The effect of stimulus intensity and gape on electrically-evoked jaw reflexes in man

Reevaluation of reflex responses of the human masseter muscle to electrical lip stimulation

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.

Effects of interocclusal distance on bite force and masseter EMG in healthy participants

The aim of this study was to investigate effects of interocclusal distance (IOD) on bite force and masseter electromyographic (EMG) activity during different isometric contraction tasks. Thirty-one healthy participants (14 women and 17 men, 21·2 ± 1·8 years) were recruited. Maximal Voluntary Occlusal Bite Force (MVOBF) between the first molars and masseter EMG activity during all the isometric-biting tasks were measured. The participants were asked to bite at submaximal levels of 20%, 40%, 60% and 80% MVOBF with the use of visual feedback. The thickness of the force transducer was set at 8, 12, 16 and 20 mm (= IOD), and sides were tested in random sequence. MVOBF was significantly higher at 8 mm compared with all other IODs (P < 0·001). Only in women, IOD always had significant influence on the corresponding root-mean-square (RMS) value of EMG (P < 0·011). When biting was performed on the ipsilateral side to the dominant hand, the working side consistently showed higher masseter EMG activity compared with the balancing side (P < 0·020). On the contralateral side, there was no difference between the masseter EMG at any IODs. The results replicated the finding that higher occlusal forces can be generated between the first molars at shorter IODs. The new finding in this study was that an effect of hand dominance could be found on masseter muscle activity during isometric biting. This may suggest that there can be a general dominant side effect on human jaw muscles possibly reflecting differences in motor unit recruitment strategies.

Jaw elevator silent periods in complete denture wearers and dentate individuals

Functional meaning and underlying mechanisms of jaw elevator silent period (SP) have still not been completely understood. Since complete denture wearers (CDWs) have no periodontal receptors in their jaws, the aim was to examine SPs in CDWs and to compare it with dentate individuals (DIs). Thirty six DIs (skeletal/occlusal Class I) and 24 eugnath CDWs participated. EMG signals were registered using the EMGA-1 apparatus from the left and the right side anterior temporalis (ATM) and masseter muscles (MM). Ten registrations of an open-close-clench (OCC) cycle were obtained for each individual. DIs had the average latency between 12.5 and 12.9 ms and always one single short inhibitory pause (IP) with complete inhibition of motoneurons (20.1-21.1 ms). On the other hand, in CDWs various types of SPs emerged: single or single prolonged SPs, double SPs, SPs with three IPs, periods of depressed muscle activity following the first, or the second IP, SPs with relative inhibition of motoneurons or even in several registrations the SP was missing. Unless more than one IP emerged, complete duration of inhibitory pauses (CDIP) was measured. CDIP varied from 37.17 to 42.49 ms. Average latencies were from 16.22 to 16.76 ms. Based on the results of this study it is obvious that both, the duration and the latencies were significantly longer in CDWs than in DIs (p<0.05), which can be explained by different mechanisms responsible for the muscle reflex behaviour.

Reflex control of human jaw muscles

The aim of this review is to discuss what is known about the reflex control of the human masticatory system and to propose a method for standardized investigation. Literature regarding the current knowledge of activation of jaw muscles, receptors involved in the feedback control, and reflex pathways is discussed. The reflexes are discussed under the headings of the stimulation conditions. This was deliberately done to remind the reader that under each stimulation condition, several receptor systems are activated, and that it is not yet possible to stimulate only one afferent system in isolation in human mastication experiments. To achieve a method for uniform investigation, we need to set a method for stimulation of the afferent pathway under study with minimal simultaneous activation of other receptor systems. This stimulation should also be done in an efficient and reproducible way. To substantiate our conviction to standardize the stimulus type and parameters, we discuss the advantages and disadvantages of mechanical and electrical stimuli. For mechanical stimulus to be delivered in a reproducible way, the following precautions are suggested: The stimulus delivery system (often a probe attached to a vibrator) should be brought into secure contact with the area of stimulation. To minimize the slack between the probe, the area to be stimulated should be taken up by the application of pre-load, and the delivered force should be recorded in series. Electrical stimulus has advantages in that it can be delivered in a reproducible way, though its physiological relevance can be questioned. It is also necessary to standardize the method for recording and analyzing the responses of the motoneurons to the stimulation. For that, a new technique is introduced, and its advantages over the currently used methods are discussed. The new method can illustrate the synaptic potential that is induced in the motoneurons without the errors that are unavoidable in the current techniques. We believe that once stimulation, recording, and analysis methods are standardized, it will be possible to bring out the real "wiring diagram" that operates in conscious human subjects.

A study on synaptic coupling between single orofacial mechanoreceptors and human masseter muscle

The connection between individual orofacial mechanoreceptive afferents and the motoneurones that innervate jaw muscles is not well established. For example, although electrical and mechanical stimulation of orofacial afferents in bulk evokes responses in the jaw closers, whether similar responses can be evoked in the jaw muscles from the discharge of type identified single orofacial mechanoreceptive afferents is not known. Using tungsten microelectrodes, we have recorded from 28 afferents in the inferior alveolar nerve and 21 afferents in the lingual nerve of human volunteers. We have used discharges of single orofacial afferents as the triggers and the electromyogram (EMG) of the masseter as the source to generate spike-triggered averaged records to illustrate time-based EMG modulation by the nerve discharge. We have then used cross correlation analysis to quantify the coupling. Furthermore, we have also used coherence analysis to study frequency-based relationship between the nerve spike trains and the EMG. The discharge patterns of the skin and mucosa receptors around the lip and the gingiva generated significant modulation in EMGs with a success rate of 40% for both cross correlation and coherence analyses. The discharge patterns of the periodontal mechanoreceptors (PMRs) generated more coupling with a success rate of 70% for cross correlation and about 35% for coherence analyses. Finally, the discharges of the tongue receptors displayed significant coupling with the jaw muscle motoneurones with a success rate of about 40% for both analyses. Significant modulation of the jaw muscles by single orofacial receptors suggests that they play important roles in controlling the jaw muscle activity so that mastication and speech functions are executed successfully.

New method for the objective evaluation of injury to the lingual nerve after operation on third molars

Existing tests of function of the lingual nerve are either subjective or, when they elicit the jaw-opening reflex, are dependent on the cooperation of the subject. We report a study in 12 healthy volunteers and 12 patients with iatrogenic injury to the lingual nerve. A bite block (containing stimulating electrodes) was held between the teeth and the tongue was held on to the electrodes by suction. When the lingual nerve was intact, an electrical stimulus elicited brief inhibition of masseteric electromyographic activity. Local analgesia and iatrogenic injury to the lingual nerve altered nerve conduction and caused a reduction in reflex inhibition. Two methods, compatible with limited numbers of applications of the stimulus, were used to quantify responses. One used an indirect measurement of intervals between action potentials of muscle and the other used a measurement of rectified signals falling below the mean amplitude before and after the stimulus. Both methods gave values that correlated with subjective sensations. The first gave an estimate of the probability of defining major malfunction of the nerve objectively; the second gave a linear measurement that allowed recovery of the nerve to be followed.

Exteroceptive reflexes in jaw-closing muscle EMG during rhythmic jaw closing and clenching in man

Exteroceptive jaw reflexes might play a role in normal functions of the mouth such as mastication. Until now these reflexes have only been studied under isometric conditions. The aim of this study was to compare exteroceptive reflexes in jaw muscle EMG during the closing phase of rhythmic open-close movements and clenching, at the same jaw gape and with similar muscle EMG. Reflexes consisting of successive waves of decreased and increased muscle activity (the Q, R, S and T waves of the post-stimulus electromyographic complex (PSEC)), evoked by light noxious electrical stimulation of the vermillion border of the lower lip, were recorded from the jaw closing muscles of 17 subjects. Differences between the two tasks occurred in two phases of the PSEC: (1) in an early phase, around the R wave, there was significantly less EMG during jaw closing (mean EMG ratio between jaw-closing and clenching 0.71), and (2) in a late phase, around the transition between the S to the T wave, there was significantly more EMG during jaw closing (mean EMG ratio: 1.40). The decrease in EMG activity around the R wave during jaw closing may be due to a change in reflex sensitivity at an interneuron level. The increase in EMG activity around the transition between the S and T waves during jaw closing might, at least in part, be due to a proprioceptive stretch reflex. This reflex is mediated by muscles spindles that are activated by the deceleration of the jaw evoked by the lip stimulus. The finding of inhibitory reflex mechanisms that predominate more during rhythmic jaw movements than during clenching in an early phase of the PSEC might be related to protecting oral tissues from trauma when the jaw is closing with potentially a large muscle force. In contrast, when food is held between the teeth, a possible inhibitory influence of light noxious stimuli is diminished.

Quantitative analysis of reflex inhibition in single motor units in human masseter muscle: effects of stimulus intensity

Inhibitory reflex responses to electrical stimulation of the mental nerve were studied in recordings from single motor units (SMU) in the human masseter muscle. A new analytical technique for spike train data was used. Electrical stimuli were delivered to the mental nerve when the SMU fired with two consecutive inter-spike intervals (ISIs) within the range of 90 ms to 110 ms. Stimuli were delivered with increasing stimulus delays after the preceding SMU action potential (AP). Sham, non-painful, and painful stimulus intensities were applied. The post-stimulus firing probability of the SMU was progressively decreased among the three conditions. Analysis of the relation between stimulus delays and ISI for the first post-stimulus APs revealed a linear relation which was shifted upward, and the slope was increased with increasing stimulus intensity. This may be explained by a differential effect of the increasing stimulus intensity on the duration and amplitude of the inhibitory post-synaptic potential. The methods used in the present study provide a useful means of quantifying the effects of motoneuron excitability in detail.

Effects of large excitatory and inhibitory inputs on motoneuron discharge rate and probability

We elicited repetitive discharge in hypoglossal motoneurons recorded in slices of rat brain stem using a combination of a suprathreshold injected current step with superimposed noise to mimic the synaptic drive likely to occur during physiological activation. The effects of repetitive en mass stimulation of afferent nerves were simulated by the further addition of trains of injected current transients of varying shapes and sizes. The effects of a given current transient on motoneuron discharge timing and discharge rate were measured by calculating a peristimulus time histogram (PSTH) and a peristimulus frequencygram (PSF). The amplitude and time course of the simulated postsynaptic potentials (PSPs) produced by the current transients were calculated by convolving the current transient with an estimate of the passive impulse response of the motoneuron. We then compared the shape of the injected current transient and the simulated PSP to the profiles of the PSTH and the PSF records. The PSTHs produced by excitatory PSPs (EPSPs) were characterized by a large, short-latency increase in firing probability that lasted slightly longer than the rising phase of the EPSP, followed by a reduced discharge probability during the falling phase of the EPSP. In contrast, the PSF analysis revealed a proportionate increase in discharge rate over the entire profile of the EPSP, even though relatively few spikes occurred during the falling phase. The PSTHs associated with inhibitory PSPs (IPSPs) indicated a reduction in discharge probability during the initial, hyperpolarizing phase of the IPSP, followed by an increase in the discharge probability during its subsequent repolarizing phase. Using the PSF analysis, the initial phase of the IPSP appeared as a large hole in the record where a very small number or no discharges occurred. The subsequent phase of the IPSP was associated with frequency values that were lower than the background values. The primary features of both PSTHs and PSFs can be used to estimate the relative amplitudes of the underlying EPSPs and IPSPs. However, PSTHs contain secondary peaks and troughs that are not directly related to the underlying PSP but instead reflect the regular recurrence of spikes following those affected by the PSP. The PSF analysis is more useful for indicating the total duration and the profile of the underlying PSP. The shape of the underlying PSP can be obtained directly from the PSF records because the discharge frequency of the spikes follow the PSPs very closely, especially for EPSPs.

Jaw reflexes evoked by mechanical stimulation of teeth in humans

Jaw reflexes evoked by mechanical stimulation of teeth in humans. The reflex response of jaw muscles to mechanical stimulation of an upper incisor tooth was investigated using the surface electromyogram (SEMG) of the masseter muscle and the bite force. With a slowly rising stimulus, the reflex response obtained on the masseter SEMG showed three different patterns of reflex responses; sole excitation, sole inhibition, and inhibition followed by excitation. Simultaneously recorded bite force, however, exhibited mainly one reflex response pattern, a decrease followed by an increase in the net closing force. A rapidly rising stimulus also induced several different patterns of reflex responses in the masseter SEMG. When the simultaneously recorded bite force was analyzed, however, there was only one reflex response pattern, a decrease in the net closing force. Therefore, the reflex change in the masseter muscle is not a good representative of the net reflex response of all jaw muscles to mechanical tooth stimulation. The net response is best expressed by the averaged bite force. The averaged bite force records showed that when the stimulus force was developing rapidly, the periodontal reflex could reduce the bite force and hence protect the teeth and supporting tissues from damaging forces. It also can increase the bite force; this might help keep food between the teeth if the change in force rate is slow, especially when the initial bite force is low.

Conditioning of the masseter inhibitory reflex by homotopically applied painful heat in humans

During contraction of the jaw-closing muscles, afferent input from the intraoral and perioral region can elicit two bilateral suppression periods (SP1 and SP2, respectively) in the masseter electromyogram (EMG). Non-painful electrical stimulation 2 cm from the left labial commissure was used in the present study to evoke these trigeminal inhibitory reflexes. The subjects maintained a level of 50% of their maximum masseter EMG. The degree of suppression was quantified as the percentage suppression of the mean EMG activity in a fixed post-stimulus interval (SP2, 40-90 ms). Further, brief (200 ms) painful radiant heat conditioning stimuli were delivered to the ipsilateral cheek, in order to investigate the influence of nociceptive input on the (non-nociceptive) trigeminal masseter inhibitory reflex. Nine different conditions combining radiant heat and electrical stimuli were used. Twelve stimuli were presented for each condition. The radiant heat preceded the electrical test stimuli by fixed inter-stimulus intervals (ISI), ranging from 100 ms to 500 ms. At 250-350 ms ISIs, the bilateral SP2 suppression was significantly reduced to less than 10%, in comparison to an average suppression degree of 32.5% without conditioning stimuli. The subjects perceived the heat stimulus before the electrical stimulus for a majority of the 12 pairs of stimuli at these ISIs. No differences were found in the VAS ratings for the different conditions. For the contralateral SP1, larger suppression was seen for the 300 ms ISI compared with stimulation without conditioning heat stimuli. Onset and offset for the SP1 was, however, only detected in three subjects using a criteria of 20% suppression of the pre-stimulus activity. A pre-pulse inhibitory effect onto inter-neurons in the SP2 pathways or habituation of the same inter-neurons by the heat stimuli are suggested as possible explanations for the interaction between the non-nociceptive and nociceptive input in the present study.

Evocation of either excitatory or inhibitory reflex responses in human masseter muscle by electrical stimulation of the lip at varying intensities

Electrical stimuli at 1 Hz with pulse widths of 0.05, 0.1 and 1 ms with intensities from two to six times sensory threshold (2-6 T) were delivered to the lower lip. The reflex responses were monitored by surface electromyography of the ipsilateral masseter muscle. An excitatory response that was not preceded or followed by an inhibition could be evoked in seven out of ten subjects at intensities below 5 T at all pulse widths. A higher stimulus intensities, the excitation disappeared and/or was preceded by as short-latency inhibition (SLI) or a long-latency inhibition (LLI). The electrical threshold for the excitatory response was statistically lower than the SLI and LLI, especially when longer pulse widths wee used. Three subjects demonstrated a primarily excitatory response, whereas four had a more pronounced inhibitory response. It was concluded that separate populations of myelinated fibres may be responsible for the responses: the lowest-threshold fibres may elicit excitatory responses and fibres with higher thresholds may evoke inhibitory responses. Another possible explanation is that central spatial summation could be responsible for the opening of the inhibitory and excitatory central pathways. The excitatory response may be the result of a reflex pathway similar to that evoked by activation of periodontal mechanoreceptors, and could be responsible for the load compensation mechanisms during chewing and/or positioning of food. The inhibitory responses are well known, and are considered to be a protective reflex.

Motor-unit firing frequency can be used for the estimation of synaptic potentials in human motoneurones

This paper describes a new method that uses the frequency of firing of motor units to estimate the stimulus-induced net post-synaptic potential (PSP) and the synaptic noise in the membrane of voluntarily active human motoneurons. Unlike the peri-stimulus time histogram (PSTH) which is the most commonly used method for assessing stimulus-induced synaptic potentials in human motoneurones, this new approach overcomes contamination of the results caused by the synchronizing effect of the stimulus on the firing pattern of the motor units. However, even after overcoming the contamination by synchronized firing, the new method does not directly represent the true net synaptic potential in the motoneurone membrane. Therefore, a new term estimated net synaptic potential (ENSP) has been introduced. This term highlights the fact that the stimulus-induced net synaptic potential has been determined indirectly and that the size and the shape of this synaptic potential may depend on the level of activity of the recording medium (i.e., pre-stimulus firing frequency of the motor unit). This paper also puts forward a normalization procedure that allows the value of the ENSP and the amplitude of the synaptic noise to be read from the ENSP graph. The normalization procedure, therefore, allows comparisons of those values within and between subjects.

Simple reaction-time responses to mechanical and electrical stimuli in human masseter muscle

The latencies of the simple reaction-time responses for opening and closing of the jaws in response to taps and pushes on teeth and lip shocks were measured in human adults. The reaction times were scored from both the integrated electromyographic (EMG) signal in individual trials, and from the cumulative sum (CUSUM) of the averaged EMG response to 50 stimuli. The mean reaction times for both closing and opening were about 80-90 ms for taps and electrical lip shocks, and about 140 ms for push, measured from the CUSUMs. The reaction times in individual trials were difficult to measure from the EMG signal because of the unsteady baseline. In contrast, the reaction times measured from the CUSUMs were clearly defined by the point at which the record began to move sharply above or below the baseline. However, because of the delays inherent in the CUSUM procedure, they were systematically longer than the means of the trial-by-trial measurements.

Quantitative analysis of reflex responses in the averaged surface electromyogram

The relationship between the averaged surface electromyogram (EMG) and the activity of motoneurones in reflex studies is analysed mathematically. This analysis reveals that, subject to certain conditions being met, the integral of the average of the unrectified EMG is linearly related to the activity of motor units in the muscle. This was tested with experimental data. The activity of 2 motor units, and the surface EMG, were recorded directly in a reflex paradigm. A close match was found between the integral of the average of the unrectified EMG and the summed peristimulus time histograms (PSTHs) of the units' activity. This analysis gives more quantitative measurements of the timing of motoneuronal activity in reflexes than the conventional analysis of the EMG. It also offers the potential for making quantitative measurements of changes in motor unit activity evoked by different stimuli. This analysis avoids the pitfall of the artefactual peaks that can occur in the average of the rectified EMG as a consequence of the full-wave rectification. It is concluded that the integral of the unrectified average offers a valuable adjunct to the conventional analysis in many reflex studies. The analysis can also be applied to quantitative studies of neurograms.

Force-related changes in the masseter muscle reflex response to tooth-taps in man

In 14 subjects with no disorder of the masticatory apparatus, excitatory and inhibitory reflex responses in the masseter muscles were derived by standardized mechanical stimulation of the upper central incisor. A series of eight taps was delivered during isometric contraction at 40% of maximum EMG activity, with tapping forces ranging from 0.25-9 N. The mean post-stimulus masseteric EMG complex (PSEC) consisted of up to three inhibitory (I-1, I-2 and I-3) and three excitatory phases. The first inhibitory wave increased in duration with increasing tapping force, and the second and third inhibitory waves occurred at higher thresholds than the first inhibitory wave.

Silent periods in dysfunction patients: a preliminary study using a novel approach

Strong peri-oral stimulation is known to elicit a transient inhibition in the activity of the jaw-closing muscles. Several reports have claimed that this 'silent period' (SP) is prolonged in patients with temporomandibular joint dysfunction syndromes. In the present preliminary study, the biphasic SP evoked by electrical lip stimulation was tested in single motor units in the masseter muscles of dysfunction patients. In comparison with normal subjects, the pattern of the SP was different in the patients in that the shorter-latency phase predominated over the later phase, whereas the converse is true for normals.

Comments on standardization of reflex measurements in human masseter muscle, including silent periods

The following comments are given on the guidelines suggested by Türker (1988) for studies on oral reflexes using the surface EMG of the masseter muscles in man, including the silent period. (i) Attention should not be confined to electrical stimulation since mechanoreceptors in the periodontium, especially in the periodontal ligament, can only be activated by mechanical stimulation of a tooth. Furthermore, different modes of stimulation and stimulation sites do not yield equivalent reflex complexes. Weak and transient mechanical stimulation of a tooth while clenching at a low level of 5 or 10% MVC is a selective model (89%) to study the influence of periodontal receptors. (ii) Statistical criteria should be applied on rectified and averaged EMG records to prevent any subjective bias in the measurements of reflex variables. Whether a period of increased EMG activity is due to clustering of action potentials of motor units firing of which was delayed by a preceding inhibition, or to a real excitatory influence, can be assessed by applying statistical criteria on averaged and subsequently rectified records. (iii) The clenching level should be less than 25% of MVC to avoid muscle fatigue, and to elicit pronounced reflexes with a weak and therefore more selective stimulus. (iv) The stimulus intensity should be much less than six times the threshold if selectivity for mechanoreceptors is desired. Furthermore, periods of increased activity in surface EMG resulting from a weak stimulus are probably due to real excitatory influences and not to clustering of motor unit action potentials after an inhibition. (v) Jaw separation and the use of a force transducer are not always advantageous. If mechanical stimulation is applied to a tooth, clenching in full habitual occlusion causes a complete suppression of the influence of muscle spindles. A shift in activity between the various elevator muscles, and hence a change in activity of the muscle studied, may occur during an experimental session if biting force is used as a feedback. Such a shift is not relevant if feedback is carried out on rectified and low-pass filtered (1.6 Hz) EMG of the muscle studied.

The silent period duration of the masticatory muscles

This study was conducted to determine whether the reflex activity of the masticatory muscles is altered in prostheses wearers. The electromyographic silent period was measured on an oscilloscope screen. Thirty subjects were examined. Five subjects had natural dentitions. Twenty-five partially edentulous subjects wore removable prostheses. The silent period duration reached 18 to 21 ms on the masseter muscles and 20 to 22 ms on the temporal muscles. These values were not significantly different for subjects with and without teeth and in the control group. The duration of the silent period was the same for patients wearing prostheses and for subjects with natural teeth. This finding suggests that wearing a prosthesis does not change the normal activity of the masticatory muscles.

Modulation of an inhibitory reflex in single motor units in human masseter at different joint angles

The inhibitory reflex evoked in single units in human masseter by lip stimulation was recorded at several joint angles. The pre-stimulus firing frequency of the unit was kept constant. Some modulation of the inhibitory response at different vertical jaw positions (i.e. temporomandibular joint angle) was observed in most masseter units, with the majority of the modulated units being inhibited less when the teeth were closer together.

A comparison of the masseteric silent period in temporomandibular joint dysfunction and normal human subjects by surface electromyography and single motor-unit recordings

Single electric stimuli were delivered to the lower lip and the reflex effects were monitored in the ipsilateral masseter. Two strengths of stimulus were delivered at two levels of background excitation (defined in terms of the firing frequency of a single motor unit). Although the threshold stimulus intensity required to produce a silent period in the single motor units was the same for the patients with temporomandibular joint dysfunction and normal subjects, there were qualitative differences in the pattern of reflex responses between the two groups. Of the two phases of inhibition elicited by the stimulus, the short-latency inhibitory period was the more prominent and more resistant to changes in the background excitation levels in the dysfunction group. In normal subjects, however this was true of the long-latency inhibition. This difference may be due to the changes in the inputs to one or more of the interneurones linking the afferent limb of the reflex to the masseteric motoneurones.

Surface electromyography, force and single motor-unit data for inhibitory reflex responses in human masseter at two levels of excitatory drive

The inhibitory reflex response evoked by mildly noxious lip stimulation was tested in up to 100 trials at two different levels of pre-stimulus excitation. To regulate that excitation, the subject voluntarily controlled the firing rate of one motor neurone at 10 Hz, and then at 15 Hz while the reflex was tested. When the frequency of the motor-unit action potential (MUAP) in the controlled unit increased or decreased, the frequency of other active units' MUAPs also changed in parallel: that is, the frequency of one MUAP was an index of whole muscle excitation. The inhibitory response in the surface electromyogram (EMG) was quantitated by rectifying and averaging the signal, and by measuring its depth and area. The best correlation between the responses evoked in single units and the response in the whole muscle EMG at the two levels of excitation was obtained when the area of inhibition in the surface record was normalized to the pre-stimulus EMG level. The inhibitory response to lip stimulation in the masseter EMG decreased when the level of pre-stimulus excitation in the muscle was increased. This was confirmed using the reflex response in the averaged force data. The findings suggest that controlling one motor unit's firing rate is a useful method for controlling the whole-muscle excitation in quantitative reflex studies.

Quantitative observations on maximum static work efforts and associated pain of the human masseter muscle

The single case experimental design was used to study day-to-day variations in the onset (PL), tolerance (PT), and intensity (VAS) of masseter muscle pain. Pain was induced by maximum voluntary teeth clenching, with no artificial feedback-control of the level of isometric activity, and static work efforts were quantified by cumulative electromyography. A continual effort to produce maximum static work, about 40% increase from baseline work, elicited in 30-40 s an initial sensation of muscular pain that had an intensity of about 25% of maximum possible score. A further increase in maximum static work effort, about 60% increase from baseline work, caused in about 2 min an intolerable increase in the intensity of muscular pain, about 50% of maximum possible score. Whereas PL showed day-to-day variation, PT and the ratio PL:PT did not. Intensity (VAS) scores and maximum static work efforts showed no day-to-day variations. Onset (PL) and tolerance (PT) showed no linear associations with VAS scores, and VAS scores showed no linear associations with maximum static work efforts; if anything, the latter associations tended to resemble a cubic parabola. Two different central neural processes, not associated with maximum static work efforts in a simple linear manner, might have been instrumental in: (i) the establishment of criteria for onset and tolerance of pain, and (ii) the discrimination of variable levels of pain intensity.

The lip-clip: a simple, low-impedance ground electrode for use in human electrophysiology

A simple and effective ground electrode is described for use in human electrophysiological recordings. This electrode consists of a wire clip that holds a silver disc of 1 cm diameter which is clipped to the lower lip of the subject. It is found that this simple ground electrode reduced the background noise and/or stimulus artifact at least as effectively as other conventional grounding techniques.

A method for standardization of silent period measurements in human masseter muscle

The effect of bite force and stimulus intensity on the electrically induced SP has been studied. The results from the present study and earlier investigations suggest that the following guidelines should be used in future SP studies. (i) The electrical rather than mechanical way of stimulation should be preferred since the stimulus parameters and the receptors stimulated can easily be determined. (ii) The sensory perception threshold (T) of subjects should be used when studying and comparing the SP between individuals rather than the actual values of the electrical stimulation since the value of the sensory perception threshold varies from subject to subject. (iii) Rectified and averaged EMG records should be used rather than single raw traces since it is not possible to measure the duration of SPs from single traces. (iv) The subject should be asked to perform 25% of his/her MBF and the BF should be given as a feedback. (v) A stimulus intensity of about 6T should be used so that small changes in the BF would not affect the SPD. (vi) A jaw separation of about 10 mm should be selected in the subjects with normal overjet (2-3 mm), this being slightly thicker than the average isometric force transducer. The transducer can be brought to this thickness using acrylic resin. (vii) A head rest should be used to keep the head position constant (and hence constant jaw position with respect to the transducer) since the head position alone may change the reflexes elicited in the jaws region.