Cerebral Responses to Electrical Stimulation of Tooth Pulp in Man
Cerebral Responses to Electrical Stimulation of Tooth Pulp in Man
复制标题
人类牙髓电刺激的大脑反应
DOI：
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发表时间：
1974
期刊：
影响因子：
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通讯作者：
R. G. Black
中科院分区：
文献类型：
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作者：
G. Chatrian;R. C. Canfield;E. Lettich;R. G. Black
在7名正常的成年志愿者中，他们在牙齿相对表面的下犬齿或侧门牙的牙本质上未经麻醉的情况下，用银汞合金修复材料将两个直径0.07毫米的钨丝电极的裸露尖端密封起来。一种快速固定的树脂材料在金属丝的绝缘层和暴露的牙齿表面之间提供连续性。橡胶坝使牙齿保持干燥。电刺激器以2.7 ~ 4.9秒的间隔传递持续时间为0.5毫秒、强度为1.5毫安的单相方波。每次刺激都会引起短暂的、中等强度的剧烈疼痛。同时记录在6个探测电极中的每一个电极和参考引线之间的50个连续脑电图（EEG）反应（头部图）被放大，存储在磁带上，由计算机求和，并由绘图仪绘制。系统的带通范围为0.16 Hz ~ 2.5 KHz （-3dB）。研究结束后，按常规修复了牙齿。牙髓诱发电位（tpep）由两个时间相关的事件序列组成。一个序列在顶点区域上发育得最好，由交替极性的五个连续波表示，初始分量为负。图中电极4的峰值潜伏期为38、72、134、234和315 msec。另一序列的电位在牙齿对侧的中央后区域下部最为突出，由最初的负偏转和随后的正波组成。在图1电极处，这些电位的峰值潜伏期分别为74和108 msec。在这些反应之后，有时会出现频率接近自发脑电图活动的有节奏的后放电。适当的操作（CltAcco和BicKFoiw， Arch Neurol 18,52 - 68,1968）证明这些tpep的起源不是肌源性的。2%盐酸甲哌卡因下颌骨阻滞麻醉使其消失。我们相信，在某种程度上，tpep代表了与疼痛感知相关的中心事件的客观、可量化、非语言伴随物，它们有望成为研究人类急性实验性牙痛的一种方法。
In seven normal, adult paid volunteers, the bare tips of two tungsten wire electrodes 0.07 mm in diameter were sealed with silver amalgam restorative material in small cavities drilled without anesthesia into the dentin of a lower canine or lateral incisor on opposite surfaces of the tooth. A quick-setting resinous material provided continuity between the insulation of the wires and the exposed tooth surface. A rubber dam kept the tooth dry. Monophasic square waves of 0.5 msec duration and 1.5 mA intensity were delivered by an electrical stimulator at intervals of 2.7 to 4.9 seconds. Each stimulus elicited brief, sharp pain of moderate intensity. Fifty consecutive electroencephalographic (EEG) responses recorded simultaneously between each of six exploring electrodes and a reference lead at the inion (head diagram) were amplified, stored on magnetic tape, summated by a computer, and graphed by a plotter. The band pass of the system was 0.16 Hz to 2.5 KHz (-3dB). The tooth was restored conventionally after the study. Tooth pulp-evoked potentials (TPEPs) consisted of two temporally related sequences of events. One sequence was best developed over the vertex area and was represented by five successive waves of alternating polarity, the initial component being negative. Peak latencies of 38, 72, 134, 234, and 315 msec were measured at electrode 4 in the Illustration. Another sequence of potentials was most prominent over the inferior portion of the postcentral region contralateral to the tooth that was stimulated and consisted of an initial negative deflection followed by a positive wave. The peak latencies of these potentials were 74 and 108 msec respectively at electrode 1 in the Illustration. These responses were followed at times by a rhythmic after-discharge of frequency close to that of the spontaneous EEG activity. Appropriate maneuvers (CltAcco and BicKFoiw, Arch Neurol 18, 52-68, 1968) demonstrated that these TPEPs were not myogenic in origin. Mandibular block anesthesia with 2% mepivacaine hydrochloride abolished them. We believe that to the extent that TPEPs represent objective, quantifiable, nonverbal concomitants of central events associated with the perception of pain, they hold promise as a method of investigating acute, experimental dental pain in man.