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Pavlou IA, Spandidos DA, Zoumpourlis V, Adamaki M. Nutrient insufficiencies and deficiencies involved in the pathogenesis of bruxism (Review). Exp Ther Med 2023; 26:563. [PMID: 37954114 PMCID: PMC10632959 DOI: 10.3892/etm.2023.12262] [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: 05/19/2023] [Accepted: 10/02/2023] [Indexed: 11/14/2023] Open
Abstract
Stress has been well-documented to have a significant role in the etiopathogenesis of bruxism. Activation of the hypothalamic-pituitary-adrenal axis (HPA) and subsequent release of corticosteroids lead to increased muscle activity. Neurological studies have demonstrated that chronic stress exposure induces neurodegeneration of important neuronal structures and destabilization of the mesocortical dopaminergic pathway. These disruptions impair the abilities to counteract the overactivity of the HPA axis and disinhibit involuntary muscle activity, while at the same time, there is activation of the amygdala. Recent evidence shows that overactivation of the amygdala under stressful stimuli causes rhythmic jaw muscle activity by over activating the mesencephalic and motor trigeminal nuclei. The present review aimed to discuss the negative effects of certain vitamin and mineral deficiencies, such as vitamin D, magnesium, and omega-3 fatty acids, on the central nervous system. It provides evidence on how such insufficiencies may increase stress sensitivity and neuromuscular excitability and thereby reduce the ability to effectively respond to the overactivation of the sympathetic nervous system, and also how stress can in turn lead to these insufficiencies. Finally, the positive effects of individualized supplementation are discussed in the context of diminishing anxiety and oxidative stress, neuroprotection and in the reversal of neurodegeneration, and also in alleviating/reducing neuromuscular symptoms.
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Affiliation(s)
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Greece
| | - Vassilis Zoumpourlis
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation, 11635 Athens, Greece
| | - Maria Adamaki
- Biomedical Applications Unit, Institute of Chemical Biology, National Hellenic Research Foundation, 11635 Athens, Greece
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Teng LY, Abd Hadi D, Anandakrishnan P, Murugesu S, Khoo TB, Mohamed AR. Geniospasm: A systematic review on natural history, prognosis, and treatment. Brain Dev 2022; 44:499-511. [PMID: 35672188 DOI: 10.1016/j.braindev.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/07/2022] [Accepted: 05/23/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Geniospasm is a rare and generally benign movement disorder of the chin yet with potentially debilitating complications. Due to its rarity, previous literature was limited to only case reports or series with critical knowledge gap on its natural history, prognosis, and management. We aimed to establish the natural history, prognosis, and treatment for geniospasm. METHODS A systematic review on case reports or series was performed with literature search on PubMed and Google Scholar, from inception through December 2021. The quality of the reports was assessed with low-quality articles excluded for analyses other than demographics. RESULTS Forty-one articles were included for demographic analysis (n = 489) while forty articles for other analyses (n = 451). There was only slight male preponderance of this disease in our cohort (Male:Female = 1.2:1) with 98.6% having family history of geniospasm, 68.1% having onset below 1 year of age, 91.4% having emotional triggers of the symptoms, 25.7% having geniospasm in sleep, 100% involving mentalis muscles, 4.9% involving muscles adjacent to mentalis, 55.2% having regular paroxysms (≥1/week, but brief in 56.3% of the cases) and only 11.1% having complications. The paroxysms reduced with age, but complete remission only happened in 9.9%. Females (p = 0.010) and those without geniospasm in sleep (p = 0.048) were associated with good outcome of the disease. Geniospasm was usually refractory to treatment except for regular botulinum toxin injections. CONCLUSION Generally, geniospasm improved with age but complete remission was rare. Considering our review limitations, our findings should be interpreted with caution. Future studies of higher evidence level are crucial.
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Affiliation(s)
- Lip-Yuen Teng
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia.
| | - Dianah Abd Hadi
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Poorani Anandakrishnan
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Sumitha Murugesu
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Teik-Beng Khoo
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Ahmad Rithauddin Mohamed
- Paediatric Neurology Unit, Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
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Kazubowska-Machnowska K, Jodkowska A, Michalek-Zrabkowska M, Wieckiewicz M, Poreba R, Dominiak M, Gac P, Mazur G, Kanclerska J, Martynowicz H. The Effect of Severity of Obstructive Sleep Apnea on Sleep Bruxism in Respiratory Polygraphy Study. Brain Sci 2022; 12:brainsci12070828. [PMID: 35884635 PMCID: PMC9313411 DOI: 10.3390/brainsci12070828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/18/2022] [Accepted: 06/22/2022] [Indexed: 02/04/2023] Open
Abstract
Obstructive sleep apnea (OSA) and sleep bruxism (SB) may appear concomitantly. Data on the relationship between OSA and SB are limited. It was shown that in a population with an increased risk of OSA, OSA was dependently correlated with SB on the degree of OSA severity only in mild and moderate cases of OSA. We aimed to confirm this relationship and affecting factors in a group of dental office patients in a prospective, observational study. Adult patients (n = 119) were evaluated using respiratory polygraphy. The risk of OSA was assessed using a STOP-Bang questionnaire (SBQ). The episodes of bruxism and respiratory events were scored according to the standards of the American Academy of Sleep Medicine. The prevalence of OSA and SB was found to be 63.02% and 41.17%, respectively. The bruxism episode index (BEI) was increased in the group with a higher risk of OSA (SBQ ≥ 3) compared to the group with a lower risk of OSA (3.49 ± 3.63 vs. 2.27 ± 2.50, p = 0.03). The sensitivity and specificity of the SBQ were not sufficient to predict SB. A positive linear correlation between AHI and BEI in the group with AHI < 23/h was found. The study confirmed that OSA was associated with SB in the group of patients with OSA and/or SB risk. The relationship between OSA and SB depended on the degree of severity of OSA and occurred in mild and moderate cases of OSA.
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Affiliation(s)
| | - Anna Jodkowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (A.J.); (R.P.); (G.M.); (J.K.); (H.M.)
| | - Monika Michalek-Zrabkowska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (A.J.); (R.P.); (G.M.); (J.K.); (H.M.)
- Correspondence: ; Tel.: +48-71-736-4000
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland;
| | - Rafal Poreba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (A.J.); (R.P.); (G.M.); (J.K.); (H.M.)
| | - Marzena Dominiak
- Department of Oral Surgery, Wroclaw Medical University, 26 Krakowska St., 50-425 Wroclaw, Poland; (K.K.-M.); (M.D.)
| | - Pawel Gac
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, 7 Mikulicza-Radeckiego St., 50-345 Wroclaw, Poland;
| | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (A.J.); (R.P.); (G.M.); (J.K.); (H.M.)
| | - Justyna Kanclerska
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (A.J.); (R.P.); (G.M.); (J.K.); (H.M.)
| | - Helena Martynowicz
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska St., 50-556 Wroclaw, Poland; (A.J.); (R.P.); (G.M.); (J.K.); (H.M.)
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Polini F, Budai R. Multimodal transcutaneous auricular vagus nerve stimulation: An option in the treatment of sleep bruxism in a "polyvagal" context. Cranio 2022:1-9. [PMID: 35322755 DOI: 10.1080/08869634.2022.2055866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To consider the possible role of the vagus nerve (VN) in the pathophysiology of sleep bruxism (SB) and introduce a multimodal protocol of transcutaneous auricular stimulation of the VN in the treatment of SB patients. METHODS Ten patients with SB underwent four sessions of electric transcutaneous auricular vagus nerve stimulation (ta-VNS) in specific auricular areas. The patients were advised to manually stimulate the same areas between sessions. Masticatory muscle activity and sleep parameters were measured by a polysomnography (PSG) before and after the treatment. Heart rate variability (HRV) parameters were measured during each stimulation. RESULTS PSG analysis revealed a statistically significant reduction in tonic SB index and tonic contraction time. HRV parameters showed a statistically significant increase in mean values of the vagal tone after each session of stimulation. No side effect was reported. CONCLUSION The stimulation of the VN might have a role in the treatment of SB.
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Affiliation(s)
- Francesco Polini
- Maxillofacial Surgery Clinic, University Hospital of Udine, Udine, Italy
| | - Riccardo Budai
- Neurophysiopathology Operative Unit, University Hospital of Udine, Udine, Italy
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Burke DJ, Seitz A, Aladesuru O, Robbins MS, Ch'ang JH. Bruxism in Acute Neurologic Illness. Curr Pain Headache Rep 2021; 25:41. [PMID: 33837858 DOI: 10.1007/s11916-021-00953-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE OF REVIEW While traditionally encountered in ambulatory settings, bruxism occurs in patients with a variety of acute neurologic illnesses including encephalitis, intracerebral hemorrhage, traumatic brain injury, hypoxic-ischemic encephalopathy, and acute ischemic stroke. Untreated bruxism in acute neurologic illness can lead to tooth loss, difficulty in mouth care resulting in recurrent aspiration pneumonia, endotracheal tube dislodgement, and even tongue laceration or amputation. Inpatient clinicians should be aware of the etiologies and management strategies for bruxism secondary to acute neurologic illness. RECENT FINDINGS Management strategies for bruxism are varied and include pharmacologic and non-pharmacologic therapies in addition to onabotulinumtoxinA (BoNT-A). Bruxism impacts patients with a variety of acute neurologic illnesses, and emerging evidence suggests successful and safe treatment strategies.
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Affiliation(s)
- Devin J Burke
- Division of Neurocritical Care, Weill Cornell Medicine, New York Presbyterian, 525 East 68th St, RM F610, New York, NY, 10065, USA
| | - Alison Seitz
- Department of Neurology, Weill Cornell, New York Presbyterian, New York, NY, USA
| | | | - Matthew S Robbins
- Department of Neurology, Weill Cornell, New York Presbyterian, New York, NY, USA
| | - Judy H Ch'ang
- Division of Neurocritical Care, Weill Cornell Medicine, New York Presbyterian, 525 East 68th St, RM F610, New York, NY, 10065, USA.
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Uginčius P, Yilmaz G, Sebik O, Türker KS. Reevaluation of reflex responses of the human masseter muscle to electrical lip stimulation. J Neurophysiol 2017; 118:1082-1091. [PMID: 28539391 PMCID: PMC5547252 DOI: 10.1152/jn.00064.2017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 05/17/2017] [Accepted: 05/17/2017] [Indexed: 11/22/2022] Open
Abstract
We examined the reflex response of the human masseter muscle to electrical stimulation of the lip using both single motor unit and surface electromyogram based methods. Using the classical analysis methods, reflex response to mild electrical stimuli generated two distinct short-lasting inhibitions. This pattern may reflect the development of combinations of short- and long-latency inhibitory postsynaptic potentials as a result of the mildly painful electrical lip stimulation. However, this pattern appearing in the classical analysis methods may have developed as a consequence of earlier responses and may not be genuine. This study examined the genuineness of these responses using both the classical analysis methods and the discharge rate method to uncover the realistic postsynaptic potentials in human trigeminal motor nucleus. Using the discharge rate method, we found that the electrical lip stimulation only generated a long-lasting single or compound inhibitory response that is followed by late, long-lasting excitation. These findings have important implications on the redrawing of the neuronal pathways of the trigeminal nerve that are frequently used to judge neuromuscular disorders of the trigeminal region.NEW & NOTEWORTHY We examined the human masseter reflex response to electrical stimulation of lower lip to uncover realistic postsynaptic potentials in the trigeminal motor nucleus. We found that the stimulation generates a long-lasting single or compound inhibitory response that is followed by a late, long-lasting excitation. These findings have important implications on the redrawing of the neuronal pathways of the trigeminal nerve that are frequently used to judge neuromuscular disorders of the trigeminal region.
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Affiliation(s)
- Paulius Uginčius
- Institute of Physiology and Pharmacology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; and
| | - Gizem Yilmaz
- Koç University School of Medicine, Sariyer, Istanbul, Turkey
| | - Oğuz Sebik
- Koç University School of Medicine, Sariyer, Istanbul, Turkey
| | - Kemal S Türker
- Koç University School of Medicine, Sariyer, Istanbul, Turkey
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