Dataset Information

Great potential of ultrasound elastography for the assessment of the masseter muscle in patients with temporomandibular disorders. A systematic review.

ABSTRACT:

Objective

To summarize the available evidence on the use of elastography in the assessment of the masseter muscle in healthy individuals and patients with masseter muscle disorders.

Methods

Systematic literature review has been performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

Results

16 of 142 studies identified were analyzed. Elastography was used in seven studies. Heterogeneity was observed in terms of study protocols, devices, patients, units of measure, and results. Elasticity values showed a correlation between the left and right masseter muscle side in healthy people, but not in patients with temporomandibular disorders (TMDs). Elasticity values increased in TMD and were correlated with the severity of TMD symptoms. Phantom studies proved the high reliability of elastography.

Conclusion

Elastography is a promising tool for the assessment of the masseter muscle elasticity, but the evidence is insufficient. Studies on larger groups are needed to determine the accuracy of elastography to characterize masticatory muscle disorders.

SUBMITTER: Olchowy A

PROVIDER: S-EPMC7719860 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

Great potential of ultrasound elastography for the assessment of the masseter muscle in patients with temporomandibular disorders. A systematic review.

Olchowy Anna A Wieckiewicz Mieszko M Winocur Efraim E Dominiak Marzena M Dekkers Ilona I Łasecki Mateusz M Olchowy Cyprian C

Dento maxillo facial radiology 20200309 8

<h4>Objective</h4>To summarize the available evidence on the use of elastography in the assessment of the masseter muscle in healthy individuals and patients with masseter muscle disorders.<h4>Methods</h4>Systematic literature review has been performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.<h4>Results</h4>16 of 142 studies identified were analyzed. Elastography was used in seven studies. Heterogeneity was observed in terms of study protoco ...[more]

PMID: 32150452

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Project description:BackgroundThe complex structure of the stomatognathic system plays a vital role in chewing, digestion, speaking, breathing, facial expression and swallowing. Its complexity is the primary reason for creating multidisciplinary teams to manage temporomandibular disorders (TMD). We aimed to assess the masseter stiffness in patients undergoing conservative therapy for masticatory muscle disorders and evaluate the efficacy of manual therapy and stabilization occlusal splint in the treatment of masticatory muscle disorders.MethodsThis uncontrolled prospective cohort study included 35 patients with masticatory muscle disorders. The study lasted for eight weeks. The patients were treated with manual therapy and stabilization occlusal splint and evaluated using shear wave elastography of the masseter muscles and patient-reported outcome measures (PROMs) to assess pain, anxiety, quality of sleep, satisfaction with life and perceived stress.ResultsAfter the treatment, the stiffness of both masseter muscles decreased significantly (by 4.21 kPa). The patients reported a significant reduction in pain. At baseline, the median scores ranged from 5 to 8; after treatment, they ranged from 0 to 1 (p < 0.0001). The patients also reported significant improvement in terms of all patient-reported outcome measures. The reduction in stiffness corresponded to the improvement in pain and PROMs, as shown by correlations which were insignificant for all measures.ConclusionsConservative therapy of masticatory muscle disorders involving manual therapy and stabilization occlusal splint is effective. It reduces the masseter stiffness as objectively shown in shear wave elastography and improves subjective PROMs scores, including numerical pain assessment and selected questionnaires. Shear wave elastography has the potential for broad application in clinical practice to monitor masticatory muscle disorders treatment effects due to its objectivity and non-invasive character. Further research is recommended on larger patient populations and longer follow-up.Trial registrationThe study was registered at clinicaltrials.gov ( NCT03844854 ). First posted date: 19/02/2019.

Project description:BACKGROUND: The phenotype of large diameter sensory afferent neurons changes in several models of neuropathic pain. We asked if similar changes also occur in "functional" pain syndromes. METHODOLOGY/PRINCIPAL FINDINGS: Acidic saline (AS, pH 4.0) injections into the masseter muscle were used to induce persistent myalgia. Controls received saline at pH 7.2. Nocifensive responses of Experimental rats to applications of Von Frey Filaments to the masseters were above control levels 1-38 days post-injection. This effect was bilateral. Expression of c-Fos in the Trigeminal Mesencephalic Nucleus (NVmes), which contains the somata of masseter muscle spindle afferents (MSA), was above baseline levels 1 and 4 days after AS. The resting membrane potentials of neurons exposed to AS (n = 167) were hyperpolarized when compared to their control counterparts (n = 141), as were their thresholds for firing, high frequency membrane oscillations (HFMO), bursting, inward and outward rectification. The amplitude of HFMO was increased and spontaneous ectopic firing occurred in 10% of acid-exposed neurons, but never in Controls. These changes appeared within the same time frame as the observed nocifensive behaviour. Ectopic action potentials can travel centrally, but also antidromically to the peripheral terminals of MSA where they could cause neurotransmitter release and activation of adjacent fibre terminals. Using immunohistochemistry, we confirmed that annulospiral endings of masseter MSA express the glutamate vesicular transporter VGLUT1, indicating that they can release glutamate. Many capsules also contained fine fibers that were labelled by markers associated with nociceptors (calcitonin gene-related peptide, Substance P, P2X3 receptors and TRPV1 receptors) and that expressed the metabotropic glutamate receptor, mGluR5. Antagonists of glutamatergic receptors given together with the 2(nd) injection of AS prevented the hypersensitivity observed bilaterally but were ineffective if given contralaterally. CONCLUSIONS/SIGNIFICANCE: Low pH leads to changes in several electrical properties of MSA, including initiation of ectopic action potentials which could propagate centrally but could also invade the peripheral endings causing glutamate release and activation of nearby nociceptors within the spindle capsule. This peripheral drive could contribute both to the transition to, and maintenance of, persistent muscle pain as seen in some "functional" pain syndromes.

Project description:BackgroundPolymyositis (PM) and dermatomyositis (DM) are two common types of idiopathic inflammatory myopathy and can lead to a poor prognosis and quality of life. We designed this cross-sectional study to investigate the abilities of high-frequency ultrasound (HFUS) and shear wave elastography (SWE) to assess muscle properties in patients with PM and DM and to distinguish healthy muscles from diseased muscles with PM and DM.MethodsA total of 60 patients (26 PM cases and 34 DM cases) and 65 matched healthy volunteers were continuously included in the case and control groups, respectively. For the bilateral deltoid, biceps brachii, rectus femoris, and vastus lateralis, the muscle thickness, echo intensity, and longitudinal shear wave velocity (SWV) of all participants were measured using HFUS and SWE. The intra- and interobserver reliability of SWV measurements of patients with PM and DM and the receiver operating characteristic curve for HFUS and SWE for PM and DM were analyzed.ResultsPatients with PM and DM had significantly decreased muscle thickness and increased muscle echo intensity compared to healthy controls (P<0.001). The patients' and healthy participants' deltoid, biceps brachii, rectus femoris, and vastus lateralis thickness was 19.75 and 23.00 mm, 20.45 and 22.80 mm, 18.40 and 20.20 mm, and 20.00 and 22.80 mm, respectively. Except for the biceps brachii, the mean SWV in the longitudinal orientation in patients with PM and DM significantly decreased (P<0.01). The mean SWV of the patients' and healthy participants' deltoid, rectus femoris, and vastus lateralis was 2.47 and 2.57 m/s, 1.73 and 1.87 m/s, and 1.57 and 1.77 m/s, respectively. Excellent intra- and interobserver reliability of SWV measurements on the deltoid and rectus femoris of PM and DM patients were found (intraclass correlation coefficient >0.95; P<0.001). The diagnostic performance of echo intensity in lower-extremity proximal muscles for PM and DM was excellent [area under the curve (AUC) >0.9]. The thickness of most muscles displayed moderate diagnostic performance (the AUC ranged from 0.700 to 0.775). The SWV of the vastus lateralis showed a stable performance (AUC =0.741). The combined diagnostic performance of echo intensity and thickness and the combined diagnostic performance of the 3 indicators were relatively high (the AUC ranged from 0.871 to 0.936 and from 0.898 to 0.938, respectively). Muscle thickness and echo intensity showed statistical differences in different disease stages of PM and DM (P'<0.01).ConclusionsHFUS and SWE may serve as imaging biomarkers for the diagnosis of PM and DM by detecting abnormal muscle thinning, enhanced muscle echo intensity, and reduced muscle SWV.

Project description:ObjectivesTo report the current elastography methods used to quantify back muscles' biomechanical characteristics in patients with musculoskeletal disorders (MSKd) and inform on their reliability, validity, and responsiveness.MethodsMEDLINE, Embase, CINAHL, Cochrane library and grey literature were consulted. Predefined criteria allowed for study selection and data extraction. The quality of evidence was rated using the COSMIN tool. Data were meta-analyzed in terms of pooled intraclass correlation coefficient (pICC) for reliability and pooled standardized mean difference (pSMD) for validity and responsiveness. Heterogeneity was assessed.ResultsSeventy-nine studies were included in the meta-analysis (total number of participants N = 3178). Three elastography methods were identified: strain imaging (SI; number of cohorts M = 26), shear wave imaging (SWI; M = 50), and vibration sonoelastography (VSE; M = 3). Strain imaging and SWI studies reported good reliability measurement properties (pICC > 0.70) and a medium pSMD (0.58 for SI and 0.60 for SWI; p ≤ 0.020) in discriminating MSKd from controls' condition (validity). Strain imaging studies reported a medium pSMD (0.64; p = 0.005) in detecting within-group changes over time, whereas SWI pSMD was very high (1.24; p = 0.005). Only SWI reported significant but small pSMD (0.30; p = 0.003) in detecting between-group changes over time. The small number of VSE studies could not be meta-analyzed. Heterogeneity was high (I-squared > 90%; p < 0.001).ConclusionsElastography presents good reliability results and a medium pSMD in discriminating MSKd from control conditions. Responsiveness data suggest detectable changes within groups over time using SI and SWI, calling for long-term longitudinal studies. Assessing changes between groups over time using elastography still needs to be proven. Highly significant heterogeneity limits meta-analytic results.Critical relevance statementWhile still in its early-stage exploration phase, musculoskeletal ultrasound elastography may reliably quantify back muscles' biomechanics in asymptomatic individuals, moderately discriminate back musculoskeletal disorders and detect biomechanical changes over time in these conditions, calling for long-term longitudinal studies.Key pointsUltrasound elastography is reviewed for back pain and related musculoskeletal disorder assessments. Growing literature supports good reproducibility, some validity and responsiveness. Back muscle elastography considers assumptions calling for standardized protocols.

Dataset Information

Great potential of ultrasound elastography for the assessment of the masseter muscle in patients with temporomandibular disorders. A systematic review.

Objective

Methods

Results

Conclusion

Publications

Great potential of ultrasound elastography for the assessment of the masseter muscle in patients with temporomandibular disorders. A systematic review.

Similar Datasets

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