with PS.
Collapse
Affiliation(s)
- Cláudia Maria de Felício
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil.
| | - Franciele Voltarelli da Silva Dias
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Gislaine Aparecida Folha
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Leila Azevedo de Almeida
- Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Jaqueline Freitas de Souza
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Wilma Terezinha Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Luciana Vitaliano Voi Trawitzki
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Fabiana Cardoso Pereira Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| |
Collapse
|
44
|
Honki H, Iida T, Komiyama O, Masuda M, Svensson P, Kawara M. Effect of a repeated tongue-lift motor task for tongue function. Eur J Oral Sci 2016; 124:540-545. [DOI: 10.1111/eos.12300] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Hisae Honki
- Department of Oral Function and Rehabilitation; Nihon University School of Dentistry at Matsudo; Matsudo Japan
| | - Takashi Iida
- Department of Oral Function and Rehabilitation; Nihon University School of Dentistry at Matsudo; Matsudo Japan
| | - Osamu Komiyama
- Department of Oral Function and Rehabilitation; Nihon University School of Dentistry at Matsudo; Matsudo Japan
| | - Manabu Masuda
- Department of Oral Function and Rehabilitation; Nihon University School of Dentistry at Matsudo; Matsudo Japan
| | - Peter Svensson
- Department of Dentistry; Section of Orofacial Pain and Jaw Function; Aarhus University; Aarhus Denmark
- Scandinavian Center for Orofacial Neurosciences (SCON); Aarhus Denmark
- Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - Misao Kawara
- Department of Oral Function and Rehabilitation; Nihon University School of Dentistry at Matsudo; Matsudo Japan
| |
Collapse
|
45
|
Kothari M, Liu X, Baad-Hansen L, Kumar A, Bin G, Svensson P. Influence of visual observational conditions on tongue motor learning. Eur J Oral Sci 2016; 124:534-539. [DOI: 10.1111/eos.12299] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Mohit Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic; Aarhus University; Hammel Denmark
| | - Xuemei Liu
- Department of Stomatology; Chinese PLA General Hospital; Beijing China
| | - Lene Baad-Hansen
- Section of Orofacial Pain and Jaw Function; Institute of Odontology and Oral Health; Aarhus University; Aarhus Denmark
- Scandinavian Center for Orofacial Neurosciences (SCON); Aarhus Denmark
| | - Abhishek Kumar
- Scandinavian Center for Orofacial Neurosciences (SCON); Aarhus Denmark
- Section of Oral Rehabilitation; Department of Dental Medicine; Karolinska Institute; Huddinge Sweden
| | - Guo Bin
- Department of Stomatology; Chinese PLA General Hospital; Beijing China
| | - Peter Svensson
- Section of Orofacial Pain and Jaw Function; Institute of Odontology and Oral Health; Aarhus University; Aarhus Denmark
- Scandinavian Center for Orofacial Neurosciences (SCON); Aarhus Denmark
- Section of Oral Rehabilitation; Department of Dental Medicine; Karolinska Institute; Huddinge Sweden
| |
Collapse
|
46
|
Fine motor control of the jaw following alteration of orofacial afferent inputs. Clin Oral Investig 2016; 21:613-626. [PMID: 27568306 PMCID: PMC5318472 DOI: 10.1007/s00784-016-1939-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 07/26/2016] [Indexed: 11/08/2022]
Abstract
Objective The study was designed to investigate if alteration of different orofacial afferent inputs would have different effects on oral fine motor control and to test the hypothesis that reduced afferent inputs will increase the variability of bite force values and jaw muscle activity, and repeated training with splitting of food morsel in conditions with reduced afferent inputs would decrease the variability and lead to optimization of bite force values and jaw muscle activity. Material methods Forty-five healthy volunteers participated in a single experimental session and were equally divided into incisal, mucosal, and block anesthesia groups. The participants performed six series (with ten trials) of a standardized hold and split task after the intervention with local anesthesia was made in the respective groups. The hold and split forces along with the corresponding jaw muscle activity were recorded and compared to a reference group. Results The hold force and the electromyographic (EMG) activity of the masseter muscles during the hold phase were significantly higher in the incisal and block anesthesia group, as compared to the reference group (P < 0.001). However, there was no significant effect of groups on the split force (P = 0.975) but a significant decrease in the EMG activity of right masseter in mucosal anesthesia group as compared to the reference group (P = 0.006). The results also revealed that there was no significant effect of local anesthesia on the variability of the hold and split force (P < 0.677). However, there was a significant decrease in the variability of EMG activity of the jaw closing muscles in the block anesthesia group as compared to the reference group (P < 0.041), during the hold phase and a significant increase in the variability of EMG activity of right masseter in the mucosal anesthesia group (P = 0.021) along with a significant increase in the EMG activity of anterior temporalis muscle in the incisal anesthesia group, compared to the reference group (P = 0.018), during the split phase. Conclusions The results of the present study indicated that altering different orofacial afferent inputs may have different effects on some aspects of oral fine motor control. Further, inhibition of afferent inputs from the orofacial or periodontal mechanoreceptors did not increase the variability of bite force values and jaw muscle activity; indicating that the relative precision of the oral fine motor task was not compromised inspite of the anesthesia. The results also suggest the propensity of optimization of bite force values and jaw muscle activity due to repeated splitting of the food morsels, inspite of alteration of sensory inputs. Clinical relevance Skill acquisition following a change in oral sensory environment is crucial for understanding how humans learn and re-learn oral motor behaviors and the kind of adaptation that takes place after successful oral rehabilitation procedures.
Collapse
|
47
|
Kothari M, Baad-Hansen L, Svensson P. Bilateral sensory deprivation of trigeminal afferent fibres on corticomotor control of human tongue musculature: a preliminary study. J Oral Rehabil 2016; 43:656-61. [PMID: 27265155 DOI: 10.1111/joor.12414] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2016] [Indexed: 12/01/2022]
Abstract
Transcranial magnetic stimulation (TMS) has demonstrated changes in motor evoked potentials (MEPs) in human limb muscles following modulation of sensory afferent inputs. The aim of this study was to determine whether bilateral local anaesthesia (LA) of the lingual nerve affects the excitability of the tongue motor cortex (MI) as measured by TMS. The effect on MEPs after bilateral LA of the lingual nerve was studied, while the first dorsal interosseous (FDI) muscle served as a control in ten healthy participants. MEPs were measured on the right side of the tongue dorsum in four different conditions: (i) immediately prior to anaesthesia (baseline), (ii) during bilateral LA block of the lingual nerve, (iii) after anaesthesia had subjectively subsided (recovery) and (iv) 3 h after bilateral lingual block injection. MEPs were assessed using stimulus-response curves in steps of 10% of motor threshold (T). Eight stimuli were given at each stimulus level. The amplitudes of the tongue MEPs were significantly influenced by the stimulus intensity (P < 0·001) but not by condition (P = 0·186). However, post hoc tests showed that MEPS were statistically significantly higher during bilateral LA block condition compared with baseline at T + 40%, T + 50% and T + 60% (P < 0·028) and also compared with recovery at T + 60% (P = 0·010) as well as at 3 h after injection at T + 50% and T + 60% (P < 0·029). Bilateral LA block of the lingual nerve seems to be associated with a facilitation of the corticomotor pathways related to the tongue musculature.
Collapse
Affiliation(s)
- M Kothari
- Hammel Neurorehabilitation Centre and University Research Clinic, Aarhus University, Hammel, Denmark
| | - L Baad-Hansen
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| | - P Svensson
- Section of Orofacial Pain and Jaw Function, Institute of Odontology and Oral Health, Aarhus University, Aarhus, Denmark.,Scandinavian Center for Orofacial Neurosciences (SCON), Aarhus, Denmark
| |
Collapse
|
48
|
Functional Assessment of Corticospinal System Excitability in Karate Athletes. PLoS One 2016; 11:e0155998. [PMID: 27218465 PMCID: PMC4878742 DOI: 10.1371/journal.pone.0155998] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 05/06/2016] [Indexed: 12/04/2022] Open
Abstract
Objectives To investigate the involvement of the primary motor cortex (M1) in the coordination performance of karate athletes through transcranial magnetic stimulation (TMS). Methods Thirteen right-handed male karate athletes (25.0±5.0 years) and 13 matched non-athlete controls (26.7±6.2 years) were enrolled. A single-pulse TMS was applied using a figure-eight coil stimulator. Resting motor threshold (rMT) was determined. Surface electromyography was recorded from the first dorsal interosseous muscle. Motor evoked potential (MEP) latencies and amplitudes at rMT, 110%, and 120% of rMT were considered. Functional assessment of the coordination performance was assessed by in-phase (IP) and anti-phase (AP) homolateral hand and foot coordination tasks performed at 80, 120, and 180 bpm. Results Compared to controls, athletes showed lower rMT (p<0.01), shorter MEP latency (p<0.01) and higher MEP amplitude (p<0.01), with a significant correlation (r = 0.50, p<0.01) between rMT and MEP latency. Coordination decreased with increasing velocity, and better IP performances emerged compared to AP ones (p<0.001). In general, a high correlation between rMT and coordination tasks was found for both IP and AP conditions. Conclusion With respect to controls, karate athletes present a higher corticospinal excitability indicating the presence of an activity-dependent alteration in the balance and interactions between inhibitory and facilitatory circuits determining the final output from the M1. Furthermore, the high correlation between corticospinal excitability and coordination performance could support sport-specific neurophysiological arrangements.
Collapse
|
49
|
Machado BCZ, Mazzetto MO, Da Silva MAMR, de Felício CM. Effects of oral motor exercises and laser therapy on chronic temporomandibular disorders: a randomized study with follow-up. Lasers Med Sci 2016; 31:945-54. [PMID: 27085322 DOI: 10.1007/s10103-016-1935-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 03/28/2016] [Indexed: 01/05/2023]
Abstract
This study investigated the efficacy of combining low-level laser therapy (LLLT) with oral motor exercises (OM-exercises) for rehabilitation of patients with chronic temporomandibular disorders (TMDs). Eighty-two patients with chronic TMD and 20 healthy subjects (control group) participated in the study. Patients were randomly assigned to treatment groups: GI (LLLT + OM exercises), GII (orofacial myofunctional therapy-OMT-which contains pain relief strategies and OM-exercises), and GIII (LLLT placebo + OM-exercises) and GIV (LLLT). LLLT (AsGaAl; 780-nm wavelength; average power of 60 mW, 40 s, and 60 ± 1.0 J/cm²) was used to promote analgesia, while OM-exercises were used to reestablish the orofacial functions. Evaluations at baseline (T1), after treatment immediate (T2), and at follow-up (T3) were muscle and joint tenderness to palpation, TMD severity, and orofacial myofunctional status. There was a significant improvement in outcome measures in all treated groups with stability at follow-up (Friedman test, P < 0.05), but GIV did not show difference in orofacial functions after LLLT (P > 0.05). Intergroup comparisons showed that all treated groups had no difference in tenderness to palpation of temporal muscle compared to GC at follow-up (Kruskal-Wallis test, P < 0.01). Moreover, GI, GII, and GIII showed no difference from GC in orofacial functional condition (T2 and T3) while they differed significantly from GIV (P < 0.01). In conclusion, LLLT combined with OM-exercises was more effective in promoting TMD rehabilitation than LLLT alone was. Similar treatment results were verified with the OMT protocol.
Collapse
Affiliation(s)
- Barbara Cristina Zanandréa Machado
- Department of Ophtalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine, University of São Paulo, Av. dos Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil.,Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil
| | - Marcelo Oliveira Mazzetto
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marco Antonio M Rodrigues Da Silva
- Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil.,Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cláudia Maria de Felício
- Department of Ophtalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine, University of São Paulo, Av. dos Bandeirantes 3900, Ribeirão Preto, São Paulo, 14049-900, Brazil. .,Craniofacial Research Support Centre, University of São Paulo, São Paulo, Brazil.
| |
Collapse
|
50
|
Zhang H, Kumar A, Kothari M, Luo X, Trulsson M, Svensson KG, Svensson P. Can short-term oral fine motor training affect precision of task performance and induce cortical plasticity of the jaw muscles? Exp Brain Res 2016; 234:1935-1943. [DOI: 10.1007/s00221-016-4598-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 02/11/2016] [Indexed: 01/17/2023]
|