Effects of bilateral anodal transcranial direct current stimulation over the tongue primary motor cortex on cortical excitability of the tongue and tongue motor functions.

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Effects of Green Tea Catechins and Theanine on Preventing Influenza Infection among Healthcare Workers: A Randomized Controlled Trial

<p>Abstract</p> <p>Background</p> <p>Experimental studies have revealed that green tea catechins and theanine prevent influenza infection, while the clinical evidence has been inconclusive. This study was conducted to determine whether taking green tea catechins and theanine can clinically prevent influenza infection.</p> <p>Methods</p> <p><b>Design, Setting, and Participants</b>: A randomized, double-blind, placebo-controlled trial of 200 healthcare workers conducted for 5 months from November 9, 2009 to April 8, 2010 in three healthcare facilities for the elderly in Higashimurayama, Japan.</p> <p><b>Interventions</b>: The catechin/theanine group received capsules including green tea catechins (378 mg/day) and theanine (210 mg/day). The control group received placebo.</p> <p><b>Main Outcome Measures</b>: The primary outcome was the incidence of clinically defined influenza infection. Secondary outcomes were (1) laboratory-confirmed influenza with viral antigen measured by immunochromatographic assay and (2) the time for which the patient was free from clinically defined influenza infection, i.e., the period between the start of intervention and the first diagnosis of influenza infection, based on clinically defined influenza infection.</p> <p>Results</p> <p>Eligible healthcare workers (n = 197) were enrolled and randomly assigned to an intervention; 98 were allocated to receive catechin/theanine capsules and 99 to placebo. The incidence of clinically defined influenza infection was significantly lower in the catechin/theanine group (4 participants; 4.1%) compared with the placebo group (13 participants; 13.1%) (adjusted OR, 0.25; 95% CI, 0.07 to 0.76, <it>P </it>= 0.022). The incidence of laboratory-confirmed influenza infection was also lower in the catechin/theanine group (1 participant; 1.0%) than in the placebo group (5 participants; 5.1%), but this difference was not significant (adjusted OR, 0.17; 95% CI, 0.01 to 1.10; <it>P </it>= 0.112). The time for which the patient was free from clinically defined influenza infection was significantly different between the two groups (adjusted HR, 0.27; 95% CI, 0.09 to 0.84; <it>P </it>= 0.023).</p> <p>Conclusions</p> <p>Among healthcare workers for the elderly, taking green tea catechins and theanine may be effective prophylaxis for influenza infection.</p> <p>Trial Registration</p> <p>ClinicalTrials (NCT): <a href="http://www.clinicaltrials.gov/ct2/show/NCT01008020">NCT01008020</a></p

Clinical application of MEG for the evaluation of sensory disturbances of the lip and tongue in patients with mandibular nerve injury

This paper reviews the clinical applications of MEG in patients with sensory disturbances of the lip and tongue due to unilateral injury of the mandibular nerve. Multiple non-invasive approaches are available for the evaluation of human brain function. Some of these approaches are electroencephalography (EEG), magnetoencephalography (MEG), functional magnetic resonance imaging (fMRI), and positron emission tomography (PET). MEG is particularly advantageous due to its high spatiotemporal resolution. Mandibular nerve injury during orofacial surgery may result in sensory deficits of the lower lip and tongue, which often lead to speech disorders, eating difficulties, and significant reductions in patients quality of life. Conventional methods for evaluating abnormalities in lip and tongue sensation in clinical settings include the von Frey and two-point discrimination tests. However, the reproducibility and reliability of such tests remains low due to the subjective nature of the information provided by the patient. In this paper we propose that MEG can be used to effectively and objectively detect sensory abnormalities of the lower lip and tongue

Cortical Mechanisms of Tongue Sensorimotor Functions in Humans: A Review of the Magnetoencephalography Approach

The tongue plays important roles in a variety of critical human oral functions, including speech production, swallowing, mastication and respiration. These sophisticated tongue movements are in part finely regulated by cortical entrainment. Many studies have examined sensorimotor processing in the limbs using magnetoencephalography (MEG), which has high spatiotemporal resolution. Such studies have employed multiple methods of analysis, including somatosensory evoked fields (SEFs), movement-related cortical fields (MRCFs), event-related desynchronization/synchronization (ERD/ERS) associated with somatosensory stimulation or movement and cortico-muscular coherence (CMC) during sustained movement. However, the cortical mechanisms underlying the sensorimotor functions of the tongue remain unclear, as contamination artifacts induced by stimulation and/or muscle activity within the orofacial region complicates MEG analysis in the oral region. Recently, several studies have obtained MEG recordings from the tongue region using improved stimulation methods and movement tasks. In the present review, we provide a detailed overview of tongue sensorimotor processing in humans, based on the findings of recent MEG studies. In addition, we review the clinical applications of MEG for sensory disturbances of the tongue caused by damage to the lingual nerve. Increased knowledge of the physiological and pathophysiological mechanisms underlying tongue sensorimotor processing may improve our understanding of the cortical entrainment of human oral functions

ピン デンキョク オ モチイタ シタ ノ デンキ シゲキ ニ ヨル タイセイ カンカク ユウハツ ノウ ジバ ハンノウ ノ カイセキ

京都大学0048新制・課程博士博士(医学)甲第14464号医博第3309号新制||医||973(附属図書館)UT51-2009-D176京都大学大学院医学研究科外科系専攻(主査)教授 大森 治紀, 教授 河野 憲二, 教授 伊藤 壽一学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDA

Somatosensory evoked magnetic fields following tongue and hard palate stimulation on the preferred chewing side.

Although oral sensory feedback is essential for mastication, whether the cortical activity elicited by oral stimulation is associated with the preferred chewing side (PCS) is unclear. Somatosensory evoked fields were measured in 12 healthy volunteers (6 with the right side as the PCS and 6 with the left side as the PCS) following tongue and hard palate stimulation. Three components were identified over the contralateral (P40m, P60m, and P80m) and ipsilateral [P40m(I), P60m(I), and P80m(I)] hemispheres. Since no component was consistently detected across subjects, we evaluated the cortical activity over each hemisphere using the activated root-mean-square (aRMS), which was the mean amplitude of the 18-channel RMS between 10 and 150ms. For tongue stimulation, the aRMS for each hemisphere was 8.23 ± 1.55 (contralateral, mean ± SEM) and 4.67 ± 0.88 (ipsilateral)fT/cm for the PCS, and 5.11 ± 1.10 (contralateral) and 4.03 ± 0.82 (ipsilateral)fT/cm for the non-PCS. For palate stimulation, the aRMS was 5.35 ± 0.58 (contralateral) and 4.62 ± 0.67 (ipsilateral)fT/cm for the PCS, and 4.63 ± 0.56 (contralateral) and 4.14 ± 0.60 (ipsilateral)fT/cm for the non-PCS. For hard palate stimulation, the aRMS did not differ between the PCS and non-PCS, whereas for tongue stimulation, the contralateral hemisphere aRMS was significantly greater for the PCS than for the non-PCS. Thus, our results show that lateralized cortical activation was associated with the PCS for tongue, but not hard palate, stimulation; a potential reason for this may be the different sensory-inputs between these two areas, specifically the presence or absence of fine motor function

Recovery of Impaired Somatosensory Evoked Fields after Improvement of Tongue Sensory Deficits with Neurosurgical Reconstruction

Somatosensory evoked fields (SEFs) induced by tongue stimulation can be useful as an objective parameter to assess sensory disturbances in the tongue. However, whether tongue SEFs can be useful as a clinical, objective follow-up assessment method of tongue sensation following oral surgery is unknown. Here we describe two cases in which tongue SEFs were successfully used in clinical assessment. Two patients with unilateral tongue sensory deficits caused by lingual nerve injury during lower third molar extraction were recruited. Both patients underwent surgery to repair the damaged nerve, and all tongue sensory evaluations were made once before and once after surgery. SEFs were recorded by stimulating the affected and unaffected sides of the tongue separately, and cortical activity was evaluated over the contralateral hemisphere. The unilaterality of the deficit was also assessed. In both patients, stimulation of the unaffected side evoked reproducible cortical responses pre- and post-surgery. Both patients also recovered some sensation following surgery, as pre-surgery stimulation of the affected side failed to evoke cortical activity, whereas post-surgery stimulation evoked cortical activity on both sides. Sensation was initially highly lateralized in both patients, but was restored to approximately normal in the post-surgery evaluation. Finally, both patients’ rated their subjective tongue sensations on the affected side over 50% better after the surgical intervention. These cases indicate that tongue SEFs may have a clinical use as an objective parameter for assessing the course of tongue sensory recovery

Neurophysiological Basis of Deep Brain Stimulation and Botulinum Neurotoxin Injection for Treating Oromandibular Dystonia

Oromandibular dystonia (OMD) induces severe motor impairments, such as masticatory disturbances, dysphagia, and dysarthria, resulting in a serious decline in quality of life. Non-invasive brain-imaging techniques such as electroencephalography (EEG) and magnetoencephalography (MEG) are powerful approaches that can elucidate human cortical activity with high temporal resolution. Previous studies with EEG and MEG have revealed that movements in the stomatognathic system are regulated by the bilateral central cortex. Recently, in addition to the standard therapy of botulinum neurotoxin (BoNT) injection into the affected muscles, bilateral deep brain stimulation (DBS) has been applied for the treatment of OMD. However, some patients&rsquo; OMD symptoms do not improve sufficiently after DBS, and they require additional BoNT therapy. In this review, we provide an overview of the unique central spatiotemporal processing mechanisms in these regions in the bilateral cortex using EEG and MEG, as they relate to the sensorimotor functions of the stomatognathic system. Increased knowledge regarding the neurophysiological underpinnings of the stomatognathic system will improve our understanding of OMD and other movement disorders, as well as aid the development of potential novel approaches such as combination treatment with BoNT injection and DBS or non-invasive cortical current stimulation therapies