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  • 1.
    Heldestad Lilliesköld, Victoria
    et al.
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Nordh, Erik
    Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
    Method-of-limits: Cold and warm perception thresholds at proximal and distal body regions2018In: Clinical Neurophysiology Practice, E-ISSN 2467-981X, Vol. 3, p. 134-140Article in journal (Refereed)
    Abstract [en]

    Objective: Thermal quantitative sensory testing with the 'Method-of-Limits' is an established rationale for detection of small nerve fiber dysfunction, but adequate reference values are crucial for such evaluations, regardless of the underlying cause. This study assessed reference data for cold- (CPT) and warm- (WPT) perception thresholds at both proximal and distal sites in eight body regions of the lower and upper extremities, all determined within the same test session for each subject.

    Methods: Seventy-five healthy subjects (aged 16-72 years) were tested according to the method-of-limit for CPT and WPT at the dorsum of the foot, the medial and lateral lower leg, the ventral thigh, the thenar eminence, the radial and ulnar part of the lower arm, and the anterior deltoid part of the upper arm.

    Results: Overall, thermal perception thresholds (TPT) varied with test location, but were higher in the lower than in the upper part of the body, also WPT were generally higher than CPT. TPT at the dorsum foot highly correlated with age, while inconsistent correlations were noted between TPT and age or height at other tested locations.

    Conclusion: This study describes for the first time reference values at eight defined body regions, at both proximal and distal sites.

    Significance: The report enables refined evaluations of general small nerve fiber function, as assessed by quantitative thermal sensory testing with the Method-of-Limits.

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  • 2.
    Lundström, Ronnie
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Dahlqvist, Håkan
    Hagberg, Mats
    Nilsson, Tohr
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Vibrotactile and thermal perception and its relation to finger skin thickness2018In: Clinical Neurophysiology Practice, E-ISSN 2467-981X, Vol. 3, p. 33-39Article in journal (Refereed)
    Abstract [en]

    Objective: Quantitative measurements of vibrotactile and thermotactile perception thresholds (VPT and TPT, respectively) rely on responses from sensory receptors in the skin when mechanical or thermal stimuli are applied to the skin. The objective was to examine if there is a relation between skin thickness (epidermis and dermis) and VPT or TPT.

    Methods: Perception thresholds were measured on the volar side of the fingertip on 148 male subjects, out of which 116 were manual workers exposed to hand-transmitted vibration and 32 were white-collar (office) workers. Skin thickness was measured using a high-frequency ultrasonic derma scanner system.

    Results: The difference in age, perception thresholds and skin thickness between manual and office workers was small and non-significant except for the perception of cold, which was decreased by vibration exposure. Skin thickness for both subgroups was mean 0.57 mm (range 0.25-0.93 mm). Increased age was associated with decreased perception of warmth and vibration. Lifetime cumulative exposure to vibration, but not age, was associated with decreased perception of cold.

    Conclusion: No association (p > .05) was found between finger skin thickness in the range of about 0.1-1 mm and vibration perception threshold for test frequencies from 8 to 500 Hz and thermotactile perception thresholds for warmth and cold. Increasing age was associated with reduced perception of vibration and warmth. Vibration exposure was associated with decreased perception of cold.

    Significance: Skin thickness is a factor that may affect the response from sensory receptors, e.g., due to mechanical attenuation and thermal insulation. Thus, to evaluate perception threshold measurements, it is necessary to know if elevated thresholds can be attributed to skin thickness. No previous studies have measured skin thickness as related to vibrotactile and thermotactile perception thresholds. This study showed no association between skin thickness and vibrotactile perception or thermotactile perception.

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