Åke Vallbo

Unmyelinated tactile afferents signal touch and project to insular cortex.

There is dual tactile innervation of the human hairy skin: in addition to fast-conducting myelinated afferent fibers, there is a system of slow-conducting unmyelinated (C) afferents that respond to light touch. In a unique patient lacking large myelinated afferents, we found that activation of C tactile (CT) afferents produced a faint sensation of pleasant touch. Functional magnetic resonance imaging (fMRI) analysis during CT stimulation showed activation of the insular region, but not of somatosensory areas S1 and S2. These findings identify CT as a system for limbic touch that may underlie emotional, hormonal and affiliative responses to caress-like, skin-to-skin contact between individuals.

The neurophysiology of unmyelinated tactile afferents.

CT (C tactile) afferents are a distinct type of unmyelinated, low-threshold mechanoreceptive units existing in the hairy but not glabrous skin of humans and other mammals. Evidence from patients lacking myelinated tactile afferents indicates that signaling in these fibers activate the insular cortex. Since this system is poor in encoding discriminative aspects of touch, but well-suited to encoding slow, gentle touch, CT fibers in hairy skin may be part of a system for processing pleasant and socially relevant aspects of touch. CT fiber activation may also have a role in pain inhibition. This review outlines the growing evidence for unique properties and pathways of CT afferents.

Somatotopic organization of gentle touch processing in the posterior insular cortex.

A network of thin (C and Aδ) afferents relays various signals related to the physiological condition of the body, including sensations of gentle touch, pain, and temperature changes. Such afferents project to the insular cortex, where a somatotopic organization of responses to noxious and cooling stimuli was recently observed. To explore the possibility of a corresponding body-map topography in relation to gentle touch mediated through C tactile (CT) fibers, we applied soft brush stimuli to the right forearm and thigh of a patient (GL) lacking Aβ afferents, and six healthy subjects during functional magnetic resonance imaging (fMRI). For improved fMRI analysis, we used a highly sensitive multivariate voxel clustering approach. A somatotopic organization of the left (contralateral) posterior insular cortex was consistently demonstrated in all subjects, including GL, with forearm projecting anterior to thigh stimulation. Also, despite denying any sense of touch in daily life, GL correctly localized 97% of the stimuli to the forearm or thigh in a forced-choice paradigm. The consistency in activation patterns across GL and the healthy subjects suggests that the identified organization reflects the central projection of CT fibers. Moreover, substantial similarities of the presently observed insular activation with that described for noxious and cooling stimuli solidify the hypothesized sensory-affective role of the CT system in the maintenance of physical well-being as part of a thin-afferent homeostatic network.

Receptive field characteristics of tactile units with myelinated afferents in hairy skin of human subjects.

1. Impulses in single nerve fibres from the lateral antebrachial cutaneous nerve were recorded using the microneurography technique in human subjects. 2. In a sample of fifty‐five mechanoreceptive units with fast‐conducting nerve fibres, five types were identified, i.e. SAI (slowly adapting type I, Merkel), SAII (slowly adapting type II, Ruffini), hair units, field units and Pacinian‐type units. The latter three unit types were all rapidly adapting. 3. The detailed structure of thirty‐five receptive fields of SAI, SAII, hair and field units was explored with a method which was objective and independent of the experimenters skill and experience. A lightweight probe was used to scan the receptive field area in a series of tracks 0.23 mm apart while single‐unit activity was recorded. 4. SAI fields were small and composed of two to four well‐separated high‐sensitivity spots and often, in addition, one minor spot of lower sensitivity. SAII units typically fired spontaneously at a low and regular rate. Most fields consisted of one single spot of high sensitivity with diffuse borders. The hair units innervated ten to thirty‐three (or more) hairs, which were evenly distributed over a large area. The field units were characterized by a number of small and closely packed high‐sensitivity spots with diffuse borders. A conservative estimate indicated eleven spots per unit. 5. The findings indicate that the sheet of mechanoreceptors on the skin of the forearm is distinctly different from that on the dorsum of the hand and in the face. It seems reasonable to assume that the former is more representative for the hairy skin covering the main parts of the body.

Functional role of unmyelinated tactile afferents in human hairy skin: sympathetic response and perceptual localization

In addition to A-beta fibres the human hairy skin has unmyelinated (C) fibres responsive to light touch. Previous functional magnetic resonance imaging (fMRI) studies in a subject with a neuronopathy who specifically lacks A-beta afferents indicated that tactile C afferents (CT) activate insular cortex, whereas no response was seen in somatosensory areas 1 and 2. Psychophysical tests suggested that CT afferents give rise to an inconsistent perception of weak and pleasant touch. By examining two neuronopathy subjects as well as control subjects we have now demonstrated that CT stimulation can elicit a sympathetic skin response. Further, the neuronopathy subjects’ ability to localize stimuli which activate CT afferents was very poor but above chance level. The findings support the interpretation that the CT system is well suited to underpin affective rather than discriminative functions of tactile sensations.

Unmyelinated tactile afferents have opposite effects on insular and somatosensory cortical processing

A previous functional magnetic resonance imaging (fMRI) study of an A-beta deafferented subject (GL) showed that stimulation of tactile C afferents (CT) activates insular cortex whereas no activation was seen in somatosensory cortices. Psychophysical studies suggested that CT afferents contribute to affective but not to discriminative aspects of tactile stimulation. We have now examined cortical processing following CT stimulation in a second similarly deafferented subject (IW), as well as revisited the data from GL. The results in IW showed similar activation of posterior insular cortex following CT stimulation as in GL and so strengthen the view that CT afferents underpin emotional aspects of touch. In addition, CT stimulation evoked significant fMRI deactivation in somatosensory cortex in both subjects supporting the notion that CT is not a system for discriminative touch.

PULSATILE MOTOR OUTPUT IN HUMAN FINGER MOVEMENTS IS NOT DEPENDENT ON THE STRETCH REFLEX

1. Stretch perturbations were delivered during slow voluntary finger movements with the aim of exploring the role of the stretch reflex in generating the 8‐10 Hz discontinuities that characterize these movements. Afferent activity from muscle spindle primary endings in the finger extensor muscles was recorded from the radial nerve, along with the EMG activity of these muscles, and kinematics of the relevant metacarpo‐phalangeal joint. 2. Perturbations elicited a distinct response from the muscle spindles appearing at the recording electrode after 13 ms, and weak reflex responses from the muscle with peak values at 53 and 63 ms during flexion and extension, respectively. 3. The time relations between kinematics, spindle firing and modulations of EMG activity elicited by the perturbations were compared with those of the self‐generated discontinuities. These analyses indicate that stretch reflex mechanisms cannot account for the modulations of EMG activity that give rise to successive 8‐10 Hz discontinuities. 4. A comparison of the reflex responses to perturbations with the EMG modulations during self‐generated movements indicates that the reflex was too weak to account for the pulsatile motor output during voluntary movements. 5. By inference it was concluded that the 8‐10 Hz discontinuities during self‐generated movements are probably generated by mechanisms within the central nervous system.

Directional tuning of human forearm muscle afferents during voluntary wrist movements

1 Single unit activity was recorded with the microneurography technique from sixteen spindle afferents and one Golgi tendon organ afferent originating from the forearm extensor muscles. Impulse rates were studied while subjects performed unobstructed aiming movements at the wrist in eight different directions 45 deg apart. In addition, similar imposed movements were performed while the subject was instructed to remain relaxed. Movement amplitudes were about 5 deg and the speed 10–30 deg s−1. Joint movements were translated to movements of a cursor on a monitor to provide visual feedback. 2 Individual spindle afferents modulated their activity over a number of targets, i.e. were broadly tuned, during these aiming movements. The preferred direction for a spindle afferent was the same during both passive and active movements, indicating that the fusimotor effects associated with active contractions had little or no effect on the direction of tuning. 3 The direction of tuning of individual spindle afferents could be predicted from the biomechanically inferred length changes of the parent muscle. Thus spindle afferents responded as stretch receptors, i.e. impulse rates increased with lengthening and decreased with shortening, in active as well as passive movements. 4 Spindles from muscles, which continuously counteracted gravity exhibited a stretch response and directional tuning during the phase of movement alone whereas their position sensitivity was poor. In contrast, spindle afferents from the muscles that had no or minimal antigravity role were directionally tuned during both the dynamic and the static phase of the aiming task and their position sensitivity was substantially higher. 5 In spite of the limited data base from three extensor muscles it could be demonstrated that wrist joint position was remarkably well encoded in the ensemble muscle spindle data. In some cases the ensemble muscle spindle data encoded the instantaneous trajectory of movement as well.

Proprioceptive feedback is reduced during adaptation to a visuomotor transformation: preliminary findings.

Adapting movements in relation to visual feedback is a ubiquitous characteristic of sensorimotor control and involves the integration of multiple sources of sensory information. We recorded sensory feedback from muscle spindle afferents during visuomotor adaptation while subjects performed an aiming task to investigate whether the activity of the muscle spindles was modulated by the fusimotor system under these learning conditions. None of the muscle spindles showed an increase in activity, rather in 83% of the trials the firing rates were decreased. These preliminary results suggest that the CNS reduces the sensory signals arising from muscle spindles perhaps as a means of resolving the conflict between visual and proprioceptive feedback during the task.

Unmyelinated tactile afferents underpin detection of low-force monofilaments

Human hairy but not glabrous skin has unmyelinated (C) tactile (CT) afferents that project to insular cortex. We studied two subjects with the rare sensory neuronopathy syndrome who lack A‐beta fibers but have relatively preserved C‐fiber function. Weak monofilaments were detected on hairy skin alone. Hence, the ability to detect light touch does not depend entirely on the A‐beta somatosensory system; CT afferents may contribute to the detection of weak monofilaments. Muscle Nerve, 2006