Skin blood flow changes in anaesthetized humans: comparison between skin thermal clearance and finger pulse amplitude measurement

The effect of general anaesthesia on skin blood flow in the left hand, measured by a new non-invasive probe using the thermal clearance method was examined. A mercury silastic gauge was placed around the third left finger and the plethysmographic wave amplitude was recorded to measure changes in finger pulse amplitude. Heart rate (HR), mean arterial blood pressure (MABP) and skin temperature were also recorded. General anaesthesia was induced by droperidol and phenoperidine injection and propanidid infusion in eight female patients. Skin thermal clearance, plethysmographic wave amplitude, HR, MABP and skin temperature were 0.40 +/- 0.02 w X m-1 degree C-1, 9 +/- 1 mm, 98 +/- 5 beats X min-1, 12.50 +/- 0.93 kPa and 33.3 +/- 3.4 degrees C respectively. The minimal value of MABP was 9.58 +/- 1.06 kPa, whereas skin thermal clearance, plethysmographic wave amplitude, HR and skin temperature increased to 0.45 +/- 0.02 w X m-1 degree C-1, 29 +/- 3 mm, 110 +/- 4 beats X min-1 and 34.4 +/- 0.4 degrees C. Changes in skin thermal clearance correlated well with plethysmographic wave amplitude. Statistically significant changes in these two parameters occurred before significant change in HR, MABP or skin temperature. The results show that the new non-invasive probe using the thermal clearance method appears to be a useful device for measuring cutaneous microcirculation in anaesthetized humans, and responds more quickly than change in skin temperature, which is a delayed effect of skin blood flow change. Our results also show that the intensity of cutaneous vasodilatation induced by general anaesthesia did not relate to the vascular tone before anaesthesia.     

Individual differences in temperature perception: evidence of common processing of sensation intensity of warmth and cold

The longstanding question of whether temperature is sensed via separate sensory systems for warmth and cold was investigated by measuring individual differences in perception of nonpainful heating and cooling. Sixty-two subjects gave separate ratings of the intensity of thermal sensations (warmth, cold) and nociceptive sensations (burning/stinging/pricking) produced by cooling (29 degrees C) or heating (37 degrees C) local regions of the forearm. Stimuli were delivered via a 4 x 4 array of 8 mm x 8 mm Peltier thermoelectric modules that enabled test temperatures to be presented sequentially to individual modules or simultaneously to the full array. Stimulation of the full array showed that perception of warmth and cold were highly correlated (Pearson r = 0.83, p < 0.05). Ratings of nonpainful nociceptive sensations produced by the two temperatures were also correlated, but to a lesser degree (r = 0.44), and the associations between nociceptive and thermal sensations (r = 0.35 and 0.22 for 37 and 29 degrees C, respectively) were not significant after correction for multiple statistical tests. Intensity ratings for individual modules indicated that the number of responsive sites out of 16 was a poor predictor of temperature sensations but a significant predictor of nociceptive sensations. The very high correlation between ratings of thermal sensations conflicts with the classical view that warmth and cold are mediated by separate thermal modalities and implies that warm-sensitive and cold-sensitive spinothalamic pathways converge and undergo joint modulation in the central nervous system. Integration of thermal stimulation from the skin and body core within the thermoregulatory system is suggested as the possible source of this convergence.     

Feedback-aided self-regulation of skin temperature with a single feedback locus

A technique has been developed that enables most humans to establish rapid self-regulatory control of their own skin temperature when provided with immediate visual feedback information concerning variations in local skin temperature. Training took place during 15-min periods within 45-min sessions. Clear evidence of learning was usually manifested within 4 sessions. After acquisition occurred, mean change per session was approximately 2.2° F, ranging up to 6.5° F. Training was continued with some subjects who were taught to alter temperature in opposite directions during successive periods on the same day. After practice, these subjects routinely displayed ranges of 9–14° F within 15 min.Portions of this paper were presented at meetings of the Biofeedback Research Society, St. Louis, October 1971, and Boston, November 1972, and the Eastern Psychological Association, New York, April 1972.     

Observing virtual arms that you imagine are yours increases the galvanic skin response to an unexpected threat

Multi-modal visuo-tactile stimulation of the type performed in the rubber hand illusion can induce the brain to temporarily incorporate external objects into the body image. In this study we show that audio-visual stimulation combined with mental imagery more rapidly elicits an elevated physiological response (skin conductance) after an unexpected threat to a virtual limb, compared to audio-visual stimulation alone. Two groups of subjects seated in front of a monitor watched a first-person perspective view of slow movements of two virtual arms intercepting virtual balls rolling towards the viewer. One group was instructed to simply observe the movements of the two virtual arms, while the other group was instructed to observe the virtual arms and imagine that the arms were their own. After 84 seconds the right virtual arm was unexpectedly "stabbed" by a knife and began "bleeding". This aversive stimulus caused both groups to show a significant increase in skin conductance. In addition, the observation-with-imagery group showed a significantly higher skin conductance (p<0.05) than the observation-only group over a 2-second period shortly after the aversive stimulus onset. No corresponding change was found in subjects' heart rates. Our results suggest that simple visual input combined with mental imagery may induce the brain to measurably temporarily incorporate external objects into its body image.     

Effect of alterations in ambient temperature on blood flow in the skin.

The effect of changing ambient temperature on skin temperature was recorded in human subjects; also, its effect on blood flow was measured using venous occlusion and optical plethysmography. When cold stimulus was removed in stages using a heating cabinet, it was found that a biphasic flow response occurred in the fingers with each step change in temperature. There was a rapid transient rise followed by a decline to an equilibrium flow level. The transient rise occurred even when the temperature rose from 37 to 40 degrees C, although at this level the equilibrium remained unchanged. It is suggested that the transient rise was due to stimulation of Hensel's dynamic warmth receptors, whereas the rise in equilibrium temperature was due to removal of cold stimulus, which at low ambient temperatures maintains reflex vasoconstriction through activation of static cold receptors. Upper arm skin responded to removal of cold stimulus by a fall in temperature. Immersion of a different limb in cold water produced vasoconstriction in fingers but vasodilatation in the upper arm skin. It is suggested that this may be due to neurogenic vasodilatation, though the present work gives no indication as to pathways.     

Individual differences in temperature perception: Evidence of common processing of sensation intensity of warmth and cold

The longstanding question of whether temperature is sensed via separate sensory systems for warmth and cold was investigated by measuring individual differences in perception of nonpainful heating and cooling. Sixty-two subjects gave separate ratings of the intensity of thermal sensations (warmth, cold) and nociceptive sensations (burning/stinging/pricking) produced by cooling (29°C) or heating (37°C) local regions of the forearm. Stimuli were delivered via a 4?×?4 array of 8 mm?×?8?mm Peltier thermoelectric modules that enabled test temperatures to be presented sequentially to individual modules or simultaneously to the full array. Stimulation of the full array showed that perception of warmth and cold were highly correlated (Pearson r?=?0.83, p?<?0.05). Ratings of nonpainful nociceptive sensations produced by the two temperatures were also correlated, but to a lesser degree (r?=?0.44), and the associations between nociceptive and thermal sensations (r?=?0.35 and 0.22 for 37 and 29°C, respectively) were not significant after correction for multiple statistical tests. Intensity ratings for individual modules indicated that the number of responsive sites out of 16 was a poor predictor of temperature sensations but a significant predictor of nociceptive sensations. The very high correlation between ratings of thermal sensations conflicts with the classical view that warmth and cold are mediated by separate thermal modalities and implies that warm-sensitive and cold-sensitive spinothalamic pathways converge and undergo joint modulation in the central nervous system. Integration of thermal stimulation from the skin and body core within the thermoregulatory system is suggested as the possible source of this convergence.     

Skin temperature and lactate threshold during muscle work in sportsmen

The purpose of the investigation was to estimate change of a thermal condition of an organism during exhausting work (maximal aerobic test) on cycle ergometer on the basis of studying of dynamics of temperature of a forehead skin. Regularly training 20 men have taken part in the research--sportsmen of various specializations (skiers, rock-climbers, boxers, etc.). Temperature of forehead skin was registered by infrared thermovision chamber Nec TH 9100SL. These results compared with the data of measurements of heart rate, gas exchange, the lactate concentration in peripheral blood, and also with anthropometrical characteristics. It was shown that on dynamics of skin temperature at maximal work load it was possible to divide all subjects into 2 unequal groups: 1 (2/3 subjects, the majority of which trains endurance) - after temperature decrease take place its smooth increase up to refusal ofwork; 2 (1/3 subjects, concerning various sports specializations)--from the moment of the beginning of active evaporation of sweat the temperature decreases to the work termination. In group 1 lactate threshold (lactate concentration in blood--4 mm/l) corresponds to the beginning of rise in temperature after its decrease as a result of sweat evaporation. In group 2 lactate threshold was necessary on a phase of decrease in temperature at the moment of active evaporation of sweat. Distinctions between groups in structure of correlation relationship between the measured indicators are revealed, inversion of a sign ofcorrelation quotient in some cases were shown. Thus significant distinctions between groups in the level of the working capacity indicators were not revealed. All it testifies to existence possibility at least two various successful strategy of urgent adaptation of system of thermoregulation to intense muscular work.     

Cheek skin temperature and thermal resistance in active and inactive individuals during exposure to cold wind

1. The present study examined the effect of the thermal state of the body (as reflected by rectal temperature) on cheek skin temperature and thermal resistance in active and inactive subjects.

2. Active subjects were exposed to a 30 min conditioning period (CP) (0 °C air with a 2 m/s wind), followed immediately by a 30 min experimental period (EP) (0 °C with a 5 m/s wind). Inactive subjects were exposed to a 30 min CP (22 °C air with no wind), followed immediately by a 45 min EP (0 °C air with a 4.5 m/s wind). The CP period was used to establish a core temperature difference between the active and inactive subjects prior to the start of EP. The 0 °C exposure was replaced with a −10 °C ambient air exposure and the experiment was repeated on a separate day. Subjects were comfortably dressed for each ambient condition.

3. Cheek skin temperature was not significantly higher in active subjects when compared to inactive subjects, but thermal resistance was higher in active subjects.

4. Cheek skin temperature and thermal resistance both decreased as ambient temperature decreased from 0 to −10 °C. The lower cheek thermal resistance at −10 °C may have been due to a greater cheek blood flow as a result of cold-induced vasodilation.

Skin temperature and lactate threshold during muscle work in athletes

The goal of the study was to evaluate the changes in the thermal state of the body during a maximal aerobic test on a bicycle ergometer on the basis of the dynamics of the skin temperature on the forehead. Twenty male athletes regularly training in various sports (skiers, rock-climbers, boxers, etc.) participated in our study. The forehead’s skin temperature was recorded using a NEC TH9100 Infrared Thermal Imaging Camera. These results were put together with the data on the heart rate, gas exchange, and lactate concentration in peripheral blood, as well as with anthropometrical parameters. It was shown that on the basis of the dynamics of the skin temperature at the maximal workload, the subjects could be divided into two groups of different sizes. In the first group (two-thirds of all subjects, most of the athletes of this group practiced endurance sports), after a temperature decrease, a smooth temperature increase took place until exhaustion. In the second group (one-third of all subjects, athletes of various sports specializations), from the beginning of active sweat evaporation, the temperature decreased until exhaustion. In the first group, the lactate threshold (a blood lactate concentration of 4 mmol/l) corresponded to the beginning of the increase in temperature after its decrease as a result of sweat evaporation. In the second group, the lactate threshold corresponded to the phase of the decrease in temperature during active sweat evaporation. The differences between the groups were expressed in the correlations of the measured parameters; in a number of cases, the inversions of the signs of correlation were found. At the same time, no significant differences in the parameters of working capacity were found between two groups. All these findings indicate the possibility of at least two successful strategies of urgent adaptation of the thermoregulatory system to intense muscular work.     

Spectral characteristics of skin temperature indicate peripheral stress-response

High-resolution measurement of skin temperature in 11 normal subjects revealed low-amplitude temperature oscillations (40 × 10^–3°C). The temperature signal measured on two hands during baseline, stress, and recovery periods, was filtered to separate the low-amplitude oscillations from the temperature signal. Spectral analysis of the filtered signal showed that most of the energy of the signal is in a range of 0.01 to 0.03 Hz. Frequency shifts and amplitude changes of the largest component were observed in response to mental stress. In subjects with high baseline values of either of these two variables, a decrease was observed in response to stress. An opposite response was observed in subjects with significantly lower baseline levels. Stress-related changes in peak frequency ranged from –25% to +18.2%; changes in peak amplitude ranged from –74.6% to +280%. Changes in the mean temperature were limited to 2.4%. Thus, the oscillatory component showed higher sensitivity to psychological stress than mean temperature. The spectrum of this component was compared to the spectrum of the blood pressure waves measured noninvasively. Both exhibited similar dynamics of energy, peak amplitude, and peak frequency in response to psychological stress. This similarity suggests that the oscillatory temperature component reflects stress-related changes of peripheral vasomotor activity.The authors are grateful to Dr. L. Cherniachovski, Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University for fruitful discussions on methodological problems of this study.     

Responses of human skin temperature and thermal sensation to step change of air temperature

1. 1. The purpose of this paper is to clarify the non-linearity of the human physiological and psychological responses to step change of air temperature by impulse response analysis using Discrete Fourier Transformation.

2. 2. Experiments were conducted to investigate the effect of thermal transients on human responses.

3. 3. Experimental conditions were as follows: lowering air temperature from 30 to 20°C and raising air temperature from 20 to 30°C.

4. 4. The responses of local skin temperature on lowering air temperature from 30 to 20°C are not necessarily opposite to the responses found on raising air temperature from 20 to 30°C.

5. 5. From impulse response analysis using Discrete Fourier Transformation, skin temperature responses to the opposite air temperature change do not necessarily coincide with each other whenever the same temperature stimulus is occurred.

Seeing the body produces limb-specific modulation of skin temperature

Vision of the body, even when non-informative about stimulation, affects somatosensory processing. We investigated whether seeing the body also modulates autonomic control in the periphery by measuring skin temperature while manipulating vision. Using a mirror box, the skin temperature was measured from left hand dorsum while participants: (i) had the illusion of seeing their left hand, (ii) had the illusion of seeing an object at the same location or (iii) looked directly at their contralateral right hand. Skin temperature of the left hand increased when participants had the illusion of directly seeing that hand but not in the other two view conditions. In experiment 2, participants viewed directly their left or right hand, or the box while we recorded both hand dorsum temperatures. Temperature increased in the viewed hand but not the contralateral hand. These results show that seeing the body produces limb-specific modulation of thermal regulation.     

Significance of skin temperature changes in surface electromyography.

Differing results have been reported concerning the direction and quantity of the electromyogram (EMG) amplitude response to changes in tissue temperature. The EMG signals from the soleus muscle of six healthy human subjects were therefore recorded during dynamic exercise (concentric contractions) at ambient temperatures of 30 degrees C and 14 degrees C. The mean skin temperature (Tsk) above the muscle investigated was 32.9 degrees C and 21.7 degrees C, respectively. The core temperature, estimated by rectal temperature, was unchanged. The cooling of the superficial tissues caused approximately a doubling of the EMG amplitude. For the probability level 0.9 in the amplitude probability distribution function, the average signal level increased from 73 microV to 135 microV (P = 0.02). The average mean power frequency of the EMG signal was reduced from 142 Hz to 83 Hz (P = 0.004). The amplitude increase was not due to shivering but other possible explanations are presented. As the changes in Tsk investigated were within the range which may occur normally during the working hours, it was concluded that Tsk should be carefully controlled in vocational EMG studies.     

Infrared methodologies for the assessment of skin temperature daily rhythm in two domestic mammalian species

To assess the accuracy of infrared methodologies for daily rhythm monitoring of skin temperature, five clinically healthy Italian Saddle gelding horses, and five not pregnant and not lactating Camosciata goats, were monitored every 4 h over a 48 h period. The horses were housed in individual boxes, while the goats in two indoor pens, under natural photoperiod and natural environmental temperature. In each animal, skin temperature was recorded with the use of a digital infrared camera and a non-contact infrared thermometer, in five regions: neck, shoulder, ribs, flank and croup. Recorded values were compared with the well-established daily rhythm of rectal temperature. Rectal temperature was recorded at the same time by means of a digital thermometer. In horses, a lower value of skin temperature was recorded using the infrared thermometer for the croup region compared to shoulder and flank; a lower value of skin temperature was recorded using thermography for the croup region compared to the shoulder. In goats, a lower value of skin temperature was recorded using the infrared thermometer for the croup region compared to the flank. In both species, higher values of rectal temperature were observed, compared to the temperature recorded at the skin regions using the other two methodologies. Cosinor rhythmometry showed a daily rhythm of rectal and skin temperature recorded using both methodologies in all the examined regions. General linear model (GLM) showed statistically significant effect of breed on all rhythmic parameters; of day of monitoring on amplitude; of site of recording (rectal vs skin regions) on mesor, amplitude and acrophase; and no effect of methodologies used. The results of this study show the differences in rhythmicity of various body regions temperature and their differences in comparison with daily rhythm rectal temperature. The use of infrared methodologies was inaccurate in assessing body core temperature, but its use could be considered for the evaluation of inflammation in the different body sites.     

Body temperature set-point and the conscious perception of skin temperature in obese women

Obese and control women were immersed in a bath of water kept at 37 degrees C. Oral temperature was measured. The subjects left hand was placed outside the bath for the local application of thermal stimuli between 20 degrees and 45 degrees C, subjects reporting the most pleasant temperature. The lower oral temperatures and lower levels of skin temperature rated as pleasant by obese women as compared with women of normal body weight or less suggests that in obesity the set-point of body temperature is lowered.     

Effect of head skin temperature on tympanic and oral temperature in man.

Five subjects were sequentially heated and cooled in a double-climate chamber while mean skin temperature (except the head) and head skin temperature were separately varied. The tympanic membrane temperatures of these subjects were disproportionately influenced by changes in head skin temperature. By heating and cooling localized regions of the head, changes in tympanic membrane temperature that followed changes in skin temperature on the ipsilateral side of the head could be produced. During heating of the head, oral and tympanic membrane temperatures were influenced to a similar degree, while esophageal temperature remained essentially unaffected. However, under conditions in which the legs and feet were heated in a water bath, esophageal temperature showed more rapid changes than either tympanic membrane or oral temperature. These findings suggest that tympanic membrane temperature and, to a lesser degree, oral temperature may be affected by thermal exchange occurring between arteries and veins in the cervical and cephalic regions. In addition, the ability to influence selectively esophageal and tympanic membrane temperatures brings into question the arbitrary use of these measurements under widely different experimental conditions as estimates of core temperature.     

Effects of ambient temperature steps on thermal comfort requirements

The purpose of this study was to determine the thermal comfort requirements for steps in temperature. Thirty male subjects were exposed for 50 min to a 34 or 37°C condition, and then quickly transferred to a cooler environment of 31, 28, 25, and 22°C for 50 min. Mean skin temperature was continuously measured, and the subjects reported their thermal sensation and comfort sensation every 2 min. Just after the step changes, the mean skin temperature immediately decreased, while the thermal sensation overshot and gradually rose again. Both the skin temperature and the thermal sensation seemed to reach a constant level within about 20 min. However, there were differences in the mean skin temperature and the neutral temperature derived from the correlation between the ambient temperature and the thermal sensation even 50 min after the steps, due to the thermal environmental condition before the changes of temperature. The change in the neutral temperature with time was expressed as two attenuating equations. These equations indicate that there is an obvious difference between the neutral temperatures due to the thermal condition before step changes, and that it takes >50 min after the step changes to reach the steady state. It is expected that these equations predict in quantitative terms the thermal comfort requirements within a given experimental condition.     

Case study of skin temperature and thermal perception in a hot outdoor environment

Focusing on the understanding and the estimation of the biometeorological conditions during summer in outdoor places, a field study was conducted in July 2010 in Athens, Greece over 6 days at three different sites: Syntagma Square, Ermou Street and Flisvos coast. Thermo-physiological measurements of five subjects were carried out from morning to evening for each site, simultaneously with meteorological measurements and subjective assessments of thermal sensation reported by questionnaires. The thermo-physiological variables measured were skin temperature, heat flux and metabolic heat production, while meteorological measurements included air temperature, relative humidity, wind speed, globe temperature, ground surface temperature and global radiation. The possible relation of skin temperature with the meteorological parameters was examined. Theoretical values of mean skin temperature and mean radiant temperature were estimated applying the MENEX model and were compared with the measured values. Two biometeorological indices, thermal sensation (TS) and heat load (HL)—were calculated in order to compare the predicted thermal sensation with the actual thermal vote. The theoretically estimated values of skin temperature were underestimated in relation to the measured values, while the theoretical model of mean radiant temperature was more sensitive to variations of solar radiation compared to the experimental values. TS index underestimated the thermal sensation of the five subjects when their thermal vote was ‘hot’ or ‘very hot’ and overestimated thermal sensation in the case of ‘neutral’. The HL index predicted with greater accuracy thermal sensation tending to overestimate the thermal sensation of the subjects.     

Characteristics of wettedness under constant average skin temperature

1. 1. Experiments were carried out concerning the characteristics of wettedness revealed under constant average skin temperature using sitting-resting nude subjects. From the basic measurements of both environmental parameters and human physiological responses, the conclusions detailed below were proposed regarding the changes of wettedness under constant average skin temperature.

2. 2. There is positive correlation between the wettedness and environmental humidity, and negative correlation between the wettedness and air temperature.

3. 3. There is positive correlation between the evaporative heat loss from the skin surface and air temperature, and negative correlation between the evaporative heat loss and environmental humidity.

4. 4. There is negative correlation between the wettedness and evaporative heat loss.

5. 5. Wettedness is not constant but takes varying values, that is, corresponding to each average skin temperature both the maximum and the minimum wettedness values occur.

6. 6. Deriving from the items mentioned above, the theoretical locus of equal average skin temperature is not a straight line, but is a curved line plotted on the psychrometric chart.

Altered thresholds for thermoregulatory sweating and vasodilatation in anorexia nervosa.

The changes in peripheral (hand) blood flow that occurred when deep body temperature was raised were measured in 13 patients with anorexia nervosa and 13 control subjects. The relation between blood flow and core temperature was shifted to the left in the patients with anorexia, with the onset of vasodilatation occurring at lower core and mean skin temperatures: no significant differences in the slopes of the responses were evident. The onset of thermal sweating occurred at lower core and mean skin temperatures in the patients with anorexia than in the controls. After ingestion of a high-energy liquid meal core temperature increased in the patients, and this was accompanied by a significant rise in peripheral blood flow in most cases. A similar meal in the normal subjects was followed by either no change in core temperature or a slight fall, and no consistent change in peripheral blood flow. These findings suggest that the lowering of thresholds for thermoregulatory sweating and vasodilatation may be a contributory factor to the abnormally low core temperature of patients with anorexia and may also explain some of their common complaints relating to feelings of warmth in the hands and feet after meals.