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Zhu Y, Toyota R, Shiraishi Y, Katagiri A, Yamada M, Higashiyama M, Toyoda H, Lavigne G, Kato T. Sleep architecture as a candidate for phenotyping sleep bruxism: A narrative physiological review. J Oral Rehabil 2024; 51:87-102. [PMID: 37114936 DOI: 10.1111/joor.13482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/20/2023] [Accepted: 04/22/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Sleep bruxism (SB), an oral behaviour in otherwise healthy individuals, is characterised by frequent rhythmic masticatory muscle activity (RMMA) during sleep. RMMA/SB episodes occur over various sleep stages (N1-N3 and rapid eye movement (REM)), sleep cycles (non-REM to REM), and frequently with microarousals. It currently remains unclear whether these characteristics of sleep architecture are phenotype candidates for the genesis of RMMA/SB. OBJECTIVES This narrative review investigated the relationship between sleep architecture and the occurrence of RMMA as a SB phenotype candidate. METHODS PubMed research was performed using keywords related to RMMA/SB and sleep architecture. RESULTS In non-SB and SB healthy individuals, RMMA episodes were most frequent in the light non-REM sleep stages N1 and N2, particularly during the ascending phase of sleep cycles. The onset of RMMA/SB episodes in healthy individuals was preceded by a physiological arousal sequence of autonomic cardiovascular to cortical activation. It was not possible to extract a consistent sleep architecture pattern in the presence of sleep comorbidities. The lack of standardisation and variability between subject complexified the search for specific sleep architecture phenotype(s). CONCLUSION In otherwise healthy individuals, the genesis of RMMA/SB episodes is largely affected by oscillations in the sleep stage and cycle as well as the occurrence of microarousal. Furthermore, a specific sleep architecture pattern cannot be confirmed in the presence of sleep comorbidity. Further studies are needed to delineate sleep architecture phenotype candidate(s) that contribute to the more accurate diagnosis of SB and treatment approaches using standardised and innovative methodologies.
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Affiliation(s)
- Yiwen Zhu
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Risa Toyota
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University, Suita, Japan
| | - Yuki Shiraishi
- Department of Orthodontics and Dentofacial Orthopedics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Ayano Katagiri
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Masaharu Yamada
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
- Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Makoto Higashiyama
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Hiroki Toyoda
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Gilles Lavigne
- Faculte de medecine dentaire, Universite de Montreal, Montreal, Quebec, Canada
| | - Takafumi Kato
- Department of Oral Physiology, Osaka University Graduate School of Dentistry, Suita, Japan
- United Graduate School of Child Development, Osaka University, Suita, Japan
- Sleep Medicine Center, Osaka University Hospital, Suita, Japan
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Martinot JB, Le-Dong NN, Cuthbert V, Denison S, Gozal D, Lavigne G, Pépin JL. Artificial Intelligence Analysis of Mandibular Movements Enables Accurate Detection of Phasic Sleep Bruxism in OSA Patients: A Pilot Study. Nat Sci Sleep 2021; 13:1449-1459. [PMID: 34466045 PMCID: PMC8397703 DOI: 10.2147/nss.s320664] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/05/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Sleep bruxism (SBx) activity is classically identified by capturing masseter and/or temporalis masticatory muscles electromyographic activity (EMG-MMA) during in-laboratory polysomnography (PSG). We aimed to identify stereotypical mandibular jaw movements (MJM) in patients with SBx and to develop rhythmic masticatory muscles activities (RMMA) automatic detection using an artificial intelligence (AI) based approach. PATIENTS AND METHODS This was a prospective, observational study of 67 suspected obstructive sleep apnea (OSA) patients in whom PSG with masseter EMG was performed with simultaneous MJM recordings. The system used to collect MJM consisted of a small hardware device attached on the chin that communicates to a cloud-based infrastructure. An extreme gradient boosting (XGB) multiclass classifier was trained on 79,650 10-second epochs of MJM data from the 39 subjects with a history of SBx targeting 3 labels: RMMA episodes (n=1072), micro-arousals (n=1311), and MJM occurring at the breathing frequency (n=77,267). RESULTS Validated on unseen data from 28 patients, the model showed a very good epoch-by-epoch agreement (Kappa = 0.799) and balanced accuracy of 86.6% was found for the MJM events when using RMMA standards. The RMMA episodes were detected with a sensitivity of 84.3%. Class-wise receiver operating characteristic (ROC) curve analysis confirmed the well-balanced performance of the classifier for RMMA (ROC area under the curve: 0.98, 95% confidence interval [CI] 0.97-0.99). There was good agreement between the MJM analytic model and manual EMG signal scoring of RMMA (median bias -0.80 events/h, 95% CI -9.77 to 2.85). CONCLUSION SBx can be reliably identified, quantified, and characterized with MJM when subjected to automated analysis supported by AI technology.
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Affiliation(s)
- Jean-Benoit Martinot
- Sleep Laboratory, CHU Université Catholique de Louvain (UCL) Namur Site Sainte-Elisabeth, Namur, 5000, Belgium.,Institute of Experimental and Clinical Research, UCL Bruxelles Woluwe, Brussels, 1200, Belgium
| | | | - Valérie Cuthbert
- Sleep Laboratory, CHU Université Catholique de Louvain (UCL) Namur Site Sainte-Elisabeth, Namur, 5000, Belgium
| | | | - David Gozal
- Department of Child Health and Child Health Research Institute, University of Missouri, Columbia, MO, 65201, USA
| | - Gilles Lavigne
- Faculté de médecine dentaire, Université de Montréal, Montréal, Québec, H3C 3J7, Canada
| | - Jean-Louis Pépin
- HP2 Laboratory, Inserm U1042, University Grenoble Alpes, Grenoble, 38000, France
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Yamada K, Higashiyama M, Toyoda H, Masuda Y, Kogo M, Yoshida A, Kato T. Experimentally induced rhythmic jaw muscle activities during non‐rapid eye movement sleep in freely moving guinea pigs. J Sleep Res 2019; 28:e12823. [DOI: 10.1111/jsr.12823] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/15/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Ken‐ichi Yamada
- Department of Oral and Maxillofacial Surgery I Osaka University Graduate School of Dentistry Osaka Japan
| | - Makoto Higashiyama
- Department of Oral Physiology Osaka University Graduate School of Dentistry Osaka Japan
| | - Hiroki Toyoda
- Department of Oral Physiology Osaka University Graduate School of Dentistry Osaka Japan
| | - Yuji Masuda
- Department of Oral and Maxillofacial NeurobiologyGraduate School of Oral MedicineMatsumoto Dental University Shiojiri Japan
| | - Mikihiko Kogo
- Department of Oral and Maxillofacial Surgery I Osaka University Graduate School of Dentistry Osaka Japan
| | - Atsushi Yoshida
- Department of Oral Anatomy and Neurobiology Osaka University Graduate School of Dentistry Osaka Japan
| | - Takafumi Kato
- Department of Oral Physiology Osaka University Graduate School of Dentistry Osaka Japan
- Sleep Medicine Center Osaka University Hospital Osaka Japan
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Electrophysiological characterization of sleep/wake, activity and the response to caffeine in adult cynomolgus macaques. Neurobiol Sleep Circadian Rhythms 2018; 6:9-23. [PMID: 31236518 PMCID: PMC6586594 DOI: 10.1016/j.nbscr.2018.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/11/2018] [Accepted: 08/14/2018] [Indexed: 12/29/2022] Open
Abstract
Most preclinical sleep studies are conducted in nocturnal rodents that have fragmented sleep in comparison to humans who are primarily diurnal, typically with a consolidated sleep period. Consequently, we sought to define basal sleep characteristics, sleep/wake architecture and electroencephalographic (EEG) activity in a diurnal non-human primate (NHP) to evaluate the utility of this species for pharmacological manipulation of the sleep/wake cycle. Adult, 9–11 y.o. male cynomolgus macaques (n = 6) were implanted with telemetry transmitters to record EEG and electromyogram (EMG) activity and Acticals to assess locomotor activity under baseline conditions and following injections either with vehicle or the caffeine (CAF; 10 mg/kg, i.m.) prior to the 12 h dark phase. EEG/EMG recordings (12–36 h in duration) were analyzed for sleep/wake states and EEG spectral composition. Macaques exhibited a sleep state distribution and architecture similar to previous NHP and human sleep studies. Acute administration of CAF prior to light offset enhanced wakefulness nearly 4-fold during the dark phase with consequent reductions in both NREM and REM sleep, decreased slow wave activity during wakefulness, and increased higher EEG frequency activity during NREM sleep. Despite the large increase in wakefulness and profound reduction in sleep during the dark phase, no sleep rebound was observed during the 24 h light and dark phases following caffeine administration. Cynomolgus macaques show sleep characteristics, EEG spectral structure, and respond to CAF in a similar manner to humans. Consequently, monitoring EEG/EMG by telemetry in this species may be useful both for basic sleep/wake studies and for pre-clinical assessments of drug-induced effects on sleep/wake. Cynomolgus macaques show diurnal sleep/wake architecture similar to humans. Caffeine enhanced wakefulness with consequent reductions in both NREM and REM sleep. Caffeine decreased slow wave activity during wakefulness. Caffeine increased higher EEG frequency activity during NREM sleep. No sleep rebound was observed during the subsequent 24 h light and dark phases after CAF treatment.
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Key Words
- A1, Adenosine sub-type 1 receptor
- A2a, Adenosine sub-type 2 receptor
- CAF, Caffeine
- Caffeine
- Cynomolgus macaque
- EEG
- EEG, Electroencephalogram
- EMG, Electromyogram
- LMA, Locomotor activity
- N1, NREM Stage 1
- N2, NREM Stage 2
- N3, NREM Stage 3
- NHP, Non-human primate
- NREM
- NREM, Non-rapid eye movement
- REM
- REM, Rapid eye movement
- ROL, REM onset latency
- SEM, Standard error of mean
- SOL, Sleep onset latency
- Sleep
- TST, Total sleep time
- WASO, Wake after sleep onset
- i.m., Intramuscular
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Sasaki A, Hasegawa N, Adachi K, Sakagami H, Suda N. Orthodontic treatment-induced temporal alteration of jaw-opening reflex excitability. J Neurophysiol 2017; 118:2289-2295. [PMID: 28724785 DOI: 10.1152/jn.00379.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/05/2017] [Accepted: 07/13/2017] [Indexed: 11/22/2022] Open
Abstract
The impairment of orofacial motor function during orthodontic treatment needs to be addressed, because most orthodontic patients experience pain and motor excitability would be affected by pain. In the present study, the temporal alteration of the jaw-opening reflex excitability was investigated to determine if orthodontic treatment affects orofacial motor function. The excitability of jaw-opening reflex evoked by electrical stimulation on the gingiva and recorded bilaterally in the anterior digastric muscles was evaluated at 1 (D1), 3 (D3), and 7 days (D7) after orthodontic force application to the teeth of right side; morphological features (e.g., osteoclast genesis and tooth movement) were also evaluated. To clarify the underlying mechanism of orthodontic treatment-induced alteration of orofacial motor excitability, analgesics were administrated for 1 day. At D1 and D3, orthodontic treatment significantly decreased the threshold for inducing the jaw-opening reflex but significantly increased the threshold at D7. Other parameters of the jaw-opening reflex were also evaluated (e.g., latency, duration and area under the curve of anterior digastric muscles activity), and only the latency of the D1 group was significantly different from that of the other groups. Temporal alteration of the jaw-opening reflex excitability was significantly correlated with changes in morphological features. Aspirin (300 mg·kg-1·day-1) significantly increased the threshold for inducing the jaw-opening reflex, whereas a lower dose (75-150 mg·kg-1·day-1) of aspirin or acetaminophen (300 mg·kg-1·day-1) failed to alter the jaw-opening reflex excitability. These results suggest that an increase of the jaw-opening reflex excitability can be induced acutely by orthodontic treatment, possibly through the cyclooxygenase activation.NEW & NOTEWORTHY It is well known that motor function is affected by pain, but the effect of orthodontic treatment-related pain on the trigeminal motor excitability has not been fully understood. We found that, during orthodontic treatment, trigeminal motor excitability is acutely increased and then decreased in a week. Because alteration of trigeminal motor function can be evaluated quantitatively by jaw-opening reflex excitability, the present animal model may be useful to search for alternative approaches to attenuate orthodontic pain.
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Affiliation(s)
- Au Sasaki
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Sakado, Saitama, Japan
| | - Naoya Hasegawa
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Sakado, Saitama, Japan
| | - Kazunori Adachi
- Division of Pharmacology, Department of Diagnostics and Therapeutics Science, Meikai University School of Dentistry, Sakado, Saitama, Japan; and
| | - Hiroshi Sakagami
- Meikai University Research Institute of Odontology, Saitama, Japan
| | - Naoto Suda
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Sakado, Saitama, Japan
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Lavigne G, Sessle B. The Neurobiology of Orofacial Pain and Sleep and Their Interactions. J Dent Res 2016; 95:1109-16. [DOI: 10.1177/0022034516648264] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This article provides an overview of the neurobiology of orofacial pain as well as the neural processes underlying sleep, with a particular focus on the mechanisms that underlie pain and sleep interactions including sleep disorders. Acute pain is part of a hypervigilance system that alerts the individual to injury or potential injury of tissues. It can also disturb sleep. Disrupted sleep is often associated with chronic pain states, including those that occur in the orofacial region. The article presents many insights that have been gained in the last few decades into the peripheral and central mechanisms involved in orofacial pain and its modulation, as well as the circuits and processes in the central nervous system that underlie sleep. Although it has become clear that sleep is essential to preserve and maintain health, it has also been found that pain, particularly chronic pain, is commonly associated with disturbed sleep. In the presence of chronic pain, a circular relationship may prevail, with mutual deleterious influences causing an increase in pain and a disruption of sleep. This article also reviews findings that indicate that reducing orofacial pain and improving sleep need to be targeted together in the management of acute to chronic orofacial pain states in order to improve an orofacial pain patient’s quality of life, to prevent mood alterations or exacerbation of sleep disorder (e.g., insomnia, sleep-disordered breathing) that can negatively affect their pain, and to promote healing and optimize their health.
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Affiliation(s)
- G.J. Lavigne
- Faculties of Dental Medicine and Medicine, University of Montréal, Montréal, Québec, Canada
- Centre for Advanced Research in Sleep Medicine and Trauma Unit, Surgery Department, Hôpital du Sacré-Cœur de Montréal, Montréal, Québec, Canada
| | - B.J Sessle
- Faculties of Dentistry and Medicine, University of Toronto, Toronto, Ontario, Canada
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Motor cortex is functionally organized as a set of spatially distinct representations for complex movements. J Neurosci 2015; 34:13574-85. [PMID: 25297087 DOI: 10.1523/jneurosci.2500-14.2014] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
There is a long-standing debate regarding the functional organization of motor cortex. Intracortical microstimulation (ICMS) studies have provided two contrasting views depending on the duration of stimulation. In the rat, short-duration ICMS reveals two spatially distributed forelimb movement representations, the rostral forelimb area (RFA) and caudal forelimb area (CFA), eliciting identical movements. In contrast, long-duration ICMS reveals spatially distributed, complex, multijoint movement areas, with grasping found exclusively in the rostral area and reach-shaping movements of the arm located in the caudal area. To provide corroboration for which interpretation is correct, we selectively inactivated the RFA/grasp area during the performance of skilled forelimb behaviors using a reversible cortical cooling deactivation technique. A significant impairment of grasping in the single-pellet retrieval task and manipulations of pasta was observed during cooling deactivation of the RFA/grasp area, but not the CFA/arm area. Our results indicate a movement-based, rather than a muscle-based, functional organization of motor cortex, and provide evidence for a conserved homology of independent grasp and reach circuitry shared between primates and rats.
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Rachalski A, Authier S, Bassett L, Pouliot M, Tremblay G, Mongrain V. Sleep electroencephalographic characteristics of the Cynomolgus monkey measured by telemetry. J Sleep Res 2014; 23:619-627. [PMID: 25109588 DOI: 10.1111/jsr.12189] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 05/24/2014] [Indexed: 12/24/2022]
Abstract
Cynomolgus monkeys are widely used as models of diseases and in pre-clinical studies to assess the impact of new pharmacotherapies on brain function and behaviour. However, the time course of electroencephalographic delta activity during sleep, which represents the main marker of sleep intensity associated with recovery during sleep, has never been described in this non-human primate. In this study, telemetry implants were used to record one spontaneous 24-h sleep-wake cycle in four freely-moving Cynomolgus monkeys, and to quantify the time course of electroencephalographic activity during sleep using spectral analysis. Animals presented a diurnal activity pattern interrupted by short naps. During the dark period, most of the time was spent in sleep with non-rapid eye movement sleep/rapid eye movement sleep alternations and sleep consolidation profiles intermediate between rodents and humans. Deep non-rapid eye movement sleep showed a typical predominance at the beginning of the night with decreased propensity in the course of the night, which was accompanied by a progressive increase in rapid eye movement sleep duration. Spectral profiles showed characteristic changes between vigilance states as reported in other mammalian species. Importantly, delta activity also followed the expected time course of variation, showing a build-up with wakefulness duration and dissipation across the night. Thus, Cynomolgus monkeys present typical characteristics of sleep architecture and spectral structure as those observed in other mammalian species including humans, validating the use of telemetry in this non-human primate model for translational sleep studies.
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Affiliation(s)
- Adeline Rachalski
- Department of Psychiatry, Université de Montréal, Montreal, QC, Canada.,Research Center, Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Simon Authier
- CiToxLAB North America, 445 Armand Frappier, Laval, QC, Canada
| | - Leanne Bassett
- CiToxLAB North America, 445 Armand Frappier, Laval, QC, Canada
| | - Mylène Pouliot
- CiToxLAB North America, 445 Armand Frappier, Laval, QC, Canada
| | - Gaétan Tremblay
- Research Center, Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada
| | - Valérie Mongrain
- Research Center, Hôpital du Sacré-Coeur de Montréal, Montreal, QC, Canada.,Department of Neurosciences, Université de Montréal, Montreal, QC, Canada
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