1
|
Monaco A, Cattaneo R, Di Nicolantonio S, Strada M, Altamura S, Ortu E. Central effects of trigeminal electrical stimulation. Cranio 2023:1-24. [PMID: 38032105 DOI: 10.1080/08869634.2023.2280153] [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: 12/01/2023]
Abstract
This is a review of the literature on the main neuromodulation techniques, focusing on the possibility of introducing sensory threshold ULFTENS into them. Electro neuromodulation techniques have been in use for many years as promising methods of therapy for cognitive and emotional disorders. One of the most widely used forms of stimulation for orofacial pain is transcutaneous trigeminal stimulation on three levels: supraorbital area, dorsal surface of the tongue, and anterior skin area of the tragus. The purpose of this review is to trigger interest on using dental ULFTENS as an additional trigeminal neurostimulation and neuromodulation technique in the context of TMD. In particular, we point out the possibility of using ULFTENS at a lower activation level than that required to trigger a muscle contraction that is capable of triggering effects at the level of the autonomic nervous system, with extreme ease of execution and few side effects.
Collapse
Affiliation(s)
- Annalisa Monaco
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | - Ruggero Cattaneo
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | | | - Marco Strada
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | - Serena Altamura
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| | - Eleonora Ortu
- MeSVA Department, Dental Unit, University of L'Aquila, L'Aquila, Italy
| |
Collapse
|
2
|
Tramonti Fantozzi MP, De Cicco V, d’Ascanio P, Cataldo E, De Cicco D, Bruschini L, Barresi M, Faraguna U, Manzoni D. Trigeminal Stimulation and Visuospatial Performance: The Struggle between Chewing and Trigeminal Asymmetries. Biomedicines 2023; 11:2307. [PMID: 37626803 PMCID: PMC10452603 DOI: 10.3390/biomedicines11082307] [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: 07/08/2023] [Revised: 07/31/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023] Open
Abstract
Chewing improves visuospatial performance through locus coeruleus (LC) activation. The effects of bilateral and unilateral mastication were investigated in subjects showing different degrees of asymmetry in masseter electromyographic (EMG) activity during clenching and in pupil size at rest (anisocoria), which is a proxy of LC imbalance. Correlations between performance changes and asymmetry values were found in males, but not in females. Among males, subjects with low asymmetry values (balanced-BAL) were more sensitive than those with high asymmetry values (imbalanced-IMB) to bilateral and unilateral chewing on the side with higher EMG activity (hypertonic). The opposite was true for hypotonic side chewing. BAL subjects were sensitive to unilateral chewing on both sides, while in IMB subjects, hypertonic side chewing did not influence performance in either males or females. Bilateral chewing elicited larger effects in BAL subjects than in IMB subjects, exceeding the values predicted from unilateral chewing in both groups. Finally, pupil size and anisocoria changes elicited by chewing were correlated with asymmetry values, independent of sex. Data confirmed the facilitation of visuospatial performance exerted by chewing. Trigeminal asymmetries modulate the chewing effects, making occlusal rebalancing an appropriate strategy to improve performance.
Collapse
Affiliation(s)
- Maria Paola Tramonti Fantozzi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56123 Pisa, Italy
| | - Vincenzo De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56123 Pisa, Italy
| | - Paola d’Ascanio
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56123 Pisa, Italy
| | - Enrico Cataldo
- Department of Physics, University of Pisa, 56127 Pisa, Italy
| | - Davide De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56123 Pisa, Italy
| | - Luca Bruschini
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56124 Pisa, Italy
| | - Massimo Barresi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56123 Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56123 Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, 56128 Pisa, Italy
| | - Diego Manzoni
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56123 Pisa, Italy
| |
Collapse
|
3
|
Tramonti Fantozzi MP, De Cicco V, De Cicco D, d'Ascanio P, Cataldo E, Bruschini L, Faraguna U, Manzoni D. Chewing and Cognitive Improvement: The Side Matters. Front Syst Neurosci 2022; 15:749444. [PMID: 35002642 PMCID: PMC8734061 DOI: 10.3389/fnsys.2021.749444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/24/2021] [Indexed: 11/13/2022] Open
Abstract
Chewing improves cognitive performance, which is impaired in subjects showing an asymmetry in electromyographic (EMG) masseter activity during clenching. In these subjects, the simultaneous presence of an asymmetry in pupil size (anisocoria) at rest indicates an imbalance in Ascending Reticular Activating System (ARAS) influencing arousal and pupil size. The aim of the present study was to verify whether a trigeminal EMG asymmetry may bias the stimulating effect of chewing on cognition. Cognitive performance and pupil size at rest were recorded before and after 1 min of unilateral chewing in 20 subjects with anisocoria, showing an EMG asymmetry during clenching. Unilateral chewing stimulated performance mainly when it occurred on the side of lower EMG activity (and smaller pupil size). Following chewing on the hypotonic side, changes in cognitive performance were negatively and positively correlated with those in anisocoria and pupil size, respectively. We propose that, following chewing on the hypotonic side, the arousing effects of trigeminal stimulation on performance are enhanced by a rebalancing of ARAS structures. At variance, following chewing on the hypertonic side, the arousing effect of trigeminal stimulation could be partially or completely prevented by the simultaneous increase in ARAS imbalance.
Collapse
Affiliation(s)
| | - Vincenzo De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Davide De Cicco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Paola d'Ascanio
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | | | - Luca Bruschini
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.,Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Diego Manzoni
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| |
Collapse
|
4
|
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
|
5
|
De Cicco D, Tartaro G, Ciardiello F, Fasano M, Rauso R, Fiore F, Spuntarelli C, Troiano A, Lo Giudice G, Colella G. Health-Related Quality of Life in Oral Cancer Patients: Scoping Review and Critical Appraisal of Investigated Determinants. Cancers (Basel) 2021; 13:cancers13174398. [PMID: 34503208 PMCID: PMC8431462 DOI: 10.3390/cancers13174398] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 12/27/2022] Open
Abstract
Simple Summary Oral cancer may strongly impair patients’ quality of life. Huge efforts have been made during recent decades in trying to improve the treatment outcomes in terms of patients’ survival, self-perception, and satisfaction. Consequently, the investigation into health-related quality of life (HRQOL) became an established and worldwide practice. Hundreds of studies tried to clarify which could be the most important variables that impact HRQOL in head and neck cancer patients. However, such a complex topic may be influenced by a multitude of interconnected aspects and several controversies were reported. In this study the current literature was reviewed to identify all those possible sources of bias that may be encountered in trying to correlate HRQOL to patient-specific or disease/treatment-specific aspects. As a result, a list of recommendations was reported to enhance the evidence of future studies. Abstract Background: health-related quality of life (HRQOL) represents a secondary endpoint of medical interventions in oncological patients. Our aim was to highlight potential sources of bias that could be encountered when evaluating HRQOL in oral cancer patients. Methods: this review followed PRISMA-ScR recommendations. Participants: patients treated for oral cancer. Concept: HRQOL assessed by EORTC QLQ-C30 and QLQ-H&N35/QLQ-H&N43. A critical appraisal of included studies was performed to evaluate the accuracy of data stratification with respect to HRQOL determinants. Results: overall, 30 studies met the inclusion criteria, totaling 1833 patients. In total, 8 sociodemographic (SDG) and 15 disease/treatment-specific (DT) HRQOL determinants (independent variables) were identified. The mean number of the independent variables was 6.1 (SD, 4.3)—5.0 (SD, 4.0) DT-related and 1.1 (SD, 1.8) SDG-related variables per article. None of the included papers considered all the identified determinants simultaneously. Conclusions: a substantial lack of evidence regarding HRQOL determinants was demonstrated. This strongly weakens the reliability of the reported findings due to the challenging presence of baseline confounding, selection, and omitted variable biases. The proposed approach recommends the use of further evaluation tools that gather more variables in a single score together with a selection of more homogeneous, reproducible, and comparable cohorts based on the identified baseline confounding.
Collapse
Affiliation(s)
- Davide De Cicco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
| | - Gianpaolo Tartaro
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (R.R.); (G.C.)
| | - Fortunato Ciardiello
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.C.); (M.F.)
| | - Morena Fasano
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (F.C.); (M.F.)
| | - Raffaele Rauso
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (R.R.); (G.C.)
| | - Francesca Fiore
- Department of Internal and Polyspecialist Medicine, A.O.U. “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Chiara Spuntarelli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
| | - Antonio Troiano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
- Correspondence:
| | - Giorgio Lo Giudice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Naples, Italy; (D.D.C.); (C.S.); (G.L.G.)
| | - Giuseppe Colella
- Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.T.); (R.R.); (G.C.)
| |
Collapse
|
6
|
Lanatà A, Greco A, Ciardelli M, Uvelli A, Fratini E, Manzoni D, Scilingo EP, Santarcangelo EL, Sebastiani L. Linear and non linear measures of pupil size as a function of hypnotizability. Sci Rep 2021; 11:5196. [PMID: 33664358 PMCID: PMC7970859 DOI: 10.1038/s41598-021-84756-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/19/2021] [Indexed: 02/01/2023] Open
Abstract
Higher arousal and cortical excitability have been observed in high hypnotizable individuals (highs) with respect to low hypnotizables (lows), which may be due to differences in the activation of ascending activating systems. The present study investigated the possible hypnotizability-related difference in the cortical noradrenergic tone sustained by the activity of the Locus Coeruleus which is strongly related to pupil size. This was measured during relaxation in three groups of participants—highs (N = 15), lows (N = 15) and medium hypnotizable individuals (mediums, N = 11)—in the time and frequency domains and through the Recurrence Quantification Analysis. ECG and Skin Conductace (SC) were monitored to extract autonomic indices of relaxation (heart interbeats intervals, parasympathetic component of heart rate variability (RMSSD) and tonic SC (MeanTonicSC). Most variables indicated that participants relaxed throughout the session. Pupil features did not show significant differences between highs, mediums and lows, except for the spectral Band Median Frequency which was higher in mediums than in lows and highs at the beginning, but not at the end of the session.Thus, the present findings of pupil size cannot account for the differences in arousal and motor cortex excitability observed between highs and lows in resting conditions.
Collapse
Affiliation(s)
- Antonio Lanatà
- Department of Information Engineering, University of Florence, Florence, Italy
| | - Alberto Greco
- Research Center "E. Piaggio", University of Pisa, Pisa, Italy
| | - Mirco Ciardelli
- Research Center "E. Piaggio", University of Pisa, Pisa, Italy
| | - Allison Uvelli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno, 31, 56127, Pisa, Italy
| | | | - Diego Manzoni
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno, 31, 56127, Pisa, Italy
| | - Enzo P Scilingo
- Research Center "E. Piaggio", University of Pisa, Pisa, Italy.,Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Enrica L Santarcangelo
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno, 31, 56127, Pisa, Italy.
| | - Laura Sebastiani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via San Zeno, 31, 56127, Pisa, Italy
| |
Collapse
|
7
|
Tramonti Fantozzi MP, Lazzarini G, De Cicco V, Briganti A, Argento S, De Cicco D, Barresi M, Cataldo E, Bruschini L, d'Ascanio P, Pirone A, Lenzi C, Vannozzi I, Miragliotta V, Faraguna U, Manzoni D. The path from trigeminal asymmetry to cognitive impairment: a behavioral and molecular study. Sci Rep 2021; 11:4744. [PMID: 33637775 PMCID: PMC7910455 DOI: 10.1038/s41598-021-82265-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 01/15/2021] [Indexed: 01/02/2023] Open
Abstract
Trigeminal input exerts acute and chronic effects on the brain, modulating cognitive functions. Here, new data from humans and animals suggest that these effects are caused by trigeminal influences on the Locus Coeruleus (LC). In humans subjects clenching with masseter asymmetric activity, occlusal correction improved cognition, alongside with reductions in pupil size and anisocoria, proxies of LC activity and asymmetry, respectively. Notably, reductions in pupil size at rest on the hypertonic side predicted cognitive improvements. In adult rats, a distal unilateral section of the trigeminal mandibular branch reduced, on the contralateral side, the expression of c-Fos (brainstem) and BDNF (brainstem, hippocampus, frontal cortex). This counterintuitive finding can be explained by the following model: teeth contact perception loss on the lesioned side results in an increased occlusal effort, which enhances afferent inputs from muscle spindles and posterior periodontal receptors, spared by the distal lesion. Such effort leads to a reduced engagement of the intact side, with a corresponding reduction in the afferent inputs to the LC and in c-Fos and BDNF gene expression. In conclusion, acute effects of malocclusion on performance seem mediated by the LC, which could also contribute to the chronic trophic dysfunction induced by loss of trigeminal input.
Collapse
Affiliation(s)
- Maria Paola Tramonti Fantozzi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
| | - Giulia Lazzarini
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Vincenzo De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
| | - Angela Briganti
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Serena Argento
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
| | - Davide De Cicco
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Massimo Barresi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
| | | | - Luca Bruschini
- Department of Surgical, Medical, Molecular Pathology and CriticalCare Medicine, University of Pisa, Pisa, Italy
| | - Paola d'Ascanio
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
| | - Andrea Pirone
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Carla Lenzi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Iacopo Vannozzi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | | | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Diego Manzoni
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Via San Zeno 31, 56127, Pisa, Italy.
| |
Collapse
|
8
|
Tramonti Fantozzi MP, Artoni F, Di Galante M, Briscese L, De Cicco V, Bruschini L, d'Ascanio P, Manzoni D, Faraguna U, Carboncini MC. Effect of the Trigeminal Nerve Stimulation on Auditory Event-Related Potentials. Cereb Cortex Commun 2021; 2:tgab012. [PMID: 34296158 PMCID: PMC8153017 DOI: 10.1093/texcom/tgab012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 11/25/2022] Open
Abstract
Trigeminal sensorimotor activity stimulates arousal and cognitive performance, likely through activation of the locus coeruleus (LC). In this study we investigated, in normal subjects, the effects of bilateral trigeminal nerve stimulation (TNS) on the LC-dependent P300 wave, elicited by an acoustic oddball paradigm. Pupil size, a proxy of LC activity, and electroencephalographic power changes were also investigated. Before TNS/sham-TNS, pupil size did not correlate with P300 amplitude across subjects. After TNS but not sham-TNS, a positive correlation emerged between P300 amplitude and pupil size within frontal and median cortical regions. TNS also reduced P300 amplitude in several cortical areas. In both groups, before and after TNS/sham-TNS, subjects correctly indicated all the target stimuli. We propose that TNS activates LC, increasing the cortical norepinephrine release and the dependence of the P300 upon basal LC activity. Enhancing the signal-to-noise ratio of cortical neurons, norepinephrine may improve the sensory processing, allowing the subject to reach the best discriminative performance with a lower level of neural activation (i.e., a lower P300 amplitude). The study suggests that TNS could be used for improving cognitive performance in patients affected by cognitive disorders or arousal dysfunctions.
Collapse
Affiliation(s)
- Maria Paola Tramonti Fantozzi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Fiorenzo Artoni
- Bertarelli Foundation Chair in Translational Neuroengineering, Center for Neuroprosthetics, Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne, Genève 1202, Switzerland
| | | | - Lucia Briscese
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Vincenzo De Cicco
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Luca Bruschini
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa 56123, Italy
| | - Paola d'Ascanio
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Diego Manzoni
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| | - Maria Chiara Carboncini
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa 56123, Italy
| |
Collapse
|
9
|
Trigeminal input, pupil size and cognitive performance: From oral to brain matter. Brain Res 2020; 1751:147194. [PMID: 33159973 DOI: 10.1016/j.brainres.2020.147194] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/14/2020] [Accepted: 10/30/2020] [Indexed: 12/19/2022]
Abstract
It has been observed that, in patients affected by temporomandibular disorders (TMDs) and edentulism, a left-right asymmetry in electromyographic (EMG) activity of masseter muscles during clenching and in pupil size at rest (anisocoria) is present. Both are greatly reduced by an orthotic-prosthetic correction. In parallel, the correction significantly improves cognitive performance. These effects are possibly due to the recovery of a cortical balance, via Locus Coeruleus (LC) modulation, whose activity is powerfully affected by the sensorimotor trigeminal input. The role of this functional axis was further investigated in subjects without overt occlusal or dental problems. In these individuals, the EMG asymmetry was significantly correlated to anisocoria at rest, with the dental arches open or in contact. Also in normal subjects, both the EMG and the pupil asymmetry during clenching could be significantly reduced by an orthotic (bite) correction. Closing the arches without bite increased anisocoria and reduced performance in the Spinnler-Tognoni matrices test, as well as the mydriasis induced by a haptic task. When the bite was interposed, anisocoria was reduced, while both performance and task-related mydriasis were enhanced. Since pupil size is considered a proxy of the LC activity, these results suggest that asymmetric occlusion biases the LC discharge and the hemispheric excitability, possibly via a sensorimotor trigeminal imbalance. Removing the anisocoria through bite correction re-establishes a symmetric LC discharge, improving performance and enhancing task-related mydriasis. Therefore, occlusal balancing may represent a tool for improving subjective performance and may be exploited for training and rehabilitative purposes.
Collapse
|
10
|
Standard Correction of Vision Worsens EMG Activity of Pericranial Muscles in Chronic TMD Subjects. Pain Res Manag 2020; 2020:3932476. [PMID: 32351638 PMCID: PMC7178530 DOI: 10.1155/2020/3932476] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/15/2020] [Accepted: 02/17/2020] [Indexed: 12/16/2022]
Abstract
Recent studies showed an evident correlation between the stomatognathic system and the visual system. These results suggest that subjects who are affected by both temporomandibular (TMD) disorders and refractive disorders present with altered control of pericranial musculature tone and higher open-eye electromyographic (EMG) values. The objective of this work was to evaluate the effects of standard vision correction on EMG in subjects suffering from TMD compared with application of the same vision treatments to non-TMD subjects. 40 subjects were enrolled in this study. The test group included 20 myopic subjects and also included patients with TMD. The control group included 20 healthy myopic subjects. All of the participants underwent a complete ocular examination and a sEMG analysis. The results showed that TMD subjects with vision disorders that are corrected with standard glasses present EMG values that are significantly higher than those presented by non-TMD subjects with vision disorders and standard glasses. Infact, in TMD subjects, eye correction did not have a positive effect on the stomatognathic or pericranial musculature.
Collapse
|
11
|
De Cicco V, Tramonti Fantozzi MP, Cataldo E, Barresi M, Bruschini L, Faraguna U, Manzoni D. Trigeminal, Visceral and Vestibular Inputs May Improve Cognitive Functions by Acting through the Locus Coeruleus and the Ascending Reticular Activating System: A New Hypothesis. Front Neuroanat 2018; 11:130. [PMID: 29358907 PMCID: PMC5766640 DOI: 10.3389/fnana.2017.00130] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 12/15/2017] [Indexed: 12/25/2022] Open
Abstract
It is known that sensory signals sustain the background discharge of the ascending reticular activating system (ARAS) which includes the noradrenergic locus coeruleus (LC) neurons and controls the level of attention and alertness. Moreover, LC neurons influence brain metabolic activity, gene expression and brain inflammatory processes. As a consequence of the sensory control of ARAS/LC, stimulation of a sensory channel may potential influence neuronal activity and trophic state all over the brain, supporting cognitive functions and exerting a neuroprotective action. On the other hand, an imbalance of the same input on the two sides may lead to an asymmetric hemispheric excitability, leading to an impairment in cognitive functions. Among the inputs that may drive LC neurons and ARAS, those arising from the trigeminal region, from visceral organs and, possibly, from the vestibular system seem to be particularly relevant in regulating their activity. The trigeminal, visceral and vestibular control of ARAS/LC activity may explain why these input signals: (1) affect sensorimotor and cognitive functions which are not directly related to their specific informational content; and (2) are effective in relieving the symptoms of some brain pathologies, thus prompting peripheral activation of these input systems as a complementary approach for the treatment of cognitive impairments and neurodegenerative disorders.
Collapse
Affiliation(s)
- Vincenzo De Cicco
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Maria P Tramonti Fantozzi
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | | | - Massimo Barresi
- Institut des Maladie Neurodégénératives, University of Bordeaux, Bordeaux, France
| | - Luca Bruschini
- Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Ugo Faraguna
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy.,Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Diego Manzoni
- Laboratory of Sensorimotor Integration, Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| |
Collapse
|