Mohit Kothari

Aarhus University, Institute of Clinical Medicine, Faculty Member

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Dentist with specialty in diagnosis and management of swallowing disorders and oral health in patients with brain injury. Research interest includes swallowing and orofacial dysfunctions with emphasis on translational research. Specialized skills with various tools like clinical, bio-medical, brain-imaging and brain stimulation devices. Current tenure also involves clinical as well as theoretical teaching to nurses, occupational therapists and dental students.
Address: Aarhus, Midtjylland, Denmark

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Phil Clatworthy

Cambridge Alumni

Don Ross

University College Cork

Vittorio Gallese

Università degli Studi di Parma (Italy)

Kelvin I. Afrashtehfar

McGill University

AGUSTIN ZERON

UNAM Universidad Nacional Autónoma de México

Joseph F Rath

New York University School of Medicine

Sanjay K munjal

PGIMER,CHD,India

Carlo Semenza

Università degli Studi di Padova

FATİH ÖZAN

Abant Izzet Baysal University, Bolu, Turkey

Liviu Steier

University of Pennsylvania

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Papers by Mohit Kothari

Can short-term oral fine motor training affect precision of task performance and induce cortical plasticity of the jaw muscles?

by Mohit Kothari and Abhishek Kumar

Experimental brain research, Jan 25, 2016

The aim was to test the hypothesis that short-term oral sensorimotor training of the jaw muscles ... more The aim was to test the hypothesis that short-term oral sensorimotor training of the jaw muscles would increase the precision of task performance and induce neuroplastic changes in the corticomotor pathways, related to the masseter muscle. Fifteen healthy volunteers performed six series with ten trials of an oral sensorimotor task. The task was to manipulate and position a spherical chocolate candy in between the anterior teeth and split it into two equal halves. The precision of the task performance was evaluated by comparing the ratio between the two split halves. A series of "hold-and-split" tasks was also performed before and after the training. The hold force and split force along with the electromyographic (EMG) activity of jaw muscles were recorded. Motor-evoked potentials and cortical motor maps of the right masseter muscle were evoked by transcranial magnetic stimulation. There was a significant effect of series on the precision of the task performance during the ...

Repeated tongue lift movement induces neuroplasticity in corticomotor control of tongue and jaw muscles in humans

Brain research, Jan 21, 2015

This study investigated the effect of repeated tongue lift training (TLT) on the excitability of ... more This study investigated the effect of repeated tongue lift training (TLT) on the excitability of the corticomotor representation of the human tongue and jaw musculature. Sixteen participants performed three series of TLT for 41min on each of 5 consecutive days. Each TLT series consisted of two pressure levels (5kPa and 10kPa). All participants underwent transcranial magnetic stimulation (TMS) and electromyographic (EMG) recordings of motor evoked potentials (MEPs) in four sessions: (1) before TLT on Day 1 (baseline), (2) after TLT on Day 1, (3) before TLT on Day 5, and (4) after TLT on Day 5. EMG recordings from the left and right tongue dorsum and masseter muscles were made at three pressure levels (5kPa, 10kPa, 100% tongue lift), and tongue, masseter, and first dorsal interosseous (FDI) MEPs were measured. There were no significant day-to-day differences in the tongue pressure during maximum voluntary contractions. The amplitudes and thresholds of tongue and masseter MEPs after TL...

Effect of Occlusal Splint

Objective: The purpose of the pilot study was to determine the effect of restoring lost occlusal ... more Objective: The purpose of the pilot study was to determine the effect of restoring lost occlusal vertical dimension (OVD) due to attrition on maximum bite force in humans. Methodology: A total of 124 subjects in age range of 25-40 years, with moderate to severe attrition, having full complement of teeth were screened according to inclusion and exclusion criteria. After consent, occlusal vertical dimension was assessed by employing mechanical and physiological methods in the experimental group and a maxillary canine guided hard splint was fabricated for each subjects fulfilling inclusion criteria and with positive consent (78). Bite force in experimental group was measured before, immediately after delivery of splint and subsequently at an interval of four, eight, and twelve weeks. Due loss during follow up, only 50 subjects could be available for bite force recording till 12 weeks. Bite force of age, gender, height and weight matched controls with no signs of attrition was also measured for comparison. Results: Bite force of the experimental group was found to be significantly less than the matched controls (P = 0.000) initially. After delivery of splint, bite force values increased progressively till twelve weeks. However comparison of bite force values of experimental group with control group showed no significant difference at end of eight (P = 0.008) and twelve weeks (P = 0.162). Conclusion: It was concluded that maximum bite force increases with restoration of lost vertical using splint therapy. A time period of 8-12 weeks is required to restore the maximum bite force value approximately similar to matched controls.

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A preliminary study to ﬁnd a possible association between occlusal wear-1

by Mohit Kothari and Abhishek Kumar

Abstract OBJECTIVE: The objective of the study was to investigate whether moderate-to-severe attr... more Abstract OBJECTIVE: The objective of the study was to investigate whether moderate-to-severe attrition is associated with maximum bite force in the first molar region. METHODOLOGY: Maximum bite force in the first molar region was measured for a total of 60 subjects having moderate-to-severe attrition of occlusal surface (experimental group) using a specially-designed piezoelectric sensor based bite force measuring device. An equal number of age, gender, height and weight matched controls (control group) were also subjected to bite force measurement for comparison. RESULTS: The maximum bite force was found to be significantly lower (p < 0.05) in the experimental group [480.32 (153.40)] as compared to the controls [640.63 (148.90)]. While analyzing the possible etiology for occlusal wear mainly two reasons were elicited, i.e. history of parafunctional habits like use of known abrasive tooth powder (sub-group A) and Bruxism (sub-group B). However, there were many subjects in which n...

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Methodological Evaluation Of Palpation With a Palpometer and Manual Palpation

by Mohit Kothari and Simple Futarmal

Objectives: Recently a new palpometer was introduced for the assessment of craniofacial pain sens... more Objectives: Recently a new palpometer was introduced for the assessment of craniofacial pain sensitivity. The aims of this methodological study were to compare test-retest variability between manual palpation and a new palpometer in terms of (1) palpation using the right and left hand (2) palpation on soft and hard surface and (3) effects of palpation for 2 s and 10 s. Methods: Sixteen experienced clinicians participated. Three experiments were carried out where the clinicians were instructed to target 0.5, 1.0 and 2.0 kg on a force meter using manual palpation and the palpometer (1) with right and left hand (2) on a hard and soft surface and (3) for 2 s and 10 s. The palpometer is based on an adjustable spring-coil with a small pin touching the examiners hand when the correct pressure is achieved. During all experiments 10 consecutive measures were taken and the displayed force values were recorded. The variability was determined as the coefficient of variation (CV) and compared wi...

Paired pulse TMS stimulation and human tongue corticomotor pathways

Objective: Paired pulse transcranial magnetic stimulation (ppTMS) can be used to assess short-ter... more Objective: Paired pulse transcranial magnetic stimulation (ppTMS) can be used to assess short-term interval intra-cortical inhibitory (SICI) and facilitatory (ICF) networks. The degree of SICI and ICF varies with interstimulus intervals (ISI) and stimulus intensities of the conditioning stimulus (CS) and the test stimulus (TS). The aim of the present methodological study was to optimize stimulus parameters for ppTMS studies of tongue motor control by examining the influence of different ISI and intensities of the CS on SICI and ICF. Methods: 17 healthy volunteers participated (mean age: 22.6±0.8 years). ppTMS was applied to the “hot-spot” of the tongue motor cortex and motor evoked potential (MEPs) were recorded from the tongue muscles with surface EMG electrodes. TS intensity was set at 120% of resting motor threshold (rMT). Single pulse and six different ISIs for ppTMS: 2, 2.5, 3, 3.5, 10, 15 ms were applied 8 times each in randomized order in two blocks (CS intensity of 70% and 8...

Test-retest variability and accuracy of a new palpometer

Objectives: Reliable assessment of deep pain sensitivity is needed for accurate diagnoses of temp... more Objectives: Reliable assessment of deep pain sensitivity is needed for accurate diagnoses of temporomandibular disorders (TMD). The aims were to compare manual palpation and a new palpometer in terms of (1) test-retest variability in actual force measures (2) effects of different force levels (3) differences between index and middle finger and (4) effects of randomized force levels. Methods: Experienced clinicians participated. Experiments were carried out where the subjects were instructed to target 0.5, 1.0 and 2.0 kg on a force meter using manual palpation and the new palpometer (n=16). The palpometer is based on an adjustable spring-coil with a small pin touching the examiners hand when the correct pressure is achieved. Additional experiments were carried out to compare manual palpation with the index and middle finger and a randomized sequence of different force levels (n=12). During each experiment 10 consecutive measures were taken and displayed force values were recorded. Th...

Influence of tongue training parameters on performance improvement

Objectives: Training of tongue function is an important part of rehabilitation of patients with b... more Objectives: Training of tongue function is an important part of rehabilitation of patients with brain damage. Present training strategies are not based on scientific evidence. A standardized tongue training task has been shown to induce cortical plasticity. This study tested the possible influence of the natural ability to roll the tongue and modulations of tongue training parameters on tongue training performance. Methods: A total of 43 healthy adult subjects participated. 28 subjects (14 with and 14 without ability to roll their tongue) performed 1 hr standard (S) tongue training. 15 subjects participated in 2 sessions: (S) and Modulation (M) in randomized order. S session: 1 hr standard tongue training with fixed training parameters; M session: 1 hr of tongue training with modulation of training parameters every 20 min (3 different settings A, B, C). Perceived task difficulty was evaluated on a 0-10 numerical rating scale. Results: All participant improved performance during trai...

Comparison of techniques for evaluation of deep pain sensitivity in the craniofacial region

Journal of orofacial pain, 2012

To determine whether a new palpometer and manual palpation can detect site-to-site differences in... more To determine whether a new palpometer and manual palpation can detect site-to-site differences in human craniofacial pain sensitivity in a similar pattern to that of an electronic pressure algometer and subsequently to compare between-session and within-session variability of palpometer and manual palpation. Sixteen volunteers participated. Experiment 1 was carried out in two sessions. In session 1, pressure pain thresholds (PPT) were determined with a pressure algometer at nine craniofacial sites. Manual palpation and the palpometer were then applied to all sites, and subjects scored perceived pressure/pain on a 0 to 100 numerical rating scale (NRS). Mean scores were compared using analysis of variance (ANOVA). Ten of the volunteers were recalled for a second session and the same protocol was carried out except for assessment of PPTs to establish between-session variability. In experiment 2, three craniofacial sites were examined using the palpometer and manual palpation. Both tech...

Adenomatoid Odontogenic Tumour Mimicking a Periapical Cyst in Pregnant Woman

Singapore Dental Journal, 2010

Adenomatoid odontogenic tumours (AOT) are uncommon odontogenic lesions characterized histologi-ca... more Adenomatoid odontogenic tumours (AOT) are uncommon odontogenic lesions characterized histologi-cally by duct-like structures derived from the epithelial component of the lesion and can be distinctly classified into follicular, extrafollicular and extraosseous variants (Neville BW, Damm DD, Allen CM, et al. Adenomatoid Odontogenic Tumor. A Text Book for Oral and Maxillofacial Pathology, 2(nd) edition, 621-3). Most of these tumours develop in the second or third decade of life and have a distinct predilection for women. The follicular variant accounts for 75% of reported cases (Curran AE, Miller EJ, Murrah VA. Adenomatoid odontogenic tumor presenting as periapical disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:557-60) and is associated with the crown of an impacted tooth, commonly the maxillary canine. We present a rare case of extrafollicular AOT mimicking a periapical cyst that originated in a woman in her first trimester of pregnancy and enlarged rapidly thereafter. The lesion was enucleated and sent for histopathology and immunohistochemistry, which revealed AOT with a cystic component with no dependence on oestrogen or progestrone for its growth. This case of AOT introduces us to the unique variation in its presentation and the difficulty in differentiation from periapical disease of inflammatory origin.

Tongue Motor Training – Behavioral and Neurophysiological Aspects

Biosystems & Biorobotics, 2014

ABSTRACT The purpose of this overall project was to elucidate the influence of different tongue t... more

Effect of occlusal splint therapy on maximum bite force in individuals with moderate to severe attrition of teeth

Journal of Prosthodontic Research, 2012

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Training-induced cortical plasticity compared between three tongue-training paradigms

Neuroscience, 2013

The primary aim of this study was to investigate the effect of different training types and secon... more The primary aim of this study was to investigate the effect of different training types and secondary to test gender differences on the training-related cortical plasticity induced by three different tongue-training paradigms: (1) therapeutic tongue exercises (TTE), (2) playing computer games with the tongue using the Tongue Drive System (TDS) and (3) tongue-protrusion task (TPT). Forty-eight participants were randomized into three groups with 1 h of TTE, TDS, or TPT. Stimulus-response curves of motor evoked potentials (MEPs) and motor cortex mapping for tongue muscles and first dorsal interosseous (FDI) (control) were established using transcranial magnetic stimulation at three time-points: (1) before tongue-training, (2) immediately after training, (3) 1 h after training. Subject-based reports of motivation, fun, pain and fatigue were evaluated on 0-10 numerical rating scales after training. The resting motor thresholds of tongue MEPs were lowered by training with TDS and TPT (P < 0.011) but not by TTE (P = 0.167). Tongue MEP amplitudes increased after training with TDS and TPT (P < 0.030) but not with TTE (P = 0.302). Men had higher MEPs than women in the TDS group (P < 0.045) at all timepoints. No significant effect of tongue-training on FDI MEPs was observed (P > 0.335). The tongue cortical motor map areas were not significantly increased by training (P > 0.142). Training with TDS was most motivating and fun (P < 0.001) and TTE was rated the most painful (P < 0.001). Fatigue level was not different between groups (P > 0.071). These findings suggest a differential effect of tongue-training paradigms on training-induced cortical plasticity and subject-based scores of fun, motivation and pain in healthy participants. Ó

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New Palpometer with Implications for Assessment of Deep Pain Sensitivity

Journal of Dental Research, 2011

The aims of this study were to compare test-retest variability and accuracy measures between (1) ... more The aims of this study were to compare test-retest variability and accuracy measures between (1) manual palpation and a novel palpometer and (2) different force levels. Sixteen clinicians were instructed to target 0.5, 1.0, and 2.0 kg on a force meter using manual palpation and the new palpometer (adjustable spring-coil with a small pin touching the examiner&#39;s hand when the correct pressure is reached). In all experiments, 10 consecutive measures of the force levels were recorded. The coefficient of variation (CV), actual force levels, and relative differences between target level and actual force level were compared between experiments and target levels. All outcome parameters had significantly lower values for the new palpometer than for manual palpation in a force-dependent manner (p&lt;0.004). CVs and actual force levels were significantly different between all target levels (p&lt;0.004). The new palpometer had low test-retest variability and provides a more accurate pressure stimulus than manual palpation.

Motivational conditions influence tongue motor performance

European Journal of Oral Sciences, 2013

Motivation plays an important role in the outcome of motor learning but has not received attentio... more Motivation plays an important role in the outcome of motor learning but has not received attention in tongue-training-induced plasticity of the corticomotor pathways. The present study investigated the influence of two different motivational conditions and gender on performance during a complex tongue-training paradigm using the tongue drive system (TDS). In addition, subject-based reports of motivation, fun, pain, and fatigue were compared between groups and genders. Sixteen subjects were randomized into three groups and were asked to use the TDS for 40 min. A motivational condition (monetary reward or self-controlled practice) was introduced in two groups and the third group served as the control. The subjects were instructed to play a computer game using the TDS, having control of the computer cursor through a magnet attached to the tongue, and performance was compared among groups. Performance improved in all groups and in both genders. The monetary reward group tended towards higher performance scores compared with the control group, whereas the self-controlled practice group performed significantly better compared with the control group. There was no significant difference between groups and genders in the subject-based report for level of motivation, fun, pain, or fatigue. In conclusion, introduction of motivational conditions influenced tongue motor performance.

Force and complexity of tongue task training influences behavioral measures of motor learning

European Journal of Oral Sciences, 2012

Relearning of motor skills is important in neurorehabilitation. We investigated the improvement o... more Relearning of motor skills is important in neurorehabilitation. We investigated the improvement of training success during simple tongue protrusion (two force levels) and a more complex tongue-training paradigm using the Tongue Drive System (TDS). We also compared subject-based reports of fun, pain, fatigue, and motivation between paradigms. Three randomized sessions and one control experiment were performed. Sixteen healthy subjects completed two different 1-h sessions of simple tongue training with 1 N and 3 N, respectively, and one TDS session. After 1 wk, six out of 16 subjects participated as experienced subjects with six naive subjects in a control experiment with 2 × 5-min TDS training separated by a 30-min rest. Performance improved during training in all sessions. The mean ± SEM relative increase in success was 80 ± 12% (1 N), 52 ± 11% (3 N), and 285 ± 45% (TDS). In the control experiment the experienced group performed equal to the last 5 min of their first TDS session and neither group improved during rest. Training with the TDS was rated as more fun, less painful, less fatiguing, and more motivating compared with simple tongue training. In conclusion, force level and complexity of tongue training influences behavioral aspects of tongue motor learning.

Standardization of Muscle Palpation— Methodological Considerations

The Clinical Journal of Pain, 2013

Objectives: To compare test-retest variability of palpation between a new palpometer and manual p... more

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Influence of position and stimulation parameters on intracortical inhibition and facilitation in human tongue motor cortex

Brain Research, 2014

Paired pulse transcranial magnetic stimulation (ppTMS) Short-interval intra-cortical inhibitory (... more Paired pulse transcranial magnetic stimulation (ppTMS) Short-interval intra-cortical inhibitory (SICI) and facilitatory (ICF) Test stimulus (TS) Conditioning stimulus (CS) Body positions a b s t r a c t Paired-pulse transcranial magnetic stimulation (ppTMS) can be used to assess short-interval intracortical inhibitory (SICI) and facilitatory (ICF) networks. Many methodological parameters may however influence the outcome. The aim of the study was to examine the influence of body positions (recline and supine), inter-stimulus intervals (ISI) between the test stimulus (TS) and conditioning stimulus (CS) and intensities of the TS and CS on the degree of SICI and ICF.

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Tongue-Controlled Computer Game: A New Approach for Rehabilitation of Tongue Motor Function

Archives of Physical Medicine and Rehabilitation, 2014

To investigate the influence of tongue disability, age, and sex on motor performance for a tongue... more To investigate the influence of tongue disability, age, and sex on motor performance for a tongue-training paradigm involving playing a computer game using the Tongue Drive System (TDS). Two controlled observational studies. A neurorehabilitation center and a dental school. In study 1, tongue-disabled patients with symptoms of dysphagia and dysarthria (n=11) and age- and sex-matched controls (n=11) participated in tongue training. In study 2, healthy elderly persons (n=16) and healthy young persons (n=16) volunteered. In study 1 and study 2, the tongue training lasted 30 and 40 minutes, respectively. Participants were instructed to play a computer game with the tongue using TDS. Motor performance was compared between groups in both studies. Correlation analyses were performed between age and relative improvement in performance. Subject-based reports of motivation, fun, pain, and fatigue evaluated on 0-to-10 numeric rating scales were compared between groups. In study 1, tongue-disabled patients performed poorer than healthy controls (P=.005) and with a trend of a sex difference (P=.046). In study 2, healthy young participants performed better than healthy elderly participants (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;.001), but there was no effect of sex (P=.140). There was a significant negative correlation between age and relative improvement in performance (δ=-.450; P=.009). There were no significant differences in subject-based reports of motivation, fun, pain, and fatigue between groups in any of the studies (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;.094). The present study provides evidence that tongue disability and age can influence behavioral measures of tongue motor performance. TDS may be a new adjunctive neurorehabilitation regimen in treating tongue-disabled patients.

Can short-term oral fine motor training affect precision of task performance and induce cortical plasticity of the jaw muscles?

by Mohit Kothari and Abhishek Kumar

Experimental brain research, Jan 25, 2016