Temperature perception on the hand during static versus dynamic contact with a surface

Tactile Location Perception Encoded by Gamma-Band Power

BACKGROUND

The perception of tactile-stimulation locations is an important function of the human somatosensory system during body movements and its interactions with the surroundings. Previous psychophysical and neurophysiological studies have focused on spatial location perception of the upper body. In this study, we recorded single-trial electroencephalography (EEG) responses evoked by four vibrotactile stimulators placed on the buttocks and thighs while the human subject was sitting in a chair with a cushion.

METHODS

Briefly, 14 human subjects were instructed to sit in a chair for a duration of 1 h or 1 h and 45 min. Two types of cushions were tested with each subject: a foam cushion and an air-cell-based cushion dedicated for wheelchair users to alleviate tissue stress. Vibrotactile stimulations were applied to the sitting interface at the beginning and end of the sitting period. Somatosensory-evoked potentials were obtained using a 32-channel EEG. An artificial neural net was used to predict the tactile locations based on the evoked EEG power.

RESULTS

We found that single-trial beta (13-30 Hz) and gamma (30-50 Hz) waves can best predict the tactor locations with an accuracy of up to 65%. Female subjects showed the highest performances, while males' sensitivity tended to degrade after the sitting period. A three-way ANOVA analysis indicated that the air-cell cushion maintained location sensitivity better than the foam cushion.

CONCLUSION

Our finding shows that tactile location information is encoded in EEG responses and provides insights on the fundamental mechanisms of the tactile system, as well as applications in brain-computer interfaces that rely on tactile stimulation.

A novel method to selectively elicit cold sensations without touch

BACKGROUND

Thermal and tactile stimuli are transduced by different receptor classes. However, mechano- and thermo-sensitive afferents interact at spinal and supraspinal levels. Yet, most studies on responses to cooling stimuli are confounded by mechanical contact, making these interactions difficult to isolate. Methods for precise control of non-mechanical thermal stimulations remain challenging, particularly in the cold range.

NEW METHOD

We developed a non-tactile, focal, temperature-controlled, multi-purpose cooling stimulator. This method controls the exposure of a target skin region to a dry-ice source. Using a thermal camera to monitor skin temperature, and adjusting the source-skin distance accordingly, we could deliver non-tactile cooling stimuli with customisable profiles, for studying different aspects of cold sensation.

RESULTS

To validate our method, we measured absolute and relative thresholds for cold sensation without mechanical contact in 13 human volunteer participants, using the method of limits. We found that the absolute cold detection threshold was 32.71 ^oC ± 0.88 ^oC. This corresponded to a threshold relative to each participant's baseline skin temperature of - 1.08 ^oC ± 0.37 ^oC.

COMPARISONS WITH EXISTING METHOD

Our method allows cooling stimulation without the confound of mechanical contact, in a controllable and focal manner.

CONCLUSIONS

We report a non-contact cooling stimulator and accompanying control system. We used this to measure cold thresholds in the absence of confounding touch. Our method enables more targeted studies of both cold sensory pathways, and of cold-touch interactions.

The Relevance of Collision Tests and Quantitative Sensory Testing in Diagnostics and Postoperative Outcome Prediction in Carpal Tunnel Syndrome

Background

The gold standards for the diagnosis and treatment of carpal tunnel syndrome (CTS) and its outcome are undecided. Using clinical and electrophysiological methods, we tried to establish which fibers achieved full postoperative recovery, and the possibility of using non-standard electrophysiological tests as outcome predictors.

Methods

The study group consisted of 35 patients and controls. The Historical–Objective Scale, standard neurography, conduction velocity distribution tests (CVD), and quantitative sensory testing (QST) were performed before and after CTS surgery.

Results

Clinical improvement was observed on average in 54.3% of the patients, higher in less advanced CTS. All parameters improved significantly after surgery, except for CVD; most remained worse than in the controls. Only QST parameters fully returned to normal limits. Patient age and CTS severity were important in the estimation of the risk of no improvement.

Conclusions

The efficiency of minimally invasive CTS surgery is higher in younger patients with less advanced CTS. Complete recovery was present only in small fibers; larger fibers could most likely be responsible for residual signs. We did not notice any benefits in CTS diagnosis using methods of small fiber assessment. QST seemed to be useful in the diagnosis of residual signs, and in deciding upon possible reoperation.

The Use of Quantitative Sensation Testing to Identify the Physiological Differences Between the Median and Ulnar Nerves

Introduction

Similarities in morphology, physiological function, and neurophysiological findings between median and ulnar nerves are not unequivocal. Our previous study confirmed differences in motor fiber parameters between these nerves in healthy persons. We made an attempt to assess and compare the physiological parameters of different sensation modalities (temperature, pain, and vibration) in median and ulnar nerves.

Methods

The study was performed in 31 healthy, right-handed volunteers: 17 women, 14 men, mean age 44.8 ± 15.5 years. Standard sensory conduction tests in the median and ulnar nerves were performed together with the estimation of vibratory, temperature, and warm- and cold-induced pain thresholds in the C7 and C8 dermatomes on the palm, using quantitative sensory testing.

Results

There were no statistically significant differences in the standard sensory conduction test in the median and ulnar nerves across the whole group: between right and left hands, and between women and men. We revealed differences in the temperature and pain thresholds between these nerves, mainly in low temperature perception. There were no differences in estimated thresholds between sides or in female and male groups. The vibratory limits did not differ significantly between nerves, and subgroups.

Conclusion

The study confirmed the differences in the physiological sensory perception between the median and ulnar nerves. The median nerve is more sensitive to temperature stimulation than the ulnar nerve, but simultaneously less sensitive to pain-inducing temperature stimuli. These findings should be considered during the examination of hand nerve pathology.

Thermal-Tactile Integration in Object Temperature Perception

The brain consistently faces a challenge of whether and how to combine the available information sources to estimate the properties of an object explored by hand. While object perception is an inference process involving multisensory inputs, thermal referral (TR) is an illusion demonstrating how the interaction between thermal and tactile systems can lead to deviations from physical reality-when observers touch three stimulators simultaneously with the middle three fingers of one hand but only the outer two stimulators are heated (or cooled), thermal uniformity is perceived across three fingers. Here, we used TR of warmth to examine the thermal-tactile interaction in object temperature perception. We show that TR is consistent with precision-weighted averaging of thermal sensation across tactile locations. Furthermore, we show that prolonged contact with TR stimulation results in adaptation to the local variations of veridical temperatures instead of the thermal uniformity perceived across three fingers. Our results illuminate the flexibility of processing that underlies thermal-tactile interactions and serve as a basis for thermal display design.

Illusion of Wetness by Dynamic Touch

Humans perceive wetness on contact with a dry-cold material; however, the magnitude of wetness that can be perceived using dynamic touch remains unclear. This study assessed how the type of touch, namely hand movement (either statically or dynamically) and pressing force (either low or high pressure), affect the perception of wetness. The participants judged the magnitude of perceived wetness after four types of touch of four stimuli comprising four fabrics of varying water content and surface temperatures. Overall, the perceived wetness was differed between static and dynamic touch independent of pressure and the participants scored the dry-cold stimulus as relatively dry for dynamic touch. Furthermore, cluster analysis revealed individual differences in the recognition of wetness in dynamic touch conditions. These results revealed the variability in the mechanisms used by humans to perceive wetness. Additionally, we discussed the optimal methods to reproduce the wetness perception using this illusion.

Detection of skin temperature differences using palpation by manual physical therapists and lay individuals

Objectives

To evaluate the accuracy of detection of temperature differences among skin sites of lay individuals and manual physical therapists.

Methods

Forty-four manual physical therapists and 44 lay individuals were recruited. Subjects palpated two temperature-controlled surfaces that ranged in temperature between 30 and 35 °C and varied randomly by 1, 2, 3, 4, or 5 °C for 10 s. The subjects were then asked to identify the warmer pad.

Results

Accuracy increased with larger temperature differences. Accuracy of detection of 1 and 3 °C temperature differences was higher in manual physical therapists than lay individuals.

Discussion

Palpation can be used to accurately detecting temperature differences between sites and is more accurately performed by an experienced practitioner.

Level of Evidence

3b.

A Protocol of Manual Tests to Measure Sensation and Pain in Humans

Numerous qualitative and quantitative techniques can be used to test sensory nerves and pain in both research and clinical settings. The current study demonstrates a quantitative sensory testing protocol using techniques to measure tactile sensation and pain threshold for pressure and heat using portable and easily accessed equipment. These techniques and equipment are ideal for new laboratories and clinics where cost is a concern or a limiting factor. We demonstrate measurement techniques for the following: cutaneous mechanical sensitivity on the arms and legs (von-Frey filaments), radiant and contact heat sensitivity (with both threshold and qualitative assessments using the Visual Analog Scale (VAS)), and mechanical pressure sensitivity (algometer, with both threshold and the VAS). The techniques and equipment described and demonstrated here can be easily purchased, stored, and transported by most clinics and research laboratories around the world. A limitation of this approach is a lack of automation or computer control. Thus, these processes can be more labor intensive in terms of personnel training and data recording than the more sophisticated equipment. We provide a set of reliability data for the demonstrated techniques. From our description, a new laboratory should be able to set up and run these tests and to develop their own internal reliability data.

Cutaneous microvascular response during local cold exposure - the effect of female sex hormones and cold perception

It is generally known that differences exist between males and females with regard to sensitivity to cold. Similar differences even among females in different hormonal balance might influence microvascular response during cold provocation testing. The aim of the present study was to measure sex hormone levels, cold and cold pain perception thresholds and compare them to cutaneous laser-Doppler flux response during local cooling in both the follicular and luteal phases of the menstrual cycle. In the luteal phase a more pronounced decrease in laser-Doppler flux was observed compared to follicular phase during local cooling at 15°C (significant difference by Dunnett's test, p<0.05). In addition, statistically significant correlations between progesterone level and laser-Doppler flux response to local cooling were observed during the follicular (R=-0.552, p=0.0174) and during the luteal phases (R=0.520, p=0.0271). In contrast, the correlation between estradiol level and laser-Doppler flux response was observed only in the follicular phase (R=-0.506, p=0.0324). Our results show that individual sensitivity to cold influences cutaneous microvascular response to local cooling; that microvascular reactivity is more pronounced during the luteal phase of the menstrual cycle; and that reactivity correlates with hormone levels. The effect of specific sex hormone levels is related to the cold-provocation temperature.

Thermal and tactile interactions in the perception of local skin wetness at rest and during exercise in thermo-neutral and warm environments

The central integration of thermal (i.e. cold) and mechanical (i.e. pressure) sensory afferents is suggested as to underpin the perception of skin wetness. However, the role of temperature and mechanical inputs, and their interaction, is still unclear. Also, it is unknown whether this intra-sensory interaction changes according to the activity performed or the environmental conditions. Hence, we investigated the role of peripheral cold afferents, and their interaction with tactile afferents, in the perception of local skin wetness during rest and exercise in thermo-neutral and warm environments. Six cold-dry stimuli, characterized by decreasing temperatures [i.e. -4, -8 and -15 °C below the local skin temperature (T(sk))] and by different mechanical pressures [i.e. low pressure (LP): 7 kPa; high pressure (HP): 10 kPa], were applied on the back of 8 female participants (age 21 ± 1 years), while they were resting or cycling in 22 or 33 °C ambient temperature. Mean and local Tsk, thermal and wetness perceptions were recorded during the tests. Cold-dry stimuli produced drops in Tsk with cooling rates in a range of 0.06-0.4 °C/s. Colder stimuli resulted in increasing coldness and in stimuli being significantly more often perceived as wet, particularly when producing skin cooling rates of 0.18 °C/s and 0.35 °C/s. However, when stimuli were applied with HP, local wetness perceptions were significantly attenuated. Wetter perceptions were recorded during exercise in the warm environment. We conclude that thermal inputs from peripheral cutaneous afferents are critical in characterizing the perception of local skin wetness. However, the role of these inputs might be modulated by an intra-sensory interaction with the tactile afferents. These findings indicate that human sensory integration is remarkably multimodal.

Does seeing ice really feel cold? Visual-thermal interaction under an illusory body-ownership

Although visual information seems to affect thermal perception (e.g. red color is associated with heat), previous studies have failed to demonstrate the interaction between visual and thermal senses. However, it has been reported that humans feel an illusory thermal sensation in conjunction with an apparently-thermal visual stimulus placed on a prosthetic hand in the rubber hand illusion (RHI) wherein an individual feels that a prosthetic (rubber) hand belongs to him/her. This study tests the possibility that the ownership of the body surface on which a visual stimulus is placed enhances the likelihood of a visual-thermal interaction. We orthogonally manipulated three variables: induced hand-ownership, visually-presented thermal information, and tactically-presented physical thermal information. Results indicated that the sight of an apparently-thermal object on a rubber hand that is illusorily perceived as one's own hand affects thermal judgments about the object physically touching this hand. This effect was not observed without the RHI. The importance of ownership of a body part that is touched by the visual object on the visual-thermal interaction is discussed.

Mechanisms underlying referral of thermal sensations to sites of tactile stimulation

When three stimulators are simultaneously touched with the middle three fingers of one hand but only the outer two stimulators are cooled or heated, the central (neutral) stimulator is also perceived to be cold or warm. This phenomenon is known as thermal referral and it shares phenomenological similarities with filling-in, in which the discontinuity in the signals of interest can be compensated perceptually on the basis of the spatially adjacent context. Although the mechanisms underlying filling-in have been well substantiated, those underlying thermal referral are still poorly understood. In the present study, we examined the intensity perception of the sensation resulting from thermal referral with human participants. We found that the sensation was uniform among the three fingers, but its apparent intensity was always lower than the physical intensity applied to the outer two fingers. These results indicate that the thermal uniformity perceived under thermal referral is not created by the brain's interpolating the thermal changes applied to the outer two fingers, as one would expect for those induced by typical filling-in. Instead, the thermal changes applied to the outer two fingers are summated and redistributed to all the fingers in contact. Our findings suggest that thermal referral is mediated by two separate processes. One determines the apparent intensity from the physical intensity and the areal extent of the thermal stimulation; the other determines the localization of the resulting sensation from the apparent sites of tactile stimulation.

Cold perception and cutaneous microvascular response to local cooling at different cooling temperatures

The aim of the present study was to investigate the effect of quantitatively measured cold perception (CP) thresholds on microcirculatory response to local cooling as measured by direct and indirect response of laser-Doppler (LD) flux during local cooling at different temperatures. The CP thresholds were measured in 18 healthy males using the Marstock method (thermode placed on the thenar). The direct (at the cooling site) and indirect (on contralateral hand) LD flux responses were recorded during immersion of the hand in a water bath at 20°C, 15°C, and 10°C. The cold perception threshold correlated (linear regression analysis, Pearson correlation) with the indirect LD flux response at cooling temperatures 20°C (r=0.782, p<0.01) and 15°C (r=0.605, p<0.01). In contrast, there was no correlation between the CP threshold and the indirect LD flux response during cooling in water at 10°C. The results demonstrate that during local cooling, depending on the cooling temperature used, cold perception threshold influences indirect LD flux response.

Cooling the thermal grill illusion through self-touch

Acute peripheral pain is reduced by multisensory interactions at the spinal level [1]. Central pain is reduced by reorganization of cortical body representations [2, 3]. We show here that acute pain can also be reduced by multisensory integration through self-touch, which provides proprioceptive, thermal, and tactile input forming a coherent body representation [4, 5]. We combined self-touch with the thermal grill illusion (TGI) [6]. In the traditional TGI, participants press their fingers on two warm objects surrounding one cool object. The warm surround unmasks pain pathways, which paradoxically causes the cool object to feel painfully hot. Here, we warmed the index and ring fingers of each hand while cooling the middle fingers. Immediately after, these three fingers of the right hand were touched against the same three fingers on the left hand. This self-touch caused a dramatic 64% reduction in perceived heat. We show that this paradoxical release from paradoxical heat cannot be explained by low-level touch-temperature interactions alone. To reduce pain, we often clutch a painful hand with the other hand. We show here that self-touch not only gates pain signals reaching the brain [7-9] but also, via multisensory integration, increases coherence of cognitive body representations to which pain afferents project [10].