Improving electrotactile communication with a multi-pad electrode under cognitive load.

BACKGROUND: Electrotactile systems are compact interfaces that can be used to convey information through the skin by producing a range of haptic sensations. In many applications, however, the user needs to perceive and interpret haptic stimulation while being engaged in parallel activities. Developing methods that ensure reliable recognition of electrotactile messages despite additional cognitive load is, therefore, an important step for the practical application of electrotactile displays. METHODS: This study investigated if a simple strategy of repeating electrotactile messages can improve message identification during multitasking. Ten participants identified 36 spatiotemporal electrotactile messages delivered through a 3 × 2 pad-matrix electrode placed on the torso while performing a concomitant cognitive task in three conditions: the messages were presented once (No-REP), and each message was repeated three (REP3) and five (REP5) times. The main outcome measure was the success rate (SR) of message identification. RESULTS: During multitasking, in the No-REP condition, the SR (median (IQR)) dropped to 56.25% (22.62%), demonstrating that the cognitive task decreased performance. However, the SR significantly improved with message repetitions, reaching 72.92% (21.87%) and 81.25% (18.66%) in REP3 and REP5 conditions respectively, without a statistically significant difference between REP3 and REP5. CONCLUSIONS: Multitasking affected the efficacy of haptic communication, but message repetition was shown to be an effective strategy for improving performance. Additionally, only three repetitions were enough, as an additional increase in the duration of message transmission (5 repetitions) did not lead to further improvement. This study is an important step toward delivering electrotactile communication that can cope with the demands of real-world applications.

Electrotactile Communication via Matrix Electrode Placed on the Torso Using Fast Calibration, and Static vs. Dynamic Encoding.

Electrotactile stimulation is a technology that reproducibly elicits tactile sensations and can be used as an alternative channel to communicate information to the user. The presented work is a part of an effort to develop this technology into an unobtrusive communication tool for first responders. In this study, the aim was to compare the success rate (SR) between discriminating stimulation at six spatial locations (static encoding) and recognizing six spatio-temporal patterns where pads are activated sequentially in a predetermined order (dynamic encoding). Additionally, a procedure for a fast amplitude calibration, that includes a semi-automated initialization and an optional manual adjustment, was employed and evaluated. Twenty subjects, including twelve first responders, participated in the study. The electrode comprising the 3 × 2 matrix of pads was placed on the lateral torso. The results showed that high SRs could be achieved for both types of message encoding after a short learning phase; however, the dynamic approach led to a statistically significant improvement in messages recognition (SR of 93.3%), compared to static stimulation (SR of 83.3%). The proposed calibration procedure was also effective since in 83.8% of the cases the subjects did not need to adjust the stimulation amplitude manually.

Encoding of spatial patterns using electrotactile stimulation via a multi-pad electrode placed on the torso.

BACKGROUND: Tactile stimulation can be used to convey information to a user in different scenarios while avoiding overloading other senses. Tactile messages can be transmitted as spatial patterns, potentially allowing for a high information throughput. The aim of the present study was to design and test different encoding schemes to determine the best approach for conveying spatial patterns. METHODS: Encoding schemes with simultaneous (SIM) and sequential pad activation (SEQ) were evaluated, including four SEQ variants designed to potentially facilitate the recognition. In SEQ-col and SEQ-row, the column and row of the activated pad were signified using different frequencies, while SEQ-all and SEQ-all-fast included the activation of all pads where those belonging to the pattern were indicated by changes in frequency (ON pads). The success rate (SR) of the pattern identification and the response time were quantified in 15 participants who recognized 20 patterns delivered through a 3 × 2 pad matrix placed on the lateral torso. RESULTS: SIM was not a feasible method to present the patterns (median, 15%; IQR, 5%). The SR improved with SEQ (median, 60%; IQR, 20%) and further increased with additional cues, particularly with SEQ-row (median, 78.3%; IQR, 23.3%) and SEQ-all (median, 96.7%; IQR, 5%). Importantly, the stimulation time of SEQ-all could be decreased without a substantial drop in accuracy (SEQ-all-fast: median, 89.2%; IQR, 19.2%). CONCLUSIONS: The spatiotemporal stimulation with sequential activation of all pads (SEQ-all) seems to be the method of choice when conveying tactile messages as spatial patterns. This is an important outcome for increasing the information bandwidth of communication through the tactile channel.

Does Threat Enlarge Nociceptive Reflex Receptive Fields?

Threat-induced pain modulation can increase survival by amplifying physiological and behavioral reactions toward danger. Threat can also modulate spinal nociception, suggesting engagement of endogenous top-down circuitry. A unique method to assess spinal nociception is via reflex receptive fields (RRF) associated with the nociceptive withdrawal reflex (NWR, a protective spinally-mediated reflex). The size of nociceptive RRFs can be modulated by top-down circuitry with the enlargement of RRFs related to increased spinal nociception. Threat has been previously shown to enhance pain and spinal nociception, but the relationship between threat and RRFs has not been investigated. The present study investigated this issue in 25 healthy individuals. RRFs were determined from NWRs measured by electromyography of the tibialis anterior following electrocutaneous stimulations. RRFs and pain were assessed during periods in which participants were under threat of unpredictable painful abdominal stimulations and when they were not under threat. Results indicated that threat periods led to significantly higher pain, larger nociceptive RRFs and NWR magnitudes. These findings imply that threat produces changes in protective reflexes related to spinal nociceptive sensitivity and increased pain perception. This is likely mediated by top-down circuitry that enhances dorsal horn nociceptive neurons by enlarging RRFs and amplifying ascending pain signals. PERSPECTIVE: This article presents the enlargement of RRF during periods of threat. The results from this study may help clarify the mechanism underlining emotional modulation of spinal nociception.

Stimulus predictability moderates the withdrawal strategy in response to repetitive noxious stimulation in humans.

Nociceptive withdrawal reflex (NWR) is a protective reaction to a noxious stimulus, resulting in withdrawal of the affected area and thus preventing potential tissue damage. This involuntary reaction consists of neural circuits, biomechanical strategies, and muscle activity that ensure an optimal withdrawal. Studies of lower limb NWR indicate that the amplitude of the NWR is highly modulated by extrinsic and intrinsic factors, such as stimulation site, intensity, frequency, and supraspinal activity, among others. Whether the predictability of the stimulus has an effect on the biomechanical strategies is still unclear. This study aimed to evaluate how the predictability of impending noxious stimuli modulate the NWR reaction in the lower limb. NWR was evoked on fifteen healthy participants by trains of electrical stimuli on the sole of the foot and was measured in one distal (tibialis anterior) and one proximal (biceps femoris) muscle. The predictability was manipulated by giving participants prior information about the onset of the stimulus trains and the number of delivered stimuli per train. Results showed that the predictability of the incoming stimuli differentially modulates the muscle activity involved in the NWR reaction. For the most unpredictable stimulus train, larger NWR at distal muscles were evoked. Furthermore, the stereotyped temporal summation profile to repeated stimulation was observed when the stimulus train was completely predictable, while it was disrupted in proximal muscles in unpredictable conditions. It is inferred that the reflex response is shaped by descending control, which dynamically tunes the activity of the muscles involved in the resulting reaction.NEW & NOTEWORTHY Innate defensive behaviors such as reflexes are found across all species, constituting preprogrammed responses to external threats that are not anticipated. Previous studies indicated that the excitability of the reflex arcs like spinal nociceptive withdrawal reflex (NWR) pathways in humans are modulated by several cognitive factors. This study assesses how the predictability of a threat affects the biomechanical pattern of the withdrawal response, showing that distal and proximal muscles are differentially modulated by descending control.

Intense and sustained pain reduces cortical responses to auditory stimuli: Implications for the interpretation of the effects of heterotopic noxious conditioning stimulation in humans.

Phasic pain stimuli are inhibited when they are applied concomitantly with a conditioning tonic stimulus at another body location (heterotopic noxious conditioning stimulation, HNCS). While the effects of HNCS are thought to rely on a spino-bulbo-spinal mechanism in animals (termed diffuse noxious inhibitory controls, DNIC), the underlying neurophysiology in humans may involve other pathways. In this study, we investigated the role of concomitant supraspinal mechanisms during HNCS by presenting auditory stimuli during a conditioning tonic painful stimulus (the cold pressor test, CPT). Considering that auditory stimuli are not conveyed through the spinal cord, any changes in brain responses to auditory stimuli during HNCS can be ascribed entirely to supraspinal mechanisms. Electroencephalography (EEG) was recorded during HNCS, and auditory stimuli were administered in three blocks, before, during and after HNCS. Nociceptive withdrawal reflexes (NWRs) were recorded at the same time points to investigate spinal processing. Our results showed that AEPs were significantly reduced during HNCS. Moreover, the amplitude of the NWR was significantly diminished during HNCS in most participants. Given that spinal and supraspinal mechanisms operate concomitantly during HNCS, the possibility of isolating their individual contributions in humans is questionable. We conclude that the net effects of HCNS are not independent from attentional/cognitive influences.