夜磨牙(SB)患者咬肌抑制反射(MIR)及其恢复曲线实验  

The masseter inhibitory reflex(MIR) and the recovery cycle of the MIR in sleep bruxism(SB) patients

作　　者：黄黄[1] 宋宇涵[1] 王继军[2] 郭茜[2] 刘伟才[1] 

机构地区：[1]同济大学口腔医学院口腔生物医学及转化医学实验室,上海200072 [2]上海交通大学医学院附属精神卫生中心脑电影像室,上海200030

出　　处：《复旦学报（医学版）》2013年第5期541-544,555,共5页Fudan University Journal of Medical Sciences

基　　金：国家自然科学基金项目(30700960);上海市青年科技启明星计划项目(10QA1407400)~~

摘　　要：目的探索夜磨牙(sleep bruxism,SB)患者三叉神经运动脑干系统的神经生理,为后续的SB治疗提供理论依据。方法对26名SB患者及30名正常人采用单脉冲和双脉冲模式磁刺激颏神经,分别进行咬肌抑制反射(masseter inhibitory reflex,MIR)及其恢复曲线实验,双脉冲模式中设置不同间隔时间:100、200、300、400、500、600ms,分析比较单脉冲模式中早期静息期(the early silent period,SP1)和晚期静息期(the late silent period,SP2)以及双脉冲模式中测试刺激SP2的恢复程度。结果单脉冲模式中SB患者组SP1潜伏期、持续时间与正常对照组无差异;SP2有5人缺失,与对照组差异有统计学意义。双脉冲模式中SB患者不同间隔时间下测试刺激SP2的恢复程度较正常人低。结论 SB患者三叉神经运动脑干系统存在异常。Objective To study the neurophysiology of the brainstem system of the trigeminal motoneuronal system in sleep bruxism （SB） patients,so as to provide a theoretical basis for the subsequent treatment of SB. Methods In 26 SB patients and 30 healthy subjects,we studied the masseter inhibitory reflex （MIR） evoked by single magnetic stimulation in the mental territory and the recovery cycle of this reflex with the paired stimuli technique at different intervals,i.e.,100,200,300,400,500,and 600 ms.Then the early silent periods （SP1） and the late silent periods （SP2）,the recovery degree of the SP2 of the test stimuli at different intervals were analyzed. Results In SB patients and normal subjects,the latency and duration of the SP1 were similar;but the SP2 was absent in 5 patients,and the difference in SP2 absence frequency between SB patients and normal subjects was significant.With paired stimuli,the recovery degree under the SP2 of the test stimuli was significantly lower in the patients compared with normal subjects at various interstimulus intervals. Conclusions The study indicates that the brainstem system of the trigeminal motoneuronal system is abnormal.

关 键 词：夜磨牙（SB） 静息期 咬肌 反射 磁刺激 三叉神经运动脑干系统 

分 类 号：R783[医药卫生—口腔医学]