Thermotactile thresholds at the fingertip: effect of contact area and contact location.

Thresholds for the detection of changes in temperature are used to indicate neuropathy, but a variety of different contact areas and contact locations are used. This study was designed to determine the effects of variations in contact area and contact location on both warm and cool thresholds at the fingertip. With 20 healthy subjects (10 females and 10 males aged 20-30 years), warm thresholds and cool thresholds were determined in two separate sessions using the method of limits. In the first part of each session, thresholds were determined around the centre of the whorl using circular contactors with five different diameters (3, 6, 9, 12, and 55 mm). In the second part of each session, thresholds were determined using two contactors (6- and 12-mm diameter) at three locations along the fingertip: (i) distal (5 mm from the nail), (ii) middle (centre of whorl), and (iii) proximal (3 mm from the distal interphalangeal joint). With increasing contact area, the warm thresholds decreased, the cool thresholds increased, and the inter-subject variability in both warm and cool thresholds decreased. Using the 6-mm diameter contactor, warm thresholds were independent of location but cool thresholds increased from distal to proximal locations. It is concluded that temperature sensitivity at the fingertip increases with increasing area of contact, with the variability in thresholds consistent with the existence of warm and cool "insensitive fields". The findings show that the influence of contact area and contact location should be considered when assessing thermotactile thresholds at the fingertip.