Tactile sensitivity of children: effects of frequency, masking, and the non-Pacinian I psychophysical channel

Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air haptics

Introduction

Carpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy, which causes numbness and pain in the thumb, the index and middle fingers and the radial side of the ring finger. Regular hand exercises may improve the symptoms and prevent carpal tunnel surgery. This study applied a novel ultrasonic stimulation method to test tactile sensitivity in CTS and also a mixed-reality-assisted (MR-assisted) exercise program which measured hand movements and provided haptic feedback for rehabilitation.

Methods

Twenty patients with mild unilateral CTS took part in the experiments. A mid-air haptics device (Ultrahaptics STRATOS Explore) was used to apply amplitude-modulated ultrasound waves (carrier frequency: 40 kHz) onto the skin to create tactile stimulation mechanically. Participants performed a two-alternative forced-choice task for measuring tactile thresholds at 250-Hz modulation frequency. They were tested at the index fingers and the thenar eminences of both hands. Additionally, 15 CTS patients used an MR-assisted program to do hand exercises with haptic feedback. Exercise performance was assessed by calculating errors between target and actual hand configurations. System Usability Scale (SUS) was adopted to verify the practical usability of the program.

Results

Thresholds at the thenar eminences of the affected and healthy hands were not significantly different. While the thresholds at the healthy index fingers could be measured, those of the affected fingers were all higher than the stimulation level produced by the maximum output from the ultrasound device. In the exercise program, a significant positive correlation (ρ = 0.89, p < 0.001) was found between the performance scores and the SUS scores, which were above the criterion value established in the literature.

Discussion

The results show that thenar tactile sensitivity is not affected in mild CTS as expected from the palmar cutaneous branch of the median nerve (PCBm), but index finger threshold is likely to be higher. Overall, this study suggests that mid-air haptics, with certain improvements, may be used as a preliminary test in the clinical setting. Moreover, the device is promising to develop gamified rehabilitation programs and for the treatment follow-up of CTS.

Mechanical Impedance of Rat Glabrous Skin and Its Relation With Skin Morphometry

The mechanical impedance of intact and epidermis-peeled rat glabrous skin was studied at two sites (digit and sole) and at two frequencies (40 Hz and 250 Hz). The thicknesses of skin layers at the corresponding regions were measured histologically from intact- and peeled-skin samples in every subject. Compared to intact sole skin, digital rat skin has thicker layers and higher mechanical resistance, and it is less stiff. The resistance of the skin significantly decreased after epidermal peeling at both the digit and the sole. Furthermore, peeling caused the reactance to become positive due to inertial effects. As the frequency was increased from 40 to 250 Hz, the resistance and stiffness also increased for the intact skin, while the peeled skin showed less frictional (i.e., resistance) but more inertial (i.e., positive reactance) effects. We estimated the mechanical properties of epidermis and dermis with lumped-element models developed for both intact and peeled conditions. The models predicted that dermis has higher mass, lower stiffness, and lower resistance compared to epidermis, similar to the experimental impedance results obtained in the peeled condition which consisted mostly of dermis. The overall impedance was simulated more successfully at 40 Hz. When both frequencies are considered, the models produced consistent results for resistance in both conditions. The results imply that most of the model parameters should be frequency-dependent and suggest that mechanical properties of epidermis can be related to its thickness. These findings may help in designing artificial skin for neuroprosthetic limbs.

Effect of Remote Masking on Tactile Perception of Electrovibration

Masking has been used to study human perception of tactile stimuli, including those created by electrovibration on touch screens. Earlier studies have investigated the effect of on-site masking on tactile perception of electrovibration. In this article, we investigated whether it is possible to change the absolute detection threshold and intensity difference threshold of electrovibration at the fingertip of index finger via remote masking, i.e., by applying a (mechanical) vibrotactile stimulus on the proximal phalanx of the same finger. The masking stimuli were generated by a voice coil (the Haptuator). For 16 participants, we first measured the detection thresholds for electrovibration at the fingertip and for vibrotactile stimuli at the proximal phalanx. Then, the vibrations on the skin were measured at four different locations on the index finger of subjects to investigate how the mechanical masking stimulus propagated as the masking level was varied. Later, masked absolute thresholds of eight participants were measured. Finally, for another group of eight participants, intensity difference thresholds were measured in the presence/absence of vibrotactile masking stimuli. Our results show that vibrotactile masking stimuli generated sub-threshold vibrations around the fingertip, and hence, probably did not mechanically interfere with the electrovibration stimulus. However, there was a clear psychophysical masking effect due to central neural processes. We measured the effect of masking stimuli, up to 40 dB SL, on the difference threshold at four different intensity standards of electrovibration. We proposed two models based on hypothetical neural signals for prediction of the masking effect on intensity difference thresholds for electrovibration: amplitude and energy models. The energy model was able to predict the effect of masking more accurately, especially at high intensity masking levels.

Psychophysical principles of discrete event-driven vibrotactile feedback for prostheses

Purpose/aim of the study: We aimed to establish psychophysical principles for non-invasive vibrotactile feedback signalling discrete transition events (e.g., extension to flexion) during use of prostheses, especially for the upper limbs.Materials and methods: Two vibrotactile actuators were used on both upper arms of 10 able-bodied human participants. Absolute thresholds, psychometric functions, and magnitude estimates were measured to equalize the sensation magnitudes for the tested vibrotactile frequencies and skin sites. Then, same-different and pattern recognition tasks were run to evaluate, respectfully, the discrimination and closed-set identification of stimuli with varying parameters (2 frequencies, 2 magnitudes, 2 sites). Finally, parameters of the left/right stimuli were mapped to hypothetical prosthesis events representing object/force and movement type. The stimuli were applied sequentially in accordance with the discrete event-driven feedback paradigm.Results: Reliable psychophysical models could be established for individual participants as verified by repetitive threshold measurements and relative adjustment of stimulus levels based on sensation magnitudes. Discrimination accuracy was higher for magnitude versus frequency comparisons; and magnitude discrimination accuracy was correlated with magnitude estimate differences. Pattern recognition recall/precision rates decreased from ∼0.7 to ∼0.5 for sequential delivery of two stimulus patterns to one arm versus to two arms. Using the patterns as two and three consecutive prosthesis events yielded statistically similar performance rates not correlated with magnitude estimate differences.Conclusions: By careful calibration of stimuli based on psychophysical principles, discrete event-driven vibrotactile feedback can be used to signal manipulated object and movement information with moderate identification rates as shown by confusion matrices.

Edge Vibration Improves Ability to Discriminate Roughness Difference of Adjoining Areas

Researchers have studied the discrimination thresholds between different vibrotactile signals under various conditions. Humans cannot recognize slight differences in vibrotactile stimuli that are smaller than the perception threshold. This is a constraint in the vibrotactile design used in practical applications. This article focuses on the vibrational feedback at the "edge" between multiple areas, while previous studies have not considered this. We assume that the edge vibration not only emphasizes the presence of the edge itself, but also has an effect on the vibrotactile perception of the adjoining areas. Specifically, we hypothesize that the edge vibration would modify the user's ability to discriminate vibrotactile differences between adjoining areas. We conducted a user study to test this hypothesis. As a result, we found that presenting edge vibrations at the boundaries between adjacent textures makes it easier to discriminate the frequency and amplitude differences of the vibrations of those uneven textures. This article could increase the flexibility of vibrotactile design, and vibrotactile designers could use these results to design a wider variety of vibrations for adjacent areas.

Tactile Masking by Electrovibration

Future touch screen applications will include multiple tactile stimuli displayed simultaneously or consecutively to single finger or multiple fingers. These applications should be designed by considering human tactile masking mechanism since it is known that presenting one stimulus may interfere with the perception of the other. In this study, we investigate the effect of masking on the tactile perception of electrovibration displayed on touch screens. Through conducting psychophysical experiments with nine participants, we measured the masked thresholds of sinusoidal electrovibration bursts (125 Hz) under two masking conditions: simultaneous and pedestal. The masking signals were noise bursts, applied at five different sensation levels varying from 2 to 22 dB SL, also presented by electrovibration. For each participant, the thresholds were elevated as linear functions of masking levels for both masking types. We observed that the masking effectiveness was larger with pedestal masking than simultaneous masking. Moreover, in order to investigate the effect of tactile masking on our haptic perception of edge sharpness, we compared the perceived sharpness of edges separating two textured regions displayed with and without various types of masking stimuli. Our results suggest that sharpness perception depends on the local contrast between background and foreground stimuli, which varies as a function of masking amplitude and activation levels of frequency-dependent psychophysical channels.

Effect of Waveform on Tactile Perception by Electrovibration Displayed on Touch Screens

In this study, we investigated the effect of input voltage waveform on our haptic perception of electrovibration on touch screens. Through psychophysical experiments performed with eight subjects, we first measured the detection thresholds of electrovibration stimuli generated by sinusoidal and square voltages at various fundamental frequencies. We observed that the subjects were more sensitive to stimuli generated by square wave voltage than sinusoidal one for frequencies lower than 60 Hz. Using Matlab simulations, we showed that the sensation difference of waveforms in low fundamental frequencies occurred due to the frequency-dependent electrical properties of human skin and human tactile sensitivity. To validate our simulations, we conducted a second experiment with another group of eight subjects. We first actuated the touch screen at the threshold voltages estimated in the first experiment and then measured the contact force and acceleration acting on the index fingers of the subjects moving on the screen with a constant speed. We analyzed the collected data in the frequency domain using the human vibrotactile sensitivity curve. The results suggested that Pacinian channel was the primary psychophysical channel in the detection of the electrovibration stimuli caused by all the square-wave inputs tested in this study. We also observed that the measured force and acceleration data were affected by finger speed in a complex manner suggesting that it may also affect our haptic perception accordingly.

Psychophysical correspondence between vibrotactile intensity and intracortical microstimulation for tactile neuroprostheses in rats

OBJECTIVE

Recent studies showed that intracortical microstimulation (ICMS) generates artificial sensations which can be utilized as somatosensory feedback in cortical neuroprostheses. To mimic the natural psychophysical response, ICMS parameters are modulated according to psychometric equivalence functions (PEFs). PEFs match the intensity levels of ICMS and mechanical stimuli, which elicit equal detection probabilities, but they typically do not include the frequency as a control variable. We aimed to establish frequency-dependent PEFs for vibrotactile stimulation of the glabrous skin and ICMS in the primary somatosensory cortex of awake freely behaving rats.

APPROACH

We collected psychometric data for vibrotactile and ICMS detection at three stimulation frequencies (40, 60 and 80 Hz). The psychometric data were fitted with a model equation of two independent variables (stimulus intensity and frequency) and four subject-dependent parameters. For each rat, we constructed a separate PEF which was used to estimate the ICMS current amplitude for a given displacement amplitude and frequency. The ICMS frequency was set equal to the vibrotactile frequency. We validated the PEFs in a modified task which included randomly selected probe trials presented either with a vibrotactile or an ICMS stimulus, and also at frequencies and intensity levels not tested before.

MAIN RESULTS

The PEFs were generally successful in estimating the ICMS current intensities (no significant differences between vibrotactile and ICMS trials in Kolmogorov-Smirnov tests). Specifically, hit rates from both trial conditions were significantly correlated in 86% of the cases, and 52% of all data had perfect match in linear regression.

SIGNIFICANCE

The psychometric correspondence model presented in this study was constructed based on surface functions which define psychophysical detection probability as a function of stimulus intensity and frequency. Therefore, it may be used for the real-time modulation of the frequency and intensity of ICMS pulses in somatosensory neuroprostheses.

Measurement of Vibration Detection Threshold and Tactile Spatial Acuity in Human Subjects

Tests that allow the precise determination of psychophysical thresholds for vibration and grating orientation provide valuable information about mechanosensory function that are relevant for clinical diagnosis as well as for basic research. Here, we describe two psychophysical tests designed to determine the vibration detection threshold (automated system) and tactile spatial acuity (handheld device). Both procedures implement a two-interval forced-choice and a transformed-rule up and down experimental paradigm. These tests have been used to obtain mechanosensory profiles for individuals from distinct human cohorts such as twins or people with sensorineural deafness.

Effects of passive and active movement on vibrotactile detection thresholds of the Pacinian channel and forward masking

We investigated the gating effect of passive and active movement on the vibrotactile detection thresholds of the Pacinian (P) psychophysical channel and forward masking. Previous work on gating mostly used electrocutaneous stimulation and did not allow focusing on tactile submodalities. Ten healthy adults participated in our study. Passive movement was achieved by swinging a platform, on which the participant's stimulated hand was attached, manually by a trained operator. The root-mean-square value of the movement speed was kept in a narrow range (slow: 10-20 cm/s, fast: 50-60 cm/s). Active movement was performed by the participant him-/herself using the same apparatus. The tactile stimuli consisted of 250-Hz sinusoidal mechanical vibrations, which were generated by a shaker mounted on the movement platform and applied to the middle fingertip. In the forward-masking experiments, a high-level masking stimulus preceded the test stimulus. Each movement condition was tested separately in a two-interval forced-choice detection task. Both passive and active movement caused a robust gating effect, that is, elevation of thresholds, in the fast speed range. Statistically significant change of thresholds was not found in slow movement conditions. Passive movement yielded higher thresholds than those measured during active movement, but this could not be confirmed statistically. On the other hand, the effect of forward masking was approximately constant as the movement condition varied. These results imply that gating depends on both peripheral and central factors in the P channel. Active movement may have some facilitatory role and produce less gating. Additionally, the results support the hypothesis regarding a critical speed for gating, which may be relevant for daily situations involving vibrations transmitted through grasped objects and for manual exploration.

Tactile spatial acuity in childhood: effects of age and fingertip size

Tactile acuity is known to decline with age in adults, possibly as the result of receptor loss, but less is understood about how tactile acuity changes during childhood. Previous research from our laboratory has shown that fingertip size influences tactile spatial acuity in young adults: those with larger fingers tend to have poorer acuity, possibly because mechanoreceptors are more sparsely distributed in larger fingers. We hypothesized that a similar relationship would hold among children. If so, children’s tactile spatial acuity might be expected to worsen as their fingertips grow. However, concomitant CNS maturation might result in more efficient perceptual processing, counteracting the effect of fingertip growth on tactile acuity. To investigate, we conducted a cross-sectional study, testing 116 participants ranging in age from 6 to 16 years on a precision-controlled tactile grating orientation task. We measured each participant's grating orientation threshold on the dominant index finger, along with physical properties of the fingertip: surface area, volume, sweat pore spacing, and temperature. We found that, as in adults, children with larger fingertips (at a given age) had significantly poorer acuity, yet paradoxically acuity did not worsen significantly with age. We propose that finger growth during development results in a gradual decline in innervation density as receptive fields reposition to cover an expanding skin surface. At the same time, central maturation presumably enhances perceptual processing.

A vibrotactile behavioral battery for investigating somatosensory processing in children and adults

The cortical dynamics of somatosensory processing can be investigated using vibrotactile psychophysics. It has been suggested that different vibrotactile paradigms target different cortical mechanisms, and a number of recent studies have established links between somatosensory cortical function and measurable aspects of behavior. The relationship between cortical mechanisms and sensory function is particularly relevant with respect to developmental disorders in which altered inhibitory processing has been postulated, such as in ASD and ADHD. In this study, a vibrotactile battery consisting of nine tasks (incorporating reaction time, detection threshold, and amplitude- and frequency discrimination) was applied to a cohort of healthy adults and a cohort of typically developing children to assess the feasibility of such a vibrotactile battery in both cohorts, and the performance between children and adults was compared. These results showed that children and adults were both able to perform these tasks with a similar performance, although the children were slightly less sensitive in frequency discrimination. Performance within different task-groups clustered together in adults, providing further evidence that these tasks tap into different cortical mechanisms, which is also discussed. This clustering was not observed in children, which may be potentially indicative of development and a greater variability. In conclusion, in this study, we showed that both children and adults were able to perform an extensive vibrotactile battery, and we showed the feasibility of applying this battery to other (e.g., neurodevelopmental) cohorts to probe different cortical mechanisms.

Recognition of Tactile Relief by Children and Adults

This study was designed to compare tactile sensitivity of children and adults on printed target stimuli covering a wide range of elevations and requiring different resolutions. A recognition-relief task using 9 digits at 6 levels of elevation from a surface (0.5, 0.4, 0.3, 0.2, 0.1, and 0.05 mm) was presented to 24 young adults and 24 children. As predicted, relief elevations as low as 0.05 mm were recognized above chance. As predicted, children performed significantly more poorly than the adults on recognition at all elevations, although the difference increased as elevation increased. Adults performed significantly better than children on high-resolution digit 8, but there was no reliable age difference on low-resolution digit 1. Recognition difference between the high- and low-resolution digits decreased nonlinearly as elevation increased, irrespective of age. Overall, the findings support previous research indicating greater tactile sensitivity in adults than in children, but the superiority was moderated by the elevation and resolution requirements of the stimuli.

Sensitivity mapping of the human foot: thresholds at 30 skin locations

BACKGROUND

Mechanoreceptors in the skin provide sensory input for the central nervous system about foot placement and loading. This information is used by the brain to actively control or regain balance and is important to establish memory traces for subsequent movement. A sensitivity map of the human foot could help to understand the mechanisms of the foot as a sensory organ for movement adjustment and balance control.

MATERIALS AND METHODS

Touch and vibration perception threshold values from 30 plantar and dorsal foot locations were determined in more than 40 women and men between 20 and 35 years. Semmes Weinstein monofilaments and a vibrotactile neurothesiometer were used for skin sensitivity threshold detection.

RESULTS

Large sensitivity differences were present between the 30 different foot sites. Gender effects were not present for touch but women had better sensitivities for vibration (p < 0.01), especially on the dorsal aspect of the foot. Age, in our cohort of 20- to 35-year-olds, did not have an influence on vibration or touch sensitivity. The heel had the highest detection thresholds for touch but was very sensitive for vibration stimuli. Compared to the dorsum, the plantar foot was substantially more sensitive, especially for vibration detection.

CONCLUSION

The results suggest that primarily the fast adapting plantar mechanoreceptors are important in assisting balance control during human locomotion.

CLINICAL RELEVANCE

The sensitivity map of the foot will help in understanding the function of the foot as a sensory organ and could be useful in creating footwear for better balance control and for the design of comfortable shoes.