Validating a population model of tactile mechanotransduction of slowly adapting type I afferents at levels of skin mechanics, single-unit response and psychophysics

Previous models of touch have linked skin mechanics to neural firing rate, neural dynamics to action potential elicitation, and mechanoreceptor populations to psychophysical discrimination. However, no one model spans all levels. The objective of work herein is to build a multi-level, computational model of tactile neurons embedded in cutaneous skin, and then validate its predictions of skin surface deflection, single-afferent firing to indenter shift, and population response for sphere discrimination. The model includes a 3D finite element representation of the distal phalange with hyper- and visco-elastic mechanics. Distributed over its surface, a population of receptor models is comprised of bi-phasic functions to represent Merkel cells' transformation of stress/strain to membrane current and a leaky integrate-and-fire neuronal models to generate the timing of action potentials. After including neuronal noise, the predictions of two population encoding strategies (gradient sum and euclidean distance) are compared to psychophysical discrimination of spheres. Results indicate that predicted skin surface deflection matches Srinivasan's observations for 50 micron and 3.17 mm diameter cylinders and single-afferent responses achieve R(2) = 0.81 when compared to Johnson's recordings. Discrimination results correlate with Goodwin's experiments, whereby 287 and 365 m(-1) spheres are more discriminable than 287 and 296 m(-1).

Oral clonidine pretreatment prior to venous cannulation

Clonidine is a preferential alpha-2 agonist drug that has been used for over 35 years to treat hypertension. Recently, it has also been used as a preoperative medication and as a sedative/anxiolytic drug. This randomized, double-blind, placebo-controlled crossover clinical trial characterized the effects of oral clonidine pretreatment on intravenous catheter placement in 13 patients. Parameters measured included the bispectral index (BIS), Observer's Assessment of Alertness/Sedation Scale (OAA/S), frontal temporal electromyogram (EMG), 30-Second Blink Count (Blink), Digit Symbol Substitution Test (DSST), State Anxiety Inventory (SAI), fingertip versus forearm skin temperatures, and multiple questionnaires. Oral clonidine significantly decreased SAI scores, OAA/S, EMG, and Blink, but did not cause statistically significant BIS or DSST reductions. Subjects preferred oral clonidine pretreatment prior to venipuncture compared to placebo. Questionnaires also indicated that clonidine provided minimal sedation, considerable anxiolysis, and some analgesia. Fingertip versus forearm skin temperature differentials were decreased. Reduced fingertip versus forearm temperature differentials suggest increased peripheral cutaneous blood flow prior to venous cannulation. Oral clonidine pretreatment not only helped control patient anxiety and pain but also provided cardiovascular stability.