İnsan Bireylerde Titreşim Algılama Eşiği ve Tactile Mekansal Keskinliği Ölçümü
Summary
Burada, protokolleri insanda psikofiziksel yöntemler kullanılarak titreşim algılama eşikleri ve dokunsal keskinliği belirlemek için sunuyoruz.
Abstract
Tests that allow the precise determination of psychophysical thresholds for vibration and grating orientation provide valuable information about mechanosensory function that are relevant for clinical diagnosis as well as for basic research. Here, we describe two psychophysical tests designed to determine the vibration detection threshold (automated system) and tactile spatial acuity (handheld device). Both procedures implement a two-interval forced-choice and a transformed-rule up and down experimental paradigm. These tests have been used to obtain mechanosensory profiles for individuals from distinct human cohorts such as twins or people with sensorineural deafness.
Introduction
Specialized mechanosensory receptors in the skin mediate the perception of vibration and grating orientation. Each mechanosensory receptor type is tuned to detect distinct features of tactile stimuli1,2. This property provides the psychophysical basis for a differentiated assessment of mechanosensory function by using tests that deliver simple sinusoidal oscillations (vibration) or fine gratings. It is known that psychophysical thresholds for vibration perception are lower for high than low frequency vibration3,4. Two types of rapidly adapting mechanoreceptors associated with the Meissner and Pacinian corpuscles primarily detect low (10-40 Hz) and high (100-200 Hz) frequency vibration stimuli, respectively5. It is thought that the psychophysical thresholds for vibration perception rely to a considerable extent on the activation of these two sets of mechanoreceptors at their best frequencies6,7. Tactile spatial acuity is tested by the grating orientation task to determine the finest grating whose orientation can be discriminated by a subject7–9. Merkel cell-neurite complex afferents are essential for detecting grating orientation8,10. Interestingly, there has been considerable recent progress in our understanding of the molecular basis of how mechanoreceptors detect extremely small tactile stimuli11. Mechanosensitive ion channels like Piezo2 and modulators like STOML3 have been directly implicated in the detection of fine tactile stimuli in touch receptors12–15. There are already human patients identified with function altering mutations in the Piezo2 gene and it will be important to test whether such patients have touch deficits16.
The determination of the vibrotactile threshold relies on the delivery of a vibrating stimulus to the skin. Vibration detection thresholds vary with the vibration frequency. Vibration frequency to detection threshold curves were described by von Bekesey, Verillo, and Bolanowski, among many others, from the 1930s up to the 1990s5,17. The devices in the early days were based on shakers and power amplifiers and several devices have been commercialized and there are a lot of variation as to choice of stimulator (testing frequency), the diameter of the probe in contact with skin, the use of a surround to limit the stimulation to one area of the skin, and the testing protocol that determines the threshold (see the following references for more detailed insight on the device and testing features)18–20. Most devices usually test one site; however, there are new devices that use vertical displacement stimulators equipped with 2 probes to deliver vibratory stimuli with separation ranges that can be varied21. Also detection thresholds are measured based on vibration frequency or intensity discrimination with continuous stimulation; or with intermittent vibration stimuli with or without a masking stimulus. Therefore, we recommend that the reader be aware of the plethora of developments in this field.
Here, we describe the components of the device and a step-by-step guide on how to conduct psychophysical tests to estimate vibration detection threshold in human subjects. We then show how to assess tactile acuity manually by using the tactile acuity cube. We use a two-interval, forced-choice paradigm: the stimulus is always presented during one of two intervals and the subject has to indicate which interval has the vibration stimulus. We employ a transformed-rule up and down as the adaptive method that executes a threshold search by changing the stimulus intensity based on the performance during the test. Both psychophysical protocols can be used by investigators as a screening tool for evaluation of alterations in touch sensitivity.
Protocol
Representative Results
Discussion
VDT değerlendirmek için kullanılan teknikler cihaz özellikleri, donanım ve test protokollerine olarak değişir. International Organization for Standardization bir vibrometreler çeşitli bileşenleri için öneriler (ISO 13091-1 ve 2 26,27) da dahil olmak üzere vibrotactile eşiklerini analiz etme ve yorumlama usul ve esasları kapsar açıklanan test sistemi test frekans aralığı için ilgili ISO önerilerini riayet (4-125 Hz), yöntem prob boyutu (yukarı-aşağı merdiven ve zorla seçim varyantı…
Disclosures
The authors have nothing to disclose.
Acknowledgements
The research and development leading to the above described vibration test was funded by the European Research Council (ERC, ADG 294678) and the German Research Council (grant, SFB665). Thanks go to the Max-Delbrück-Center technical and support staff, Mr. R. Fischer, B. Neumann, and Mr. M. Pflaume, who provided invaluable assistance with the project.
Materials
| Piezo actuator | Physik Instrument, Germany | P-602.1L | The linear piezoelectric actuator, with integrated position sensor and motion amplifier, contains a piezoceramic material that elongates and contracts when voltage is applied. The piezoelectric actuator travels up to100 µm. The actuator is equipped with a flexure guide that ensures straight motion without tilting or lateral offset. The displacement is linear and calibration is done and checked by the manufacturer. It is recommended that on-axis movement of the probe be checked under the microscope. According to the manufacturer, the stimulus amplitude dampens by less than 20% at oscillating frequencies of 1000 Hz. This can be checked by using a force or displacement measuring device (e.g. force transducer from Kleindiek). | The linear piezoelectric actuator, with integrated position sensor and motion amplifier, contains a piezoceramic material that elongates and contracts when voltage is applied. The piezoelectric actuator travels up to100 µm. The actuator is equipped with a flexure guide that ensures straight motion without tilting or lateral offset. The displacement is linear and calibration is done and checked by the manufacturer. It is recommended that on-axis movement of the probe be checked under the microscope. According to the manufacturer, the stimulus amplitude dampens by less than 20% at oscillating frequencies of 1000 Hz. This can be checked by using a force or displacement measuring device (e.g. force transducer from Kleindiek). |
| Piezo Amplifier / Servo Controller | Physik Instrument, Germany | E-665 | E-665 amplifier/controller drives and controls the displacement of a low-voltage piezoelectric actuator in a system with sensor position feedback (SGS sensors). The servo-controller provides the option for closed loop operation. When applying sinusoidal and oscillating stimuli the amplitude signal deviates from the set amplitude starting from 500 Hz and reaches a maximum decrease of 20% at 1000Hz. | E-665 amplifier/controller drives and controls the displacement of a low-voltage piezoelectric actuator in a system with sensor position feedback (SGS sensors). The servo-controller provides the option for closed loop operation. When applying sinusoidal and oscillating stimuli the amplitude signal deviates from the set amplitude starting from 500 Hz and reaches a maximum decrease of 20% at 1000Hz. |
| LabChart Software | ADInstruments, USA | LabChart 7, MLU60/8 | Can create, store and run macro of the psychophysical testing algorithm. | Can create, store and run macro of the psychophysical testing algorithm. |
| PowerLab | ADInstruments, USA | PowerLab 4/35 PL3504 | Data Acquisition Hardware. Used with LabChart software. | Data Acquisition Hardware. Used with LabChart software. |
| Brass bar | Custom-made | Bar made of pure brass, weighs 15.5Kg. When the peizoelectric actuator is mounted on the brass bar it should exert a force of 30 g weight on skin surface. | ||
| Monitor | Custom-made | To mark the 1st and the 2nd interval. The monitor indicates to the subject the time intervals during which the stimulus may be presented. | ||
| Response box | Custom-made | The subject indicates the interval at which stimulus occurred. | ||
| Board | Custom-made | Upper surface should be smooth (Plastic), lower surface made of foam to prevent stray vibration ot be transmitted to the stimulating pobe. | ||
| Probe | Custom-made | A flat circular probe with smoothed edges (thermoplastic material) attached to a screw head. The screw should be of appropriate size to be tightened directly to the moving part of piezoelectric actuator. Size of the probe can be according to preference; in our case, diameter 8.21mm and surface area 52.9mm2. | ||
| Labchart Script | Can be sent on request. See supplementary code file. | |||
| Tactile Acuity Cube | MedCore | The cube is comprised of 6 sides each containing a grating (bar and groove) whose widths are 0.75, 1.25, 1.75, 3.0, 4.5, and 6.0 mm. | ||
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