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PubMed2002

Globus sensation and gastroesophageal reflux.

Recent studies suggest that gastroesophageal reflux disease (GERD) may be a major cause of globus sensation. However, the incidence and severity of GERD in patients with globus sensation without reflux symptoms are unknown. In order to establish the relationship between globus sensation in the jugular fossa and GERD, 20 patients attending our ear, nose and throat (ENT) outpatient clinic with globus sensation were investigated with 24-h pH monitoring. A four-channel pH catheter was used with the pH electrodes spaced 5 cm apart in order to detect reflux along the whole length of the esophagus. Fifteen patients complained about globus sensation only; five patients complained additionally about classical reflux symptoms. Thirteen patients showed pathologic reflux measurements. Most of the patients had reflux limited to the distal one-third of the esophagus. Patients with pathologic pH measurements were treated with proton pump inhibitors. Ten out of 13 patients improved with treatment. This study suggests that globus may be associated with reflux, and acidity does not have to reach the pharynx to produce globus sensation.

Adult↗
PubMed1994

The sensate fibula osteoseptocutaneous flap: a preliminary report.

The ideal oromandibular reconstruction calls for restoration of intraoral sensation as well as tissue replacement because the loss of sensation in the oral cavity impairs oral function. The versatility and flexibility of the fibula osteoseptocutaneous flap in complex three dimensional spatial positioning lends itself to be desirable in composite oromandibular reconstruction. It falls short of being ideal because the skin paddle of the flap is usually insensate and thus oral sensation is not restored. The skin paddle of the fibula osteoseptocutaneous flap is innervated by the lateral sural cutaneous nerve and this nerve can be preserved and reinnervated to restore sensation to the skin paddle. The sensate fibula osteoseptocutaneous flap may be the ideal flap for one stage composite reconstruction of oromandibular defects. This is a preliminary report on the sensory return of the sensate fibula osteoseptocutaneous flap in oromandibular reconstruction.

Adult↗
PubMed1982

Electrical stimulation of tooth pulp in humans. II. Qualities of sensations.

Individual premolar teeth of 22 normal volunteers were stimulated via intradentinal electrodes using brief electrical pulses. Questionnaires were used to determine the qualities of sensations produced by this stimulation. Operationally defined 'innocuous' sensations predominated between 1 and 10 dB SL, and were absent above 30 dB SL. Similarly defined 'painful' sensations were observed throughout the range of suprathreshold intensities but were most common above 20 dB SL. These findings demonstrate that non-painful sensations can arise from electrical tooth pulp excitation in circumstances in which spread of the stimulating current to periodontal and gingival structures is most unlikely. Two interpretations of these results are considered: (1) that tooth pulp afferents may have some unspecified sensory function besides mediation of painful sensations and (2) that they may be specialized in the mediation of nociceptive impulses but may give rise to innocuous sensations under special circumstances.

Adolescent↗
PubMed2004

Neural basis of sensation in intact and injured corneas.

A renewed interest in the characteristics and neural basis of corneal and conjunctival sensations is developing in recent years due to the high incidence of discomfort and altered sensitivity of the cornea following refractive surgery, use of contact lenses and dry eyes. Corneal nerves are functionally heterogeneous: about 20% respond exclusively to noxious mechanical forces (mechano-nociceptors); 70% are additionally excited by extreme temperatures, exogenous irritant chemicals and endogenous inflammatory mediators (polymodal nociceptors), and 10% are cold-sensitive and increase their discharge with moderate cooling of the cornea (cold receptors). Each of these types of sensory fibres contributes distinctly to corneal sensations. Mechano-nociceptors mediate, sharp acute pain produced by touching of the cornea. Polymodal nociceptors elicit the sustained irritation and pain that accompany corneal wounding; cold receptors evoke cooling sensations. Depending on the relative activation by the stimulus of each subpopulation of corneal sensory fibres, different subqualities of irritation and pain sensations are evoked. Corneal sensations can be explored experimentally in humans with a gas esthesiometer that applies controlled mechanical, chemical and thermal stimuli to the corneal surface. When the cornea is wounded, corneal nerves are excited and eventually severed in a variable degree and local inflammation is produced. Activated corneal nerves release neuropeptides (SP, CGRP) that contribute to the inflammatory reaction (neurogenic inflammation). They also become sensitized by local inflammatory mediators, such as prostaglandins or bradykinin and thus exhibit spontaneous activity, lowered threshold and enhanced responses to new stimuli. This leads to spontaneous pain and hyperalgesia. Nerves destroyed by injury soon start to regenerate and form microneuromas that exhibit abnormal responsiveness and spontaneous discharges, due to an altered expression of ion channel proteins in the soma and in regenerating nerve terminals. Presumably, this altered excitability is the origin of the lowered sensitivity and the spontaneous pain, dry eye sensations and other disaesthesias reported in patients following refractive surgery.

Cornea↗
PubMed1997

Sensation seeking and risky driving: a review and synthesis of the literature.

The relationship between sensation seeking and risky behaviour has been observed since the 1970s. During the late 1980s and early 1990s, road safety researchers have examined the relationship between sensation seeking and risky driving (e.g. driving while impaired, speeding, following too closely), as well as its consequences (e.g. collisions, violations). There is also growing evidence that sensation seeking may also moderate the manner in which drivers respond to other factors such as alcohol impairment and perceived risk. This paper reviews and synthesizes the literature on sensation seeking as a direct influencer of risky driving and its consequences and as a moderator of the influence of other factors. The vast majority of the 40 studies reviewed showed positive relationships between sensation seeking (SS) and risky driving, with correlations in the 0.30-0.40 range, depending on gender and the measure of risky driving and SS employed. Of those studies that have looked at the subscales of Zuckerman's Sensation Seeking Scale, Thrill and Adventure Seeking appears to have the strongest relationship to risky driving. The biological bases of SS is discussed as are the implications for collision prevention measures.

Accidents, Traffic↗
PubMed2000

Corneal sensation after laser in situ keratomileusis.

PURPOSE: To report the time course for the return of corneal sensation following laser in situ keratomileusis (LASIK). SETTING: University-based retractive surgery practice. METHODS: Twenty-eight eyes of 18 patients having LASIK were evaluated. Preoperative and postoperative corneal sensation at the nasal flap hinge, at the central cornea, and within the temporal flap edge were measured before and after LASIK for a 3 week period using the Cochet-Bonnet esthesiometer (Luneau). RESULTS: Corneal sensation initially decreased in all 3 positions of the flap measured after LASIK; the greatest decrease was in the central cornea. Near preoperative corneal sensation returned by 3 weeks. The degree of sensation loss did not appear to correlate with the ablation depth. CONCLUSION: Corneal sensation is significantly decreased for approximately 2 to 3 weeks after LASIK, centrally greater than nasally at the flap hinge or temporally within the flap edge, but it generally returns to near the preoperative level by 3 weeks postoperatively.

Cornea↗
PubMed1999

Sensations experienced during removal of tubes in acute postoperative patients.

The major purpose of this study was to determine the types and intensity of sensations that patients experience when chest tubes (CTs) and Jackson-Pratt (JP) abdominal tubes are removed. A convenience sample of 62 hospitalized subjects, 31 with CTs and 31 with JP tubes, participated. Each subject was interviewed after tube removal. Sensations were identified, and intensity of sensation was marked on a 100-mm Visual Analogue Scale. Similar sensations were reported by both groups. Intensity of sensation was consistently higher in the JP group. The most frequently reported sensations were pain (77%) on JP tube removal and pulling (90%) upon CT removal.

Adult↗
PubMed1989

Sensation seeking and marital adjustment.

Seventy-two married couples completed Zuckerman's Sensation Seeking Scale, Form V, and the Kimmel and VanderVeen modification of the Locke Marital Adjustment Questionnaire. Marital adjustment was not related to the difference between husbands' and wives' sensation-seeking scores, but a negative relationship was found between sensation seeking and marital adjustment for women but not for men. This suggests that high sensation seeking in women has a negative impact on their marital satisfaction independent of their husband's sensation-seeking score. Assortative mating for sensation seeking was also observed.

Adaptation, Psychological↗
PubMed2000

Contributions of local and central sensations to the perception of exertion during cycling: effects of work rate and cadence.

There is evidence to suggest that perception of exertion during exercise is based on both local and central sensations. The aim of the present experiment was to determine the relative contributions of different sensations to overall perceived exertion during cycling. Eighteen trained cyclists pedalled on a cycle ergometer for 4 min at each of three work rates (100, 150 and 200 W) and cadences (50, 70 and 90 rev x min(-1)). At the end of each bout, they used Borg's category-ratio (CR-10) scale to rate their overall perceived exertion, leg muscle pain, knee pain, breathlessness and heart beat intensity. The results indicated that cadence only influenced local sensations (muscle pain and knee pain), which were significantly higher at slower pedalling rates. Neither overall perceived exertion nor central sensations (breathlessness and heart beat intensity) were significantly affected by cadence. In contrast, increases in work rate were associated with higher ratings for all sensations. Further analyses revealed that variations in these overall ratings of perceived exertion as a function of work rate were accounted for by variations in ratings of muscle pain and breathlessness. The general implication is that perceived exertion during cycling derives from a combination of muscle and respiratory sensations.

Adult↗
PubMedDate not supplied

Prospective diary study of nonpainful and painful phantom sensations in a preselected sample of child and adolescent amputees reporting phantom limbs.

OBJECTIVE: To prospectively study factors associated with the occurrence of phantom sensations and pains in a pre-selected sample of child and adolescent amputees reporting phantom limbs. DESIGN: Prospective diary study over 1 month. PARTICIPANTS: Fourteen child and adolescent amputees from 10-18 years of age who were missing a limb due to trauma (n = 12) or congenital limb deficiency (n = 2), and who had previously reported having phantom sensations and pain. MAIN OUTCOME MEASURE: Diary used to assess the occurrence of non-painful and painful phantom sensations. Items included age, sex, location and cause of amputation, past experience with stump pain and pre-amputation pain, and intensity, quality, duration, and triggers of the sensations and pains. RESULTS: Thirteen amputees reported having 104 incidents of non-painful phantom sensations with an average intensity of 4.17 (SD = 2.14) on a 0-10 rating scale. Fifty-three incidents of phantom pain with an average intensity of 6.43 (SD = 1.76) were recorded by 8 amputees. Both amputees with a congenital limb deficiency reported phantom phenomena. Girls reported more psychosocial triggers than did boys whereas boys were more likely than girls to report that they could not identify a trigger (P = 0.0001). Boys also reported a higher proportion of physical triggers than psychosocial triggers while there were no differences for girls (P = 0.0001). DISCUSSION: Child and adolescent amputees experience phantom sensations and pains on a regular basis over a 1-month period. Differences in triggers of phantom phenomena between boys and girls may be due to differences in activities, awareness, attribution, and willingness to report psychosocial triggers.

Adolescent↗
PubMed1988

Skin sensation after suction lipectomy: a prospective study of 50 consecutive patients.

Using a reproducible pain stimulus, skin sensation was evaluated in a prospective study of 50 consecutive patients who underwent suction lipectomy. A total of 294 anatomic areas were evaluated and treated. Before operation, many patients were found to have patchy areas of decreased sensation, a condition that was unknown to them. Initially after surgery, all patients had decreased sensation in the treated areas. However, sensation usually returned to normal in 6 to 8 months. In some patients, sensory return to preoperative levels took as long as 1 year, and in a few, patchy areas of decreased sensation were present even longer. In general, the larger the treated area, the larger are the area and degree of sensory loss and the slower is the return of sensation.

Adipose Tissue↗
PubMed2005

Barostat testing of rectal sensation and compliance in humans: comparison of results across two centres and overall reproducibility.

We assessed reproducibility of measurements of rectal compliance and sensation in health in studies conducted at two centres. We estimated samples size necessary to show clinically meaningful changes in future studies. We performed rectal barostat tests three times (day 1, day 1 after 4 h and 14-17 days later) in 34 healthy participants. We measured compliance and pressure thresholds for first sensation, urgency, discomfort and pain using ascending method of limits and symptom ratings for gas, urgency, discomfort and pain during four phasic distensions (12, 24, 36 and 48 mmHg) in random order. Results obtained at the two centres differed minimally. Reproducibility of sensory end points varies with type of sensation, pressure level and method of distension. Pressure threshold for pain and sensory ratings for non-painful sensations at 36 and 48 mmHg distension were most reproducible in the two centres. Sample size calculations suggested that crossover design is preferable in therapeutic trials: for each dose of medication tested, a sample of 21 should be sufficient to demonstrate 30% changes in all sensory thresholds and almost all sensory ratings. We conclude that reproducibility varies with sensation type, pressure level and distension method, but in a two-centre study, differences in observed results of sensation are minimal and pressure threshold for pain and sensory ratings at 36-48 mmHg of distension are reproducible.

Adult↗
PubMed1995

CO2 stimulation of the cornea: a comparison between human sensation and nerve activity in polymodal nociceptive afferents of the cat.

Excitation of nociceptors by low pH has been proposed as a cause of pain following tissue injury. Here we have studied the effect of pH reductions caused by application of CO2 pulses to the cornea on the activity of corneal afferent nerves of the cat and on the magnitude of pain sensations in humans. Single-unit activity was recorded from corneal afferent fibres in anaesthetized cats. The corneal receptive field of A-delta or C polymodal nociceptive units was exposed for 30 s to a gas mixture with different concentrations of CO2 in air (0, 35, 50, 65, 80 and 98.5%). Responses to CO2 were evoked at a mean threshold concentration of 40 +/- 3% CO2. They consisted of a discharge of impulses that decayed gradually to a tonic level. In 15% of the units the initial burst was absent. The CO2 concentration and firing frequency data could be fitted to a power function with an exponent of 1.12. Pulses of CO2 were also applied to the cornea of 16 human volunteers. Sensations experienced were measured by means of a visual analogue scale and a verbal descriptor scale. Flow was adjusted below the mechanical stimulation threshold (2.8 +/- 0.5 mg). When mixtures containing 10-90% CO2 in 5% steps were applied as 3 s pulses, threshold sensation, described as a mild stinging pain, was evoked at 33.5 +/- 4.0% CO2. This sensation became overtly painful with higher CO2 concentrations (47.5 +/- 3.6% CO2). For the same subject the sensory threshold was remarkably constant, though it changed with longer exposure times. The relationship between CO2 concentration and magnitude of pain could be adjusted to a power function with a power exponent of 1.12. Curves of CO2 concentration versus neural discharges in the cat and versus psychophysical sensation in humans were very similar. These results show that corneal polymodal nociceptors respond to protons, and encode changes in CO2 concentration presumably reflecting pH changes. The same stimulus evokes corneal pain sensations in humans, thus opening the possibility of using CO2 as an effective stimulus for corneal aesthesiometry.

Adult↗
PubMed2001

Rectal compliance, capacity, and rectoanal sensation in fecal incontinence.

OBJECTIVE: Assessments of the pathophysiology of fecal incontinence are skewed toward anal sphincter function; however, rectal compliance, rectoanal sensation and capacity may also be relevant. The aim of this study was to evaluate the usual and some novel diagnostic approaches in fecal incontinence. METHODS: In 22 unselected patients with fecal incontinence (21 F, 33-75 yr), we quantified: 1) symptoms, anorectal manometry, and anal ultrasound; 2) anal perception of temperature and light touch; 3) rectal sensitivity and compliance to distension; and 4) rectal reservoir function. Control values were obtained from two groups of 11 (seven F, 32-53 yr), and 32 (18 F, 19-44 yr) volunteers. RESULTS: Patients had urge (14), passive (four), or combined (four) fecal incontinence; symptoms were mild in three, moderate in nine, and severe in 10 patients. Most had low sphincteric pressures and ultrasonic abnormalities. Temperature perception was impaired (p < 0.05) in incontinent patients, to a greater extent in the proximal anal canal and in patients with passive, as opposed to urge, incontinence. Intraluminal pressures for sensations of rectal distension were lower in incontinent patients (p = 0.02). Artificial stools elicited sensations of rectal filling at lower volumes than did a barostat bag, and in patients with urge, as opposed to passive, incontinence. In patients and controls, the sensation of urgency was associated (r2 = 0.2, p < 0.01) with rectal compliance. CONCLUSIONS: We confirm that temperature sensation is impaired, and perception of rectal distension is not always reduced in fecal incontinence. Artificial stool tended to induce sensations at lower volumes than did balloon inflation. Altered sensory mechanisms may contribute to the pathophysiology of fecal incontinence.

Adult↗
PubMed2005

Corneal sensation after myopic and hyperopic LASIK: clinical and confocal microscopic study.

AIM: To assess the long term (1 year) effect of myopic and hyperopic LASIK on corneal sensation and innervation. METHODS: 83 eyes of 43 patients having LASIK were evaluated. According to the preoperative spherical equivalent, the eyes were divided into three groups: group 1, myopia from -0.75 to -6.00 D; group 2, myopia from -6.25 to -11.50 D; and group 3, hyperopia from 1.25 to 5.00 D. Corneal sensation was measured and in vivo confocal microscopy (IVCM) was done at the central cornea before, and at 1 month, 3 months, 6 months, and 1 year after LASIK. RESULTS: The mean corneal sensation in group 1 was greater than in groups 2 and 3 at all postoperative measurements. The difference between group 1 on one hand and groups 2 and 3 on the other hand was statistically significant at 1 month and 3 months after LASIK and was not statistically significant afterwards. IVCM study of 27 eyes revealed that the number and length of nerve fibre bundles in the sub-basal region decreased after LASIK and was significantly lower at all times after surgery despite the return of corneal sensation to preoperative level. CONCLUSION: After LASIK, central corneal sensitivity is decreased for as long as 6 months or more. The results suggest that lamellar cutting of the cornea during LASIK impairs corneal sensitivity and is related to the ablation depth. The diameter of ablation too may contribute to this drop in sensitivity. The return of corneal sensations does not directly correlate with the regeneration of nerve fibres as determined by confocal imaging. Sensations return to normal values before complete restoration of normal innervation if this indeed ever occurs.

Adult↗
PubMed2006

Relationship between impulsive sensation seeking traits, smoking, alcohol and caffeine intake, and Parkinson's disease.

BACKGROUND: An inverse relation exists between smoking and coffee intake and Parkinson's disease (PD). The present study explored whether this is explained by low sensation seeking, a personality trait believed to characterise PD. METHODS: A total of 106 non-demented patients with PD and 106 age and sex matched healthy controls completed a short version of Zuckerman's Sensation Seeking Scale (SSS), the Geriatric Depression Scale, and the Trait Anxiety Inventory. Data were collected on past and current cigarette smoking, and participants also completed food frequency questionnaires to estimate current caffeine and alcohol intake. RESULTS: Patients with PD had lower sensation seeking and higher depression and anxiety scores. They were also less likely to have ever smoked, and had lower caffeine and alcohol intakes. Analysis of the data using conditional logistic regression suggested that the inverse association of PD risk with sensation seeking was independent of smoking, and caffeine and alcohol intake. Moreover, low sensation seeking explained some of the apparent effect of caffeine and alcohol intake on PD. However, the effect of smoking was weakened only slightly when SSS was included in the regression model. CONCLUSION: This study raises the possibility that there is a neurobiological link between low sensation seeking traits--which might underlie the parkinsonian personality--and the hypothetical protective effect of cigarette smoking and caffeine consumption on PD.

Aged↗
PubMed2006

Neurophysiological evaluation of healthy human anorectal sensation.

Patients with functional gastrointestinal disorders often demonstrate abnormal visceral sensation. Currently, rectal sensation is assessed by manual balloon distension or barostat. However, neither test is adaptable for use in the neurophysiological characterization of visceral afferent pathways by sensory evoked potentials. The aim of this study was to assess the reproducibility and quality of sensation evoked by electrical stimulation (ES) and rapid balloon distension (RBD) in the anorectum and to apply the optimum stimulus to examine the visceral afferent pathway with rectal evoked potentials. Healthy subjects (n = 8, median age 33 yr) were studied on three separate occasions. Variability, tolerance, and stimulus characteristics were assessed with each technique. Overall ES consistently invoked pain and was chosen for measuring rectal evoked potential whereas RBD in all cases induced the strong urge to defecate. Rectal intraclass correlation coefficient (ICC) for ES and RBD (0.82 and 0.72, respectively) demonstrated good reproducibility at pain/maximum tolerated volume but not at sensory threshold. Only sphincter ICC for ES at pain showed acceptable between-study reproducibility (ICC 0.79). Within studies ICC was good (>0.6) for anorectal ES and RBD at both levels of sensation. All subjects reported significantly more unpleasantness during RBD than ES (P < 0.01). This study demonstrates that ES and RBD are similarly reproducible. However, the sensations experienced with each technique differed markedly, probably reflecting differences in peripheral and/or central processing of the sensory input. This is of relevance in interpreting findings of neuroimaging studies of anorectal sensation and may provide insight into the physiological characteristics of visceral afferent pathways in health and disease.

Adolescent↗
PubMed1982

Sensation of inspired volume in normal subjects and quadriplegic patients.

To investigate the influence of respiratory muscle tension and feedback from rib cage receptors, the sensation of inspired volume was compared in normal subjects and quadriplegic patients during active breathing, with and without the addition of an inspiratory resistive load, and during passive ventilation produced by a tank respirator. In separate trials, volume sensation was assessed using tests of magnitude estimation and volume reproduction. The mean exponents and standard errors for the magnitude estimation of inspired volume in normal subjects were 1.32 +/- 0.08, 1.24 +/- 0.06, and 1.23 +/- 0.09 during passive, active, and loaded breathing, respectively. These values were not significantly different from one another, nor were there any differences between normal subjects and quadriplegics. During volume reproduction trials where the mechanical conditions were different between control and test breaths, the inspired volumes during active unloaded breathing were significantly smaller than during passive ventilation but greater than the inspired volumes during loaded breathing. Errors in volume reproduction were no different in normal subjects and quadriplegics, suggesting that inputs from rib cage receptors are not essential for the sensation of inspired volume. The sensation of inspired volume in both normal subjects and quadriplegics was found to be unaffected by inhalation of a 2% lidocaine solution. This suggests that upper airway receptors are also not essential for volume sensation. The intensity of the sensation of a given inspired volume may depend on the level of the central nervous system motor command and/or on the tension developed by the diaphragm.

Adult↗