Mechanoreceptive units in the human infra-orbital nerve

Relations between tactile sensitivity of the finger, arm, and cheek skin over the lifespan showing decline only on the finger

Touch sensitivity generally declines with age, contributing to loss of manual dexterity and tactile function. We investigated how touch changes over the lifespan, using different tests and on three body sites. We used a classical test of force detection sensitivity, where calibrated monofilaments were applied passively to the right index finger pad, forearm, and cheek. In addition, at the index, we used an active touch spatial discrimination task, developed by our group. Spatial discrimination was estimated through participants' ability to evaluate the distance between parallel bands printed on acrylic plates. Data were collected from 96 healthy women, aged 20-75 years. Force detection and tactile spatial discrimination on the index deteriorated significantly with age; however, no change was found for tactile detection on the forearm or cheek. Tactile detection on the cheek remained remarkably highly sensitive throughout life. There was a significant positive relationship between force detection and spatial discrimination on the index. Further, force detection on the forearm was significantly associated with detection on the index and cheek. Our results suggest a decrease in touch perception with age on the index finger pad, yet a preservation of tactile sensitivity in hairy skin. This opens discussion about the impact of daily activities upon the glabrous hand skin and on the function of hairs in tactile sensitivity. We highlight the need for new methods in evaluating tactile sensitivity on hairy skin.

Effect of complete dentures on oral stereognostic ability in edentulous patients: A systematic review

Aim:

Oral stereognosis is an important sensation for a human being to percept any type of materials that are introduced in the oral cavity. It is defined as the ability of an individual to recognize objects using only tactile sensation without using vision, audition, balance, somatic function, taste, or smell. The primary purpose of this review was to evaluate the effect of complete dentures on oral stereognostic ability in edentulous subjects.

Settings and Design:

Systematic review based on PRISMA guidelines.

Materials and Methods:

A systematic search of the electronic databases like PubMed and Web of Science was done using keywords – “stereognosis,” “oral stereognosis,” “complete denture,” and “complete edentulism.” In addition to this, a manual search of references mentioned in the articles and gray literature was done. Data extraction and assessment were done by two independent reviewers.

Statistical Analysis Used:

Qualitative analysis.

Results:

The literature search yielded a total of 61 articles. Thirteen duplicate articles were removed and 36 articles were rejected after initial screening of titles and abstracts. A total of 12 articles were selected for full text reading and 5 of them were included for qualitative analysis.

Conclusion:

All the included studies showed complete denture treatment therapy improved stereognostic ability in terms of correct identification of test pieces and time taken to identify the objects. There is also a direct relationship between the adaptability of dentures and stereognostic ability.

Facial Transplantation: Complications, Outcomes, and Long-Term Management Strategies

Within the past two decades, vascularized facial composite allotransplantation has evolved into a viable option in the reconstructive surgeons' armamentarium for patients with extensive facial disfigurements. As it has expanded the frontiers of microsurgical reconstructive techniques, facial transplantation has come to garner widespread interest within both the medical community and the general public. The procedure has established itself as an amalgamation of the forefronts of reconstructive microsurgery, immunology, and transplantation science. Therein too lies its complexity as multifaceted scientific developments are met with ethical and social issues. Both patients and physicians are faced with the everlasting challenges of immunosuppression regimens and their inherent complications, long-term aesthetic and functional considerations, the role of revision procedures, and the inevitable psychosocial implications. This article reflects on the medical and surgical advancements in facial transplantation surgery and highlights anticipated future challenges. It aims to encourage discussion regarding anticipated barriers to current practice and suggest future directions as we transition into the next phase of facial allograft transplantation.

Tactile innervation densities across the whole body

The skin is our largest sensory organ and innervated by afferent fibers carrying tactile information to the spinal cord and onto the brain. The density with which different classes of tactile afferents innervate the skin is not constant but varies considerably across different body regions. However, precise estimates of innervation density are only available for some body parts, such as the hands, and estimates of the total number of tactile afferent fibers are inconsistent and incomplete. Here we reconcile different estimates and provide plausible ranges and best estimates for the number of different tactile fiber types innervating different regions of the skin, using evidence from dorsal root fiber counts, microneurography, histology, and psychophysics. We estimate that the skin across the whole body of young adults is innervated by ∼230,000 tactile afferent fibers (plausible range: 200,000–270,000), with a subsequent decrement of 5–8% every decade due to aging. Fifteen percent of fibers innervate the palmar skin of both hands and 19% the region surrounding the face and lips. Slowly and fast-adapting fibers are split roughly evenly, but this breakdown varies with skin region. Innervation density correlates well with psychophysical spatial acuity across different body regions, and, additionally, on hairy skin, with hair follicle density. Innervation density is also weakly correlated with the size of the cortical somatotopic representation but cannot fully account for the magnification of the hands and the face.

Contributions of viscosity and friction properties to oral and haptic texture perception of iced coffees

Creaminess is affected by bulk properties (i.e. viscosity) and surfaces properties (i.e. friction). This study aimed (i) to assess contributions of viscosity and friction properties to creaminess, thickness and slipperiness perception; and (ii) to compare oral and haptic thickness and slipperiness perception of iced coffees. Three iced coffees differing in viscosity and friction properties were prepared: low viscosity - high friction (LV-HF); low viscosity - low friction (LV-LF) and high viscosity - low friction (HV-LF) iced coffee. Viscosity of iced coffees was adjusted by addition of maltodextrin, and viscosity of HV-LF was 2.5 times higher than that of LV-HF and LV-LF (10 vs. 4 mPa s at 100 s-1). Friction coefficients of LV-LF were reduced by addition of polyethylene glycol (PEG, Mw 6000), and were up to 25% lower than those of LV-HF. Forty-seven untrained panellists (18-27 years) performed two-alternative forced choice (2-AFC) and rank-rating tests to compare creaminess by oral assessment, and thickness and slipperiness by oral and haptic assessment. Results from 2-AFC and rank-rating congruently showed that HV-LF was creamier, thicker and more slippery than LV-HF and LV-LF, both orally and haptically. LV-LF was orally perceived as less creamy and less thick, but haptically as more slippery than LV-HF. Creaminess was more strongly correlated to thickness than to slipperiness. Oral and haptic evaluation of thickness was congruent, whereas differences between oral and haptic slipperiness evaluation were product-dependent. We conclude that increasing viscosity enhances creaminess, whereas increasing lubrication is not necessarily sufficient to increase creaminess in iced coffees.

Wireless Sensing of Lower Lip and Thumb-Index Finger 'Ramp-and-Hold' Isometric Force Dynamics in a Small Cohort of Unilateral MCA Stroke: Discussion of Preliminary Findings

Automated wireless sensing of force dynamics during a visuomotor control task was used to rapidly assess residual motor function during finger pinch (right and left hand) and lower lip compression in a cohort of seven adult males with chronic, unilateral middle cerebral artery (MCA) stroke with infarct confirmed by anatomic magnetic resonance imaging (MRI). A matched cohort of 25 neurotypical adult males served as controls. Dependent variables were extracted from digitized records of ‘ramp-and-hold’ isometric contractions to target levels (0.25, 0.5, 1, and 2 Newtons) presented in a randomized block design; and included force reaction time, peak force, and dF/dt_max associated with force recruitment, and end-point accuracy and variability metrics during the contraction hold-phase (mean, SD, criterion percentage ‘on-target’). Maximum voluntary contraction force (MVCF) was also assessed to establish the force operating range. Results based on linear mixed modeling (LMM, adjusted for age and handedness) revealed significant patterns of dissolution in fine force regulation among MCA stroke participants, especially for the contralesional thumb-index finger followed by the ipsilesional digits, and the lower lip. For example, the contralesional thumb-index finger manifest increased reaction time, and greater overshoot in peak force during recruitment compared to controls. Impaired force regulation among MCA stroke participants during the contraction hold-phase was associated with significant increases in force SD, and dramatic reduction in the ability to regulate force output within prescribed target force window (±5% of target). Impaired force regulation during contraction hold-phase was greatest in the contralesional hand muscle group, followed by significant dissolution in ipsilateral digits, with smaller effects found for lower lip. These changes in fine force dynamics were accompanied by large reductions in the MVCF with the LMM marginal means for contralesional and ipsilesional pinch forces at just 34.77% (15.93 N vs. 45.82 N) and 66.45% (27.23 N vs. 40.98 N) of control performance, respectively. Biomechanical measures of fine force and MVCF performance in adult stroke survivors provide valuable information on the profile of residual motor function which can help inform clinical treatment strategies and quantitatively monitor the efficacy of rehabilitation or neuroprotection strategies.

Orofacial somatosensory inputs modulate word segmentation in lexical decision

There is accumulating evidence that articulatory/motor knowledge plays a role in phonetic processing, such as the recent finding that orofacial somatosensory inputs may influence phoneme categorization. We here show that somatosensory inputs also contribute at a higher level of the speech perception chain, that is, in the context of word segmentation and lexical decision. We carried out an auditory identification test using a set of French phrases consisting of a definite article "la" followed by a noun, which may be segmented differently according to the placement of accents within the phrase. Somatosensory stimulation was applied to the facial skin at various positions within the acoustic utterances corresponding to these phrases, which had been recorded with neutral accent, that is, with all syllables given similar emphasis. We found that lexical decisions reflecting word segmentation were significantly and systematically biased depending on the timing of somatosensory stimulation. This bias was not induced when somatosensory stimulation was applied to the skin other than on the face. These results provide evidence that the orofacial somatosensory system contributes to lexical perception in situations that would be disambiguated by different articulatory movements, and suggests that articulatory/motor knowledge might be involved in speech segmentation.

Orofacial and thumb-index finger ramp-and-hold isometric force dynamics in young neurotypical adults

The relation among several parameters of the ramp-and-hold isometric force contraction (peak force and dF/dt_max during the initial phase of force recruitment, and the proportion of hold-phase at target) was quantified for the right and left thumb-index finger pinch, and lower lip midline compression in 40 neurotypical right-handed young adults (20 female/20 males) using wireless force sensors and data acquisition technology developed in our laboratory. In this visuomotor control task, participants produced ramp-and-hold isometric forces as 'rapidly and accurately' as possible to end-point target levels at 0.25, 0.5, 1 and 2 Newtons presented to a computer monitor in a randomized block design. Significant relations were found between the parameters of the ramp-and-hold lip force task and target force level, including the peak rate of force change (dF/dt_max), peak force, and the criterion percentage of force within ±5% of target during the contraction hold phase. A significant performance advantage was found among these force variables for the thumb-index finger over the lower lip. The maximum voluntary compression force (MVCF) task revealed highly significant differences in force output between the thumb-index fingers and lower lip (∼4.47-4.70 times greater for the digits versus lower lip), a significant advantage of the right thumb-index finger over the non-dominant left thumb-index finger (12% and 25% right hand advantage for males and females, respectively), and a significant sex difference (∼1.65-1.73 times greater among males).

The Effects of Tooth Brushing on Whole Salivary Flow Rate in Older Adults

Objectives

(1) To determine whether manual (MTB), or electric, tooth brushing (ETB) modulates whole salivary flow rate in older adults who are free of systemic disease. (2) To determine the duration of the brushing-related modulation of salivary flow rate. (3) To compare salivary flow rate modulation associated with MTB and ETB.

Method

Twenty-one adults aged 60 years and older participated in two experimental sessions during which they used a manual, or electric, toothbrush to brush their teeth, tongue, and palate. Whole salivary flow rates were determined using the draining method before, during, and after brushing. Differences in salivary flow rates across time periods, and between conditions, were examined using paired samples t-tests applying a Holm-Bonferroni sequential procedure (p_corr < 0.0045). The relationship between tooth brushing and age with respect to maximum salivary flow rate increase was examined using Pearson's correlation coefficient (p < 0.05).

Results/Conclusion

Whole salivary flow rates increased during, and for up to 5 minutes following, tooth brushing in adults aged 60 years and older who were free of systemic disease. The salivary effects of MTB and ETB were not significantly different. A moderate, positive correlation was observed between tooth-brushing-related maximum salivary flow rate increase and age.

Brain encoding of saltatory velocity through a pulsed pneumotactile array in the lower face

Processing dynamic tactile inputs is a primary function of the somatosensory system. Spatial velocity encoding mechanisms by the nervous system are important for skilled movement production and may play a role in recovery of sensorimotor function following neurological insult. Little is known about tactile velocity encoding in mechanosensory trigeminal networks required for speech, suck, mastication, and facial gesture. High resolution functional magnetic resonance imaging (fMRI) was used to investigate the neural substrates of velocity encoding in the human orofacial somatosensory system during unilateral saltatory pneumotactile stimulation of perioral and buccal hairy skin in 20 neurotypical adults. A custom multichannel, scalable pneumotactile array consisting of 7 TAC-Cells was used to present 5 stimulus conditions: 5cm/s, 25cm/s, 65cm/s, ALL-ON synchronous activation, and ALL-OFF. The spatiotemporal organization of whole-brain blood oxygen level-dependent (BOLD) response was analyzed with general linear modeling (GLM) and fitted response estimates of percent signal change to compare activations associated with each velocity, and the main effect of velocity alone. Sequential saltatory inputs to the right lower face produced localized BOLD responses in 6 key regions of interest (ROI) including; contralateral precentral and postcentral gyri, and ipsilateral precentral, superior temporal (STG), supramarginal gyri (SMG), and cerebellum. The spatiotemporal organization of the evoked BOLD response was highly dependent on velocity, with the greatest amplitude of BOLD signal change recorded during the 5cm/s presentation in the contralateral hemisphere. Temporal analysis of BOLD response by velocity indicated rapid adaptation via a scalability of networks processing changing pneumotactile velocity cues.

Neuronal responses to tactile stimuli and tactile sensations evoked by microstimulation in the human thalamic principal somatic sensory nucleus (ventral caudal)

The normal organization and plasticity of the cutaneous core of the thalamic principal somatosensory nucleus (ventral caudal, Vc) have been studied by single-neuron recordings and microstimulation in patients undergoing awake stereotactic operations for essential tremor (ET) without apparent somatic sensory abnormality and in patients with dystonia or chronic pain secondary to major nervous system injury. In patients with ET, most Vc neurons responded to one of the four stimuli, each of which optimally activates one mechanoreceptor type. Sensations evoked by microstimulation were similar to those evoked by the optimal stimulus only among rapidly adapting neurons. In patients with ET, Vc was highly segmented somatotopically, and vibration, movement, pressure, and sharp sensations were usually evoked by microstimulation at separate sites in Vc. In patients with conditions including spinal cord transection, amputation, or dystonia, RFs were mismatched with projected fields more commonly than in patients with ET. The representation of the border of the anesthetic area (e.g., stump) or of the dystonic limb was much larger than that of the same part of the body in patients with ET. This review describes the organization and reorganization of human Vc neuronal activity in nervous system injury and dystonia and then proposes basic mechanisms.

Somatosensory Event-related Potentials from Orofacial Skin Stretch Stimulation

Cortical processing associated with orofacial somatosensory function in speech has received limited experimental attention due to the difficulty of providing precise and controlled stimulation. This article introduces a technique for recording somatosensory event-related potentials (ERP) that uses a novel mechanical stimulation method involving skin deformation using a robotic device. Controlled deformation of the facial skin is used to modulate kinesthetic inputs through excitation of cutaneous mechanoreceptors. By combining somatosensory stimulation with electroencephalographic recording, somatosensory evoked responses can be successfully measured at the level of the cortex. Somatosensory stimulation can be combined with the stimulation of other sensory modalities to assess multisensory interactions. For speech, orofacial stimulation is combined with speech sound stimulation to assess the contribution of multi-sensory processing including the effects of timing differences. The ability to precisely control orofacial somatosensory stimulation during speech perception and speech production with ERP recording is an important tool that provides new insight into the neural organization and neural representations for speech.

Face-referenced measurement of perioral stiffness and speech kinematics in Parkinson's disease

PURPOSE

Perioral biomechanics, labial kinematics, and associated electromyographic signals were sampled and characterized in individuals with Parkinson's disease (PD) as a function of medication state.

METHOD

Passive perioral stiffness was sampled using the OroSTIFF system in 10 individuals with PD in a medication ON and a medication OFF state and compared to 10 matched controls. Perioral stiffness, derived as the quotient of resultant force and interoral angle span, was modeled with regression techniques. Labial movement amplitudes and integrated electromyograms from select lip muscles were evaluated during syllable production using a 4-D computerized motion capture system.

RESULTS

Multilevel regression modeling showed greater perioral stiffness in patients with PD, consistent with the clinical correlate of rigidity. In the medication-OFF state, individuals with PD manifested greater integrated electromyogram levels for the orbicularis oris inferior compared to controls, which increased further after consumption of levodopa.

CONCLUSIONS

This study illustrates the application of biomechanical, electrophysiological, and kinematic methods to better understand the pathophysiology of speech motor control in PD.

Facial transplantation: the first 9 years

Since the first facial transplantation in 2005, 28 have been done worldwide with encouraging immunological, functional, psychological, and aesthetic outcomes. Unlike solid organ transplantation, which is potentially life-saving, facial transplantation is life-changing. This difference has generated ethical concerns about the exposure of otherwise young and healthy individuals to the sequelae of lifelong, high-dose, multidrug immunosuppression. Nevertheless, advances in immunomodulatory and immunosuppressive protocols, microsurgical techniques, and computer-aided surgical planning have enabled broader clinical application of this procedure to patients. Although episodes of acute skin rejection continue to pose a serious threat to face transplant recipients, all cases have been controlled with conventional immunosuppressive regimens, and no cases of chronic rejection have been reported.

The facial motor system

Facial movements support a variety of functions in human behavior. They participate in automatic somatic and visceral motor programs, they are essential in producing communicative displays of affective states and they are also subject to voluntary control. The multiplicity of functions of facial muscles, compared to limb muscles, is reflected in the heterogeneity of their anatomical and histological characteristics that goes well beyond the conventional classification in single facial muscles. Such parcellation in different functional muscular units is maintained throughout the central representation of facial movements from the brainstem up to the neocortex. Facial movements peculiarly lack a conventional proprioceptive feedback system, which is only in part vicariated by cutaneous or auditory afferents. Facial motor activity is the main marker of endogenous affective states and of the affective valence of external stimuli. At the cortical level, a complex network of specialized motor areas supports voluntary facial movements and, differently from upper limb movements, in such network there does not seem to be a prime actor in the primary motor cortex.

The face as a sensory organ

BACKGROUND

The human face is a highly specialized organ for receiving the sensory information from the environment and for its transmission to the cortex. The advent of facial transplantation has shown that excellent reconstruction of disfiguring defects can be achieved; thus, the expectations are now focused on functional recovery of the transplant. So far, restoration of facial sensation has not received the same attention as the recovery of motor function.

METHODS

A thorough review of the literature was performed to investigate the current knowledge on the sensory pathways of the human face and their functions to evaluate current methods of sensory assessment and the available data on normal sensation.

RESULTS

The presence of Meissner and Ruffini corpuscles, Merkel disks, hair-associated fibers, and intraepidermal free nerve endings was confirmed. Occurrence of extensive cross-communications between trigeminal and facial nerve was substantiated. Two-point discrimination and pressure thresholds represented the most objective measures of facial sensation. Age, sex, and smoker status of the patients were shown to influence normal sensibility values. The most suitable areas for sensory testing based on the tested modality and innervation were inferred. The anatomical course of the nerves and their variations had implications for the harvest of face allografts and repair of the sensory nerves.

CONCLUSIONS

This review has illustrated the complexity of sensory pathways of the face and their influence on somatic and visceral responses. In view of the discussed data, during facial transplantation, it is important to consider different mechanisms of restoration of facial sensation.

TAC-Cell inputs to human hand and lip induce short-term adaptation of the primary somatosensory cortex

A new pneumatic tactile stimulator, called the TAC-Cell, was developed in our laboratory to non-invasively deliver patterned cutaneous stimulation to the face and hand in order to study the neuromagnetic response adaptation patterns within the primary somatosensory cortex (S1) in young adult humans. Individual TAC-Cells were positioned on the glabrous surface of the right hand, and midline of the upper and lower lip vermilion. A 151-channel magnetoencephalography (MEG) scanner was used to record the cortical response to a novel tactile stimulus which consisted of a repeating 6-pulse train delivered at three different frequencies through the active membrane surface of the TAC-Cell. The evoked activity in S1 (contralateral for hand stimulation, and bilateral for lip stimulation) was characterized from the best-fit dipoles of the earliest prominent response component. The S1 responses manifested significant modulation and adaptation as a function of the frequency of the punctate pneumatic stimulus trains and stimulus site (glabrous lip versus glabrous hand).

Cutaneous stimulation of the digits and lips evokes responses with different adaptation patterns in primary somatosensory cortex

Neuromagnetic evoked fields were recorded to compare the adaptation of the primary somatosensory cortex (SI) response to tactile stimuli delivered to the glabrous skin at the fingertips of the first three digits (condition 1) and between midline upper and lower lips (condition 2). The stimulation paradigm allowed to characterize the response adaptation in the presence of functional integration of tactile stimuli from adjacent skin areas in each condition. At each stimulation site, cutaneous stimuli (50 ms duration) were delivered in three runs, using trains of 6 pulses with regular stimulus onset asynchrony (SOA). The pulses were separated by SOAs of 500 ms, 250 ms or 125 ms in each run, respectively, while the inter-train interval was fixed (5s) across runs. The evoked activity in SI (contralateral to the stimulated hand, and bilaterally for lips stimulation) was characterized from the best-fit dipoles of the response component peaking around 70 ms for the hand stimulation, and 8 ms earlier (on average) for the lips stimulation. The SOA-dependent long-term adaptation effects were assessed from the change in the amplitude of the responses to the first stimulus in each train. The short-term adaptation was characterized by the lifetime of an exponentially saturating model function fitted to the set of suppression ratios of the second relative to the first SI response in each train. Our results indicate: 1) the presence of a rate-dependent long-term adaptation effect induced only by the tactile stimulation of the digits; and 2) shorter recovery lifetimes for the digits compared with the lips stimulation.

Sensations evoked by microstimulation of single mechanoreceptive afferents innervating the human face and mouth

Intraneural microneurography and microstimulation were performed on single afferent axons in the inferior alveolar and lingual nerves innervating the face, teeth, labial, or oral mucosa. Using natural mechanical stimuli, 35 single mechanoreceptive afferents were characterized with respect to unit type [fast adapting type I (FA I), FA hair, slowly adapting type I and II (SA I and SA II), periodontal, and deep tongue units] as well as size and shape of the receptive field. All afferents were subsequently microstimulated with pulse trains at 30 Hz lasting 1.0 s. Afferents recordings whose were stable thereafter were also tested with single pulses and pulse trains at 5 and 60 Hz. The results revealed that electrical stimulation of single FA I, FA hair, and SA I afferents from the orofacial region can evoke a percept that is spatially matched to the afferent's receptive field and consistent with the afferent's response properties as observed on natural mechanical stimulation. Stimulation of FA afferents typically evoked sensations that were vibratory in nature; whereas those of SA I afferents were felt as constant pressure. These afferents terminate superficially in the orofacial tissues and seem to have a particularly powerful access to perceptual levels. In contrast, microstimulation of single periodontal, SA II, and deep tongue afferents failed to evoke a sensation that matched the receptive field of the afferent. These afferents terminate more deeply in the tissues, are often active in the absence of external stimulation, and probably access perceptual levels only when multiple afferents are stimulated. It is suggested that the spontaneously active afferents that monitor tension in collagen fibers (SA II and periodontal afferents) may have the role to register the mechanical state of the soft tissues, which has been hypothesized to help maintain the body's representation in the central somatosensory system.

Somatosensory gating is dependent on the rate of force recruitment in the human orofacial system

PURPOSE

Functional orofacial behaviors vary in their force endpoint and rate of recruitment. This study assessed the gating of orofacial cutaneous somatosensation during different cyclic lip force recruitment rates. Understanding how differences in the rate of force recruitment influences trigeminal system function is an important step toward furthering the knowledge of orofacial sensorimotor control.

METHOD

Lower lip vibrotactile detection thresholds (LL-VDTs) were sampled in response to sinusoidal inputs delivered to the lip vermilion at 5, 10, 50, and 150 Hz while adult participants engaged in a baseline condition (no force), 2 low-level lip force recruitment tasks differing by rate (0.1 Hz or 2 Hz), and passive displacement of the lip as a control to approximate the mechanosensory consequences of voluntary movement.

RESULTS

LL-VDTs increased significantly for test frequencies at or below 50 Hz during voluntary lip force recruitment. LL-VDT shifts were positively related to changes in the rate of lip force recruitment, whereas passively imposed displacements of the lip were ineffective in shifting LL-VDTs.

CONCLUSIONS

These findings are considered in relation to published reports of force-related sensory gating in orofacial and limb systems and the potential role of somatosensory gating along the trigeminal system during orofacial behaviors.

The human thalamic somatic sensory nucleus [ventral caudal (Vc)] shows neuronal mechanoreceptor-like responses to optimal stimuli for peripheral mechanoreceptors

Although the response of human cutaneous mechanoreceptors to controlled stimuli is well studied, it is not clear how these peripheral signals may be reflected in neuronal activity of the human CNS. We now test the hypothesis that individual neurons in the human thalamic principal somatic sensory nucleus [ventral caudal (Vc)] respond selectively to the optimal stimulus for one of the four mechanoreceptors. The optimal stimuli for particular mechanoreceptors were defined as follows: Pacinian corpuscles (PC), vibration at 128 Hz; rapidly adapting (RA), vibration at 32 or 64 Hz; slowly adapting type 1 (SA1), edge; slowly adapting type 2 (SA2), skin stretch. Nineteen neurons had a significant response to at least one optimal stimulus, and 17 had a significantly greater response to one stimulus than to the other three, including 7 PC-related, 7 RA-like, 3 SA1-like, and 2 SA2-like neurons. One of each of the SA1- and SA2-like thalamic neurons responded to vibration with firing rates that were lower than those to edge or stretch but not significantly. Except in the case of PC-related neurons, the receptive field (RF) sizes were larger for these thalamic neurons than for the corresponding mechanoreceptor. Von Frey thresholds were higher than those for the corresponding human RA and SA1 mechanoreceptors. These results suggest that there is a convergence of pathways transmitting input from multiple mechanoreceptors of one type on single thalamic neurons via the dorsal columns. They are also consistent with the presence of primate thalamic elements of modality and somatotopic isorepresentation.

From osseoperception to implant-mediated sensory-motor interactions and related clinical implications

Osseointegration of implants in the jaw bone has been studied thoroughly, dealing with various aspects such as bone apposition, bone quality, microbiology, biomechanics, aesthetics, etc. A key issue that has received much less attention is the physiologic integration of the implant(s) and the associated prosthesis in the body. The latter aspect is however very important to obtain new insights in oral functioning with implant-supported prostheses. Amputated patients rehabilitated with a lower limb prosthesis anchored to the bone by means of an osseointegrated implant, have reported that they could recognize the type of soil they were walking on. Clinical observations on patients with oral implants, have confirmed a special sensory perception skill. The underlying mechanism of this so-called 'osseoperception' phenomenon remains a matter of debate, because extraction of teeth involves elimination of the extremely sensitive periodontal ligaments while functional reinnervation around implants is still uncertain. Histological, neurophysiological and psychophysical evidence of osseoperception have been collected, making the assumption more likely that a proper peripheral feedback pathway can be restored when using osseointegrated implants. This implant-mediated sensory-motor control may have important clinical implications, because a more natural functioning with implant-supported prostheses can be attempted. It may open doors for global integration in the human body.

Microneurography as a tool in clinical neurophysiology to investigate peripheral neural traffic in humans

Microneurography is a method using metal microelectrodes to investigate directly identified neural traffic in myelinated as well as unmyelinated efferent and afferent nerves leading to and coming from muscle and skin in human peripheral nerves in situ. The present paper reviews how this technique has been used in clinical neurophysiology to elucidate the neural mechanisms of autonomic regulation, motor control and sensory functions in humans under physiological and pathological conditions. Microneurography is particularly important to investigate efferent and afferent neural traffic in unmyelinated C fibers. The recording of efferent discharges in postganglionic sympathetic C efferent fibers innervating muscle and skin (muscle sympathetic nerve activity; MSNA and skin sympathetic nerve activity; SSNA) provides direct information about neural control of autonomic effector organs including blood vessels and sweat glands. Sympathetic microneurography has become a potent tool to reveal neural functions and dysfunctions concerning blood pressure control and thermoregulation. This recording has been used not only in wake conditions but also in sleep to investigate changes in sympathetic neural traffic during sleep and sleep-related events such as sleep apnea. The same recording was also successfully carried out by astronauts during spaceflight. Recordings of afferent discharges from muscle mechanoreceptors have been used to understand the mechanisms of motor control. Muscle spindle afferent information is particularly important for the control of fine precise movements. It may also play important roles to predict behavior outcomes during learning of a motor task. Recordings of discharges in myelinated afferent fibers from skin mechanoreceptors have provided not only objective information about mechanoreceptive cutaneous sensation but also the roles of these signals in fine motor control. Unmyelinated mechanoreceptive afferent discharges from hairy skin seem to be important to convey cutaneous sensation to the central structures related to emotion. Recordings of afferent discharges in thin myelinated and unmyelinated fibers from nociceptors in muscle and skin have been used to provide information concerning pain. Recordings of afferent discharges of different types of cutaneous C-nociceptors identified by marking method have become an important tool to reveal the neural mechanisms of cutaneous sensations such as an itch. No direct microneurographic evidence has been so far proved regarding the effects of sympathoexcitation on sensitization of muscle and skin sensory receptors at least in healthy humans.

Mechanical frequency and stimulation-site-related differences in vibrotactile detection capacity along the lip vermilion in young adults

Accurate clinical assessment of the infraorbital and mental branch of the trigeminal nerve is aided by an appreciation of the variations in sensitivity that may exist along the surface of the perioral region under examination. The purpose of this investigation was to map the mediolateral spatial and frequency variations in vibrotactile detection capacity to inputs delivered to the upper lip (UL) and lower lip (LL) vermilion. Mechanical vibrotactile inputs at frequencies of 5, 10, 50, and 150 Hz were delivered to three locations on the vermilion of the UL and LL: midsagittally and laterally (left and right) at a point halfway between the midsagittal plane and the oral angle. An adapted staircase tracking method was used to converge upon a threshold value for each test frequency at each stimulation site. The results indicated that midsagittal vermilion sites were significantly more sensitive to our range of vibrotactile inputs compared to lateral vermilion locations. In addition, no significant differences in sensitivity as a function of laterality or between the UL and LL vermilion sites were noted. Greater midline sensitivity to vibrotactile stimulation suggests that receptive fields at this location may be of greater density and/or demonstrate greater overlap compared to lateral vermilion sites.

Changes in the perioral muscle responses to cortical TMS induced by decrease of sensory input and electrical stimulation to lower facial region

OBJECTIVE

To determine the changes in the motor cortex due to repetitive electrical stimulation and cutaneous anesthesia in lower facial region.

METHODS

A total of 11 subjects participated in the study of repetitive electrical stimulation, and 10 other subjects in the study of lower facial anesthesia. Facial nerve root and face associated cortical MEPs by transcranial magnetic stimulation (eight-shaped coil) were recorded from perioral muscles pre- and post- electrical stimulation and lower facial anesthesia. Cheek near to the corner of the mouth was transcutaneously stimulated by bipolar surface electrode giving repetitive electrical shocks at 5 Hz. Five percent lidocain/prilocain local anesthetic cream was applied to left or right lip-cheek region.

RESULTS

There was no significant change in perioral MEP responses after 10-30 min of 5 Hz electrical stimulation. We found a significant increase of amplitude in cortical MEP recordings during lower facial anesthesia especially in cases of cortical magnetic stimulations ipsilateral and contralateral to the anaesthetized side and in perioral recordings contralateral to the anaesthetized side.

CONCLUSIONS

The present study demonstrates that topical anesthesia to the lower facial region leads to cortical modulation and fast plastic changes in both hemispheres that are directed to the normal side.

A method for intraoperative microneurographic recording of unitary activity in the trigeminal ganglion of patients with trigeminal neuralgia

The etiology of trigeminal neuralgia appears to be vascular compression of the nerve at the root entry zone. However, the physiologic mechanism of trigeminal neuralgia remains uncertain. To gain insight into the pathophysiology of the disorder, we developed a method for intraoperative microneurographic recordings from the trigeminal ganglion of patients with trigeminal neuralgia. The recordings are performed immediately prior to standard percutaneous trigeminal gangliolysis for pain relief. Spontaneous or evoked single- and multi-unit action potential activity can be recorded and the location of receptive fields determined. The method should facilitate the testing of hypotheses concerning the origin of this unique pain disorder.

Microstimulation in the region of the human thalamic principal somatic sensory nucleus evokes sensations like those of mechanical stimulation and movement

We explored the region of human thalamic somatic sensory nucleus (ventral caudal, Vc), corresponding to monkey ventral posterior (VP), with threshold microstimulation (TMIS) during stereotactic procedures for the treatment of tremor. Of 122 sites in 116 patients (124 thalami) where mechanical (touch, pressure, and sharp) or movement [movement through the body (movement) and vibration] sensations were evoked, 72 sites were found in the core or in adjacent regions, posterior-inferior (33), inferior (4), and posterior to the core (13). Sites where TMIS evoked touch were less frequently found in the core than those where movement or pressure sensations were evoked. Pressure was more commonly (P < 0.05) evoked than vibration at sites where cells had intraoral receptive fields (RFs). Touch and vibration were more commonly (P < 0.05) evoked than pressure at sites where cells had facial RFs, consistent with the relative density of rapidly adapting (RA) receptors in the mouth and face. Sites described as deep and movement were found superior and anterior in the core, consistent with the location of cells responding to stimulation of muscle afferents. At 72 of 122 sites, TMIS evoked the same sensation at two or more sites in the same plane. Of these sites, 58 are adjacent to each other, in a cluster, consistent with studies of the localization of cells responding to different modalities. These results demonstrate that mechanical and movement sensations can be evoked by stimulation in the region of Vc. The characteristics of these sites suggest that the sensations are evoked by stimulation of pathways specific to cutaneous and deep mechanoreceptors.

Influence of object shape on responses of human tactile afferents under conditions characteristic of manipulation

Most objects that we grasp, lift and further manipulate are curved, with curvatures of the same order of magnitude as those of the fingertips. Tactile information pertaining to such 'gross' geometrical features of objects are used in the automatic control of fingertip actions. We analyzed responses from 172 human tactile afferents distributed over the entire terminal phalanx when spherically shaped surfaces were applied to a standard site on the fingertip; the curvatures and force magnitudes and directions used were representative of everyday manipulations. Nearly all SA-I, SA-II and FA-I afferents responded, and for more than 80% of these afferents the response intensity was correlated with curvature. The correlation was positive for approximately half the afferents and negative for the other half, resulting in a curvature contrast signal within the populations of tactile afferents; afferents terminating at the sides and end of the fingertip tended to show negative correlations. For nearly all afferents, curvature and force direction had interactive effects. Changing the direction of force affected an afferent's sensitivity to curvature and vice versa. We conclude that recognition of such shapes takes advantage of signals originating from tactile afferents distributed over the entire terminal phalanx, and that both the direction of fingertip forces and the curvatures of objects contacted during natural manipulations influence the afferents' responses. Consequently, if humans are able to perceive independently curvature and force direction from signals in tactile afferents, then the CNS must possess mechanisms that disentangle interactions between these and other parameters of stimuli on the fingertips.

Movement-related modulation of vibrotactile detection thresholds in the human orofacial system

By virtue of the direct coupling between circumoral skin and the underlying orofacial musculature, mechanosensation associated with precise orofacial force control may contribute significantly to processes associated with perception, proprioception, and sensorimotor control in this region. The purpose of this study was to assess lower lip (LL) vibratory detection thresholds of adult subjects during the simultaneous performance of a visually guided and continuous lip motor control task. Vibrotactile inputs were delivered to the right LL vermilion at test frequencies of 5, 10, 50, 150, 250, and 300 Hz. The psychophysical detection task was performed simultaneously with the three force control conditions: a null-force baseline condition, an active force control task performed with the right index finger, and an active force control task performed with the lip musculature. For the active tasks, subjects were instructed to use their analog force signal (lip or finger) to continuously perform a visually guided precision force task by tracking a 2 Hz sinusoidally moving target calibrated to a peak-to-peak force load of 0.2 N. Both the analog force signal and the target-tracking signal were displayed in real-time on an oscilloscope. Results showed a statistically significant elevation of LL vibrotactile detection thresholds for test frequencies below 50 Hz during the simultaneous performance of the lip force control task. Disassociating the site of motor control from the location of sensory stimulation (active control task) was effective in normalizing the elevations in LL vibrotactile thresholds, thus demonstrating that the threshold elevation during the lip force task was not solely an artifact of the added attentional load resulting from combining a perceptual task with a motor control requirement. These findings are discussed in relation to published reports of movement-related sensory gating in limb systems and the possible significance that this phenomenon may have for perception and proprioception in the orofacial system.

Stretch sensitivity of cutaneous afferent neurons

Experiments were done to characterize responses to stretch and to determine what stretch-related mechanical variables are most closely associated with stretch. Cutaneous afferent neurons were recorded using an in vitro preparation of rat hairy skin. SA2 afferents and mechanically sensitive C afferents were studied using static stretch stimuli in which the skin was stretched along different directions. RA afferents were studied using uniaxial, dynamic stimuli. Both applied loads and skin deformations were recorded; they were used to calculate tensile stresses and strains, respectively. SA2 afferents were highly directionally sensitive and had low thresholds for activation. Their responses to static stimuli were closely related to tissue stress and poorly related to strain. C mechanoreceptors lacked directional selectivity, and had thresholds for activation that were similar to SA2s. Their responses to static stretch were more strongly related to stress than to strain variables. The main focus of this chapter is RA afferents. It was possible to apply powerful methods for determining the relationship between RA responses and cutaneous stresses and strains. RA responses were strongly driven by rate of change of stress, with a very small contribution from the static component of stress. There were strong memory effects. The strongest influence on RA afferents was by the rate of change of stress approximately 30 msec prior to the occurrence of a spike.

Orofacial mechanoreceptors in humans: encoding characteristics and responses during natural orofacial behaviors

We used microneurography to characterize stimulus-encoding properties of low-threshold mechanoreceptive afferents in human orofacial tissues. Signals were recorded from single afferents in the infraorbital, lingual and inferior alveolar nerves while localized, controlled, mechanical stimuli were delivered to the facial skin, lips, oral mucosa and teeth. We likewise analyzed activity in these afferents during orofacial behaviors such as speech, chewing and biting. The afferents in the soft tissues functionally resemble four types described in the human hand: hair follicle afferents, slowly adapting (SA) type I and type II afferents and fast adapting (FA) type I afferents. Afferents in the facial skin, lips and buccal mucosa respond not only to contact with environmental objects, but also to contact between the lips, changes in air pressure generated for speech sounds, and to facial skin and mucosa deformations that accompany lip and jaw movements associated with chewing and swallowing. Hence, in addition to exteroceptive information, these afferents provide proprioceptive information. In contrast, afferents terminating superficially in the tongue do not signal proprioceptive information about tongue movements in this manner. They only respond when the receptive field is brought into contact with other intraoral structures or objects, e.g. the teeth or food. All human periodontal afferents adapt slowly to maintained tooth loads. Populations of periodontal afferents encode information about both which teeth are loaded and the direction of forces applied to individual teeth. Most afferents exhibit a markedly curved relationship between discharge rate and force amplitude, featuring the highest sensitivity to changes in tooth load at low forces (below 1 N). Accordingly, periodontal afferents efficiently encode tooth load when subjects first contact, hold, and gently manipulate food by the teeth. In contrast, only a minority of the afferents encodes the rapid and strong force increase generated when biting through food. We conclude, that humans use periodontal afferent signals to control jaw actions associated with intraoral manipulation of food rather than exertion of jaw power actions.

Mechanically evoked perioral reflexes in premature and term human infants

Neurophysiological assessment of the preterm human neonatal oromotor system has been limited due to their fragile medical state, and methodological limitations. A new, noninvasive technology known as the actifier was developed and used to evoke perioral motor unit activity during non-nutritive suck in preterm infants. A significant ontologic trend for the early component of the perioral reflex (R1) was discovered in the context of spontaneous, centrally-patterned oromotor behavior.

Unmyelinated afferents constitute a second system coding tactile stimuli of the human hairy skin

Impulses were recorded from unmyelinated afferents innervating the forearm skin of human subjects using the technique of microneurography. Units responding to innocuous skin deformation were selected. The sample (n = 38) was split into low-threshold units (n = 27) and high-threshold units (n = 11) on the basis of three distinctive features, i.e., thresholds to skin deformation, size of response to innocuous skin deformation, and differential response to sharp and blunt stimuli. The low-threshold units provisionally were denoted tactile afferents on the basis of their response properties, which strongly suggest that they are coding some feature of tactile stimuli. They exhibited, in many respects, similar functional properties as described for low-threshold C-mechanoreceptive units in other mammals. However, a delayed acceleration, not previously demonstrated, was observed in response to long-lasting innocuous indentations. It was concluded that human hairy skin is innervated by a system of highly sensitive mechanoreceptive units with unmyelinated afferents akin to the system previously described in other mammals. The confirmation that the system is present in the forearm skin and not only in the face area where it first was identified suggests a largely general distribution although there are indications that the tactile C afferents may be lacking in the very distal parts of the limbs. The functional role of the system remains to be assessed although physiological properties of the sense organs invite to speculations that the slow tactile system might have closer relations to limbic functions than to cognitive and motor functions.

Responses of rapidly adapting afferent neurons to dynamic stretch of rat hairy skin

Twenty-four rapidly adapting (RA) cutaneous afferents were recorded from a preparation of isolated, innervated hairy skin from the rat hindlimb for the purpose of identifying the mechanical variables associated with the initiation of afferent discharge. Neurons were studied while the skin was stretched dynamically along a single direction with the use of a linear actuator and a feedback controller. Input signals were load- or displacement-controlled stretches that followed either periodic or pseudorandom Gaussian noise control signals. When the tissue was actuated, loads and displacements were measured along the direction of stretch and neuronal responses were recorded. All RA afferents were activated by dynamic stretching. None had a sustained response to static stretch. Cross-correlation products, calculated between neuronal responses and either stress- or strain-related variables observed at the time of the spike, revealed a strong relationship between neuronal responses and tensile stress. Neuronal responses were observed at rates of change of stress between +1,000 and -800 kPa/s. Neuronal responses were poorly related to skin strain. Two loading conditions were used along the direction transverse to the stretch. In one condition the sides were unconstrained, so that on axial loading there was zero stress and negative strain along the transverse axis. In the other condition the sides were constrained so that when the tissue was loaded axially there was zero strain and positive stress along the transverse axis. In these two conditions the same level of axial stress was associated with two levels of axial strain. The neuronal responses were determined by the stress and not the strain. Neuronal responses were observed at stresses >5 kPa. It appears that RA afferents make little contribution to signaling limb movements or position in rat hindlimb on the basis of the behavior of rat hindlimb skin, as observed when the limb is rotated.

The methodology and scope of human microneurography

Microneurography was introduced in 1967 and has developed into an invaluable tool for investigating human somatosensory, motor and cardiovascular physiology and pathophysiology. It involves percutaneous insertion of a metal microelectrode into fascicles of limb and facial nerves. This review covers the procedures and equipment necessary for microneurography and provides a current circuit for a preamplifier. Evidence is presented that (i) most recordings from myelinated axons involve an effective penetration of the myelin by the electrode; (ii) based on physiological criteria, microstimulation through the electrode can be used to activate single axons although the probability of this is relatively low and (iii) despite 'micro' lesions caused by the electrode insertion into the nerve and its fascicles, the morbidity with the procedure is acceptably low.

Low-threshold mechanoreceptive afferents in the human lingual nerve

Intrafascicular multiunit activity and impulses in single mechanoreceptive afferents were recorded from the human lingual nerve with permucosally inserted tungsten microelectrodes. Nylon filaments and blunt glass probes were used for mechanical stimulation of the mucosa of the dorsal surface of the tongue. The innervation territories of nine nerve fascicles were mapped during multiunit recordings. All fascicle fields included the tip of the tongue, suggesting a particularly high innervation density for this area. Thirty-three single mechanoreceptive afferents were isolated and studied. Of these afferents, 22 were characterized by very small mucosal receptive fields (range: 1-19.6 mm2; geometric mean: 2.4 mm2) and responded to extremely low mechanical forces (force threshold range: 0.03-2 mN; geometric mean: 0.15 mN). As such, it was concluded that these "superficial" units terminated near the surface of the tongue. The remaining 11 units responded to probing of large areas of the tongue (> 200 mm2) and exhibited high force thresholds (> or = 4 mN). It was concluded that these "deep" units terminated in the muscle mass of the tongue. Fourteen of the superficial units were classified as rapidly adapting and resembled the fast-adapting type I afferents described for the glabrous skin of the human hand. The rapidly adapting units responded both during the application and removal of, but not during maintenance of, the mechanical stimuli on the receptive field. Two types of slowly adapting responses were observed. One type (characteristic of only 2 units) was characterized by a pronounced sensitivity to force change during the application and removal of the mechanical stimuli and an irregular static discharge during maintenance of the stimulus on the receptive field. In contrast, the other six units exhibited a weak sensitivity to force change, a highly regular static discharge, and spontaneous activity. As such, these two types of slowly adapting units resembled the slowly adapting I and II afferents, respectively, described for the hand. All 11 deep units were slowly adapting, and 7 were, in addition, spontaneously active. The units were not equally sensitive to the application and removal of the mechanical stimuli, suggesting at least two different modes of termination in tongue muscle. The deep units reliably encoded information about tongue movements in the absence of direct contact with the receptive field. In contrast, the superficial units responded vigorously when the tongue was moved to bring the receptive field into physical contact with other intraoral structures.

Rapid astroglial reactions in the motor cortex of adult rats following peripheral facial nerve lesions

We report on changes in the motor cortex of adult rats that rapidly and transiently followed various types of facial nerve lesions. These reactions led to enhanced immunoreactivities of various astroglial markers: S-100 protein (a Ca2+- and Zn2+-binding protein predominantly located in the cytosol of astrocytes), glial fibrillary acidic protein (a cytoskeletal protein) and connexin 43 (the astroglial gap junction protein). Reactions could be visualized 1 h after the facial nerve lesion and disappeared within about 5 days after surgery. Combined lesions of the facial and trigeminal nerves modified the spatial pattern of the astroglial reaction, similar to intramuscular injections of botulinum toxin, which inhibits the release of acetylcholine in motor endplates. Data presented suggest that peripheral interference with muscular functions rapidly induces modifications in the motor cortex.

Mechanosensory modulation of perioral neuronal groups during active force dynamics

The spatiotemporal organization of the mechanically evoked perioral sensorimotor response was sampled from five normal females using a custom-designed linear motor operating under force feedback. Electromyographic activity was sampled from the superior and inferior segments of the orbicularis oris muscle during the production of a visually guided ramp-and-hold lip-rounding task. Brief mechanical inputs of approximately 0.45 N delivered to the left upper lip during the ramp-and-hold task produced a composite myogenic response characterized by phases of excitation and suppression. Modulation of the primary excitatory component (R1) of the mechanically evoked perioral response was found to be highly dependent upon the rate of force recruitment (1 N/s vs. 4 N/s) and the phase of force recruitment (20% vs. 50% vs. 80% of 1 N end-point force). Modulation of later occurring inhibitory (S1) and excitatory (R2) potentials were also found to be dependent upon differences in the rate and phase of force recruitment. The organization of the perioral sensorimotor response is considered in relation to speech motor control and the dynamic organization of neuronal groups subserving perioral sensorimotor activity.

Comparison of perioral reflex modulation in the upper and lower lip

The spatiotemporal organization and specificity of the mechanically evoked, short latency perioral response (R1) was sampled from a group of normal adult humans. Perioral reflex activity was sampled during passive and active static force conditions in the presence of servo-controlled mechanical inputs to lip vermilion. Results confirmed that the sensorimotor apparatus of the lower face is very responsive to low level mechanical inputs and highly dependent on several factors including input site (upper vs. lower lip), amount of glabrous tissue stimulated (contactor array size), and task dynamics (passive vs. active subject-generated lip force). Arguments are presented to support the idea that several features of the peripheral sensory environment encoded by primary trigeminal afferents, including afferent gain, specificity, locus, and spatial summation, collectively provide inputs vital to higher order sensory relays in the development of a central representation and dynamic conformational map of perioral space. These sensorimotor features encoded by trigeminal afferents are presumed important for motor learning and maintenance of oromotor control during speech, suck, mastication and swallow, and gesture.

Receptive field characteristics of tactile units with myelinated afferents in hairy skin of human subjects

1. Impulses in single nerve fibres from the lateral antebrachial cutaneous nerve were recorded using the microneurography technique in human subjects. 2. In a sample of fifty-five mechanoreceptive units with fast-conducting nerve fibres, five types were identified, i.e. SAI (slowly adapting type I, Merkel), SAII (slowly adapting type II, Ruffini), hair units, field units and Pacinian-type units. The latter three unit types were all rapidly adapting. 3. The detailed structure of thirty-five receptive fields of SAI, SAII, hair and field units was explored with a method which was objective and independent of the experimenter's skill and experience. A lightweight probe was used to scan the receptive field area in a series of tracks 0.23 mm apart while single-unit activity was recorded. 4. SAI fields were small and composed of two to four well-separated high-sensitivity spots and often, in addition, one minor spot of lower sensitivity. SAII units typically fired spontaneously at a low and regular rate. Most fields consisted of one single spot of high sensitivity with diffuse borders. The hair units innervated ten to thirty-three (or more) hairs, which were evenly distributed over a large area. The field units were characterized by a number of small and closely packed high-sensitivity spots with diffuse borders. A conservative estimate indicated eleven spots per unit. 5. The findings indicate that the sheet of mechanoreceptors on the skin of the forearm is distinctly different from that on the dorsum of the hand and in the face. It seems reasonable to assume that the former is more representative for the hairy skin covering the main parts of the body.

Intrafascicular recordings of afferent multi-unit activity from the human supraorbital nerve

Intrafascicular recordings of afferent multi-unit activity were obtained from the supraorbital nerve in 40 healthy human volunteers, using tungsten micro-electrodes inserted percutaneously at the eyebrow. Seventy-seven fascicular receptive fields were mapped; their area ranged from 2 to 76 cm2, with a median of 19 cm2. The smallest fields were found in the eyebrow region, and the largest on the scalp. In response to non-painful electrical intradermal stimulation, the conduction velocity of the fastest nerve fibres was calculated to be 40 +/- 2 m s-1 (mean +/- SEM), and the later part of the afferent volley corresponded to a velocity of 20 +/- 1 m s-1. The responses to skin indentation indicated that the density of mechanoreceptive innervation was higher in the lower part of the forehead than in the upper/posterior part of the innervation territory of the nerve. A rapid mechanical tap on the forehead and scalp evoked two major afferent volleys corresponding to the on- and off-phase of the stimulus. Manipulation of hairs resulted not only in dynamic responses to hair movement, but also in a static discharge during sustained hair displacement. When a fascicular field included the eyebrow region, skin stretching during blinking movements evoked distinct afferent activity. Following mechanical and electrical stimuli there were no signs of 'trigeminal antidromic potentials' of the type described in the cat and monkey.

Responsiveness of single afferents in the infraorbital nerve to oral air pressures generated by consonants

The responsiveness of receptors supplying the oral mucosa to air pressures generated during consonant production was investigated to obtain information about hypothetical mechanisms underlying speech deficits. The delay between the onset of the neural discharge and the pop puff of phonation (mouth-exist pressure) for /pa/ production was significantly shorter and less variable than it was for /ta/ and /ka/ production, suggesting that the discharge is more closely coupled to the onset of /pa/ production. The data were interpreted to imply that single fibers of the infraorbital nerve respond to the build-up of oral air pressure during /pa/ production. This, and similar sensory information, may be used by the central neural mechanisms which monitor and control the air pressures required for phonation.

Microneurography and applications to issues of motor control: Fifth Annual Stuart Reiner Memorial Lecture

Among the hypotheses regarding fusimotor functions based on earlier animal experiments some are inconsistent, others are in conformity with microneurographic observations in man. The human data provide evidence against the following two theories: (1) the length follow-up servo theory; and (2) the theory that fusimotor neurons can be selectively activated to produce spindle sensitization and stretch reflex reinforcements. The human data support the theory of alpha-gamma coactivation. In particular, in the early phase of isometric voluntary contractions fusimotor-driven afferent spindle activity assists in autogenetic activation of alpha motoneurons and in reciprocal relaxation of antagonists. As muscle fatigue develops, the autogenetic reflex drive via the fusimotor route declines. The fusimotor bias during contraction provides for maintenance of spindle sensitivity to minute perturbations and for load-compensating reflex adjustments to such perturbations. Reflex overcorrections may lead to uncontrollable oscillations of the type seen in enhanced physiological tremor.

Low-threshold mechanoreceptive and nociceptive units with unmyelinated (C) fibres in the human supraorbital nerve

1. In recordings from the human supraorbital nerve with tungsten microelectrodes, eleven afferent units with unmyelinated (C) axons were identified on the basis of their conduction velocities (0.6-1.4 m/s). 2. Eight units had low mechanical thresholds (less than or equal to 0.23 g) and could be activated up to their maximal firing rates of about 100 impulses/s by weak tactile stimuli, whereas three units had higher thresholds (5.5 g) and responded vigorously to noxious stimuli only. 3. During a skin indentation the low-threshold units adapted to an irregular low-frequency discharge, and release of the stimulus elicited a prominent off-response often ending with an after-discharge. Slow stroking was a particularly effective stimulus, even when done with cotton wool, whereas rapid stroking reduced the response. All types of stroking stimuli were occasionally followed by after-discharges. Repeated mechanical stimulation at short intervals resulted in a decline of the response, indicating receptor fatigue. For two units a response to skin cooling was observed. 4. The above low-threshold C units have all the main characteristics of the C mechanoreceptors known from the cat and primates but not previously proven to exist in man. The high-threshold C units are similar to the polymodal nociceptors found in other human skin areas.