The effects of a home exercise program on pain and perceived dysfunction in a woman with TMD: a case study.

There are few reports analyzing the effects of exercise on patients with temporomandibular disorders. This paper presents a case study examining whether there were additional benefits from performing neuromuscular control home exercises (NMCHE) in a patient with temporomandibular disorder who was already receiving conventional treatment. A woman, 41 years of age, completed a health status questionnaire called the TMJ Scale prior to being accepted. She completed additional TMJ Scales after receiving conventional treatment and again after conventional treatment was combined with neuromuscular control home exercises. Based on the TMJ Scale's best subscore indicator of the presence or absence of a temporomandibular disorder, the patient did not derive benefit from conventional treatment without exercise. However, she received a large benefit from the addition of NMCHE. It was concluded that exercises for patients with temporomandibular disorders may be beneficial to those who do not improve with conventional treatment alone.

Effect of soft lumbar support belt on abdominal oblique muscle activity in nonimpaired adults during squat lifting.

STUDY DESIGN: A counterbalanced repeated measures design. OBJECTIVE: To determine the effect of a soft lumbar support on abdominal oblique muscle electromyography (EMG) during lifting. BACKGROUND: Use of a soft lumbar back support is a common preventive measure to reduce the incidence of back injuries. Because the abdominal oblique muscles stabilize the spine during lifting, wearing this support may alter the activity level of these muscles. METHODS AND MEASURES: Twenty nonimpaired subjects (14 women and 6 men, mean age 28.9 +/- 8.1 years) were tested using surface electrodes to record the EMG of the right abdominal oblique muscles during lifting with and without the support. RESULTS: A paired t test revealed a significant decrease in activity of the abdominal oblique muscles during lifting with the support (29.7 +/- 3.13 mV) compared to without it (33.3 +/- 3.05 mV). Of the 20 subjects, the 14 women showed decreased EMG amplitude during the lift with the lumbar support compared to without the support, while 5 of the men showed increased EMG amplitude with the support and 1 man showed no change. CONCLUSION: This finding suggests that the soft lumbar support may play some role in the stabilization of the lumbar region during lifting.

Large-scale cortical reorganization following forelimb deafferentation in rat does not involve plasticity of intracortical connections.

Physiological mapping of the body representation 1 month or longer after forelimb removal in adult rats revealed new pockets of shoulder representation in the forepaw barrel subfield (FBS) in the first somatosensory cortex (SI). These "new" shoulder representations have longer evoked response latencies than sites in the shoulder representation within the trunk subfield, hereafter referred to as the "original" shoulder representation. We postulated that the "new" shoulder representations in the FBS were relayed from the "original" shoulder representation. We investigated this hypothesis by studying anatomical connectivity between the "original" shoulder representation and the FBS in intact control and forelimb deafferented adult rats using Phaseolus vulgaris leucoagglutinin (PHA-L), biocytin, and biotin dextran-amine (BDA) as anterograde tracers. The retrograde tracer cholera toxin beta subunit (CT-B) injected into the FBS was also used to study connectivity between the "original" shoulder representation and the FBS. Using these anatomical tracing techniques, we were unable to show the existence of a direct corticocortical connection between the "original" shoulder representation in the trunk subfield and the FBS in either intact or deafferented rats. Functional connectivity between the two cortical regions was studied by ablating the "original" shoulder representation alone or in combination with the shoulder representation in the second somatosensory cortex (SII) while recording evoked responses in the FBS following electrical stimulation of the shoulder. Both ablations failed to eliminate the evoked responses at the "new" shoulder sites in the FBS, suggesting that SI and SII are not necessary for "new" shoulder input in the FBS. It is suggested that subcortical sites may play a major role in large-scale cortical reorganization. Results of projections from the "original" shoulder representation to parietal medial (PM), parietal lateral (PL), SII, parietal ventral (PV), and parietal rhinal (PR) sensory fields and agranular lateral (AgL) and agranular medial (AgM) motor fields are also described.

Location and distribution of Fos protein expression in rat hippocampus following acute moderate aerobic exercise.

Hippocampal neurons are activated during endurance exercise; however, little attention has been given to the location and spatial distribution of these neurons. We have, therefore, used Fos protein expression to identify the location and distribution of hippocampal neurons that become activated during acute moderate aerobic exercise. Adult rats were assigned into trained running (TR), trained nonrunning (TNR), untrained nonrunning (UNR), and cage-bound (CB) groups. Rats in the TR and TNR groups were trained to run, for three 20-min running periods separated by 3 min rest, on a treadmill. Rats in the UNR group spent identical time on a nonactivated treadmill, while rats in the CB group remained in their home cages throughout the training and experimentation. After training to criterion performance for both TR and TNR groups, both groups were rested for 1 day. Rats in the TR were then run on the treadmill to criterion level, while those in TNR and UNR groups spent equivalent time on the nonactivated treadmill. Animals in all groups were then killed and their brains removed, sectioned, and processed for Fos protein immunocytochemistry. Fos-like immunoreactive (FLI) neurons were counted in the dentate and CA1-3 fields of the hippocampus. The total numbers of hippocampal FLI neurons, as well as FLI neurons in each hippocampal region, were compared among groups. The total numbers of FLI neurons in the hippocampus, as well as in individual regions, were significantly greater in the TR group compared with the other three groups. Similarly, significant differences were found between the TNR group when compared with UNR and CB groups. Conversely, a significant difference existed between UNR and CB only in the CA1 field, which may account for the significant difference in the total number of hippocampal FLI neurons between these two groups. These results show that Fos induction occurs in the hippocampus during moderate physical exercise. Furthermore, the importance of the incorporation of adequate controls to account for possible differences in expression of immediate early gene expression due to trained performing, trained nonperforming, and untrained groups is discussed. The results indicate that adequate control for nonexercise stimuli is necessary for studies of the effect of exercise on the brain when expression of immediate early genes such as c-fos is used as an outcome measure.

Relationship between representation of hindpaw and hindpaw barrel subfield (HBS) in layer IV of rat somatosensory cortex.

We describe the organization of the hindpaw barrel subfield (HBS) in layer IV of rat somatosensory cortex (SI) and relate this organization to the representation of the hindpaw. The ovoid-shaped, HBS is oriented anterior to posterior and comprises barrels and barrel-like structures, the most prominent of which consist of at least five anteriorly-located elongated barrel bands. Posterior to these elongated bands is a cluster of four barrels. Two additional barrels are found, one lateral, the other medial. The lateral border is formed by a nearly continuous band that overlaps portions of the anterior elongated bands and posterior barrels. The HBS shows considerable variability in size and shape; nevertheless, the overall pattern reflects a common plan of organization. Electrophysiological mapping confirmed that hindpaw representation is somatotopically organized. The glabrous toes are represented anteriorly, the pads posteriorly, and the dorsal hairy skin of the toes and hindpaw laterally. By aligning physiological and morphological (HBS) maps according to lesion sites, our data suggest that the elongated anteriorly-located barrel bands represent the hindpaw toes, the four toe pads are represented immediately posterior followed by barrels representing the plantar pads. The representations of dorsal hairy skin of toe and dorsal hindpaw form the lateral border; the heel and ankle are represented most posterior. We interpret our findings as support that individual barrels in the HBS are associated with discrete regions of the hindpaw; however, the precise relationship of structure and function reported between the vibrissae and posteromedial barrel subfield (PMBSF) and between the forepaw and the forepaw barrel subfield (FBS) were not observed.

Hypothalamic prostaglandin E2 during lipopolysaccharide-induced fever in guinea pigs.

Prostaglandin E2 (PGE2) is postulated to be a central mediator of fever. It is generally believed that it is produced in the preoptic area of the anterior hypothalamus (POA) because, among other evidence, its level increases both in the third ventricle and in the POA in response to pyrogens. However, lately, the question has arisen whether PGE2 might, in fact, be formed outside of the brain substance and then penetrate it, in particular through the organum vasculosum laminae terminalis. If produced outside the brain substance, the peripheral blockade of its synthesis should prevent lipopolysaccharides (LPS)-induced fever, whereas the intracarotid infusion of PGE2 should produce an increase in core temperature (T(C)) as well as in preoptic PGE2. To verify this hypothesis, continuous measurements of T(C) and preoptic PGE2 levels were made in conscious guinea pigs administered the PGE2 synthase inhibitor, indomethacin (10 or 50 mg/kg, im) 30 min before S. enteritidis LPS (2 mu g/kg, iv) or before PGE2 microdialyzed into the POA (1 mu g/mu l at 2 mu g/min for 2.5 h) and during PGE2 infused into a carotid artery (1 mu g and 10 mu g/mu l at 2 mu g/min for 1 h). LPS induced a biphasic 1.4 degrees C fever that was consistently associated with an increase in the level of PGE2 in the POA. Indomethacin at 10 mg/kg attenuated the course of the LPS-induced fever and prevented the associated increase in preoptic PGE2 for 90 min after fever onset; thereafter, PGE2 was significantly reduced by comparison with controls. Indomethacin at 50 mg/kg completely abolished both the fever and the increased levels of PGE2 in the POA; the fever induced by PGE2 microdialyzed into the POA was not affected by indomethacin pretreatment The intracarotid infusion of PGE2 produced T(C) falls and no increase in preoptic PGE2 levels. The indomethacin-induced blockade of fever and inhibition of the associated increase in preoptic PGE2 levels further substantiates the presumptive link between PGE2 in the POA and fever caused by LPS. The failure of exogenous PGE2 infusion to induce increases in T(C) and preoptic PGE2 levels excludes the possibility that PGE2 formed outside of the brain penetrates the POA and induces fever. Thus, in guinea pigs, the PGE2 associated with LPS-induced fever may be synthesized in the POA.

Lipopolysaccharide-induced Fos expression in hypothalamic nuclei of neonatal rats.

The inability of neonates to fully evoke the acute-phase reaction to infection is thought to be due in part to central nervous system immaturity. We used the expression of Fos protein to evaluate whether acute-phase reaction deficits in neonates may indeed be linked to unresponsiveness of brain regions that mediate the responses to infection in adult animals. In this study, we used lipopolysaccharide (LPS) as the infectious agent. Rats aged 0-1, 3, 6, 9, 12 and 15 days were divided into groups treated with low- or high-dose LPS (Escherichia coli; 50 and 500 micrograms/kg, respectively, i.p.) or pyrogen-free saline (PFS) i.p. Two hours after injection, the animals were deeply anesthetized, sacrificed, and their brains removed for Fos immunocytochemistry. Fos-like immunoreactive (FLI) neurons in the preoptic area (POA), paraventricular nucleus of the hypothalamus (PVN), and organum vasculosum laminae terminalis (OVLT) were compared between the treatment and the age groups. The forebrain was devoid of FLI neurons in 1-day-old rats, but FLI neurons were present at 3 days of age and continued to increase with age until 9 days after birth. There were no significant differences between the LPS- and PFS-treated groups until day 12 of age. At 12 and 15 days of age, FLI neurons in the PVN, medial preoptic and lateral preoptic nuclei, and the area surrounding the OVLT were greater in the LPS-treated animals. The expression appeared to be both age- and dose-dependent. These observations show that the rat brain structures that participate in the mediation of the acute-phase reaction do not become responsive to systemic pyrogens until 12 days of age, thus suggesting that insensitivity of the brain to pyrogenic agents may be partly responsible for the poor response of neonates to infectious agents.

Large unresponsive zones appear in cat somatosensory cortex immediately after ulnar nerve cut.

The organization of the primary somatosensory cortex innervated by the ulnar nerve was studied before and immediately after ulnar nerve transection in 11 cats electrophysiologically mapped under Nembutal or Ketamine anesthesia. The cortex was reexamined a second time beginning 42 hr after nerve transection in four cats anesthetized with Nembutal. One additional sham-operated control was also mapped. The region of cortex formerly served by the ulnar nerve remained largely unresponsive to somatic stimulation independent of the type of anesthetic used during recording. Nonetheless, animals anesthetized with Ketamine had more new responsive sites in deafferented cortex following nerve cut than cats anesthetized with Nembutal. New responses, when observed, were evoked by stimulation of a region of skin adjacent to the region served by the ulnar nerve. These findings suggest that the immediate response to deafferentation of somatosensory cortex is a limited acquisition of novel responses restricted to a region immediately adjacent to cortex containing normal afferent input.

Ulnar nerve innervation of paw and SI cortex of cat: substrate for reorganization.

We studied the distribution of the peripheral nerves innervating the distal forepaw by recording receptive fields from fascicles of the ulnar, radial, and median nerves and compared this result with the peripheral nerve representation in primary somatosensory (SI) cortex of cat. Our findings suggest that SI cortex receives input, in large part, from multiple peripheral nerves even when those nerves do not show a strong overlapping pattern in the periphery. This overlap pattern observed in SI cortex may be responsible, in part, for the immediate reorganization which is known to follow peripheral nerve deafferentation.