Faculty of Rehabilitation, Kansai Medical University, Uyama-higashi 18-89, Hirakata 573-1136, Japan.
Department of Neurological Diagnosis and Restoration, Graduate School of Medicine, Osaka University, Yamadaoka 2-2, Suita 565-0871, Japan.
Toxins (Basel). 2022 Nov 2;14(11):751. doi: 10.3390/toxins14110751.
Oromandibular dystonia (OMD) induces severe motor impairments, such as masticatory disturbances, dysphagia, and dysarthria, resulting in a serious decline in quality of life. Non-invasive brain-imaging techniques such as electroencephalography (EEG) and magnetoencephalography (MEG) are powerful approaches that can elucidate human cortical activity with high temporal resolution. Previous studies with EEG and MEG have revealed that movements in the stomatognathic system are regulated by the bilateral central cortex. Recently, in addition to the standard therapy of botulinum neurotoxin (BoNT) injection into the affected muscles, bilateral deep brain stimulation (DBS) has been applied for the treatment of OMD. However, some patients' OMD symptoms do not improve sufficiently after DBS, and they require additional BoNT therapy. In this review, we provide an overview of the unique central spatiotemporal processing mechanisms in these regions in the bilateral cortex using EEG and MEG, as they relate to the sensorimotor functions of the stomatognathic system. Increased knowledge regarding the neurophysiological underpinnings of the stomatognathic system will improve our understanding of OMD and other movement disorders, as well as aid the development of potential novel approaches such as combination treatment with BoNT injection and DBS or non-invasive cortical current stimulation therapies.
口颌肌张力障碍(OMD)可导致严重的运动障碍,如咀嚼障碍、吞咽困难和构音障碍,从而导致生活质量严重下降。脑电图(EEG)和脑磁图(MEG)等非侵入性脑成像技术是一种强大的方法,可以高时间分辨率阐明人类皮质活动。以前的 EEG 和 MEG 研究表明,口腔系统的运动由双侧中央皮质调节。最近,除了在受累肌肉中注射肉毒杆菌神经毒素(BoNT)的标准治疗外,还应用双侧深部脑刺激(DBS)来治疗 OMD。然而,一些患者的 OMD 症状在 DBS 后并未得到充分改善,他们需要额外的 BoNT 治疗。在这篇综述中,我们使用 EEG 和 MEG 概述了双侧皮质中这些区域的独特的中央时空处理机制,因为它们与口腔系统的感觉运动功能有关。对口颌系统神经生理学基础的认识的提高将有助于我们理解 OMD 和其他运动障碍,并有助于开发潜在的新方法,如 BoNT 注射和 DBS 的联合治疗或非侵入性皮质电流刺激治疗。