Normative values of the vibration perception thresholds at finger pulps and metatarsal heads in healthy adults

Abstract

Aims To establish normative values of vibration perception thresholds (VPTs), using multi-frequency vibrometry at finger pulps and at metatarsal heads of the foot in healthy adults. We also aimed to investigate factors that could potentially affect VPTs such as age, sex, height, weight, foot- or handedness and skin temperature. Methods VPTs were examined in 924 healthy and randomly selected subjects in the southern Sweden (mean 46 years; 628 women and 296 men). Inclusion criterias were adult subjects (>18 years) in considerable health without diabetes mellitus or other nerve affecting disorders. VPTs were measured at the finger pulps of index and little finger, as well as the first and fifth metatarsal heads of the foot, through multi-frequency vibrometry using the VibroSense Meter® I device. Patient characteristics were recorded and skin temperature was measured before assessment of VPTs. Results We present normative values of VPTs for a large population of both male and female subjects in various ages. VPTs detoriated as age increased (0.09–0.59 dB per year; p<0.001), i.e. progressing with normal aging. Increasing skin temperature affected VPTs in finger pulps, but not at metatarsal heads, with -0.2 to -1.6 dB, i.e. vibration perception improved with higher temperatures. Height was only found to affect the VPTs of metatarsal heads (250 Hz: 0.42 dB per cm). Sex, weight and handedness did not affect the VPTs. Conclusion We investigated the normative values of VPTs and presented affecting factors as age, skin temperature and height. With these results, VPT testing through multi-frequency vibrometry is enabled to be used in a clinical practice as a diagnostic tool when investigating neuropathy and other neurological disorders.

Quantitative proteomic analysis of human peripheral nerves from subjects with type 2 diabetes

“…A study by Ekman et al on normative values of vibration perception thresholds shows that the thresholds deteriorate every year, as is expected considering the impact of ageing on neuronal health 37 . However, Ekman et al show that the deterioration is small with only one year of aging, in both upper and lower extremities, while clearer changes in vibration perception thresholds can be seen over a longer aging period, for example 10 years 37 . Moreover, in this study, the nerve function of the upper extremity, analysed in the ulnar nerve not affected by any nerve compression lesion, did not differ between type 2 diabetes and healthy controls.…”

“…We strongly believe that this age difference, of in median 2 years, will not impact the results in a cohort of participants around 70 years of age. A study by Ekman et al on normative values of vibration perception thresholds shows that the thresholds deteriorate every year, as is expected considering the impact of ageing on neuronal health 37 . However, Ekman et al show that the deterioration is small with only one year of aging, in both upper and lower extremities, while clearer changes in vibration perception thresholds can be seen over a longer aging period, for example 10 years 37 .…”

Peripheral and Autonomic Neuropathy Status of Young Patients With Type 1 Diabetes Mellitus at the Time of Transition From Pediatric Care to Adult-Oriented Diabetes Care

“…The examination of the vibration perception can be useful to detect diabetic peripheral sensory neuropathy at an early stage, and it can be easily assessed by a 128 Hz tuning fork (54). Normative values of vibration perception thresholds in finger pulps and metatarsal heads have been published in healthy children and adolescents (62) and in adults (63). A recent study by Abraham et al (64) found impaired vibration perception both in the fingers and in the toes among patients with type 1 and type 2 diabetes mellitus; however, the difference was significant only in the toes compared to healthy controls.…”

Addressing Chemotherapy-Induced Peripheral Neuropathy Using Multi-Frequency Vibrometry and Patient-Reported Outcomes

“…Multi-frequency vibrometry was performed at baseline. All evaluations and follow-up visits used the VibroSense Meter ® II (Vibrosense Dynamics AB, Malmö, Sweden)—a CE-marked Class I medical device licensed to measure vibration perception thresholds (VPTs) between 4 and 500 Hz within a pre-specified skin temperature—and an applied pressure range [ 12 , 31 ]. VPTs were measured at 32, 125, and 250 Hz on the tactile surface of the finger pulp of the index (referred to as DigII-32 Hz, DigII-125 Hz, and DigII-250 Hz) and little finger (DigV-32 Hz, DigV-125 Hz, and DigV-250 Hz) on the patient’s dominant hand, and VPTs at 8, 32, and 125 Hz on the palmar skin of the first (MT-I-8 Hz, MT-I-32 Hz, and MT-I-125 Hz) and fifth metatarsal head (MT-V-8 Hz, MT-V-32 Hz, and MT-V-125 Hz) of the patient’s dominant foot [ 32 ].…”

“…Multi-frequency vibrometry (MF-V) is a novel semiquantitative psychophysiological measurement that captures multiple vibration perception thresholds (VPTs) from tactile non-glabrous skin [ 12 ]. Low-frequency MF-V has shown promise in early subclinical detection of diabetic neuropathy, linking measurements to worse glycemic control [ 13 ] and also showing a strong association with the risk of developing diabetic ulcers [ 14 ].…”