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Behavioural Brain Research 228 (2012) 254–260

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Behavioural Brain Research


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Research report

Increased occlusal vertical dimension induces cortical plasticity in the rat face
primary motor cortex
C. Kato ∗ , K. Fujita, S. Kokai, T. Ishida, M. Shibata, S. Naito, T. Yabushita, T. Ono
Department of Orofacial Development and Function, Orthodontic Science, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan

a r t i c l e i n f o a b s t r a c t

Article history: Previous studies have demonstrated that functional plasticity in the primary motor cortex (M1) is related
Received 24 September 2011 to motor-skill learning and changes in the environment. Increased occlusal vertical dimension (iOVD) may
Received in revised form modulate mastication, such as in the masticatory cycle, and the firing properties of jaw-muscle spindles.
10 November 2011
However, little is known about the changes in motor representation within the face primary motor cortex
Accepted 11 November 2011
(face-M1) after iOVD. The purpose of the present study was to determine the effect of iOVD on the face-
Available online 22 November 2011
M1 using intracortical microstimulation (ICMS). In an iOVD group, the maxillary molars were built-up by
2 mm with acrylic. The electromyographic (EMG) activities from the left (LAD) and right (RAD) anterior
Keywords:
Plasticity
digastric (AD), masseter and genioglossus (GG) muscles elicited by ICMS within the right face-M1 were
Intracortical microstimulation recorded 1, 2 and 8 weeks after iOVD. IOVD was associated with a significant increase in the number of
Orofacial sites within the face-M1 from which ICMS evoked LAD and/or GG EMG activities, as well as a lateral shift
Jaw muscle in the center of gravity of the RAD and LAD muscles at 1 and 2 weeks, but not at 8 weeks. These findings
Occlusal vertical dimension suggest that a time-dependent neuroplastic change within the rat face-M1 occurs in association with
Rat iOVD. This may be related to the animal’s ability to adapt to a change in the oral environment.
Crown Copyright © 2011 Published by Elsevier B.V. All rights reserved.

1. Introduction microstimulation (ICMS) [14]. ICMS can identify M1 neuroplastic-


ity induced by motor-skill learning or peripheral manipulations.
Various parts of the body are precisely encoded into the primary The M1 shows a use-dependent increase in movement represen-
motor cortex (M1) of the cerebrum [1]. Representations of parts of tations [15,16], and these increased motor representations endure
the body that are capable of fine motor control (e.g., fingers and long after the manipulations [17,18]. Meanwhile, peripheral nerve
face) occupy a greater amount of the M1 area than those that exhibit lesions result in a decrease in motor representation and an increase
less-precise motor control (e.g., the trunk) [2]. The orofacial region in association with nerve recovery [19]. Moreover, limb immobi-
occupies 68% of the M1 area of the rat [3], which is greater than lization in humans with a surgical cast has been shown to affect
the actual proportion. Since orofacial movements are controlled M1 neuroplasticity [20,21].
by feedback from the periphery [4–7] and the M1 receives input In the orofacial region of the M1 (face-M1), neuronal activity
indirectly from the orofacial region [8,9], the exaggerated orofacial increases in relation to the training of tongue movements [22,23].
motor representation in rats and humans indicates the importance Whisker motor representation decreases following facial nerve
of feedback from the orofacial region in these species. Previous damage and increases with age [24]. Dental extraction is associ-
studies using lesions or reversible cold-block of the M1 have shown ated with a significant increase in the number of sites within the
that the duration of some masticatory-related electromyographic face-M1 from which ICMS evokes EMG activity in jaw-opening [i.e.,
(EMG) activities [10] is affected, the amount of mouth-opening in anterior digastrics (AD)] and tongue-protruding [i.e., genioglossus
mastication is decreased [11], and the performance in a tongue- (GG)] muscles [25]. Likewise, lingual nerve transaction is associ-
protrusion task is impaired [12]. ated with neuroplastic changes in tongue motor representations in
Previous studies have demonstrated that plastic changes occur the face-M1 [26].
in the M1 in association with motor-skill learning and changes in The orofacial region responds to environmental changes, which
the environment [4,11–18]. One of the methods used to measure can include tooth [25] and dental pulp [27] extraction that
such changes involves the mapping of motor cortical represen- are accompanied by sensory disruption, and changes in the
tations of muscle movements through the use of intracortical occlusal vertical dimension (OVD) that are accompanied by sen-
sory changes. OVD is defined as the vertical dimension of the face
when the teeth and/or dentures are in maximum contact in centric
∗ Corresponding author. Tel.: +81 3 5803 5963; fax: +81 3 5803 5963. occlusion [28]. A decreased OVD due to the loss or severe abra-
E-mail address: c.kato.orts@tmd.ac.jp (C. Kato). sion/attrition of the posterior teeth can be restored by treatment

0166-4328/$ – see front matter. Crown Copyright © 2011 Published by Elsevier B.V. All rights reserved.
doi:10.1016/j.bbr.2011.11.013
C. Kato et al. / Behavioural Brain Research 228 (2012) 254–260 255

Instruments,Tokyo, Japan) were used to record EMG activities from the left (LAD)
and right (RAD) AD and jaw-closing (masseter) muscles as well as the left GG muscle.
A craniotomy was performed to expose the right cortical hemispheres. To avoid
thick surface blood vessels, a fine glass-insulated tungsten microelectrode (250 ␮m-
diameter shaft with an 8◦ tapered tip; A-M Systems, Inc., Carlsborg, WA, USA) was
inserted transdurally into the exposed hemispheres in a standardized systematic
series of microelectrode penetrations. Penetrations had a horizontal spatial resolu-
tion of 0.5 mm, which coincided with the estimated extent of ICMS current spread
of less than 0.5 mm at an intensity of 60 ␮A [3,36]. Monophasic, cathodal, constant-
current stimulation trains at 333 Hz (i.e., 33.2-ms trains comprising 12 pulses of
0.2-ms and 2.8-ms interpulse intervals) were delivered through a stimulus isolator.
At each ICMS site, five trains were delivered at 1 Hz with a suprathreshold ICMS
intensity of 60 ␮A.

2.4. Histological analysis

The rats were sacrificed and fixed by the transcardial perfusion of 10% buffered
formalin. Nissl staining of coronal sections (100 ␮m) was used for subsequent veri-
fication of the three-dimensional positions of positive ICMS-penetrations and sites.
Sites located outside the cortical grey matter were excluded from the data analy-
Fig. 1. A schematic illustration of an animal in the increased occlusal vertical dimen- sis, and cytoarchitectonic features were used to delineate the borders between the
sion (iOVD) group. The vertical dimension between the maxillary and mandibular granular and agranular cortex [37].
molars was increased by 2.0 mm with the build-up of acrylic on the maxillary molars.
2.5. Data acquisition and analysis

[29,30]. In orthodontic treatment, anterior cross-bite patients can EMG activity was amplified using a high-input impedance differential amplifier
benefit from an increase in the OVD [31]. On the other hand, ante- (DAM 80, World Precision Instruments, Sarasota, FL, USA; ×1000 gain, 300 Hz and
rior open-bite patients can benefit from a decrease in the OVD 3 kHz for low- and high-pass filters, respectively) followed by full-wave rectifica-
[32]. In either situation, the change in the OVD should be limited tion and integration. All data were captured and analyzed on a computer with a CED
1401 interface and Spike2 software for Windows, version 5.21 (Cambridge Elec-
to within a physiological range [33]. The mechanism of the adap-
tronic Design, Cambridge, UK). An ICMS site was defined and counted as a positive
tation in response to a change in the OVD is believed to involve
denaturation of the muscle spindle and temporomandibular joint
mechanoreceptors in the short term, and adaptation in the long
term [27,34,35]. However, it is unclear whether a change in the
peripheral environment (i.e., an increase in OVD) is associated with
reorganization of the central nervous system. Thus, we tested the
null hypothesis that an increase in OVD (iOVD) is not associated
with a plastic change in the motor cortex.

2. Materials and methods

2.1. Animals

In this study, 28 13-week-old male Wistar albino rats were used. They were
housed in groups of 2–3 in plastic cages in an animal colony under a 12 h–12 h
light–dark cycle, with lights off at 19:00 pm. All experimental procedures described
here were approved by the Animal Welfare Committee and performed in accor-
dance with the Animal Care Standards of Tokyo Medical and Dental University
(#0100204C, 0110197A, 0110337A).

2.2. Surgical preparation

The rats were randomly divided into control (n = 7) and iOVD (n = 21) groups. The
animals were lightly anesthetized with thiamylal sodium (Isozol® , Yoshitomi Phar-
maceutical, Osaka, Japan; 60 mg/kg i.p.). In the iOVD group, the dimension between
the maxillary and mandibular molars was increased by 2.0 mm with the build-up
of acrylic on the bilateral maxillary molars (Fig. 1). To minimize the reduction in
the molar height due to abrasive movement of the mandible, the occlusal surfaces
of the lower molars were coated with acrylic fluid. Lateral radiographic images of
the skull of all rats were taken using a soft X-ray system (SRO-M50, Sofron, Tokyo,
Japan). The rats were then returned to their cages and allowed to recover from anes-
thesia. Intracortical microstimulation mapping was performed in iOVD animals after
1 (iOVD1 w ), 2 (iOVD2 w ) and 8 (iOVD8 w ) weeks (n = 7 each). ICMS was performed in
the control animals at 17-week old. The body weights of rats in both the control and
iOVD groups were monitored during the entire experimental period for assessment
of the general health status.

2.3. ICMS and EMG recordings

Before ICMS, lateral radiographic images of the skull of all rats were taken again
and we confirmed that the amount of iOVD did not change. The rats were kept
under a stable level of general anesthesia with ketamine–HCl (Ketalor® , Daiichi
Sankyo Propharma, Tokyo, Japan; 25–50 mg/kg/h, i.v.) throughout the ICMS experi- Fig. 2. A representative electromyographic (EMG) recording of the responses
ments. Additional anesthetic agent was injected when mild spontaneous whisking to intracortical microstimulation (ICMS) taken from the anterior digastric and
or mild pinch-withdrawal and eyelid reflexes were observed. A stereotaxic appara- genioglossus muscles of a rat. The latency was defined as the time when the
tus (models SN-2 and SM-15 M, Narishige Scientific Instruments, Tokyo, Japan) was ICMS-evoked EMG response exceeded 2 standard deviations of the baseline activ-
used to place the animals in a prone position. Bipolar electrodes (100 ␮m diameter, ity. Abbreviations: LAD, left anterior digastric muscle; RAD, right anterior digastric
single-stranded, Teflon-insulated stainless-steel wires; type E-2, Narishige Scientific muscle; GG, genioglossus muscle.
256 C. Kato et al. / Behavioural Brain Research 228 (2012) 254–260

Fig. 3. Representative motor maps of the left (LAD) and right (RAD) digastric and genioglossus (GG) muscles in a rat from the increased occlusal vertical dimension group at
2 weeks (iOVD2 w ; right) and a rat from the control group (control; left). The sites at which intracortical microstimulation (ICMS) was effective for eliciting electromyographic
(EMG) responses in the LAD, RAD and GG muscles are depicted by orange, green and blue dots, respectively. Black dots represent sites where ICMS did not evoke EMG activity
in the LAD, RAD, or GG muscles. Abbreviation: AP, anteroposterior.

ICMS site if at least three of five ICMS trains evoked an EMG response in a muscle
with an onset latency of maximally 40 ms and a peak activity that exceeded the
mean value in the initial 10 ms of the EMG response plus 2SDs (Fig. 2).

2.6. Center of gravity (CoG)

The CoG of positive ICMS sites, which defines the three-dimensional [medio-
lateral (ML)/superoinferior (SI)/anteroposterior (AP)] center position of the motor
maps weighted relative to the extent of the muscle motor representations,
was determined as described previously [38]. The following equation was used:
X = ai Xi /ai , where ai is the number of positive ICMS sites at a cortical ML coor-
dinate, Xi . In a similar manner, the SI coordinates Yi and the AP coordinate Zi were
determined.

2.7. Statistical analyses

Data from all groups and subgroups were compared using repeated measures
ANOVA, followed by the Bonferroni/Dunn post hoc test (5% significance level).
Statview for Windows, version 5.0 (SAS Institute, Cary, NC, USA), was used for the
statistical analysis.

3. Results
Fig. 4. The number of independent sites within the face-M1 at which intracortical
There was no significant difference in mean body weight microstimulation (ICMS) effectively elicited electromyographic (EMG) responses in
between the control and iOVD groups throughout the experiment. the left (LAD) or right anterior digastric (RAD) or genioglossus (GG) muscles in the
Within the mapped area in the control and iOVD groups, ICMS control (n = 7) and iOVD (1, 2 and 8 W) groups (n = 7 each). Significant differences in
number of sites at different times were labeled with asterisks (p < 0.05). Bars indicate
evoked EMG activities in the AD and/or GG muscles from an exten-
the standard deviations of the mean.
sive area within the right face-M1; the positive ICMS sites were
located along the entire depth of layers V and VI (Fig. 3). Within
the mapped area, both the AD and GG muscles showed extensive
motor representations within the face-M1, but there were very no statistically significant differences between the LAD and GG
few positive ICMS sites for the masseter muscle. Since the num- muscles in the right hemisphere in the control and iOVD groups.
ber of positive ICMS sites for the masseter muscle was negligible, There were significant differences between the control and both
the masseter muscle was excluded from further analysis. the iOVD1 w and iOVD2 w groups with regard to the number of inde-
There were no significant differences in the number of inde- pendent positive ICMS sites in the LAD and GG muscles, but not the
pendent positive ICMS sites among muscles in the control group. RAD muscle (Fig. 4). On the other hand, there were no significant
The LAD muscle had a significantly more independent positive site differences between the control and iOVD8 w groups with regard to
than the RAD muscle in the right hemisphere, although there were the number of positive ICMS sites in the LAD and GG muscles.
C. Kato et al. / Behavioural Brain Research 228 (2012) 254–260 257

Table 1
Onset latency of electromyographic (EMG) activities in the left (LAD) and right
anterior digastric (RAD) and genioglossus (GG) muscles evoked by intracortical
microstimulation (ICMS).

Variables LAD RAD GG

Mean SD Mean SD Mean SD


a
Control 15. 3 4.1 22.3 5.6 19.6 5.4
iOVD1 w 15.4a 5.6 24.1 2.7 20.2 6.1
iOVD2 w 15.4a 5.4 23.8 2.7 21.0 5.7
iOVD8 w 12.7a 4.1 20.6 3.2 17.7 7.4

Means and standard deviations of the mean (SD) are shown in ms. Within each of
the iOVD groups, the LAD muscle showed a significantly shorter onset latency than
the RAD muscle (control: p = 0.015, iOVD1 w : p < 0.0001, iOVD2 w : p = 0.0015, iOVD8 w :
p < 0.0001). Within each of the iOVD groups, the LAD muscle showed a significantly
shorter onset latency than the GG muscle (control: p = 0.013, iOVD1 w : p = 0.0053,
iOVD2 w : p = 0.015, iOVD8 w : p < 0.0001).
a
Indicates a significant difference between the LAD and RAD/GG muscles in the
control and iOVD1 w , iOVD2 w and iOVD8 w groups.

Fig. 5. The number of overlapping sites within the face-M1 at which intracortical
microstimulation (ICMS) effectively elicited electromyographic (EMG) responses in
two or more of the left (LAD) and right anterior digastric (RAD) and genioglossus
(GG) muscles, in the control (n = 7) and iOVD (1, 2 and 8 W) groups (n = 7 each). Sig- The LAD, RAD and GG muscles did not show any significant dif-
nificant differences in number of sites at different times were labeled with asterisks ferences in onset latency between the control and iOVD groups.
(p < 0.05). Bars indicate the standard deviations of the mean. Within each of the iOVD subgroups, the LAD muscle showed
significantly shorter onset latencies than the RAD muscle (con-
trol: p = 0.015, iOVD1 w : p < 0.0001, iOVD2 w : p = 0.0015, iOVD8 w :
The number of sites at which ICMS evoked concurrent EMG p < 0.0001; see Table 1). Within each of the iOVD groups, the LAD
activity in the LAD and GG muscles (i.e., overlapping positive ICMS muscle showed a significantly shorter onset latency than the GG
sites) was significantly increased in both the iOVD1 w and iOVD2 w muscle (control: p = 0.013, iOVD1 w : p = 0.0053, iOVD2 w : p = 0.015,
groups (Fig. 5). However, the number of overlapping positive ICMS iOVD8 w : p < 0.0001).
sites for other pairs or triads did not show any significant differ- With regard to the temporal displacement of the CoG, there was
ence between the iOVD groups and the control group, except for a significant difference in the CoG between the LAD and GG mus-
the RAD, LAD and GG muscles in the iOVD1 w group and control cles in the iOVD1 w and iOVD2 w groups compared with the iOVD8 w
group. group and the control group. (Fig. 6)

Fig. 6. Centers of gravity weighted against the number of effective intracortical microstimulation (ICMS) sites for the right (B) and left anterior digastric (C) and genioglossus
(D) muscles in three-dimensional space. The directions of the three axes are indicated on the rat brain (modified from Paxinos G, Watson C. The Rat Brain. sixth ed. The
Netherlands: Amsterdam; 2007.) (A). Abbreviations: AP, anteroposterior; ML, mediolateral; SI, superoinferior.
258 C. Kato et al. / Behavioural Brain Research 228 (2012) 254–260

4. Discussion for both the AD and GG muscles was significantly greater than that
in the control group at the same recording timing, which suggests
In this study, the null hypothesis was rejected in the the occurrence of cortical map expansion associated with synap-
iOVD1 w and iOVD2 w groups. However, it was supported in the togenesis. Therefore, iOVD is more analogous to skill training than
iOVD8 w group. These findings suggest that a time-dependent strength or endurance training, since iOVD may have changed the
neuroplastic change occurs in the face-M1 in association with oral environment and rats acquired a new skill.
iOVD. The orofacial area has rich sensory innervations, and M1 receives
these inputs indirectly. Somatosensory inputs provide peripheral
4.1. Methodological considerations feedback that is used to control orofacial motor functions [4–7].
IOVD appeared to modulate afferent inputs, and in turn affected
In this study, we selected an animal model with an increase in efferent output. Increased EMG activity of AD muscles throughout
OVD to investigate the effects of the passive restriction of move- the day has been attributed to iOVD [42,52,53]. Moreover, subjects
ment without any damage to the muscles or nerves. We increased with anterior open-bite showed more GG EMG activity than those
OVD, and this was estimated to be within 30% of the rat’s maxi- without anterior open-bite [54]. These findings in previous studies
mum mouth-opening. This is equivalent to the freeway space in are consistent with the increased AD and GG EMG activities at 1 or
humans [39,40]. The freeway space is defined as the interocclusal 2 weeks after iOVD.
separation between the maxillary and mandibular teeth when the In the iOVD8 w group, there were significantly fewer positive
mandible is in the physiological rest position; the position when the ICMS sites for the AD and GG muscles than in the iOVD1 w and
condylar head is nearly in the centric position in the glenoid fossa. iOVD2 w groups. Moreover, there were no significant differences
It has been reported that an increase in the OVD within the range of between the iOVD8 w and control groups. This means that there
the freeway space satisfactorily adapted and remained stable over were no significant long-term changes associated with iOVD in the
a two-year observation period [40]. In our study, there was no sig- face-M1. Playing with string and reading Braille result in long-term
nificant difference in body weight between the control and iOVD changes in cortical motor representations [17,18]. It has been sug-
groups after 8 weeks; iOVD had no effect on the general condition. gested that, under these conditions, changes in muscle activities
This suggests that weight differences between iOVD and control modify the state of the M1 [55]. Learning is a voluntary activity,
groups did not influence the oral condition or the face-M1. Indeed, but orofacial movements (e.g., tongue protrusion and jaw-opening)
dentists often increase OVD within the range of the freeway space are semi-automatic and peripheral feedback plays an important
during the course of treatment [35,41], which is accompanied by role [56,57]. According to our study, the mechanism of the change
changes in EMG activities during mastication [42]. in neural activity observed 8 weeks after iOVD can be explained
We used ICMS in the right hemisphere and recordings of evoked by the assumption that recovery in peripheral structures causes
EMG activity in the present study. The LAD muscle had signifi- reconstruction of the central nervous system, and efferent output
cantly more positive sites than the RAD muscle in both the iOVD then adapts to this change in the CNS.
and control groups. Contralateral dominance of the motor cortex
has been demonstrated in humans [43], monkeys [6,12,44,45] and 4.3. Overlapping positive ICMS sites for the AD and GG muscles
rats [3,45]. The masseter muscle had very few positive sites, and
this finding is consistent with previous studies in rats [24] and ICMS simultaneously evoked more AD and GG EMG activities
monkeys [6,7,24]. In contrast, a previous study on cortical map- in the iOVD1 w and iOVD2 w groups. Such overlapping of cortical
ping of the human masticatory muscle using transcranial magnetic motor representations, along with the extensive representations
stimulation found that the masseter muscle was represented [46]. of the AD and GG muscles, may be important for the coordina-
tion of dynamic orofacial movements that involve several muscles
4.2. Changes in the face-M1 responsible for the AD and GG and may also serve as the substrate that underlies neuroplastic
muscles mechanisms that are manifest in the reorganization of motor rep-
resentations in the face-M1 [58,59]. The overlap of jaw and tongue
IOVD was associated with a significant increase in the num- motor representations has previously been reported after 1 week
ber of positive ICMS sites, and with a shift in the CoG of the LAD of extraction of the incisor in the rat [25]. This indicates that the
and GG muscles within the face-M1. It should be pointed out that face-M1 adjust in response to a new environment in the iOVD1 w
any modification (i.e., increase or decrease) of cortical maps, occur- and iOVD2 w . In a study in the cat, sites at which multiple responses
ring without a shift in the CoG of positive ICMS sites, cannot truly could be evoked decreased as the cat grew and the brain map was
distinguish the plastic reorganization of the cortical motor out- segmented [60]. Therefore, the temporal decrease in the overlap of
put from increased excitability of the corticospinal system. In fact, motor representations suggests both an increase in accuracy and
when cortical stimuli are delivered to the region surrounding the a reduction in the diversity of movement. We speculate that the
motor-representation area, they may be equally able to induce acti- simultaneous decrease in the ICMS-evoked AD and GG EMG activ-
vation of the muscles simply because the corticospinal system is ities in the iOVD8 w indicates a decreased demand for coordinated
more excitable [47]. Therefore, any enlargement of the motor area motor control.
extension can be considered to reflect cortical rearrangement only
if spinal excitability is not modified [48]. Thus, we speculate that 4.4. Latency of ICMS-evoked EMG activity
there was no significant change from the face-M1 to the trigeminal
motor nucleus that was analogous to the corticospinal system for A significant contralateral dominance was reflected in the dif-
limbs, while there were changes in motor representations based ference in the latency of ICMS-evoked jaw responses in the control
on a shift in the CoG and a greater number of positive ICMS sites and iOVD groups, which is attributable to the difference in the
within the face-M1. pathways to the RAD and LAD muscles from the right hemisphere.
Skill training has been associated with cortical map expansion These findings are consistent with findings in previous studies in
and synaptogenesis [15,16,25,49]. Strength and endurance train- the rat AD muscle [25,61]. Also, there was no significant change
ing induce angiogenesis in the motor cortex [50,51], but not motor in the latency with iOVD. This indicates that iOVD had no signif-
map reorganization or an increase in the number of synapses. In icant effects on the fastest corticofugal projections to trigeminal
the iOVD1 w and iOVD2 w groups, the number of positive ICMS sites motor nucleus premotoneuronal structures [62]. A previous study
C. Kato et al. / Behavioural Brain Research 228 (2012) 254–260 259

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