Abstract

The role of the autonomic nervous system (ANS) was recently investigated in Temporomandibular disorders (TMD). Several authors argue that in subjects with TMD there is a dysregulation of ANS. Recent literature support that Pupillometry is a simple non-invasive tool to study ANS. The aim of this study was to investigate the relationship between TMD and ANS activity using pupillometry recording in Infrared light at rest Mandible Position (RP); Infrared light at Forced Habitual Occlusion (FHO); Yellow-green light at RP; Yellow-green light at FHO. Forty female subjects were enrolled: 20 case patients showed TMD based on the Research Diagnostic Criteria for TMD, and 20 control patients, aged matched, had no signs or symptoms of TMD. Statistical analysis was performed on average pupil size. Ratio between pupil size in FHO and RP (FHO/RP ratio) and yellow-green and infrared (light/darkness ratio) lighting were carried out. Within group differences of pupil size and of “ratio” were analyzed using a paired t test, while differences of pupil size between groups were tested using an unpaired t test. Statistical comparisons between groups showed no significant differences of absolute values of pupil dimension in RP and FHO, both in yellow-green and in infrared lighting. In addition, there were no significant differences within groups comparing RP and FHO in yellow-green light. In within group comparison of pupil size, differences between RP and FHO were significant in infrared conditions. Control subjects increased, whereas TMD patients decreased pupil size at FHO in infrared lightening. FHO/RP ratio in darkness and light/darkness ratio in RP were significantly different between groups. Taken together, these data suggest that TMD subjects have an impairment of the sympathetic-adrenergic component of the ANS to be activated under stress. The present study provides preliminary pupillometric data confirming that adrenergic function is dysregulated in patients with TMD.

Highlights

  • The role of the autonomic nervous system (ANS) was recently investigated in Temporomandibular Disorders (TMD)

  • Statistical comparisons between groups showed no significant differences of absolute values of pupil dimension in rest Mandible Position (RP) and Forced Habitual Occlusion (FHO), both in yellow-green and in infrared lighting

  • Light/darkness ratio showed a high significance (p = 0.0008) in the comparison between Control Group (0.662) and TMD Group (0.486) at RP, while there was no significant difference between the two groups at FHO (Table 3)

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Summary

Introduction

The role of the autonomic nervous system (ANS) was recently investigated in Temporomandibular Disorders (TMD). Several authors argue that in subjects with TMD there is a dysregulation of ANS [1,2,3]. Such a dysregulation is in part based on genetics [4]. It implies that the patients’ enhanced sympathetic drive inhibites normal catecholamine release resulting in significant effects on peripheral target organs and functions of the ANS, which would become less efficient in adapting to the needs of environmental and physiologic demands [5]. The control of contraction and dilation of the pupil is due to the sympathetic nerve centers (Budge’s ciliospinalis centre) and parasympathetic centre (Edinger- Wesphal Nucleus). The first promotes the pupil dilation (mydriasis), the second the constriction (miosis) according to the light stimulation

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