Hellström F, Thunberg J, Bergenheim M, Sjölander P, Pedersen J, Johansson H
Centre for Musculoskeletal Research, National Institute for Working Life, Umeå, Sweden.
J Dent Res. 2000 Oct;79(10):1815-22. doi: 10.1177/00220345000790101401.
Patients suffering from temporomandibular dysfunction exhibit clinical findings such as fatigue, painful muscles, and muscles that are tender to palpation, not only in the temporomandibular area, but also in the neck/shoulder region. The mechanisms behind this are not known, although previous studies of similar spreading phenomena have revealed a possible involvement of the fusimotor system. In the present study, we evaluated the activity of this system by recording the activity of muscle spindle afferents from dorsal neck muscles after intramuscular injections of 6 microg to 25 microg bradykinin in the ipsilateral masseter muscle. A total of 23 muscle spindle afferents from the trapezius and splenius muscles was recorded at the C3-C4 level in 7 adult cats anesthetized with alpha-chloralose. Of these 23 afferents, 17 (74%) showed significantly different responses to bradykinin injections compared with control injections (dissolving agent, Tyrode), and the majority of the effects were compatible with an increased static fusimotor drive to the muscle spindle system. Thus, the results demonstrate potent reflex connections from groups III and IV masseter muscle afferents to fusimotor neurones on the C3-C4 level. It is concluded that the fusimotor system might play a significant role in the mechanisms behind the spread of muscle pain and tension from the temporomandibular region to the neck.
患有颞下颌关节功能紊乱的患者不仅在颞下颌区域,而且在颈部/肩部区域都表现出疲劳、肌肉疼痛和触诊时肌肉压痛等临床症状。尽管之前对类似扩散现象的研究表明牵张运动系统可能参与其中,但其背后的机制尚不清楚。在本研究中,我们通过在同侧咬肌内注射6微克至25微克缓激肽后记录颈背肌的肌梭传入活动,来评估该系统的活性。在7只使用α-氯醛糖麻醉的成年猫中,于C3 - C4水平记录了来自斜方肌和夹肌的总共23条肌梭传入纤维。在这23条传入纤维中,17条(74%)对缓激肽注射的反应与对照注射(溶解剂,台氏液)相比有显著差异,并且大多数效应与增加对肌梭系统的静态牵张运动驱动相一致。因此,结果表明Ⅲ类和Ⅳ类咬肌传入纤维与C3 - C4水平的牵张运动神经元之间存在强大的反射连接。得出的结论是,牵张运动系统可能在从颞下颌区域到颈部的肌肉疼痛和紧张扩散背后的机制中起重要作用。