不同体感输入对运动皮层咀嚼肌控制区兴奋性的影响  

Influence of different somatosensory inputs on excitability of masticatory control area of motor cortex

作　　者：许梦涵 王可心 欧阳奕彬 苏晶 陈欣 刘星纲[3] 吕绳漪[3] Xu Menghan;Wang Kexin;Ouyang Yibin;Su Jing;Chen Xin;Liu Xinggang;Lv Shengyi(Beijing Stomatological Hospital,Capital Medical University,Beijing 100070,China;Department of Stomatology,Eighth Medical Center,Chinese PLA General Hospital,Beijing 100091,China;Department of Prosthodontics,Wangfujing Branch,Beijing Stomatological Hospital,Capital Medical University,Beijing 100006,China)

机构地区：[1]首都医科大学附属北京口腔医院,北京100070 [2]解放军总医院第八医学中心口腔科 [3]首都医科大学附属北京口腔医院王府井院区口腔修复科

出　　处：《口腔颌面修复学杂志》2025年第3期170-177,共8页Chinese Journal of Prosthodontics

基　　金：北京市属医院科研培育计划(PX2021058)。

摘　　要：目的:本研究通过在受试者切咬训练中加入视觉与听觉等体感输入条件,探究不同体感输入对精细切咬训练促进运动皮层咀嚼肌控制区兴奋性的影响。方法:本实验招募12名受试者,采用自身配对设计,前后对照,进行4期不同组别(空白组、听觉组、视觉组、视听结合组)的精细切咬训练实验,4组间的区别在于切咬训练中加入的体感输入条件不同,每组实验间洗脱期至少2周,利用导航经颅磁刺激在切咬训练前后分别对受试者的咬肌及第一背侧骨间肌进行皮质兴奋性相关统计指标的测量及分析。结果:在咬合控制训练前后,对照组vs视觉组、视觉组vs听觉组无明显统计学差异(P>0.05),对照组vs听觉组、对照组vs视听结合组、视觉组vs视听结合组、听觉组vs视听结合组均有统计学差异(P<0.05)。在咬合力的判断训练中,训练前后仅视听结合组vs对照组差异显著(P<0.05),其余各组间对比无明显差异(P>0.05)。视觉、听觉、及视听结合组训练前后运动皮层咬肌控制区的运动诱发电位平均振幅均有统计学意义(P<0.05),视听结合组训练前后运动皮层咬肌控制区的控制区域面积有统计学意义(P<0.05)。结论:体感输入的加入尤其是视觉与听觉联合叠加对咬合训练的皮层兴奋效果能起到一定程度的促进作用,可运用在今后皮层兴奋性研究中的咬合训练设计中,并且为今后临床提高咬合重建适应性提供方法学参考。Objective:In this study,visual input and auditory input conditions were added to the subjects'fine bite training to explore the effects of different somatosensory input on the stimulation of masticatory control area of motor cortex during fine bite training.Methods:In this experiment,12 subjects were recruited,and 4 periods of fine cutting and biting training experiments were conducted in different groups(blank group,auditory group,visual group,audio-visual combination group)by self-matching design before and after control.The difference among the 4 groups was that the sensory input conditions were different in the bite training,and the washout period between each group was at least 2 weeks.The statistical indexes of cortical excitability of masseter muscle and first dorsal interosseous muscle were measured and analyzed by using navigational transcranial magnetic stimulation before and after bite training.Results:Before and after bite training,there were no statistically significant differences between control group vs visual group and visual group vs auditory group(P>0.05),while there were statistically significant differences between control group vs auditory group,control group vs audio-visual combination group,visual group vs audio-visual combination group,and auditory group vs audio-visual combination group(P<0.05).In the judgment training of bite force,there was significant difference between audio-visual combination group and control group before and after training(P<0.05),but no significant difference between other groups(P>0.05).The mean amplitude of motor evoked potentials in the masseter control area of motor cortex before and after training was statistically significant in the visual,auditory,and audiovisual combined groups(P<0.05).The excitability of the masseter control area in the motor cortex showed a statistically significant increase before and after training in the audiovisual combined group(P<0.05).Conclusion:The addition of sensory input,especially the combination of visual and auditory input

关 键 词：体感输入 经颅磁刺激 皮质兴奋性 精细切咬训练 

分 类 号：R783.3[医药卫生—口腔医学]