Relative roles of spatial and intensive cues in the discrimination of spatial tactile stimuli

Biological sex influences psychological aspects of the biopsychosocial model related to chronic pain intensity and interference among South Korean patients with chronic secondary musculoskeletal pain in rheumatic diseases

Introduction

Pain is a prominent contributor to negative personal and social outcomes, including increased disability and mortality, in many rheumatic diseases. In the Biopsychosocial model of chronic pain, psychological and social factors share roles with the biology of the injury in determining each patient's pain and suffering. The current study explored factors associated with clinical pain intensity and interference among patients with chronic secondary musculoskeletal pain in rheumatic diseases.

Methods

In total, 220 patients experiencing chronic secondary musculoskeletal pain participated. Biological factors (age, biological sex, pain condition, pain duration, pain sensitivity, and comorbidity), socio-economic factors, psychological factors (pain catastrophizing and depressive symptoms), and pain intensity and interference were measured. Descriptive, multivariable linear regression and partial correlation analyses were conducted. Subgroup analysis by sex was conducted to examine differences in how different factors affect the pain experience.

Results

The mean age of the participants was 52.3 years (SD = 12.07) and ranged from 22 to 78. Average pain intensity was 3.01 (0-10 scale) and average total pain interference score was 21.07 (0-70 scale). Partial correlation found positive correlations between pain intensity and interference with depression (intensity: R = 0.224; p = 0.0011; interference: R = 0.351; p < 0.001) and pain catastrophizing (intensity: R = 0.520; p < 0.001; interference: R = 0.464; p < 0.001). In males, pain condition (β = -0.249, p = 0.032) and pain catastrophizing (R = 0.480, p < 0.001) were associated with pain intensity. In males, the simple correlation between pain intensity and depression (R = 0.519; p < 0.001) was driven by pain catastrophizing. In females, pain catastrophizing (R = 0.536, p < 0.001) and depressive symptoms (R = 0.228, p = 0.0077) were independently associated with pain intensity. Age (β = -0.251, p = 0.042) and pain catastrophizing (R = 0.609, p < 0.001) were associated with pain interference in males, while depressive symptoms (R = 0.439, p < 0.001) and pain catastrophizing (R = 0.403, p < 0.001) were associated with pain interference in females. Again, in males, the simple correlation between pain interference and depression (R = 0.455; p < 0.001) was driven by pain catastrophizing.

Discussion

In this study, females were more directly affected by depressive symptoms than males, regarding pain intensity and interference. Pain catastrophizing was a significant factor influencing chronic pain for both males and females. Based on these findings, a sex-specific approach to the Biopsychosocial model should be considered in understanding and managing pain among Asians with chronic secondary musculoskeletal pain.

Intact tactile anisotropy despite altered hand perception in complex regional pain syndrome: rethinking the role of the primary sensory cortex in tactile and perceptual dysfunction

Complex Regional Pain Syndrome (CRPS) is characterised by pain, autonomic, sensory and motor abnormalities. It is associated with changes in the primary somatosensory cortex (S1 representation), reductions in tactile sensitivity (tested by two-point discrimination), and alterations in perceived hand size or shape (hand perception). The frequent co-occurrence of these three phenomena has led to the assumption that S1 changes underlie tactile sensitivity and perceptual disturbances. However, studies underpinning such a presumed relationship use tactile sensitivity paradigms that involve the processing of both non-spatial and spatial cues. Here, we used a task that evaluates anisotropy (i.e., orientation-dependency; a feature of peripheral and S1 representation) to interrogate spatial processing of tactile input in CRPS and its relation to hand perception. People with upper limb CRPS (n = 14) and controls with (n = 15) or without pain (n = 19) judged tactile distances between stimuli-pairs applied across and along the back of either hand to provide measures of tactile anisotropy. Hand perception was evaluated using a visual scaling task and questionnaires. Data were analysed with generalised estimating equations. Contrary to our hypotheses, tactile anisotropy was bilaterally preserved in CRPS, and the magnitude of anisotropic perception bias was comparable between groups. Hand perception was distorted in CRPS but not related to the magnitude of anisotropy or bias. Our results suggest against impairments in spatial processing of tactile input, and by implication S1 representation, as the cause of distorted hand perception in CRPS. Further work is warranted to elucidate the mechanisms of somatosensory dysfunction and distorted hand perception in CRPS.

Detection of Simulated Tactile Gratings by Electro-Static Friction Show a Dependency on Bar Width for Blind and Sighted Observers, and Preliminary Neural Correlates in Sighted Observers

The three-dimensional micro-structure of physical surfaces produces frictional forces that provide sensory cues about properties of felt surfaces such as roughness. This tactile information activates somatosensory cortices, and frontal and temporal brain regions. Recent advances in haptic-feedback technologies allow the simulation of surface micro-structures via electro-static friction to produce touch sensations on otherwise flat screens. These sensations may benefit those with visual impairment or blindness. The primary aim of the current study was to test blind and sighted participants' perceptual sensitivity to simulated tactile gratings. A secondary aim was to explore which brain regions were involved in simulated touch to further understand the somatosensory brain network for touch. We used a haptic-feedback touchscreen which simulated tactile gratings using digitally manipulated electro-static friction. In Experiment 1, we compared blind and sighted participants' ability to detect the gratings by touch alone as a function of their spatial frequency (bar width) and intensity. Both blind and sighted participants showed high sensitivity to detect simulated tactile gratings, and their tactile sensitivity functions showed both linear and quadratic dependency on spatial frequency. In Experiment 2, using functional magnetic resonance imaging, we conducted a preliminary investigation to explore whether brain activation to physical vibrations correlated with blindfolded (but sighted) participants' performance with simulated tactile gratings outside the scanner. At the neural level, blindfolded (but sighted) participants' detection performance correlated with brain activation in bi-lateral supplementary motor cortex, left frontal cortex and right occipital cortex. Taken together with previous studies, these results suggest that there are similar perceptual and neural mechanisms for real and simulated touch sensations.

Interhemispheric transfer of post-amputation cortical plasticity within the human somatosensory cortex

Animal models reveal that deafferenting forelimb injuries precipitate reorganization in both contralateral and ipsilateral somatosensory cortices. The functional significance and duration of these effects are unknown, and it is unclear whether they also occur in injured humans. We delivered cutaneous stimulation during functional magnetic resonance imaging (fMRI) to map the sensory cortical representation of the intact hand and lower face in a group of chronic, unilateral, upper extremity amputees (N = 19) and healthy matched controls (N = 29). Amputees exhibited greater activity than controls within the deafferented former sensory hand territory (S1f) during stimulation of the intact hand, but not of the lower face. Despite this cortical reorganization, amputees did not differ from controls in tactile acuity on their intact hands. S1f responses during hand stimulation were unrelated to tactile acuity, pain, prosthesis usage, or time since amputation. These effects appeared specific to the deafferented somatosensory modality, as fMRI visual mapping paradigm failed to detect any differences between groups. We conclude that S1f becomes responsive to cutaneous stimulation of the intact hand of amputees, and that this modality-specific reorganizational change persists for many years, if not indefinitely. The functional relevance of these changes, if any, remains unknown.

To Improve Your Surgical Drilling Skills, Make Use of Your Index Fingers

BACKGROUND

Surgery has greatly benefited from various technologic advancements over the past decades. Surgery remains, however, mostly manual labor performed by well-trained surgeons. Little research has focused on improving osseous drilling techniques. The objective of this study was to compare the accuracy and precision of different orthopaedic drilling techniques involving the use of both index fingers.

QUESTIONS/PURPOSES

(1) Does the shooting grip technique and aiming at the contralateral index finger improve accuracy and precision in drilling? (2) Is the effect of drilling technique on accuracy and precision affected by the experience level of the performer?

METHODS

This study included 36 participants from two Dutch training hospitals who were subdivided into three groups (N = 12 per group) based on their surgical experience (that is, no experience, residents, and surgeons). The participants had no further experience with drilling outside the hospital nor were there other potential confounding variables that could influence the test outcomes. Participants were instructed to drill toward a target exit point on a synthetic bone model. There were four conditions: (1) clenched grip without aiming; (2) shooting grip without aiming; (3) clenched grip with aiming at the contralateral index finger; and (4) shooting grip aiming at the contralateral index finger. Participants were only used to a clenched grip without aiming in clinical practice. Each participant had to drill five times per technique per test, and the test was repeated after 4 weeks. Accuracy was defined as the systematic error of all measurements and was calculated as the mean of the five distances between the five exit points and the target exit point, whereas precision was defined as the random error of all measurements and calculated as the SD of those five distances. Accuracy and precision were analyzed using mixed-design analyses of variance.

RESULTS

Accuracy was highest when using a clenched grip with aiming at the index finger (mean 4.0 mm, SD 1.1) compared with a clenched grip without aiming (mean 5.0 mm, SD 1.2, p = 0.004) and a shooting grip without aiming (mean 4.9 mm, SD 1.4, p = 0.015). The shooting grip with aiming at the index finger (mean 4.1 mm, SD 1.2) was also more accurate than a clenched grip without aiming (p = 0.006) and a shooting grip without aiming (p = 0.014). Shooting grip with aiming at the opposite index finger (median 2.0 mm, interquartile range [IQR] 1.2) showed the best precision and outperformed a clenched grip without aiming (median 2.9 mm, IQR 1.1, p = 0.016), but was not different than the shooting grip without aiming (median 2.2 mm, IQR 1.4) or the clenched grip with aiming (median 2.4 mm, IQR 1.3). The accuracy of surgeons (mean 4.1 mm, SD 1.1) was higher than the inexperienced group (mean 5.0 mm, SD 1.1, p = 0.012). The same applied for precision (median 2.2 mm, IQR 1.0 versus median 2.8 mm, IQR 1.4, p = 0.008).

CONCLUSIONS

A shooting grip combined with aiming toward the index finger of the opposite hand had better accuracy and precision compared with a clenched grip alone. Based on this study, experience does matter, because the orthopaedic surgeons outperformed the less experienced participants. Based on our study, we advise surgeons to aim at the index finger of the opposite hand when possible and to align the ipsilateral index finger to the drill bit.

LEVEL OF EVIDENCE

Level II, therapeutic study.

Changes in Tactile Function During Intensive Bimanual Training in Children With Unilateral Spastic Cerebral Palsy

Recently, an intensive bimanual intervention using sensory enriched materials resulted in improved tactile function in children with unilateral spastic cerebral palsy (USCP), raising the question of whether the observed tactile function improvement was due to the sensory enriched environment or the bimanual intervention per se. The present study investigates whether a bimanual intensive intervention improves tactile function. Nineteen children with USCP received 90 hours of bimanual training without enriched environment. Primary outcomes: Manual Form Perception Test/MFPT, Grating Orientation Task/GOT. Children were assessed before, after the training, and at the 4-month follow-up. Significant improvements were observed in MFPT for the more affected hand ( P = .015). Larger stereognosis/MFPT improvements correlated with poorer baseline motor function. Intensive bimanual training alone was sufficient to improve stereognosis, though no improvement in GOT was observed. Present and previously published findings suggest that environmental tactile enrichment incorporated into a bimanual motor training may be needed to improve spatial discrimination/GOT in children with USCP.

Does somatosensation change with age in children and adolescents? A systematic review

BACKGROUND

Somatosensory modalities, such as touch, proprioception and haptic ability, greatly influence the achievement of developmental milestones for children. Describing somatosensory impairment, natural variability and typical or expected developmental changes across age groups will help establish frameworks for intervention in clinical populations. This systematic review aimed to determine how different somatosensory modalities develop across childhood into adolescence to use as a point of reference for children at risk of somatosensory impairment.

METHODS

Searches of five electronic databases were undertaken through EBSCO-host (MEDLINE, CINAHL, PsycINFO, SPORTDiscus and ERIC) for studies measuring at least one somatosensory modality in typically developing individuals between birth and 18 years and analysed by age. Characteristics of studies were collected including country of origin, sample size, demographics and outcome measure used. Quality assessment and data extraction were performed by two independent reviewers.

RESULTS

Twenty three cross-sectional studies were included from a total of 188 articles retrieved: 8 examined aspects of touch, 5 proprioception and 10 haptic ability. Variability of study designs and variation in assessment tools precluded any formal meta-analysis.

CONCLUSIONS

Somatosensation matures through childhood into adolescence; however, the present review found the pattern of somatosensory development varied depending on the assessment tool used and the aspect of somatosensation being measured, making it difficult to describe typical performance. There is a need for comprehensive assessment batteries to measure the somatosensation, including touch, proprioception and haptic ability, of children at risk of somatosensory impairment to aid in the development of effective interventions.

Two-point orientation discrimination versus the traditional two-point test for tactile spatial acuity assessment

Two-point discrimination is widely used to measure tactile spatial acuity. The validity of the two-point threshold as a spatial acuity measure rests on the assumption that two points can be distinguished from one only when the two points are sufficiently separated to evoke spatially distinguishable foci of neural activity. However, some previous research has challenged this view, suggesting instead that two-point task performance benefits from an unintended non-spatial cue, allowing spuriously good performance at small tip separations. We compared the traditional two-point task to an equally convenient alternative task in which participants attempt to discern the orientation (vertical or horizontal) of two points of contact. We used precision digital readout calipers to administer two-interval forced-choice versions of both tasks to 24 neurologically healthy adults, on the fingertip, finger base, palm, and forearm. We used Bayesian adaptive testing to estimate the participants’ psychometric functions on the two tasks. Traditional two-point performance remained significantly above chance levels even at zero point separation. In contrast, two-point orientation discrimination approached chance as point separation approached zero, as expected for a valid measure of tactile spatial acuity. Traditional two-point performance was so inflated at small point separations that 75%-correct thresholds could be determined on all tested sites for fewer than half of participants. The 95%-correct thresholds on the two tasks were similar, and correlated with receptive field spacing. In keeping with previous critiques, we conclude that the traditional two-point task provides an unintended non-spatial cue, resulting in spuriously good performance at small spatial separations. Unlike two-point discrimination, two-point orientation discrimination rigorously measures tactile spatial acuity. We recommend the use of two-point orientation discrimination for neurological assessment.

Tactile roughness discrimination of the finger pad relies primarily on vibration sensitive afferents not necessarily located in the hand

This study aims to investigate the relative contribution of remote mechanoreceptors to perception of roughness and spatial acuity. We examined two unilateral pathological conditions affecting differently innervation of the index finger: unilateral carpal tunnel syndrome (n=12) and surgically repaired complete traumatic median nerve section at the wrist following surgical repair (n=4). We employed a control condition consisting of ring-block anesthesia of the entire index in 10 healthy subjects to model pathological denervation of the fingertip. Spatial acuity and the ability to discern roughness were assessed using a grating orientation task and a roughness discrimination task, respectively. In patients with carpal tunnel syndrome, we observed a significant reduction of spatial resolution acuity but an intact ability to discriminate roughness with the fingertip. For patients with traumatic median nerve section there was no recovery with the grating orientation task up to 20 months post surgery but a progressive and full recovery with the roughness discrimination task between 6 and 9 months. Finally, in the anesthetic ring bloc group, the nerve block completely disrupted performances in grating orientation task, but unexpectedly left unaffected performances in the roughness discrimination task. Taken together, these lines of evidence support the view that the neural mechanisms underlying tactile roughness discrimination differ from those involved in spatial resolution acuity. Vibrotaction is necessary and sufficient for the perception of fine textures and, when the innervation of the fingerpad is compromised, information about textures can be captured and encoded by remote mechanoreceptors located in more proximal tissues where the innervation is intact.

Tactile spatial acuity enhancement in blindness: evidence for experience-dependent mechanisms

Tactile spatial acuity is enhanced in blindness, according to several studies, but the cause of this enhancement has been controversial. Two competing hypotheses are the tactile experience hypothesis (reliance on the sense of touch drives tactile-acuity enhancement) and the visual deprivation hypothesis (the absence of vision itself drives tactile-acuity enhancement). Here, we performed experiments to distinguish between these two hypotheses. We used force-controlled grating orientation tasks to compare the passive (finger stationary) tactile spatial acuity of 28 profoundly blind and 55 normally sighted humans on the index, middle, and ring fingers of each hand, and on the lips. The tactile experience hypothesis predicted that blind participants would outperform the sighted on the fingers, and that Braille reading would correlate with tactile acuity. The visual deprivation hypothesis predicted that blind participants would outperform the sighted on fingers and lips. Consistent with the tactile experience hypothesis, the blind significantly outperformed the sighted on all fingers, but not on the lips. Additionally, among blind participants, proficient Braille readers on their preferred reading index finger outperformed nonreaders. Finally, proficient Braille readers performed better with their preferred reading index finger than with the opposite index finger, and their acuity on the preferred reading finger correlated with their weekly reading time. These results clearly implicate reliance on the sense of touch as the trigger for tactile spatial acuity enhancement in the blind, and suggest the action of underlying experience-dependent neural mechanisms such as somatosensory and/or cross-modal cortical plasticity.

Diminutive digits discern delicate details: fingertip size and the sex difference in tactile spatial acuity

We have observed that passive tactile spatial acuity, the ability to resolve the spatial structure of surfaces pressed upon the skin, differs subtly but consistently between the sexes, with women able to perceive finer surface detail than men. Eschewing complex central explanations, we hypothesized that this sex difference in somatosensory perception might result from simple physical differences between the fingers of women and men. To investigate, we tested 50 women and 50 men on a tactile grating orientation task and measured the surface area of the participants' index fingertips. In subsets of participants, we additionally measured finger skin compliance and optically imaged the fingerprint microstructure to count sweat pores. We show here that tactile perception improves with decreasing finger size, and that this correlation fully explains the better perception of women, who on average have smaller fingers than men. Indeed, when sex and finger size are both considered in statistical analyses, only finger size predicts tactile acuity. Thus, a man and a woman with fingers of equal size will, on average, enjoy equal tactile acuity. We further show that sweat pores, and presumably the Merkel receptors beneath them, are packed more densely in smaller fingers.

Tactile roughness discrimination threshold is unrelated to tactile spatial acuity

The present study examined the relationship between the tactile roughness discrimination threshold (TRDT) and the tactile spatial resolution threshold (TSRT) at the index fingertip in humans. A new device was built for measuring TRDT, allowing pair-wise presentations of two sets of six different sandpaper grits. The smoothest grits ranged from 18 to 40 microm and the roughest grits ranged from 50 to 195 microm particle size. The reference sandpaper had a 46 microm particle size. A two-alternative forced choice paradigm and a double interlaced adaptive staircase procedure yielding a 75% just noticeable difference (75%jnd) was used according to Zwislocki and Relkin. Contact force and scanning velocity were measured at the fingertip with a built-in sensor. The TSRT was assessed with an extended set of grating domes. Fifty-three male and female subjects, spanning a wide age range participated in this study. The JND75% or TRDT was lower for the smoothest sandpapers (15+/-8.5 microm) compared to the roughest sandpapers (44+/-32.5 microm). TRDT performance was unrelated to age or gender. Additionally, grit size had no effect on the mean forces (normal and tangential) exerted at the fingertip or the mean scan velocities. In contrast, there was a significant degradation of TSRT performance with age. Lastly, there was no significant correlation between TRDT and TRST performance. Results of this study support the theory that the neural mechanisms underlying the perception of tactile roughness discrimination for fine textures differ from those involved in spatial resolution acuity often associated with the SA1 afferents.

Age-related changes in tactile spatial resolution from 6 to 16 years old

The aim of this study was to determine age-related changes in tactile spatial resolution from 6 to 16 years old. Two hundred and twenty-two healthy children (105 boys and 117 girls) were assessed. The tactile spatial resolution threshold was determined using a classic set of JVP domes with a procedure adapted for children. Preadolescence appears to be an important step in tactile spatial resolution since children aged between 6 and 9 years old had a worse tactile spatial resolution than older children. Both peripheral and central explanations for this improvement of tactile spatial resolution with age are considered. The authors suggest that cortical maturational processes are likely to explain the better results of older children.

Tactile co-activation improves detection of afferent spatial modulation

Tactile co-activation, i.e., synchronous stimulation of a region of skin, has been reported to improve tactile spatial acuity and expand the corresponding somatosensory cortical representation. The current study aimed to clarify the nature of the changes resulting from tactile co-activation, using three measures of tactile sensitivity obtained with controlled mechanical stimulation. One was the grating orientation (GR/OR) discrimination task, where acuity is indexed by the threshold groove width required for 75% correct discrimination between two orthogonal orientations of a grating on the fingerpad. Since this task may be susceptible to intensity cues due to tactile anisotropy, another acuity measure, the 3-dot task, was also used. In this task, the acuity threshold corresponds to 75% correct discrimination of the direction of offset of the central dot in a 3-dot array. In Experiment 1, co-activation failed to induce significant improvement in acuity with either of these measures. Experiment 2 employed both the GR/OR task, and a third measure based on discriminating a grooved from a smooth surface (SM/GV). While the former task demands detailed spatial resolution, the latter requires only that spatial modulation in the afferent population be detected. This experiment also included a control group. GR/OR performance did not significantly improve for either the control or experimental groups. There was, however, a significant improvement in SM/GV performance following co-activation for the experimental but not the control group. These findings indicate that the SM/GV task may be better suited than the GR/OR or 3-dot tasks for measuring changes in tactile sensitivity following co-activation.

Discriminating smooth from grooved surfaces: effects of random variations in skin penetration

The ability to discriminate a smooth surface from a grooved one depends on several variables, including the width of the grooves and the force with which the skin is contacted. It has been hypothesized that this smooth-grooved discrimination with statically presented stimuli is based on intensity cues, namely, the overall difference in perceived intensity between the smooth and grooved surfaces. To test this hypothesis, the perceived intensities of test stimuli were varied on a trial-by-trial basis by varying the depth of penetration the contactor was allowed to travel into the skin. As compared to a control condition in which stimuli were presented with the same average penetration and contrary to the hypothesis, random variations in penetration produced no decline in smooth-grooved performance. The total amount of conformance was an accurate predictor of sensitivity across various penetrations and across two test sites (distal finger pad and finger base). It appears that subjects are making absolute rather than comparative judgments in the smooth-grooved task. A recently developed continuum mechanical model of the responses of first-order mechanoreceptive afferents to static stimuli provided both a good fit to the data and indicated what aspect of the peripheral neural image was relevant for discriminating smooth surfaces from grooved surfaces.

Performance of blind and sighted humans on a tactile grating detection task

We compared the abilities of blind and sighted humans to distinguish grooved from smooth surfaces pressed against the stationary index fingertip. Ranging in age from 20 to 72 years, 37 blind and 47 sighted subjects participated in an automated two-alternative forced-choice tactile grating detection task. The tactile acuity of blind and sighted subjects declined with age at equivalent rates (0.011-mm threshold increase per year), but the blind subjects were able to perceive significantly thinner grooves than were their sighted peers (the average difference between blind and sighted subjects of the same age and gender was 0.267 mm). The blind Braille readers performed no better than the blind nonreaders, and the congenitally blind subjects performed equivalently to those with adult-onset blindness. The superior tactile acuity of blind persons may result from the involvement of normally visually responsive cerebrocortical areas in tactile processing, as shown by functional-imaging studies.

Tactile spatial sensitivity and anisotropy

A gap detection task was examined for its usefulness as a measure of tactile spatial sensitivity and as a measure of anisotropy. In Experiment 1, sensitivity was measured with a gap detection task both with and without a latex glove at three locations on the hand: the fingerpad, fingerbase, and palm. Results showed that sensitivity varied as a function of location and was correlated with changes in the density of innervation of the primary afferent fibers. In accord with other measures of spatial sensitivity, the glove had a moderate effect on sensitivity in the gap detection task. The results both with and without the glove were more similar to those obtained using another measure of spatial sensitivity, the grating orientation task, than to those obtained using the smooth-grooved task, which is considered an intensive measure. In Experiments 2-4, anisotropy was examined using the gap detection and grating orientation tasks, as well as the smooth-grooved task. Locations on the index finger, palm, and arm were tested. Results indicated that anisotropy was revealed only by tasks that relied on spatial cues. The differences between spatial sensitivity measured in the proximal-distal orientation as compared with the lateral-medial orientation varied by location and were as much as 2.35/1. The results are discussed in terms of what they may reveal about the underlying mechanisms responsible for tactile anisotropy.

The effect of force and conformance on tactile intensive and spatial sensitivity

The effect of force on intensive and spatial processing was examined with three measures of tactile sensitivity. One of the measures based on intensive cues is the smooth-grooved (SM/GV) task, and the two other measures based on spatial cues are the grating orientation and gap detection tasks. Measures were made at two locations that vary in sensitivity and in the density of innervation of the primary afferent fibers, the right index fingerpad and the palmar surface of the proximal phalanx (fingerbase). At each location, psychometric functions were generated for each of the three measures for two forces (50 and 200 g). The results indicated that increasing force led to marked improvement on the task that relied on intensive cues; however, on the tasks that relied on spatial cues, force had no effect on performance. Biomechanical measures were made of the depth to which the skin invades the grooves of the contactors (conformance) at the two test sites, with the two forces, and with different groove widths. Conformance was found to be a joint function of force and groove width. Further, performance on the SM/GV task could be predicted by the amount of conformance. The psychophysical results are consistent with the view that increasing conformance increases neural activity in the primary afferent fibers, and that this increase in neural activity improves SM/GV performance, but has little effect on the quality of the spatial image.