Assessment of Brainstem Reflexes with Transcranial Magnetic Stimulation in Bruxism: The Role of Central Mechanisms in Pathophysiology

Year 2023, , 122 - 129, 26.12.2023

Bilgin Ali Şentürk , Gaye Yıldırım , Ayşegül Özer Çelik Çelik , İbrahim Öztura

https://doi.org/10.29228/erd.56

Abstract

Objectives: We aim to prove the central etiology hypothesis for bruxism, we plan to examine the structural components that contribute to the occurance of RMMA/Bruxism such as cortical, subcortical structures and as a key roleplaying component, the brainstem structures by investigating the MEP, CSP, MIR (SP1 and SP2) and the blink reflex (R1 and R2) and central conduction time.
Materials and Methods: In this study, a total of 77 subjects investigated to find any difference between the two groups. The MIR and blink reflexes studied by transcranial magnetic stimulation (TMS) and electric stimulation. The cortical silent period (CSP) evoked in contralateral masseter muscle by TMS. Central motor conducting times were evaluated.
Results: The absence of SP2 (component of MIR), R2 (component of blink reflex) latency and left APB (abductor pollicis brevis) muscle F wave latency are found to be significantly different between two groups.
Conclusions: As a result of our study, the loss of the SP2 component and the prolongation of the latency of the R2 component, and the localization of reflex circuits in the brainstem, although their pathways are separate, bruxer suggested that the pathophysiology may have a central origin in most of the bruxers.

Keywords

Bruxism, Transcranial Magnetic Stimulation, Masseter Inhibitory Reflex

Bruksizmde Transkraniyal Manyetik Stimülasyon ile Beyin Sapı Reflekslerinin Değerlendirilmesi: Merkezi Mekanizmaların Patofizyolojideki Rolü

Abstract

Amaç: Bu çalışmada bruksizmin merkezi mekanizmalarla ilgili olabileceği hipotezini kanıtlamak için MEP, CSP, MIR (SP1 and SP2), göz kırpma refleksi (R1 and R2) ve merkezi iletim zamanını inceleyerek RMMA/Bruksizm oluşumuna katkıda bulunan kortikal, subkortikal yapılar ve anahtar rol oynayan beyin sapı yapıları gibi yapısal bileşenlerin incelenmesi amaçlanmaktadır.
Gereç ve Yöntemler: Bu çalışmada, iki grup arasında herhangi bir fark olup olmadığını bulmak için toplam 77 kişi ile çalışılmıştır. MIR ve göz kırpma refleksleri, transkraniyal manyetik stimülasyon (TMS) ve elektrik stimülasyonu ile incelenmiştir. Kortikal sessiz periyot (CSP) kontralateral masseter kasta TMS ile uyarılmıştır. Merkezi motor iletim süreleri değerlendirilmiştir.
Bulgular: SP2 (MIR komponenti)’nin olmayışı, R2 (blink refleks komponenti)’nin latansı ve sol APB (Abdüktör pollisis brevis) kastan ölçülen F dalgası latansı incelendiğinde iki grup arasında istatistiksel olarak anlamlı şekilde fark bulunmuştur.
Sonuç: Çalışmamız sonucunda SP2 bileşeninin kaybolması ve R2 bileşeninin gecikme süresinin uzaması ve beyin sapındaki refleks devrelerinin lokalizasyonu, yolları ayrı olmasına rağmen, patofizyoloji bruksistlerin çoğunda merkezi bir kökene sahip olabileceğini desteklemektedir.

Keywords

Bruksizm, Transkraniyal Manyetik Stimülasyon, Masseter Inhibitor Reflex

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