Somatosensation assessment using the NIH Toolbox

Abstract

Touch sensation is one element of sensory function. As such, somatosensation is one of the sensory domains included in the NIH Toolbox, which is an assessment battery for measuring a range of human functions including emotional health, sensation, cognition, and motor function. We evaluated a variety of methods for inclusion in the NIH Toolbox main battery. In a convenience sample of 409 participants, we evaluated aspects of kinesthesia, pain, and tactile discrimination. We present results on these measures across the lifespan and discuss implications for future studies that use the NIH Toolbox and these measures. Touch sensations contribute to somatic aspects of body scheme as a basis for interacting with the environment. 1 Somatosensation includes responses to touch, pressure, temperature, and changes in movement related to the skin and joints. 2,3 After a series of meetings, a team of consultants to the NIH Toolbox with expertise in somatosensation defined the construct to include the following.Somatosensory function refers to the detection, discrimination, and recognition of body sensations. Somatosensation includes submodalities of touch sensation such as light touch, vibration, firm pressure and texture discrimination, proprioception involving sensing the location and movement of body parts, temperature sensation, and pain. For the NIH Toolbox, the term "somatosensation" will refer to all aspects of touch and proprioception that contribute to a person's awareness of his or her body parts and the direct interface of these with objects and the environment. The experience of sensing often involves a more complex integration of somatosensory inputs and may be influenced by emotional and social contexts.Somatosensation is mediated, in part, by the somatosensory and posterior parietal cortices, which underlie the ability to identify tactile characteristics of surroundings, create meaning about sensations, and formulate body actions related to the sensations. [4][5][6] Proprioception-based abilities include locating one's limbs without looking, directing a limb to a given point, and judging the weight of an object. 7 The term kinesthesia specifically refers to the ability to detect the movement and position of one's limb in space without vision. 1 Somatosensory function changes over the lifespan and strongly affects functioning in everyday life. 1,8,9 People in mid to late adulthood experience decreased sensitivity to light touch and texture discrimination compared with children, adolescents, and young adults. [10][11][12][13] There are also age-related differences in cutaneous pain, 14 vibration and warm temperature sense, 15-17 and spatial acuity. 18-20 Much of this decline over time is attributed to progressive change in the sensitivity of cutaneous receptors 21 and has functional implications. 22 Difficulties in tactile and proprioceptive discrimination can limit a person's spontaneous hand use and the ability to manipulate and grip objects, affecting quality of life and, perhaps more importantly, saf...

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