Vibrotactile perception threshold measurements for diagnosis of sensory neuropathy. Description of a reference population

Abstract

Recognition of the fact that impairment of the tactile sense may occur independently of other disturbances in the vibration syndrome has rekindled an interest in developing a diagnostic method for early detection of vibration-induced neuropathy. There is also evidence suggesting that vibrotactile measurements represent a valuable diagnostic tool in compressive neuropathies, such as the carpal tunnel syndrome. The method may also become useful for diagnosing sensory neuropathies caused by other factors, such as solvents, pesticides, heavy metals, alcoholism, and diabetes. However, before vibrotactile measurement can be accepted and established as a tool for clinical diagnostic purposes, for screening, and in research, the level and the shape of the normal threshold curve have to be specified. With the purpose of assembling normative data, the vibrotactile perception thresholds (8-500 Hz) of the right index fingertip were measured in 171 healthy males (19-75 years) not exposed to vibration. A Békésy audiometer was modified to operate in combination with a vibration exciter, instead of headphones, at frequencies lower than usual (8-500 Hz). The results showed that the perception thresholds increased from about 100 dB to about 140 dB (rel. 10(-6) m/s2rms) as a function of frequency and age. The frequency-dependent changes were not linear, however, but displayed a peak in sensitivity at 125 Hz. Threshold changes due to aging were most pronounced at the highest frequencies. It is of the utmost importance that these natural changes are taken into account when making comparisons between groups or individuals.