Effect of intravenous infusion of a beta-adrenergic blocking agent on the haemodynamic changes in human masseter muscle induced by cold-pressor stimulation.

Eight healthy non-smoking males (mean age: 24.1 +/- 1.1 years) without any history of chronic muscle pain and migraine participated in this study. Haemoglobin (Hb) and oxygen (O2) saturation in the right masseter muscle were continuously recorded with a non-invasive near-infrared spectroscopic device. Heart rate and blood pressure were also recorded. The experiment had three phases: a placebo drug (physiological saline) with cold-pressor trial, a 30-sec maximal voluntary clenching (MVC) trial, and a propranolol with cold-pressor trial. The saline and drug trials each involved continuous recording for 1 min before, 2 min during and 5 min after the cold-pressor stimulation (4 degrees C). Physiological saline (20 ml) or propranolol hydrochloride (20 ml) were infused at the rate of 2 ml/min. This infusion was begun 20 min before the baseline recording and participants did not know which solution (saline or propranolol) was being infused. For the MVC trial, each participant was asked to perform a 30-sec clench of their jaw-closing muscles. There was a rest period of 15 min between each trial. The individual Hb and O2 data were normalized so that the baseline at the beginning of the experiment was equal to zero, and the Hb and O2 data were normalized as a percentage of the individual's own highest absolute Hb and O2 after and during the MVC, respectively. The results showed that the mean baseline Hb 1 min before cold-pressor stimulation was significantly lower in the beta-blocker trial than in the placebo trial (p = 0.035). The mean change in Hb from baseline during cold-pressor stimulation in the beta-blocker trial was also significantly less than in the placebo trial (p = 0.035). The mean Hb rebound change after the cold-pressor stimulation in the beta-blocker trial was significantly higher than in the placebo trial, and no significant heart-rate differences were observed in the period after cold-pressor stimulation. Overall, the mean heart rate before and during that stimulation was significantly lower in the beta-blocker trial than the placebo trial (p < 0.001). There was no significant mean blood-pressure difference between placebo and beta-blocker trials at any time. These results suggest that beta-adrenoceptor blocking decreases the blood volume in the resting masseter, suppresses the incremental blood-volume change during cold-pressor stimulation, and discloses a hidden vasoconstrictive effect after that stimulation.     

Effect of cold pressor stimulation (4 degrees C) on human masseter muscle haemodynamics during and after sustained isometric contraction

The effect of cold pressor (CP) stimulation and sustained isometric contraction on the blood volume of the right masseter muscle was examined in seven healthy males, who performed 1 min of isometric jaw clenching at 50% of their maximum voluntary contraction without, with and again without a 4 degrees C CP stimulation. Total haemoglobin was measured in the masseter before, during and after the contraction task using near-infrared spectroscopy. CP stimulation during the isometric contraction diminished the magnitude of the contraction-induced decrease of blood volume when compared to the trials without CP stimulation. However, in the immediate post-contraction period (while the CP stimulation was still in place), no increase in blood volume above the usual post-contraction hyperaemia was evident. Once the CP stimulation had been removed, there was a clear decrease (faster return to baseline) in the vasodilation occurring in the post-contraction period. This diminished period of vasodilation occurred in spite of the fact that the vascular resistance (blood pressure) and heart rate were still substantially elevated by the CP effect during this same period. These data suggest that the strong CP stimulation produced a biphasic response. First, there was an early-onset strong vasodilation (during CP), which was followed by a period of diminished vasodilation, suggesting that an active, but delayed, vasoconstrictive drive may be induced by the CP stimulus.     

Haemodynamic responses in chronically painful, human trapezius muscle to cold pressor stimulation.

The aim was to compare haemodynamic responses in trapezius muscles to cold pressor stimulation in individuals with localized trapezius myalgia and asymptomatic controls. Nine males with chronic localized pain in the trapezius (mean age, 23.2 years) and nine male controls (mean age, 24.6 years) who had no medical history of migraine, hypertension or sustained pain in the trapezius region were investigated. Two experimental (cold pressor and mock) trials were performed in a randomly assigned sequence. In the cold pressor trial the participant's left foot and ankle were immersed in 4 degrees C cold water for 2 min; the mock trial was done without that stimulus. Blood volume was continuously recorded 1 min before, 2 min during, and 5 min after cold pressor stimulation using near-infrared spectroscopy. Each participant's blood-volume data were baseline-corrected and submitted to statistical analysis. Results showed that the individuals with muscle pain exhibited a significantly lower mean blood volume than the controls during cold pressor stimulation (p = 0.0367). Upon withdrawal of that stimulation, the mean blood volume in both groups fell below the baseline. These results suggest that individuals with chronic regional trapezius myalgia have less capacity to vasodilate this muscle during cold pressor stimulation than those without such myalgia. It is not yet known if this difference in the haemodynamic response is a cause or an effect of the myalgia.     

Reperfusion response changes induced by repeated,sustained contractions in normal human masseter muscle

The purpose was to evaluate the intramuscular reperfusion response characteristics associated with repeated isometric contractions in normal human masseter. Intramuscular blood volume was quantified with a near-infrared spectroscopic device that measured the total haemoglobin (Hb) concentration in the muscle. Electromyographic (EMG) activity from the masseter and total bite forces were also recorded. Sixteen healthy volunteers, eight females and eight males, without masticatory muscle pain participated. They were asked first to clench their teeth for as long as possible at 50% of their maximum voluntary contraction (MVC). This was followed by a 60s rest and then immediately by a standard clenching task (50% MVC for 30s) and a 60s recovery period, immediately after which they were asked to repeat exactly the same procedure, with a final 5 min recovery period after the second 30s contraction. Bite force, EMG and Hb concentration were measured continuously and the duration of the two endurance tasks and the amplitudes of all recorded signals were compared (first trial versus second trial). Specifically, the difference between the lowest Hb (trough) seen during the standardised 30s contractions and the highest (peak) seen just after them was assessed. The trough-to-peak difference in Hb concentration of the second standard contraction task was significantly smaller than that of the first standard task (P<0.05, paired t-test). These data show that with sustained effort the post-contraction vasodilatory reperfusion responses of the human masseter are diminished, suggesting a progressive desensitisation of the vasodilatory system.     

Effect of 5-hydroxytryptamine infusion on microcirculation in the rabbit masseter muscle measured by laser-Doppler flowmetry.

The aim was to test the hypothesis that 5-hydroxytryptamine (5-HT) influences the microcirculation of the masseter muscle. Rabbit masseters were infused with increasing concentrations of 5-HT (10(-9)-10(-5) M) on the experimental side and with saline on the control side. The effect on microcirculatory blood flow was measured by laser-Doppler flowmetry. The intramuscular temperature was recorded to monitor the influence of tissue temperature. 5-HT infusion resulted in a statistically significant decrease in blood flow at the lowest concentration (10(-9) M) (median; -11.2%: Wilcoxon signed-rank test; p<0.05). At concentrations greater than 10(-9) M, there was no significant change in blood flow. This study shows a decrease of microcirculatory blood flow in the rabbit masseter following 5-HT infusion (10(-9) M).     

Mental stress-induced physiological changes in the human masseter muscle

The effect of a long mental stress on the hemodynamics of masticatory muscles has not been investigated to date. We hypothesized some hemodynamic and electromyographic changes in jaw-closure muscles related to sympathetic nervous system activity. While healthy adult female volunteers performed a two-hour mental stress task, electromyographic activity of the temporal and masseteric muscles was recorded, and hemodynamic changes of the masseter muscle were measured non-invasively. Autonomic function was assessed by heart rate spectral analysis. Integrated electromyographic activity of the temporalis muscle, but not the masseter muscle, showed an increase that coincided with the increase in sympathetic nervous activity. In the masseter muscle, despite little change in integrated electromyographic activity, notable changes were found in hemodynamic parameters. These results suggest that hemodynamics of jaw muscles is susceptible to mental stress, implying a potential role in the etiology of jaw muscle dysfunction associated with mental stress.     

Electromyographic heterogeneity in the human masseter muscle.

The complex, pennate architecture of the human masseter muscle points to a functional division into more than the commonly distinguished deep and superficial parts. In this study, the possible existence of regional differences in activation was examined. EMG activity was registered in three deep and three superficial regions with the use of bipolar fine-wire electrodes. Recordings were made during different static bite tasks, in specified directions, and with a specified bite-force magnitude. A linear bite-force/EMG relationship was observed. Furthermore, it appeared that muscle regions showed a different pattern of change in activity as a function of bite-force direction. Heterogeneity was nearly absent in anteriorly-, anteriomedially-, and medially-directed bites, but became increasingly obvious in the other bite-force directions. The posterior deep region showed the most aberrant activation pattern, which was almost opposite that from the other regions. This part was fully active in posterolaterally-directed bites. The posterior superficial region showed the largest variability in activity as a function of bite-force direction. The results point to a functional partition of the masseter muscle in at least three parts: anterior deep, posterior deep, and superficial. A further subdivision of the superficial portion might be present, but was not as obvious as the division of the deep masseter.     

Effect of 5-hydroxytryptamine-2 and alpha-adrenergic receptor antagonists on the 5-hydroxytryptamine-induced decrease in rabbit masseter muscle blood flow.

A previous study showed a significant decrease in blood flow in the rabbit masseter during infusion of 5-hydroxytryptamine (5-HT) (10(-9) mol/l). The aim of the present study was to test the hypothesis that blockade of the 5-HT2 or the alpha-adrenergic receptor would inhibit the 5-HT-induced decrease of microcirculatory blood flow in the masseter. In 12 rabbits, the masseters were infused with 5-HT (10(-9) mol/l) in combination with the alpha-adrenoceptor antagonist phentolamine (10(-6) mol/l) or the 5-HT2-receptor antagonist ritanserin (10(-6) mol/l). The effect on microcirculatory blood flow was measured by laser-Doppler flowmetry. Infusion of 5-HT induced a significant decrease in blood flow. Inclusion of ritanserin in the 5-HT infusion solution significantly inhibited this decrease, while inclusion of phentolamine did not. This study therefore showed that the 5-HT2 receptor antagonist ritanserin inhibited the 5-HT-induced decrease in microcirculatory blood flow in the rabbit masseter. This decrease in blood flow is thus mediated by the 5-HT2 receptor.     

Haemodynamic changes in human masseter and temporalis muscles induced by different levels of isometric contraction.

This study evaluated the influence of low contraction forces on intramuscular haemodynamics in human masseter and temporalis using near-infrared tissue spectroscopy. This method allowed the intramuscular haemoglobin (Hb) to be assessed dynamically before, during and after a 5, 15, 25 and 100% maximum voluntary contraction (MVC). Twenty volunteers, 10 males and 10 females, without pain or dysfunction in the masticatory system were included in this study. Data were recorded for 30 s before, 30 s during and 5 min after the four sustained contraction tasks. The results showed that all four levels of voluntary contraction produced a clear haemodynamic response (during and after contraction) in both muscles. For analytical purposes, the maximum Hb achieved after 100% MVC was set equal to 1.00. In the masseter the mean peak Hb during the 5, 15, 25 and 100% MVC was 0.49, 0.92, 1.30 and 1.73 while after the contractions it was 0.50, 0.65, 0.78 and 1.00, respectively. In the temporalis the peak Hb during the contractions was 0.23, 0.36, 0.48 and 0.66 and after the contractions 0.32, 0.45, 0.56 and 1.00, respectively. Repeated-measures analysis of variance revealed a significant main effect for the different contraction levels both in the masseter (during contraction, p = 0.001; after contraction, p<0.001) and the temporalis (during contraction, p = 0.002; after contraction, p<0.001). These data suggest that low levels of contraction induce a clear haemodynamic response, even at 5% effort. When compared, the masseter and anterior temporalis showed clearly different patterns for the Hb signal during the contraction (p<0.001) as well as after it (p = 0.007). Specifically, the Hb during the contractions in the masseter appeared more stable than in the temporalis, which showed a strong return to baseline. Obviously the contracting masseter had a stronger and more sustained venous occlusion than the contracting temporalis. It is speculated that variation in architecture between the two muscles contributes to these differences in blood flow.     

Electromyographic power-spectrum changes during repeated fatiguing contractions of the human masseter muscle

During 7 sessions at weekly intervals, 10 healthy males performed the same endurance test three times by isometrically contracting the masseter muscles at 20, 30, 40, 50, 60, 75 or 90 per cent of maximal electromyographic activity. The interval between the tests in any one session was 30 s. Changes in the surface electromyogram were monitored by calculating the changes in mean power frequency (MPF) of the signals. With the higher contraction levels, endurance times were shorter, the MPF shifted to lower frequencies more rapidly and the MPF value was lower at the end of the test. At these levels, the subjects reported lack of power as the sole reason for stopping the test but at low levels, pain was the important reason. The endurance time and the rate of MPF shift for the second and third test of each experiment were the same. For the first test, the endurance time was longer (p less than 0.025) and the rate of MPF shift was lower (p less than 0.05). Thus the analysis of specific electromyographic (MPF) indicators provides information about the development of muscle fatigue.     

Effect of motor tasks on the cortical topography of the human masseter muscle

Non-invasive magnetic stimulation of the brain was earlier used to reveal the corticomotor representation of the human masseter muscle but it is unclear how motor tasks affect this map. An experimental approach incorporating transcranial magnetic stimulation of verified locations on the scalp, surface electromyography, and controlled muscle facilitation was used to disclose the corticomotor output map of the masseter during three isometric tooth-contact tasks, viz., tooth clenching in the intercuspal position, biting on the left molar teeth, and biting on the incisors. Map area was significantly different for all tasks, and map height and volume were also different for biting on the incisor teeth (p<0.05). There was evidence of task-related modulation of corticobulbar activity that appeared to be mainly of corticomotoneuronal origin, although the role of differential, task-associated peripheral afferent input from orofacial receptors could not be discounted.     

Comparison of 133Xe clearance and laser Doppler flowmetry in assessment of blood flow changes in human masseter muscle induced by isometric contraction

Changes induced by 30 s of isometric contraction at 10% and 50% of the maximum voluntary contraction were assessed in 10 healthy subjects; there was a median increase of 1.8 and 0.3 times in 133Xe clearance and 5.3 and 2.7 times in laser Doppler flowmetry. In the first minute after 10% maximum voluntary contraction, 133Xe clearance increased 12.1 times in relation to the initial resting level, and flowmetry values decreased to become 3.5 times higher than the basal flow; corresponding values after 50% maximum voluntary contraction were 24.3 times and 3.7 times. From the second minute after contraction, there was a rapid decrease in 133Xe clearance and a slow decrease in flowmetry values. Five minutes after biting at 10% maximum voluntary contraction, both methods showed a total net increase of about 15 times; after biting at 50% maximum voluntary contraction the corresponding values were 38 and 23 times. Thus laser Doppler flowmetry can be used to assess changes in blood flow in the masseter; it registers a greater increase in flow during isometric contraction than does 133Xe clearance. The significant difference between methods immediately after either chosen level of contraction disappears when the total net post-contraction hyperaemia is assessed over a period of 2 and 5 min, respectively.     

Fatigue and damage to the masseter muscle by prolonged low-frequency stimulation in the rat

This study aimed to examine peripheral fatigue and the resultant damage to the masseter muscle due to prolonged low-frequency stimulation. Thirty male rats were divided into S1, S2, S4, Dantr and Sham groups. The left masseters were used as experimental muscles. A pair of stimulation electrodes was placed on the left masseter. A stimulating session included rectangular electric pulses of 18 Hz (5 mA, 18 V, 0.7 ms) for 2 h with a 3 min rest period between sessions. One session was given to the S1 group, two sessions to the S2 group and four sessions to the S4 group. Four sessions were given to the Dantr group with administration of dantrolene to determine any artifacts of the electrical current. No electric stimulation was given to both side masseters in the Sham group or to the control (right) masseters in the other groups. In each session, jaw-closing force increased to a peak within 1 min and attenuated to the steady force. The peak force decreased as the session advanced in each group. Both side masseters were dissected after the stimulations and examined histologically. The experimental masseter was significantly heavier than that of the controls in the S1, S2 and S4 groups, and the muscle fibres showed irregularity of size and shape with enlargement of interstitial space and infiltration of mononuclear cells into the fibres. However, no such histological change was observed in the Dantr and Sham groups. It was confirmed that fatigue and damage to muscle fibres could be induced in masticatory muscles by prolonged low-frequency stimulation.     

Cold pressor stimulation effect on hemodynamic changes following sustained isometric contraction in human jaw-closure muscles

It is postulated that an altered adrenergic response pattern may be associated with chronic muscle pain states. To evaluate this hypothesis, one must fully understand the effect of an adrenergic activation on masticatory muscle blood flow under various conditions. This study evaluated the effect of a 12 degrees C cold pressor stimulation (a mild adrenergic activator), applied to the hand-forearm area, on intramuscular hemodynamics in the human masseter and temporalis muscles following a sustained isometric contraction. We assessed hemodynamics by measuring intramuscular hemoglobin concentration repeatedly, using a non-invasive near-infrared spectroscopy device. Measurements were taken before, during, and after a 30-second sustained 50% maximum voluntary contraction task. Fourteen healthy subjects, seven males and seven females, with no history of muscle pain in the masticatory system participated in this study. This protocol was repeated three times, but in the second trial, the cold pressor stimulation was applied to the subject during and for 5 min after the sustained contraction task. Repeated-measure analysis of variance performed on these data revealed that the peak hemoglobin concentration levels in the post-contraction recovery period were significantly reduced (between 13 and 14%) with cold pressor stimulation, both in the masseter (p < 0.001) and in the temporalis (p < 0.001) muscles. The results suggest that cold pressor stimulation produced a reduced intramuscular vasodilative response in these muscles during the immediate post-contraction period. One explanation for these results is that altering the local chemical environment of the muscle affects the adrenergic response pattern typically induced by a cold pressor stimulation.     

Effect of complete edentulism on masseter muscle thickness and changes after complete denture rehabilitation: an ultrasonographic study

Aim: The aim of the present study was to determine the changes in masseter muscle thickness due to the state of complete edentulism and the effect of complete denture rehabilitation on the masseter muscle. Methods: Real‐time ultrasonography of the masseter muscle at relaxed and contracted states was carried out for twelve patients (six dentulous and six completely edentulous). Edentulous patients were scanned at the time of denture insertion and at the end of 3 months’ follow up. Results: The mean masseter muscle thickness of the edentulous patients was significantly increased after the 3‐month follow‐up than the thickness at the time of denture insertion, but was significantly lower than that of the dentulous patients of the same age group. Conclusion: Within the limitations of this study, it can be concluded that change occurs in the masseter muscle thickness after rehabilitation with complete dentures in the form of increased muscle thickness. However, the thickness of the muscle remains smaller than that of dentate individuals.     

Effect of ibuprofen on isometric contractions and associated pain of the human masseter muscle

A randomized, single-blind crossover trial tested the effect of 1,000 mg of ibuprofen on jaw muscle pain induced by maximum voluntary teeth clenching (MVC). Subjects exercised MVC until there was onset of pain in the masseter muscles (pain latency in seconds), and until pain and exhaustion of the masseter and anterior temporalis muscles could no longer be endured (pain tolerance in seconds). Pain intensity was quantified by visual analogue scores, and pain sensitivity by the pain sensitivity range and the pain sensitivity ratio. During MVC the mean voltage of the left masseter muscle was recorded by cumulative surface electromyography. Ibuprofen had no significant effect on the pain latency and the pain tolerance. Neither did ibuprofen significantly decrease the pain intensity nor significantly affect the pain sensitivity range and the pain sensitivity ratio. After intake of ibuprofen, the number of electromyograms with a decrease in mean voltage was significantly increased--credibly, an expression of increased central fatigue with voluntary decruitment of motor units, and possibly the result of increased contraction times because of an undisclosed effect of ibuprofen. There was no circumstantial evidence of impaired motor activity that could be attributed to biosynthesis of prostaglandins.     

Effect of topical cheek surface anesthesia on isometric contractions of the human masseter muscle

To study the possibility of interactions between buccal cutaneous sensory receptors and voluntary maximum isometric contractions of the masseter muscles, six adult subjects exercised maximum teeth clenching before and after spraying the right cheek surface with aerosol containing 20% benzocaine. The right cheek and masseter muscle served as the experimental side, the left cheek and masseter muscle as the control side. Isometric motor outputs, on the right and left sides, were monitored by integrated surface electromyography over periods of 10 seconds. Topical surface anesthesia provided no evidence of motor modulation by cutaneous tactile receptors. Before and after anesthesia, the two muscles showed nearly identical and well-coordinated motor innervation patterns. It is suggested that the cortical motor commands of maximum isometric contractions, with recruitment of practically all available motor units, overrule all modulatory inputs except those of fatigue.     

Responses of the hypothalamic-pituitary-adrenal axis and pain threshold changes in the orofacial region upon cold pressor stimulation in normal volunteers

AIM: This study focused on the relationship between the HPA axis function and the heat pain threshold in the orofacial region upon cold pressor (CP) stimulation. METHODS: Ten healthy male individuals participated in this study. CP stimulation was applied to each participant, and their peripheral blood was collected 5 min before, during and 5, 15, 30, 45, 60 min after receiving CP. In addition, 5 of those 10 participants were selected at random and they experienced a mock CP trial on different days. The heat pain thresholds on the facial skin about 10mm anterior to the right external auditory canal (trigeminal V2 region) in each subject were simultaneously recorded 5 min before and 5, 30, 60 min after CP stimulation. The blood pressure and heart rate were continuously monitored throughout the course of the CP and mock trials using an electric blood pressure meter. RESULTS: Significant increases in the plasma concentration of cortisol, beta-endorphin and ACTH were induced by CP stimulation, while no significant increases were observed under the mock trial conditions. The blood pressure and heart rate showed concomitant increases during CP stimulation. In addition, the heat pain threshold in the orofacial region significantly increased after receiving CP stimulation. These results suggest that CP stimulation activated the HPA axis thereby increasing the heat pain threshold in the orofacial region in healthy individuals. CONCLUSIONS: This observed pain threshold increase might be due to the activation of an endogenous opioid system, such as increase in the circulating beta-endorphin levels.     

Acoustic myography in the assessment of human masseter muscle

The feasibility of examining electro-mechanical activity of the human masseter muscles using non-invasive recording techniques was examined in six healthy dentate adults (aged 34-57 years). Electrical activity of the muscle was examined by surface electro-myography (EMG) and the mechanical activity, in the form of muscle sounds, was examined by acoustic myography (AMG).
Bilateral recordings of EMG and AMG were made simultaneously using composite probes which were placed on the skin over the masseter muscles. A standardized pressure was applied to the probes via adjustable rods attached to a safety helmet. Pressures were monitored by strain gauges placed between the ends of the rods and the probes. With the subject seated, recordings of AMG and EMG were obtained during maximal jaw clenching for 4s and the raw signals were stored on a computer. Of three maximal contractions performed, the last two were used in the analysis. The raw amplified signals underwent frequency analysis by fast Fourier Transform. Total activity was also assessed after amplification, full-wave rectification and integration, and repeatability of the results was assessed.
The AMG frequency range was 6-15 Hz and was similar to values for other human skeletal muscles. The integrated values for EMG and AMG were repeatable on both sides of the face (IEMG, right r = 0.99, left r = 0.99; IAMG right r = 0.70, left r = 0.71). Simultaneous recordings of AMG and EMG from the masseter muscles may be useful for assessing electro-mechanical muscle function but further validation studies are required before the technique can be used clinically.     

Reliability of maximum static work efforts by the human masseter muscle

To study the reliability of nonfatiguing maximum voluntary static work efforts by the masseter muscle, six healthy subjects exercised teeth clenching in centric occlusion. Maximum voluntary teeth clenching was performed for 10 seconds on 2 different days, each with two trials, and maximum static work efforts (without artificial feedback-control) were quantified by integrated surface electromyography. Reliability was determined by factorial analyses of variance and intraclass correlations. Data reduction showed that maximum voluntary static work efforts were reproduced reliably during the four different trials.