Debilitating lower back pain during menses unexpectedly resolved after treatment of subclinical temporomandibular disorder: a case report.

This case report describes a patient in whom debilitating lower back pain that always occurred during menses resolved when she received treatment for subclinical temporomandibular disorder (TMD). The patient was diagnosed with subclinical TMD and facial myalgia based on the results of clinical and radiographic examinations. She was treated with maxillary (nighttime) and mandibular (daytime) dental orthotics to provide stabilization and decompression of the temporomandibular joints. After 12 weeks of appliance therapy, which resulted in resolution of the TMD symptoms, the patient reported that the debilitating lower back pain she experienced during menses had ceased. Her back pain did not return after the use of the mandibular appliance was discontinued. The authors discuss how neurologic, postural, inflammatory, and qi flow changes attributed to the patient's TMD treatment may have contributed to the cessation of the patient's menses-related lower back pain.

A case study on myofunctional therapy and malocclusions created by oral habits.

Purpose: To demonstrate the effect of an orofacial myofunctional therapy intervention by an interdisciplinary team composed of a registered dental hygienist who is also a certified orofacial myologist (COM®), a general dentist, and an orthodontist on the elimination of oral habits and changes in dental malocclusion. Method: This case study describes a 7-year-old female who underwent an individualized myofunctional therapy program and was given supervised education on a series of exercises targeting the muscles of mastication and facial expression over 5 months. Correct oral rest postures of the tongue and the lips were also established through therapy. Results: The intervention enabled the client to eliminate multiple oral habits, which corrected oral rest postures of the lips and tongue. This correction consequently improved the client's malocclusion and further prepared the client for future orthodontic treatment. Conclusion: Myofunctional therapy facilitated the elimination of unfavourable oral habits that led to malocclusion. Eliminating oral habits better prepared the client for orthodontic treatment and retention. Use of an interdisciplinary team facilitates optimal client care.

Objectif: Démontrer l'effet d'une thérapie orofaciale myofonctionnelle par une équipe interdisciplinaire composée d'un hygiéniste dentaire autorisé qui est aussi un myologiste orofacial certifié (COM®), d'un dentiste généraliste et d'un orthodontiste sur l'élimination des habitudes buccales et les changements de la malocclusion dentaire. Méthodologie: La présente étude de cas décrit une fille de 7 ans qui a suivi un programme personnalisé de thérapie myofonctionnelle et a reçu une éducation supervisée sur une série d'exercices ciblant les muscles de la mastication et de l'expression faciale au cours d'une période de 5 mois. La thérapie a aussi permis d'établir des postures appropriées de repos de la langue et des lèvres. Résultats: Grâce à la thérapie, la cliente a pu éliminer de multiples habitudes buccales, ce qui a corrigé les postures de repos buccal des lèvres et de la langue. Cette modification a par conséquent amélioré la malocclusion de la cliente et a permis de la préparer à un futur traitement orthodontique. Conclusion: La thérapie myofonctionnelle a favorisé l'élimination d'habitudes buccales défavorables qui ont mené à la malocclusion. En éliminant les habitudes buccales, la cliente était mieux préparée au traitement orthodontique et à la rétention. L'utilisation d'une équipe interdisciplinaire optimise les soins du client.

Treating Post-traumatic Stress Disorder with Neuromodulation Therapies: Transcranial Magnetic Stimulation, Transcranial Direct Current Stimulation, and Deep Brain Stimulation.

Post-traumatic stress disorder (PTSD) is a prevalent and debilitating illness. While standard treatment with pharmacotherapy and psychotherapy may be effective, approximately 20 to 30% of patients remain symptomatic. These individuals experience depression, anxiety, and elevated rates of suicide. For treatment-resistant patients, there is a growing interest in the use of neuromodulation therapies, including transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS). We conducted a systematic review on the use of neuromodulation strategies for PTSD and pooled 13 randomized clinical trials (RCTs), 11 case series, and 6 case reports for analysis. Overall, most studies reported favorable outcomes in alleviating both PTSD and depressive symptoms. Although several RCTs described significant differences when active and sham stimulations were compared, others found marginal or nonsignificant differences between groups. Also positive were studies comparing PTSD symptoms before and after treatment. The side effect profile with all 3 modalities was found to be low, with mostly mild adverse events being reported. Despite these encouraging data, several aspects remain unknown. Given that PTSD is a highly heterogeneous condition that can be accompanied by distinct psychiatric diagnoses, defining a unique treatment for this patient population can be quite challenging. There has also been considerable variation across trials regarding stimulation parameters, symptomatic response, and the role of adjunctive psychotherapy. Future studies are needed to address these issues.

Mice lacking neuronal calcium sensor-1 show social and cognitive deficits.

Neuronal calcium sensor-1 or Frequenin is a calcium sensor widely expressed in the nervous system, with roles in neurotransmission, neurite outgrowth, synaptic plasticity, learning, and motivated behaviours. Neuronal calcium sensor-1 has been implicated in neuropsychiatric disorders including autism spectrum disorder, schizophrenia, and bipolar disorder. However, the role of neuronal calcium sensor-1 in behavioural phenotypes and brain changes relevant to autism spectrum disorder have not been evaluated. We show that neuronal calcium sensor-1 deletion in the mouse leads to a mild deficit in social approach and impaired displaced object recognition without affecting social interactions, behavioural flexibility, spatial reference memory, anxiety-like behaviour, or sensorimotor gating. Morphologically, neuronal calcium sensor-1 deletion leads to increased dendritic arbour complexity in the frontal cortex. At the level of hippocampal synaptic plasticity, neuronal calcium sensor-1 deletion leads to a reduction in long-term potentiation in the dentate gyrus, but not area Cornu Ammonis 1. Metabotropic glutamate receptor-induced long-term depression was unaffected in both dentate and Cornu Ammonis 1. These studies identify roles for neuronal calcium sensor-1 in specific subregions of the brain including a phenotype relevant to neuropsychiatric disorders.

The Integration of Clinical and Research Training: How and Why MD-PhD Programs Work.

For over 60 years, MD-PhD programs have provided integrated clinical and research training to produce graduates primed for physician-scientist careers. Yet the nature of this integrated training is poorly characterized, with no program theory of MD-PhD training to guide program development or evaluation. The authors address this gap by proposing a program theory of integrated MD-PhD training applying constructs from cognitive psychology and medical education. The authors argue that integrated physician-scientist training requires development of at least three elements in trainees: cognitive synergy, sense of self, and professional capacity. First, integrated programs need to foster the cognitive ability to synergize and transfer knowledge between the clinical and research realms. Second, integrated programs need to facilitate development of a unique and emergent identity as a physician-scientist that is more than the sum of the individual roles of physician and scientist. Third, integrated programs should develop core competencies unique to physician-scientists in addition to those required of each independently. The authors describe how programs can promote development of these elements in trainees, summarized in a logic model. Activities and process measures are provided to assist institutions in enhancing integration. Specifically, programs can enact the proposed theory by providing tailored MD-PhD curricula, personal development planning, and a supportive community of practice. It is high time to establish a theory behind integrated MD-PhD training as the basis for designing interventions and evaluations to develop the foundations of physician-scientist expertise.