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Biomedical subjects

Kemal S Türker

Publications and source records attributed to Kemal S Türker.

16 recordsLinked to original sources
PubMed2007

The role of periodontal mechanoreceptors in mastication.

The aim of this review is to discuss what is known about the reflex control of the human masticatory system by the periodontal mechanoreceptors and to put forward a method for standardised investigation. To deliver mechanical stimulus in a reproducible way, the following precautions are suggested: the stimulus should be brought into secure contact with the area of stimulation, and slack between the probe and the area to be stimulated should be taken up by the application of a preload. It is also important to ensure that there is minimal simultaneous activation of receptor systems other than the periodontal mechanoreceptors. It is also necessary to standardise the method for recording and analysing the response.

Humans↗
PubMed2007

Periodontal anaesthetisation decreases rhythmic synchrony between masseteric motor units at the frequency of jaw tremor.

This study links the reduction in jaw physiological tremor around 8 Hz following periodontal mechanoreceptor (PMR) anaesthetisation to changes in coherence between masseteric motor unit discharges. We have recorded single motor unit activity from two separate sites in the right masseter muscle during a low level tonic contraction, both prior to and during anaesthetisation of the peri-incisal PMRs. Anaesthetisation of PMRs decreased coherent activity between motor units circa 8 Hz, and decreased synchrony between the same motor unit pairs. It is proposed that tremor-generating inputs that cause rhythmic synchronisation of masseteric motor units arise from, or are amplified by the PMRs.

Action Potentials↗
PubMed2006

Mandibular tremor during isometric contractions.

The purpose of this short review is to consider the various hypotheses that are attributed to genesis of physiological tremor seen in the human jaw during isometric contractions.

Electromyography↗
PubMed2005

A review of the H-reflex and M-wave in the human triceps surae.

The soleus is the most commonly used muscle for H-reflex studies in humans, while limited comparable data have been produced from the gastrocnemii muscles. This article reviews the fundamental differences between the structure and function of the human soleus and gastrocnemii muscles, including recent data published about their complex innervation zones. Protocols for eliciting, recording, and assessing the H-reflex and M-wave magnitude in the human triceps surae are also discussed.

Electric Stimulation↗
PubMed2005

A study on synaptic coupling between single orofacial mechanoreceptors and human masseter muscle.

The connection between individual orofacial mechanoreceptive afferents and the motoneurones that innervate jaw muscles is not well established. For example, although electrical and mechanical stimulation of orofacial afferents in bulk evokes responses in the jaw closers, whether similar responses can be evoked in the jaw muscles from the discharge of type identified single orofacial mechanoreceptive afferents is not known. Using tungsten microelectrodes, we have recorded from 28 afferents in the inferior alveolar nerve and 21 afferents in the lingual nerve of human volunteers. We have used discharges of single orofacial afferents as the triggers and the electromyogram (EMG) of the masseter as the source to generate spike-triggered averaged records to illustrate time-based EMG modulation by the nerve discharge. We have then used cross correlation analysis to quantify the coupling. Furthermore, we have also used coherence analysis to study frequency-based relationship between the nerve spike trains and the EMG. The discharge patterns of the skin and mucosa receptors around the lip and the gingiva generated significant modulation in EMGs with a success rate of 40% for both cross correlation and coherence analyses. The discharge patterns of the periodontal mechanoreceptors (PMRs) generated more coupling with a success rate of 70% for cross correlation and about 35% for coherence analyses. Finally, the discharges of the tongue receptors displayed significant coupling with the jaw muscle motoneurones with a success rate of about 40% for both analyses. Significant modulation of the jaw muscles by single orofacial receptors suggests that they play important roles in controlling the jaw muscle activity so that mastication and speech functions are executed successfully.

Action Potentials↗
PubMed2005

Periodontal anaesthesia reduces common 8 Hz input to masseters during isometric biting.

During isometric contractions of the jaw muscles, oscillations in the rectified masseteric EMG record that are coherent with the mandibular force output are evident at ~8 Hz. We have investigated the load dependence of these oscillations under both force and EMG feedback conditions and the extent to which these oscillations are coupled bilaterally in the jaw muscles. We further investigated the extent to which afferent information arising from the periodontium during biting influenced the extent of ~8 Hz EMG tremor and the bilateral coupling between masseters at this frequency. Using coherence analysis we have shown that a significant load-independent coupling of EMG between the closing muscles of the jaw occurs at ~8 Hz as a result of common ~8 Hz input to the masseters. This common input is significantly reduced when afferent information from the periodontium is blocked. These results suggest that afferent information arising from the periodontium enhances the expression of peripheral tremulous activity, which may be important for optimising the response of the jaw to changes in forces occurring between the teeth.

Adolescent↗
PubMed2005

Methods of time and frequency domain examination of physiological tremor in the human jaw.

This paper discusses, using the human jaw as a model, some of the commonly used techniques for examining physiological tremor. The EMG component driving mandibular physiological tremor approximately 7Hz can be revealed in the time domain manifestation of EMG by demodulation. The co-occurrence of approximately 7Hz physiological tremor (PT) in force and EMG can also be seen in the frequency domain representations of these signals and coherence analysis provides a method by which the degree of co-occurrence can be statistically investigated. Additionally, estimation of time lags between the signals by phase and cumulant density analysis provides evidence of the direction of dependence. Data presented herein using these techniques illustrates that for the human jaw, PT arises from a rhythmic component of EMG. This component is frequency and amplitude invariant across a range of bite forces indicating that it is not due to interaction between the stretch reflex and the mechanical resonance of the system.

Biomechanical Phenomena↗
PubMed2005

Jaw movement alters the reaction of human jaw muscles to incisor stimulation.

The changes in the minimum time to consciously react (reaction time) and the order of jaw muscle recruitment to precisely controlled axial stimulation of the incisors during controlled jaw movements are not known. To this end, ten subjects were recruited to investigate the reaction time of bilateral temporalis and masseter muscles and bite force. Stimuli were delivered axially to the upper central incisors during active jaw closing and opening, and under static conditions. The results showed that the reaction time was increased an average of 35% during both jaw opening and closing movements when compared with static jaw conditions. The left temporalis was recruited approximately 10 ms before the right temporalis, whereas no significant side differences were found between the masseter muscles. The masseter muscles were recruited an average of 20 ms before the temporalis muscles during jaw closing, but no difference existed during opening. Under static conditions the reaction time in the bite force was approximately 16 ms longer than the left temporalis, but was not significantly different from the reaction time of any of the other muscles, indicating that, under the static conditions tested, the left temporalis was more often responsible for initiation of the mechanical reactions in the jaw. Because of active compensation, no force measurements were made during jaw movement. This study is a prerequisite for investigations into the modulation of reflexes during jaw movement, because a response to a stimulus commencing after the minimum reaction time may not be entirely reflex in origin.

Adult↗
PubMed2005

Perceptual distortion of face deletion by local anaesthesia of the human lips and teeth.

As visual guidance of facial movements is impossible, accurate movements for speech and mastication require an established body image that is formed via the information from mechanoreceptors in the skin, mucosa, periodontium, and proprioceptors in the facial and masticatory muscles and in the jaw joints. In this study we aimed to investigate how the acute deafferentation of lips and teeth alters the established image of lips, teeth and the thumb. We used a psychophysical method to determine whether the perceived sizes of the upper lip and front teeth change when the sensory input from the lips and front teeth is fully blocked. We also examined the perceived size of the thumb to test for acute interactions between the thumb and facial structures. Local anaesthetic blocking of upper lip and upper front teeth significantly increased the perceived size of the upper lip by as much as 100% (range 21-100%) in ten out of eleven subjects tested (overall mean 52%; p=0.001). The perceived size of the upper teeth also significantly increased by as much as 155% (range 30-155%) in eight of the eleven subjects during anaesthesia (overall mean 41%; p=0.035). When the region of anaesthesia was increased and both upper and lower teeth and lips were anaesthetised, the perceived size of the upper lip again increased, by 53% (p=0.040), but the change in perceived size of the upper front teeth (18%) was not significant (p=0.206). In both studies there was no change in perceived size of the thumb. The results illustrate the labile central interaction between sensory inputs and the importance of feedback from peripheral afferents in generating the subjective facial image. The timing, level, and area of anaesthesia may be important modifiers of these interactions.

Adolescent↗
PubMed2004

EMG, force and discharge rate analysis of human jaw reflexes in response to axial stimulation of the incisor.

Reflex studies utilising controlled stimulation along the long axis of human incisors are relatively new, and the effects that various stimulus parameters have on the elicited reflexes are not fully understood. Twelve subjects were recruited to determine the effects that contraction level, stimulus force and amount of constant force applied between stimuli have on the reflex response of the masseter muscle. Multi-unit intramuscular electromyogram (EMG) was recorded alongside surface EMG to determine whether any differences existed between the two. Furthermore, cumulative peri-stimulus "dischargegrams" were constructed to determine whether events seen in the EMG corresponded to changes in the discharge rates of the underlying motor units. Axial stimulation of the incisor induced a response in the EMG comprising of peak-trough-peak, with the trough being the most dominant. The bite force record showed only a reduction (relaxation) in response to the stimulation. The most significant experimental factor affecting the reflex occurrence and strength was the stimulus force. Although the latency, duration and occurrence rates were not significantly different, the strength of the responses was greater in intramuscular recordings compared with the surface recordings. Discharge rate analysis showed that approximately two-thirds of the late peaks detected in the EMG did not correspond to an increase in the discharge rates of the underlying units; hence they were due to the clustering of action potentials following the trough and not to a change in the membrane potential of the motoneurone. It was also found that the duration of the trough, as seen by the reduced cumulative discharge rate of the underlying units, was longer than indicated by the EMG.

Adult↗
PubMed2004

Response of human jaw muscles to axial stimulation of a molar tooth.

The reflexes of the main jaw-closer muscles (masseter and anterior temporalis) on both sides of the jaw were investigated using surface electromyography to observe reflex activity following mechanical stimulation of the 1st right upper-molar tooth at various forces under a number of levels of jaw-muscle activity. As with analogous studies performed on the incisor, three distinct reflex events were identified in the EMG before the earliest conscious subject reaction: early excitation, inhibition and late excitation. However, contrary to observations found during studies on the incisor, excitation, not inhibition was the primary reflex response. The application of a local anaesthetic block around the stimulated molar showed that the primary agents in eliciting the observed reflexes were not contained within the periodontium of the stimulated tooth. A diminished representation of periodontal mechanoreceptors around the molar teeth and more elaborate root structures, hence a more solid connection to the jaw and consequently less tooth movement, were deemed the likely reason for the distinction between the reflex responses of the incisal and molar regions. In addition to the reflex studies, the minimum reaction time of a number of subjects was determined to permit the distinction of a reflex event and an event that could be a conscious subject reaction. It was found that the reaction time of the temporalis muscles was significantly shorter than those of the masseter, while no significant difference was found between the left and right sides. Overall, the data showed that the presence or absence of background muscle activity and subject variability were the main causes of changes in the reflex response, provided the level of the stimulus was greater than 3 N. The application of local anaesthetic had no impact on the reflexes evoked.

Adolescent↗
PubMed2003

A method for quantifying reflex responses from intra-muscular and surface electromyogram.

Measuring human reflex responses from electromyogram (EMG) traces in an accurate, repeatable and reliable way with a high degree of specificity has traditionally been a difficult task. This paper describes a new method that can be used to quantify reflex responses from both surface and intra-muscular EMG. This technique extends the classical cumulative sum (CUSUM) calculations by defining precise points for the calculation of latencies, durations and strengths to facilitate automatic reflex detection and permit the strength of a reflex to be defined in absolute units. The effect of varying the pre-stimulus time, the number of trials averaged and the amount of filtering used on the identification and classification of reflex parameters are also investigated. Furthermore, the effect of noise on these values, and how to remove it, is discussed. The new method, which is an expansion of the CUSUM analysis, is compared and contrasted with the more common threshold-crossing method in two different muscles: masseter and first dorsal interosseous (FDI), in experiments utilizing both mechanical and electrical stimulation. There are a number of advantages to using the new method; not only does the modified CUSUM method detect reflexes earlier than threshold-crossing methods but also the strength and duration are less susceptible to averaging and filtering parameters while giving a better indication of the reflex size. The data suggests that a pre-stimulus analysis period of at least 100 ms be used to correctly identify the variability inherent in EMG traces. It is also concluded that for subtle reflexes, 50 stimuli should be the minimum number used when spike trigger averaging is employed as lower numbers are associated with much greater pre-stimulus variability. Zero-phase filtering the rectified averaged EMG traces is recommended as this makes it easier to identify significant changes in the electrical activity of the muscle in question. In addition, noise estimation and removal from averaged rectified EMG recordings yields results that are a more accurate representation of the synaptic activity of the motor units in question.

Action Potentials↗
PubMed2002

Response of human jaw muscles to axial stimulation of the incisor.

The role of periodontal mechanoreceptors (PMRs) in the reflex control of the jaw muscles has thus far been mainly derived from animal studies. To date, the work that has been done on humans has been limited and confined to orthogonal stimulation of the labial surface of the tooth. The purpose of this study was to investigate the response of the masseter and digastric muscles in humans to controlled axial stimulation of the upper left central incisor, both before and during a local anaesthetic block of the PMRs. Ten neurologically normal young adult females were tested, each on two separate occasions to confirm the reproducibility of the results. It was found that the reflex response in the masseter was modulated by the rate of rise of the stimulus used and, to a lesser degree, the level of background muscle activity. There was little detectable change in the activity of the digastric muscle under the tested conditions and what was found could be attributed to cross-talk with the masseter. The reflex responses obtained were significantly different between subjects; however retesting the same subject on a different occasion yielded similar results. The results indicate that the most common response of the masseter muscle to brisk axial stimulation of the incisor is a reflex inhibition at 20 ms, followed by a late excitation at 44 ms. However, it is possible that this late excitation could be due to delayed action potentials and hence be artefactual. As the application of a local anaesthetic block removed or significantly reduced both of these responses, it was concluded that they originated from the PMRs. Unlike during orthogonal stimulation, slowly rising stimuli did not produce any excitatory reflex activity. This indicated a difference in jaw reflexes to forces applied in different directions, possibly due to the activation of different receptor types when stimulating the tooth in either the orthogonal or axial directions.

Adolescent↗
PubMed2002

What can be learned about motoneurone properties from studying firing patterns?

The discharge patterns of tonically-firing neurones are influenced by both the characteristics of their presynaptic input and their intrinsic properties. The regularity of the discharge of motoneurones is thought to reflect their prominent post-spike afterhyperpolarization (AHP). When a motoneurone fires at steady mean rate, the distribution of interspike intervals is determined by the amplitude and frequency content of the synaptic noise together with the decrease in excitability following a spike due to AHP. This paper considers how motoneurone discharge statistics can be used to estimate AHP trajectories as well as a motoneurone's sensitivity to excitatory input.

Animals↗
PubMed2002

Reflex control of human jaw muscles.

The aim of this review is to discuss what is known about the reflex control of the human masticatory system and to propose a method for standardized investigation. Literature regarding the current knowledge of activation of jaw muscles, receptors involved in the feedback control, and reflex pathways is discussed. The reflexes are discussed under the headings of the stimulation conditions. This was deliberately done to remind the reader that under each stimulation condition, several receptor systems are activated, and that it is not yet possible to stimulate only one afferent system in isolation in human mastication experiments. To achieve a method for uniform investigation, we need to set a method for stimulation of the afferent pathway under study with minimal simultaneous activation of other receptor systems. This stimulation should also be done in an efficient and reproducible way. To substantiate our conviction to standardize the stimulus type and parameters, we discuss the advantages and disadvantages of mechanical and electrical stimuli. For mechanical stimulus to be delivered in a reproducible way, the following precautions are suggested: The stimulus delivery system (often a probe attached to a vibrator) should be brought into secure contact with the area of stimulation. To minimize the slack between the probe, the area to be stimulated should be taken up by the application of pre-load, and the delivered force should be recorded in series. Electrical stimulus has advantages in that it can be delivered in a reproducible way, though its physiological relevance can be questioned. It is also necessary to standardize the method for recording and analyzing the responses of the motoneurons to the stimulation. For that, a new technique is introduced, and its advantages over the currently used methods are discussed. The new method can illustrate the synaptic potential that is induced in the motoneurons without the errors that are unavoidable in the current techniques. We believe that once stimulation, recording, and analysis methods are standardized, it will be possible to bring out the real "wiring diagram" that operates in conscious human subjects.

Afferent Pathways↗