Auto-adjusting mandibular repositioning device for in-home use.

Obstructive Sleep Apnea (OSA) is a form of respiratory dysfunction that affects 20% of adults in the world. Among the first-line treatments that are used to mitigate the effects of OSA are continuous positive airway pressure (CPAP) and mandibular repositioning devices (MRD). Although CPAP provides a more efficacious therapy than MRDs, recent studies suggest that both are comparable in overall effectiveness due to greater patient preference and adherence to MRD therapy. In this paper, we present the Auto-Positioner, a novel add-on for MRDs that adjusts the extent to which the mandible (lower jaw) is advanced in response to respiratory signals indicating labored breathing during sleep, and to changes in sleeping position known to affect individual patient's airway patency.

Sleep apnea symptoms and risk of temporomandibular disorder: OPPERA cohort.

The authors tested the hypothesis that obstructive sleep apnea (OSA) signs/symptoms are associated with the occurrence of temporomandibular disorder (TMD), using the OPPERA prospective cohort study of adults aged 18 to 44 years at enrollment (n = 2,604) and the OPPERA case-control study of chronic TMD (n = 1,716). In both the OPPERA cohort and case-control studies, TMD was examiner determined according to established research diagnostic criteria. People were considered to have high likelihood of OSA if they reported a history of sleep apnea or ≥ 2 hallmarks of OSA: loud snoring, daytime sleepiness, witnessed apnea, and hypertension. Cox proportional hazards regression estimated hazard ratios (HRs) and 95% confidence limits (CL) for first-onset TMD. Logistic regression estimated odds ratios (OR) and 95% CL for chronic TMD. In the cohort, 248 individuals developed first-onset TMD during the median 2.8-year follow-up. High likelihood of OSA was associated with greater incidence of first-onset TMD (adjusted HR = 1.73; 95% CL, 1.14, 2.62). In the case-control study, high likelihood of OSA was associated with higher odds of chronic TMD (adjusted OR = 3.63; 95% CL, 2.03, 6.52). Both studies supported a significant association of OSA symptoms and TMD, with prospective cohort evidence finding that OSA symptoms preceded first-onset TMD.

Food oral processing: conversion of food structure to textural perception.

Food oral processing includes all muscle activities, jaw movements, and tongue movements that contribute to preparing food for swallowing. Simultaneously, during the transformation of food structure to a bolus, a cognitive representation of food texture is formed. These physiological signals detected during oral processing are highly complex and dynamic in nature because food structure changes continuously due to mechanical and biochemical breakdown coupled with the lubricating action of saliva. Multiple and different sensations are perceived at different stages of the process. Although much work has focused on factors that determine mechanical (e.g., rheological and fracture) and sensory properties of foods, far less attention has been paid to linking food transformations that occur during oral processing with sensory perception of texture. Understanding how food structure influences specific patterns of oral processing and how these patterns relate to specific textural properties and their cognitive representations facilitates the design of foods that are nutritious, healthy, and enjoyable.

Touching and feeling: differences in pleasant touch processing between glabrous and hairy skin in humans.

Previous functional magnetic resonance imaging studies in two rare patients, together with microneurography and psychophysical observations in healthy subjects, have demonstrated a system of mechanosensitive C-fiber tactile (CT) afferents sensitive to slowly moving stimuli. They project to the posterior insular cortex and signal pleasant aspects of touch. Importantly, CTs have not been found in the glabrous skin of the hand, yet it is commonly observed that glabrous skin touch is also perceived as pleasant. Here we asked if the brain processing of pleasant touch differs between hairy and glabrous skin by stroking the forearm and glabrous skin of the hand during positron emission tomography. The data showed that, when contrasting slow brush stroking on the forearm with slow brush stroking on the palm, there were significant activations of the posterior insular cortex and mid-anterior orbitofrontal cortex. The opposite contrast showed a significant activation of the somatosensory cortices. Although concurrent psychophysical ratings showed no differences in intensity or pleasantness ratings, a subsequent touch questionnaire in which subjects used a newly developed 'touch perception task' showed significant difference for the two body sites. Emotional descriptors received higher ratings on the forearm and sensory descriptors were rated more highly on the palm. The present findings are consistent with the hypothesis that pleasant touch from hairy skin, mediated by CT afferents, is processed in the limbic-related cortex and represents an innate non-learned process. In contrast, pleasant touch from glabrous skin, mediated by A-beta afferents, is processed in the somatosensory cortex and represents an analytical process dependent on previous tactile experiences.

Non-invasive therapy for altered facial sensation following orthognathic surgery: an exploratory randomized clinical trial of intranasal vitamin B12 spray.

AIM: The aim of the study was to obtain pilot data on the putative effects of intranasal spray Vitamin B12 in lessening the impairment from orthognathic surgery on large and small diameter nerve fiber functions. METHODS: Thirty-five subjects scheduled for a mandibular osteotomy were enrolled in an open-label two-group parallel stratified-block randomized clinical trial: Intranasal Vitamin B12 Spray (B12), with weekly doses self-administered two weeks before until 6 months after surgery, or no intranasal spray. All subjects received sensory retraining exercises. Large fiber tactile (contact detection) and small fiber thermal (warm, cool, heat discomfort, and cold discomfort) thresholds were obtained before and at 1, 3, and 6 months after surgery. For each, the mean maximum impairment was estimated for group and visit, controlling for age and type of surgery. RESULTS: The demographics and pre-surgery threshold values of the two groups did not differ (P>0.16). At and 6 months after surgery, serum B12 levels were substantially higher in the B12 group (P<0.01). At one month post, average impairment for every threshold measure was less for the B12 group. From 1 to 3 months, the differences between the two groups decreased for the tactile measures but stayed the same (cool and warm perception) or increased (cold and heat discomfort perception) for the thermal measures. At 6 months, the B12 group remained less impaired for the thermal measures. CONCLUSION: This pilot RCT indicates that the effects of intranasal Vitamin B12 spray, initiated prior to surgery, on sensory function are sufficiently promising to justify progression to a Phase III RCT.

Guidelines and recommendations for assessment of somatosensory function in oro-facial pain conditions--a taskforce report.

The goals of an international taskforce on somatosensory testing established by the Special Interest Group of Oro-facial Pain (SIG-OFP) under the International Association for the Study of Pain (IASP) were to (i) review the literature concerning assessment of somatosensory function in the oro-facial region in terms of techniques and test performance, (ii) provide guidelines for comprehensive and screening examination procedures, and (iii) give recommendations for future development of somatosensory testing specifically in the oro-facial region. Numerous qualitative and quantitative psychophysical techniques have been proposed and used in the description of oro-facial somatosensory function. The selection of technique includes time considerations because the most reliable and accurate methods require multiple repetitions of stimuli. Multiple-stimulus modalities (mechanical, thermal, electrical, chemical) have been applied to study oro-facial somatosensory function. A battery of different test stimuli is needed to obtain comprehensive information about the functional integrity of the various types of afferent nerve fibres. Based on the available literature, the German Neuropathic Pain Network test battery appears suitable for the study of somatosensory function within the oro-facial area as it is based on a wide variety of both qualitative and quantitative assessments of all cutaneous somatosensory modalities. Furthermore, these protocols have been thoroughly described and tested on multiple sites including the facial skin and intra-oral mucosa. Standardisation of both comprehensive and screening examination techniques is likely to improve the diagnostic accuracy and facilitate the understanding of neural mechanisms and somatosensory changes in different oro-facial pain conditions and may help to guide management.

Inferior alveolar nerve injury following orthognathic surgery: a review of assessment issues.

The sensory branches of the trigeminal nerve encode information about facial expressions, speaking and chewing movements, and stimuli that come into contact with the orofacial tissues. Whatever the cause, damage to the inferior alveolar nerve negatively affects the quality of facial sensibility as well as the patient's ability to translate patterns of altered nerve activity into functionally meaningful motor behaviours. There is no generally accepted, standard method of estimating sensory disturbances in the distribution of the inferior alveolar nerve following injury. Assessment of sensory alterations can be conducted using three types of measures: (i) objective electrophysiological measures of nerve conduction, (ii) sensory testing (stimulus) measures and (iii) patient report. Each type of measure with advantages and disadvantages for use are reviewed.

Sensations evoked by microstimulation of single mechanoreceptive afferents innervating the human face and mouth.

Intraneural microneurography and microstimulation were performed on single afferent axons in the inferior alveolar and lingual nerves innervating the face, teeth, labial, or oral mucosa. Using natural mechanical stimuli, 35 single mechanoreceptive afferents were characterized with respect to unit type [fast adapting type I (FA I), FA hair, slowly adapting type I and II (SA I and SA II), periodontal, and deep tongue units] as well as size and shape of the receptive field. All afferents were subsequently microstimulated with pulse trains at 30 Hz lasting 1.0 s. Afferents recordings whose were stable thereafter were also tested with single pulses and pulse trains at 5 and 60 Hz. The results revealed that electrical stimulation of single FA I, FA hair, and SA I afferents from the orofacial region can evoke a percept that is spatially matched to the afferent's receptive field and consistent with the afferent's response properties as observed on natural mechanical stimulation. Stimulation of FA afferents typically evoked sensations that were vibratory in nature; whereas those of SA I afferents were felt as constant pressure. These afferents terminate superficially in the orofacial tissues and seem to have a particularly powerful access to perceptual levels. In contrast, microstimulation of single periodontal, SA II, and deep tongue afferents failed to evoke a sensation that matched the receptive field of the afferent. These afferents terminate more deeply in the tissues, are often active in the absence of external stimulation, and probably access perceptual levels only when multiple afferents are stimulated. It is suggested that the spontaneously active afferents that monitor tension in collagen fibers (SA II and periodontal afferents) may have the role to register the mechanical state of the soft tissues, which has been hypothesized to help maintain the body's representation in the central somatosensory system.

Functional properties of low-threshold mechanoreceptive afferents in the human labial mucosa.

We used microneurography to investigate the functional properties of low-threshold mechanoreceptive afferents innervating the oral mucosa of the inside of the lower lip. Impulse responses were recorded from the inferior alveolar nerve of four human subjects. The threshold force and receptive field boundaries were identified for 19 single mechanoreceptive afferents using thin filaments (von Frey hairs) that applied known forces to the mucosa. Most of the receptive fields were located close to the corners of the mouth. Twelve of the afferents were slowly adapting (SA) and the remaining seven units were fast adapting (FA). Two types of slowly adapting responses were observed, SA I and SA II. Four of the six SA II units were spontaneously active. The geometric mean value of the receptive field sizes was 4.20 mm(2) for the SA I units, 5.65 mm(2) for the SA II units, and 5.60 mm(2) for the FA I units. None of the FA afferents showed response properties characteristic of Pacinian-corpuscle type afferents (FA II units). All afferents showed low force threshold between 0.06 and 1 mN. The properties of the mechanoreceptors supplying the human labial mucosa appear more similar to those of the vermilion and facial skin of the lower lip than those supplying the mucosa of the dorsal tongue.

Sensory retraining following orthognathic surgery: effect on threshold measures of sensory function.

The purpose of this analysis was to examine the effect of sensory retraining on sensory function after bilateral sagittal split osteotomy (BSSO). A total of 186 subjects were enrolled in a multi-centre double-blind two parallel group stratified block randomized clinical trial. Subjects were randomized to group immediately after surgery. Threshold measures for contact detection, two-point discrimination and two-point perception were obtained on the chin before and 1, 3 and 6 months and 1 and 2 years after surgery. The ratio of each threshold measure (post-surgery value/pre-surgery value) was calculated to characterize subjects' impairment. A general linear mixed model was fit for the impairment to examine the effect of the sensory retraining before and after adjusting for demographic, surgical and psychological factors. On average, two-point perception was less impaired in subjects who were retrained than in those who were not retrained (P = 0.04). Significant recovery continued up to 6 months after surgery for contact detection and two-point perception and up to 24 months for two-point discrimination. Older subjects experienced more impairment in two-point discrimination than younger subjects (P = 0.009). Subjects who received maxillary surgery in addition to mandibular surgery experienced more impairment on the chin in both two-point discrimination (P = 0.0003) and perception (P = 0.0013) than subjects who received mandibular surgery only. Psychological factors did not explain additional variability in subjects' impairment post-surgery. These finding indicate that a simple non-invasive exercise programme initiated shortly after orthognathic surgery can alter the way patients experience or respond to tactile stimulation long after the exercise regimen has stopped.

Effect of facial sensory re-training on sensory thresholds.

Nearly 100% of patients experience trauma to the trigeminal nerve during orthognathic surgery, impairing sensation and sensory function on the face. In a recent randomized clinical trial, people who performed sensory re-training exercises reported less difficulty related to residual numbness and decreased lip sensitivity than those who performed standard opening exercises only. We hypothesized that re-training reduces the impaired performance on neurosensory tests of tactile function that is commonly observed post-surgically. We analyzed thresholds for contact detection, two-point discrimination, and two-point perception, obtained during the clinical trial before and at 1, 3, and 6 months after surgery, to assess tactile detection and discriminative sensitivities, and subjective interpretation of tactile stimulation, respectively. Post-surgery, the retrained persons exhibited less impairment, on average, than non-retrained persons only in two-point perception (P < 0.025), suggesting that retrained persons experienced or interpreted the tactile stimuli differently than did non-retrained persons.

Facial altered sensation and sensory impairment after orthognathic surgery.

The aim of this study was to determine whether impairment of sensory functions after trigeminal nerve injury differs in severity among patients who report qualitatively different altered sensations. Data were obtained from 184 patients. Before and at 1, 3 and 6 months after orthognathic surgery, patients were grouped as having no altered sensation, negative sensations only (hypoaesthetic), mixed sensations (negative+active), or active sensations only (paraesthetic or dysaesthetic). Bias-free estimates of contact detection and two-point discrimination were obtained to assess, via ANOVA, whether patients in the four groups exhibited different levels of sensory impairment. Impairment in contact detection and two-point discrimination was found to differ significantly among the groups at 6 months but not at 1 month. At 6 months, patients who reported negative sensations only exhibited the greatest impairment, on average, in contact detection; in contrast, patients who reported mixed sensations exhibited the greatest impairment in two-point discrimination. The least residual impairment at 6 months was observed in patients who reported no altered sensation. It is recommended that clinical judgments regarding nerve injury-associated sensory dysfunction should not be based on threshold testing results without consideration of patients' subjective reports of altered sensation.

Capturing the spatial percepts evoked by moving tactile stimuli: a novel approach.

Forced-choice procedures are conventionally used to study the percepts evoked by stimuli that move across the skin and enable an unbiased estimation of subjects' sensory capacities. These procedures, however, require subjects to assign complicated percepts to one of a small number of experimenter-defined response categories, none of which may satisfactorily describe the perceptual experience. To address this limitation, we developed a psychophysical approach, which graphically captures spatial information about a moving stimulus in a holistic manner. Briefly summarized, the stimulus object controlled for location, velocity, direction and distance is moved across the skin of a blind-folded subject, after which the subject draws its path on a life-size, two-dimensional photograph of the body region stimulated. Using this approach, we demonstrated that the drawings contain perceptually relevant information, estimates of direction discrimination and subjective traverse length derived from the drawings closely parallel data obtained with forced-choice and magnitude estimation methods, respectively, and generate comparable psychophysical functions of stimulus velocity. In addition, information is represented in the complex shapes of the curves and in the locations at which they are drawn. Analyses of these latter features support the hypothesis that non-sensory factors (individual subject biases) also affect the drawings.

A longitudinal study of the association between tooth loss and age-related hearing loss.

The purpose of this study was to investigate cross-sectional and longitudinal associations between hearing acuity and tooth loss in 1156 US veterans taking part in the Veterans Affairs' Normative Aging (NAS) and Dental Longitudinal (DLS) Studies in the Boston, MA, area. The mean age was 48 years (SD = 8.9), 5.3% were edentulous, and 15.4% had < 17 teeth at baseline. Hearing acuity was determined by puretone, air- and bone-conduction audiometry, and speech discrimination tests at triennial examinations over a 20-year follow-up period. Hearing decline was defined as a change from baseline in the average puretone air-conduction thresholds of > or = 20 dB at 0.25, 0.5, 1, 2, 3, 4, 6, and 8 kHz. The explanatory variables of interest were change since baseline in dentate status (cut points at < 1, < 17, and < 20 teeth), and in the number of teeth lost (linear). Linear and logistic regression models--which controlled for baseline audiological status, age, air-bone gap, and otoscopic examination at current visit--showed that subjects who went from having > or = 17 to < 17 teeth had 1.64 times (95% CI, 1.24-2.17) as high odds of having hearing decline as those with no change in their dentate status. For every tooth lost since baseline, there was a 1.04 times as high odds (95% CI, 1.02-1.06) for hearing decline, when additional baseline and time-varying covariates were taken into account in the model.

Frequency and site-dependent variations in vibration detection thresholds on the face.

An adaptive psychophysical procedure was used to estimate the vibration detection threshold at seven spatially matched sites on the two sides of the face and at one scalp site. Repeated measurements over six testing sessions were made for stimuli vibrating at 1, 10 and 100 Hz for each of 21 neurologically healthy, young adult females. Approximately 14 stimulus trials were required to obtain each estimate of the threshold amplitude. Thresholds varied as a function of frequency (p < 0.0001), side (p < 0.001) and site (p < 0.0001). Compared to stimulation at 100 Hz at which the estimates were lowest, thresholds were 3.1 times greater at 10 Hz and 5.4 times greater at 1 Hz. Thresholds were lowest on the vermilion and highest on the cheek and chin. The preauricular skin and scalp exhibited an intermediate level of sensitivity. Whereas thresholds were comparable on the two sides of the face for stimulation at 1 Hz, they averaged 1.33 times greater on the right side for stimulation at 10 and 100Hz. Moreover, thresholds obtained during the last two sessions were 16% higher than those obtained during the first two sessions (p < 0.02), suggesting that subjects on average became more conservative in reporting the presence of the stimulus. The sensitivity in discriminating differences in tactile function favors use of the rapidly administered testing procedure in a clinical setting.

Three-dimensional nasolabial displacement during movement in repaired cleft lip and palate patients.

The objective of this study was two-fold: (1) to explore the suitability of a novel modified Procrustes fit method to adjust data for head motion during instructed facial movements, and (2) to compare the adjusted data among repaired unilateral (n = 4) and bilateral (n = 5) cleft lip and palate patients and noncleft control subjects (n = 50). Using a video-based tracking system, three-dimensional displacement of 14 well-defined nasolabial landmarks was measured during four set facial animations without controlling for head motion. The modified Procrustes fit method eliminated the contributions of head motion by matching the most stable landmarks of each video-recorded frame of the face during function to frames at rest. Its effectiveness was found to approximate that of a previous method (i.e., use of a maxillary occlusal splint to which stable dentition-based markers were attached). Data from both the unilateral and bilateral cleft lip and palate patients fell outside the normal range of maximum displacements and of asymmetry, and individual patients demonstrated greater right-versus-left asymmetry in maximum displacement than did individual noncleft subjects. It is concluded that the modified Procrustes fit method is fast, is easy to apply, and allows subjects to move the head naturally without the inconvenience of a splint while facial movement data are being collected. Results obtained using this method support the view that facial movements in cleft patients may be severely hampered and that assessment of facial animation should be strongly considered when contemplating surgical lip revisions.

A letter-recognition task to assess lingual tactile acuity.

PURPOSE: This study evaluated a novel neurosensory test based on letter recognition developed for the assessment of spatial acuity of the tongue. PATIENTS AND METHODS: An up-down tracking procedure was used to estimate the threshold height for the recognition of embossed letters of the alphabet examined by the tongue tip. The 48 stimuli consisted of acrylic strips, one side of which bore a letter (A, I, J, L, O, T, U, or W) of 3, 4, 5, 6, 7, or 8 mm in height. Twenty neurologically normal young adults were tested. RESULTS: Stable estimates of the threshold height were obtained after delivery of only 15 trials. Threshold height averaged 5.1 mm (range, 3.7 to 6.6 mm) and was unaffected by gender (P>.88). Although the letters were identified correctly 54% of the time, on average, the tangibility of individual letters varied from 5% correct (for W) to 82% correct (for T). The letter W was never identified by 16 of 20 subjects; T, O, and U were identified by all subjects. Analysis of errors confirmed that subjects relied on spatial cues to make the discriminations; 58% of the incorrect responses were made to 1 or 2 letters with spatial features similar to those of the stimulus letter. CONCLUSIONS: The threshold height for letter recognition can be obtained easily and rapidly, exhibits low among-subject variability, and reflects the capacity to extract and process spatial information. Letters of similar legibility on the tongue should be used to minimize underestimation of subjects' true acuities.

Psychophysical assessment of the affective components of non-painful touch.

A novel psychophysical procedure for the evaluation of the affective components of touch was developed. A fabric material was stroked across the test site at a controlled direction and velocity, after which the subject provided a numerical estimate of pleasantness. Significant differences were detected for the sites tested (FACE vs ARM), the fabric materials used (VELVET, COTTON and PLASTIC MESH), and the velocity of motion (0.5, 5 and 50 cm/s). Attesting to their validity, estimates of pleasantness correlated negatively with estimates of unpleasantness obtained for the same stimuli. Moreover, subjects were reasonably consistent in their ratings upon stimulus replication. These findings demonstrate that the hedonic qualities of touch can be psychophysically evaluated, and that valid and reliable estimates are obtained.

SI neuron response variability is stimulus tuned and NMDA receptor dependent.

Skin brushing stimuli were used to evoke spike discharge activity in single skin mechanoreceptive afferents (sMRAs) and anterior parietal cortical (SI) neurons of anesthetized monkeys (Macaca fascicularis). In the initial experiments 10-50 presentations of each of 8 different stimulus velocities were delivered to the linear skin path from which maximal spike discharge activity could be evoked. Mean rate of spike firing evoked by each velocity (MFR) was computed for the time period during which spike discharge activity exceeded background, and an across-presentations estimate of mean firing rate (MFR) was generated for each velocity. The magnitude of the trial-by-trial variation in the response (estimated as CV; where CV = standard deviation in MFR/MFR) was determined for each unit at each velocity. MFR for both sMRAs and SI neurons (MFRsMRA and MFRSI, respectively) increased monotonically with velocity over the range 1-100 cm/s. At all velocities the average estimate of intertrial response variation for SI neurons (CVSI) was substantially larger than the corresponding average for sMRAs (CVsMRA). Whereas CVsMRA increased monotonically over the range 1-100 cm/s, CVSI decreased progressively with velocity over the range 1-10 cm/s, and then increased with velocity over the range 10-100 cm/s. The position of the skin brushing stimulus in the receptive field (RF) was varied in the second series of experiments. It was found that the magnitude of CVSI varied systematically with stimulus position in the RF: that is, CVSI was lowest for a particular velocity and direction of stimulus motion when the skin brushing stimulus traversed the RF center, and CVSI increased progressively as the distance between the stimulus path and the RF center increased. In the third series of experiments, either phencylidine (PCP; 100-500 microg/kg) or ketamine (KET; 0.5-7.5 mg/kg) was administered intravenously (iv) to assess the effect of block of N-methyl-D-aspartate (NMDA) receptors on SI neuron intertrial response variation. The effects of PCP on both CVSI and MFRSI were transient, typically with full recovery occurring in 1-2 h after drug injection. The effects of KET on CVSI and MFRSI were similar to those of PCP, but were shorter in duration (15-30 min). PCP and KET administration consistently was accompanied by a reduction of CVSI. The magnitude of the reduction of CVSI by PCP or KET was associated with the magnitude of CVSI before drug administration: that is, the larger the predrug CVSI, the larger the reduction in CVSI caused by PCP or KET. PCP and KET exerted variable effects on SI neuron mean firing rate that could differ greatly from one neuron to the next. The results are interpreted to indicate that SI neuron intertrial response variation is 1) stimulus tuned (intertrial response variation is lowest when the skin stimulus moves at 10 cm/s and traverses the neuron's RF center) and 2) NMDA receptor dependent (intertrial response variation is least when NMDA receptor activity contributes minimally to the response, and increases as the contribution of NMDA receptors to the response increases).

Evocation and characterization of percepts of apparent motion on the face.

The percepts evoked by sequential stimulation of sites in close spatial proximity (< or = 2.5 cm) on the face were studied. Both method-of-limits and magnitude-estimation procedures were used to identify and characterize alterations in the percepts produced by systematic changes in the temporal and spatial parameters of the sequence. Each site was stimulated by a vertically oriented row of miniature vibrating probes. Apparent motion was consistently perceived when the delay between the onsets of sequentially activated rows (interstimulus onset interval, or ISOI) fell within a relatively narrow range of values, the lower limit of which approximated 5 msec. Both the upper limit and the perceived smoothness and continuity of the motion percepts (goodness of motion) increased with the duration for which each row stimulated the skin over the range evaluated, 15-185 msec. For the successive activation of only two rows, goodness of motion was not influenced by changes in their separation from 0.4 to 2.5 cm. The ISOI values at which magnitude estimates of goodness of motion were highest increased with the duration for which each row stimulated the skin. As such, maximum goodness of motion decreased with increases in the apparent velocity of motion. When the number of sequentially activated rows was increased from two to four or more, the quality of the motion percepts improved. For the successive activation of multiple closely spaced rows, values of ISOI at which numerical estimates of goodness of motion were highest approximated integral fractions of the duration for which each row stimulated the skin. In this situation, the probes rose and fell in a regular, step-locked rhythm to simulate an edge-like or rectangular object moving across the skin. The goodness of motion so attained was relatively independent of the apparent velocity of motion.