While it is well known that skin physiology – and consequently sensitivity to peripheral stimuli – degrades with age, what is less appreciated is that centrally mediated mechanisms allow for maintenance of the same degree of functionality in processing these peripheral inputs and interacting with the external environment. In order to demonstrate this concept, we obtained observations of processing speed, sensitivity (thresholds), discriminative capacity, and adaptation metrics on subjects ranging in age from 18 to 70. The results indicate that although reaction speed and sensory thresholds change with age, discriminative capacity, and adaptation metrics do not. The significance of these findings is that similar metrics of adaptation have been demonstrated to change significantly when the central nervous system (CNS) is compromised. Such compromise has been demonstrated in subject populations with autism, chronic pain, acute NMDA receptor block, concussion, and with tactile–thermal interactions. If the metric of adaptation parallels cortical plasticity, the results of the current study suggest that the CNS in the aging population is still capable of plastic changes, and this cortical plasticity could be the mechanism that compensates for the degradations that are known to naturally occur with age. Thus, these quantitative measures – since they can be obtained efficiently and objectively, and appear to deviate from normative values significantly with systemic cortical alterations – could be useful indicators of cerebral cortical health.

Objective To investigate the clinical correlates of central nervous system (CNS) alterations among women with vulvodynia. Altered central sensitization has been linked to dysfunction in CNS inhibitory pathways (e.g. GABAergic), and metrics of sensory adaptation, a centrally mediated process that is sensitive to this dysfunction, could potentially be used to identify women at risk of treatment failure using conventional approaches. Methods Twelve women with vulvodynia and twenty age-matched controls participated in this study, which was conducted by sensory testing of the right hand’s index and middle fingers. The following sensory precepts were assessed: 1) vibrotactile detection threshold; 2) amplitude discrimination capacity (defined as the ability to detect differences in intensity of simultaneously delivered stimuli to two fingers); and 3) a metric of adaptation (determined by the impact that applying conditioning stimuli have on amplitude discriminative capacity). Results Participants did not differ on key demographic variables, vibrotactile detection threshold, and amplitude discrimination capacity. However, we found significant differences from controls in adaptation metrics in one subgroup of vulvodynia patients. Compared to healthy controls and women with a shorter history of pain (n=5; duration (yr) = 3.4 ± 1.3), those with a longer history (n=7; duration (yr) = 9.3 ±1.4)) were found to be less likely to have adaptation metrics similar to control values. Discussion Chronic pain is thought to lead to altered central sensitization, and adaptation is a centrally mediated process that is sensitive to this condition. This report suggests that similar alterations exist in a subgroup of vulvodynia patients.

In this study, we investigated the changes in perceptual metrics of amplitude discrimination that were observed in ten healthy human subjects with increasing intensities of stimulation. The ability to perceive differences in vibrotactile amplitude changed systematically with increasing stimulus magnitude (i.e., followed Weber's Law) in a near linear fashion (R (2) = 0.9977), and the linear fit determined by the amplitude discrimination task predicted the subjects' detection thresholds. Additionally, the perceptual metrics correlated well with observations from a previously reported study in which measures of SI cortical activity in non-human primates (squirrel monkeys) evoked by different amplitudes of vibrotactile stimulation were obtained (Simons et al. in BMC Neurosci 6:43, 2005). Stimuli were delivered simultaneously to two different skin sites (D2 and D3), enabling a method for the relatively rapid acquisition of the data. Stability and robustness of the measure, its rapid acquisition, and its apparent relationship with responses previously observed in SI cortex, led to the conclusion that deviations from the baseline values observed in the obtained perceptual metric could provide a useful indicator of cerebral cortical health.

Current methods for applying multi-site vibratory stimuli to the skin typically involve the use of multiple, individual vibrotactile stimulators. Limitations of such an arrangement include difficulty with both positioning the stimuli as well as ensuring that stimuli are delivered in a synchronized and deliberate manner. Previously, we reported a two-site tactile stimulator that was developed in order to solve these problems (Tannan et al., 2007a). Due to both the success of that novel stimulator and the limitations that were inherent in that device, we designed and fabricated a four-site stimulator that provides a number of advantages over the previous version. First, the device can stimulate four independent skin sites and is primarily designed for stimulating the digit tips. Second, the positioning of the probe tips has been re-designed to provide better ergonomic hand placement. Third, the device is much more portable than the previously-reported stimulator. Fourth, the stimulator head has a much smaller footprint on the table or surface where it resides. To demonstrate the capacity of the device for delivering tactile stimulation at four independent sites, a finger agnosia protocol, in the presence and absence of conditioning stimuli, was conducted on seventeen healthy control subjects. The study demonstrated that with increasing amplitudes of vibrotactile conditioning stimuli concurrent with the agnosia test, inaccuracies of digit identification increased, particularly at digits D3 and D4. The results are consistent with prior studies that implicated synchronization of adjacent and near-adjacent cortical ensembles with conditioning stimuli in impacting TOJ performance (Tommerdahl et al., 2007).

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