Modulation of Cortical Potential Related with Jaw Movement and Its Pato-functional Relationships in Temporomandibular Disorders

本研究旨在探讨颞下颌关节紊乱病(TMD)患者运动相关皮层电位的调制及其病理功能关系。受试者为健康对照组和TMJ点击障碍(TMJ-Click)。以张口动作作为作业绩效，用EEG和MEG诊断系统对TMJ点击的病理反馈进行检测，结果表明：1)健康受试者随着张口量的增加，准备能力增强。2)TMJ-Click显示大颌运动时张口准备电位的下降。3)健康受试者的就绪性电位、下颌运动和肌肉活动之间无相关性。4)‘imj-Click’显示准备电位与肌肉活动呈负相关。5)健康受试者出现双侧准备场，伴随着颌骨的运动、张开、关闭和侧向。6)在运动区，张开的颌骨表现为双侧的MF，而侧颌运动则表现为健侧感觉运动皮质区的MF。7)健康受试者出现双侧运动诱发电位(MEF)，并伴有张口和侧向运动。8)TMJ-Click表现为Mf随颌骨运动困难程度的变化而变化，如TMJ点击引起的颌侧活动区受限。9)TMJ-Click显示MEF较健康受试者降低，本研究阐明了感觉运动皮质活动与TMJ点击外周病理反馈之间的病理功能关系，发现TMJ-Click反馈感觉影响皮层活动的调节。

The modulation of movement related cortical potentials of temporomandibular disorders (TMD) and its patho-functional relationship were investigated in this study. The subjects were healthy controls and TMJ clicking disorders (TMJ-Click). Jaw opening movement was used as task performance, and examination of pathological feedback from TMJ clicking was conducted with EEG and MEG diagnostic systems, and the following results were obtamed1) Healthy subjects showed increased readiness potential according to the increase of jaw openig volume. 2)TMJ-Click showed the dedaralion of jaw opening readiness potentials during large jaw qenings. 3) Healthy subjects showed no relationships among readiness potentials, inandilmiar jaw movement and muscle activities. 4) 'IMJ-Click showed a negative correlation between readiness potentials and muscle activities. 5) Healthy subjects showed the bilateral appearance of readiness fields accmpanying jaw movements, opening, c1osing, and lateral direction. 6) In the motor fields, jaw opening showed bilateral appearance of MF, while lateral jaw movements showed the predcmninance of MF in the contralateral sensorimotor cortical area to the movement side. 7) Healthy subjects showed the bilateral appearance of movement evoked fields (MEF) accompanying jaw opening and lateral movements. 8) TMJ-Click showed the modulation of MF in accordance with difficulty of jaw movement, such as restriction of the lateral jaw movement area caused by TMJ clicking. 9) TMJ-Click showed the decrease of MEF compared from that of healthy subjects.In this study, patho-functional relationships were clarifled between sensorimotor cortical activity and peripheral pathological feedback from TMJ clicking, and the findinga indicated that the feedback sensation of TMD_S affects the modulation of cortical activities.