Letters, 43 (1988) 321-343
Toxicology
321
Elsevier
TXL 02048
Quantitative sensory assessment in toxicology and occupational medicine: applications, theory, and critical appraisal Jacques P .J. Maurissen The Dow Chemical Company, Midland, MI (U.S.A.) (Received
20 January,
(Revision
received
(Accepted
Toxicology Research Laboratory,
1988)
1988)
Key words: Psychophysics; Forced-choice
and Environmental
1988)
8 April,
23 June,
Mammalian
Threshold;
paradigm;
Rating
Signal detection
paradigm;
Up-down
theory;
Response
rule; Up-down
paradigm;
transformed
Yes-no
paradigm;
rule; PEST
SUMMARY systems
are affected
with psychophysical
Sensory
methods.
physical
dimension(s)
of a stimulus
and the behavioral
tion of psychophysics
to toxicology
is illustrated
vision, and somatosensory and followed by delivering the subject. method
sensitivity.
quantified
stimuli
Psychophysical
Sensory
specify
of constant
The three major
processes
study
response
can be quantitatively
of the relationship
it generates.
with a few examples foundations.
in a prespecified
taken
order and by requesting
response
can be studied
evaluation of stimuli,
terminology
illustrate
the potential
are the yes-no,
as well as in animals
and methodology.
Finally,
brought
a few suggestions
about
from the
methods.
The
the subject has to make to stimuli presented
in humans
confusion
response and include
and tracking forced-choice,
accord-
and rating
by several techniques,
as classical conditioning, operant behavior, and reflex modulation. A critical review of the application of psychophysical methods and response Several examples
is presented
is accomplished
a standardized
of presentation
paradigms
the
contribu-
from the fields of audition, of psychophysics
as well as the adjustment
response
assessed
between
First, the unique
Psychophysical
the sequence
stimuli,
specify the standardized
format.
Their functions
is the scientific
Then, a brief survey of the evolution
methods
the method
paradigms
ing to a specific paradigms.
of chemicals.
Psychophysics
by a review of its basic scientific
of limits,
response
by a number
paradigms
by unorthodox
such
is developed.
use of psychophysical
are given for the evaluation
of sensory
pro-
cesses in humans.
Address Toxicology,
for correspondence: J.P.J. Maurissen, Midland, MI 48674, U.S.A.
Abbreviations:
UDTR,
up-down
transformed
Ph.D., rule; PEST,
The Dow Chemical parameter
estimation
Company,
1803 Bldg -
by sequential
testing.
322
INTRODUCTION
Sensory systems provide the interface between the living organism and the external milieu, and represent targets of pathological processes affecting the nervous system in animals and humans. Endogenous diseases as well as exogenous events (physical or chemical) can alter the structure and function of sensory receptors, afferent pathways, and primary projection areas in the brain. It is important to evaluate the integrity of sensory systems from a functional point of view. Solely relying on a morphological approach presents some inherent problems. A morphopathological evaluation is destructive and does not usually lend itself to repeated measures in the same organism. Sophisticated morphological techniques (e.g., electron microscopy) can also generate data difficult to interpret. Perturbation of sensory functions may not be detected by simple clinical observation. More elaborate techniques are necessary. In this context, psychophysics provides exquisite and robust tools to quantify sensory functions in animals and humans. The intent of this paper is 4-fold. (1) Illustrate the contribution of psychophysical (i.e., sensory) studies to toxicology with a few examples. (2) Recount briefly the salient events forging the history of psychophysics, and to define its scope. (3) Acquaint the reader with the (often misunderstood) methods, paradigms, and techniques for the assessment of sensory functions in humans and animals. (4) Evaluate critically the methodology used in human sensory studies as applied to toxicology
and occupational
NEUROTOXICANTS
A large number
AND SENSORY
of chemicals
medicine. FUNCTIONS:
affect
SELECTED
sensory
organs
EXAMPLES
and functions
[l-3].
Some
overviews have focused more specifically on the psychophysical approach to chemically induced auditory [4], visual [S], somatosensory [6,7], and olfactory disorders [8]. The intent of this section is not to review this literature exhaustively, but to show some examples of the unique contributions of psychophysics to toxicology. Audition The ototoxic effects of toluene were unknown until Pryor et al. described them in 1983 191. The authors exposed rats to 1400 and 1200 ppm of toluene, 14 h/day, 7 days/week for 5 weeks. Rats were trained to avoid an electrical shock delivered to the floor by climbing a pole suspended from the ceiling of the cage. The aversive stimulus was preceded by a tone. Climbing the pole during this warning tone ter-
323
minated the trial and reflected detection of the auditory stimulus. Both intensity and frequency of the tone were varied. Comparison of the conditioned avoidance performance of the control and exposed groups revealed that toluene impaired hearing markedly at 12, 16, and 20 kHz, and slightly at 8 kHz. No difference in hearing was found between control and exposed rats at 4 kHz. These data showed for the first time that toluene preferentially affected hearing at higher frequencies in the rat, and left the low frequencies practically untouched. Subsequently, electrophysiological techniques revealed that the latency of the 8th nerve component of the brainstem auditory-evoked response was prolonged in toluene-exposed rats at high frequencies in comparison to control animals [lo]. Vision The effects of acrylamide on visual functions were first described by Merigan et al. [ 111. Macaque monkeys faced two oscilloscopes with evenly illuminated displays. One of two types of stimuli appeared randomly on either scope, while the other scope was blank; a fine grating or a flickering unpatterned stimulus was used to measure visual acuity or flicker fusion, respectively. In both cases, the monkeys received some fruit juice after pressing the button corresponding to the scope presenting the stimulus. Four monkeys were trained in both visual modalities. Three of them were administered oral doses of acrylamide (10 mg/kg/day, 5 days a week) until they showed overt signs of intoxication. Each monkey was used as its own control, and one served as a time-matched control. By the end of dosing (7-9 weeks after the first dose), visual acuity and flicker fusion were reduced in dosed monkeys. After termination of dosing, flicker fusion recovered quickly and completely. Visual acuity substantially improved, but had not completely recovered by 19-20 weeks after the end of dosing. Morphological examination of a monkey killed at the end of the dosing period indicated that the described loss of function was accompanied by distal axonal swelling in the optic tract and lateral geniculate nucleus [ 12,131. Somatosensory
sensitivity
Acrylamide causes central-peripheral distal axonopathy. Since sensory signs and symptoms usually dominate the clinical manifestations of intoxication with this chemical, Maurissen et al. [14] developed a system to assess quantitatively the effects of acrylamide on vibration and electrical sensitivity in monkeys, and to follow the functional recovery after cessation of intoxication. Six monkeys were trained to report detection of a vibratory or electrical stimulus applied to the fingertip. After baseline data were obtained, four monkeys were dosed orally with 10 mg/kg of acrylamide 5 days/week until the appearance of overt
324
toxic signs. Each monkey served as its own control. The other two monkeys were used as time-matched controls. Fine visuomotor coordination and body weights diminished during dosing, but had recovered within 5-8 weeks. Vibration sensitivity also decreased during the same period, but remained impaired much longer, outlasting all the other effects. Electrical sensitivity had been unaffected during the whole study. These data indicate that vibration sensitivity can trace the time course of acrylamide intoxication, and provide unique information on the clinical status of the peripheral nervous system that could not be inferred from the other observations made here. Morphological analysis of sural nerve biopsies in two exposed monkeys revealed that the extent of the damage considerably differed between the two animals (25% of nerve fibers vs. an occasional nerve fiber affected), while their sensitivity to vibration was reduced in a comparable manner. These data emphasize the importance and complementarity of a functional approach to sensory analysis. In this study, a morphological approach alone could have given a distorted conception of the clinical status of the subject. BRIEF HISTORICAL
SURVEY
The study of sense organs evolved from developments occurring mainly in the field of physiology during the 19th century. In the early 1800s special attention began to focus on the peripheral nervous system and the sense organs. Theodore Schwann, from the University of Liege, discovered the myelin sheath [1.5]. Bell [16] demonstrated that the anterior root of the spinal cord was motor in function, while Magendie [17] described the sensory function of the posterior roots. The formulation of the doctrine of specific energies, which states that a given nerve generates only one type of sensation, gave an impetus to sensory physiology during the 19th century [18]. Ernst Heinrich Weber (17951878), professor of anatomy and physiology in Leipzig, began the study of the innervation of the skin and special sense organs in humans, and investigated two-point discrimination, as well as perception of weight and temperature [19,20]. But it was Gustav Theodor Fechner (1801-1887) who really formalized the study of sense organs in his ‘Elemente der Psychophysik’ in 1860 [21]. In this book, he also described psychophysical methods still in use today. More recently, signal detection theory elaborated a theoretical framework that directly benefited psychophysics. It was developed in the 1950s by engineers who drew upon statistical decision theory and electronic communications. Signal detection theory provides a means of analyzing detection problems. It has broadened the scope of the psychophysical approach [22], and its major contribution has been to isolate the system’s intrinsic discriminative capabilities from factors affecting the translation of these discriminations into decisions. In other words, it has allowed the experimenter to tease apart true sensory events from nonsensory events that can
325
significantly contaminate the results of sensory testing. Signal detection theory has distinguished between three main experimental situations in which detection tasks can be performed (yes-no, forced-choice, and rating paradigms). These paradigms will be described later. OBJECT
OF PSYCHOPHYSICS:
MEASURING
THE
‘UNMEASURABLE’
Psychophysics is the scientific study of the relationship between a physical dimension of a stimulus and the behavioral response it generates. To describe the psychological aspect of the word ‘psychophysics’, the term ‘behavioral response’ is used here instead of ‘sensation’ to avoid introspectionistic and mental dimensions, which hamper the scientific approach. Operational definitions are indispensable to scientific endeavor. Stevens [23] has best captured the true nature of the psychophysical approach: ‘What we can get at in the study of living things
are the responses
of organisms,
physical
eludes
test.
Consequently,
- about
differential
mental
stuff,
which,
statements
about
sensation
organisms.
(...) I know nothing
by definition,
become
statements
about
about your sensations
objective responses
except what your behavior
not some hyperverifiable reactions
of
tells me.’ (p. 386)
The realm of psychophysics is still commonly misunderstood nowadays, and a recurrent fallacy is that ‘sensations’ can only be studied in humans due to their intimate nature, a mistake made by Claude Bernard himself [24]. It is, however, more surprising to read a similar statement in a more recent publication [25]: ‘Resort to animal the organoleptic
experimentation or sensory
instead
response...’
of man, eliminates
one whole area of response,
namely,
(pp. 18-19)
Basically, psychophysical evaluation is accomplished by delivering stimuli in a prespecified order (psychophysical methods) and by requesting from the subject (human or nonhuman) a codified response to the stimuli presented according to a specific format (response paradigm). PSYCHOPHYSICAL
METHODS
Psychophysical methods, established by Fechner [21], describe presentation of stimuli. Associated with each stimulus is a response function that relates these two parameters is usually characterized called the psychometric function. More details on psychophysical found in a number of textbooks [26-301.
the sequence of probability. The as ogival and is methods can be
Method of limits The method of limits consists of an equal number of presentations of ascending and descending stimulus levels. In the descending series, the first stimulus magnitude exceeds the detection level and is decreased until the first report of ‘no
326
*et
2nd
4th
set
3rd set
+
+
+
+
+
+ + +
+
+
T3 TRIALS Fig. 1. Stimulus
sequence
in the method
sequence
‘-I’
TRIALS of limits. The plus sign means ‘correct
sign means Fig. 2. Stimulus
:
‘1’:‘6
in the method
‘incorrect
of constant
the minus
stimuli.
sign means
response’,
and the minua
response’. The plus sign means ‘correct
‘incorrect
response’,
and
response’.
detection’ by the observer. In an ascending series, the first stimulus magnitude is situated below the detection threshold and is increased until the first detection response is given (Fig. 1). In each series, the midpoint between the last two levels is calculated and the threshold consists of the average of these midpoints. Two types of errors have been reported with this method in humans. One is the error of habituation, in which the observer has a tendency to repeat the preceding response, and the other is the error of anticipation, in which the observer prematurely changes the response from ‘detection’ to ‘no detection’ (or vice versa) in view of the number of stimuli already presented in this series. Starting each series at a different stimulus level is therefore mandatory. B-
16 12 z + Cl ++ + + z 8
6- ++
+ -++
++ s -
:: z z
.+-
-+++
15
10
5
++ ++
_
L
++
z -
_
0
20
sequence intensity
Fig. 4. Stimulus
sequence
the intensity
in an up-down
down
-
+.
!,-,,,
5
10
15
20
TRIALS
in the simple up-down at the next trial,
+-
2
TRIALS Fig. 3. Stimulus
-
W
1
0
++ ++
++ 4
rule: one correct
while one incorrect transformed
at the next trial,
response
response
rule: two correct
while one incorrect
(-)
(+)
responses
response
decreases
increases
(-)
the stimulus
it.
in a row (+ +) drive drives it up.
327
Method of constant stimuli This method obviates some of the errors potentially associated with the method of limits. Stimuli are delivered in a random order to prevent the observer from anticipating the magnitude of the following stimulus. Every stimulus of each set is presented for the same number of times (Fig. 2). The percentage of correct responses to each stimulus level is calculated, a psychometric function is derived, and the level corresponding to some predetermined correct response rate represents the threshold. This method, however, has an important disadvantage: every stimulus level must be tested many times before a threshold can be determined with a reasonable level of accuracy.
Method of adjustment The method of adjustment or of average error is a variant of the method of limits. The observer, most often an active participant, has direct control over the attribute of the stimulus under evaluation [31], and is requested to adjust the stimulus level to reach some criterion (e.g., to make the stimulus just detectable). One of the advantages of this method is that it provides a rapid way of obtaining thresholds. This is especially interesting when one is measuring a quickly changing threshold. However, test results can easily be biased by the subject.
Tracking methods Simple up-down
rule
The simple up-down rule is a variation of the method of limits. The order of stimulus presentation depends directly on the subject’s performance. If the observer detects the presence of the stimulus, its intensity is decreased at the next trial. If the observer does not detect the stimulus, its intensity is increased at the next trial [32]. Going
from a ‘detection’
to a ‘no detection’
(or vice versa) defines
3). With this up-down rule, all the observations on the stimulus level that is detected on 50% estimate of this stimulus level and is calculated sities [33], or the stimulus intensities associated
a reversal
(Fig.
are hovering about and converging of the trials. The threshold is an by averaging all the stimulus intenwith each reversal [34]. This simple
up-down rule has the advantage of maximizing the presentation of stimuli in the neighborhood of the threshold, and typically requires less time than the method of limits or of constant stimuli.
Up-down
transformed
rule
The up-down transformed rule (UDTR) is a generalization of the simple up-down rule, and it aggregates responses around a stimulus level correctly detected in a prespecified percentage of the trials, usually other than 50%. Figure 4 illustrates
328
:
“Q
qa5 Ql
,
-
z”’ 4
+ I
+ I +++
%
” Q”C
+‘r ’ ++
+
329
an example of a transformed rule: two consecutive correct responses will decrease the stimulus level at the next trial, while only one incorrect response is needed to increase the stimulus level at the next trial. Table I (panel A) shows that, with this rule, the series of responses will converge from any start point to a stimulus level correctly detected in 70.7% of the cases. The average stimulus level at steady state represents the threshold. Panels B and C (Table I) illustrate two additional strategies. More details on these procedures can be obtained from Wetherill and Levitt [34]. Parameter estimation by sequential testing The parameter estimation by sequential testing (PEST) method is also a variant of the up-down rule. It automatically determines each stimulus level to obtain information about the location of the threshold as efficiently as possible. Stimulus step size is variable and the testing session ends when a selected criterion has been met, that is, when some predetermined minimum step size has been reached. By the end of the session, the threshold is represented by the last stimulus level tested. Such a technique uses precise rules to determine step size and number of trials needed to calculate a threshold. This method can reduce the total number of trials to achieve some predetermined criterional stability. PEST was developed by Taylor and Creelman [35] and has been revisited on several occasions since [36-411. RESPONSE
PARADIGMS
While psychophysical methods only specify the rules governing a change in stimulus level, response paradigms define the type of response requested from the observer to some signals presented according to a specified format (i.e., one or several stimuli presented in each trial). The three major paradigms will be briefly mentioned here. Yes-no paradigm In the yes-no paradigm, the subject has to decide at each presentation whether an observation interval contains a signal (i.e., stimulus) or not (‘yes’ or ‘no’). No other response is accepted in the simple detection task. To minimize bias, the number of trials without a signal (also called ‘catch’ or ‘blank’ trials) should approximate the number of trials with a signal (‘test’ or ‘stimulus’ trials). It is advisable to let the subject know whether the response was correct or not. From these two stimulus and response alternatives (presence/absence vs. ‘yes’/‘no’), one can build a stimulus-response matrix, in which entries in each cell contain conditional probabilities (Fig. 5). With the yes-no paradigm, the criterion used by the subject to report the presence or the absence of the stimulus can vary widely among observers and even within
330
STIMULUS
F--e!-
ws %
: fn
l-----i
Fig. 5. Stimulus-response
matrix
false
hit
positive
P(Nls) miss
denoted
p(Sln)
P(SlS)
in a yes-no
P(Nln)
correct rejectton
paradigm.
Actual
by ‘s’ or ‘n’, while ‘S’ and ‘N’ refer to the reported
presence
presence
or absence
or absence
of the signal
of a signal
is
by the
observer.
observers over time. Several factors will affect this criterion. Two of these are the probability of signal presentation (i.e., the proportion of trials with and without a signal), and the payoff matrix, which assigns rewards and penalties associated with right and wrong decisions. These two nonsensory factors are under the direct control of the experimenter and directly manipulate the observer’s response. A high probability of stimulus presentation will favor ‘yes’ responses [42], and will result in an increased proportion of false positives (‘yes’ responses in the absence of a stimulus). As a consequence, it will artificially drive the ‘threshold’ to lower values if no correction is applied. Table II illustrates how false positives can affect sensory thresholds. The raw percentage of ‘yes’ responses is corrected for three falsepositive rates, using a correction described by Blackwell [43]. The thresholds are calculated here by linear interpolation between two points (for the sake of simplicity) and set as the stimulus level corresponding native ways of dealing with false positives detection theory (Ref. 22, pp. 86-116).
to the 50% detection point. Alterhave been proposed by the signal
Forced-choice paradigm In the forced-choice paradigm, the subject is presented with several intervals or alternatives, and has to indicate which one contains the stimulus. If no signal is clearly perceived, guessing is required. Abstaining from making a choice is not allowed. It is recommended that feedback be given to the subject [44]. When two alternatives are used, they may be distributed in the spatial or temporal domains and are referred to as (spatial) two-alternative forced-choice and two-interval forcedchoice paradigms, respectively. In a two-interval forced choice, for example, the signal is presented during the first or the second interval with the same probability. With this paradigm, the point
331
TABLE
II
CALCULATION
OF THE
OF FALSE-POSITIVE
50% THRESHOLD
IN THE YES-NO
PROCEDURE
AS A FUNCTION
RATES of ‘yes’ responses
corrected
for
Raw percentage
false positives
level
‘yes’ responses (hits)
10% FP
20% FP
30% FP
6
100
100
100
100
5
70
67
63
57
4
60
56
50
43
3 2
40
33
25
14
10
0
1
0 Intensity
of
Percentage
Stimulus intensity
level corresponding
3.5 a Correction
according
to 50% of ‘yes’ responses 3.7
to Blackwell
(FP)a
4.0
4.5
[43]; (p. 309).
of no detection will necessarily correspond to 50% of correct answers. The threshold is defined as the stimulus level corresponding to some response probability or discriminability, usually to the midpoint of the psychometric function, that is, to the 75% correct response rate for the two-alternative and two-interval forced-choice paradigms [35,38,40,45-551.
Rating paradigm This paradigm is a variation of the yes-no paradigm, and is designed for humans. One signal per trial is presented to the observer who is instructed to report, on a several-point scale, the likelihood that the signal or no signal was presented. TECHNIQUES
FOR ANIMAL
STUDIES
The basic psychophysical methods and response paradigms developed for a human observer are germane to those designed for lower order animals. Sensory capacities of nonverbal subjects can be assessed by several techniques: classical conditioning, operant behavior, and reflex modulation.
Classical conditioning In 1927, Pavlov published a new method for the investigation of reflexes [56]. By pairing a stimulus that had no observable effects (neutral stimulus), with another stimulus capable of eliciting a response or reflex (unconditioned stimulus), Pavlov was able to induce the same response by presenting the once neutral (now condition-
332
ed) stimulus alone. This method of pairing is called classical or Pavlovian tioning. This principle underlies the ‘method of contrast’ also developed by Pavlov
condito dif-
ferentiate a conditioned stimulus, which was always accompanied by an unconditioned stimulus and a response, from a neighboring neutral stimulus never followed by the unconditional stimulus or response. Differential responding entailed sensory differentiation. An example of the application of classical conditioning in psychophysics can be seen in Northmore and Muntz [57], who measured the sensitivity of fish to moving and stationary bars of light and to diffuse light. An electrical shock served as the unconditional stimulus. Its effect was to produce a consistent increase in the activity of the fish. By pairing neutral and unconditional stimuli a certain number of times, the neutral (now conditioned) stimulus alone produced the increased swimming activity and was evidence of detection. In a similar manner, Otis et al. [58] induced decreased respiration and heart rates by electrical stimulation in goldfish to assess detection of a change in illumination. Passe [59] used a classical conditioning technique, called autoshaping, to evaluate the absolute visual sensitivity in pigeons. In this experiment, the pigeons were fooddeprived to reach 80% of their free-feeding body weights. A response key was illuminated and followed by grain delivery. After an adequate number of trials, the pigeons reliably pecked the key only when it was illuminated, even though pecking the key was not required for grain delivery. The intensity of the key illumination was varied, and pecking the key when it was illuminated indicated detection of the light. Hearing also can be studied with classical conditioning techniques. Jamison [60] used ammonia as the unconditional stimulus to decrease heart rate in rats. After pairing a tone with ammonia presentation, the tone alone reduced heart rate. Detection of the stimulus was evidenced by a change in heart rate. Overall, there are limitations to the classical conditioning approach: total number of trials per day, necessity for reconditioning due to loss of the conditioned reflex, and problem of defining a criterional response change, to name a few.
Operant behavior In 1938, Skinner elaborated on Thorndike’s ‘law of effect’, systematized an approach to learned motivated behavior, and developed the methods of experimental analysis of behavior [61]. He explained behavior by its consequences: previous consequences model current performance. Because an operant (i.e., any response that modifies the environment) can be placed under the differential control of a stimulus, new possibilities for sensory research emerged. Several procedures have been designed to analyze sensory processes in animals, and they use one or more response manipulanda. The major drawback of this method lies in the training required to place a behavior under stimulus control.
333
Go/no-go procedure This procedure
is the operant
version
of the yes-no
paradigm.
The animal
is train-
ed to give a response in the presence of a standard stimulus and to withhold it in its absence or in the presence of a comparison stimulus. Terman and Terman [62] used this procedure to evaluate rats’ discriminative capabilities for auditory intensity. By pressing a bar, the rats turned on a tone. After the tone, a 3-s choice interval was presented. Rats received a reward (or reinforcement) if: (1) they pressed the bar during the choice interval following presentation of the tone at standard intensity, (2) they did not press the bar during the choice interval following presentation of a tone at a different intensity. Aversive stimuli can also control such a behavior. Clack and Herman [63] tested monkeys’ auditory thresholds by shock avoidance conditioning and generated data comparable to those obtained with positive reinforcement.
Forced-choice paradigm The forced-choice paradigm also has been used successfully in animal sensory research. Typically, two stimuli are presented. They can be spatially or temporally spaced, and each stimulus is associated with one response manipulandum or one interval. For example, Yager and Thorpe [48] tested color vision in goldfish in the following manner: the fish first swam to the back of the tank, made an observing response by pressing a key that illuminated both choice keys, swam toward the choice keys, and struck one of them. On the average, every third correct response was reinforced. A correction procedure prevented the formation of a position habit.
Conditioned
suppression procedure
In 1941, Estes and Skinner when a signal that terminates
described the ‘conditioned emotional response’ [64]: with a shock is superposed over a steady rate of an
operant, it acquires suppressing properties. The suppression is measured by the ratio of the response rates before vs. during the signal and reflects detection of the stimulus. However, it was not until later that this procedure was exploited in psychophysics [65,66]. Using this procedure, Sidman et al. [65] studied hearing and vision in animals. Mice were trained to lick a tube and received a drop of milk after a variable number of licks. This schedule of reinforcement generates a sustained rate of licking sufficiently stable so that the interfering effects of random signals announcing an electrical shock can be evaluated. These warning stimuli have a fixed duration and develop conditioned suppression (i.e., the rate of licking is drastically reduced during the warning stimuli and therefore indicates detection). Excellent reviews of animal psychophysics can be found in Blough and Blough [67], Stebbins [68], and Blough and Young [69].
334
RefIex modulation Hoffman phenomenon presentation,
and Ison [70] defined reflex modulation or reflex modification as ‘. ..the whereby the reflex elicited by one stimulus is modified by the prior withdrawal, or change of another (usually weaker) stimulus’.
As early as 1863, Sechenov showed that stimulation of the frog’s brain inhibited reflexes to painful cutaneous stimuli [71]. One of the first applications of reflex modification to sensory analysis goes back to Yerkes [72]. He established that ringing a bell before tapping on the frog’s head modified the flexor jerk reflex, and concluded that frogs can hear. More recently, the technique has been refined and applied by several laboratories to assess sensory processes. For example, Young and Fechter [73] investigated animal audiometry and used reflex modulation with the method of constant stimuli. They tested rats and guinea pigs with 115 dBA white noise startle bursts of 20-ms duration. On control trials, the startle-eliciting stimulus was presented alone. On prestimulus trials, a pure-tone stimulus of varying intensity and frequency preceded the startle-eliciting stimulus by 100 ms. For each test session, an average startle amplitude was calculated at each prestimulus intensity and frequency and expressed as a percentage of average startle amplitude during control trials. A psychometric function relating relative startle amplitude to prestimulus intensity was generated for each tested frequency. The data calculated for rats and guinea pigs with reflex modulation are comparable to those collected with operant techniques on rats by Kelly and Masterton [74] and on guinea pigs by Prosen et al. [75]. One of the problems of reflex modulation consists in the definition of a response change that can evidence sensory detection. More details on this technique can be found in Hoffman and Ison [70], Ison and Hoffman [76], Hoffman [77], and Fechter CRITICAL
and Young
[78].
EVALUATION
OF HUMAN PSYCHOPHYSICAL
STUDIES
Psychophysics grew roots in the middle of the 19th century, and its methods have been refined, analyzed and criticized since. Overlooking more than 100 years of scientific advancement in psychophysics, as well as neglecting the framework of signal detection theory, has fostered confusion in the application of psychophysical methods in human toxicology and occupational medicine. In the next few paragraphs, this point will be illustrated.
Nonclassical terminology It has been implied that the ‘method of constant stimuli’ is always present, when, in fact, it signifies that discrete, generated randomly, as described earlier:
means that the stimulus prespecified stimuli are
335
‘Some methods the stimulus
use constant
is always
The forced-choice ‘In the forced
paradigm
choice method
does not necessarily defined This
stimuli
present...’
stimulus
presentation.
also has been erroneously
defined
the examinee
of discrete
knows when the stimulus
know it was. In this procedure
by a light clue, the observer
(1791, P. 8) is, in fact,
instead
the accepted
In these procedures
([79], p. 9)
is required
definition
during
to indicate
of the yes-no
as follows:
may have been presented,
a fixed time interval,
whether
or not the stimulus
paradigm,
but
which is usually was present.’
which is diametrical-
ly opposite to the forced-choice paradigm. Similarly, giving a choice between two intervals and also allowing the observer to abstain from making a choice has been erroneously referred to as a forced-choice paradigm (in a commercially available operating manual). By definition, abstention is not allowed in a forced-choice situation. The ‘method of limits’ has been contrasted with the ‘forced-choice paradigm’ although these two pertain to two entirely different domains, as explained above. The former refers to a method of stimulus presentation and the latter to a response paradigm. The method of limits conceivably can be used in a forced-choice situation. What some authors really meant by ‘method of limits’ was the ‘yes-no paradigm’ used in conjunction with the method of limits. Such confusion also has been perpetuated in some brochures and operating manuals for commercially available devices.
Nonconventional
procedures
Some authors do not describe the psychophysical method or the response paradigm used in their studies [80]. Sometimes modified or new methods are adopted for which no or almost no literature exists, or for which no clear rationale is given. For example, Arezzo et al. [81] used the following up-down transformed rule to test sensation: if stimuli are correctly identified on two out of three trials, the stimulus level is decreased; if errors are made on two out of three trials, the stimulus level is increased. Binomial analysis of this strategy and of the simple up-down procedure (Table III, panels A and B) shows that both rules converge on the exact same stimulus level (i.e., the level corresponding to the 50% correct response rate). Therefore, both procedures give the same estimate, but, by definition, it will take between 2 and 3 times longer to get the same answer with the transformed strategy described above (Table III, panel B), compared to the simple up-down rule (Table III, panel A). Advantages of this up-down transformed procedure are elusive.
Unorthodox Sosenko (described
threshold definition et al. [82] and Arezzo et al. [81] used the modified up-down rule in Table III, panel B) in conjunction with the two-alternative forced-
____
_ +-T +--r PC1-PY
P(1 -PY
(1-PI2
.__-..
2PU -HZ+
----____.
6p*--4p3-l=O
..
2&l -p)+p2=
p=i-p
-
._-.-.-_ ___ Condition of convergenceb
(1 -Pf2
-_.-._____
p=o.s
p=o.s
--
Probability of correct response convergence __.-_-
‘The series converges or stabilizes at the level where the sum of the probabilities of a decrease equals the sum of the probabilities of an increase.
“p= probability of a correct response.
Two out of three incorrect responses + increased level
t
&l-P)
-++i
--
P2
P%-PI
+-+1
1-P
P
Probability of changing level”
++l
-1;
Incorrect response + increased level
B: Two out of three correct responses --*decreased level
t-l
Symbolic representation
+ decreased Level
A: Correct response
-~
UP-DOWN RULES -_-_-___ .~ Up-down rules for stimulus sequence
TABLE III
337
STIMULUS
Fig. 6. Psychometric
function
relating
detection
INTENSITY
probability
forced-choice
to stimulus
intensity
in a two-alternative
paradigm.
choice paradigm. They calculated the sensitivity threshold as the stimulus level corresponding to a 50% correct response rate (i.e., chance detection). Such a threshold definition is unusual in a two-alternative forced choice because it corresponds to a stimulus level that cannot be detected by definition. There is no single point on the abscissa of the psychometric function that corresponds to the 50% correct response rate but rather an infinity of points encompassing all potential levels that the subject could not detect (Fig. 6). This criterion would be equivalent to estimating the stimulus level corresponding to 0% detection in a yes-no paradigm. A similar approach has already been criticized by Rose et al. [47] who stated: ‘...it makes point,
no sense to use the yes-no
but a continuum
of stimulus
rule in a forced-choice
situation
since there is not just one
values for which the forced-choice
psychometric
function
has
the value of 0.5.’ (p. 200)
by Kershaw [83] who wrote: ‘In a few papers interpretation
other UDTR
is used in 2IFC experiments, or no chance
by Penner paradigm: ‘Obviously,
of detecting
estimates
the stimulus.’
it is necessary
terest as a dependent these thresholds
to track
many stimulus variable.
are not unique.
probability
associated
(...) It is difficult
that they obtain.
then levels will drift toward
low stimulus
rule
levels for which there is little
stimulus
statement
about
levels for which a unique
detection
levels result in 100% and 50% detection, We cannot
compare
thresholds
We must restrict our measures with them.’
the forced-choice
obtained to stimulus
for an invisible
probability
exists.
these levels are of no inin various
conditions
if
levels that have a unique
(p. 115)
and by Levine and Shefner [52] who wrote about the forced-choice ‘As 50% is the score expected
to see what
If the Up-and-Down
(p. 36)
[51] who made the following
Since infinitely
detection
rules are used with the 21FC procedure.
can be made of the threshold
stimulus,
it cannot
paradigm:
be taken as the threshold.’
(p. 17)
Limited number of trials Care should be taken to use an adequate number of trials to ensure threshold reliability and validity. On the basis of statistical analysis, Dixon and Mood [84]
338
recommended a sample size of 40-50 trials for the up-down method. Shelton et al. [38] showed that neither PEST nor the transformed up-down rule will converge on a threshold with only ten trials and recommend threshold with the up-down transformed rule. their tests after a total of five incorrect average Some earlier, absence
responses
running 40-60 trials to evaluate a However, some authors conclude and report
their thresholds
as the
of eight values [82]. authors have used only 20% of catch trials per session [85]. As discussed such a practice will most likely underestimate the actual threshold in the of correction.
Nontraditional
units
Physical parameters of stimuli should be fully characterized and calibrated so that similar conditions can be replicated in a different setting. Vibration sensitivity amplitude thresholds have been expressed in inappropriate and/or erroneous units, such as ‘Biothesiometer units’, or more simply, ‘units’ [82,86], ‘volts’ [8.5,87-931, ‘volts square’ [94] and even in ‘Hertz’ [95]. In the field of vision, it is not unusual to see light flash intensity characterized only in terms of a device setting on a specified photostimulator rather than in appropriate optical units 1961. The experimenter should measure the stimulus of interest rather than an attribute generated before or during the production of this stimulus. For example, Bleecker [88] and Anger et al. [91] studied vibration sensitivity, but they measured the voltage applied to the vibrator rather than the actual vibration amplitude. With the same device, the former reported a threshold of 3.67 volts in normal subjects of 31-40 years of age, while the latter recorded 8.8 volts in a reference group with an average age of 36 years. As a test score of about 7 volts should be considered as significantly elevated according to the nomograms furnished by the manufacturer, a value of 8.8 volts would certainly have to be considered as highly pathological although it characterizes a control group. More likely, this difference may be related to lack of calibration of the two units. CONCLUSION
AND RECOMMENDATIONS
Psychophysical studies have helped characterize the toxic potential of chemicals to sensory functions in a quantitative and noninvasive manner. Extrapolation of psychophysical observations from one species to another is facilitated because sensory pathways are phylogenetically old structures, and very similar methods can be used across species. This psychophysical approach has appealed to many, and a large number of studies have flourished. On several occasions, however, sensory testing in humans has presented deficiencies not usually present in most animal studies. Therefore, it is suggested that major methodological features developed for sensory assessment
339
in animals (including signal detection theory approach) be taken into consideration in human sensory analysis. The following recommendations should be considered. (1) Minimize evaluation. (2) Automate
relations
between
stimulus
the
delivery
tester
and
and response
the
testee
during
sensory
recording.
(3) Standardize instructions. (4) Preestablish rigid objective rules to define all the test events (i.e., response, stimulus sequence,. . .), and to accept or reject data points. (5) Choose appropriate units of measurement that will allow for comparison between different studies. (6) Describe all relevant physical dimensions of stimuli, and perform frequent calibrations. (7) Insert catch trials (whenever appropriate) in adequate proportions to correct sensory data. (8) Use appropriate number of trials. (9) Give feedback on subject’s performance. (10) Use correction procedures to prevent position habits, whenever applicable. All these factors will minimize errors and potential unconscious bias on the part of the subject and/or test administrator, and will increase the reliability, accuracy, and validity of the data collected.
REFERENCES
1 Merigan, York,
W.H.
and Weiss, B. (Eds.) (1980) Neurotoxicity
of the Visual System,
Raven
Press,
New
Special Senses, Raven Press,
New
NY.
2 Hayes,
A.W.
York,
NY.
3 Miller,
J.J.
4 Stebbins,
(Ed.) (1985) Toxicology (1985) Handbook
W.C.
behavioral
(1982)
toxicology.
5 Merigan,
W.H.
of the Eye, Ear, and Other
of Ototoxicity,
Concerning Environ.
(1979) Effects
CRC Press,
the need
Health
for
Perspect.
of toxicants
more
Boca Raton, sophisticated
FL. animal
models
in sensory
44, 77-85.
on visual
systems.
Neurobehav.
Toxicol.
1 (Suppl.
l),
15-22. 6 Maurissen, (Suppl.
J.P.J.
7 Maurissen,
J.P.J.
Neurobehav. 8 Halpern,
of toxicants
(1985) Psychophysical
Toxicol.
Teratol.
on the somatosensory
system.
Neurobehav.
Toxicol.
1
testing
in human
populations
exposed
to neurotoxicants.
7, 309-317.
B.P. (1982) Environmental
Perspect. 9 Pryor,
(1979) Effects
l), 23-31.
factors
affecting
chemoreceptors:
an overview.
Environ.
Health
44, 101-105. G.T.,
Dickinson,
high-frequency
hearing
J., Howd,
R.A.
loss in weanling
and Rebert, rats exposed
C.S. (1983) Transient to toluene.
cognitive
Neurobehav.
Toxicol.
deficits
and
Teratol.
5,
53-57. 10 Rebert,
C.S.,
Sorenson,
rats evidenced 11 Merigan,
W.H.,
in primates.
S.S., Howd,
by the brainstem Barkdoll,
Toxicol.
Appl.
R.A.
and Pryor,
auditory-evoked
E. and Maurissen, Pharmacol.
G.T.
response. J.P.J.
62, 342-345.
(1983) Toluene-induced Neurobehav.
Toxicol.
(1982) Acrylamide-induced
hearing Teratol.
loss in
5, 59-62.
visual impairment
340
12 Merigan, effects
W.H.,
Barkdoll,
on the macaque
E., Maurissen,
visual system.
J.P.J.,
Eskin, T.A. and Lapham,
I. Psychophysics
L.W. (1985) Acrylamide
and electrophysiology.
Invest.
Ophthalmol.
Visual Sci. 26, 309-316. 13 Eskin, T.A., macaque
Lapham,
visual
L.W.,
system.
Maurissen,
II.
J.P.J.
Retinogeniculate
and Merigan,
W.H.
morphology.
Invest.
(1985) Acrylamide Ophthalmol.
effects on the Visual
Sci. 26,
317-329. 14 Maurissen,
J.P.J.,
to acrylamide. 15 Schwann,
Weiss, B. and Davis, H.T.
Toxicol.
Appl.
Pharmacol.
T. (1839) Mikroskopische
dem Wachsthum
der Thiere
Untersuchungen
und Pflanzen,
Pathol.
F. (1822) Experiences
2, 276-219,
18 Miiller, 19 Weber,
E.H.
(1834)
E.H.
22 Green,
De
Pulsu,
G.T.
York,
J. Physiol.
Exp.
und der Thiere,
Auditu
Annotationes
Anatomicae
Huntington,
Hazards,
In: R. Wagner
(Ed.), Handworterbuch
Vol. 1 and 2, Breitkopf Theory
and man.
Science
der
und Hartel,
and Psychophysics,
Leipzig.
Robert
E. Krieger
127, 383-389.
a 1’Etude de la Medecine toxicology
and I. de Groot
HEW
et
NY.
C. (1856) Introduction
B.L. Johnson
et Tactu.
pp. 481-588.
der Psychophysik,
Publication
Washington, DC. 26 Guilford, J.P. (1954) Psychometric 27 Corso,
London.
des Menschen
(1974) Signal Detection
Paris, 1966, p. 212. 25 Stokinger, H.E. (1974) Behavioral tional
and Preston,
des nerfs rachidiens.
des Gesichtssinnes
und das Gemeingeftihl.
S.S. (1958) Measurement
Xintaras,
Strahan
des racines
Physiologie
Braunschweig,
(1860) Elemente
Co.,
24 Bernard,
of the Brain,
Resorptione,
(1846) Der Tastsinn
D.M. and Swets, J.A.
23 Stevens,
und
Lipsiae.
Vol. 3, Vieweg,
Publishing
in der Struktur
366-371.
C.F. Koehler,
Physiologie, 21 Fechner,
exposed
Leipzig.
Physiologicae, 20 Weber,
in monkeys
Berlin.
sur les fonctions
J. (1826) Zur vergleichenden
C. Cnobloch,
thresholds
tiber die Uebereinstimmung
Sander,
16 Bell, C. (1811) Idea of a New Anatomy 17 Magendie,
(1983) Somatosensory
71, 266-279.
in the development
(Eds.),
No.
Behavioral
(NIOSH)
Methods,
J.F. (1967) The Experimental
Experimentale,
McGraw-Hill
Psychology
of threshold
Toxicology.
74-126,
Editions
US
Government
Behavior,
Beltond,
limit values.
Early Detection
Book Company,
of Sensory
Pierre
In: C.
of Occupa-
Printing
New York,
Office, NY.
Rinehart
and Winston,
Psychophysics,
and
New
NY.
28 D’Amato,
M.R.
McGraw-Hill 29 Scharf,
(1970)
Experimental
Book Company,
B. (1975) Experimental
30 Gescheider, Hillsdale,
G.A.
(1976)
Psychology:
New York, Sensory
Psychology,
Psychophysics.
Methods
32 Cornsweet,
T.N.
33 Brownlee,
K.A.,
samples.
Scott, and
Foresman Theory,
Hodges,
and Co.,
Lawrence
Glenview,
Erlbaum
IL.
Associates,
Stat. Psychol.
H. (1965) Sequential
J. Psychol.
75, 485-491. method
with small
estimation
of points
on a psychometric
efficient
estimates
on probability
function.
18, l-10.
and Creelman,
Sot.
Am. 41, 782-787.
J.M.
Am.
M. (1953) The up-and-down
48, 262-277.
M.M.
36 Findlay,
35, 41 l-422.
in psychophysics.
Jr., J.L. and Rosenblatt,
G.B. and Levitt,
Br. J. Math.
Acta Otolaryngol.
(1962) The staircase-method
J. Am. Stat. Assoc.
34 Wetherill,
Acoust.
Learning,
NJ.
31 BCkCsy, G. von (1947) A new audiometer.
35 Taylor,
Methodology,
NY.
C.D.
(1978) Estimates
phys. 23, 181-185. 37 Pentland, A. (1980) Maximum
(1967) PEST:
on probability likelihood
functions: estimation:
a more virulent the best PEST.
PEST. Percept.
functions.
Percept.
Psycho-
Psychophys.
377-379. 38 Shelton,
B.R.,
procedures.
Picardi,
J. Acoust.
M.C. and Green, Sot.
D.M. (1982) Comparison
Am. 71, 1527-1533.
of three adaptive
J.
psychophysical
28,
341
39 Watson,
A.B.
and Pelli, D.G.
Psychophys. 40 Mad&an,
R.
alternative 41 Relkin,
E.M.
Williams,
and Pelli, D.G.
43 Blackwell,
H.R.
44 Lukaszewski,
adaptive
(1987) Probe
psychometric
psychometric Percept.
tone thresholds
J. Acoust.
Sot. Am.
discrimination:
functions.
method.
Percept.
procedures
Psychophys.
in the auditory
in two-
42, 240-249.
nerve measured
by two-
82, 1679-1691.
effects of probability
M.,
of stimulus
presentation.
J. Exp.
Stamm,
J.S.
J. Acoust.
and
Pribram,
lesions in monkeys.
R.A.
(1963) Detection
procedures
upon
psychophysical
measure-
44, 306-315.
D.N. (1962) Auditory
and motivation.
parietal
of data collection
J. Exp. Psychol.
J.S. and Elliott,
46 Campbell,
Maximum-likelihood
and recommendations.
(1952) The influence
feedback,
posterior
a Bayesian
18, 465-469.
ment of two sensory
45 Wilson,
(1987)
procedures.
T.F. (1972) Duration
Behav.
nique,
D.
evaluation
forced-choice
42 Elsmore, Anal.
and
forced-choice:
interval
(1983) QUEST:
33, 113-120.
threshold
Sot. Am.
K.H.
(1960)
J. Comp.
Deficits
Physiol.
of a noise signal
as a function
of forced-choice
tech-
discrimination
after
34, 223-228. in roughness
Psychol.
of varying
53, 535-539.
duration.
J. Acoust.
Sot.
Am.
35,
1732-1737. 47 Rose,
R.M.,
Percept.
Teller,
D.Y.
Psychophys.
48 Yager,
D. and Thorpe,
Animal
and
Rendleman,
P. (1970) Statistical
Psychophysics:
S. (1970) Investigations
of goldfish
The Design and Conduct
of Sensory
color vision.
50 Dyck,
functions.
P.J.,
(1978)
cutaneous
I.R.,
in man.
Hillsdale,
54 Pasternak,
T., Flood, W.H.
D.G.,
Eskin, T.A.
cells. Vision
I.P.
(1927) Conditioned
57 Northmore,
for measurement
of hearing.
P.E.,
Karnes,
touch-pressure,
J. and Bushek,
vibration,
and
W.
thermal
4, 502-510.
(translated
D.P.M.
analysis.
pathway
and Eskin,
Cortex
(Ed.),
In: M.S. Mayzner Research, Lawrence
and T.R. Erlbaum
of Sensation
and Perception,
Addison-Wesley
MA, p. 17.
ganglion
Cerebral
Neurol.
Ness, A., Caskey, to evaluate
J.M. (1981) Fundamentals
of probit
in the cat retinogeniculate
56 Pavlov,
procedure
Klein, S.A. and Teller, D.Y. (1985) Statistical
implications
retinal
P.C.,
systems
Ann.
Reading,
functions:
55 Merigan,
O’Brien,
Stebbins
Appleton-Century-Crofts,
NJ, pp. 100, 115.
Company,
53 McKee, S.P.,
estimates.
Am. 57, 431-436.
(1978) Psychophysical methods and the minicomputer. Minicomputers in Sensory and Information-Processing
M.W. and Shefner,
Publishing
Sot.
of automated
sensation
Associates, 52 Levine,
J. Acoust
Zimmerman,
Introduction
51 Penner, M.J. Dolan (Eds.),
of staircase In: W.C.
Experiments,
New York, NY, pp. 259-275. 49 Pfingst, B.E., Hienz, R. and Miller, J. (1975) Reaction-time II. Threshold
properties
8, 199-204.
Percept.
T.A.
properties
Psychophys.
and Merigan,
W.H.
by 2,5-hexanedione.
of forced-choice
(1985) Selective damage
J. Neurosci.
(1986) Spatio-temporal
psychometric
37, 286-298. to large cells
5, 1641-1652.
vision of macaques
with severe loss of Pp
Res. 26, 1751-1761. Reflexes:
An Investigation
by G.V. Anrep),
and Muntz,
(Scardinius erythrophthalmus),
W.R.A.
Dover
(1974) Effects
measured
of the Physiological
Publications,
New York,
of stimulus
with a classical
Activity
size on spectral
conditioning
of the
NY, 1960.
paradigm.
sensitivity Vision
in fish Res. 14,
503-514. 58 Otis, L.S., Cerf, in the goldfish. 59 Passe,
D.H.
pigeon.
J.H.
autonomic Crofts,
B.F.
Behav.
as a psychophysical
J. Comp. NY.
of auditory
Physiol.
(1938) The Behavior
New York,
(1957) Conditioned
inhibition
of respiration
and heart rate
paradigm:
absolute
visual
sensitivity
in the
in the rat by conditioning
of an
36, 133-139.
(1951) Measurement
response.
G.J.
126, 263-264.
(1981) Autoshaping
J. Exp. Anal.
60 Jamison, 61 Skinner,
J.A. and Thomas, Science
intensity
Psychol.
of Organisms.
thresholds
44, 118-125. An Experimental
Analysis,
Appleton-Century-
342
62 Terman,
M. and Terman,
operant-psychophysical 63 Clack,
T.D.
measuring
and
J.S.
(1972) Concurrent
test. Percept. Herman,
auditory
P.N.
thresholds
64 Estes, W.K. and Skinner,
variation
Psychophys.
(1963)
A single-lever
in the monkey.
of response
bias and sensitivity
in an
11, 428-432. psychophysical
J. Audit.
adjustment
procedure
for
Res. 3, 175-183.
B.F. (1941) Some quantitative
properties
of anxiety.
J. Exp. Psychol.
29,
390-400. 65 Sidman,
M., Ray, B.A.,
mutant 66 Smith, Crofts,
D. and
(Eds.),
P. (1977) Animal
(Ed.)
Behavior,
(1970)
Animal
P.M.
nonhuman
and
Young,
subjects.
Press,
70 Hoffman,
(1966) Hearing
technique.
of Sensory
New York,
New York,
J.S.
In: A.W.
Psychophysics.
Prentice-Hall,
In: W.C. Stebbins
Experiments,
(1985)
Hayes
In: W.K.
Englewood
Appleton-Century-
The
Psychophysical
(Ed.),
Honig
Cliffs,
Design
and
J.E.R.
Staddon
NJ, pp. 514-539.
and
Conduct
of Sensory
Ex-
dysfunction
in
NY. assessment
Toxicology
of
sensory
of the Eye, Ear, and Other
Special
Senses,
pp. 79-90.
H.S. and Ison, J.R. (1980) Reflex modification
findings
and vision in neurological
16, 377-402.
psychophysical
Psychophysics:
Appleton-Century-Crofts,
69 Blough,
as an animal
The Design and Conduct
of Operant
W.C.
periments,
J.M.
Exp. Neurol.
NY, pp. 125-159.
Blough,
Handbook
68 Stebbins,
suppression
Psychophysics:
New York,
67 Blough,
R.L. and Klinger,
for their evaluation.
J. (1970) Conditioned
(Ed.), Animal
Raven
Sidman,
mice: a method
and their implications
for how the nervous
in the domain
system processes
of startle.
sensory
I. Some empirical
input.
Psych.
Rev. 87,
175-189. 71 Sechenov,
I.M. (1863) Reflexes of the Brain (translated
by S. Belsky), M.I.T.
Press, Cambridge,
MA,
1965, p. 14. 72 Yerkes,
R.M.
73 Young,
J.S. and Fechter,
(1905) The sense of hearing
nique for assessing 74 Kelly,
J.B.
Psychol.
and
L.D.
ototoxicity.
Masterton,
J. Comp.
J. Acoust.
Neurol.
procedures
Psychol.
for animal
15, 279-304. audiometry:
a tech-
Sot. Am. 73, 1686-1693.
B. (1977) Auditory
sensitivity
of the albino
rat.
J. Comp.
Physiol.
91, 930-936.
75 Prosen,
C.A.,
Petersen,
kanamycin-induced Acoust.
Sot.
M.R.,
hearing
of a robust
77 Hoffman, of Startle
procedures Behavior,
L.D. and Young, Johns
Hopkins
79 Wilber,
L.A.
(1979)
(Ed.),
81 Arezao, 82 Sosenko, functional
factors
in the behavioral
Publishing
thresholds
reinforcement
and
procedure.
J.
Threshold
Hearing
Press,
measures.
II. The anomalous
of startle.
The use of reflex
(Ed.), Neural
Mechanisms
NY, pp. 267-285.
In: 2. Annau
(Ed.), Neurobehavioral
Tox-
MD, pp. 23-42.
methods
University
analysis
In: R.C. Eaton
New York,
Baltimore,
measurement
Assessment,
Schaumburg, assessment
J.M.,
Corporation,
of startle.
Bull. 94, 3-17.
of threshold.
J.S. (1986) Reflexive University
Gadia,
testing
H.H.
Park
and Press,
special
considerations.
Baltimore,
In:
W.F.
MD.
M.T.,
Stat.
C. (1986) Thermal
sense in diabetic
Natori,
for the detection
Br. J. Math.
and of
27, 505-507.
and Laudadio,
of thermal
1741-1744. 83 Kershaw, C.D. (1985) Statistical periments.
(1978) Auditory
in the domain
Psychol.
Eur. J. Clin. Pharmacol.
J.C.,
quantitative
W.C.
by a positive
D., de Weisse, C., Meyer, J.J., Bousquet, A. Safran, A.B., Desangles, A. (1984) Evaluation of visual function in healthy subjects after administration
80 Lupolover, Y., Assimacopoulos, Ro 15-1788.
pig assessed
phenomenon.
and the assessment
Plenum
icology,
Rintelmann
D.B. and Stebbins,
H.S. (1983) Reflex modification
and ubiquitous
H.S. (1984) Methodological
modification 78 Fechter,
Moody,
loss in the guinea
Am. 63, 559-566.
76 Ison, J.R. and Hoffman, history
in frogs.
(1983) Reflex inhibition
N., Ayyar,
D.R.,
of diabetic
peripheral
properties Psychol.
neuropathy.
of staircase
38, 35-43.
Ramos,
tester.
Device
for
35, 590-592.
L.B. and Skyler,
neuropathy.
estimates
sensitivity
Diabetes
Arch.
from two interval
J.S. (1987) NeuroIntern. forced
Med.
147,
choice ex-
343
84 Dixon, Stat.
W.J.
and Mood,
Assoc.
85 Arezzo,
J.C.
technique
A.M.
(1948) A method
for obtaining
and analyzing
sensitivity
data.
J. Am.
device.
A new
43, 109-126. and Schaumburg,
for detecting
H.H.
sensory
(1980) The use of the Optacon
loss in individuals
exposed
as a screening
to neurotoxins.
J. Occup.
Med.
22,
461-464. 86 LeQuesne, lesions.
P.M. and Fowler,
J. Neurol.
87 Kardel,
T. and Nielsen,
Acta Neurol. 88 Bleecker,
Stand.
M.L.
Cassito
Press,
Elmsford,
90 Arezzo, titative 91 Anger, Setzer,
and
W.K.,
fumigators
Moody,
clinical
H.H. H.H.
D.J.,
P.H. sensory
94 Nielsen, vibratory 95 Bleecker, vibration Biological Service, 96 Onofrj, rat VEP:
and
L., Burg,
and electrophysiological neuropathies.
in Occupational
foot study.
In: R. Gilioli,
Health,
Pergamon
Galer,
B.S.,
Dutcher,
and Schaumburg, neuropathy
perception
Soffar,
induced
is prevalent
in patients
and Moreland,
R. (1984) Carpal
Monitoring Springfield, M., Harnois, a comparison
for the Effects
R.K.,
C. and Bodis-Wollner, of flash and pattern
Russo,
J.M.,
Berger,
Screening
pesticide
Toxicologist
7, 134.
A., Arezzo,
sensory
testing
Arch.
Dickerson,
N.,
of soil and structural
7, 137-156.
(1987)
(OPIDN).
in chronic
Mizruchi,
demonstrates
Neurol.
renal failure.
J.C.,
plant M.,
that sub-
44, 944-946.
IV. An analysis
of the
191, 287-296. tunnel
studies.
of Exposure
VA, No. PB86-242641,
peripheral
a simple device for quan-
evaluation
with cancer.
nerve function
for
l), 169.
B.J.,
D.A.
neuropathy
Portenoy,
electrodiagnostic
screening
Neurotoxicology
Otto,
(1987) Quantitative
Acta Med. Stand.
versus
Taylor,
fluoride. A. and
threshold.
threshold
35 (Suppl.
W.S.,
delayed
J.P., H.H.
Rapid
K. (1986) Neurobehavioral
and sulfuryl
S.A.,
(1983)
33, 626-629.
C. (1985) The Vibratron:
J., Brightwell,
bromide
Soliman,
C.A.
Neurology
sense. Neurology
V.K. (1972) The peripheral M.L.
Methods
Petersen,
and Laudadio,
B.L. and Hicks,
using methyl
R.B.,
Wiernik,
A clinical
device for peripheral
Neurobehavioral
with the Optacon.
for organophosphorus
93 Lipton,
neuropathy.
a new screening
of tactile/vibratory
Johnson,
92 Svendsgaard,
-
V. FOB (Eds.),
Schaumburg,
evaluation
workers
V.K. (1974) Hepatic
Schaumburg,
J.V.,
with neuropathic
50, 513-526.
a field study
J.C.,
in diabetics
49, 1191-1194.
NY, pp. 41-46.
J.C.,
neuropathy:
Psychiatry
(1983) Optacon
M.G. 89 Arezzo,
C.J. (1986) A study of pain threshold
Neurosurg.
syndrome:
comparisons
In: Conference
in the Workplace,
of alterations
on Medical
National
Screening
Technical
in and
Information
p. 27. I. (1985) The hemispheric stimulation.
Exp. Brain
distribution
of the transient
Res. 59, 427-433.