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New Findings: What is the central question of this study? Does recreational cold exposure result in cold sensitivity and is this associated with endothelial dysfunction and impaired sensory thermal thresholds? What is the main finding and its importance? Previous cold exposure was correlated with cold sensitivity of the foot, which might indicate the development of a subclinical non-freezing cold injury. Endothelial function and thermal detection were not impaired in cold-sensitive individuals; therefore, further research is required to understand the pathophysiology of subclinical and clinical forms of non-freezing cold injury., Abstract: In this study, we investigated whether cold-sensitive (CS) individuals, who rewarm more slowly after a mild cold challenge, have impaired endothelial function and sensory thermal thresholds (STTs) and whether this is related to reported cold exposure. Twenty-seven participants with varying previous cold exposure undertook three tests: an STT test, i.e. determination of warm and cold STTs of the fingers and dorsal foot; an endothelial function test, i.e. measurement of cutaneous vascular conductance (CVC) during iontophoresis of ACh on the forearm, finger and foot; and a CS test, involving immersion of a foot for 2 min in water at 15°C followed by 10 min of rewarming in air at 30°C. Toe skin temperature (T sk ) measured during the CS test was used to form a CS group (<32°C before and 5 min after immersion) and an otherwise closely matched control group [T sk >32°C; n = 9 (four women) for both groups]. A moderate relationship was found between cold exposure ranking and T sk rewarming (r = 0.408, P = 0.035, n = 27) but not STT or endothelial function. The T sk and blood flow were lower in CS compared with control subjects before and after foot immersion [T sk , mean (SD): 30.3 (0.9) versus 34.8 (0.8) and 27.9 (0.8) versus 34.3 (0.8)°C, P < 0.001; and CVC: 1.08 (0.79) versus 3.82 (1.21) and 0.79 (0.52) versus 3.45 (1.07) flux mmHg -1 , n = 9, P < 0.001, respectively]. However, no physiologically significant differences were observed between groups for endothelial function or STT. A moderate correlation between previous cold exposure and toe T sk rewarming after foot immersion was observed; however, CS was not associated with impaired endothelial function or reduced thermal detection., (© 2020 The Authors. Experimental Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.)

Digit tip regeneration is one of the few examples of true multi-tissue regeneration in an adult mammal. The key step in this process is the formation of the blastema, a transient proliferating cell mass that generates the different cell types of the digit to replicate the original structure. Failure to form the blastema results in a lack of regeneration and has been postulated to be the reason why mammalian limbs cannot regrow following amputation. Understanding how the blastema forms and functions will help us to determine what is required for mammalian regeneration to occur and will provide insights into potential therapies for mammalian tissue regeneration and repair. This review summarizes the cellular and molecular mechanisms that influence murine blastema formation and govern digit tip regeneration.

The cerebellum is known to contain a double somatotopic body representation. While the anterior lobe body map has shown a robust somatotopic organization in previous fMRI studies, the representations in the posterior lobe have been more difficult to observe and are less precisely characterized. In this study, participants went through a simple motor task asking them to move either the eyes (left-right guided saccades), tongue (left-right movement), thumbs, little fingers or toes (flexion). Using high spatial resolution fMRI data acquired at ultra-high field (7T), with special care taken to obtain sufficient B 1 over the entire cerebellum and a cerebellar surface reconstruction facilitating visual inspection of the results, we were able to precisely map the somatotopic representations of these five distal body parts on both subject- and group-specific cerebellar surfaces. The anterior lobe (including lobule VI) showed a consistent and robust somatotopic gradient. Although less robust, the presence of such a gradient in the posterior lobe, from Crus II to lobule VIIIb, was also observed. Additionally, the eyes were also strongly represented in Crus I and the oculomotor vermis. Overall, crosstalk between the different body part representations was negligible. Taken together, these results show that multiple representations of distal body parts are present in the cerebellum, across many lobules, and they are organized in an orderly manner., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

The differences in the anatomy of the foot and the hand may affect the dorsal flap design for web space reconstruction. In this study, the authors aimed to identify the differences in web space anatomy of the foot and the hand and provide a guideline of flap design for web space reconstruction in the foot and the hand. The right hands and right feet of adult volunteers were measured, including surgical landmarks (i.e., the dorsal prominence of proximal interphalangeal and metacarpophalangeal joints [or metatarsophalangeal joints]), proximal phalangeal length, tip of the web space, and width of web space. The web spaces and other parameters were analyzed and compared between the foot and the hand by using a paired t test with p < .05 to indicate statistical significance. A total of 108 web spaces of the foot and hand from 18 adult volunteers were analyzed. The parameters that were significantly different between the foot and the hand included (1) proximal phalangeal length (34.63 vs 60.16 mm), (2) average web height ratio (0.72 vs 0.51), (3) average web width ratio (0.69 vs 0.81), (4) mean slope angle (4.89° vs 19.26°), and (5) average abduction angle (25.33° vs 31.07°). In conclusion, the foot web space had a higher slope angle, less abduction angle, and shorter proximal phalangeal length. Therefore, the flap design for foot web space reconstruction requires a longer and narrower flap than the design for the hand. The recommended flap design length should be at least 72% of proximal phalangeal length for the foot versus 51% for the hand, and the width should be at least 69% of the distance between the tips of adjacent metatarsophalangeal joints for the foot versus 81% for the hand., (Copyright © 2019 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)

There are many similarities and differences between the human hands and feet. On a psychological level, there is some evidence from clinical disorders and studies of tactile localisation in healthy adults for deep functional connections between the hands and feet. One form these connections may take is in common high-level mental representations of the hands and feet. Previous studies have shown that there are systematic, but distinct patterns of confusion found between both the fingers and toes. Further, there are clear individual differences between people in the exact patterns of mislocalisations. Here, we investigated whether these idiosyncratic differences in tactile localisation are shared between the fingers and toes, which may indicate a shared high-level representation. We obtained confusion matrices showing the pattern of mislocalisation on the hairy skin surfaces of both the fingers and toes. Using a decoding approach, we show that idiosyncratic differences in individuals' pattern of confusions are shared across the fingers and toes, despite different overall patterns of confusions. These results suggest that there is a common representation of the fingers and toes., (Copyright © 2019 Elsevier B.V. All rights reserved.)

This Ultrasound study identified spaces within the pulp of distal phalanx of the fingers and toes that halve in area after Water Induced Skin Wrinkling. These spaces appeared as fluid filled sacculi between connective tissue compartments accountable for distending digital pulp under normal circumstances and skin wrinkling after water immersion. Whilst studying conditions related to sympathetic nerve function with WISW ultrasound imaging is a valuable adjunct to the visual assessment.

Recent research has shown systematic patterns of confusions between digits of the hands and feet. The present study addressed whether such confusions arise from early somatosensory maps or higher level body representations. As the glabrous and hairy skin of the hands and feet have distinct representations in somatosensory cortex, an effect arising from early somatotopic maps may show distinct patterns on each skin surface. In contrast, if the effect arises from higher level body representations which represent the digits as volumetric units, similar patterns should be apparent regardless of which side of the digit is touched. We obtained confusion matrices showing the pattern of mislocalization on the glabrous and hairy skin surfaces of the toes (Experiment 1) and fingers (Experiment 2). Our results replicated the characteristic pattern of mislocalizations found on the glabrous skin reported in previous studies. Critically, these effects were highly similar on the hairy skin surface of both the toes and fingers. Despite the pattern of mislocalizations being highly stereotyped across participants, there were consistent individual differences in the pattern of confusions across the two skin surfaces. These results suggest that mislocalizations occur at the level of individual digits, consistent with their resulting from higher level body representations. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Claw finger is a sequela of fingers without intrinsic function. Claw toe deformity is common after toe transfer, as simultaneous intrinsic reconstruction has yet to be reported in the literature. The authors present their experience of simultaneous tendon transfer during second-toe transplantation. Seven second-toe transfers were performed in five metacarpal-like and metacarpal hands. The Stiles-Bunnell tendon transfer was incorporated into toe transfers. Toe lumbrical tendons were repaired to the flexor digitorum sublimis of the same recipient digit. The active motion values of the proximal interphalangeal joint were 61 ± 9.5 degrees and 36 ± 6.4 degrees in the middle and ring fingers, respectively. The extension lag overall was 19.9 ± 9.9 degrees. The transferred toe proximal interphalangeal joints had minimal extensor lag with the metacarpophalangeal joint in flexion position. The flexion sweep of the toe was improved by the intrinsic reconstruction. The patients were able to use the transferred toes for sophisticated daily activities. From the results seen, simultaneous intrinsic reconstruction appears to enhance the dexterity and thus function of transferred toes., Clinical Question/level of Evidence: Therapeutic, IV.

Purpose: The purpose was to examine whether associations exist between temperature responses in the fingers vs. toes and hand vs. foot during local cold-water immersion and rewarming phases., Methods: Seventy healthy subjects (58 males, 12 females) immersed their right hand or right foot, respectively, in 8 °C water for 30 min (CWI phase), followed by a 15-min spontaneous rewarming (RW) in 25 °C air temperature., Results: Temperature was lower in the toes than the fingers during the baseline phase (27.8 ± 3.0 vs. 33.9 ± 2.5 °C, p < 0.001), parts of the CWI phase (min 20-30: 8.8 ± 0.7 vs. 9.7 ± 1.4 °C, p < 0.001), and during the RW phase (peak temperature: 22.5 ± 5.1 vs. 32.7 ± 3.6 °C, p < 0.001). Cold-induced vasodilatation (CIVD) was more common in the fingers than in the toes (p < 0.001). Within the first 10 min of CWI, 61% of the subjects exhibited a CIVD response in the fingers, while only 6% of the subjects had a CIVD response in the toes. There was a large variability of temperature responses both within and between extremities, and there was a weak correlation between finger- and toe temperature both during the CWI (r = 0.21, p = 0.08) and the RW phases (r = 0.26, p = 0.03)., Conclusions: Results suggest that there is generally a lower temperature in the toes than the fingers after a short time of local cold exposure and that the thermal responses of the fingers/hands are not readily transferable to the toes/foot.

The study examined the effects of a 10-day normobaric hypoxic confinement on the finger and toe temperature responses to local cooling. Eight male lowlanders underwent a normoxic (NC) and, in a separate occasion, a normobaric hypoxic confinement (HC; FO 2 : 0.154; simulated altitude ~3400m). Before and after each confinement, subjects immersed for 30min their right hand and, in a different session, their right foot in 8°C water, while breathing either room air (AIR) or a hypoxic gas mixture (HYPO). Throughout the cold-water immersion tests, thermal responses were monitored with thermocouples on fingers and toes. Neither confinement influenced thermal responses in the fingers during the AIR or HYPO test. In the foot, by contrast, HC, but not NC, reduced the average toe temperature by ~1.5°C (p=0.03), both during the AIR and HYPO test. We therefore conclude that a 10-day confinement to normobaric hypoxia per se augments cold-induced vasoconstriction in the toes, but not in the fingers. The mechanism underlying this dissimilarity remains to be established., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

It has long been thought that quadrupedal primates successfully occupy arboreal environments, in part, by relying on their grasping feet to control balance and propulsion, which frees their hands to test unstable branches and forage. If this interlimb decoupling of function is real, there should be discernible differences in forelimb versus hind limb musculoskeletal control, specifically in how manual and pedal digital flexor muscles are recruited to grasp during arboreal locomotion. New electromyography data from extrinsic flexor muscles in red ruffed lemurs (Varecia rubra) walking on a simulated arboreal substrate reveal that toe flexors are activated at relatively higher levels and for longer durations than finger flexors during stance phase. This demonstrates that the extremities of primates indeed have different functional roles during arboreal locomotion, with the feet emphasizing maintenance of secure grips. When this dichotomous muscle activity pattern between the forelimbs and hind limbs is coupled with other features of primate quadrupedal locomotion, including greater hind limb weight support and the use of diagonal-sequence footfall patterns, a complex suite of biomechanical characters emerges in primates that allow for the co-option of hands toward non-locomotor roles. Early selection for limb functional differentiation in primates probably aided the evolution of fine manipulation capabilities in the hands of bipedal humans., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Magnetoencephalographic (MEG) signals recorded from the primary sensorimotor (SM1) cortex are coherent with kinematics of both active and passive finger movements. The coherence mainly reflects movement-related proprioceptive afference to the cortex. Here we describe a novel MEG-compatible stimulator to generate computer-controlled passive finger and toe movements that can be used as stimuli in functional brain-imaging experiments. The movements are produced by pneumatic artificial muscle (PAM), elastic actuator that shortens with increasing air pressure. To test the applicability of the stimulator to functional brain-imaging, 4-min trains of passive repetitive 5-mm flexion-extension movements of the right and left index finger and the right hallux were produced at 3Hz while the subject's brain activity was measured with whole-scalp MEG and finger or toe kinematics with an accelerometer. In all ten subjects studied, statistically significant coherence (up to 0.78) occurred between the accelerometer and MEG signals at the movement frequency or its first harmonic. Sources of coherent activity were in the contralateral hand or foot SM1 cortices. Movement-evoked fields elicited with intermittent movements of the right index finger (once every 3.2-4.0s; mean±SD peak response latency 88±25ms) were co-located with the respective coherent sources. We further moved the right index finger at 3, 6, and 12Hz (movement ranges 5, 3, and 2mm, respectively), and analyzed the first 1, 2, and 4-min epochs of data. One minute of data was sufficient to locate the left hand area of the SM1 cortex at all movement frequencies. Sound-induced spurious coherence was reliably ruled out in a control experiment. Our novel movement stimulator thus provides a robust and reliable tool to track proprioceptive afference to the cortex and to locate the SM1 cortex., (Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.)

A previous functional magnetic resonance imaging study elucidated the specific activity of the inferior parietal lobe (IPL) during a two-point discrimination task compared with that during an intensity discrimination task Akatsuka et al. (Neuroimage 40: 852-858, 2008). If the posterior parietal cortex (PPC), including IPL, is responsible for detecting changes in stimulus sites, PPC activity depends on the level of change at stimulus sites. The aim of this study was to clarify whether a particular site exists that could detect changes in stimulus sites using the oddball paradigm. Somatosensory-evoked magnetic fields were recorded in 10 right-handed subjects. Three oddball conditions were performed by all subjects, with the probability of deviant and standard stimuli being 20 and 80 %, respectively, under all three conditions. Deviant stimuli were always presented to the second digit of the hand and standard stimuli were presented to the first (small deviance: SD) and fifth digits (medium deviance: MD) of the hand and the first digit of the toe (large deviance: LD). Inter-stimulus intervals were set at 500 ms. A brain electrical source analysis showed that activities of areas 1 and 3b elicited by the deviant stimuli were not significantly different among the three conditions. In contrast, PPC activity was significantly greater for LD than for SD and MD. PPC activity tended to increase with greater deviance at stimulus sites, but activities of areas 1 and 3b did not differ. These findings suggest that PPC may have a functional role in automatic change detection systems with regard to deviance of stimulus sites.

The measurement of volume pulse waves may be easily affected based on the measured position (different fingers or toes), body posture, as well as other factors. Therefore, interferences during measurement need to be removed. For this study, relevant parameters of volume pulse wave were obtained by changing the affecting factors. The data were analyzed in order to indicate the differences in volume pulse wave parameters among different fingers and toes in four postures. Results showed that when subjects were lying, inclined or in a sitting posture, volume pulse wave parameters of the index finger, middle finger and ring finger on both hands displayed no apparent differences. When subjects were in a sitting posture, volume pulse wave parameters of the big, second and third toes on both feet showed no significant differences.

The aim of this study was to determine whether skin temperature measurement by digital thermography on hands and feet is useful for diagnosis of Raynaud's phenomenon (RP). Fifty-seven patients with RP (primary RP, n = 33; secondary RP, n = 24) and 146 healthy volunteers were recruited. After acclimation to room temperature for 30 min, thermal imaging of palmar aspect of hands and dorsal aspect of feet were taken. Temperature differences between palm (center) and the coolest finger and temperature differences between foot dorsum (center) and first toe significantly differed between patients and controls. The area under curve analysis showed that temperature difference of the coolest finger (cutoff value: 2.2℃) differentiated RP patients from controls (sensitivity/specificity: 67/60%, respectively). Temperature differences of first toe (cutoff value: 3.11℃) also discriminated RP patients (sensitivity/specificity: about 73/66%, respectively). A combination of thermographic assessment of the coolest finger and first toe was highly effective in men (sensitivity/specificity : about 88/60%, respectively) while thermographic assessment of first toe was solely sufficient for women (sensitivity/specificity: about 74/68%, respectively). Thermographic assessment of the coolest finger and first toe is useful for diagnosing RP. In women, thermography of first toe is highly recommended.

It is well-known that physical exercise can affect cognition and the frontal lobe is an important structure involved in motor function and cognition. Furthermore, many functional neuroimaging studies have demonstrated that cortical activation patterns of hand and leg movements differ. However, no study has been undertaken to identify differences between the frontal activation patterns generated by hand and leg movements. In the present study, the frontal activation patterns associated with finger and toe movements, as visualized by functional MRI, were investigated and compared. Twelve healthy volunteers were recruited. Functional MRI was performed using a 1.5 T Philips Gyroscan Intera. Flexion-extension movements of fingers or toes were performed in one extremity. Regions of interest (ROIs) were set at the primary sensory-motor cortex (SM1: Brodmann area [BA] 1, 2, 3, 4), the premotor area (PMA: BA 6), and the prefrontal cortex (PFC: BA 8, 9, 10, 11, 46). In SM1, finger movements (10,809) induced more activation than toe movements (5349). On the other hand, in the PMA and PFC, toe movements (PMA: 4201, PFC: 921) induced more activation than finger movements (PMA: 2887, PFC: 912) respectively. In the analysis of relative voxel counts in the PMA and PFC versus the SM1, toe movements generated more activation in the PMA and PFC than finger movements. The PMA and PFC were more activated by toe than finger movements, although the SM1 was more activated by finger movements., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Here we show theoretically that swimming animals and athletes gain an advantage in force and speed by spreading their fingers and toes optimally. The larger force means larger body mass lifted and greater speed, in accord with the constructal theory of all animal locomotion. The spacing between fingers must be twice the thickness of the boundary layer around one finger. This theoretical prediction is confirmed by computational fluid dynamics simulations of flow across two and four cylinders of diameter D. The optimal spacing is in the range 0.2D-0.4D, and decreases slightly as the Reynolds number (Re) increases from 20 to 100. For example, the total force exerted by two optimally spaced cylinders exceeds by 53% the total force of two cylinders with no spacing when Re=20. These design features hold for both time-dependent and steady-state flows., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Subjects that repeatedly have to expose the extremities to cold may benefit from a high peripheral temperature to maintain dexterity and tissue integrity. Therefore, we investigated if repeated immersions of a hand and a foot in cold water resulted in increased skin temperatures. Nine male and seven female subjects (mean 20.4; SD 2.2 years) immersed their right (trained) hand and foot simultaneously in 8°C water, 30 min daily for 15 days. During the pre and post-test (days 1 and 15, respectively) the left (untrained) hand and foot were immersed as well. Pain, tactile sensitivity and skin temperatures were measured every day. Mean (SD) toe temperature of the trained foot increased from 9.49°C (0.89) to 10.03°C (1.38) (p < 0.05). The trained hand, however, showed a drop in mean finger temperature from 9.28°C (0.54) to 8.91°C (0.44) (p < 0.001) and the number of cold induced vasodilation (CIVD) reactions decreased from 52% during the first test to 24% during the last test. No significant differences occurred in the untrained extremities. Pain diminished over time and tactile sensitivity decreased with skin temperature. The combination of less CIVD responses in the fingers after training, reduced finger skin temperatures in subjects that did show CIVD and the reduced pain and tactile sensitivity over time may lead to an increased risk for finger cold injuries. It is concluded that repeated cold exposure of the fingers does not lead to favorable adaptations, but may instead increase the injury risk.

The corticospinal tract (CST) is the most important motor tract in the human brain. The authors compared CST fibers of the fingers and toes using diffusion tensor imaging. Eleven normal healthy subjects were recruited for this study. Functional MRI stimulation was performed using finger grasp-release movements and toe flexion-extension movements (1 Hz). CST fibers of the fingers and toes were determined by selecting fibers passing through seed (the CST portion in the pons) and target regions of interest (the activation areas of the cerebral cortex during active finger and toe movements, respectively). No significant differences were observed between CST fibers of the fingers and toes in terms of fractional anisotropy, mean diffusivity, or tract volume (P> 0.05), and no differences were observed between the connectivities of CST fibers of the fingers and toes and the dorsal premotor cortex or the supplementary motor area (P>0.05). However, the connectivities between CST fibers of legs and the contralateral primary motor cortex were greater than those of CST fibers of the fingers (P< 0.05). It was found that somatotopic CST fibers of the fingers and toes did not differ in terms of diffusion tensor imaging characteristics, but that transcallosal fibers to the contralateral motor cortex were more frequent for CST fibers of the toes than for CST fibers of the fingers.

How do we achieve unitary perception of an object when it touches two parts of the sensory epithelium that are not contiguous? We investigated this problem with a simple psychophysical task, which we then used in an fMRI experiment. Two wooden rods were moved over two digits positioned to be spatially adjacent. The digits were either from one foot (or hand) or one digit was from either foot (or hand). When the rods were moving in phase, one object was reliably perceived. By contrast, when the rods were moving out of phase, two objects were reliably perceived. fMRI revealed four cortical areas where activity was higher when the moving rods were perceived as one object relative to when they were perceived as two separate objects. Areas in the right inferior parietal lobule, the left inferior temporal sulcus and the left middle frontal gyrus were activated for this contrast regardless of the anatomical configuration of the stimulated sensory epithelia. By contrast, the left intraparietal sulcus was activated specifically when integration across the midline was required, irrespective of whether the stimulation was applied to the hands or feet. These results reveal a network of brain areas involved in generating a unified percept of the presence of an object that comes into contact with different parts of the body surface.

Introduction: Subjects with a weak cold-induced vasodilatation response (CIVD) to experimental cold-water immersion of the fingers in a laboratory setting have been shown to have a higher risk for local cold injuries when exposed to cold in real life. Most of the cold injuries in real life, however, occur in the foot in cold air rather than in the hand in cold water. Therefore, an experiment was conducted to investigate the within-subject relation between CIVD in the fingers and toes exposed to cold water and cold air., Methods: In 4 experimental sessions, 11 healthy male subjects immersed their toes and fingers in 5 degrees C water and exposed the fingers and toes to -18 degrees C cold air for 30 min. The pad temperature of the middle three digits was measured., Results: CIVD in water was more pronounced in the fingers (onset time 5.1 +/- 1.8 min; amplitude 5.0 +/- 2.1 degrees C) than in the toes (onset time 10.6 +/- 6.0 min; amplitude 3.0 +/- 1.0 degrees C). Out of 22 skin temperature responses to cold air, 13 were not identifiable as CIVD. The mean skin temperatures for fingers and toes during the last 20 min of cold exposure were 25.6 +/- 7.1 degrees C and 20.9 +/- 6.8 degrees C, respectively, for air and 9.3 +/- 1.9 degrees C and 7.1 +/- 1.3 degrees C for water immersion. There was a strong relation between the mean temperature of the fingers during cold-water immersion and toes during cold air exposure (r = 0.83, P < 0.01), showing that a weak CIVD response in the hand is related to a weak response in the foot., Discussion: We conclude that the cold-water finger immersion test is related to the temperature response in the toes and may thus continue to serve as a valid indicator for the risk of local cold injuries.

The differential representation of the toes/feet and fingers/hands along the medial and lateral surfaces of the cerebral cortices, respectively, may have diagnostic utility. Normative data for errors for toe and finger graphaesthesia and gnosis, as well as foot and finger agility, were collected for 86 children (ages 7 to 14). The fingers were more agile than the feet, and the right side of the body was more agile than the left side, regardless of age. A marked improvement in toe gnosis, but not in finger gnosis occurred in children after 11-12 years of age. A statistically significant interaction between laterality and gender was due to the greater numbers of errors for both toe and finger gnosis, displayed by girls for the left sides of their bodies compared to their right sides. This discrepancy was not significant for boys.

Objective: An Arctic expedition provided an opportunity to examine the interaction between cold injury and peripheral acclimatization. The conditions were similar to those during which acclimatization has been demonstrated, yet they were also conducive to development of peripheral cold injury., Methods: Extremity digit temperatures were measured during 30-minute peripheral cold-water (4 degrees C) immersion (CWI) in 2 explorers (R.G. and T.L.) before and after a 109-day Arctic ski trek (average T(air) = -21 degrees C). This self-supported trek involved carrying heavy backpacks (up to 45 kg) and hauling sleds (approximately 100 kg)., Results: During the expedition, the explorers' hands did not sustain frostbite, but their feet developed moderate trench foot. Unexpectedly, both men exhibited lower mean finger temperatures during CWI after the expedition in right and left hands (R.G. by 0.9 degrees C and 0.2 degrees C; T.L. by 1.8 degrees C and 1.1 degrees C), suggesting peripheral acclimatization was impaired. In contrast, mean toe temperatures during CWI were warmer in both right and left feet for T.L. (by 3.6 degrees C and 2.3 degrees C) and in the left foot for R.G. (by 1.3 degrees C) postexpedition. There was no change in R.G.'s right toe mean temperature., Conclusions: We speculate that prolonged heavy load carriage may have impaired blood flow or nerve conduction in the hands and inhibited acclimatization. Our data also suggest that despite incidence of moderate trench foot, acclimatization can still occur after resolving this injury.

Both otoacoustic emissions (OAEs) and the relative length of the index and ring fingers (the 2D:4D ratio) exhibit large sex differences, and both exhibit masculinization effects in female homosexuals and bisexuals. Because these sex differences exist in young children, the implication is that both types of measure are affected by prenatal androgen exposure, but it has been unknown to what degree these two types of measure are related. Accordingly, OAEs and the relative lengths of the fingers and the toes were measured in 59 heterosexual females, 55 heterosexual males, 29 homosexual females, and 33 homosexual males. The correlations between the two types of measure were unexpectedly quite low in both the heterosexual and nonheterosexual groups. For example, the correlation between number of spontaneous OAEs per ear and 2D:4D was less than 0.25, for both sexes and both sexual orientations. One interpretation of these results is that the prenatal hormonal mechanisms producing the sex differences in OAEs differ in quality, degree, or timing from those producing the sex differences in relative finger length. That is, OAEs and 2D:4D may be windows onto slightly different prenatal processes or times during prenatal development. Measures of mental-rotation ability also were obtained on these participants, and those correlations with relative finger length also were small.

Classification of movement-related potentials recorded from the scalp to their corresponding limb is a crucial task in brain-computer interfaces based on such potentials. Many features can be extracted from raw electroencephalographic signals to be used for classification, but the utilization of irrelevant or superfluous features is detrimental to the performance of classification algorithms. It is, therefore, necessary to select a small number of relevant features for the classification task. This paper demonstrates the use of two feature selection methods to choose a small number (10-20) of relevant features from a bank containing upward of 1000 features. One method is based on information theory and the other on the use of genetic algorithms. We show that the former is poorly suited for the aforementioned classification task and discuss the probable reasons for this. However, using a genetic algorithm on data recorded from five subjects we demonstrate that it is possible to differentiate between the movements of two limbs with a classification accuracy of 87% using as little as 10 features without subject training. With the addition of a simple coding scheme, this method can be applied to multiple limb classification and a 63% classification accuracy rate can be reached when attempting to distinguish between three limbs.

Somatotopic organization of the human medial wall of the cerebral hemispheres was studied using functional MRI conducted at high field strength (3 T) with fine spatial resolution ( approximately 2 mm). Healthy subjects performed paced, repetitive movements of the fingers and toes. Within the supplementary motor area (SMA), two regions were identified: finger movements activated a region rostral and superior to that for toe movements. Two activation foci were also identified in the cingulate motor area: toe movements activated a region rostral and ventral to that activated by finger movements. All foci were located between the anterior and posterior commissures. Our results confirm previous human and non-human primate studies regarding the rostral-caudal organization of the SMA and CMA. The dorsal-ventral organization of the CMA, however, appears to be divergent from results derived from cortical stimulation studies conducted in non-human primates.

The classic view of representation in the cerebellum assumes two homunculi, one in the anterior lobe and one in the posterior lobe. Functional imaging has confirmed this somatotopy in the human anterior lobe but not, so far, in the posterior lobe. Using fMRI, we found separate peaks of activation for finger and toe in three ipsilateral cerebellar regions. In both the anterior and posterior lobe, the toe representation was semicircular around the finger area, with peaks of activation aligned in accord with the classic homunculi. Also, segregated peaks of activation were found in the pyramis vermis. These results confirm the existence of a second homunculus in the posterior lobe of the human cerebellum and suggest a third one.

Assessment of vibrotactile threshold has gained application in studies of neuropathies induced by toxic substances, compression, and vibration. The effect of age and height on vibrotactile threshold is of interest for its own sake and for the purpose of confounder control. We have studied the relation between finger and toe vibrotactile thresholds and age and height in five studies carried out by the National Institute for Occupational Safety and Health with vibrometry data (N = 1,663). A unique property of the merged data set was its wide age range from 14 to 82 years (mean 42 years). We demonstrate a J-shaped increase in finger threshold value (expressed on a log scale) with age, with no increase up to age 35 and a linear increase thereafter. For finger threshold, height was not an important predictor. The data were sparser (n = 541) for toe threshold but suggested a linear increase with both age and height. While consistent with prior data, this study provides a better understanding of the relation between vibrotactile threshold and age and height than has been available before. The greater effect of age and height on toe rather than finger threshold is consistent with the hypothesis that the length of the nerve increases susceptibility to peripheral neuropathy.

The perception of transplanted toes following toe-to-finger transplantation was investigated. Forty-six (77%) of 60 patients perceived transplanted toes as their fingers immediately or within 6 months after surgery. Such perception occurred following satisfactory surgical outcome, the appearance of adequate sensory or motor function, or both. In the remaining 14 patients, the transplanted toe was perceived as a toe, a toe as well as a finger, or something else. The present data suggest that human perception of transplanted toes appears to be geared toward restoration of the original body image.

The present study aimed at determining the distribution and somatotopical organization of striatal activation during performance of simple motor tasks. Ten right-handed healthy volunteers were studied by using a 3-T whole-body magnetic resonance unit and echo planar imaging. The tasks consisted of self-paced flexion/extension of the right fingers or toes. Motor activation was found mainly in the putamen posterior to the anterior commissure (10 of 10 subjects) and the globus pallidus (6 subjects), whereas the caudate nucleus was activated in only 3 subjects, and in a smaller area. Thus, performance of a simple motor task activated the sensorimotor territory of the basal ganglia. Within the putamen, there was a somatotopical organization of the foot and hand areas similar to that observed in nonhuman primates. These data suggest that functional magnetic resonance imaging can be used to study normal function of the basal ganglia and should therefore also allow investigation of patients with movement disorders.

Accuracies of two-point discrimination (successive 2-min increments between 0 and 10 mm) for the middle fingers and the middle toes for 87 children from ages 7 through 15 years were measured to obtain normative data. The finer discriminative capacity for the fingers rather than the toes was evident. Whereas discriminative accuracy approached the asymptote with distances equal to or greater than 4 mm for the fingers, distances equal to or greater than 8 mm were required for the toes. For this ontogenetic range, the effects for toes vs fingers was much greater than the effect size for age.

To determine whether single motor units (MUs) in multitendoned muscles distribute tension to multiple tendons or instead focus tension selectively on a single tendon, we examined the distribution of tension generated by single MUs in the cat extensor digitorum lateralis (EDLat), and in its macaque homolog, the extensor digiti quarti et quinti (ED45). General properties of MUs (maximal tetanic tension, axonal conduction velocity, and twitch rise time) were similar in these muscles to those reported for other limb muscles in cats and monkeys. Most cat EDLat MUs were found to exert tension rather selectively on one of the three tendons of the muscle. Fast fatigable MUs were slightly but significantly more selective than fast fatigue-resistant and slow MUs. In contrast, and contrary to expectation, the macaque ED45 contained a lower proportion of MUs that exerted tension selectively on one of the two tendons of the muscle, and a higher proportion of relatively nonselective MUs. These findings suggest that the cat EDLat may consist of three functional subdivisions, each acting preferentially on a different tendon, whereas the macaque ED45 is more likely to function as a single multitendoned muscle.

A technique is described for reconstruction of a pincer, by a second toe transfer, in traumatic and congenital deformities, leaving only the wrist. Transfer on the anterior aspect of the radius allows to benefit from the wrist mobility to compensate for the limited range of motion of the second toe. Proximal situation of the toe gives the possibility of harvesting plenty of tendons to balance the toe. Results have been encouraging in two traumatic and 6 congenital cases of peromelic type of symbrachydactyly.

Finger and toe pulse waves were simultaneously recorded in medical students and outpatient hypertensive patients. The delay of the rise of toe pulse to that of finger pulse (t) was almost halved in students on postural change from the supine position to the sitting position. This was mainly due to an increase in the pulse wave velocity in the aorta, which was thought to be induced by the increase in hydrostatic pressure in the aorta. In students a marked dicrotic wave was observed in both finger and toe pulse waves. That the interval between the main and dicrotic waves (T) was shorter for finger pulse than toe pulse also seems to be ascribable to the influence of the intraaortic pressure: Pulse was transmitted faster in the systolic phase than in the diastolic phase. The features of pulse waves of hypertensive patients were that (t) was short even in the supine position, and that dicrotic wave was small or absent especially for toe pulse. These differences were considered to be accounted for by the high blood pressure and the structural change of arterial wall in the hypertensive patients.

Twenty-five cases of second-toe transplantation to replace the thumb and other fingers are reported. There were 20 toal successes, four partial successes and one total failure. A total of eight patients had circulatory complications at some stage after operation. The overall motor and sensory functions of the transplanted toes were highly satisfactory. The donor foot did not suffer functionally despite the absent second toe.

A review of replanted digits has indicated that excellent sensory function can be recovered in replants that are distal, in which the mechanism of injury has been a sharp cut, in which the patient's age is young, and in cases where the patient receives postoperative sensory re-education. It appears that poor sensory recovery in replanted digits is most directly attributable to crush or avulsion type injuries and lack of sensory re-education in the postoperative period. The level of sensory recovery in toe-to-thumb transfers appears to be better than in the donor toe and better than in replanted digits. The explanation for this most likely lies in the sharp "mechanism of injury" in the toe-to-thumb transfer and in the "extra" postoperative rehabilitation such cases receive. Future improvements in recovery of sensation in replanted digits may come from increased use of nerve grafting in those digits that have been crushed or avulsed, and by instituting routine sensory re-education in the postoperative period.

The left thumbs and great toes of three 8 1/2 month old Rhesus monkeys (Macaca mulatta) were amputated in guillotine fashion one millimeter distal to the base of the nail and allowed to heal by the conservative open wound method. Healing occurred in seven to ten days in these small digits. Each of the thumbs and toes grew back with some blunting and shortening of the digit tips, but were functional. The new structures were cosmetically pleasing as in the human instances. The nails grew essentially to normal size and shape supported by the remaining portions of the distal phalanges. Histological studies showed no evidence of blastema formation such as is observed in the regenerating limb of the Urodele (newt) taken as the comparative representative. The possibility of improving the regrowth is discussed against the background of our knowledge of the importance of nerve during limb regeneration in lower vertebrates.

The cerebral potentials associated with voluntary, self-paced rapid flexions of (1) right fingers, (2) left fingers, (3) right toes, and (4) left toes were compared in the same experiment using 32 right- and left-handed subjects. The Bereitschaftspotential (BP) or readiness potential was, in the first half of the foreperiod, bilaterally symmetrical for both finger and toe movements of either side. In the later foreperiod there were differences: Finger movements showed two maxima, an early one at Cz and a late one, which was lateralized toward the contralateral precentral region. With toe movements, the maximum BP amplitude was always at Cz and not lateralized and was twice as large as with finger movements. The data are compatible with the view that two principal sources of different spatial and temporal characteristics are active in the foreperiod of a voluntary movement. The early generator is probably the supplementary motor area (SMA) on the mesial surface of the hemispheres; the later is the primary motor cortex (MI) which is lateralized for finger but not for toe movements. In lateral leads, rather remote from the mesial source, the BP for toe movements showed a small but significant ipsilateral preponderance, which is obviously due to the fact that dipole sources located on the mesial surface of the hemispheres point to the opposite direction as compared to those on the convexity.(ABSTRACT TRUNCATED AT 250 WORDS)