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PubMed2005

Integration of touch and sound in auditory cortex.

To form a coherent percept of the environment, our brain combines information from different senses. Such multisensory integration occurs in higher association cortices; but supposedly, it also occurs in early sensory areas. Confirming the latter hypothesis, we unequivocally demonstrate supra-additive integration of touch and sound stimulation at the second stage of the auditory cortex. Using high-resolution fMRI of the macaque monkey, we quantified the integration of auditory broad-band noise and tactile stimulation of hand and foot in anaesthetized animals. Integration was found posterior to and along the lateral side of the primary auditory cortex in the caudal auditory belt. Integration was stronger for temporally coincident stimuli and obeyed the principle of inverse effectiveness: greater enhancement for less effective stimuli. These findings demonstrates that multisensory integration occurs early and close to primary sensory areas and--because it occurs in anaesthetized animals--suggests that this integration is mediated by preattentive bottom-up mechanisms.

Animals↗
PubMed2005

Vision and touch in ageing: crossmodal selective attention and visuotactile spatial interactions.

We investigated whether ageing affects crossmodal selective attention (the ability to focus on a relevant sensory modality and ignore an irrelevant modality) and the spatial constraints on such selective processing. Three groups of 24 participants were tested: Young (19-25 years), Young-Old (65-72 years) and Old-Old (76-92 years). The participants had to judge the elevation of vibrotactile targets (upper/index finger and lower/thumb), presented randomly to either hand while ignoring concurrent visual distractors. In a second task, the role of the target and distractor modalities was reversed. Crossmodal selective attention was assessed by comparing performance in the presence versus absence of distractors. Spatial constraints on selective attention were also investigated by comparing the effect of distractors presented on the same versus opposite side as the target. When attending to touch, the addition of visual distractors had a significantly larger effect on error rates in both of the older groups as compared to the Young group. This indicates that ageing has a detrimental effect on crossmodal selective attention. In all three age groups, performance was impaired when the target and distractor were presented at incongruent as compared to congruent elevations in both tasks. This congruency effect was modulated by the relative spatial location of the target and distractor in certain conditions for the Young and the Young-Old group. That is, participants in the two younger age groups found it harder to attend selectively to targets in one modality, when distractor stimuli came from the same side rather than from the opposite side. However, no significant spatial modulation was found in the Old-Old group. This suggests that ageing may also compromise spatial aspects of crossmodal selective attention.

Adult↗
PubMed2006

The postural disorientation induced by neck muscle vibration subsides on lightly touching a stationary surface or aiming at it.

The aim of this study was to investigate whether the standing body spatial disorientation, induced by neck muscle vibration, and the related post-effects can be suppressed by light finger touch (LFT) of a stationary surface. Continuous (60 s) vibration of dorsal neck or sternocleidomastoid muscle was administered with eyes closed. The center of foot pressure (CFP) displacement, measured by a stabilometric platform, indicated the degree of vibration-induced body tilt. We also investigated whether sensory information from LFT itself was necessary or anticipation of a more secure posture was enough for reducing vibration effects. To this aim, we administered a vibration pulse (5 s) to dorsal neck or sternocleidomastoid muscle and during reaching to the stationary surface. CFP was recorded during both vibration and post-vibration condition and during the aiming task. Neck vibration induced significant CFP displacement in the direction opposite to vibration site. Post-vibration, CFP slowly returned to control values with ample oscillations. LFT during vibration reduced body tilt. LFT was more effective when fingertip contact was in the plane of the greatest tilt. LFT applied during either vibration or post-vibration period reduced post-vibration effects. Reaching toward the stationary surface was enough for reducing vibration-induced body tilt to values close to those observed during actual LFT. The novel conclusions of this study are: 1) LFT is able to relieve the effects of vibration-induced abnormal proprioceptive input from the neck, a segment central to postural control and orientation; 2) LFT during vibration also attenuates vibration post-effects, further suggesting that its action is not merely mechanical; 3) the intention to stabilize the body generates a new postural 'set' sufficient for diminishing body tilt.

Adult↗
PubMed2005

Evaluation of healing by gentle touch.

OBJECTIVES: To evaluate the effectiveness and safety of healing by gentle touch in clients attending The Centre for Complementary Care (CCC) in Eskdale, Cumbria. STUDY DESIGN: An evaluation of data collected by questionnaire over 6 years. METHODS: All clients attending the CCC between 1995 and 2001 were invited to participate in this study, and data were collected from 300 subjects with a wide range of ailments who received four treatment sessions within 6 weeks. Exclusion criteria were: recent treatment at the CCC; failure to complete four treatment sessions; and age under 16 years. Outcome measures included comparison of pre- and post-treatment levels of physical (pain, disability, immobility, sleep disturbances, reliance upon medication, daily activities) and psychological (stress, panic, fear, anger, relaxation, coping, depression/anxiety) functioning; these were assessed using a questionnaire with visual analogue scales for subjective rating of symptoms and the EuroQoL (EQ-5D), a generic state-of-health measure. RESULTS: Wilcoxon signed ranks tests showed statistically significant improvements in both psychological and physical functioning, particularly in stress reduction (median stress levels fell by four points), pain relief (median pain ratings fell by two points), increased ability to cope (median improvement of three points) and increased general health ratings (median improvement of 20 points) between study entry and end of treatment (P < 0.0004 for all these symptoms). The most substantial improvements were seen in those with the most severe symptoms at study entry. No adverse effects of treatment were documented. CONCLUSIONS: This audit of treatment outcomes provides evidence consistent with the hypothesis that healing, as provided at the CCC, was associated with improved psychological and physical functioning in the majority of subjects, and is worthy of further evaluation.

Adolescent↗
PubMed1999

The surgical significance of therapeutic touch.

Therapeutic touch (TT) is believed to help promote relaxation, reduce pain, accelerate the healing process, and alleviate psychosomatic illness. Patients who undergo surgery frequently experience stressors such as anxiety and pain. Although there have been limited studies on the use of TT in the surgical arena, it is a stress-reduction method that should be explored further. This article discusses studies that examined the use of TT in reducing anxiety and pain.

Consciousness↗
PubMed2002

Tool-use changes multimodal spatial interactions between vision and touch in normal humans.

In a visual-tactile interference paradigm, subjects judged whether tactile vibrations arose on a finger or thumb (upper vs. lower locations), while ignoring distant visual distractor lights that also appeared in upper or lower locations. Incongruent visual distractors (e.g. a lower light combined with upper touch) disrupt such tactile judgements, particularly when appearing near the tactile stimulus (e.g. on the same side of space as the stimulated hand). Here we show that actively wielding tools can change this pattern of crossmodal interference. When such tools were held in crossed positions (connecting the left hand to the right visual field, and vice-versa), the spatial constraints on crossmodal interference reversed, so that visual distractors in the other visual field now disrupted tactile judgements most for a particular hand. This phenomenon depended on active tool-use, developing with increased experience in using the tool. We relate these results to recent physiological and neuropsychological findings.

Adult↗
PubMed1990

Failure to manipulate objects secondary to active touch disturbance.

A peculiar type of sensori-motor disturbance consequent to a lesion in the contralateral postcentral gyrus was reported. The symptom was characterized by motor clumsiness of the left hand without loss of strength and with preserved finger movements on visual imitation. Motor difficulty was most marked when the patient had to manipulate an object. The analysis of the patient's behavior and of his sensory deficits suggests that the basis of the clumsiness was a deficit in active touch perception.

Cerebral Infarction↗
PubMed1998

Dynamics of effortful touch and interlimb coordination.

In biological movement systems, the level of muscular-articular links is responsible for assembling highly reliable, stable, and reproducible coordination patterns involving very many joints and muscles. Research shows that the important perceptual capabilities of this level arise from the bulk sensitivity of muscles and tendons, so-called effortful or dynamic touch, to the quantities of rotational dynamics that remain invariant (such as the inertia tensor) over variations in rotational forces and motions. The power laws characterizing this sensitivity point to underlying fractal (self-similar) processes. Other research shows that the hallmark ability of this level to produce repetitive interlimb coordinations can be addressed through a dynamics of coordination in which equations express the time-evolution of collective neuromuscular states. This research also suggests that the assembled rhythms exploit the unique blend of stability and variability characteristic of low-dimensional chaotic motion on strange attractors. In overview, research into the capabilities of the level of muscular-articular links highlights the importance of applying classical and modern (nonlinear) dynamics to understanding the assembly and perceptual control of biological movements.

Extremities↗
PubMed2001

Crossmodal links in spatial attention between vision, audition, and touch: evidence from event-related brain potentials.

Results from event-related potential (ERP) studies are reviewed that investigated crossmodal links in spatial attention between vision, audition and touch to find out which stages in the processing of sensory stimuli are affected by such crossmodal links. ERPs were recorded in response to visual, auditory, and tactile stimuli under conditions where attention was directed to a specific location within one (primary) modality, while stimuli in another (secondary) modality were to be ignored regardless of their position. Systematic ERP effects of spatial attention were observed not only in the primary modality, but also for secondary modality stimuli, thus revealing crossmodal links in spatial attention. These links affected relatively early sensory-specific ERP components between 100 and 200 ms post-stimulus. Beyond 200 ms, ERPs to secondary modality stimuli were little affected by the current focus of attention within another modality. This pattern of results suggests that crossmodal links in spatial attention may affect sensory-perceptual processes within modality-specific cortical regions, but have little impact on later post-perceptual processing stages.

Attention↗
PubMed1997

Attentional competition between modalities: extinction between touch and vision after right hemisphere damage.

The phenomenon of extinction, which occurs frequently after unilateral brain damage, involves a failure to detect the more contralesional of two simultaneously presented stimuli, but with preserved detection of single ipsilesional or contralesional stimuli. Current accounts suggest that the disorder reflects a bias of selective attention, in which ipsilesional stimuli have a competitive advantage. Extinction may be manifested within any one of the major sensory modalities (vision, audition, touch), or it may occur within several modalities in a given individual. Given recent evidence in normals for attentional links between separate sensory modalities, we examined whether extinction can also occur cross-modally, i.e. for double-simultaneous stimuli in separate sensory modalities. We tested whether an ipsilesional event sufficient to extinguish a contralesional stimulus within the same modality may also extinguish a contralesional stimulus in a different modality. Our three patients had right hemisphere damage, and reliable within-modality extinction for visual and tactile stimuli. They also showed significant cross-modal extinction, such that an ipsilesional tactile (or visual) event extinguished awareness of a simultaneous visual (or tactile) event on the contralesional side. These results, which provide the first quantitative evidence for cross-modal extinction, were replicated in a second experiment in which visual and tactile stimuli in the cross-modal conditions were presented at non-homologous elevations within each hemispace. We conclude that after unilateral damage, ipsilesional stimuli have a competitive advantage over contralesional stimuli, and that this affects competition between stimuli from different modalities as well as stimuli within the same modality. These findings are consistent with recent evidence for competitive interactions between tactile and visual events in the control of spatial attention in normals.

Adult↗
PubMedDate not supplied

Music, imagery, touch, and prayer as adjuncts to interventional cardiac care: the Monitoring and Actualisation of Noetic Trainings (MANTRA) II randomised study.

BACKGROUND: Data from a pilot study suggested that noetic therapies-healing practices that are not mediated by tangible elements-can reduce preprocedural distress and might affect outcomes in patients undergoing percutaneous coronary intervention. We undertook a multicentre, prospective trial of two such practices: intercessory prayer and music, imagery, and touch (MIT) therapy. METHODS: 748 patients undergoing percutaneous coronary intervention or elective catheterisation in nine USA centres were assigned in a 2x2 factorial randomisation either off-site prayer by established congregations of various religions or no off-site prayer (double-blinded) and MIT therapy or none (unmasked). The primary endpoint was combined in-hospital major adverse cardiovascular events and 6-month readmission or death. Prespecified secondary endpoints were 6-month major adverse cardiovascular events, 6 month death or readmission, and 6-month mortality. FINDINGS: 371 patients were assigned prayer and 377 no prayer; 374 were assigned MIT therapy and 374 no MIT therapy. The factorial distribution was: standard care only, 192; prayer only, 182; MIT therapy only, 185; and both prayer and MIT therapy, 189. No significant difference was found for the primary composite endpoint in any treatment comparison. Mortality at 6 months was lower with MIT therapy than with no MIT therapy (hazard ratio 0.35 (95% CI 0.15-0.82, p=0.016). INTERPRETATION: Neither masked prayer nor MIT therapy significantly improved clinical outcome after elective catheterisation or percutaneous coronary intervention.

Aged↗
PubMed1996

Mechanisms of touch-evoked pain (allodynia): a new model.

In this paper we review the current neurophysiological models of touch-evoked pain and present a new proposal that addresses the mechanisms of allodynia. The new model is based on the notion that A-beta mechanoreceptors can gain access to nociceptive neurones by means of a presynaptic link, at central level, between low threshold mechanoreceptors and nociceptors. We propose that the excitation of nociceptors provoked by a peripheral injury activates the spinal interneurones that mediate primary afferent depolarization (PAD) between low threshold mechanoreceptors and nociceptors. As a consequence of the increased and persistent barrage driving these neurones their excitability is increased such that, when activated by low threshold mechanoreceptors from areas surrounding the injury site, they produce a very intense PAD in the nociceptive afferents which is capable of generating spike activity. This activation would be conducted antidromically in the form of dorsal root reflexes (DRRs) but would also be conducted forward activating the second order neurones normally driven by nociceptors. The sensory consequence of this mechanism is pain evoked by the activation of low threshold mechanoreceptors from an area surrounding an injury site (allodynia).

Afferent Pathways↗
PubMed1998

Does intravenous administration of GABA(A) receptor antagonists induce both descending antinociception and touch-evoked allodynia?

Effects of intravenous administration of picrotoxin (PTX), a GABA(A) receptor antagonist, upon activities of wide dynamic range (WDR) neurons in the lumbar spinal cord were studied in urethane-chloralose anesthetized cats. Intravenous PTX augmented tactile evoked responses of WDR neurons, but reduced nociceptive responses dose-dependently. Spinal transection reversed the suppression of nociceptive responses. In the spinal cat, intravenous PTX enhanced the tactile evoked response. Intravenous PTX enhanced the spontaneous firing of nucleus raphe dorsalis (NRD) and/or ventral periaqueductal gray (PAG) neurons projecting to nucleus raphe magnus. Lidocaine injected into NRD/PAG reversed the antinociceptive action of intravenous PTX. PTX injected into NRD/PAG reduced heat-evoked responses of WDR units. These data suggest that antinociceptive effects of intravenous PTX is primarily due to disinhibitory activation of the descending antinociceptive system originating from NRD and PAG, and that PTX reinforces touch-evoked responses in the spinal cord.

Analgesics↗
PubMed1999

A case of referred pain evoked by remote light touch after partial nerve injury.

An unusual case of referred pain is presented in which a 63-year-old man, who suffered a severe injury to his right hand and arm during young adulthood, describes the later development of dysesthesia and shooting pain in his arm subsequent to stimulation of the ipsilateral scalp, the temporal and infrazygomatic region of the face, and the back. Referred sensations of this type are usually reported following amputation of an arm. Clinical examination of the sensory and motor function of the arm and hand revealed partial damage to the radial, ulnar and median nerves as well as possible brachial plexus involvement. Interestingly, pain could be evoked by repeated light touches applied to the remote trigger areas suggesting the involvement of a 'wind-up'-like process.

Arm↗
PubMedDate not supplied

The effect of wrist position on testing light touch sensation using the Semmes-Weinstein pressure aesthesiometer: a preliminary study.

The objective of the study was to determine the normative values for light touch sensation measured by the Semmes-Weinstein pressure aesthesiometer when the wrist is held in the maximal flexed position and when the wrist is held in the maximal extended position. Currently, normative values exist only for measurements taken when the wrist is held in a neutral position. Thirty-one subjects with no previous hand injury or pathology participated in this preliminary study. Each subject served as his or her own control; i.e., each finger with the wrist in a neutral position served as the control for the same finger when the wrist was positioned in maximal flexion and then in maximal extension. The neutral position was used as the control, because normative values already exist for that position. The results revealed no consistent differences between measurements taken when the wrist was held in a neutral position and those taken with the wrist held in the maximal, or complete, flexed or extended position. This suggests that any difference in sensation found when hands are placed in a provocative position--i.e., when wrists are flexed or extended rather than placed in a neutral resting position--may be due to pathology and not to position.

Adult↗
PubMedDate not supplied

Therapeutic touch with HIV-infected children: a pilot study.

In this pilot study, 20 HIV-infected children, 6 to 12 years of age, were randomly assigned into therapeutic touch (TT) and mimic TT groups. The effectiveness of TT in reducing anxiety was evaluated. The self-report measure, the A-State Anxiety subscale of the Spielberger State-Trait Anxiety Inventory For Children, was administered before and immediately after interventions. As predicted, the TT intervention resulted in lower overall mean anxiety scores, whereas the mimic TT did not. These findings provide preliminary support for the use of TT in reducing the state anxiety of children with HIV infection.

Analysis of Variance↗
PubMed1997

Therapeutic touch: nursing activity or form of spiritual healing?

There is a major movement in nursing which is exploring the part that a wide range of complementary therapies can play in expanding the therapeutic role of the nurse. Courses have been developed that will enable nurses to apply these skills to their daily practice (Faltermeyer 1995). Therapeutic Touch (TT) is being advocated as one such therapy, primarily developed and researched by nurses for nurses (Sayre-Adams & Wright 1995). Early writings and thinking on TT speak of origins in the ancient practice of the 'laying on of hands'; the purpose of which was and is to 'heal or encourage healing in a sick person' (Krieger 1979). Its application in practice can be helped or hindered by this statement since this might be interpreted as spiritual healing, a term which can be confusing, open to misinterpretation and can spark controversy.

Holistic Nursing↗
PubMed1999

Physiologic and psychodynamic responses to the administration of therapeutic touch in critical care.

Recent publications have questioned the efficacy of therapeutic touch (TT). The focus of attention has been on substantiating the existence of the recipient's energy field rather than on the physiologic and psychodynamic responses to TT. In this article the physiologic and psychodynamic responses during and following the administration of TT is described. The project involved the implementation of a time series design in which the physiologic and psychodynamic responses were measured. It is acknowledged that critical care environments are stressful for patients in terms of invasive medical and nursing procedures. Continuous bright lighting, and excessive noise prohibits the potential for relaxation and sleep. Within this context, the control of confounding variables was not possible, and therefore not an object of concern in the study. Rather the responses to TT in the natural setting were of importance to discern. Statistical repeated measures analysis of variance (one way) indicated there was no significant difference between pre-, during and post-physiologic variables in response to TT. However psychodynamic responses demonstrated significant correlation's in terms of relaxation and sleep. The non significance of physiologic change in variables pre-, during and post-administration of TT indicates critically ill patients remained physiologically stable. Significant correlations of psychodynamic responses demonstrated it is possible for critically ill patients to experience periods of relaxation and sleep in an otherwise stressful environment. TT was found to be a useful therapy to enhance relaxation and sleep in critically ill patients.

Adult↗