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ABSTRACT: Corticomotor control of the human tongue has been reported to undergo neuroplastic changes following several days of training in a tongue-protrusion task. The aims of the present study were to determine if a 1h tongue-task training is sufficient to induce signs of neuroplastic changes in the corticomotor pathways, and to obtain preliminary information on the time course of such changes. Corticomotor excitability was assessed by changes in electromyographic activity evoked by transcortical magnetic stimulation (TMS) in 11 healthy subjects. Motor evoked potentials (MEPs) recorded in the tongue musculature and the first dorsal interosseous (FDI) muscle were assessed at four sessions: at baseline before training, 30min after training, and 1 and 7days after training. All subjects performed successfully the task (success rate: 38±4%). Thresholds for evoking MEPs by TMS in the tongue were decreased at 30min, 1 and 7days after training compared with baseline (ANOVA: P<0.001). Tongue MEP amplitudes were significantly increased at 1day follow-up and had returned to baseline values at 7days follow-up (ANOVA: P<0.001). No significant effect of tongue-task training on FDI MEPs was observed (ANOVA: P=0.160). Corticomotor topographic maps revealed increases (ANOVA: P<0.001) in area at the 1day follow-up. The success rate was significantly correlated to the net increases in tongue MEPs at 1day follow-up (Spearman: 0.615; P=0.0039). The present findings confirm that tongue task training is associated with plasticity of corticomotor excitability specifically related to the tongue musculature and further document that plasticity is evident within 30min post-training and may last up to at least 7days.
Experimental Brain Research 04/2012; 173(1):165-173. · 2.39 Impact Factor
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ABSTRACT: This study tested the hypothesis that painful injections of glutamate into the human masseter muscle differentially affect the distribution of the electromyographic (EMG) activity in the masseter muscle at rest and during tooth clenching. Surface EMG signals were recorded bilaterally from the superficial masseter of nine healthy men with a grid of 32 electrodes, before and after intramuscular injection of glutamate or isotonic saline, during rest and isometric contractions at 20%, 40%, 60% and 80% of the maximal voluntary bite force. Intramuscular injection of glutamate evoked moderate pain (0-10 visual analogue scale: 6·4 ± 1·4), with sensory-discriminative characteristics of the perceived pain, evaluated with the use of the McGill Pain Questionnaire (MPQ), similar to those previously reported for patients with temporomandibular disorders. There was no effect of the glutamate injection on EMG amplitude during rest, whereas during tooth clenching, the spatial distribution of the masseter EMG activity on both sides was more uniform in the painful condition compared to the control condition. Moreover, the overall EMG amplitude decreased on both sides during the more forceful tooth clenching following glutamate injection. In conclusion, a unilateral painful stimulation was associated with a bilateral inhibition of the masseter muscles during tooth clenching which resulted in a more uniform distribution of EMG activity.
Journal of Oral Rehabilitation 08/2011; 39(2):81-92. · 1.53 Impact Factor
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ABSTRACT: The aim of this study was to examine the inhibitory responses in bilateral masseter and temporalis muscle activity when electrical stimulation with short or long duration was applied to six oro-facial locations. The exteroceptive suppression period (ES2) and inhibitory responses were recorded in the surface electromyogram (EMG) of bilateral masseter and temporalis muscles in 16 healthy subjects. Two stimulus durations (1 ms single pulse and 450 ms pulse train) adjusted to a perceived intensity of 7 (distinct painful) on a 0-10 Numerical Rating Scale (NRS) were applied to the following six oro-facial locations on the right side while the subject was biting at 50% of the maximal voluntary contraction: masseter muscle, temporalis muscle, temporomandibular joint, infraorbital nerve, supraorbital nerve, and mental nerve. The stimulus intensity required to reach an NRS score of 7 was significantly lower for 450 ms train stimuli than for 1 ms single stimuli (P<0·001). There were no significant differences in the magnitude of ES2 suppression among the six different locations (P>0·876) for the 1 ms single stimuli. There were significant decreases in Root-Mean-Square-EMG values in the 400-500 ms post-stimulus epoch compared with the pre-stimulus epoch (P<0·023) for 450 ms train stimuli, but there were no significant differences in the magnitude of inhibition among the six different locations (P<0·893). Short- and long-lasting electrical stimulation of various oro-facial locations induces similar bilateral inhibitory effects in the jaw-closing muscles but with different propensity which may reflect the somatotopic organisation of these responses.
Journal of Oral Rehabilitation 11/2010; 38(7):487-500. · 1.53 Impact Factor
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ABSTRACT: The aim of the study was to investigate the interaction between glutamate and capsaicin-evoked muscle pain on human jaw motor functions.
Fifteen male volunteers participated. Glutamate or capsaicin or isotonic saline, in a paired-sequence order, was injected randomly into the right or left masseter muscle. Two injections were given in a double-blinded design 25 min apart in one session/week over four weeks: isotonic saline (A1) followed by glutamate (A2), capsaicin (B1) followed by glutamate (B2), isotonic saline (C1) followed by capsaicin (C2), and glutamate (D1) followed by capsaicin (D2). The resting electromyographic (EMG) activity of the right and left masseter muscles, maximum voluntary bite force (MVBF), and maximum voluntary jaw opening (MVJO) were recorded before and after injection and subsequently at 5-min intervals for 50 min. The pain intensity was recorded on a 0-10 numerical rating scale during each MVBF or MVJO jaw function.
Resting EMG activity was significantly increased after 5 min of D2 (ANOVA: P=0.028) injection. The percentage change (compared with baseline) in EMG activity was significantly different between D2 (116.1+/-6.1%) and C2 (102.1+/-3.4%) injections (paired t-test: P=0.039). The MVBF and MVJO were significantly decreased after injection of glutamate or capsaicin, however, there was no significant difference in the relative decrease between A2 and B2, or between C2 and D2 at any time point (P>0.152). There was a significantly higher peak pain rating after D2 compared to C2 during MVBF or MVJO (P<0.022), whereas no significant difference in peak pain ratings was found between A2 and B2 (P>0.084). There were significant negative correlations between pain ratings and MVBF or MVJO (Pearson correlation: P<0.001).
The results indicate that intramuscular administration of glutamate and capsaicin induces muscle pain which has the potential to perturb some normal jaw motor functions.
The present findings suggest that peripheral glutamate and capsaicin receptor mechanisms interact to affect some jaw motor as well as sensory (i.e. pain) functions and provide new insights into the complexity of orofacial pain. Management approaches that target the peripheral nervous system and receptor mechanisms may prevent such changes in jaw motor function.
Clinical neurophysiology: official journal of the International Federation of Clinical Neurophysiology 02/2010; 121(6):950-6. · 3.12 Impact Factor
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ABSTRACT: To compare the jaw-stretch reflex and pressure pain thresholds (PPT) in chronic tension-type headache (CTTH) patients and healthy controls, 30 patients (15 male and 15 female) and 30 age- and sex-matched healthy subjects were investigated. Stretch reflexes were recorded in the temporalis and masseter muscles and PPT was determined in the anterior temporalis, splenius capitis and masseter muscles. The results showed that the amplitude of the stretch reflex in CTTH patients was higher compared with control subjects (P < 0.045), and higher in women compared with men in the right and left anterior temporalis muscles (P < 0.009). There were no differences in the PPT value between CTTH and control subjects (P > 0.509), whereas women showed significantly lower PPT measurements (P < 0.046). The results demonstrated a facilitation of the stretch reflex pathways in CTTH patients that is unrelated to measures of pericranial sensitivity.
Cephalalgia 02/2009; 29(5):556-65. · 3.43 Impact Factor
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ABSTRACT: The aim of the study was to investigate the interaction between glutamate and capsaicin in inducing muscle pain and sensitization in humans. Fifteen male volunteers participated. Glutamate or capsaicin or isotonic saline, in a paired-sequence order, was injected randomly into the right or left masseter muscle. Two injections were given in a double-blinded design 25 min apart in 1 session/week over 4 weeks: saline (A1) followed by glutamate (A2), capsaicin (B1) followed by glutamate (B2), saline (C1) followed by capsaicin (C2), and glutamate (D1) followed by capsaicin (D2). The subjects drew the area of perceived pain and scored pain intensity on a 0-10 visual analogue scale (VAS). Pressure pain threshold (PPT) at the injection site, at a site 2-cm away, and on the contralateral side, as well as pressure pain tolerance (PPTol) at the injection site and contralateral site, were also measured before and after injection and subsequently at 5-min intervals. Paired t-test analyses showed that the pain drawing area was significantly smaller in the B2 compared to the A2 condition (P=0.028), and significantly larger in the D2 compared to the C2 condition (P=0.027). It also revealed significantly lower VAS peak pain intensity (P=0.008) and smaller VAS area under the curve (P=0.003) for the B2 compared to the A2 condition, and significantly higher VAS peak pain (P=0.015) and larger VAS area under the curve (P=0.037) for the D2 compared to the C2 condition. There was a significant PPT and PPTol decrease at the injection site after glutamate or capsaicin injection (ANOVA: P<0.028). The percentage decrease in PPT or PPTol (at the injection site) was not significantly different for the B2 compared to the A2 condition (Paired t-test: P>0.682) or for the D2 compared to the C2 condition (P>0.133). Significant PPT changes were also observed at the site 2 cm away, but not on the contralateral side. In conclusion, these findings indicate that intramuscular administrations of glutamate and capsaicin interact and influence pain and sensitization of muscle nociceptors: glutamate causes a sensitization to subsequent administration of capsaicin, whereas capsaicin is associated with a desensitization to subsequent injection of glutamate. These findings support previous animal data.
European journal of pain (London, England) 07/2008; 12(5):661-70. · 3.37 Impact Factor
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ABSTRACT: To investigate the influence of conditioning cutaneous nociceptive inputs by a new "pinch" model on the jaw-stretch reflex and the exteroceptive suppression periods (ES1 and ES2) in jaw muscles.
The jaw-stretch reflex was evoked with the use of a custom-made muscle stretcher and electrical stimuli were used to evoke an early and late exteroceptive suppression period (ES1 and ES2) in the jaw-closing muscles. Electromyographic (EMG) activity was recorded bilaterally from the masseter and temporalis muscles. These brainstem reflexes were recorded in 19 healthy men (28.8+/-1.1 years) during three different conditions: one painful clip applied to the earlobe; one painful clip applied to the nostril, and four painful clips applied simultaneously to the earlobe, nostril, eyebrow, and lower lip. Pain intensity induced by the application of the clips was scored continuously by the subjects on a 100mm visual analogue scale (VAS).
The highest VAS pain scores were evoked by placement of four clips (79+/-0.5mm). There was no significant modulation of the jaw-stretch reflex (ANOVAs: P=0.929), the ES1 (P=0.298) or ES2 (P=0.082) in any of the three painful conditions.
Intense and tonic cutaneous pain could be elicited by this new "pinch" pain model; however, there was no significant modulation on either excitatory or inhibitory brainstem reflex responses.
The novel observation that high-intensity pinch stimuli applied to the craniofacial region fail to modulate two different brainstem reflexes is in contrast to other experimental pain studies documented facilitation of the jaw-stretch reflexes or inhibition of exteroceptive suppression periods. The clinical implication of the present findings is that only some craniofacial pain conditions could be expected to show perturbation of the brainstem reflex responses.
Clinical Neurophysiology 11/2007; 118(10):2180-8. · 3.41 Impact Factor
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ABSTRACT: The present study evaluated the reproducibility of the late exteroceptive suppression period (ES2) and of pain perception. The surface electro-myogram (EMG) was recorded from the left masseter muscle in 12 males and 12 females (22-31 year). Thirteen fixed stimulus intensities from 5 to 25 mA with 2.5 mA intervals were applied at random to the left mental area, and stimulus-response (S-R) curves were built for each subject. The first stimulation intensity at which the ES2 appeared was defined the reflex threshold, while the lowest stimulus intensity the subjects scored as painful, was called the pain threshold. Using the S-R curves, the other reflex parameters (appearance level, saturation level, slope from appearance to saturation, maximum duration of ES2, and maximum suppression degree) were also determined. Two measurement sessions were scheduled. Both the reflex and the pain sensation appeared at significantly lower stimulus intensity in females than males (P < 0.05). The reflex threshold, the reflex appearance and saturation level showed a significant decrease from the first to second session (P < 0.05), while the pain threshold was significantly higher during the second session (P < 0.01). By contrast, a good reproducibility was found for the maximum duration and suppression degree of ES2. Consequently, if S-R curves would be used to study the relation between the ES2 parameters and stimulus intensity in normal subjects for their applicability in clinical conditions, maximum duration and maximum suppression degree should be focused upon, in order to avoid session and gender effects as confounding factors.
Journal of Oral Rehabilitation 11/2006; 33(10):741-8. · 1.53 Impact Factor
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ABSTRACT: Seeking information on the physiological properties of the trigeminal motoneuronal pool we investigated changes in the excitability of trigeminal motor system induced by two types of experimental pain (muscle and skin). In one session, we studied the effect of muscle pain induced by hypertonic saline infusion into the masseter muscle on the recovery cycle of the heteronymous H-reflex in the temporalis muscle and the homonymous silent period (SP) in the masseter muscle, both elicited by stimulation of the masseteric nerve in ten-healthy subjects. In another session, we studied the effect of laser stimuli applied to the perioral region, at conditioning intervals from 20 to 160 ms, on the temporalis H-reflex and masseter SP in nine healthy subjects. Whereas laser-induced skin pain significantly inhibited the temporalis H-reflex and facilitated the masseter SP (P < 0.01), muscle pain left the time course of the temporalis H-reflex and masseter SP unchanged (P > 0.05). The timing of temporalis H-reflex suppression and masseter-SP enhancement induced by laser stimuli indicates that facial skin nociceptors inhibit trigeminal motoneurones via multysynaptic reflex pathways. Hypertonic saline, a stimulus that predominantly activates group III and IV afferents, left both variables reflecting trigeminal motoneuron excitability unchanged. Due to the differences between the two experimental models, we cannot conclude that such inhibitory reflex pathway does not exist from muscle nociceptors to trigeminal motoneurones.
Experimental Brain Research 10/2006; 174(4):622-9. · 2.39 Impact Factor
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ABSTRACT: Corticomotor control of the human tongue has been reported to undergo neuroplastic changes following several days of training in a tongue-protrusion task. The aims of the present study were to determine if a 1 h tongue-task training is sufficient to induce signs of neuroplastic changes in the corticomotor pathways, and to obtain preliminary information on the time course of such changes. Corticomotor excitability was assessed by changes in electromyographic activity evoked by transcortical magnetic stimulation (TMS) in 11 healthy subjects. Motor evoked potentials (MEPs) recorded in the tongue musculature and the first dorsal interosseous (FDI) muscle were assessed at four sessions: at baseline before training, 30 min after training, and 1 and 7 days after training. All subjects performed successfully the task (success rate: 38+/-4%). Thresholds for evoking MEPs by TMS in the tongue were decreased at 30 min, 1 and 7 days after training compared with baseline (ANOVA: P<0.001). Tongue MEP amplitudes were significantly increased at 1 day follow-up and had returned to baseline values at 7 days follow-up (ANOVA: P<0.001). No significant effect of tongue-task training on FDI MEPs was observed (ANOVA: P=0.160). Corticomotor topographic maps revealed increases (ANOVA: P<0.001) in area at the 1 day follow-up. The success rate was significantly correlated to the net increases in tongue MEPs at 1 day follow-up (Spearman: 0.615; P=0.0039). The present findings confirm that tongue task training is associated with plasticity of corticomotor excitability specifically related to the tongue musculature and further document that plasticity is evident within 30 min post-training and may last up to at least 7 days.
Experimental Brain Research 08/2006; 173(1):165-73. · 2.39 Impact Factor
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ABSTRACT: Although pain and neuromuscular function are clearly linked in several clinical conditions manifested in the craniofacial and cervical regions, it is unclear if pain in these regions influences reflexly evoked activity in the jaw or neck muscles in humans. The aim of the present study was to test the effects of glutamate-evoked jaw or neck muscle pain on the jaw stretch reflex recorded in both jaw and neck muscles.
Nineteen healthy men participated in the study. Electromyographic (EMG) recordings were made from the left masseter (MAL) and right masseter (MAR) muscles and the right sternocleidomastoid (SCM) and splenius (SP) muscles. Glutamate (1 M) or isotonic saline was injected into the MAR or right SP in random order and then the other solution was injected 1-3 weeks later. Pain intensity was scored on a 10 cm visual analogue scale. Stretch reflexes were evoked by standardized jaw stretches before, during and 15 min after the end of the experimental muscle pain. Twenty trials were averaged in each condition.
Pain evoked by MAR or SP glutamate injections was associated with a significant increase in the stretch reflex amplitude recorded in both MAR and SCM. The onset and offset times and duration of the stretch reflex did not change in any muscle during the various pain conditions. Injection of isotonic saline into the MAR or SP did not produce any significant change in the reflex parameters in any of the muscles.
The results indicate the close interplay between the craniofacial and cervical regions in the neuromuscular changes that may result from musculoskeletal pain in either region.
The changes in neuromuscular activity documented in this study may be involved in the clinical occurrence of altered muscle activity in the orofacial and cervical regions as a result of deep tissue trauma and pain.
Clinical Neurophysiology 07/2004; 115(6):1288-95. · 3.41 Impact Factor
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ABSTRACT: The pathophysiology of painful temporomandibular disorders is not fully understood, but evidence suggests that muscle pain modulates motor function in characteristic ways. This study tested the hypothesis that activation of nociceptive muscle afferent fibers would be linked to an increased excitability of the human jaw-stretch reflex and whether this process would be sensitive to length and velocity of the stretch. Capsaicin (10 micro g) was injected into the masseter muscle to induce pain in 11 healthy volunteers. Short-latency reflex responses were evoked in the masseter and temporalis muscles by a stretch device with different velocities and displacements before, during, and after the pain. The normalized reflex amplitude increased with an increase in velocity at a given displacement, but remained constant with different displacements at a given velocity. The normalized reflex amplitude was significantly higher during pain, but only at faster stretches in the painful muscle. Increased sensitivity of the fusimotor system during acute muscle pain could be one likely mechanism to explain the findings.
Journal of Dental Research 10/2002; 81(9):650-4. · 3.49 Impact Factor
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ABSTRACT: Muscle pain imposes significant changes on natural motor tasks, but the consequences for stretch reflexes are still disputed. The present study examined the jaw reflexes to fast (10 ms) stretches of the mandible in an experimental model with local pain in the masseter muscle and remote pain in the tibialis anterior muscle. The stretch reflexes were elicited in healthy volunteers (n=13) before, during, and after periods with constant levels of experimental pain and while the subjects clenched at 0%, 15%, 30%, and 45% of the maximal voluntary contraction (MVC) levels. Surface electromyography (EMG) was used to record the reflex responses. Pain in the masseter muscle (mean +/- SEM, 3.8+/-0.4 on a 10-cm visual analogue scale), but not in the tibialis anterior muscle (3.4+/-0.3; paired t-test, P=0.318) was associated with significant changes in both prestimulus EMG activity (ANOVA, P=0.002) and in peak-to-peak amplitudes of the stretch reflex (ANOVA, P=0.022). However, when the changes in prestimulus EMG activity were taken into consideration a significant increase in the stretch reflex persisted in the painful muscle at 15% and 30% MVC. Local circuits at the trigeminal level involving the fusimotor system are proposed to mediate a significant part of this modulatory effect.
Experimental Brain Research 09/2001; 139(4):495-502. · 2.39 Impact Factor
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ABSTRACT: It has recently been shown that a slow stretch evokes a short-latency (probably monosynaptic) and a long-latency (polysynaptic) reflex response in human jaw-closing muscles. The effect of nociceptive muscle input on the fusimotor system has not been investigated in detail. In order to investigate the effect of sustained muscle pain on the jaw stretch reflex, two main experiments were performed. Stretch reflex responses were evoked in the masseter and temporalis muscles by slow stretches (1-mm displacement, 40-ms ramp time) before, during and 15 min after a period of experimentally induced muscle pain. In experiment I, a dose of 1.0 M hypertonic or 154 mM isotonic (control) saline was infused in random order into the left masseter for up to 15 min (n=12). The level of excitation of the left masseter at 15% maximal voluntary contraction was controlled by visual feedback of the surface EMG (sEMG). In experiment II, a dose of 1.0 M saline was infused into the left masseter but with feedback from the sEMG of the right masseter (n=12). In a control experiment, both sEMG and intramuscular EMG (imEMG) were recorded from the left and right masseters; the feedback was from imEMG of the left masseter (n=12). The early (onset: 9--10 ms) and late (duration from 25 to 40 ms) reflex components were recorded and analysed in all experiments. Infusion of 1.0 M saline caused moderate pain (mean score on a Visual Analogue Pain Scale: 4.9--5.0 cm). The peak-to-peak amplitude of the early reflex component in the painful masseter normalized to the pre-stimulus EMG activity was significantly higher during the pain than the pre- and post-infusion conditions in all experiments. The normalized area of the late reflex component in the painful masseter was significantly larger than in the pre-infusion condition in all experiments. Isotonic saline had no significant effect on the jaw stretch reflexes. These results indicate that experimental jaw-muscle pain in humans facilitates the early as well as the late component of the jaw stretch reflex response as revealed by both sEMG and imEMG. This effect appears to be independent of the level of excitation of the muscle and not related to volume effects of the injected saline. A change in the sensitivity of the fusimotor system during muscle pain is suggested as an explanation.
Archives of Oral Biology 06/2001; 46(5):433-42. · 1.60 Impact Factor
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ABSTRACT: The influence of methodological parameters and experimental conditions on the human jaw-stretch reflex was studied in healthy subjects in order to develop a reliable tool for investigation of the excitability of motoneuron pool. Short-latency excitatory reflex responses were evoked by a custom-made stretch device with the subjects biting on a jaw-bar with their front teeth. The displacement and ramp time of the stretches were accurately controlled and automatically triggered by a computer. The reflex responses were measured in the surface electromyogram (EMG) of the masseter and anterior temporalis muscles with online monitoring of the clenching level. The peak-to-peak amplitude of the jaw-stretch reflex was shown to be proportional to the level of EMG activity during isometric contractions, to increase proportionally with increasing stretch displacement at a given ramp time, and to decrease proportionally with increasing ramp time at a given stretch displacement. There were no significant differences in the reflex amplitude between repeated recordings within one session or between different sessions. Local anesthetic around the lower incisors as well as the upper incisors had no significant influence on the reflex amplitude. However, different biting positions on the bars of the stretch device significantly influenced the amplitude of the stretch reflex.
European Journal Of Oral Sciences 05/2001; 109(2):86-94. · 1.88 Impact Factor
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ABSTRACT: The modulation of human jaw-stretch reflexes by experimental muscle pain was studied in three experiments. Short-latency reflex responses were evoked in the masseter and temporalis muscles by fast stretches (1 mm displacement, 10 ms ramp time) before, during and 15 min after a period with tonic pain. In Expt. I, a dose of 5.8% hypertonic or 0.9% isotonic (control) saline was infused in random order into the left masseter for up to 15 min (n=12). The level of excitation of the left masseter was kept constant at 15% of maximal effort by visual feedback and on-line calculation of the root-mean-square value of the surface electromyogram (sEMG). In Expt. II, a dose of 5.8% saline was infused into the left masseter but with feedback from the right masseter sEMG (n=12). In Expt. III, both sEMG and intramuscular (im) EMG was recorded from the left and right masseter muscles. The feedback was from either the sEMG or imEMG of the left masseter in which 5.8% saline was infused (n=12). In all experiments, subjects continuously rated their perceived pain intensity on a 10-cm visual analogue scale (VAS). Infusion of 5.8% saline caused moderate levels of pain (mean VAS 4.9-5.0 cm) whereas infusion of 0.9% saline was almost pain-free (mean VAS 0.3 cm). The pre-stimulus EMG activity in the masseter, which served as the feedback muscle during the recording, was constant across the different conditions. During painful infusion of 5.8% saline in Expts. I and III, the pre-stimulus sEMG activity in the non-painful masseter was significantly higher than baseline when the sEMG on the painful side was used as feedback signal, and in Expt. II significantly lower on the painful side when the non-painful side served as feedback signal (Student-Newman-Keuls: P<0.05). Isotonic saline did not affect the pre-stimulus sEMG activity or the jaw-stretch reflex parameters. The peak-to-peak amplitude of the stretch reflex in the painful masseter normalized to the pre-stimulus EMG activity was significantly higher during the pain conditions compared with the pre- and post-infusion conditions in all experiments. These results indicate that experimental jaw-muscle pain facilitates the short-latency (8-9 ms), probably monosynaptic, jaw-stretch reflex as revealed by both sEMG and imEMG. This effect could not be accounted for by variability in pre-stimulus EMG activity. An increased sensitivity of the fusimotor system at this level of static muscle excitation is suggested as a possible mechanism, which could contribute to an increased stiffness of the jaw-muscles during pain.
Pain 12/2000; 88(2):189-97. · 5.78 Impact Factor
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ABSTRACT: The bite force at different levels and the corresponding electromyographic (EMG) activity of the masseter and anterior temporalis muscles were recorded in 12 healthy subjects in order to evaluate the modulation of EMG-force curves by a standardized painful stimulus. Hypertonic saline (5%) was infused into the right masseter muscle for up to 15 min to induce pain. The pain intensity was scored continuously by the subjects on a 10-cm visual analogue scale (VAS). Subjects were asked to bite on a force transducer at the maximum voluntary bite force (MVBF). They were then asked to bite at submaximum levels of 12, 25, 37, 50, 67, 75 and 87% of MVBF. The biting was performed in three different positions (right first molar, left first molar and incisor) before, during and after infusion. Hypertonic saline caused moderate pain during infusion (mean VAS +/- s.e.m. = 6.5+/-0.5 cm). Both the MVBF and the maximum EMG activity in the right masseter and the left anterior temporalis muscles were significantly decreased during muscle pain when the subjects bit on the painful side. The EMG-force curves could be fit by linear relationships. The slope of the curve became less steep in the right masseter muscle during and after painful biting in every position. The results suggest that tonic saline-induced jaw-muscle pain is able to modulate the motor unit recruitment pattern of the jaw-closing muscles on the painful side. The main effect of pain in this experiment was an inhibition of static EMG activity.
Journal of Oral Rehabilitation 06/2000; 27(5):394-402. · 1.53 Impact Factor
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ABSTRACT: Perioral electrical stimuli cause inhibitory reflex responses in single motor-units (SMU) and surface electromyographic (EMG) recordings from voluntary contracted human jaw-closing muscles. Tonic experimental masseter pain has recently been shown to reduce the inhibitory reflex response in surface EMG recordings but the effect on SMU activity has not been described. In this study, motor-unit action potentials were recorded with wire electrodes inserted into the left masseter in eleven subjects. The subjects kept the SMU firing rate around 10 Hz by feedback. Ninety-nine electrical stimuli were applied sequentially to the left mental nerve with increasing stimulus delays in steps of 1 ms after the preceding motor unit action potential. The inhibitory reflex in SMU was recorded before, during and after infusion of hypertonic saline (5%) into the ipsilateral masseter muscle. Spike train data were used to calculate (1) the mean pre- and post-stimulus inter-spike-intervals (ISI) in all of the 99 trials, (2) cumulative changes in firing probability, and (3) estimation of the compound inhibitory post-synaptic potential (IPSP) in the masseter motoneuron. Tonic masseter pain did not change pre-stimulus SMU firing characteristics but the mean ISI for the first post-stimulus discharge (158.2+/-9.2 ms) was significantly decreased compared to the pre-pain (175.8+/-11.3 ms, P<0.05) and post-pain conditions (172. 6+/-11.6 ms, P<0.05). The post-stimulus firing probability was significantly increased and the relative amplitude of the estimated IPSP significantly decreased during tonic masseter pain compared to pre-pain and post-pain conditions. In conclusion, this study indicates that tonic masseter pain has a net excitatory effect on the inhibitory jaw-reflexes, which could be mediated by presynaptic mechanisms on the involved motoneurons.
Pain 12/1999; 83(3):441-6. · 5.78 Impact Factor
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ABSTRACT: The exteroceptive suppression periods (ES) in human jaw-closing muscles can be conditioned by a wide range of somatosensory stimuli and cognitive states. The aim of this study was to examine the effects of tonic experimental jaw-muscle pain versus remote muscle pain on the short-latency (ES1) and long-latency (ES2) reflex in the jaw-closing muscles. Twelve healthy subjects participated in the first experiment with jaw-muscle pain. In random order 5% hypertonic or 0.9% isotonic saline was infused into the left masseter muscle for 15 min. The pain intensity was scored continuously by the subjects on a 10-cm visual analogue scale (VAS). Electromyographic (EMG) activity was recorded bilaterally from the masseter and temporalis muscles during the pre-infusion, early phase of infusion (from 120 to 480 s), late phase of infusion (from 540 to 900 s) and post-infusion. An electrical stimulus was delivered to the skin above the left mental nerve (ipsilateral to the painful muscle) to evoke the ES in the contracting jaw-closing muscles. Ten healthy subjects participated in experiment 2 which was as identical to experiment 1 except that the electrical stimulus was delivered to the right mental nerve (contralateral to the painful muscle). Nine healthy subjects participated experiment 3 where remote muscle pain was induced in the left tibialis anterior muscle. In experiment 1 painful infusion of hypertonic saline caused a significantly later onset latency of ES2 in the left masseter muscle during the late phase of infusion compared to pre-infusion values (P < 0.05). The duration of ES2 in the same muscle was significantly shorter during the late infusion phase compared to pre- and post-infusion values (P < 0.05) and the degree of suppression was significantly reduced during the early infusion compared to the pre-infusion values (P < 0.05). Isotonic saline did not influence the ES1 or ES2. In experiment 2, similar significant inhibitory changes were found in the ES2 on the painful side. In experiment 3, no significant effects on ES1 and ES2 were observed during painful infusion of hypertonic saline into the leg muscle. These results indicate that the effects of tonic jaw-muscle pain on ES2 can be distinguished from a generalized effect of muscle pain. Furthermore, there seems to be a differential and lateralized effect of jaw-muscle pain on the brain stem reflex circuits involved in the generation of ES1 and ES2 probably through a presynaptic mechanism.
Pain 10/1999; 82(3):253-62. · 5.78 Impact Factor
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ABSTRACT: ObjectiveExamine the effect of stimulus duration, intensity and level of muscle contraction on the inhibitory responses evoked by electrical stimuli in human jaw-closing muscles applied to the right mental nerve.DesignThe inhibitory jaw-reflexes, short-latency (ES1) and long-latency (ES2), were recorded in the surface electromyogram (EMG) of masseter and temporalis muscles in 16 healthy subjects. Three stimulus durations (1 ms single square-wave pulse, 10 and 450 ms square-wave pulse train), two stimulus intensities adjusted to perceived intensity of 3 (non-painful) and 7 (distinct painful) on a 0–10 verbal rating scale were applied to the right mental nerve while the subject was biting at 25% and 50% of the maximal voluntary contraction (MVC).ResultsThe magnitude of suppression in the ES2 evoked by 1 and 10 ms stimuli was dependent on stimulus intensity (P < 0.002 and P < 0.001, respectively) but not contraction level. However, ES1 could not be observed in most of the recordings. There were significant decreases evoked by the 450 ms stimuli in RMS–EMG values in the 400–500 ms compared with the pre-stimulus interval (P < 0.001) which was dependent on contraction level (P < 0.01) but not on stimulus intensity (P = 0.486).ConclusionsThe present results suggest that the ES2 reflex response is associated with the duration of the electrical stimuli, the intensity level but not the contraction level. In contrast, the inhibitory effects of ultra-long stimuli (450 ms) are not specifically related to the intensity level suggesting that this is a non-nociceptive response.
Archives of Oral Biology.
