Effect of mandibular advancement device on plasticity in corticomotor control of tongue and jaw muscles

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  • Satoshi Matsuzaki, Scandinavian Center for Orofacial Neurosciences (SCON), Malmö, Department of Fixed Prosthodontics and Occlusion, Osaka Dental University, Japan, Osaka Dental University, Osaka, Japan
  • ,
  • Akiko Shimada, Department of Geriatric Dentistry, Osaka Dental University, Japan, Osaka Dental University, Osaka, Japan
  • ,
  • Junko Tanaka, Osaka Dental University, Osaka, Japan
  • ,
  • Mohit Kothari
  • Eduardo Castrillon
  • Takashi Iida, Department of Anesthesiology, Nihon University School of Dentistry at Matsudo, Matsudo, Japan
  • ,
  • Peter Svensson

STUDY OBJECTIVES: This study aims to investigate if the use of a mandibular advancement device (MAD) is associated with neuroplasticity in corticomotor control of tongue and jaw muscles.

METHODS: Eighteen healthy individuals participated in a randomized crossover study with 3 conditions for 2 weeks each: baseline, wearing an oral appliance (OA: sham MAD) or MAD during sleep. The custom-made MAD was constructed by positioning the mandible to 50% of its maximal protrusion limit. Transcranial magnetic stimulation (TMS) was applied to elicit motor evoked potentials (MEPs). The MEPs were assessed by constructing stimulus-response curves at four stimulus intensities: 90%, 100%, 120%, and 160% of the motor threshold (MT) from the right tongue and right masseter, and the first dorsal interosseous muscles (FDI, control) at baseline, after the first and the second intervention.

RESULTS: There was a significant effect of condition and stimulus intensity both on the tongue and as well as on masseter MEPs (P < 0.01). Tongue and masseter MEPs were significantly higher at 120% and 160% following the MAD compared to the OA (P < 0.05). There were no effects of condition on FDI MEPs (P = 0.855).

CONCLUSIONS: The finding suggests that MAD induces neuroplasticity in the corticomotor pathway of the tongue and jaw muscles associated with the new jaw position. Further investigations are required in patients with obstructive sleep apnea (OSA) to see if this cortical neuroplasticity may contribute or perhaps predict treatment effects with MADs in OSA.

Original languageEnglish
JournalJournal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
Publication statusE-pub ahead of print - 27 Apr 2021

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© 2021 American Academy of Sleep Medicine.

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