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PubMed1995

The restoration or preservation of sensation in the oral cavity following ablative surgery.

The importance of sensory feedback from the oral cavity is evaluated in the context of functional rehabilitation following ablative surgery using three techniques that restore or preserve sensation. Nerve grafts to restore the continuity of sensory nerves interrupted during ablative surgery, as well as the role of sensate flaps and the protection of palatal sensation following soft palate resection or total glossectomy, are discussed.

Feedback↗
PubMed1978

Introduction of automated systems to evaluate touch-pressure, vibration, and thermal cutaneous sensation in man.

Systems for automatic assessment of cutaneous touch-pressure, vibratory, and thermal sensation have been developed. These systems use stimuli which are quantified and reproducible, a two-alternative forced-choice technique, and programmed steps to test, score, and report. If normal responses from series of healthy persons have been measured, percentile values specific for test, site, age, and sex can be determined. Abnormality, as in neurological disease, can then be defined as the response which has a value greater than that of the 95th (or other) percentile. These systems may be used to detect and validate abnormalities of sensation in neurological disease and in persons at risk from new medications or from industrial toxins, and to monitor worsening or improvement of sensation in follow-up of a patient or in evaluation of therapeutic regimens.

Adult↗
PubMed1988

Anal sensation after restorative proctocolectomy for ulcerative colitis.

The hypothesis that anal sensation might be better after restorative proctocolectomy with end-to-end ileoanal anastomosis than after mucosal proctectomy with endo-anal anastomosis was tested in this study. Anal sensation was measured in 14 patients before operation, 16 patients after restorative proctocolectomy with end-to-end anastomosis (RP + EEA) and 13 patients after mucosal proctectomy with endo-anal anastomosis 1 cm above the dentate line (MP + EAA). Threshold electrosensitivity was measured in the upper, mid and lower anal canal by means of a bipolar constant current stimulator probe. The 'recto'-anal inhibitory reflex was tested, and the patients' ability to discriminate between flatus and faeces and to release flatus 'safely' was assessed by interview. In the upper anal canal, threshold sensitivity was significantly greater in patients who had undergone MP + EAA than in patients who had undergone RP + EEA (P less than 0.05). In the mid and lower anal canal, electrosensitivity in the three groups of patients did not differ significantly. Twelve patients (75 per cent) regained the 'recto'-anal reflex after RP + EEA, but after MP + EAA only three patients (23 per cent) did so (P less than 0.02). Thirteen patients after RP + EEA could release flatus safely without fear of faecal leakage, compared with only four after MP + EAA (P less than 0.02). The proportions of patients in these two groups who said they were able to discriminate flatus from faeces did not differ significantly. Anal sensation and discriminatory function are significantly better after end-to-end ileoanal anastomosis than after mucosal proctectomy with endo-anal anastomosis.

Adult↗
PubMed2004

Intraoral sensation before and after radiotherapy and surgery for oral and pharyngeal cancer.

BACKGROUND: Patients with unilateral oral or pharyngeal cancer often receive bilateral radiotherapy because of the potential for metastases. Because postoperative sequelae are evident on the tumor side, to date little attention has been paid to sensory alterations after radiotherapy on the healthy, nontumor side. The objective of this study was to investigate possible sensory alterations. METHODS: Intraoral sensation was tested bilaterally at standardized sites in 27 patients and 20 controls. Preoperative radiotherapy was bilateral in 19 patients and unilateral in eight patients. Patients were tested before treatment, after radiotherapy, and after surgery at 6 months and 1 year. Comparisons were performed interindividually and intraindividually and between groups. RESULTS: A delayed deterioration of sensation was revealed on the nontumor side 6 months after radiotherapy. There was no recovery 1 year after treatment. CONCLUSIONS: Intraoral sensation cannot be evaluated directly after radiotherapy. It is plausible that sensory deterioration after radiotherapy has an impact on functional rehabilitation after tumor treatment.

Adult↗
PubMed2006

Bladder sensation in peripheral nerve lesions.

OBJECTIVE: To present bladder sensory data of three common peripheral nerve lesions (e.g., distal, intermediate/focal, and proximal). METHODS: We measured first sensation (FS) and bladder capacity (BC) (not exceeding 600 ml) in 71 patients with peripheral nerve lesions: 35 diabetic neuropathy (D group), 6 post-pelvic surgery (S), and 27 cauda equina syndrome due to lumbar spondylosis (L). We excluded those with detrusor overactivity or low compliance that might affect bladder sensation. RESULTS: The mean FS was 301.7 ml (D), 271.3 ml (S), and 189.4 ml (L), with the largest being in the D group (P < 0.05); the mean BC was 495.2, 475.4, and 391.4 ml, with the largest being in the D group (P < 0.05); who commonly had less frequent toileting. The mean post-void residual volume was 106.5, 29.0, and 42.0 ml; the values tended to increase along with BC. In the D group, the mean FS in patients with skin hypoalgesia as detected by pin prick and in those without it was 407.8 and 210.0 ml. The percentage of patients with FS < 100 ml was 5.7%, 0%, and 7.4%, respectively, who commonly had urinary urgency and frequency. CONCLUSIONS: Bladder sensation is affected in diabetic neuropathy more severely than in intermediate/proximal lesions, together with somatic sensory disturbance. Bladder sensory disturbance leads to less frequent toileting, resulting in bladder over-distension and large post-void residuals. A small proportion of patients with peripheral nerve lesions develop urinary urgency, presumably reflecting irritation of the afferent nerve fibers or the urothelium.

Aged↗
PubMed1980

The chill sensation in fever.

Seven men were almost totally immersed in water at a neutral temperature (34.5 degrees) and given an intravenous injection of exogenous pyrogen. Five subjects who exhibited fever and visible shivering all reported sensations of chill at the time of shivering. Two subjects who did not shiver reported neutral sensation throughout. The results indicate that reduction of skin temperature is not necessary for the chill sensation in fever. The chill must arise from some central action of pyrogen.

Adult↗
PubMed1995

Model of respiratory sensation and wilful control of ventilation.

A mathematical model has been developed that includes sensations of breathlessness and a dynamic CO2 respiratory controller. Breathing sensations, which are represented as a discomfort index, are assumed to depend on arterial PCO2 level, automatic and wilful motor commands and mechanoreceptor feedback. Wilful control is assumed to arise from cortical centres of the brain and is independent of the reflex control system. The bulbopontine respiratory controller produces the automatic motor command, which is determined by chemical and mechanical feedback. Simulations demonstrate how the controller output and breathing sensations change when wilful motor commands disturb spontaneous breathing. Simulations include isocapnic hyper- and hypoventilation and deliberate hypoventilation during CO2 rebreathing. Simulations are compared with experimental data from human subjects. Simulations predict that the discomfort index intensifies when ventilation is either voluntarily raised or lowered from the optimal level; and discomfort is greater when ventilation is lowered than when it is raised at a given level of PCO2. The simulated results agree with those obtained experimentally. The simulations suggest that respiratory drive integration may depend not only on the direct effects of chemical and mechanical feedback, but also on the perceptual consequences of these stimuli.

Carbon Dioxide↗
PubMed2002

Increased sensations of intensity of breathlessness impairs maintenance of intense intermittent exercise.

To identify the reserve of an individual's tolerance of the sensation of breathlessness and metabolic stress in maintaining intense intermittent exercise at exhaustion under conditions of normal breathing, the contribution of the effect of modest inspiratory load on these two responses to the change in the exercise sustainability (Ex(sus)) were examined. Seven men repeatedly performed 12 s exercise at 160% maximal aerobic power output followed by passive recovery for 18 s under normal and ventilatory muscle loaded (VML) breathing conditions until exhaustion. In the VML trial, ventilatory muscle work at exhaustion was double that of the normal control. The control Ex(sus) was reduced [mean (SEM)] [31.7 (6.6)%] while the slope of the time course for the rating of the perceived magnitude of breathing effort (RPMBE/Time), which reflected the intensity of breathlessness, was increased [164.8 (32.2)%] from control and the RPMBE at exhaustion was higher than corresponding control value [144.4 (21.8)%]. Moreover, increases in plasma ammonia and uric acid concentrations, which indicated metabolic stress, were increased [168.1 (28.0)% and 251.7 (57.4)%, respectively], with no change in total oxygen uptake from control when the control exercise was repeated with an identical duration of VML exercise. It was found that the reduction in Ex(sus) in the VML trial was correlated to the increase in their sensations of the intensity of breathlessness (RPMBE/Time: r=0.81; RPMBE at exhaustion: r=0.97, P<0.05). The reduction in Ex(sus), however, was not correlated to the increase in metabolite concentrations. These findings implied that there was no substantial reserve of tolerance of the sensation of breathlessness relative to that of metabolic stress in subjects maintaining intense intermittent exercise at exhaustion under normal conditions of breathing.

Adult↗
PubMed2004

Reduced sensations of intensity of breathlessness enhances maintenance of intense intermittent exercise.

To identify the effect of normal breathlessness sensation elicited during intense intermittent exercise at exhaustion on limitation of exercise maintenance (Ex), the contribution of the flow-resistive unloading effect of normoxic helium-oxygen breathing on the breathlessness sensation to the change in the Ex was examined. Seven men repeatedly performed 12-s exercise at 160% maximal aerobic power output followed by passive recovery for 18-s under normal (CON) and unloaded (UL) breathing conditions until exhaustion. In UL, Ex was enhanced [mean (SD) 127.2 (11.8)% CON] concomitantly with reduction in averaged peak inhaled mouth pressure (PPmi) of recorded breathing cycles that reflected approximate true inspiratory muscle force output. At the iso-time point of CON exhaustion, the reduction in PPmi to [75.7(10.2)% CON] in UL was concomitant with the reductions in the rating of perceived breathlessness (RPB) [87.5 (13.1)% CON] and in the slope of time course for RPB (RPB/2-min period) [82.1 (17.2)% CON]. It was also concomitant with increases in ventilation and total oxygen consumption. However, the augmented oxygen consumption did not result in lowering of subjects' metabolic stress that was indicated by accumulations of blood lactate and plasma ammonia and uric acid. Nevertheless, the reductions in the RPB and RPB/2-min period, which reflected the breathlessness intensity, were correlated to the CON Ex enhancement in UL (RPB r=-0.57, RPB/2-min period r=-0.83; P<0.05). These findings implied that the normal noxious breathlessness sensation elicited during intense intermittent exercise at exhaustion might contribute to the limitation of subjects' exercise maintenance.

Adaptation, Physiological↗
PubMed2005

A pilot study of the effects of sildenafil on stool characteristics, colon transit, anal sphincter function, and rectal sensation in healthy men.

Nitric oxide is an important mediator of gut smooth muscle relaxation and visceral sensation. Sildenafil results in stimulation of the nitric oxide-cyclic GMP pathway. We sought to determine the effects of daily sildenafil administration on colorectal function. Over a 4-week period, sildenafil was administered during weeks 2 and 3. Stool frequency and consistency were assessed daily. Anorectal manometry, rectal sensation, and colon transit testing were performed at the end of weeks 1 and 3. Ten healthy men were studied. No significant differences in segmental or total colon transit time were noted; however, significant changes in stool frequency and trends toward decreased stool consistency were noted during sildenafil use. A trend toward reduced resting anal sphincter pressure was seen after sildenafil. Rectal volumes to first sensation and desire to defecate were significantly increased after sildenafil on test day 2 only. Additionally, volumes to desire to defecate and maximal tolerable volume were significantly increased before sildenafil on test day 2 compared to before sildenafil on test day 1. We conclude that daily administration of sildenafil is well tolerated and results in alterations in colorectal function.

Adult↗
PubMed1980

Latencies of chemically evoked discharges in human cutaneous nociceptors and of the concurrent subjective sensations.

Percutaneous recordings from single nociceptive A delta- and C-fibers have been performed from the superficial radial nerves of conscious human subjects. Nociceptors were tested with a chemical irritant substance, which induced a burning sensation when applied to the intact skin. A comparison of the onset of spike discharges in nociceptors and the onset of the subjective burning sensation indicated that under the conditions of our experiments summation of input from nociceptors is needed in order to induce pain sensations. In particular, our results indicate spatial summation.

Adult↗
PubMed1995

Increasing background inspiratory resistance changes somatosensory sensations in healthy man.

The central purpose of the study was to investigate if increasing background inspiratory resistance, a circumstance which activated afferents from the lungs and respiratory muscles, modified somatosensory and/or auditory sensations in healthy individuals. Estimation of mechanical stimulations applied on the middle finger (somatosensory sensation) and unilateral sound-pressure stimulations (auditory sensation) was based on the computation of Stevens' power function psi = k.phi n, where psi is the estimate and phi is either the somatosensory stimuli or sound-pressures. This was studied during eupnoeic unloaded ventilation then during a 10-min period of loaded breathing followed by a 10-min recovery period. Loaded breathing significantly lowered the estimate of somatosensory stimuli (decreased n coefficient). This effect persisted during the two first minutes of recovery period. By contrast, loaded breathing did not modify the perception of auditory stimulus. As somesthetic and respiratory afferents, but not auditory afferents, project on the same area in the sensory cortex we suggest the existence of central interactions which could explain observations of the difficulties to execute accurate tasks in patients suffering from obstructive lung disease independently from the alterations in their arterial blood gases.

Acoustic Stimulation↗
PubMed1995

The prevalence of phantom sensation and pain in pediatric amputees.

Phantom sensations and pain occur with an unknown frequency in children. We hypothesized that such experiences are common among children, and occur more often than is recognized by health-care personnel. Children and adolescents, ages 5-19 years, who had undergone limb amputation in the past 10 years, served as subjects for this retrospective study. Subjects were divided into three major groups depending upon the indication for amputation: congenital deformity (CD), trauma/infection (TI), and cancer (Ca). Surveys assessing phantom sensations and phantom pain were mailed to children and their parents/guardians. The incidence of phantom sensations was 100% in each group, and phantom pain occurred in the overwhelming majority. Both types of phantom phenomena began within days of surgery for almost all patients. Seventy-five percent of children and adolescents who had experienced phantom pain also had preoperative limb pain. At the time of the study, phantom pain had resolved in only 35% of the subjects. Phantom pain was documented in the medical records of only 40% of those answering positively to questions regarding phantom pain on the questionnaire. We conclude that phantom pain occurs commonly in children and adolescents. The association of preoperative pain in the diseased extremity and the later occurrence of phantom pain suggests that preoperative regional anesthesia may prevent phantom pain.

Adolescent↗
PubMed2005

The relationship between impaired decision-making, sensation seeking and readiness to change in cigarette smokers.

OBJECTIVE: The study investigated whether impaired decision-making as measured by the Gambling Task and Sensation Seeking, on one hand, and nicotine-dependence and readiness to change, on the other hand, show mutual influences in cigarette smokers. METHODS: Cigarette smokers were classified as dependent or non-dependent smokers. Assessment included stages of change (RCQ), decisional balance (DBS), Sensation Seeking Scale Form-V (SSS-V), and performance on the Gambling Task (GT). RESULTS: With the exception of a significant higher score in the SSS-V subscale Experience Seeking in dependent smokers, correlations between nicotine-dependence and cognitive features were not significant. The directions of the non-significant differences were not consistent. No significant relationship was found between the SSS-V and the GT, on one hand, and the readiness to change smoking behaviour, on the other hand. CONCLUSIONS: The results of the present study suggest that impaired performance on the GT and high scores in Sensation Seeking do not play an important role in nicotine-dependence and readiness to change smoking behaviour or vice versa.

Adaptation, Psychological↗
PubMed2006

Brief report: sexual sensation seeking and its relationship to risky sexual behaviour among African-American adolescent females.

The relationship between sexual sensation seeking and sexual risk taking has been investigated among adult populations. There are limited data, however, regarding this relationship for adolescents. Since African-American adolescent females continue to be disproportionately diagnosed with STDs, including HIV, we examined this association among a clinic-based sample of African-American adolescent females (N=715) enrolled in an STD/HIV prevention intervention. Participants (ages 15-21) endorsing higher levels of sexual sensation seeking reported higher levels of sexual risk-taking behaviours (e.g. frequency of vaginal intercourse, number of sexual partners, and poorer condom use). Results remained significant after controlling for known covariates associated with sexual risk-taking behaviours. Results are consistent with the adult literature and highlight the need for future investigations examining sexual sensation seeking among adolescents. These results, though preliminary, could be used to better inform prevention interventions and clinicians/health educators who provide direct services to adolescents.

Adolescent↗
PubMed2005

Segmental inhibition of cutaneous heat sensation and of laser-evoked potentials by experimental muscle pain.

The aim of the study was to evaluate the effect of tonic muscle pain evoked by injection of 5% hypertonic saline in the right brachioradialis muscle on the somatosensory sensation of laser-evoked heat pain and laser-evoked potentials. The heat pain pathways were studied in 9 healthy human subjects by recording the scalp potentials evoked by CO(2) laser stimuli delivered on four sites: the skin above the right brachioradialis muscle (ipsilateral local pain), the wrist area where muscle pain was referred in all subjects (ipsilateral referred pain), and two areas on the left arm symmetrical to both local and referred pain (contralateral local pain and contralateral referred pain). Laser-evoked potentials were obtained from 31 scalp electrodes before saline injection, during saline infusion (bolus injection with 0.3 ml saline infused over 20 s, followed by a steady infusion rate of 30 ml/h for the next 25 min), and 20 min after muscle pain had disappeared. While the early N1/P1 component (around 130 ms and 145 ms of latency after stimulation of the skin over the brachioradialis muscle and the wrist, respectively) was not affected by muscle pain, the amplitudes of the later vertex laser-evoked potentials (N2 latency of around 175 ms and 210 ms after stimulation of the skin over the brachioradialis muscle and the wrist, respectively; P2 latency of around 305 ms and 335 ms after stimulation of the skin over the brachioradialis muscle and the wrist, respectively) evoked from ipsilateral local pain, ipsilateral referred pain, and contralateral local pain sites were significantly decreased during muscle pain compared with the baseline recording, while they recovered after pain had disappeared. At the same stimulation sites, the rating of the laser-evoked pain sensation was reduced significantly during muscle pain as compared with the baseline and it recovered after pain had disappeared. On the contrary, muscle pain did not show any effect on both laser-evoked pain and laser-evoked potential amplitude when the contralateral referred pain site was stimulated. The muscle pain inhibitory effect on both heat pain sensation and laser-evoked potential amplitude is probably mediated by an ipsilateral and contralateral segmental mechanism which acts also on the referred pain area, while more general inhibitory mechanisms, such as a distraction effect or a diffuse noxious inhibitory control, are excluded by the absence of any effect of muscle pain on laser-evoked pain and laser-evoked potentials obtained from a remote site, such as the contralateral referred pain area. Since muscle pain induced by hypertonic saline injection is very similar to clinical pain, our results can be useful in understanding the pathophysiology of the somatosensory modifications which can be observed in patients with musculoskeletal pain syndromes.

Adult↗
PubMed2006

Does the chorda tympani nerve confer general sensation from the tongue?

OBJECTIVE: Patients often complain of numbness of the tongue after otologic procedures; this symptom may occur with or without taste alterations. The purpose of this study was to objectively assess possible changes in the general sensation of the tongue in patients undergoing middle ear surgery. STUDY DESIGN AND SETTING: Thirty-three individuals were included in this prospective controlled clinical study conducted at a tertiary referral center. Fifteen patients underwent middle ear surgery and 18 volunteers served as a control group. Subjects underwent objective tests to assess general sensation of the tongue before and twice after surgery. RESULTS: Forty-seven percent of the patients complained of numbness or tingling of the tongue shortly after surgery. In these patients, a significant reduction in sensitivities to light touch and 2-point discrimination on the operated side were noted at that time (P < 0.01; P < 0.009 respectively). Values returned to baseline on subsequent evaluations. No sensitivity change was noted for the contralateral hemi-tongue. CONCLUSION: Objective changes in the general sensory function of the tongue correlated with post-operative clinical symptoms experienced by patients. The results of this study support the notion that the chorda tympani nerve confers general sensation from the tongue. EBM RATING: A-1b.

Adult↗
PubMed2004

Associations between taste genetics, oral sensation and alcohol intake.

Alcohol produces a range of oral sensations, some of which have been shown to vary with the perceived bitterness of 6-n-propylthiouracil (PROP), one marker for genetic variation in taste. Some studies report that offspring of alcoholics are most likely to be PROP nontasters [Physiol. Behav. 51 (1992) 1261; Physiol. Behav. 64 (1998) 147], yet others report the offspring as more responsive to sodium chloride (NaCl) and citric acid, which appears to contradict the taste genetic hypothesis. We predicted alcohol sensation and intake from measures of taste genetics (PROP bitterness and number of fungiform papilla), NaCl and citric acid intensity, and spatial taste pattern in 40 females and 43 males. Subjects used the general Labeled Magnitude Scale (gLMS) [Chem. Senses 18 (1993) 683; J. Food Qual. Pref. 14 (2002) 125] as an intensity and hedonic scale. Those who tasted PROP as most bitter or had highest numbers of fungiform papilla reported greatest oral burn from an alcohol probe; those who tasted least PROP bitterness consumed alcoholic beverages most frequently. Although higher NaCl and citric acid ratings associated with more frequent consumption of alcoholic beverages, the findings could be explained by lower intensity of tastants on the tongue tip (chorda tympani nerve) relative to whole mouth perception. In multiple regression analyses, PROP bitterness and the spatial pattern of taste perception were independent contributors to the prediction of alcohol intake. In summary, the results support that variation in oral sensation associates with alcohol intake. Those who taste PROP as least bitter and have low chorda tympani relative to whole mouth taste intensity appear to have fewest oral sensory hindrances to the consumption of alcoholic beverages.

Adult↗