Study on symptoms in the limbs and hips related to temporomandibular disorders using cerebral evoked potential

本研究的目的是通过使用体感诱发电位（SEP）估计脑功能来阐明颞下颌疾病（TMD）与四肢和臀部症状之间的关系。记录正常受试者和颅面症状TMD患者的SEP，并观察误读对体感觉系统的影响。记录2例正常人（正常组）和2例伴有颅面症状的TMD患者（TMD组）经电、磁刺激下的下颌神经和正中神经的sep。磁刺激下的中短潜伏期波在正常组为19.7msec（平均值），在TMD组为19.2msec（平均值），两者间差异无统计学意义（t检验，p < 0.05）。电刺激正中神经N_<20>的潜伏期，正常组为19.1msec（平均值），TMD组为20.4msec（平均值），两者差异无统计学意义（t检验，p>0.05）。从这些结果中，得到以下结论。1. 磁刺激评价SEP.2还需进一步改进记录方法。由于正常组和TMD组的P1潜伏期和N_<20>潜伏期差异无统计学意义，提示TMD伴慢性疼痛患者的误读可能调节包括锥体束在内的高级脑功能或运动系统。

The aim of this study is to clarify the relationship between temporomandibular disorders (TMD) and symptoms in the limbs and hips by estimation of brain function using somatosensory evoked potential (SEP). SEP in both normal subjects and TMD patients with craniofacial symptoms were recorded, and then the effect of malocculusion on somatosensory system was examined.SEPs by the electrical and magnetic stimulation to the madibular nerve and the median nerve were recorded in two normal subjects (normal group) and two TMD patients with craniofacial symptoms (TMD group).Short and medium latency wave of SEP could not be detected by the magnetic stimulation to the madibular and median nerve because of mixture of stimulus artifact to SEP.The latencies of P1 by the electrical stimulation to the madibular nerve were 19.7msec (ave.) in the normal group and 19.2msec (ave.) in the TMD group, and there were not significant difference between them (t-test, p>0.05). Furthermore, the latencies of N_<20> by the electrical stimulation to the median nerve were 19.1msec (ave.) in the normal group and 20.4msec (ave.) in the TMD group, and there were not significant difference between them (t-test, p>0.05).From these results, the following conclusions were obtained. 1. Further improvement of recording method are needed to apply the magnetic stimulation for evaluation of SEP.2. Because there were not significant difference in the latencies of P1 and N_<20> between the normal group and the TMD group, it was suggested that malocculusion in the TMD patients with chronic pain modulate higher cerebral function or motor system including pyramidal tract.