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Difference between revisions of "Trigeminal Nervous System Segmentation/it"
Trigeminal Nervous System Segmentation/it (view source)
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'''Bruxismo''' <span lang="en" dir="ltr" class="mw-content-ltr">is usually believed to be related to musculoskeletal pain, such as pain from TMDs, but also to muscular-tensive headache</span>. <span lang="en" dir="ltr" class="mw-content-ltr">Few studies have actually tried to fully describe the pain associated with bruxism examining the neurobiological and physiological characteristics of the mandibular muscles</span>. <span lang="en" dir="ltr" class="mw-content-ltr">There are some clinical cases in the literature and small studies suggesting that some drugs related to dopaminergic, serotonergic, and adrenergic systems, can both suppress and exacerbate bruxism</span>. <span lang="en" dir="ltr" class="mw-content-ltr">Most of the pharmacological studies mentioned before indicate that several classes of medications can affect muscle activity related to bruxism without having any effect on Orofacial Pain</span> (OP: | '''Bruxismo''' <span lang="en" dir="ltr" class="mw-content-ltr">is usually believed to be related to musculoskeletal pain, such as pain from TMDs, but also to muscular-tensive headache</span>. <span lang="en" dir="ltr" class="mw-content-ltr">Few studies have actually tried to fully describe the pain associated with bruxism examining the neurobiological and physiological characteristics of the mandibular muscles</span>. <span lang="en" dir="ltr" class="mw-content-ltr">There are some clinical cases in the literature and small studies suggesting that some drugs related to dopaminergic, serotonergic, and adrenergic systems, can both suppress and exacerbate bruxism</span>. <span lang="en" dir="ltr" class="mw-content-ltr">Most of the pharmacological studies mentioned before indicate that several classes of medications can affect muscle activity related to bruxism without having any effect on Orofacial Pain</span> (OP: Dolore orofacciale)<ref>{{cita libro | ||
| autore = Winocur E | | autore = Winocur E | ||
| autore2 = Gavish A | | autore2 = Gavish A | ||
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}}</ref>. <span lang="en" dir="ltr" class="mw-content-ltr">It seems that the ‘sensitization’ of the trigeminal nociception system, the facilitation effect on the mandibular reflesxs, and the hyper-excitability of CNS are neurophysiopathogenetic phenomena that are related to pain in the craniofacial district</span>. <span lang="en" dir="ltr" class="mw-content-ltr">At the same time, the recovery cycle of the torpedo period shows the level of neuronal excitability of the trigeminal system, and it could be a valid method of testing the excitability of the nervous system</span>. | }}</ref>. <span lang="en" dir="ltr" class="mw-content-ltr">It seems that the ‘sensitization’ of the trigeminal nociception system, the facilitation effect on the mandibular reflesxs, and the hyper-excitability of CNS are neurophysiopathogenetic phenomena that are related to pain in the craniofacial district</span>. <span lang="en" dir="ltr" class="mw-content-ltr">At the same time, the recovery cycle of the torpedo period shows the level of neuronal excitability of the trigeminal system, and it could be a valid method of testing the excitability of the nervous system</span>. | ||
<span lang="en" dir="ltr" class="mw-content-ltr">The recovery cycle of the masseteric reflection reflex</span> (<sub>rc</sub> MIR: recovery cycle Masseteric Inhibitory Reflex) <span lang="en" dir="ltr" class="mw-content-ltr">has been studied by generating pairs of stimuli with identical characteristics provided percutaneously by an electrical stimulator positioned on the patient’s face in the emergency area of the mental nerves</span> ( | <span lang="en" dir="ltr" class="mw-content-ltr">The recovery cycle of the masseteric reflection reflex</span> (<sub>rc</sub> MIR: recovery cycle Masseteric Inhibitory Reflex) <span lang="en" dir="ltr" class="mw-content-ltr">has been studied by generating pairs of stimuli with identical characteristics provided percutaneously by an electrical stimulator positioned on the patient’s face in the emergency area of the mental nerves</span> (Figura 8). | ||
<span lang="en" dir="ltr" class="mw-content-ltr">Stimulation was carried out with a square-wave electrical stimulation that was 2.5 times the inhibitory reflection threshold, which was able to evoke a distinct <sub>rc</sub> MIR, composed of the two silent periods called ‘exteroceptive suppression’ to distinguish them from separate mechanical Silent Periods (SPs)</span>; <span lang="en" dir="ltr" class="mw-content-ltr">these can be recognized in a first silent period called ES</span><sub>1</sub> (<span lang="en" dir="ltr" class="mw-content-ltr">Exteroceptive Suppression</span> <sub>1</sub>) <span lang="en" dir="ltr" class="mw-content-ltr">and a second silent period named ES</span><sub>2</sub> (<span lang="en" dir="ltr" class="mw-content-ltr">Exteroceptive Suppression</span> <sub>2</sub>) <span lang="en" dir="ltr" class="mw-content-ltr">interspersed by the resumption of the activity EMG</span> (<span lang="en" dir="ltr" class="mw-content-ltr">Interposed IA Activity</span>). <span lang="en" dir="ltr" class="mw-content-ltr">The first stimulus (S1) is considered to be conditioning and the second (S2) a stimulation test</span>. <span lang="en" dir="ltr" class="mw-content-ltr">The interstimulus range to verify the presence of a neural hyperexcitability between S1 and S2 has been set at 150 ms</span>. | <span lang="en" dir="ltr" class="mw-content-ltr">Stimulation was carried out with a square-wave electrical stimulation that was 2.5 times the inhibitory reflection threshold, which was able to evoke a distinct <sub>rc</sub> MIR, composed of the two silent periods called ‘exteroceptive suppression’ to distinguish them from separate mechanical Silent Periods (SPs)</span>; <span lang="en" dir="ltr" class="mw-content-ltr">these can be recognized in a first silent period called ES</span><sub>1</sub> (<span lang="en" dir="ltr" class="mw-content-ltr">Exteroceptive Suppression</span> <sub>1</sub>) <span lang="en" dir="ltr" class="mw-content-ltr">and a second silent period named ES</span><sub>2</sub> (<span lang="en" dir="ltr" class="mw-content-ltr">Exteroceptive Suppression</span> <sub>2</sub>) <span lang="en" dir="ltr" class="mw-content-ltr">interspersed by the resumption of the activity EMG</span> (<span lang="en" dir="ltr" class="mw-content-ltr">Interposed IA Activity</span>). <span lang="en" dir="ltr" class="mw-content-ltr">The first stimulus (S1) is considered to be conditioning and the second (S2) a stimulation test</span>. <span lang="en" dir="ltr" class="mw-content-ltr">The interstimulus range to verify the presence of a neural hyperexcitability between S1 and S2 has been set at 150 ms</span>. | ||
<span lang="en" dir="ltr" class="mw-content-ltr">In our studies, healthy subjects were instructed to tighten their teeth to produce the maximum EMG activity and maintain it for at least 3 seconds with the help of visual and sound feedback</span>. <span lang="en" dir="ltr" class="mw-content-ltr">After 60 seconds of rest, the subject repeated the contraction</span>. <span lang="en" dir="ltr" class="mw-content-ltr">The EMG signal was recorded both in direct mode and in mediated mode</span>. <span lang="en" dir="ltr" class="mw-content-ltr">The disposition of the recorder electrodes must be the same as for the registration of the <sub>b</sub> Root, jaw jerk, and SP</span>. <span lang="en" dir="ltr" class="mw-content-ltr">The parameters of the preamplifier will have to be set in 50 ms per division, 100 mV per division, and the filter bandwidth of 50 Hz–1 kHz</span>. | <span lang="en" dir="ltr" class="mw-content-ltr">In our studies, healthy subjects were instructed to tighten their teeth to produce the maximum EMG activity and maintain it for at least 3 seconds with the help of visual and sound feedback</span>. <span lang="en" dir="ltr" class="mw-content-ltr">After 60 seconds of rest, the subject repeated the contraction</span>. <span lang="en" dir="ltr" class="mw-content-ltr">The EMG signal was recorded both in direct mode and in mediated mode</span>. <span lang="en" dir="ltr" class="mw-content-ltr">The disposition of the recorder electrodes must be the same as for the registration of the <sub>b</sub> Root, jaw jerk, and SP</span>. <span lang="en" dir="ltr" class="mw-content-ltr">The parameters of the preamplifier will have to be set in 50 ms per division, 100 mV per division, and the filter bandwidth of 50 Hz–1 kHz</span>. | ||
[[File:Laser test.jpg|thumb|''' | [[File:Laser test.jpg|thumb|'''Figura 9:''' <span lang="en" dir="ltr" class="mw-content-ltr">Preparation of the subject to laser stimulation to evoke nociceptive evoked potentials and masseteric inhibitory reflexes</span>.]] | ||
====<span lang="en" dir="ltr" class="mw-content-ltr">Laser Evoked Potentials and Masseteric Laser Silent Period</span>==== | ====<span lang="en" dir="ltr" class="mw-content-ltr">Laser Evoked Potentials and Masseteric Laser Silent Period</span>==== | ||
<span lang="en" dir="ltr" class="mw-content-ltr">To evoke motor responses from the masticatory muscles or potential laser evenings, we employ a laser stimulator</span> CO<sub>2</sub> (Neurolas, | <span lang="en" dir="ltr" class="mw-content-ltr">To evoke motor responses from the masticatory muscles or potential laser evenings, we employ a laser stimulator</span> CO<sub>2</sub> (Neurolas, Firenze, Italia) <span lang="en" dir="ltr" class="mw-content-ltr">capable of generating a radiant caloria (10.6 mm; intensity 1.5–15 W; duration of 10–15 ms; diameter of the 2.5 mm spot) in the area of the skin in upper and lower upper and lower region (trigeminal terrain V2 and V3)</span>. <span lang="en" dir="ltr" class="mw-content-ltr">The subjects must sit comfortably in the dental chair and wear protective goggles</span> (Figura 9). <span lang="en" dir="ltr" class="mw-content-ltr">To avoid the habit to the nociceptive stimuli and the overheating of the skin, the irradiated points have been shifted after each stimulation</span>. | ||
[[File:Laser_Evoked_Potentials_-_Blink_reflex_-_Masseter_Silent_Period.jpg|left|thumb|'''<span lang="en" dir="ltr" class="mw-content-ltr">Figure</span> 10:''' <span lang="en" dir="ltr" class="mw-content-ltr">Laser stimulation that evoke a Blink reflex (BR), a Masseter Inhibitor Reflex (MIR) and Evoked Potentials Laser</span> (LEPs)]] | [[File:Laser_Evoked_Potentials_-_Blink_reflex_-_Masseter_Silent_Period.jpg|left|thumb|'''<span lang="en" dir="ltr" class="mw-content-ltr">Figure</span> 10:''' <span lang="en" dir="ltr" class="mw-content-ltr">Laser stimulation that evoke a Blink reflex (BR), a Masseter Inhibitor Reflex (MIR) and Evoked Potentials Laser</span> (LEPs)]] | ||