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体感诱发电位(SEP)评估大脑功能，以明确TMD与四肢和髋部症状的关系。对2例正常人(正常组)和2例有颅面症状的TMD患者(TMD组)进行体感诱发电位(SEP)检查，观察错觉对躯体感觉系统的影响。对2例正常人(正常组)和2例TMD(TMD组)患者分别记录电刺激下颌神经和正中神经的体感诱发电位(SEP)。电刺激下颌神经和正中神经的潜伏期为19.7毫秒(Ave)。在正常组和19.2毫秒(平均)在TMD组，两组比较差异无统计学意义(t检验，p&gt；0.05)。电刺激正中神经的潜伏期为19.1毫秒(Ave.)正常组和20.4毫秒(Ave.)在TMD组中，两组间差异无统计学意义(t检验，p&gt；0.05)。1.将磁刺激应用于SEP的评价，需要进一步改进记录方法。由于正常组和TMD组的P_1和N_(20)潜伏期与TMD组无显著差异，提示TMD伴慢性疼痛患者的错觉调节了包括锥体束在内的较高的大脑功能或运动系统。

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.