Adrian Ujin Yap, Jie Lei, Cheng-Ge Liu, Zhi-Wei Huang, Kai Yuan Fu
Background
Although females comprise the majority of patients with temporomandibular disorders (TMDs), few studies have prioritised the influence of sex on symptom severity and impact.
Objectives
This cross-sectional study investigated sex-related differences in TMD symptom severity, jaw functional limitation (JFL) and oral health-related quality of life (OHRQoL); examined their interrelationships by sex; and identified symptom-specific factors linked to high JFL and low OHRQoL.
Methods
Consecutively enrolled patients completed a survey including demographics, the Four-Dimensional Six TMD symptoms (6Ts-4D) screener, JFL Scale-8 (JFLS-8) and Oral Health Impact Profile for TMDs (OHIP-TMD). TMD diagnostic subtypes were subsequently determined according to the DC/TMD protocol. Data were evaluated using chi-square, non-parametric tests and logistic regression (α = 0.05).
Results
Among 280 participants (mean age 31.2 years [SD 11.8]), 79.3% were female. Females showed significantly higher rates of combined pain-related and intra-articular TMDs, more TMD symptoms, more severe headaches, greater JFL and poorer overall OHRQoL than males. They also demonstrated stronger correlations between global TMD severity and OHRQoL dimensions (rs = 0.38–0.66), as well as between JFL and OHRQoL (rs = 0.48–0.79). Multivariate analysis revealed that high JFL was significantly associated with jaw muscle pain (OR 1.22), jaw joint pain (OR 1.21), TMJ closed-lock (OR 1.24) and open-lock (OR 1.25), while low OHRQoL was related to jaw muscle pain (OR 1.16), jaw joint pain (OR 1.24), headache (OR 1.23) and TMJ closed-lock (OR 1.13).
Conclusions
Findings support sex-informed TMD care, though generalizability is constrained by study design and sample composition.
{"title":"Sex-Related Differences in Temporomandibular Disorder Symptom Severity: Correlates With Jaw Function and Oral Health-Related Quality of Life Among Patients","authors":"Adrian Ujin Yap, Jie Lei, Cheng-Ge Liu, Zhi-Wei Huang, Kai Yuan Fu","doi":"10.1111/joor.70103","DOIUrl":"10.1111/joor.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although females comprise the majority of patients with temporomandibular disorders (TMDs), few studies have prioritised the influence of sex on symptom severity and impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This cross-sectional study investigated sex-related differences in TMD symptom severity, jaw functional limitation (JFL) and oral health-related quality of life (OHRQoL); examined their interrelationships by sex; and identified symptom-specific factors linked to high JFL and low OHRQoL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutively enrolled patients completed a survey including demographics, the Four-Dimensional Six TMD symptoms (6Ts-4D) screener, JFL Scale-8 (JFLS-8) and Oral Health Impact Profile for TMDs (OHIP-TMD). TMD diagnostic subtypes were subsequently determined according to the DC/TMD protocol. Data were evaluated using chi-square, non-parametric tests and logistic regression (<i>α</i> = 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 280 participants (mean age 31.2 years [SD 11.8]), 79.3% were female. Females showed significantly higher rates of combined pain-related and intra-articular TMDs, more TMD symptoms, more severe headaches, greater JFL and poorer overall OHRQoL than males. They also demonstrated stronger correlations between global TMD severity and OHRQoL dimensions (<i>r</i>s = 0.38–0.66), as well as between JFL and OHRQoL (<i>r</i>s = 0.48–0.79). Multivariate analysis revealed that high JFL was significantly associated with jaw muscle pain (OR 1.22), jaw joint pain (OR 1.21), TMJ closed-lock (OR 1.24) and open-lock (OR 1.25), while low OHRQoL was related to jaw muscle pain (OR 1.16), jaw joint pain (OR 1.24), headache (OR 1.23) and TMJ closed-lock (OR 1.13).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings support sex-informed TMD care, though generalizability is constrained by study design and sample composition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"537-548"},"PeriodicalIF":4.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Asquini, V. Devecchi, G. Borromeo, P. Tessera, A. Russillo, A. Michelotti, R. Bucci, D. Falla
<div> <section> <h3> Background</h3> <p>Manual therapy (MT) is frequently used to manage temporomandibular disorders (TMDs), yet patient responses vary significantly. Predictive models may help clinicians tailor treatments to individual patients.</p> </section> <section> <h3> Objectives</h3> <p>The primary aim of this study was to externally validate a previously developed prediction model for identifying patients with TMDs who are more likely to benefit from MT. Additionally, new prognostic models to predict outcomes at a one-month follow-up were developed.</p> </section> <section> <h3> Methods</h3> <p>A cohort of 124 adults with a diagnosis of a TMD received a four-week MT program (one session per week) applied to craniomandibular structures. Predictors collected at baseline included clinical and psychosocial variables: pain during mouth opening, pain localisation, treatment expectations, and the central sensitisation inventory (CSI). The primary outcome was a ≥ 30% pain reduction post-treatment. Model performance was assessed using discrimination, calibration, and decision curve analysis. New models predicting one-month outcomes were developed and internally validated via bootstrapping.</p> </section> <section> <h3> Results</h3> <p>The original model showed strong discrimination and overall fit in the validation cohort (AUC = 0.95, <i>R</i><sup>2</sup> = 0.75). Except for pain location, the predictors in the original model also showed excellent discrimination in the developed model based on the outcome at the one-month follow-up (AUC = 0.96). A significant interaction between treatment expectations and CSI was found, with high CSI negatively affecting the outcome in people with positive treatment expectations.</p> </section> <section> <h3> Conclusions</h3> <p>This study externally validated a clinical prediction model for pain reduction in people with TMDs following MT, confirming previously identified predictors of good outcome such as pain during mouth opening, positive treatment expectations, localisation of pain in the craniocervical region, and lower CSI scores. A link to a web-based calculator of the prediction model is provided. The interaction between treatment expectations and CSI suggests that CSI plays a key role in shaping treatment response, modulating the influence of treatment expectation. Future studies with a control group are needed to confirm these results and distinguish true treatment effect modifiers from general prognostic
{"title":"External Validation of a Clinical Prediction Tool for the Use of Manual Therapy in Patients With Temporomandibular Disorders","authors":"G. Asquini, V. Devecchi, G. Borromeo, P. Tessera, A. Russillo, A. Michelotti, R. Bucci, D. Falla","doi":"10.1111/joor.70092","DOIUrl":"10.1111/joor.70092","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Manual therapy (MT) is frequently used to manage temporomandibular disorders (TMDs), yet patient responses vary significantly. Predictive models may help clinicians tailor treatments to individual patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary aim of this study was to externally validate a previously developed prediction model for identifying patients with TMDs who are more likely to benefit from MT. Additionally, new prognostic models to predict outcomes at a one-month follow-up were developed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort of 124 adults with a diagnosis of a TMD received a four-week MT program (one session per week) applied to craniomandibular structures. Predictors collected at baseline included clinical and psychosocial variables: pain during mouth opening, pain localisation, treatment expectations, and the central sensitisation inventory (CSI). The primary outcome was a ≥ 30% pain reduction post-treatment. Model performance was assessed using discrimination, calibration, and decision curve analysis. New models predicting one-month outcomes were developed and internally validated via bootstrapping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The original model showed strong discrimination and overall fit in the validation cohort (AUC = 0.95, <i>R</i><sup>2</sup> = 0.75). Except for pain location, the predictors in the original model also showed excellent discrimination in the developed model based on the outcome at the one-month follow-up (AUC = 0.96). A significant interaction between treatment expectations and CSI was found, with high CSI negatively affecting the outcome in people with positive treatment expectations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study externally validated a clinical prediction model for pain reduction in people with TMDs following MT, confirming previously identified predictors of good outcome such as pain during mouth opening, positive treatment expectations, localisation of pain in the craniocervical region, and lower CSI scores. A link to a web-based calculator of the prediction model is provided. The interaction between treatment expectations and CSI suggests that CSI plays a key role in shaping treatment response, modulating the influence of treatment expectation. Future studies with a control group are needed to confirm these results and distinguish true treatment effect modifiers from general prognostic","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"515-528"},"PeriodicalIF":4.0,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.70092","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anita Almeida Gonzaga, Jade Louise Alves Macedo Padilha Silva, Rafaella Silva dos Santos Aguiar Gonçalves, Luiz Felipe Tavares, Álvaro Campos Cavalcanti Maciel, Karyna Myrelly Oliveira Bezerra Figueiredo Ribeiro
Background
Increased personal protective equipment (PPE) use, working hours and psychological disorders were observed among healthcare workers during the COVID-19 pandemic, possibly leading to craniocervical and otological symptoms.
Objective
This study aimed to identify factors associated with craniocervical and otological symptoms in healthcare workers during the COVID-19 pandemic.
Methods
A total of 147 healthcare workers in the care of patients with COVID-19 were included. Craniocervical symptoms (headache, orofacial pain and neck pain), otological symptoms and PPE use before and during the pandemic were assessed. Pearson's chi-square, McNemar's tests, the paired t-test and a binary logistic regression were used for analysis.
Results
The onset of symptoms during the pandemic was 44.2% for headache, 36.7% for orofacial pain, 38.0% for neck pain and 54.4% for otological symptoms. Worsening of pre-existing symptoms was observed for headache (59.5%), orofacial pain (60.8%), neck pain (38.7%), and otological symptoms (29.4%). Depressive symptoms, associated symptoms and co-occurrence of symptoms during the pandemic were associated with the onset of craniocervical symptoms (OR 2.42–3.99). The use and duration of surgical masks before the pandemic and face shield and orofacial pain during the pandemic were associated factors to the onset of otological symptoms (OR 2.98–3.89). Working in the nursing ward, female sex, lack of physical activity and previous medical history were associated with the worsening of pre-existing craniocervical symptoms (OR 3.25–4.72).
Conclusion
Craniocervical and otological symptoms increased among healthcare workers during the COVID-19 pandemic. Addressing biopsychosocial factors may mitigate the health burden and improve the quality of care.
{"title":"Factors Associated With Craniocervical and Otological Symptoms in Healthcare Workers During Covid-19 Pandemic: A Cross-Sectional Study","authors":"Anita Almeida Gonzaga, Jade Louise Alves Macedo Padilha Silva, Rafaella Silva dos Santos Aguiar Gonçalves, Luiz Felipe Tavares, Álvaro Campos Cavalcanti Maciel, Karyna Myrelly Oliveira Bezerra Figueiredo Ribeiro","doi":"10.1111/joor.70099","DOIUrl":"10.1111/joor.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Increased personal protective equipment (PPE) use, working hours and psychological disorders were observed among healthcare workers during the COVID-19 pandemic, possibly leading to craniocervical and otological symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to identify factors associated with craniocervical and otological symptoms in healthcare workers during the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 147 healthcare workers in the care of patients with COVID-19 were included. Craniocervical symptoms (headache, orofacial pain and neck pain), otological symptoms and PPE use before and during the pandemic were assessed. Pearson's chi-square, McNemar's tests, the paired t-test and a binary logistic regression were used for analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The onset of symptoms during the pandemic was 44.2% for headache, 36.7% for orofacial pain, 38.0% for neck pain and 54.4% for otological symptoms. Worsening of pre-existing symptoms was observed for headache (59.5%), orofacial pain (60.8%), neck pain (38.7%), and otological symptoms (29.4%). Depressive symptoms, associated symptoms and co-occurrence of symptoms during the pandemic were associated with the onset of craniocervical symptoms (OR 2.42–3.99). The use and duration of surgical masks before the pandemic and face shield and orofacial pain during the pandemic were associated factors to the onset of otological symptoms (OR 2.98–3.89). Working in the nursing ward, female sex, lack of physical activity and previous medical history were associated with the worsening of pre-existing craniocervical symptoms (OR 3.25–4.72).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Craniocervical and otological symptoms increased among healthcare workers during the COVID-19 pandemic. Addressing biopsychosocial factors may mitigate the health burden and improve the quality of care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"505-514"},"PeriodicalIF":4.0,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Transcutaneous auricular vagus nerve stimulation (TAVNS) stands out as a neuromodulation method that shows therapeutic potential thanks to its ability to regulate autonomic responses. However, the role of TAVNS in the management of bruxism-related clinical parameters has not been sufficiently investigated.
Objective
This study aimed to investigate the holistic effects of TAVNS added to exercise therapy on bruxism-related clinical parameters in patients with clinically based bruxism.
Methods
This randomised, controlled, single-blind experimental clinical study included 40 individuals diagnosed with clinically based bruxism, who were randomly assigned to two groups: the TAVNS group (n = 20) and the control group (n = 20). Both groups performed the Rocabado exercise program for 8 weeks, while the TAVNS group additionally performed TAVNS. Oral health-related quality of life, sleep quality, perceived stress level, pain intensity, pain threshold, biomechanical properties of masticatory muscles, masseter muscle activation and autonomic parameters were evaluated before and after treatment.
Results
The TAVNS group showed significantly better results in oral health-related quality of life, stress levels, masseter muscle functional parameters (resting activation, tonus, stiffness), and autonomic parameters (pulse rate, respiratory rate, sympathetic activity, sympathovagal balance) compared to the control group (p < 0.05).
Conclusion
This study revealed that TAVNS added to exercise therapy provided significant improvements in key clinical parameters associated with bruxism, including both local symptoms (muscle activation and biomechanical properties) and systemic parameters (autonomic parameters, stress, oral health-related quality of life) in bruxism. Although our findings support the clinical potential of TAVNS as a non-invasive complementary option for managing bruxism-related dysfunctions, these effects need to be confirmed in larger samples and long-term follow-ups.
{"title":"Effectiveness of Transcutaneous Auricular Vagus Nerve Stimulation in Bruxism: A Randomised, Controlled, Single-Blind Experimental Trial","authors":"Hazel Celik Guzel, Ozan Bahadır Turkmen, Ebru Kaya Mutlu, Gizem Turkmen, Olcay Sakar, Gülsen Ozturk Ormeci","doi":"10.1111/joor.70096","DOIUrl":"10.1111/joor.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Transcutaneous auricular vagus nerve stimulation (TAVNS) stands out as a neuromodulation method that shows therapeutic potential thanks to its ability to regulate autonomic responses. However, the role of TAVNS in the management of bruxism-related clinical parameters has not been sufficiently investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to investigate the holistic effects of TAVNS added to exercise therapy on bruxism-related clinical parameters in patients with clinically based bruxism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This randomised, controlled, single-blind experimental clinical study included 40 individuals diagnosed with clinically based bruxism, who were randomly assigned to two groups: the TAVNS group (<i>n</i> = 20) and the control group (<i>n</i> = 20). Both groups performed the Rocabado exercise program for 8 weeks, while the TAVNS group additionally performed TAVNS. Oral health-related quality of life, sleep quality, perceived stress level, pain intensity, pain threshold, biomechanical properties of masticatory muscles, masseter muscle activation and autonomic parameters were evaluated before and after treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The TAVNS group showed significantly better results in oral health-related quality of life, stress levels, masseter muscle functional parameters (resting activation, tonus, stiffness), and autonomic parameters (pulse rate, respiratory rate, sympathetic activity, sympathovagal balance) compared to the control group (<i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study revealed that TAVNS added to exercise therapy provided significant improvements in key clinical parameters associated with bruxism, including both local symptoms (muscle activation and biomechanical properties) and systemic parameters (autonomic parameters, stress, oral health-related quality of life) in bruxism. Although our findings support the clinical potential of TAVNS as a non-invasive complementary option for managing bruxism-related dysfunctions, these effects need to be confirmed in larger samples and long-term follow-ups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov identifier: NCT06386809</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"493-504"},"PeriodicalIF":4.0,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In order to understand the psychological aspects of chronic pain, it is important to consider the relationships between pain and psychosocial factors in patients with chronic pain. While psychosocial factors are known to affect pain intensity in temporomandibular disorders, few studies have evaluated them in patients with other types of chronic orofacial pain.
Objective
The purpose of the present study was to evaluate the relationships between pain intensity and patient characteristics, diagnostic categories and psychosocial factors in chronic non-nociceptive orofacial pain patients.
Methods
In a retrospective, cross-sectional study, we collected information from the medical records of 123 patients with chronic non-nociceptive orofacial pain. Pain intensity was measured using the Brief Pain Inventory (BPI) total score. Analysis of the correlations among the variables revealed several strong correlations. Principal component analysis identified two components: the psychological distress and self-efficacy/quality of life (QOL) components. Multiple linear regression analyses of the overall study population and each ICOP pain category were also performed.
Results
In the overall sample, higher BPI scores were significantly associated with a greater psychological distress component and lower self-efficacy/QOL component. The pain category was not a significant predictor of the BPI score. In the subgroup analyses, both components were significant predictors of the BPI score in myofascial orofacial pain; whereas, only the self-efficacy/QOL component was in idiopathic orofacial pain.
Conclusion
The results indicated that pain intensity in chronic non-nociceptive orofacial pain is related to the self-efficacy/QOL psychosocial factor component. These findings suggest that assessing psychosocial factors may be clinically important for the diagnosis and treatment of chronic orofacial pain.
{"title":"Is Pain Intensity Related to Psychosocial Factors in Chronic Non-Nociceptive Orofacial Pain Patients?","authors":"Akiko Kawase, Hitoshi Higuchi, Fumika Hashimoto, Saki Miyake, Yukiko Nishioka, Midori Inoue, Hitomi Ujita, Aki Kawauchi, Shigeru Maeda, Takuya Miyawaki","doi":"10.1111/joor.70094","DOIUrl":"10.1111/joor.70094","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In order to understand the psychological aspects of chronic pain, it is important to consider the relationships between pain and psychosocial factors in patients with chronic pain. While psychosocial factors are known to affect pain intensity in temporomandibular disorders, few studies have evaluated them in patients with other types of chronic orofacial pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The purpose of the present study was to evaluate the relationships between pain intensity and patient characteristics, diagnostic categories and psychosocial factors in chronic non-nociceptive orofacial pain patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a retrospective, cross-sectional study, we collected information from the medical records of 123 patients with chronic non-nociceptive orofacial pain. Pain intensity was measured using the Brief Pain Inventory (BPI) total score. Analysis of the correlations among the variables revealed several strong correlations. Principal component analysis identified two components: the psychological distress and self-efficacy/quality of life (QOL) components. Multiple linear regression analyses of the overall study population and each ICOP pain category were also performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the overall sample, higher BPI scores were significantly associated with a greater psychological distress component and lower self-efficacy/QOL component. The pain category was not a significant predictor of the BPI score. In the subgroup analyses, both components were significant predictors of the BPI score in myofascial orofacial pain; whereas, only the self-efficacy/QOL component was in idiopathic orofacial pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results indicated that pain intensity in chronic non-nociceptive orofacial pain is related to the self-efficacy/QOL psychosocial factor component. These findings suggest that assessing psychosocial factors may be clinically important for the diagnosis and treatment of chronic orofacial pain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"466-474"},"PeriodicalIF":4.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.70094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bo Young Jeong, Seong Hae Kim, Xin Xiong, Ji Woon Park
Objectives
To analyse clinical features and psychological status according to the presence of concomitant headache in a well-defined group of temporomandibular disorders (TMD).
Methods
Graded Chronic Pain Scale and Symptom Checklist-90-Revision were applied to evaluate pain disability and psychological characteristics in a group of 793 TMD patients. The presence of generalised bodily symptoms, sleep disturbance, and general health status was collected. Clinical and psychological variables associated with concomitant headache were statistically identified.
Results
Among the TMD patients, 290 reported headache (37%). Those with headache reported higher levels of TMD pain intensity (p = 0.005) and more frequently reported pain on palpation of the masticatory muscles (p = 0.031) and temporomandibular joint (p = 0.007). Also, clenching (p = 0.016), sleep disturbance (p < 0.001), and insomnia (p < 0.001) were more prevalent. Those with headache experienced pain in other body regions more frequently. Higher levels of somatization (p < 0.001), depression (p = 0.045), anxiety (p = 0.005), and paranoid ideation (p = 0.022) were found in the headache group.
Conclusions
TMD patients when reporting concomitant headache showed higher pain levels, widespread pain, and higher levels of psychological distress. The results indicate the need to appropriately address the issue of headache in TMD patients with an emphasis on psychological issues to improve overall prognosis.
{"title":"Concomitant Headache and Its Association With Worse Psychological and Clinical Status in Temporomandibular Disorders","authors":"Bo Young Jeong, Seong Hae Kim, Xin Xiong, Ji Woon Park","doi":"10.1111/joor.70100","DOIUrl":"10.1111/joor.70100","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To analyse clinical features and psychological status according to the presence of concomitant headache in a well-defined group of temporomandibular disorders (TMD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Graded Chronic Pain Scale and Symptom Checklist-90-Revision were applied to evaluate pain disability and psychological characteristics in a group of 793 TMD patients. The presence of generalised bodily symptoms, sleep disturbance, and general health status was collected. Clinical and psychological variables associated with concomitant headache were statistically identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the TMD patients, 290 reported headache (37%). Those with headache reported higher levels of TMD pain intensity (<i>p</i> = 0.005) and more frequently reported pain on palpation of the masticatory muscles (<i>p</i> = 0.031) and temporomandibular joint (<i>p</i> = 0.007). Also, clenching (<i>p</i> = 0.016), sleep disturbance (<i>p</i> < 0.001), and insomnia (<i>p</i> < 0.001) were more prevalent. Those with headache experienced pain in other body regions more frequently. Higher levels of somatization (<i>p</i> < 0.001), depression (<i>p</i> = 0.045), anxiety (<i>p</i> = 0.005), and paranoid ideation (<i>p</i> = 0.022) were found in the headache group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TMD patients when reporting concomitant headache showed higher pain levels, widespread pain, and higher levels of psychological distress. The results indicate the need to appropriately address the issue of headache in TMD patients with an emphasis on psychological issues to improve overall prognosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"483-492"},"PeriodicalIF":4.0,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
While whole-body postural control requires integration of the sensorimotor system, the involvement of jaw muscle activity in this control remains unclear.
Objective
This study aimed to clarify the relationship between jaw muscle activity and whole-body postural stability by measuring jaw-opening and closing muscle activities, as well as whole-body postural sway during postural perturbations with two different levels of predictability.
Methods
Twelve healthy adults (7 males, 5 females; median age 21.0 years) underwent vertical perturbations by holding a bar at shoulder height. In the cued condition (C-cond), the participants were given a 3-s countdown before the bar was loaded with 3% of their body weight, whereas in the uncued condition (U-cond), the load was applied without prior cueing. Jaw-closing (masseter) and jaw-opening (anterior suprahyoid) muscle activities were measured using surface electromyography (EMG). Bar dynamics and center-of-foot-pressure (COP) were assessed with motion capture and a force plate. Bar-drop distances, EMG activity, and the proportion of trials with muscle activity exceeding baseline were compared between conditions using the Wilcoxon signed-rank test, Friedman, Mann–Whitney U and chi-square tests, as appropriate, with Bonferroni corrections.
Results
Vertical bar displacement was greater in the U-cond compared with the C-cond (−46.0 mm vs. −27.4 mm, the Wilcoxon signed-rank test, p < 0.05). Left anterior suprahyoid activity exceeded baseline in 91.7% of uncued trials versus 58.3% in cued trials (the chi-square test with the Bonferroni correction applied, adjusted p < 0.05). COP displacement increased when masseter and anterior suprahyoid muscle activity exceeded baseline in the U-cond (the Mann–Whitney U test with Bonferroni correction, adjusted p < 0.05).
Conclusion
Increased activation of jaw-opening muscles during uncued perturbations compared with cued perturbations suggests that anterior suprahyoid muscles are recruited for postural control, supporting their involvement in maintaining stability.
背景：虽然全身姿势控制需要感觉运动系统的整合，但下颌肌肉活动在这种控制中的参与尚不清楚。目的：本研究旨在通过测量两种不同可预测水平的姿势扰动下下颌开闭肌肉活动以及全身姿势摆动，阐明下颌肌肉活动与全身姿势稳定性之间的关系。方法：12名健康成人（男7名，女5名，中位年龄21.0岁）在肩高处持杆进行垂直摄动。在提示条件下（C-cond），参与者在加载体重的3%之前有3秒倒计时，而在未提示条件下（U-cond），负载在没有事先提示的情况下施加。采用表面肌电图（EMG）测量合颌肌（咬肌）和开颌肌（舌骨前上肌）的活动。用动作捕捉和测力板评估杆动力学和足部压力中心（COP）。使用Wilcoxon sign -rank检验、Friedman、Mann-Whitney U检验和卡方检验（视情况而定）并进行Bonferroni校正，比较不同条件下的条形距离、肌电活动和肌肉活动超过基线的试验比例。结果：与C-cond相比，U-cond的垂直杆位移更大（-46.0 mm vs -27.4 mm）， Wilcoxon符号秩检验。结论：与有线索的扰动相比，在无线索的扰动下，下颌开口肌肉的激活增加，表明前舌骨上肌参与姿势控制，支持其参与维持稳定性。
{"title":"Jaw Muscle Electromyographic Response to Whole-Body Postural Perturbation","authors":"Akari Shibagaki, Yosuke Tomita, Yoshitaka Suzuki, Kazuo Okura, Masamitsu Oshima, Jaime Fabillar Jr., Yoshizo Matsuka","doi":"10.1111/joor.70086","DOIUrl":"10.1111/joor.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>While whole-body postural control requires integration of the sensorimotor system, the involvement of jaw muscle activity in this control remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to clarify the relationship between jaw muscle activity and whole-body postural stability by measuring jaw-opening and closing muscle activities, as well as whole-body postural sway during postural perturbations with two different levels of predictability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twelve healthy adults (7 males, 5 females; median age 21.0 years) underwent vertical perturbations by holding a bar at shoulder height. In the cued condition (C-cond), the participants were given a 3-s countdown before the bar was loaded with 3% of their body weight, whereas in the uncued condition (U-cond), the load was applied without prior cueing. Jaw-closing (masseter) and jaw-opening (anterior suprahyoid) muscle activities were measured using surface electromyography (EMG). Bar dynamics and center-of-foot-pressure (COP) were assessed with motion capture and a force plate. Bar-drop distances, EMG activity, and the proportion of trials with muscle activity exceeding baseline were compared between conditions using the Wilcoxon signed-rank test, Friedman, Mann–Whitney <i>U</i> and chi-square tests, as appropriate, with Bonferroni corrections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Vertical bar displacement was greater in the U-cond compared with the C-cond (−46.0 mm vs. −27.4 mm, the Wilcoxon signed-rank test, <i>p</i> < 0.05). Left anterior suprahyoid activity exceeded baseline in 91.7% of uncued trials versus 58.3% in cued trials (the chi-square test with the Bonferroni correction applied, adjusted <i>p</i> < 0.05). COP displacement increased when masseter and anterior suprahyoid muscle activity exceeded baseline in the U-cond (the Mann–Whitney <i>U</i> test with Bonferroni correction, adjusted <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Increased activation of jaw-opening muscles during uncued perturbations compared with cued perturbations suggests that anterior suprahyoid muscles are recruited for postural control, supporting their involvement in maintaining stability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"456-465"},"PeriodicalIF":4.0,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joor.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The aim of this study was to investigate the associations between bodily pain (BP) and painful temporomandibular disorders (PT) in the general population in China. It also focused on evaluating how psychological distress and sleep disturbance mediated the association.
Materials and Methods
Data were derived from a community survey conducted in mainland China in 2024 (N = 1920). Participants were categorised by BP sites: none (PF group), single site (SP group), and multiple sites (MP group). Psychological distress was measured using the Patient Health Questionnaire-4 (PHQ-4), and the Insomnia Severity Index (ISI) was used to evaluate sleep disturbances. Statistical analyses were performed using univariate and multivariate logistic regression analyses, as well as chain mediation analysis.
Results
The prevalence of PT was highest in the MP group, followed by the SP group, and lowest in the PF group. Multivariate logistic regression showed that BP (SP: OR 1.672, 95% CI 1.27–2.202; MP: OR 2.148; 95% CI 1.661–2.776), PHQ-4 (OR 1.12; 95% CI 1.07–1.172), and ISI (OR 1.076; 95% CI 1.051–1.1) were positively associated with PT. Chain mediation analysis showed significant direct (Effect: 0.268; 95% CI 0.046–0.094) and the indirect effect of both PHQ-4 and ISI scores (Effect: 0.018; 95% CI 0.023–0.044) between BP and PT.
Conclusions
Psychological distress and sleep disturbance have a chain mediation effect on the association between BP and PT.
Clinical Relevance
Our findings highlight the significance of considering the comorbidity of BP in patients with PT and implementing interventions that address psychological distress and sleep disturbance in clinical practice.
目的：本研究的目的是调查中国普通人群中躯体疼痛（BP）和疼痛性颞下颌疾病（PT）之间的关系。它还侧重于评估心理困扰和睡眠障碍如何介导这种关联。资料和方法：数据来源于2024年在中国大陆进行的一项社区调查（N = 1920）。参与者按BP位点分类：无BP位点（PF组）、单BP位点（SP组）和多BP位点（MP组）。采用患者健康问卷-4 （PHQ-4）测量心理困扰，采用失眠严重程度指数（ISI）评估睡眠障碍。统计分析采用单变量和多变量逻辑回归分析，以及链中介分析。结果：PT患病率以MP组最高，SP组次之，PF组最低。多因素logistic回归显示，BP （SP: OR 1.672, 95% CI 1.27-2.202; MP: OR 2.148, 95% CI 1.661-2.776）、PHQ-4 （OR 1.12, 95% CI 1.07-1.172）和ISI （OR 1.076, 95% CI 1.051-1.1）与PT呈正相关。链式中介分析显示，PHQ-4和ISI得分的直接影响（Effect: 0.268, 95% CI 0.046-0.094）和间接影响(Effect: 0.018；结论：心理困扰和睡眠障碍在血压和睡眠障碍之间具有连锁中介作用。临床意义：我们的研究结果强调了在临床实践中考虑血压在PT患者中的合并症，并实施针对心理困扰和睡眠障碍的干预措施的重要性。
{"title":"Psychological Distress and Sleep Disturbance as Mediators in the Association Between Bodily Pain and Painful Temporomandibular Disorders","authors":"Xinyi Fang, Jiamin Wan, Jiu Lin, Xiao Lu, Jiale Wang, Yu Long, Yuanwei Xie, Haoming An, Qianming Chen, Xin Xiong, Xiaoyan Chen","doi":"10.1111/joor.70101","DOIUrl":"10.1111/joor.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study was to investigate the associations between bodily pain (BP) and painful temporomandibular disorders (PT) in the general population in China. It also focused on evaluating how psychological distress and sleep disturbance mediated the association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Data were derived from a community survey conducted in mainland China in 2024 (<i>N</i> = 1920). Participants were categorised by BP sites: none (PF group), single site (SP group), and multiple sites (MP group). Psychological distress was measured using the Patient Health Questionnaire-4 (PHQ-4), and the Insomnia Severity Index (ISI) was used to evaluate sleep disturbances. Statistical analyses were performed using univariate and multivariate logistic regression analyses, as well as chain mediation analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of PT was highest in the MP group, followed by the SP group, and lowest in the PF group. Multivariate logistic regression showed that BP (SP: OR 1.672, 95% CI 1.27–2.202; MP: OR 2.148; 95% CI 1.661–2.776), PHQ-4 (OR 1.12; 95% CI 1.07–1.172), and ISI (OR 1.076; 95% CI 1.051–1.1) were positively associated with PT. Chain mediation analysis showed significant direct (Effect: 0.268; 95% CI 0.046–0.094) and the indirect effect of both PHQ-4 and ISI scores (Effect: 0.018; 95% CI 0.023–0.044) between BP and PT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Psychological distress and sleep disturbance have a chain mediation effect on the association between BP and PT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Relevance</h3>\u0000 \u0000 <p>Our findings highlight the significance of considering the comorbidity of BP in patients with PT and implementing interventions that address psychological distress and sleep disturbance in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"448-455"},"PeriodicalIF":4.0,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oral health is strongly associated with dietary habits; however, most relevant studies have focused on single dietary components. Dietary patterns, integrating data on the diversity of food group consumption, can offer a comprehensive understanding of the diet–health association.
Objective
We classified dietary patterns among Chinese older adults based on dietary diversity (DD) and evaluated the association of oral health with latent classes of dietary patterns.
Methods
We analysed the data of 11 948 older adults from the 2018 Chinese Longitudinal Healthy Longevity Study (CLHLS) dataset. Latent class analysis (LCA) was employed to identify distinct dietary pattern classes based on DD. We then used multivariate logistic regression to examine the associations between oral health indicators and latent dietary pattern classes.
Results
The LCA results demonstrated four latent dietary pattern classes: plant protein-dominant, omnivorous with limited diversity, balanced diversity and animal protein-dominant. Multivariate logistic regression revealed that various oral health indicators—including the number of teeth, denture use, daily toothbrushing frequency and facial or jaw pain within the previous 6 months—significantly influenced dietary pattern classification.
Conclusions
We identified four dietary patterns through LCA and noted that oral health status significantly affects dietary preferences among older adults. Adaptive eating behaviours influenced by cultural and socioeconomic factors aid in reducing the negative impact of oral health issues on diet. Our results indicated a dynamic, multifactorial relationship between oral health and dietary patterns in the older population, underscoring the necessity for integrated interventions combining oral care with dietary guidance.
{"title":"Impact of Oral Health on Potential Categories of Dietary Patterns in Chinese Older Adults: Based on the 2018 Chinese Longitudinal Healthy Longevity Survey Dataset","authors":"Xiaoke Li, Chengfengyi Yang, Jing Zhang, Libing Tan, Yuanxun Liu, Mingming Xu, Yue Yang","doi":"10.1111/joor.70095","DOIUrl":"10.1111/joor.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Oral health is strongly associated with dietary habits; however, most relevant studies have focused on single dietary components. Dietary patterns, integrating data on the diversity of food group consumption, can offer a comprehensive understanding of the diet–health association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We classified dietary patterns among Chinese older adults based on dietary diversity (DD) and evaluated the association of oral health with latent classes of dietary patterns.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed the data of 11 948 older adults from the 2018 Chinese Longitudinal Healthy Longevity Study (CLHLS) dataset. Latent class analysis (LCA) was employed to identify distinct dietary pattern classes based on DD. We then used multivariate logistic regression to examine the associations between oral health indicators and latent dietary pattern classes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The LCA results demonstrated four latent dietary pattern classes: plant protein-dominant, omnivorous with limited diversity, balanced diversity and animal protein-dominant. Multivariate logistic regression revealed that various oral health indicators—including the number of teeth, denture use, daily toothbrushing frequency and facial or jaw pain within the previous 6 months—significantly influenced dietary pattern classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We identified four dietary patterns through LCA and noted that oral health status significantly affects dietary preferences among older adults. Adaptive eating behaviours influenced by cultural and socioeconomic factors aid in reducing the negative impact of oral health issues on diet. Our results indicated a dynamic, multifactorial relationship between oral health and dietary patterns in the older population, underscoring the necessity for integrated interventions combining oral care with dietary guidance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"430-438"},"PeriodicalIF":4.0,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William Poncin, Simple Futarmal Kothari, Jin Magara, Makoto Inoue, Eduardo Castrillon, Mohit Kothari
Background
In transcranial magnetic studies (TMS), motor-evoked potentials (MEPs) recorded from the tongue provide important insights into corticobulbar excitability and neuromuscular control. However, their clinical and research utility remains limited due to anatomical and technical challenges, particularly those affecting electrode stability and signal quality.
Objective
This study aimed to compare TMS-derived outcomes obtained with traditional surface electrodes and novel suction-based electrodes.
Methods
Nineteen healthy adults participated in a repeated-measures, cross-over design. On Day 1, each participant completed two test sessions per electrode type (intra-session reliability). Thirteen participants returned for a third test session at least 1 week later (inter-session reliability). Resting motor threshold (rMT) was determined. MEP amplitude (MEP_Amp) and latency (MEP_Lat) were assessed at five single-pulse stimulation intensities (90%, 100%, 120%, 140% and 160% of rMT). Reliability was analyzed using intraclass correlation coefficients (ICCs, using lower 95% CI bound to gauge reliability strength).
Results
Suction electrodes yielded significantly lower rMT and higher MEP_Amp at 120%–160% rMT. For both electrode types, intra-session reliability for rMT was excellent (ICCs > 0.90) and poor to moderate for MEP_Amp and MEP_Lat (ICCs < 0.75). Inter-session reliability was poor (ICCs < 0.50) across all outcomes for both electrode types.
Conclusion
Compared to surface electrodes, suction electrodes improved signal quality as indicated by lower rMT and higher MEP_Amp. However, both electrode types exhibited substantial intra- and inter-session variability. Although suction electrodes enhance TMS signal quality, the poor test–retest reliability of tongue MEPs currently limits their utility as biomarkers. Methodological refinements are needed to further improve reliability in TMS-based tongue assessments.
{"title":"Can Recordings of Tongue Motor-Evoked Potentials Be Improved? Comparison of Two Electrode Types and Their Reliability","authors":"William Poncin, Simple Futarmal Kothari, Jin Magara, Makoto Inoue, Eduardo Castrillon, Mohit Kothari","doi":"10.1111/joor.70098","DOIUrl":"10.1111/joor.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In transcranial magnetic studies (TMS), motor-evoked potentials (MEPs) recorded from the tongue provide important insights into corticobulbar excitability and neuromuscular control. However, their clinical and research utility remains limited due to anatomical and technical challenges, particularly those affecting electrode stability and signal quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to compare TMS-derived outcomes obtained with traditional surface electrodes and novel suction-based electrodes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nineteen healthy adults participated in a repeated-measures, cross-over design. On Day 1, each participant completed two test sessions per electrode type (intra-session reliability). Thirteen participants returned for a third test session at least 1 week later (inter-session reliability). Resting motor threshold (rMT) was determined. MEP amplitude (MEP_Amp) and latency (MEP_Lat) were assessed at five single-pulse stimulation intensities (90%, 100%, 120%, 140% and 160% of rMT). Reliability was analyzed using intraclass correlation coefficients (ICCs, using lower 95% CI bound to gauge reliability strength).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Suction electrodes yielded significantly lower rMT and higher MEP_Amp at 120%–160% rMT. For both electrode types, intra-session reliability for rMT was excellent (ICCs > 0.90) and poor to moderate for MEP_Amp and MEP_Lat (ICCs < 0.75). Inter-session reliability was poor (ICCs < 0.50) across all outcomes for both electrode types.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared to surface electrodes, suction electrodes improved signal quality as indicated by lower rMT and higher MEP_Amp. However, both electrode types exhibited substantial intra- and inter-session variability. Although suction electrodes enhance TMS signal quality, the poor test–retest reliability of tongue MEPs currently limits their utility as biomarkers. Methodological refinements are needed to further improve reliability in TMS-based tongue assessments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16605,"journal":{"name":"Journal of oral rehabilitation","volume":"53 2","pages":"439-447"},"PeriodicalIF":4.0,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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