Cacciatore Martina, Magnani Francesca Giulia, Ippoliti Camilla, Barbadoro Filippo, Anversa Paola, Portincaso Lara, Visani Elisa, Navarro Jorge, Devalle Guya, Lanfranchi Maurizio, Pingue Valeria, Marelli Sara, Ferini Strambi Luigi, Lunardini Francesca, Ferrante Simona, Tremolati Marco, Leonardi Matilde, Rossi Sebastiano Davide, Sattin Davide
SC Neurologia, Salute Pubblica, Disabilità-Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy.
SC Neurofisiopatologia-Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy.
Diagnostics (Basel). 2023 Mar 10;13(6):1053. doi: 10.3390/diagnostics13061053.
The presence of involuntary, non-functional jaw muscle activity (NFJMA) has not yet been assessed in patients with disorders of consciousness (DOC), although the presence of bruxism and other forms of movement disorders involving facial muscles is probably more frequent than believed. In this work, we evaluated twenty-two prolonged or chronic DOC patients with a long-lasting polygraphic recording to verify NFJMA occurrence and assess its neurophysiological patterns in this group of patients. A total of 5 out of 22 patients showed the presence of significant NFJMA with electromyographic patterns similar to what can be observed in non-DOC patients with bruxism, thus suggesting a disinhibition of masticatory motor nuclei from the cortical control. On the other hand, in two DOC patients, electromyographic patterns advised for the presence of myorhythmia, thus suggesting a brainstem/diencephalic involvement. Functional, non-invasive tools such as long-lasting polygraphic recordings should be extended to a larger sample of patients, since they are increasingly important in revealing disorders potentially severe and impacting the quality of life of DOC patients.
意识障碍(DOC)患者中尚未评估非自愿性、无功能的颌肌活动(NFJMA)的存在情况,尽管磨牙症和其他涉及面部肌肉的运动障碍形式的存在可能比人们认为的更为常见。在这项研究中,我们对22例长期或慢性DOC患者进行了长时间的多导记录,以验证NFJMA的发生情况并评估该组患者的神经生理模式。22例患者中有5例表现出明显的NFJMA,其肌电图模式与非DOC磨牙症患者中观察到的相似,这表明咀嚼运动核从皮质控制中去抑制。另一方面,在2例DOC患者中,肌电图模式提示存在肌节律,这表明脑干/间脑受累。诸如长时间多导记录等功能性、非侵入性工具应扩展到更大的患者样本,因为它们在揭示可能严重且影响DOC患者生活质量的疾病方面越来越重要。