Avivi-Arber L, Sessle B J
Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.
J Oral Rehabil. 2018 Jan;45(1):50-80. doi: 10.1111/joor.12554. Epub 2017 Oct 6.
The oro-facial sensorimotor system is a unique system significantly distinguished from the spinal sensorimotor system. The jaw muscles are involved in mastication, swallowing and articulatory speech movements and their integration with respiration. These sensorimotor functions are vital for sustaining life and necessitate complex neuromuscular processing to provide for exquisite sensorimotor control of numerous oro-facial muscles. The function of the jaw muscles in relation to sensorimotor control of these movements may be subject to ageing-related declines. This review will focus on peripheral, brainstem and higher brain centre mechanisms involved in reflex regulation and sensorimotor coordination and control of jaw muscles in healthy adults. It will outline the limited literature bearing on age-related declines in jaw sensorimotor functions and control including reduced biting forces and increased risk of impaired chewing, speaking and swallowing. The mechanisms underlying these alterations include age-related degenerative changes within the peripheral neuromuscular system and in brain regions involved in the generation and control of jaw movements. In the light of the vital role of jaw sensorimotor functions in sustaining life, normal ageing involves compensatory mechanisms that utilise the neuroplastic capacity of the brain and the recruitment of additional brain regions involved in sensorimotor performance and closely associated functions (e.g. cognition and memory). However, these regions are themselves susceptible to detrimental age-related changes. Thus, better understanding of the peripheral and central mechanisms underlying age-related sensorimotor impairment is crucial for developing improved treatment approaches to prevent or cure impaired jaw sensorimotor functions and to thereby improve health and quality of life.
口腔面部感觉运动系统是一个独特的系统，与脊髓感觉运动系统有显著区别。咀嚼肌参与咀嚼、吞咽、言语发音运动以及它们与呼吸的整合。这些感觉运动功能对维持生命至关重要，需要复杂的神经肌肉处理来实现对众多口腔面部肌肉的精确感觉运动控制。咀嚼肌在这些运动的感觉运动控制方面的功能可能会受到与衰老相关的衰退影响。本综述将聚焦于健康成年人中参与咀嚼肌反射调节、感觉运动协调和控制的外周、脑干及更高脑中枢机制。它将概述与口腔感觉运动功能和控制方面与年龄相关衰退相关的有限文献，包括咬合力降低以及咀嚼、说话和吞咽受损风险增加。这些改变背后的机制包括外周神经肌肉系统以及参与下颌运动产生和控制的脑区中与年龄相关的退行性变化。鉴于口腔感觉运动功能在维持生命中的重要作用，正常衰老涉及利用大脑神经可塑性能力以及招募参与感觉运动表现和密切相关功能（如认知和记忆）的额外脑区的代偿机制。然而，这些区域本身也易受与年龄相关的有害变化影响。因此，更好地理解与年龄相关的感觉运动损伤背后的外周和中枢机制，对于开发改进的治疗方法以预防或治愈受损的口腔感觉运动功能，从而改善健康和生活质量至关重要。
