Research on Biomedical Engineering
http://www.rbejournal.periodikos.com.br/article/doi/10.1590/2446-4740.06617
Research on Biomedical Engineering
Original Article

Neuro-behavioral pattern of sleep bruxism in wakefulness

Marila Rezende Azevedo; Ronaldo Sena; Amanda Medeiros de Freitas; Andrei Nakagawa Silva; Edgard Afonso Lamounier Júnior; Alcimar Barbosa Soares

Abstract

Abstract Introduction: Sleep Bruxism (SB) is a non-functional rhythmic movement of the mandible with multifactorial aetiology and complex diagnose. It has been the subject of various studies over the past decades and it is considered a result of actions of the Central Nervous System modulated by Autonomous Nervous System. In this work, we test the hypothesis that SB subjects present a typical and defined neurobehavioral pattern that can be distinct from that of non-bruxers subjects and can be measured during wakefulness.

Methods: Fifteen sleep bruxers (experimental-group EG) and fifteen non-bruxers (control-group CG) took part in the experiments. To verify the presence and severity of SB, clinical examinations, anamneses and questionnaires, including Visual Analogic Scale - faces (VAS-f) and State-Trait Anxiety Inventory (STAI) were applied. To legitimate the diagnoses of SB, a disposable instrument (Bitestrip®) to assess the masseter activity during sleep was employed. All subjects were submitted to a set of experiments for measuring various visual evoked responses during the presentation of visual stimuli (pleasant, unpleasant and neutral images). Events in Visual Evoked Potential (VEP) were used to compare the neural responses of both CG and EG.

Results: VAS-f showed EG with higher perception of stress than CG (trait: p=0.05), and lower quality of life for (state: p=0.007). STAI I and II showed significant differences of anxiety between CG and EG (p=0.013 and p=0.004, respectively), being EG the highest. The EG Bitestrip scores confirmed that 100% of subjects were sleep bruxers. Significant differences were found between EG and CG for events associated with emotional (pleasant and unpleasant) images in the first 250 ms after stimulation. In general, EG subjects showed higher amplitude and shorter latency of VEP events.

Conclusion: It is possible to distinguish between SB and non-bruxers subjects during wakefulness, based on differences in amplitude and latency of cortical event related potentials elicited by visual stimulation. SB subjects show greater amplitudes in specific events in frontal areas when non-pleasant images are shown. Latencies tend to be anticipated in SB compared to CG subjects.

Keywords

Sleep bruxism, Emotion, EEG, Visual evoked potential, Anxiety, Wakefulness

References

Ahlberg J, Lobbezoo F, Ahlberg K, Manfredini D, Hublin C, Sinisalo J, Könönen M, Savolainen A. Self-reported bruxism mirrors anxiety and stress in adults. Med Oral Patol Oral Cir Bucal. 2013; 18(1):e7-11. PMid:22926484. http://dx.doi.org/10.4317/medoral.18232.

Amrhein C, Muhlberger A, Pauli P, Wiedemann G. Modulation of event-related brain potentials during affective picture processing: a complement to startle reflex and skin conductance response? Int J Psychophysiol. 2004; 54(3):231-40. PMid:15331214. http://dx.doi.org/10.1016/j.ijpsycho.2004.05.009.

Armony J, Dolan R. Modulation of spatial attention by fear-conditioned stimuli: an event-related fMRI study. Neuropsychologia. 2002; 40(7):817-26. PMid:11900732. http://dx.doi.org/10.1016/S0028-3932(01)00178-6.

Bar-Haim Y, Lamy D, Pergamin L, Bakermans-Kranenburg MJ, van Ijzendoorn MH. Threat-related attentional bias in anxious and nonanxious individuals: a meta-analytic study. Psychol Bull. 2007; 133(1):1-24. PMid:17201568. http://dx.doi.org/10.1037/0033-2909.133.1.1.

Barreto JEF, Silva LP. Sistema límbico e as emoções: uma revisão anatômica. Rev Neurocienc. 2010; 18(3):386-94.

Bayar GR, Tutuncu R, Acikel C. Psychopathological profile of patients with different forms of bruxism. Clin Oral Investig. 2012; 16(1):305-11. PMid:21221680. http://dx.doi.org/10.1007/s00784-010-0492-9.

Behr M, Hahnel S, Faltermeier A, Bürgers R, Kolbeck C, Handel G, Proff P. The two main theories on dental bruxism. Ann Anat. 2012; 194(2):216-9. PMid:22035706. http://dx.doi.org/10.1016/j.aanat.2011.09.002.

Brown G, Donovan S. Measuring change in place values for environmental and natural resource planning using public participation GIS (PPGIS): results and challenges for longitudinal research. Soc Nat Resour. 2014; 27(1):36-54. http://dx.doi.org/10.1080/08941920.2013.840023.

Cacioppo JT, Gardner WL. Emotion. Annu Rev Psychol. 1999; 50(1):191-214. PMid:10074678. http://dx.doi.org/10.1146/annurev.psych.50.1.191.

Capela NF, Georgieva P. Aplicação de técnicas de aprendizagem automática para classificação de emoções humanas com sinais de EEG. Electrónica e Telecomunicações. 2012; 5(4):391-9.

Carretié L, Hinojosa JA, Albert J, Mercado F. The neural response to sustained affective visual stimulation using an indirect task. Exp Brain Res. 2006; 174(4):630-7. PMid:16708242. http://dx.doi.org/10.1007/s00221-006-0510-y.

Carretié L, Hinojosa JA, Martín-Loeches M, Mercado F, Tapia M. Automatic attention to emotional stimuli: neural correlates. Hum Brain Mapp. 2004; 22(4):290-9. PMid:15202107. http://dx.doi.org/10.1002/hbm.20037.

Clark VP, Fan S, Hillyard SA. Identification of early visually evoked potential generators by retinotopic and topographic analyses. Hum Brain Mapp. 1994; 2(3):170-87. http://dx.doi.org/10.1002/hbm.460020306.

Codispoti M, Ferrari V, Bradley M. Repetitive picture processing: autonomic and cortical correlates. Brain Res. 2006; 1068(1):213-20. PMid:16403475. http://dx.doi.org/10.1016/j.brainres.2005.11.009.

Dubé C, Rompre PH, Manzini C, Guitard F, De Grandmont P, Lavigne GJ. Quantitative polygraphic controlled study on efficacy and safety of oral splint devices in tooth-grinding subjects. J Dent Res. 2004; 83(5):398-403. PMid:15111632. http://dx.doi.org/10.1177/154405910408300509.

Flykt A, Caldara R. Tracking fear in snake and spider fearful participants during visual search: a multi-response domain study. Cogn Emotion. 2006; 20(8):1075-91. http://dx.doi.org/10.1080/02699930500381405.

Foti D, Hajcak G, Dien J. Differentiating neural response to emotional pictures: evidence from temporal-spatial PCA. Psychophysiology. 2009; 46(3):521-30. PMid:19496228. http://dx.doi.org/10.1111/j.1469-8986.2009.00796.x.

Freunberger R, Klimesch W, Doppelmayr M, Höller Y. Visual P2 component is related to theta phase-locking. Neurosci Lett. 2007; 426(3):181-6. PMid:17904744. http://dx.doi.org/10.1016/j.neulet.2007.08.062.

Gómez-Herrero G, De Clercq W, Anwar H, Kara O, Egiazarian K, Huffel SV, Van Paesschen W. Automatic removal of ocular artefacts in the EEG without an EOG reference channel. In: Proceedings of the 7th Nordic Signal Processing Symposium (NORSIG 2006); 2006; Rejkjavik, Iceland. USA: IEEE; 2006.

Guo M, Xu G, Wang L, Masters M, Milsap G, Thakor N, Soares AB. The anterior contralateral response improves performance in a single trial auditory oddball BMI. Biomed Signal Process Control. 2015; 22:74-84. http://dx.doi.org/10.1016/j.bspc.2015.06.014.

Hajcak G, MacNamara A, Olvet DM. Event-related potentials, emotion, and emotion regulation: an integrative review. Dev Neuropsychol. 2010; 35(2):129-55. PMid:20390599. http://dx.doi.org/10.1080/87565640903526504.

Herbert BM, Pollatos O, Schandry R. Interoceptive sensitivity and emotion processing: an EEG study. Int J Psychophysiol. 2007; 65(3):214-27. PMid:17543405. http://dx.doi.org/10.1016/j.ijpsycho.2007.04.007.

Huynh N, Manzini C, Rompré PH, Lavigne GJ. Weighing the potential effectiveness of various treatments for sleep bruxism. J Can Dent Assoc. 2007; 73(8):727-30. PMid:17949541.

Jung TP, Makeig S, Humphries C, Lee TW, Mckeown MJ, Iragui V, Sejnowski TJ. Removing electroencephalographic artefacts by blind source separation. Psychophysiology. 2000; 37(2):163-78. PMid:10731767. http://dx.doi.org/10.1111/1469-8986.3720163.

Kaipper MB. Avaliação do inventário de ansiedade traço-estado (IDATE) através da análise de Rasch [dissertation]. Porto Alegre: Universidade Federal do Rio Grande do Sul; 2008.

Kato T, Velly AM, Nakane T, Masuda Y, Maki S. Age is associated with self-reported sleep bruxism, independently of tooth loss. Sleep Breath. 2012; 16(4):1159-65. PMid:22146891. http://dx.doi.org/10.1007/s11325-011-0625-7.

Kawasaki H, Kaufman O, Damasio H, Damasio AR, Granner M, Bakken H, Hori T, Howard MA 3rd, Adolphs R. Single neuron responses to emotional visual stimuli recorded in human ventral prefrontal cortex. Nat Neurosci. 2001; 4(1):15-6. PMid:11135639. http://dx.doi.org/10.1038/82850.

Keil A, Bradley MM, Hauk O, Rockstroh B, Elbert T, Lang P. Large-scale neural correlates of affective picture processing. Psychophysiology. 2002; 39(5):641-9. PMid:12236331. http://dx.doi.org/10.1111/1469-8986.3950641.

Klasser GD, Rei N, Lavigne GJ. Sleep bruxism etiology: the evolution of a changing paradigm. J Can Dent Assoc. 2015; 81:f2. PMid:25633110.

Lang PJ, Bradley MM, Cuthbert BN. International Affective Picture System (IAPS): affective ratings of pictures and instruction manual. Gainesville: University of Florida; 2005. Technical Report A-6.

Lavigne GJ, Huynh N, Kato T, Okura K, Adachi K, Yao D, Sessle B. Genesis of sleep bruxism: motor and autonomic-cardiac interactions. Arch Oral Biol. 2007; 52(4):381-4. PMid:17313939. http://dx.doi.org/10.1016/j.archoralbio.2006.11.017.

Lobbezoo F, Ahlberg J, Glaros AG, Kato T, Koyano K, Lavigne GJ, de Leeuw R, Manfredini D, Svensson P, Winocur E. Bruxism defined and graded an international consensus. J Oral Rehabil. 2013; 40(1):2-4. PMid:23121262. http://dx.doi.org/10.1111/joor.12011.

Lobbezoo F. Bruxism: definition, diagnosis, epidemiology, and etiology. In: Proceedings of the II Congresso Nazionale GSID (Gruppo di Studio Italiano Disordini Craniomandibolari); 2016 July 3-4; Marina di Carrara, Italy. Italy: GSID; 2016. p. 1-5.

Mainieri VC, Saueressig AC, Pattussi MP, Fagondes SC, Grossi ML. Validation of the Bitestrip versus polysomnography in the diagnosis of patients with a clinical history of sleep bruxism. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 113(5):612-7. PMid:22668619. http://dx.doi.org/10.1016/j.oooo.2011.10.008.

Manfredini D, Fabbri A, Peretta R, Guarda-Nardini L, Lobbezoo F. Influence of psychological symptoms on home-recorded sleep-time masticatory muscle activity in healthy subjects. J Oral Rehabil. 2011; 38(12):902-11. PMid:21569074. http://dx.doi.org/10.1111/j.1365-2842.2011.02226.x.

Mathews A, MacLeod C. Induced processing biases have causal effects on anxiety. Cogn Emotion. 2002; 16(3):331-54. http://dx.doi.org/10.1080/02699930143000518.

Mayer P, Heinzer R, Lavigne G. Sleep bruxism in respiratory medicine practice. Chest. 2016; 149(1):262-71. PMid:26225899. http://dx.doi.org/10.1378/chest.15-0822.

Michalowski JM, Melzig CA, Weike AI, Stockburger J, Schupp HT, Hamm AO. Brain dynamics in spider-phobic individuals exposed to phobia-relevant and other emotional stimuli. Emotion. 2009; 9(3):306-15. PMid:19485608. http://dx.doi.org/10.1037/a0015550.

Olofsson JK, Nordin S, Sequeira H, Polich J. Affective picture processing: an integrative review of ERP findings. Biol Psychol. 2008; 77(3):247-65. PMid:18164800. http://dx.doi.org/10.1016/j.biopsycho.2007.11.006.

Polich J. Updating P300: an integrative theory of P3a and P3b. Clin Neurophysiol. 2007; 118(10):2128-48. PMid:17573239. http://dx.doi.org/10.1016/j.clinph.2007.04.019.

Pfurtscheller G, Lopes da Silva FH. Event-related EEG/MEG synchronization and desynchronization: basic principles. Clin Neurophysiol. 1999; 110(11):1842-57. PMid:10576479. http://dx.doi.org/10.1016/S1388-2457(99)00141-8.

Riemann D, Spiegelhalder K, Feige B, Voderholzer U, Berger M, Perlis M, Nissen C. The hyperarousal model of insomnia: a review of the concept and its evidence. Sleep Med Rev. 2010; 14(1):19-31. PMid:19481481. http://dx.doi.org/10.1016/j.smrv.2009.04.002.

Rossignol M, Philippot P, Douilliez C, Crommelinck M, Campanella S. The perception of fearful and happy facial expression is modulated by anxiety: an event-related potential study. Neurosci Lett. 2005; 377(2):115-20. PMid:15740848. http://dx.doi.org/10.1016/j.neulet.2004.11.091.

Sarter M, Givens B, Bruno JP. The cognitive neuroscience of sustained attention: where top–down meets bottom up. Brain Res Rev. 2001; 35(2):146-60. PMid:11336780. http://dx.doi.org/10.1016/S0165-0173(01)00044-3.

Sato S, Sasaguri K, Ootsuka T, Saruta J, Miyake S, Okamura M, Sato C, Hori N, Kimoto K, Tsukinoki K, Watanabe K, Onozuka M. Bruxism and stress relief. In: Onozuka M, Yen CT, editors. Novel trends in brain science. Tokyo: Springer; 2008. p. 183-200. http://dx.doi.org/10.1007/978-4-431-73242-6_11.

Sato S, Slavicek R. The masticatory organ and stress management. Int J Stomatol Occlusion Med. 2008; 1(1):51-7. http://dx.doi.org/10.1007/s12548-008-0010-8.

Schames SE, Schames J, Schames M, Chagall-Gungur SS. Sleep bruxism, an autonomic self-regulating response by triggering the trigeminal cardiac reflex. J Calif Dent Assoc. 2012; 40(8):670-1, 674-6. PMid:22953526.

Schupp HT, Junghofer M, Weike AI, Hamm AO. Attention and emotion: an ERP analysis of facilitated emotional stimulus processing. Neuroreport. 2003; 14(8):1107-10. PMid:12821791. http://dx.doi.org/10.1097/00001756-200306110-00002.

Schupp HT, Junghöfer M, Weike AI, Hamm AO. The selective processing of briefly presented affective pictures: An ERP analysis. Psychophysiology. 2004; 41(3):441-9. PMid:15102130. http://dx.doi.org/10.1111/j.1469-8986.2004.00174.x.

Seger L. Odontologia e psicologia: uma abordagem integradora. São Paulo: Santos; 1998.

Shochat T, Gavish A, Arons E, Hadas N, Molotsky A, Lavie P, Oksenberg A. validation of the BiteStrip screener for sleep bruxism. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 104(3):e32-9. PMid:17618147. http://dx.doi.org/10.1016/j.tripleo.2007.03.009.

Taylor SE, Eisenberger NI, Saxbe D, Lehman BJ, Lieberman MD. Neural responses to emotional stimuli are associated with childhood family stress. Biol Psychiatry. 2006; 60(3):296-301. PMid:16460697. http://dx.doi.org/10.1016/j.biopsych.2005.09.027.

Weinberg A, Hajcak G. Beyond good and evil: the time-course of neural activity elicited by specific picture content. Emotion. 2010; 10(6):767-82. PMid:21058848. http://dx.doi.org/10.1037/a0020242.

Witz K, Hinkle DE, Wiersma W, Jurs SG. Applied statistics for the behavioral sciences. J Educ Behav Stat. 1990; 15(1):84-7. http://dx.doi.org/10.2307/1164825.
 

5ad4e1390e88259b7448954d rbejournal Articles
Links & Downloads

Res. Biomed. Eng.

Share this page
Page Sections