Much is unclear about the pathophysiological mechanisms underlying painful temporomandibular disorders. In addition to various other theories, masticatory muscle dysfunction and pain have also been attributed to primary central nervous system hyperactivity. We assessed this possibility in a study using recent neurophysiological techniques. From among outpatients whose diagnosis of temporomandibular disorders had been obtained in stomatognathic facilities, we studied 10 patients with bilateral pain and 15 patients with unilateral pain, in whom electromyographic examination of the trigeminal reflexes disclosed normal findings except for absence or amplitude asymmetry of the jaw jerk. Transcranial magnetic stimulation yielded masseter motor evoked potentials of normal latency and amplitude, but five patients had to exert a near-maximum contraction to obtain their responses. The masseter silent periods elicited by the double-shock technique recovered normally. Because these tests measure the excitability of the masticatory system (including motor cortex, corticobulbar and corticoreticular connections, reticular interneurones and lower motoneurones), the lack of facilitation in these patients' responses excluded central hyperactivity as the primary cause of their masticatory dysfunction and pain. (C) 1997 International Association for the Study of Pain. Published by Elsevier Science B.V.

Excitability of the central masticatory pathways in patients with painful temporomandibular disorders / Cruccu, Giorgio; G., Frisardi; G., Pauletti; A., Romaniello; Manfredi, Mario. - In: PAIN. - ISSN 0304-3959. - 73:3(1997), pp. 447-454. [10.1016/s0304-3959(97)00139-5]

Excitability of the central masticatory pathways in patients with painful temporomandibular disorders

CRUCCU, Giorgio;MANFREDI, Mario
1997

Abstract

Much is unclear about the pathophysiological mechanisms underlying painful temporomandibular disorders. In addition to various other theories, masticatory muscle dysfunction and pain have also been attributed to primary central nervous system hyperactivity. We assessed this possibility in a study using recent neurophysiological techniques. From among outpatients whose diagnosis of temporomandibular disorders had been obtained in stomatognathic facilities, we studied 10 patients with bilateral pain and 15 patients with unilateral pain, in whom electromyographic examination of the trigeminal reflexes disclosed normal findings except for absence or amplitude asymmetry of the jaw jerk. Transcranial magnetic stimulation yielded masseter motor evoked potentials of normal latency and amplitude, but five patients had to exert a near-maximum contraction to obtain their responses. The masseter silent periods elicited by the double-shock technique recovered normally. Because these tests measure the excitability of the masticatory system (including motor cortex, corticobulbar and corticoreticular connections, reticular interneurones and lower motoneurones), the lack of facilitation in these patients' responses excluded central hyperactivity as the primary cause of their masticatory dysfunction and pain. (C) 1997 International Association for the Study of Pain. Published by Elsevier Science B.V.
1997
adult; analysis of variance; case-control studies; complications/physiopathology; electromyography; etiology/physiopathology; evoked potentials; humans; jaw reflexes; magnetics; mandible; masseter muscle; masseter silent periods; middle aged; motor; pain; physiology; reaction time; reflex; stomatognathic system; stretch; temporomandibular disorder; temporomandibular joint disorders; temporomandilubar disorder; transcranial magnetic stimulation
01 Pubblicazione su rivista::01a Articolo in rivista
Excitability of the central masticatory pathways in patients with painful temporomandibular disorders / Cruccu, Giorgio; G., Frisardi; G., Pauletti; A., Romaniello; Manfredi, Mario. - In: PAIN. - ISSN 0304-3959. - 73:3(1997), pp. 447-454. [10.1016/s0304-3959(97)00139-5]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/405605
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