Functional magnetic resonance imaging of human jaw movements

Effect of Chewing Hardness on Cognitive-Associated Brain Regions Activation

INTRODUCTION AND AIMS

Recent findings suggest a potential correlation between mastication and cognitive processes. However, the comprehensive investigation into the neurobiological mechanisms of masticatory control, such as the impact of chewing hardness, on cognitive function, remains incomplete. This study aims to investigate the impact of chewing hardness, as an aspect of masticatory control, on cognitive function by examining brain activation patterns during hard and soft chewing conditions.

METHODS

A total of 52 healthy young adults (average age of 21.81 years; 24 men and 28 women) underwent fMRI scanning, during which 27 individuals chewed soft and 25 individual chewed hard material. The functional magnetic resonance imaging (fMRI) was employed to elucidate the overlapping and distinct patterns of activated brain regions associated with soft- and hard-chewing conditions. Subsequently, correlations between these activated brain regions and neuropsychological measures were assessed.

RESULTS

Conjunction analysis revealed that both soft- and hard-chewing conditions stimulated brain regions directly associated with orofacial movement and spatial information processing. Two-sample t-test result indicated that the hard-chewing group had higher activation mostly in the caudate nucleus and frontal brain regions associated with cognitive function compared with the soft-chewing group. Furthermore, the activation strength of these brain regions positively correlated with neuropsychological measures.

CONCLUSION

The findings suggest that hard-chewing may be more effective than soft-chewing in stimulating cognition-associated brain regions, potentially enhancing cognitive processing.

CLINICAL RELEVANCE

Our study shows that hard-chewing activates brain regions linked to cognitive function more than soft-chewing. This suggests that harder chewing could be used as a simple, non-invasive method to enhance cognitive processing. Incorporating harder foods into the diet may offer a practical approach to support cognitive health and improve mental performance.

The Relationship between Removable Dental Prostheses and Brain Activity in Elderly Individuals: Systematic Review

BACKGROUND

There is an increasing body of literature associating edentulism with cognitive impairment. The aim of this systematic review was to summarize the available data, emphasizing the role of removable dental prostheses in preventing cognitive deterioration and promoting brain health in elderly individuals.

AIM

This systematic review investigates the relationship between the use of removable dental prostheses and physiological or adaptive changes at the cerebral level in partially and completely edentulous patients.

METHODS

A systematic review was conducted following PRISMA guidelines, with an initial search across PubMed, Scopus, and Web of Science databases. Studies published up to June 2023 in English were considered. A risk of bias assessment was performed for included studies.

RESULTS

Of the 86 studies initially screened, 13 met the inclusion criteria. Findings indicate a positive association between the use of removable dental prostheses and improved cognitive function, with potential therapeutic implications for managing cognitive decline.

CONCLUSION

Removable dental prostheses play a crucial role in enhancing neurological health and preventing cognitive decline, making them an important consideration in the management of neurodegenerative diseases.

The neural substrates of bruxism: current knowledge and clinical implications

Bruxism is a complex orofacial behavior that can occur during sleep or wakefulness, characterized by the involuntary grinding or clenching of teeth, involving repetitive activity of the jaw muscles. Its etiology is multifactorial, influenced by genetic, psychological, physiological, and lifestyle factors. While the mild bruxism may not necessitate treatment, severe bruxism can lead to significant consequences, including tooth damage, jaw pain, fatigue, and headaches. The bruxism has been associated with medical conditions, such as stress, anxiety, sleep disorders, and various neurological disorders; however, the exact pathophysiology remains elusive. Although the central nervous system is strongly implicated in the development of bruxism, specific neural substrates have not yet been conclusively established. Furthermore, there is evidence to suggest that individuals with bruxism may exhibit neural plasticity, resulting in the establishment of distinct neural circuitry that control the jaw movements. The application of various neurophysiological techniques in both clinical and pre-clinical studies provides valuable insights into the neural mechanisms underlying bruxism. This review aims to comprehensively examine the current literature on the neural pathways involved in bruxism, with the goal of improving the clinical approach and therapeutics for this condition. A deeper understanding of the neural circuitry controlling bruxism holds the potential to advance future treatment approaches and improve the management of patients with bruxism.

Prolongation of absence seizures and changes in serotonergic and dopaminergic neurotransmission by nigrostriatal pathway degeneration in genetic absence epilepsy rats

OBJECTIVE

Basal ganglia structures play an important role in the pathophysiology of absence epilepsy, known as remote control of absence seizures. We examined the role of the nigrostriatal dopaminergic pathway in absence epilepsy through behavioral and electroencephalography (EEG) parameters, immunohistochemical, and biochemical characteristics of dopamine and serotonin in the genetic absence epilepsy rat model.

METHODS

The nigrostriatal pathway was degenerated by the injection of chemical 6-hydroxydopamine hydrobromide (6-OHDA) into the medial forebrain bundle (MFB) in Wistar and genetic absence epilepsy rats from Strasbourg (GAERS). On the 21st day after stereotaxic surgery, spike-and-wave discharges (SWDs) on EEG were recorded in GAERS groups. Thereafter, Wistar-Control, GAERS-Control, Wistar-6OHDA, GAERS-6OHDA rats were subjected to the cylinder and apomorphine-induced rotation tests. Dopaminergic or serotonergic immunoreactivity was examined in the cortex, striatum, and substantia nigra pars compacta. High-performance liquid chromatography method was used for biochemical analysis of dopamine and serotonin in the cortex and thalamus.

RESULTS

In behavioral analysis, the number of rotations in the GAERS-6OHDA group was significantly higher than in Wistar-6OHDA rats. The degeneration of the nigrostriatal dopaminergic pathway produced a significant increase in the cumulative duration of SWDs and the duration of each SWD in GAERS-6OHDA rats. GAERS-Control rats displayed significantly higher cortical and striatal serotonin immunoreactivity and cortical serotonin level compared to Wistar-Control animals. Moreover, cortical and striatal serotonin immunoreactivity and cortical serotonin levels increased in Wistar-6OHDA and GAERS-6OHDA groups compared to their control groups.

SIGNIFICANCE

The effect of 6-OHDA-induced MFB lesion on absence epilepsy was examined for the first time by comparing Wistar and GAERS rats. The nigrostriatal dopaminergic pathway as a part of the remote-control system is likely to participate in the seizure network.

Effect of fixed dental prosthesis on the brain functions of partially edentulous patients - pilot study with power spectrum density analysis

Purpose:

This study was done to analyse the influence of fixed dental prosthesis (FDP) on brain function by analysing power spectral density of partially edentulous patients.

Materials and methods:

The study included unilateral missing mandibular molar replacement patients. The patients were restored with three-unit metal ceramic FDP restorations. The cognitive function was analysed with a mental state questionnaire. Power spectral density (PSD) analysis of EEG alpha waves was made pre- treatment, post treatment and 3 months after FDP treatment to analyse the brain function. The data in various phases were obtained before and after chewing. The results were statistically analysed.

Results:

The mean pre and post treatment PSD was 0.0175 (SD ±0.0132) and 0.0178 (SD ±0.0135). The mean post treatment PSD after three months was 0.024 (SD± 0.019). The results were analysed with repeated ANOVA and were statistically significant. (p<0.01).

Conclusion:

The study displayed improvement in brain function of partially edentulous patients with FDP rehabilitation.

An fMRI Study of the Brain Network Involved in Teeth Tapping in Elderly Adults

Cortical activity during jaw movement has been analyzed using various non-invasive brain imaging methods, but the contribution of orofacial sensory input to voluntary jaw movements remains unclear. In this study, we used functional magnetic resonance imaging (fMRI) to observe brain activities during a simple teeth tapping task in adult dentulous (AD), older dentulous (OD), and older edentulous subjects who wore dentures (OEd) or did not wear dentures (OE) to analyze their functional network connections. (1) To assess the effect of age on natural activation patterns during teeth tapping, a comparison of groups with natural dentition—AD and OD—was undertaken. A general linear model analysis indicated that the major activated site in the AD group was the primary sensory cortex (SI) and motor cortex (MI) (p < 0.05, family wise error corrected). In the OD group, teeth tapping induced brain activity at various foci (p < 0.05, family wise error corrected), including the SI, MI, insula cortex, supplementary motor cortex (SMC)/premotor cortex (PMA), cerebellum, thalamus, and basal ganglia in each group. (2) Group comparisons between the OD and OEd subjects showed decreased activity in the SI, MI, Brodmann’s area 6 (BA6), thalamus (ventral posteromedial nucleus, VPM), basal ganglia, and insular cortex (p ¡ 0.005, uncorrected). This suggested that the decreased S1/M1 activity in the OEd group was related to missing teeth, which led to reduced periodontal afferents. (3) A conjunction analysis in the OD and OEd/OE groups revealed that commonly activated areas were the MI, SI, cerebellum, BA6, thalamus (VPM), and basal ganglia (putamen; p < 0.05, FWE corrected). These areas have been associated with voluntary movements. (4) Psychophysiological interaction analysis (OEd vs OE) showed that subcortical and cortical structures, such as the MI, SI, DLPFC, SMC/PMA, insula cortex, basal ganglia, and cerebellum, likely function as hubs and form an integrated network that participates in the control of teeth tapping. These results suggest that oral sensory inputs are involved in the control of teeth tapping through feedforward control of intended movements, as well as feedback control of ongoing movements.

Twitches, Blinks, and Fidgets: Important Generators of Ongoing Neural Activity

Animals and humans continuously engage in small, spontaneous motor actions, such as blinking, whisking, and postural adjustments ("fidgeting"). These movements are accompanied by changes in neural activity in sensory and motor regions of the brain. The frequency of these motions varies in time, is affected by sensory stimuli, arousal levels, and pathology. These fidgeting behaviors can be entrained by sensory stimuli. Fidgeting behaviors will cause distributed, bilateral functional activation in the 0.01 to 0.1 Hz frequency range that will show up in functional magnetic resonance imaging and wide-field calcium neuroimaging studies, and will contribute to the observed functional connectivity among brain regions. However, despite the large potential of these behaviors to drive brain-wide activity, these fidget-like behaviors are rarely monitored. We argue that studies of spontaneous and evoked brain dynamics in awake animals and humans should closely monitor these fidgeting behaviors. Differences in these fidgeting behaviors due to arousal or pathology will "contaminate" ongoing neural activity, and lead to apparent differences in functional connectivity. Monitoring and accounting for the brain-wide activations by these behaviors is essential during experiments to differentiate fidget-driven activity from internally driven neural dynamics.

Dental deafferentation and brain damage: A review and a hypothesis

In the last few decades, neurobiological and human brain imaging research have greatly advanced our understanding of brain mechanisms that support perception and memory, as well as their function in daily activities. Knowledge of the neurobiological mechanisms behind the deafferentation of stomatognathic systems has also expanded greatly in recent decades. In particular, current studies reveal that the peripheral deafferentations of stomatognathic systems may be projected globally into the central nervous system (CNS) and become an associated critical factor in triggering and aggravating neurodegenerative diseases. This review explores basic neurobiological mechanisms associated with the deafferentation of stomatognathic systems. Further included is a discussion on tooth loss and other dental deafferentation (DD) mechanisms, with a focus on dental and masticatory apparatuses associated with brain functions and which may underlie the changes observed in the aging brain. A new hypothesis is presented where DD and changes in the functionality of teeth and the masticatory apparatus may cause brain damage as a result of altered cerebral circulation and dysfunctional homeostasis. Furthermore, multiple recurrent reorganizations of the brain may be a triggering or contributing risk factor in the onset and progression of neurodegenerative conditions such as Alzheimer's disease (AD). A growing understanding of the association between DD and brain aging may lead to solutions in treating and preventing cognitive decline and neurodegenerative diseases.

Decreased γ-aminobutyric acid levels in the brainstem in patients with possible sleep bruxism: A pilot study

BACKGROUND

An increasing number of studies have indicated that the central and autonomic nervous systems play roles in the genesis of sleep bruxism (SB). The role of specific neurochemicals in SB has been a subject of interest.

OBJECTIVE

In this study, we use proton magnetic resonance spectroscopy (¹ H-MRS) to determine whether the levels of γ-aminobutyric acid (GABA) and glutamate (Glu) are different in the brainstem and bilateral cortical masticatory area (CMA) between possible sleep bruxism (SB) patients and controls, and discuss whether the brainstem or cortical networks which may affect the central masticatory pathways are under the genesis of SB.

METHODS

Twelve possible SB patients and twelve age- and gender-matched controls underwent ¹ H-MRS using the "MEGA-Point Resolved Spectroscopy Sequence" (MEGA-PRESS) technique in the brainstem and bilateral CMA. Proton magnetic resonance spectroscopy data were processed using LCModel. Because the signal detected by MEGA-PRESS includes contributions from GABA, macromolecules (primarily proteins) and homocarnosine, the GABA signal is referred to as "GABA+". The glutamate complex (Glx) signal contains both glutamate (Glu) and glutamine (Gln), which mainly reflect glutamatergic metabolism.

RESULTS

Edited spectra were successfully obtained from the bilateral CMA in all subjects. There were no significant differences in neurochemical levels between the left and right CMA in possible SB patients and controls. In the brainstem, significantly lower GABA+ levels were found in possible SB patients than in controls (P = .011), whereas there was no significant difference (P = .307) in Glx levels between the 2 groups.

CONCLUSIONS

SB patients may possess abnormalities in the GABAergic system of brainstem networks.

Effect of Gum Chewing Frequency on Oxygenation of the Prefrontal Cortex

Since increased cerebral oxygenation reflects cerebral activation, this study investigated the effect of mastication frequency on prefrontal cortex oxygenation. Eleven young volunteers (nine women, two men; M age = 20.9 years, SD = 0.9) carried out three trials in which they were asked to chew a tasteless gum for 3 min at varying (rates of mastication frequency: 30, 70, and 110). Breaks of 2 min each were interleaved between trials. The oxygenation of the left prefrontal cortex was monitored by near-infrared spectroscopy. We found a significant increase in cortical oxygenation during gum chewing in all three conditions ( p < .05), compared with a resting level; we also found a significant difference between the Fast and Slow chewing conditions, and between the Fast and Normal (70 rpm) conditions, both findings seemingly related to activation of a motor command in frontal brain regions. To our knowledge, this is the first report on the effect of mastication frequency on cerebral oxygenation. Possible implications of this finding are discussed.

Influence of Human Jaw Movement on Cerebral Blood Flow

Temporal changes in cerebral blood flow induced by jaw movement have yet to be investigated. To assess the influence of pattern and intensity of muscle contraction during jaw movement on task-induced change in cerebral blood flow, we performed bilateral transcranial Doppler ultrasound examination during clenching, gum chewing, and tooth tapping in healthy volunteers. A random-effects model analysis revealed a significant increase in middle cerebral artery blood flow velocity during clenching (high muscle activity) and gum chewing (moderate muscle activity), compared with the preceding rest period; however, such an increase was not detected during tooth tapping (low muscle activity). Cerebral blood flow was greater on the working side during the intensive isometric contraction of the masseter muscle in clenching. These results suggest that task-induced change in cerebral blood flow during jaw movement is influenced by the change in peripheral circulation evoked by muscle contraction.

Chewing-side Preference is Involved in Differential Cortical Activation Patterns during Tongue Movements after Bilateral Gum-chewing: a Functional Magnetic Resonance Imaging Study

Contralateral dominance in the activation of the primary sensorimotor cortex (S1/M1) during tongue movements (TMs) has been shown to be associated with a chewing-side preference (CSP). However, little is known about its interaction with chewing-related cortical activation. Functional magnetic resonance imaging was performed before and after gum-chewing in six subjects who exhibited a left CSP to determine the relationship between the CSP and activation patterns in the S1/M1 during TMs. Before the subjects chewed the gum, activation foci were found in the bilateral S1/M1. In the left hemisphere, both signal intensity and the area of activation significantly increased during TMs within 10 min after subjects chewed gum. Moreover, this augmented activation significantly decreased within 20 min during tongue protrusion and leftward movement. In the right hemisphere, there were no marked changes during TMs. These results suggest that bilateral gum-chewing enhances activation of the S1/M1 ipsilateral to the CSP during TMs.

Altered neural activation pattern during teeth clenching in temporomandibular disorders

OBJECTIVE

The aim was to explore the neural activations during teeth clenching in TMDs patients pre- and post-treatment.

SUBJECTS AND METHODS

Thirty TMDs patients and 20 controls underwent clinical evaluations and functional magnetic resonance imaging with a teeth clenching task. Eleven patients received repeat evaluation and imaging after wearing a stabilization splint for 3 months.

RESULTS

During teeth clench, the TMDs patients showed decreased positive activity in the left precentral gyrus, right and left inferior temporal gyrus, and left cerebellum and increased negative activations in the right medial prefrontal cortex (P < 0.05 after AlphaSim correction). The 11 TMDs patients after treatment showed a return to normal neural activity in these areas. No brain areas in TMDs patients showed differences in activation after treatment compared with the controls, except for an increase in activation in the right cerebellum in the 11 TMDs patients (P < 0.05 after AlphaSim correction).

CONCLUSION

Decreased activations in cerebral areas associated with motor and cognitive functions in TMDs patients during teeth clenching were observed. Normalized activations of these areas happened in patients after routine treatment. These findings may facilitate the understanding of TMDs pathogenesis and the therapeutic mechanisms of the stabilization splint.

Animal Models for Elucidation of the Mechanisms of Neuropsychiatric Disorders Induced by Sleep and Dietary Habits

Numerous changes in human lifestyle in modern life increase the risk of disease. Especially, modern sleep and dietary habits are crucial factors affecting lifestyle disease. In terms of sleep, decreases in total sleep time and in rapid eye movement sleep time have been observed in attention-deficit/hyperactivity disorder (ADHD) patients. From a dietary perspective, mastication during eating has several good effects on systemic, mental, and physical functions of the body. However, few animal experiments have addressed the influence of this decline in sleep duration or of long-term powdered diet feeding on parameters reflecting systemic health. In our studies, we examined both the influence of intermittent sleep deprivation (SD) treatment and long-term powdered diet feeding on emotional behavior in mice, and focused on the mechanisms underlying these impaired behaviors. Our findings were as follows: SD treatment induced hypernoradrenergic and hypodopaminergic states within the frontal cortex. Furthermore, hyperactivity and an explosive number of jumps were observed. Both the hypernoradrenergic state and the jumps were improved by treatment with ADHD therapeutic drugs. On the other hand, long-term powdered diet feeding increased social interaction behaviors. The feeding affected the dopaminergic function of the frontal cortex. In addition, the long-term powdered diet fed mice presented systemic illness signs, such as elevations of blood glucose, and hypertension. This review, describing the SD mice and long-term powdered diet fed mice can be a useful model for elucidation of the mechanism of neuropsychiatric disorders or the discovery of new therapeutic targets in combatting effects of the modern lifestyle.

Effects of neuromuscular electrical stimulation on masticatory muscles in elderly stroke patients

[Purpose] This study aimed to examine the effects of neuromuscular electrical stimulation on masticatory muscle activation in elderly stroke patients. [Subjects and Methods] The subjects included 20 elderly patients diagnosed with stroke and 10 healthy elderly individuals. The neuromuscular electrical stimulation group received stimulation on the masseter muscle in the affected side for 30 min each day, 3 times per week for 8 weeks. In all the subjects, surface electromyography was used to measure activity of the masseter and temporal muscles in both sides under resting and clenching conditions. [Results] In the neuromuscular electrical stimulation group, after the intervention, an increase in the activity of all of the masticatory muscles was observed during clenching, with a significant increase in the activity of the masseter muscle in the affected side. Significant differences between the groups were not observed after the interventions. [Conclusion] The results of this study suggest that application of neuromuscular electrical stimulation effectively improves muscle activity in elderly stroke patients during clenching, and that this technique can be applied particularly for the improvement of the clenching activity of the masseter muscle in the affected side.

Mastication as a Stress-Coping Behavior

Exposure to chronic stress induces various physical and mental effects that may ultimately lead to disease. Stress-related disease has become a global health problem. Mastication (chewing) is an effective behavior for coping with stress, likely due to the alterations chewing causes in the activity of the hypothalamic-pituitary-adrenal axis and autonomic nervous system. Mastication under stressful conditions attenuates stress-induced increases in plasma corticosterone and catecholamines, as well as the expression of stress-related substances, such as neurotrophic factors and nitric oxide. Further, chewing reduces stress-induced changes in central nervous system morphology, especially in the hippocampus and hypothalamus. In rodents, chewing or biting on wooden sticks during exposure to various stressors reduces stress-induced gastric ulcer formation and attenuates spatial cognitive dysfunction, anxiety-like behavior, and bone loss. In humans, some studies demonstrate that chewing gum during exposure to stress decreases plasma and salivary cortisol levels and reduces mental stress, although other studies report no such effect. Here, we discuss the neuronal mechanisms that underline the interactions between masticatory function and stress-coping behaviors in animals and humans.

To see bruxism: a functional MRI study

OBJECTIVE

Since the pathophysiology of bruxism is not clearly understood, there exists no possible treatment. The aim of this study is to investigate the cerebral activation differences between healthy subjects and patients with bruxism on behalf of possible aetiological factors.

METHODS

12 healthy subjects and 12 patients with bruxism, a total of 24 right-handed female subjects (aged 20-27 years) were examined using functional MRI during tooth-clenching and resting tasks. Imaging was performed with 3.0-T MRI scanner with a 32-channel head coil. Differences in regional brain activity between patients with bruxism and healthy subjects (control group) were observed with BrainVoyager QX 2.8 (Brain Innovation, Maastricht, Netherlands) statistical data analysis program. Activation maps were created using the general linear model: single study and multistudy multisubject for statistical group analysis. This protocol was approved by the ethics committee of medical faculty of Kirikkale University, Turkey (02/04), based on the guidelines set forth in the Declaration of Helsinki.

RESULTS

The group analysis revealed a statistically significant increase in blood oxygenation level-dependent signal of three clusters in the control group (p<0.005), which may indicate brain regions related with somatognosis, repetitive passive motion, proprioception and tactile perception. These areas coincide with Brodmann areas 7, 31, 39 and 40. It is conceivable that there are differences between healthy subjects and patients with bruxism.

CONCLUSIONS

Our findings indicate that there was a decrease of cortical activation pattern in patients with bruxism in clenching tasks. This indicates decreased blood flow and activation in regional neuronal activity. Bruxism, as an oral motor disorder concerns dentistry, neurology and psychiatry. These results might improve the understanding and physiological handling of sleep bruxism.

Influence of a long-term powdered diet on the social interaction test and dopaminergic systems in mice

It is well known that the characteristics of mastication are important for the maintenance of our physical well-being. In this study, to assess the importance of the effects of food hardness during mastication, we investigated whether a long-term powdered diet might cause changes in emotional behavior tests, including spontaneous locomotor activity and social interaction (SI) tests, and the dopaminergic system of the frontal cortex and hippocampus in mice. Mice fed a powdered diet for 17 weeks from weaning were compared with mice fed a standard diet (control). The dopamine turnover and expression of dopamine receptors mRNA in the frontal cortex were also evaluated. Spontaneous locomotor activity, SI time and dopamine turnover of the frontal cortex were increased in powdered diet-fed mice. On the other hand, the expression of dopamine-4 (D4) receptors mRNA in the frontal cortex was decreased in powdered diet-fed mice. Moreover, we examined the effect of PD168077, a selective D4 agonist, on the increased SI time in powdered diet-fed mice. Treatment with PD168077 decreased the SI time. These results suggest that the masticatory dysfunction induced by long-term powdered diet feeding may cause the increased SI time and the changes in the dopaminergic system, especially dopamine D4 receptor subtype in the frontal cortex.

Effects of chewing on cognitive processing speed

In recent years, chewing has been discussed as producing effects of maintaining and sustaining cognitive performance. We have reported that chewing may improve or recover the process of working memory; however, the mechanisms underlying these phenomena are still to be elucidated. We investigated the effect of chewing on aspects of attention and cognitive processing speed, testing the hypothesis that this effect induces higher cognitive performance. Seventeen healthy adults (20-34 years old) were studied during attention task with blood oxygenation level-dependent functional (fMRI) at 3.0 T MRI. The attentional network test (ANT) within a single task fMRI containing two cue conditions (no cue and center cue) and two target conditions (congruent and incongruent) was conducted to examine the efficiency of alerting and executive control. Participants were instructed to press a button with the right or left thumb according to the direction of a centrally presented arrow. Each participant underwent two back-to-back ANT sessions with or without chewing gum, odorless and tasteless to remove any effect other than chewing. Behavioral results showed that mean reaction time was significantly decreased during chewing condition, regardless of speed-accuracy trade-off, although there were no significant changes in behavioral effects (both alerting and conflict effects). On the other hand, fMRI analysis revealed higher activations in the anterior cingulate cortex and left frontal gyrus for the executive network and motor-related regions for both attentional networks during chewing condition. These results suggested that chewing induced an increase in the arousal level and alertness in addition to an effect on motor control and, as a consequence, these effects could lead to improvements in cognitive performance.

Brain activity and human unilateral chewing: an FMRI study

Brain mechanisms underlying mastication have been studied in non-human mammals but less so in humans. We used functional magnetic resonance imaging (fMRI) to evaluate brain activity in humans during gum chewing. Chewing was associated with activations in the cerebellum, motor cortex and caudate, cingulate, and brainstem. We also divided the 25-second chew-blocks into 5 segments of equal 5-second durations and evaluated activations within and between each of the 5 segments. This analysis revealed activation clusters unique to the initial segment, which may indicate brain regions involved with initiating chewing. Several clusters were uniquely activated during the last segment as well, which may represent brain regions involved with anticipatory or motor events associated with the end of the chew-block. In conclusion, this study provided evidence for specific brain areas associated with chewing in humans and demonstrated that brain activation patterns may dynamically change over the course of chewing sequences.

Stress and chewing affect blood flow and oxygen levels in the rat brain

OBJECTIVE

Mastication, including chewing, would be of great importance not only for food intake, but also for the mental, physical and physiological functioning of the body. Our study showed that mastication, especially chewing, suppresses the stress response and was regarded as a biological response to defend against various stresses. Although mastication altered brain function during stress, the underlying mechanisms have not been elucidated.

METHODS

The effects of chewing during restraint stress on blood flow and oxygen partial pressure (PO(2)) levels in the rat amygdala and hypothalamus were measured using laser Doppler flowmetry and O(2)-selective electrodes.

RESULTS

Amygdaloidal and hypothalamic blood flow were not affected by restraint stress, but PO(2) levels were significantly reduced by restraint stress for 180 min compared to unrestrained control rats. The decrease in amygdaloidal and hypothalamic PO(2) levels during restraint stress was reduced after chewing for 30 min.

CONCLUSION

These results suggested that it is possible to evaluate hypothalamic and amygdaloidal blood flow and PO(2) levels in rat brains during restraint stress. Restraint stress reduced cerebral PO(2) levels. In addition, chewing would lead to increased blood flow and to recover cerebral PO(2) levels.

Both texting and eating are associated with impaired simulated driving performance

OBJECTIVE

Distracted driving is a known contributor to traffic accidents, and many states have banned texting while driving. However, little is known about the potential accident risk of other common activities while driving, such as eating. The objective of the current study was to examine the adverse impact of eating/drinking behavior relative to texting and nondistracted behaviors on a simulated driving task.

METHODS

A total of 186 participants were recruited from undergraduate psychology courses over 2 semesters at Kent State University. We utilized the Kent Multidimensional Assessment Driving Simulation (K-MADS) to compare simulated driving performance among participants randomly assigned to texting (N = 45), eating (N = 45), and control (N = 96) conditions. Multivariate analyses of variance (MANOVA) were conducted to examine between-group differences on simulated driving indices.

RESULTS

MANOVA analyses indicated that groups differed in simulated driving performance, F(14, 366) = 7.70, P < .001. Both texting and eating produced impaired driving performance relative to controls, though these behaviors had approximately equal effect. Specifically, both texting and eating groups had more collisions, pedestrian strikes, and center line crossings than controls. In addition, the texting group had more road edge excursions than either eating or control participants and the eating group missed more stop signs than controls.

CONCLUSIONS

These findings suggest that both texting and eating are associated with poorer simulated driving performance. Future work is needed to determine whether these findings generalize to real-world driving and the development of strategies to reduce distracted driving.

Interactions between occlusion and human brain function activities

There are few review articles in the area of human research that focus on the interactions between occlusion and brain function. This systematic review discusses the effect of occlusion on the health of the entire body with a focus on brain function. Available relevant articles in English from 1999 to 2011 were assessed in an online database and as hard copies in libraries. The selected 19 articles were classified into the following five categories: chewing and tongue movements, clenching and grinding, occlusal splints and occlusal interference, prosthetic rehabilitation, and pain and stimulation. The relationships between the brain activity observed in the motor and sensory cortices and movements of the oral and maxillofacial area, such as those produced by gum chewing, tapping and clenching, were investigated. It was found that the sensorimotor cortex was also affected by the placement of the occlusal interference devices, splints and implant prostheses. Brain activity may change depending on the strength of the movements in the oral and maxillofacial area. Therefore, mastication and other movements stimulate the activity in the cerebral cortex and may be helpful in preventing degradation of a brain function. However, these findings must be verified by evidence gathered from more subjects.

Sensorimotor cortical activation in patients with sleep bruxism

Sleep bruxism is assumed to be triggered by a dysfunctional subcortical and cortical network. This study investigates sensorimotor cortical activation in patients with sleep bruxism during clenching and chewing. Nine polysomnographically diagnosed patients and nine healthy control subjects underwent magnetoencephalography (MEG). During clenching and chewing, patients with bruxism revealed significantly larger event-related desynchronization in the somatomotor area (Brodmann area 4) than healthy subjects. Group differences in the muscle activity were ruled out by electromyography (EMG) assessments during MEG. This result might be regarded as a consequence of increased sensorimotor cortical representation of the tongue and chewing musculature due to an enhanced parafunctional muscle activity in bruxers potentially triggered by occlusal factors. Alternatively, a secondary activation of cortical structures during sleep bruxism in the context of an activated network of subcortical and cortical structures might lead to increased cortical representation of the chewing musculature via use dependent plasticity.

The cerebral representation of temporomandibular joint occlusion and its alternation by occlusal splints

Occlusal splints are a common and effective therapy for temporomandibular joint disorder. Latest hypotheses on the impact of occlusal splints suggest an altered cerebral control on the occlusion movements after using a splint. However, the impact of using a splint during chewing on its cerebral representation is quite unknown. We used functional magnetic resonance imaging (fMRI) to investigate brain activities during occlusal function in centric occlusion on natural teeth or on occlusal splints in fifteen healthy subjects. Comparisons between conditions revealed an increased activation for the bilateral occlusion without a splint in bilateral primary and secondary sensorimotor areas, the putamen, inferior parietal and prefrontal cortex (left dorsal and bilateral orbital) and anterior insular. In contrast, using a splint increased activation in the bilateral prefrontal lobe (bilateral BA 10), bilateral temporo-parietal (BA 39), occipital and cerebellar hemispheres. An additionally applied individually based evaluation of representation sites in regions of interest demonstrated that the somatotopic representation for both conditions in the pre- and postcentral gyri did not significantly differ. Furthermore, this analysis confirmed the decreasing effect of the splint on bilateral primary and secondary motor and somatosensory cortical activation. In contrast to the decreasing effect on sensorimotor areas, an increased level of activity in the fronto-parieto-occipital and cerebellar network might be associated with the therapeutic effect of occlusal splints.

Comparison of cerebral activation involved in oral and manual stereognosis

Brain activity associated with manual stereognosis has been the focus of increasing recent research effort. However, although oral stereognosis, defined as the ability to recognize and discriminate the food bolus in the mouth, is important for mastication and swallowing, there is little information available about the neural network relating to this function. In the present study, cerebral activation associated with oral stereognosis was evaluated as compared with manual stereognosis. Brain imaging data were acquired by functional MRI (fMRI). fMRI experiments were performed on 16 healthy right-handed young adults without any history of neurological or psychiatric disorders. All subjects had all teeth without malocclusion. Ten stereognosis test shape pieces sized approximately 20 mm × 20 mm × 10 mm were fabricated for this experiment. All test pieces had a complicated form that made them difficult to recognize with ease. Subjects were instructed to assess the shape of the test piece in the mouth or hand. The ten test pieces were randomly assigned to each subject and each run. Stereognosis-specific activation was found in the primary somatosensory area, primary motor area, supramarginal gyrus, premotor area, supplementary motor area, fusiform gyrus, frontopolar area and dorsolateral prefrontal cortex. Differences in cerebral activation between oral and manual stereognosis were found in the insular cortex and visual association cortex.

fMRI study of brain activity elicited by oral parafunctional movements

Parafunctional masticatory activity, such as the tooth clenching and grinding that is associated with bruxism, is encountered by clinicians in many disciplines, including dentistry, neurology and psychiatry. Despite this, little is known about the neurological basis for these activities. To identify the brain network engaged in such complex oromotor activity, functional magnetic resonance imaging (fMRI) was used to elucidate the brain activation patterns of 20 individuals (10 males and 10 females, mean s.d. age of 26.3+/-4.1 years) with (parafunctional, PFx group, 5M/5F) and without (normal functional, NFx group, 5 M/5F) self-reported parafunctional grinding and clenching habits during clenching and grinding tasks. Subject group classification was based on: (i) self-reported history, (ii) clinical examination, (iii) evaluation of dental casts and (iv) positive responses to the temporomandibular disorder (TMD) History Questionnaire [Dworkinand LeResche, Journal of Craniomandibular Disorders, (1992) 6:301]. While subjects performed these oromotor tasks, each wore a custom-designed oral appliance minimizing head motion during imaging. Mean per cent signal changes showed significant between group differences in motor cortical (supplementary motor area, sensorimotor cortex and rolandic operculum) and subcortical (caudate) regions. Supplementary motor area data suggest that motor planning and initiation, particularly during the act of clenching, are less prominent in individuals with oromotor parafunctional behaviours. The overall extent of activated areas was reduced in subjects with self-reported parafunctional masticatory activity compared with the controls. This study's methodology and findings provide an initial step in understanding the neurological basis of parafunctional masticatory activities that are relevant for therapeutic research applications of temporomandibular joint and muscle disorders and associated comorbidities.