Deng Hongyan, Gao Shang, Lu Shengyi, Kumar Abhishek, Zhang Zhenting, Svensson Peter
Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
Capital Medical University, Beijing, China.
J Oral Rehabil. 2018 Sep;45(9):710-719. doi: 10.1111/joor.12682. Epub 2018 Jul 10.
To investigate the effect of altering occlusal vertical dimension (OVD) in patients with severe attrition on corticomotor control of the masseter muscles as assessed by navigated transcranial magnetic stimulation (nTMS).
Seven patients (58.6 ± 8.4 years) with decreased OVD due to severe attrition were given mandibular occlusal splints to alter the OVD with the instruction to wear during the whole awake time for a period of four weeks. Motor-evoked potentials (MEPs) and the motor cortex maps of the masseter muscles and first dorsal interosseous (FDI) muscles as control were recorded by nTMS at baseline and at least 4 weeks after the alteration of OVD. The stimulus-response curves of MEPs were analysed with two-way repeated-measures ANOVA, and the numerical rating scale scores, motor thresholds, onset latencies, motor cortex maps and centre of gravity (COG) were analysed with paired t tests.
There was a significant increase in the amplitude of the masseter muscle MEPs (P = 0.036), but no change in the motor cortex map areas (P = 0.111) four weeks after the alteration of OVD. Furthermore, there was no significant difference in either the amplitude of the FDI muscle MEPs (P = 0.466) or the motor cortex map areas (P = 0.230) before and after OVD alteration.
The results suggest that alteration of OVD in patients with severe attrition was associated with signs of neuroplastic changes in the corticomotor control of the masseter muscles. The results of the study may add to our understanding of the putative mechanisms related to cortical changes in response to OVD alterations.
通过导航经颅磁刺激(nTMS)评估,研究改变严重磨耗患者的咬合垂直距离(OVD)对咬肌皮质运动控制的影响。
7例(58.6±8.4岁)因严重磨耗导致OVD降低的患者佩戴下颌咬合夹板以改变OVD,并按要求在整个清醒时间佩戴,为期4周。在基线时以及改变OVD至少4周后,通过nTMS记录咬肌和作为对照的第一背侧骨间肌(FDI)的运动诱发电位(MEP)和运动皮层图。MEP的刺激-反应曲线采用双向重复测量方差分析进行分析,数字评分量表得分、运动阈值、起始潜伏期、运动皮层图和重心(COG)采用配对t检验进行分析。
改变OVD 4周后,咬肌MEP的波幅显著增加(P = 0.036),但运动皮层图面积无变化(P = 0.111)。此外,改变OVD前后,FDI肌MEP的波幅(P = 0.466)或运动皮层图面积(P = 0.230)均无显著差异。
结果表明,严重磨耗患者OVD的改变与咬肌皮质运动控制中神经可塑性变化的迹象有关。该研究结果可能有助于我们理解与OVD改变引起皮层变化相关的假定机制。