WO2019151181A1 - Cutaneous sensation stimulation apparatus and method for measuring sensory threshold - Google Patents

Cutaneous sensation stimulation apparatus and method for measuring sensory threshold Download PDF

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Publication number
WO2019151181A1
WO2019151181A1 PCT/JP2019/002732 JP2019002732W WO2019151181A1 WO 2019151181 A1 WO2019151181 A1 WO 2019151181A1 JP 2019002732 W JP2019002732 W JP 2019002732W WO 2019151181 A1 WO2019151181 A1 WO 2019151181A1
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temperature
stimulation
stimulation surface
sensation
subject
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PCT/JP2019/002732
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French (fr)
Japanese (ja)
Inventor
一之 小田
尚省 岡
寛英 新里
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インタークロス株式会社
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/01—Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue

Definitions

  • the present invention relates to a skin sensory stimulation device and a sensory threshold measurement method for stimulating warm, cold, and painful sensations by changing the temperature of a stimulation surface in contact with the skin.
  • Patent Document 1 discloses that in a thermal sensation testing apparatus that inspects thermal sensation by contacting a human skin surface, the skin temperature and the temperature applied to the skin can be measured with one temperature sensor, and the measured skin temperature is measured.
  • the structure which sets the temperature which should be given in consideration of, and implements a thermal sensation test is disclosed.
  • Patent Document 2 discloses a state in which the stimulation surface of the temperature stimulation unit is arranged to face the subject's skin surface and from when the temperature stimulation by the temperature stimulation unit is started to when the subject becomes aware of warm or cold sensation.
  • a configuration is disclosed in which a heat amount threshold value, which is a heat amount per unit area obtained based on the heat flux and temperature change with time, is used as an evaluation value of the temperature sense.
  • patent document 3 is disclosing the structure which judges the presence or absence of central sensitization from the residual time of the residual sensation after completion
  • Non-Patent Document 1 raises the temperature from a specific temperature, and after a temperature test in which the measurement of the temperature at which the subject is aware of the temperature sensation is repeated a plurality of times, the temperature is lowered from the specific temperature, The structure which performs the cold sense test
  • JP2015-159898A Japanese Patent Laid-Open No. 10-179591 International Publication No. 2013/125518
  • the temperature of an endothermic body that gives thermal stimulation to the skin (for example, skin temperature + 5 ° C.) is adjusted using the same temperature sensor. During this temperature adjustment, the test probe needs to be separated from the skin of the subject so that thermal stimulation is not applied to the test site of the subject.
  • the skin temperature may fluctuate during the waiting time during the temperature adjustment of the heat-absorbing / heating element.
  • the waiting time increases, so the possibility that the skin temperature fluctuates further increases.
  • the skin temperature after the fluctuation can be obtained by re-measurement. However, if the skin temperature is measured every time the temperature difference between the skin temperature and the temperature of the heat-absorbing and heating element is changed and further re-measurement is required, the inspection time will be significantly increased.
  • the skin temperature and the temperature of the heat-absorbing / heating element must be matched in advance.
  • Such temperature adjustment needs to be performed in a state where the test site of the subject is in contact with the thermal stimulus generation site of the thermal sensation testing apparatus.
  • a relatively large overshoot occurs in the temperature of the heat-absorbing / heating element in the temperature adjustment based on the measurement result of the temperature sensor. Therefore, heat transfer occurs between the test site of the subject and the heat absorption / exothermic body, and the skin temperature may fluctuate during the temperature adjustment. Therefore, a problem similar to the above problem occurs.
  • Patent Documents 2 and 3 propose new evaluation values, and it is difficult to apply them as they are to the skin sensation test that uses temperature as an evaluation value.
  • the present invention has been proposed in view of the above-described conventional circumstances, and in skin sensation inspection using temperature as an evaluation value, skin capable of realizing a quantitative and more reproducible inspection in a shorter time.
  • An object is to provide a sensory stimulation device and a sensory threshold measurement method.
  • the present invention is premised on a skin sensation stimulation apparatus that applies thermal stimulation to an examination site on the skin surface of a subject.
  • the skin sensation stimulation device includes a stimulation surface, a heat flow sensor, a temperature adjustment element, a reference adjustment unit, and an examination execution unit.
  • the stimulation surface is disposed to face the examination site and applies thermal stimulation to the examination site.
  • the heat flow sensor detects the heat flux passing through the stimulation surface.
  • the temperature adjustment element increases or decreases the temperature of the stimulation surface.
  • the reference adjustment unit matches the temperature of the stimulation surface and the temperature of the examination site by controlling the temperature adjustment element so that the heat flux detected by the heat flow sensor is within a range specified in advance.
  • the examination execution unit raises or lowers the temperature of the stimulation surface by controlling the temperature adjustment element from a state in which the temperature of the stimulation surface and the temperature of the examination site coincide with each other by the reference adjustment unit.
  • the temperature of the stimulation surface and the temperature of the examination site are made the same based on the heat flux detected by the heat flow sensor.
  • the temperature of the stimulation surface and the temperature of the examination site can be matched with high accuracy in a short time. As a result, quantitative and more reproducible inspection can be realized in a shorter time.
  • the skin sensation stimulating apparatus further includes an input unit for inputting that the subject is aware of warm sensation, cold sensation, or pain sensation, and the inspection execution unit determines whether the temperature of the stimulation surface and the temperature of the inspection site are detected by the reference adjustment unit.
  • a configuration is adopted in which the temperature of the stimulation surface is increased or decreased by controlling the temperature adjustment element from the coincidence state, and then the temperature increase and decrease of the stimulation surface are switched each time an input is made by the subject through the input unit. be able to.
  • the reference adjustment unit controls the temperature adjustment element so that the heat flux detected by the heat flow sensor is within a pre-specified range. It is also possible to adopt a configuration in which the temperature of the examination site is matched.
  • the apparatus further includes a temperature acquisition unit that acquires the temperature of the stimulation surface, and the inspection execution unit is designated in advance by the reference adjustment unit with respect to the temperature of the stimulation surface in a state where the temperature of the stimulation surface matches the temperature of the inspection site. It is also possible to adopt a configuration in which the temperature of the stimulation surface is increased or decreased to the temperature obtained by adding the temperature difference.
  • the skin sensory stimulation device described above includes a temperature acquisition unit that acquires the temperature of the stimulation surface, the temperature of the stimulation surface when the subject is aware of warm sensation, cold sensation, or pain sensation, and the reference adjustment unit.
  • the difference between the temperature of the stimulation surface when the temperature and the temperature of the examination site match, or the temperature of the stimulation surface when the subject is aware of pain sensation and the stimulation surface when the subject is aware of warm or cold sensation It is also possible to employ a configuration further including a calculation unit that calculates a difference from the temperature as a sensory threshold value. It is also possible range of predesignated heat flux described above to employ a configuration is -50 W / m 2 or more and + 50 W / m 2 or less.
  • the present invention can also provide a method for measuring a sensory threshold when a thermal stimulus is applied to an examination site on the skin surface of a subject. That is, in the sensory threshold value measuring method according to the present invention, first, the heat flux detected by the heat flow sensor that detects the heat flux that passes through the stimulation surface that applies the thermal stimulus to the examination site is within a predetermined range. By controlling the temperature adjusting element that raises or lowers the temperature of the stimulation surface according to the state, the temperature of the stimulation surface matches the temperature of the examination site. Next, the temperature of the stimulation surface is raised or lowered by controlling the temperature adjustment element from the state where the temperature of the stimulation surface and the temperature of the examination site match.
  • a difference between the temperature of the stimulation surface when the subject is aware of warm sensation, cold sensation, or pain sensation, and the temperature of the stimulation surface in a state where the temperature of the stimulation surface and the temperature of the examination site match A difference between the temperature of the stimulation surface at the time when the pain sensation is recognized and the temperature of the stimulation surface at the time when the subject is aware of the warm sensation or the cold sensation is calculated as a sensory threshold value.
  • the temperature of the stimulation surface and the temperature of the examination site can be matched with high accuracy in a short time. As a result, quantitative and more reproducible inspection can be realized in a shorter time.
  • FIG. 1 is a schematic configuration diagram showing a configuration of a skin sensation stimulating device according to an embodiment of the present invention.
  • FIG. 2A to FIG. 2D are schematic views illustrating thermal stimulation in one embodiment of the present invention.
  • FIG. 3 is a flowchart showing an example of a sensory threshold measurement method according to an embodiment of the present invention.
  • FIG. 4 is a schematic view illustrating thermal stimulation in one embodiment of the present invention.
  • FIG. 5 is a flowchart showing an example of a sensory threshold measurement method according to an embodiment of the present invention.
  • FIG. 6 is a diagram illustrating a comparative example of a sensory threshold value measurement method and a measurement method using a temperature sensor according to an embodiment of the present invention.
  • FIG. 7 is a schematic view illustrating thermal stimulation in one embodiment of the present invention.
  • FIG. 8 is a flowchart showing an example of a sensory threshold measurement method according to an embodiment of the present invention.
  • FIG. 1 is a schematic configuration diagram showing a configuration of a skin sensation stimulating device according to an embodiment of the present invention.
  • Skin sensation stimulating apparatus 100 of the present embodiment applies thermal stimulation to an inspection site (hereinafter also simply referred to as an inspection site) on the skin surface of a subject.
  • an inspection site hereinafter also simply referred to as an inspection site
  • warm sensation, cold sensation, and pain sensation are evaluated.
  • a thermal stimulus having a temperature higher than the skin temperature is applied to the examination site, and a threshold value at which the subject is aware of the sense of warmth is acquired.
  • a thermal stimulus having a temperature lower than the skin temperature is applied to the examination site, and a threshold at which the subject is aware of cold sensation is acquired.
  • the subject becomes aware of the pain sensation To come.
  • pain sensation can be evaluated by acquiring a threshold value at which the subject is aware of warm sensation.
  • the pain on the warm side is related to slow pain transmitted through the C fiber
  • the pain on the cold side is related to fast pain transmitted through the A ⁇ fiber.
  • the skin sensation stimulating device 100 of this embodiment includes a probe 10 and a main body 20.
  • the probe 10 includes a heat flow sensor 11, a temperature adjustment element 12, and a cooling unit 13.
  • the temperature adjustment element 12 is configured by a Peltier element.
  • the cooling unit 13 is disposed in contact with the first surface of the Peltier element, and the heat flow sensor 11 is disposed in contact with the second surface of the Peltier element.
  • the cooling unit 13 may be configured to absorb the heat when the first surface is in a heat generating state, and the configuration of the cooling unit 13 is not particularly limited. For example, an air-cooled heat sink or a water-cooled heat sink is used. be able to.
  • the heat flow sensor 11 has a flat plate shape and detects the size of the heat flux passing through the thickness direction.
  • the surface opposite to the contact surface of the temperature adjusting element 12 constitutes the stimulation surface 11a. Therefore, the heat flow sensor 11 detects the heat flux passing through the stimulation surface 11a.
  • the thickness of the heat flow sensor 11 is about 0.4 mm.
  • the stimulation surface 11a is disposed in a state of facing the inspection part and in contact with the inspection part.
  • the second surface of the Peltier element which is the temperature adjusting element 12
  • the temperature of the stimulation surface 11a rises and thermal stimulation is applied to the examination site.
  • the 2nd surface of a Peltier device is made into an endothermic state, the temperature of the stimulation surface 11a will fall and a cold stimulation will be provided to a test
  • the probe 10 of the present embodiment is installed on a table or the like with the stimulation surface 11a facing upward.
  • thermal stimulation is applied in a state where an examination site such as a fingertip of the subject is in contact with the stimulation surface 11a.
  • the test subject's fingertip is shown with the broken line as the test
  • the main body 20 includes a heat flow acquisition unit 21, a temperature acquisition unit 22, a temperature control unit 23, an input unit 24, and a calculation unit 25.
  • the heat flow acquisition unit 21 acquires the size of the heat flux passing through the stimulation surface based on the output value of the heat flow sensor 11.
  • the temperature acquisition unit 22 acquires the temperature of the stimulation surface 11a. In the present embodiment, the temperature acquisition unit 22 acquires the temperature of the stimulation surface 11a by the temperature sensor 14 disposed in the center of the second surface of the Peltier element in plan view.
  • the temperature control unit 23 includes a reference adjustment unit 23a, an inspection execution unit 23b, and a power supply unit 23c.
  • the reference adjustment unit 23a controls the temperature adjustment element 12 so that the magnitude of the heat flux detected by the heat flow sensor 11 falls within a range specified in advance, whereby the temperature of the stimulation surface 11a and the temperature of the examination site are determined. To match.
  • the reference adjustment unit 23a acquires the size of the heat flux from the heat flow acquisition unit 21.
  • pre-specified range of heat flux above is -50 W / m 2 or more and + 50 W / m 2 or less. Outside the range, as described later, the subjective skin temperature and the subjective heat flux cannot be stably measured, which is not preferable.
  • the direction in which heat flows from the examination site to the stimulation surface is positive.
  • the reference adjusting unit 23 a adjusts the amount of heat generated or absorbed by the temperature adjusting element 12 by adjusting the energization amount of the power supply unit 23 c that supplies operating power to the temperature adjusting element 12. To match the temperature.
  • the examination execution unit 23b raises or lowers the temperature of the stimulation surface 11a by controlling the temperature adjustment element 12 from a state in which the temperature of the stimulation surface 11a and the temperature of the examination site coincide with each other by the reference adjustment unit 23a. Similarly to the reference adjustment unit 23a, the inspection execution unit 23b also adjusts the amount of heat generation or heat absorption of the temperature adjustment element 12 by adjusting the energization amount of the power supply unit 23c, and increases or decreases the temperature of the stimulation surface 11a.
  • the input unit 24 is used to input that the subject is aware of warm sensation, cold sensation, or pain sensation.
  • the input unit 24 is configured by a pushbutton switch. When the subject presses the push button to switch the switch from the off state to the on state, the fact that he / she has sensed warm sensation, cold sensation, or pain sensation is input.
  • the calculation unit 25 calculates a sensory threshold value that is an evaluation value of the skin sensation.
  • the sensory threshold includes a warm threshold, a cold threshold, and a pain threshold.
  • the warmth threshold is a value that quantitatively indicates that the subject is aware of warmth.
  • the cold threshold value is a value that quantitatively indicates that the subject is aware of cold sensation.
  • the pain sensation threshold is a value that quantitatively indicates that the subject has noticed pain sensation.
  • the calculation unit 25 matches the temperature of the stimulation surface 11a at the time when the subject is aware of warm sensation, cold sensation, or pain sensation, and the temperature of the stimulation surface 11a and the temperature of the examination site by the reference adjustment unit 23a. The difference with the temperature of the stimulation surface 11a in the performed state is calculated as a sensory threshold value.
  • the temperature of the stimulation surface 11a in a state in which the temperature of the stimulation surface 11a matches the temperature of the examination site by the reference adjustment unit 23a is appropriately referred to as a base temperature.
  • the temperature of the stimulation surface 11a is acquired.
  • the temperature of the stimulation surface 11a and the temperature of the examination site coincide with each other, the temperature of the examination site is substantially acquired.
  • FIG. 4 are schematic views illustrating thermal stimulation output by the skin sensation stimulating device 100.
  • FIG. 3 is a flowchart showing the sensory threshold measurement method. The flow proceeds as a trigger when a test start instruction is input to the main body 20 through a test start button (not shown) in a state where the test site of the subject is in contact with the stimulation surface 11a.
  • the reference adjusting unit 23a matches the temperature of the stimulation surface 11a with the temperature of the inspection site (No in step S301 in FIG. 3). For example, when the magnitude of the heat flux acquired by the heat flow acquisition unit 21 is a positive value, the temperature of the examination site is higher than the temperature of the stimulation surface 11a. Therefore, the reference adjustment unit 23a increases the amount of heat generated on the second surface of the Peltier element by adjusting the amount of current supplied by the power supply unit 23c to the Peltier element that is the temperature adjustment element 12. Thereby, the magnitude
  • the reference adjustment unit 23a adjusts the energization amount to the Peltier element to generate the amount of heat generated on the second surface of the Peltier element. Increase.
  • the heat flow acquisition unit 21 matches the temperature of the stimulation surface 11a with the temperature of the examination site.
  • the range of heat flux that is detected by the heat flow sensor 11 is designated in advance (here, -50 W / m 2 or more and + 50 W / m 2 or less) there become a state In other words, it is defined that the temperature of the stimulation surface 11a matches the temperature of the examination site.
  • the reference adjustment unit 23a notifies the inspection execution unit 23b and the calculation unit 25 that the process is completed (step S301 Yes in FIG. 3).
  • the arithmetic unit 25 acquires the temperature of the stimulation surface 11a as a base temperature T 0 through temperature acquiring unit 22.
  • various processes necessary for temperature adjustment based on the temperature sensor process for converting the detected value to temperature, converted temperature and previously acquired skin
  • Temperature comparison and temperature determination processing is not necessary, and there is no need to wait until the temperature measurement position is in thermal equilibrium. Converge in a short time.
  • the temperature of the stimulation surface 11a is matched with the temperature of the examination site in a short time and with high accuracy. be able to.
  • the examination execution unit 23b to which the above notification is input from the reference adjustment unit 23a increases the temperature of the stimulation surface 11a (step S302 in FIG. 3).
  • the subject becomes aware of the temperature sensation in the process of increasing the temperature of the stimulation surface 11a
  • the subject notifies the main body 20 of the sense of temperature sensation through the input unit 24 (steps S303 No and S303 Yes in FIG. 3).
  • the rate of change in temperature when the temperature rises can be, for example, within a range of 0.1 to 10 degrees per second (for example, 0.3 degrees per second).
  • the calculation unit 25 acquires the temperature of the stimulation surface 11 a through the temperature acquisition unit 22. Then, the arithmetic unit 25, and the temperature of the stimulation surface 11a at the time the subject was aware of warmth (here, Warm threshold) difference sensory threshold and base temperature T 0 of the above is calculated as ( Figure 3 step S304).
  • the calculation unit 25 outputs the sensory threshold value calculated by, for example, displaying on a display unit (not shown) or transmitting data to a portable storage medium such as a USB memory through a USB (Universal Serial Bus) port (not shown). Further, when the awareness of the temperature sensation is notified, the examination execution unit 23b stops the supply of power to the temperature adjustment element 12.
  • the temperature of the stimulation surface 11a and the temperature of the examination site are matched.
  • the temperature of the stimulation surface and the temperature of the examination site can be matched with high accuracy in a short time. As a result, quantitative and more reproducible inspection can be realized in a shorter time.
  • Table 1 shows the results of changing the magnitude of the heat flux detected by the heat flow sensor 11 when starting the thermal stimulation application and measuring the temperature threshold value for each.
  • the setting value (heat flux condition) of the size of heat flux when starting thermal stimulation application, the skin temperature (starting skin temperature) when applying thermal stimulation, and the application of thermal stimulation are started.
  • the test execution unit 23b obtains the pain threshold value by configuring the subject to notify the main body 20 of pain perception through the input unit 24 in the process of increasing the temperature of the stimulation surface 11a.
  • the arithmetic unit 25 subjects the temperature of the stimulation surface 11a at the time of conscious of pain, the difference sensation threshold of (in this case, the pain threshold) and base temperature T 0 of the above is calculated as.
  • Tables 2 and 3 show the results of measurement of the sensation threshold and the pain threshold.
  • thermal stimulation in which the temperature rises continuously is given to four subjects without sensory impairment.
  • Table 2 when the application of thermal stimulation is started, the temperature of the stimulation surface 11a is matched with the temperature of the examination site.
  • Table 3 when the application of thermal stimulation is started, the temperature of the stimulation surface 11a is set to a specific temperature (here, 30 ° C.).
  • the temperature of the test site (starting skin temperature) when applying thermal stimulation, the temperature of the stimulation surface 11a when detecting thermal sensation in the process of applying thermal stimulation (temperature consciousness temperature), and thermal stimulation 3 shows the temperature of the stimulation surface 11a (pain perception temperature), the difference between the temperature perception temperature and the start skin temperature, and the difference between the perception perception temperature and the start skin temperature, respectively.
  • the temperature (starting temperature) of the stimulation surface 11a at the start of applying the thermal stimulus, and the temperature of the stimulation surface 11a when the thermal sense is sensed in the process of applying the thermal stimulus (temperature consciousness temperature). The temperature of the stimulation surface 11a (pain perception temperature), the difference between the perception temperature and the start temperature, and the difference between the perception temperature and the start temperature, respectively, when the pain sensation is recognized in the process of applying thermal stimulation. .
  • the Warm threshold and pain threshold relative to the base temperature T 0 of the above show that it is possible to obtain a stable value with less variation among subjects.
  • the fact that the variation in the warmth threshold and the pain threshold is small means that each subject is aware of the applied thermal stimulus as a similar stimulus. Therefore, compared to setting a temperature difference based on a specific temperature as a thermal stimulus, a subject with no sensory impairment has a similar temperature when setting a temperature difference based on the starting skin temperature as a thermal stimulus. It can be said that a stimulus that is felt as a sensation stimulus or a pain sensation can be applied more stably.
  • the configuration is described in which the temperature of the examination site is matched with the temperature of the stimulation surface 11a, and then the thermal stimulation is applied in which the temperature continuously rises from the temperature of the examination site. It is also possible to apply a thermal stimulus in which the temperature continuously decreases from the temperature of the examination site as shown in FIG.
  • the test execution unit 23b notifies the main body 20 that the subject has sensed cold through the input unit 24 in the process of lowering the temperature of the stimulation surface 11a, whereby the cold threshold is set. It becomes possible to get.
  • the arithmetic unit 25 calculates the temperature of the stimulation surface 11a at the time the subject was aware of the cold sensation, the difference between the base temperature T 0 of the above as a cold sensation threshold.
  • the test execution unit 23b obtains a pain threshold by notifying the main body 20 that the subject has noticed pain through the input unit 24 in the process of lowering the temperature of the stimulation surface 11a. It becomes possible.
  • the calculation unit 25 calculates the difference between the above-described base temperature T 0 and the temperature of the stimulation surface 11a at the time when the subject senses pain as a pain threshold.
  • the temperature change rate per unit time of thermal stimulation in which the temperature continuously rises or falls is constant, but the temperature change rate per unit time increases with the elapsed time or unit time
  • a thermal stimulus in which the rate of change in temperature per hour decreases with time may be used.
  • the examination execution unit 23b does not perform thermal stimulation in which the temperature continuously rises or falls as shown in FIGS. 2A and 2B, but FIGS. 2C and 2D.
  • the thermal stimulation in which the temperature rises stepwise calculates, for example, a plurality of set temperatures obtained by sequentially adding a predetermined temperature difference with respect to the base temperature T 0 , and the temperature of the stimulation surface 11 a is determined for a predetermined time. This can be achieved by maintaining the calculated temperatures at intervals.
  • a plurality of set temperatures obtained by sequentially subtracting a temperature difference designated in advance from the base temperature T 0 are calculated, and the temperature of the stimulation surface 11a is calculated for a time designated in advance. This can be achieved by maintaining each calculated temperature at each temperature.
  • 2C and 2D show examples in which the temperature difference sequentially added or subtracted with respect to the base temperature T 0 is the same, but the temperature difference sequentially added or subtracted is different. May be. Further, a configuration in which addition and subtraction are mixed (that is, a configuration in which a temperature increase and a temperature decrease are mixed) may be employed. Similarly, FIGS.
  • 2C and 2D show examples in which the time for maintaining the temperature of the stimulation surface 11a at the calculated temperatures is the same, but the time for maintaining the temperature is different. May be.
  • a configuration in which the calculation unit 25 performs the calculation of the set temperature as described above may be employed.
  • the thermal stimulus as a temperature difference with reference to the base temperature T 0 , the stimulus that the subject feels to the same degree is more stably applied to the test site of each subject as described above. It becomes possible.
  • a sensory threshold is measured in a situation where a thermal stimulus with a continuously rising temperature and a thermal stimulus with a continuously decreasing temperature are repeatedly applied (that is, a warm threshold and a cold threshold).
  • a thermal stimulus with a continuously rising temperature and a thermal stimulus with a continuously decreasing temperature are repeatedly applied (that is, a warm threshold and a cold threshold).
  • FIG. 5 is a flowchart showing the sensory threshold measurement method. The flow proceeds as a trigger when a test start instruction is input to the main body 20 through a test start button (not shown) in a state where the test site of the subject is in contact with the stimulation surface 11a.
  • the reference adjusting unit 23a matches the temperature of the stimulation surface 11a with the temperature of the examination site by the above-described method (No in step S501 in FIG. 5).
  • the reference adjustment unit 23a notifies the inspection execution unit 23b and the calculation unit 25 (Yes in step S501).
  • the arithmetic unit 25 acquires the temperature of the stimulation surface 11a as a base temperature T 0 through temperature acquiring unit 22.
  • the examination execution unit 23b to which the above notification is input from the reference adjustment unit 23a increases the temperature of the stimulation surface 11a (step S502 in FIG. 5).
  • the subject becomes aware of warm sensation in the process of increasing the temperature of the stimulation surface 11a, the subject notifies the main body 20 that he / she has sensed warm sensation through the input unit 24 (No in steps S503 and S503 in FIG. 5).
  • the calculation unit 25 acquires the temperature of the stimulation surface 11 a through the temperature acquisition unit 22. Then, the arithmetic unit 25 calculates the difference between the base temperatures T 0 temperature above the stimulation surface 11a at the time the subject was aware of Warm as Warm threshold (Fig. 5 step S504).
  • the examination execution unit 23b switches the temperature of the stimulation surface 11a from the temperature increase to the temperature decrease (No in steps S505 and S506 in FIG. 5).
  • the subject notifies the main body 20 of the sense of cold through the input unit 24 (No in steps S503 and S503 in FIG. 5).
  • the calculation unit 25 acquires the temperature of the stimulation surface 11 a through the temperature acquisition unit 22. Then, the arithmetic unit 25 calculates the difference between the temperature of the stimulation surface 11a at which the base temperature T 0 and the subject described above is aware of cold sensation as cold sensation threshold (Fig. 5 step S504).
  • the examination execution unit 23b switches the temperature of the stimulation surface 11a from a temperature decrease to a temperature increase (No in steps S505 and S506 in FIG. 5).
  • the subject becomes aware of warm sensation in the process of increasing the temperature of the stimulation surface 11a, the subject notifies the main body 20 that he / she has sensed warm sensation through the input unit 24 (No in steps S503 and S503 in FIG. 5).
  • the calculation unit 25 acquires the temperature of the stimulation surface 11a through the temperature acquisition unit 22, and calculates the temperature threshold value as described above (step S504 in FIG. 5).
  • the inspection execution unit 23b performs switching between the continuous thermal increase thermal stimulation and the continuous thermal decrease thermal stimulation as described above a predetermined number of times. When the number of times of switching reaches the number of times designated in advance, the inspection execution unit 23b stops the power supply to the temperature adjustment element 12 (steps S505 and S506 in FIG. 5).
  • the examination execution unit 23b controls the temperature adjustment element 12 from the state in which the temperature of the stimulation surface 11a and the temperature of the examination site coincide with each other by the reference adjustment unit 23a. After raising or lowering, each time an input is made by the subject through the input unit 24, the temperature of the stimulation surface 11a is switched between increasing and decreasing. By such a series of thermal stimulations, it is possible to acquire a sensory threshold value in a state where the examination site is used to the thermal stimulation.
  • the measured warm threshold and cold threshold tend to vary widely (warm temperature).
  • the difference between the average value of the sensation threshold and the average value of the cold sensation threshold tends to increase).
  • the variation is large, the quantitative property is lowered, and the difference between the warm threshold and the cold threshold is increased, resulting in a longer examination time.
  • FIG. 6 is a diagram showing a comparative example of the sensory threshold measurement method and the measurement method using a temperature sensor in the present embodiment.
  • the horizontal axis corresponds to the elapsed time
  • the vertical axis corresponds to the temperature.
  • the sensory threshold measurement method in the present embodiment is indicated by a solid line
  • the measurement method using a temperature sensor is indicated by a broken line and a one-dot chain line.
  • the measurement of the warm threshold and the measurement of the cold threshold are repeated five times.
  • the temperature difference is increased. ing.
  • the variation of the sensory threshold perceived by the subject is larger than the sensory threshold measurement method in the present embodiment, and the examination time is longer than the sensory threshold measurement method in the present embodiment.
  • the sensory threshold value measurement method in the present embodiment has a shorter time for matching the temperature of the examination site and the temperature of the stimulation surface 11a than the measurement method using the temperature sensor, and the examination time itself. In addition, it can be said that stable measurement with little variation is possible.
  • the sensory threshold value is set in a situation where the thermal stimulation is continuously applied with the temperature rising a plurality of times, and then the thermal stimulation is continuously applied with the temperature decreasing a plurality of times.
  • a case where measurement is performed that is, a case where the cold threshold is continuously measured a plurality of times after the temperature threshold is continuously measured a plurality of times) will be described.
  • FIG. 8 is a flowchart showing the sensory threshold measurement method. The flow proceeds as a trigger when a test start instruction is input to the main body 20 through a test start button (not shown) in a state where the test site of the subject is in contact with the stimulation surface 11a.
  • the reference adjusting unit 23a matches the temperature of the stimulation surface 11a with the temperature of the examination site by the above-described method (No in step S801 in FIG. 8).
  • the reference adjustment unit 23a notifies the inspection execution unit 23b and the calculation unit 25 (Yes in step S801 in FIG. 8).
  • the arithmetic unit 25 acquires the temperature of the stimulation surface 11a as a base temperature T 0 through temperature acquiring unit 22.
  • the examination execution unit 23b to which the above notification is input from the reference adjustment unit 23a increases the temperature of the stimulation surface 11a (step S802 in FIG. 8).
  • the subject When the subject becomes aware of the temperature sensation in the process of increasing the temperature of the stimulation surface 11a, the subject notifies the main body 20 of the sense of temperature sensation through the input unit 24 (No in steps S803 and S803 in FIG. 8).
  • the calculation unit 25 acquires the temperature of the stimulation surface 11 a through the temperature acquisition unit 22. Then, the arithmetic unit 25 calculates the difference between the temperature of the stimulation surface 11a at the time the subject was aware of the warmth and base temperature T 0 of the above as Warm threshold (FIG. 8 step S804).
  • the examination execution unit 23b instructs the reference adjustment unit 23a to match the temperature of the stimulation surface 11a with the temperature of the examination site.
  • the reference adjusting unit 23a matches the temperature of the stimulation surface 11a with the temperature of the examination site by the above-described method (steps S805 No and S801 No in FIG. 8).
  • the reference adjustment unit 23a notifies the inspection execution unit 23b and the calculation unit 25 (Yes in step S801 in FIG. 8).
  • the arithmetic unit 25 acquires the temperature of the stimulation surface 11a as a new base temperature T 0 through temperature acquiring unit 22.
  • the examination execution unit 23b to which the above notification is input from the reference adjustment unit 23a increases the temperature of the stimulation surface 11a (step S802 in FIG. 8).
  • the subject when the subject is aware of the temperature sensation, the subject notifies the main body 20 of the sense of temperature sensation through the input unit 24 (No in steps S803 and S803 in FIG. 8).
  • the calculation unit 25 acquires the temperature of the stimulation surface 11 a through the temperature acquisition unit 22. Then, the arithmetic unit 25 calculates the difference between subjects and temperature stimuli surface 11a at the time of conscious of warmth as a new base temperature T 0 of the above as Warm threshold (FIG. 8 step S804).
  • the examination execution unit 23b performs the temperature threshold measurement as described above for the number of times designated in advance. When the number of times specified in advance is reached, the examination execution unit 23b performs the number of times specified in advance to measure the cold sensation threshold by the same method using the heat stimulation in which the temperature continuously decreases from the base temperature. Just implement. When the number of times designated in advance is reached, the power supply to the temperature adjustment element 12 is stopped (FIG. 8, step S805 Yes).
  • the reference adjustment unit 23a is configured so that the heat flux detected by the heat flow sensor 11 is within a predesignated range each time input by the subject is made through the input unit 24. 12 is made to match the temperature of the stimulation surface 11a with the temperature of the examination site. By such a series of thermal stimulation, it is possible to perform a test in which the warm threshold and the cold threshold are measured a plurality of times in a short time.
  • the temperature of the stimulation surface 11a and the temperature of the examination site are made the same based on the heat flux detected by the heat flow sensor 11.
  • the temperature of the stimulation surface 11a and the temperature of the examination site can be matched with high accuracy in a short time. As a result, quantitative and more reproducible inspection can be realized in a shorter time.
  • the calculation unit 25 exemplifies a configuration in which the pain threshold is calculated based on the difference between the temperature of the stimulation surface when the subject is aware of pain and the base temperature T 0 , but the subject is aware of pain.
  • the difference between the temperature of the stimulation surface at the time of the stimulation and the temperature of the stimulation surface when the subject is aware of the warm or cold sensation may be calculated as the pain threshold. That is, under the situation where a thermal stimulus that continuously increases in temperature as shown in FIG. 2A is applied, even after the subject has notified the main body 20 of the sense of temperature through the input unit 24.
  • the temperature rise is continued, and the subject notifies the main body 20 of the pain perception through the input unit 24.
  • the calculating part 25 calculates the difference of the temperature of the stimulation surface 11a when a test subject is aware of pain sensation, and the temperature of the stimulation surface 11a when a test subject is aware of warm sense as a pain threshold value. According to such a configuration, the magnitude of a stimulus that feels pain can be quantitatively evaluated with respect to the slow pain transmitted through the C fiber based on a stimulus that can be perceived.
  • the calculating part 25 calculates the difference of the temperature of the stimulation surface 11a when a test subject is aware of pain sensation, and the temperature of the stimulation surface 11a when a test subject is aware of cold sensation as a pain threshold value. According to such a configuration, it is possible to quantitatively evaluate the magnitude of a stimulus that feels pain on the basis of a stimulus that can be perceived with respect to fast pain transmitted through A ⁇ fibers.
  • providing the calculating part 25 is not essential.
  • it may be configured to output only the temperature of the stimulation surface 11a when the subject is aware of warm sensation, cold sensation, or pain sensation, and may be configured to separately perform a calculation for calculating a sensory threshold.
  • it is not essential to provide the input unit 24.
  • a display unit that displays the temperature of the stimulation surface 11a is provided on the main body 20, and when the subject is aware of warm sensation, cold sensation, or pain sensation, the temperature displayed on the display unit is determined by the tester ( It is possible to adopt a configuration in which an operator) records.
  • the test subject verbally answers the degree of warm sensation, cold sensation, or pain sensation You can also
  • the order of the steps can be changed as appropriate within the range where the equivalent action is achieved.
  • the sensory threshold value is calculated every time there is an input by the subject through the input unit.
  • the calculation for calculating the sensory threshold value is performed collectively at an arbitrary timing. Also good.
  • thermal stimulation profiles shown in FIGS. 4 and 7 are merely examples.
  • the respective profiles illustrated in FIGS. 2A to 2D are represented by the thermal stimulations shown in FIGS. It is also possible to use as a profile.
  • a quantitative and more reproducible test can be realized in a shorter time, which is useful as a skin sensory stimulation device and a sensory threshold measurement method.

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Abstract

A cutaneous sensation stimulation apparatus according to the present invention is provided with: a probe; a heat flow sensor; a temperature adjustment element; a reference adjustment unit; and an examination execution unit. The probe is disposed facing an examination site and has a stimulation surface that thermally stimulates the examination site. The heat flow sensor detects the heat flux that passes through the stimulation surface. The temperature adjustment element raises and lowers the temperature of the stimulation surface. The reference adjustment unit equalizes the temperature of the stimulation surface and the temperature of the examination site by controlling the temperature adjustment element so that the heat flux detected by the heat flow sensor is within a pre-designated range. The examination execution unit controls the temperature adjustment element to raise or lower the temperature of the stimulation surface from a state in which the temperature of the stimulation surface and the temperature of the examination site are equalized by the reference adjustment unit.

Description

皮膚感覚刺激装置及び感覚閾値の計測方法Skin sensory stimulation device and sensory threshold measurement method
　本発明は、皮膚に接触させた刺激面の温度を変化させることで、温覚、冷覚、痛覚を刺激する皮膚感覚刺激装置及び感覚閾値の計測方法に関する。 The present invention relates to a skin sensory stimulation device and a sensory threshold measurement method for stimulating warm, cold, and painful sensations by changing the temperature of a stimulation surface in contact with the skin.
　従来、線維筋痛症等の慢性疼痛のような疾患における痛みの評価や、脳障害、脊髄損傷、糖尿病等に伴う感覚障害の評価では、痛覚、温度覚、触覚、振動覚等の皮膚感覚の検査が行われている。このような検査では、定量的でより再現性の高い検査の実現が求められている。 Conventionally, in the evaluation of pain in diseases such as chronic pain such as fibromyalgia and the evaluation of sensory disturbances associated with brain damage, spinal cord injury, diabetes, etc., skin sensation such as pain, temperature, touch, vibration, etc. Inspection is being conducted. In such inspections, realization of quantitative and more reproducible inspections is required.
　例えば、特許文献１は、人体の皮膚表面に接触させて温冷覚を検査する温冷覚検査装置において、１つの温度センサで皮膚温度と皮膚に与える温度とを測定可能とし、計測した皮膚温度を考慮した上で与えるべき温度を設定して温冷覚検査を実施する構成を開示している。また、特許文献２は、被験者の皮膚面に対向させて温度刺激手段の刺激面を配置した状態で、温度刺激手段による温度刺激を開始した時点から被験者が温覚又は冷覚を自覚する時点までの熱流束と温度の経時変化に基づいて得られる単位面積当たりの熱量である熱量閾値を温度覚の評価値とする構成を開示している。また、特許文献３は、被検部位に連続的な熱刺激を加えた場合の、熱刺激終了後の残感覚の残存時間により中枢感作の有無を判断する構成を開示している。 For example, Patent Document 1 discloses that in a thermal sensation testing apparatus that inspects thermal sensation by contacting a human skin surface, the skin temperature and the temperature applied to the skin can be measured with one temperature sensor, and the measured skin temperature is measured. The structure which sets the temperature which should be given in consideration of, and implements a thermal sensation test is disclosed. Further, Patent Document 2 discloses a state in which the stimulation surface of the temperature stimulation unit is arranged to face the subject's skin surface and from when the temperature stimulation by the temperature stimulation unit is started to when the subject becomes aware of warm or cold sensation. A configuration is disclosed in which a heat amount threshold value, which is a heat amount per unit area obtained based on the heat flux and temperature change with time, is used as an evaluation value of the temperature sense. Moreover, patent document 3 is disclosing the structure which judges the presence or absence of central sensitization from the residual time of the residual sensation after completion | finish of thermal stimulation when continuous thermal stimulation is applied to the test site.
　一方、非特許文献１は、特定の温度から温度を上昇させ、被験者が温覚を自覚する温度の計測を複数回繰り返す温覚検査の後、特定の温度から温度を下降させ、被験者が冷覚を自覚する温度の計測を複数回繰り返す冷覚検査を行う構成を開示している。また、特定の温度から温度を上昇させ、被験者が温覚を自覚する温度を計測した後、温度を下降させて被験者が冷覚を自覚する温度計測し、その後、温度上昇させ、被験者が温覚を自覚する温度を計測する、という温度上昇、温度下降を複数回繰り返し、被験者が温覚又は冷覚を自覚した温度を複数回取得する構成を開示している。 On the other hand, Non-Patent Document 1 raises the temperature from a specific temperature, and after a temperature test in which the measurement of the temperature at which the subject is aware of the temperature sensation is repeated a plurality of times, the temperature is lowered from the specific temperature, The structure which performs the cold sense test | inspection which repeats the measurement of the temperature which recognizes this several times is disclosed. Also, after increasing the temperature from a specific temperature and measuring the temperature at which the subject is aware of the temperature sensation, the temperature is decreased to measure the temperature at which the subject is aware of the cold sensation. The structure which repeats the temperature rise and temperature fall of measuring the temperature which is aware of this multiple times, and obtains the temperature at which the subject is aware of the warm or cold sense multiple times is disclosed.
特開２０１５－１５９８９８号公報JP2015-159898A 特開平１０－１７９５９１号公報Japanese Patent Laid-Open No. 10-179591 国際公開第２０１３／１２５５１８号International Publication No. 2013/125518
　温冷覚検査では、同一の被験者であっても、検査部位の皮膚温度が低い場合（例えば、３０℃）と高い場合（例えば、３５℃）とでは、温覚又は冷覚を自覚する温度が異なる。特許文献１が開示する技術では、温冷覚検査に際し、検査部位に付与する熱刺激の温度を測定した皮膚温度を考慮して設定する構成であるため、検査部位の皮膚温度に関わらず、定量的な温冷覚検査を実施することができる。 In the thermal and cold sense test, even if the subject is the same, when the skin temperature of the examination site is low (for example, 30 ° C.) or high (for example, 35 ° C.), Different. In the technology disclosed in Patent Document 1, since the configuration is set in consideration of the skin temperature obtained by measuring the temperature of the thermal stimulus applied to the examination site in the case of the thermal and cold sensation examination, it is determined regardless of the skin temperature of the examination site. Thermal sensation can be performed.
　しかしながら、特許文献１が開示する構成では、皮膚温度の測定後に、同一の温度センサを使用して皮膚に熱刺激を与える吸発熱体の温度（例えば、皮膚温度＋５℃）が調整される。この温度調整の間は、被験者の検査部位に熱刺激が付与されることがないように、検査用プローブが被験者の皮膚から離す必要がある。また、被験者が温覚又は冷覚を自覚する温度差を取得するためには、皮膚温度と吸発熱体の温度との温度差を異ならせた熱刺激を順次付与する必要があるため、吸発熱体の温度を繰り返し調整する必要がある。すなわち、検査用プローブを皮膚に接触させる動作と皮膚から離す動作とを繰り返すという煩雑な動作が必要になる。また、吸発熱体の温度調整中の待ち時間の間に皮膚温度が変動してしまう可能性もある。また、皮膚温度と吸発熱体の温度との温度差が大きくなると待ち時間も大きくなるため、皮膚温度が変動してしまう可能性がより高まることになる。変動後の皮膚温度は、再測定により取得することも可能である。しかしながら、皮膚温度と吸発熱体の温度の温度差を変更する度に皮膚温度を測定し、さらに、再測定も必要となると検査時間が著しく長くなってしまう。 However, in the configuration disclosed in Patent Document 1, after the skin temperature is measured, the temperature of an endothermic body that gives thermal stimulation to the skin (for example, skin temperature + 5 ° C.) is adjusted using the same temperature sensor. During this temperature adjustment, the test probe needs to be separated from the skin of the subject so that thermal stimulation is not applied to the test site of the subject. In addition, in order to obtain a temperature difference at which the subject is aware of warm or cold sensation, it is necessary to sequentially apply thermal stimulation with different temperature differences between the skin temperature and the temperature of the heat-absorbing and heat-generating body. It is necessary to adjust the body temperature repeatedly. That is, a complicated operation of repeating the operation of bringing the inspection probe into contact with the skin and the operation of separating the probe from the skin is necessary. In addition, the skin temperature may fluctuate during the waiting time during the temperature adjustment of the heat-absorbing / heating element. In addition, when the temperature difference between the skin temperature and the temperature of the heat absorbing / generating body increases, the waiting time also increases, so the possibility that the skin temperature fluctuates further increases. The skin temperature after the fluctuation can be obtained by re-measurement. However, if the skin temperature is measured every time the temperature difference between the skin temperature and the temperature of the heat-absorbing and heating element is changed and further re-measurement is required, the inspection time will be significantly increased.
　また、皮膚温度から連続的に温度が上昇又は下降する熱刺激を付与する場合には、皮膚温度と吸発熱体の温度とを予め一致させる必要がある。このような温度調整は、温冷覚検査装置の熱刺激発生部位に被験者の検査部位を接触させた状態で実施する必要がある。この温度調整の際には、温度センサの測定結果に基づく温度調整では吸発熱体の温度に比較的大きなオーバーシュートが発生する。そのため、被験者の検査部位と吸発熱体との間で熱の移動が生じ、当該温度調整の間に皮膚温度が変動してしまう可能性がある。したがって、上述の問題と同様の問題が発生することになる。 In addition, when applying a thermal stimulus in which the temperature rises or falls continuously from the skin temperature, the skin temperature and the temperature of the heat-absorbing / heating element must be matched in advance. Such temperature adjustment needs to be performed in a state where the test site of the subject is in contact with the thermal stimulus generation site of the thermal sensation testing apparatus. At the time of this temperature adjustment, a relatively large overshoot occurs in the temperature of the heat-absorbing / heating element in the temperature adjustment based on the measurement result of the temperature sensor. Therefore, heat transfer occurs between the test site of the subject and the heat absorption / exothermic body, and the skin temperature may fluctuate during the temperature adjustment. Therefore, a problem similar to the above problem occurs.
　また、特許文献２、３が開示する技術は、新たな評価値を提案するものであり、従来から使用されている、温度を評価値とする皮膚感覚検査にそのまま適用することは困難である。 Further, the techniques disclosed in Patent Documents 2 and 3 propose new evaluation values, and it is difficult to apply them as they are to the skin sensation test that uses temperature as an evaluation value.
　本発明は、上記従来の事情を鑑みて提案されたものであって、温度を評価値とする皮膚感覚検査において、定量的でより再現性の高い検査をより短時間で実現することができる皮膚感覚刺激装置及び感覚閾値の計測方法を提供することを目的とする。 The present invention has been proposed in view of the above-described conventional circumstances, and in skin sensation inspection using temperature as an evaluation value, skin capable of realizing a quantitative and more reproducible inspection in a shorter time. An object is to provide a sensory stimulation device and a sensory threshold measurement method.
　上述の目的を達成するために、本発明は以下の技術的手段を採用している。まず、本発明は、被験者の皮膚面の検査部位に対して熱刺激を付与する皮膚感覚刺激装置を前提としている。そして、本発明に係る皮膚感覚刺激装置は、刺激面、熱流センサ、温度調整素子、基準調整部、及び検査実施部を備える。刺激面は、検査部位に対向して配置され、検査部位に熱刺激を付与する。熱流センサは、刺激面を通過する熱流束を検知する。温度調整素子は、刺激面の温度を上昇又は下降させる。基準調整部は、熱流センサにより検知される熱流束が予め指定された範囲内となる状態に温度調整素子を制御することにより、刺激面の温度と検査部位の温度とを一致させる。検査実施部は、基準調整部により刺激面の温度と検査部位の温度とが一致した状態から温度調整素子を制御することにより刺激面の温度を上昇又は下降させる。 In order to achieve the above object, the present invention employs the following technical means. First, the present invention is premised on a skin sensation stimulation apparatus that applies thermal stimulation to an examination site on the skin surface of a subject. The skin sensation stimulation device according to the present invention includes a stimulation surface, a heat flow sensor, a temperature adjustment element, a reference adjustment unit, and an examination execution unit. The stimulation surface is disposed to face the examination site and applies thermal stimulation to the examination site. The heat flow sensor detects the heat flux passing through the stimulation surface. The temperature adjustment element increases or decreases the temperature of the stimulation surface. The reference adjustment unit matches the temperature of the stimulation surface and the temperature of the examination site by controlling the temperature adjustment element so that the heat flux detected by the heat flow sensor is within a range specified in advance. The examination execution unit raises or lowers the temperature of the stimulation surface by controlling the temperature adjustment element from a state in which the temperature of the stimulation surface and the temperature of the examination site coincide with each other by the reference adjustment unit.
　この皮膚感覚刺激装置では、熱流センサにより検知される熱流束に基づいて、刺激面の温度と検査部位の温度とを同一にしている。本構成では、短時間で高精度に刺激面の温度と検査部位の温度とを一致させることができる。その結果、定量的でより再現性の高い検査をより短時間で実現することができる。 In this skin sensation stimulating device, the temperature of the stimulation surface and the temperature of the examination site are made the same based on the heat flux detected by the heat flow sensor. In this configuration, the temperature of the stimulation surface and the temperature of the examination site can be matched with high accuracy in a short time. As a result, quantitative and more reproducible inspection can be realized in a shorter time.
　上記皮膚感覚刺激装置では、被験者が温覚、冷覚、又は痛覚を自覚した旨を入力する入力部をさらに備え、検査実施部が、基準調整部により刺激面の温度と検査部位の温度とが一致した状態から温度調整素子を制御することにより刺激面の温度を上昇又は下降させた後、入力部を通じて被験者による入力がなされる都度、刺激面の温度上昇と温度下降とを切り替える構成を採用することができる。また、基準調整部が、入力部を通じて被験者による入力がなされる都度、熱流センサにより検知される熱流束が予め指定された範囲内となる状態に温度調整素子を制御することにより、刺激面の温度と検査部位の温度とを一致させる構成を採用することもできる。また、刺激面の温度を取得する温度取得部をさらに備え、検査実施部が、基準調整部により刺激面の温度と検査部位の温度とが一致した状態における刺激面の温度に対して予め指定された温度差を加算した温度に刺激面の温度を上昇又は下降させる構成を採用することもできる。 The skin sensation stimulating apparatus further includes an input unit for inputting that the subject is aware of warm sensation, cold sensation, or pain sensation, and the inspection execution unit determines whether the temperature of the stimulation surface and the temperature of the inspection site are detected by the reference adjustment unit. A configuration is adopted in which the temperature of the stimulation surface is increased or decreased by controlling the temperature adjustment element from the coincidence state, and then the temperature increase and decrease of the stimulation surface are switched each time an input is made by the subject through the input unit. be able to. In addition, each time the subject adjusts the input through the input unit, the reference adjustment unit controls the temperature adjustment element so that the heat flux detected by the heat flow sensor is within a pre-specified range. It is also possible to adopt a configuration in which the temperature of the examination site is matched. Further, the apparatus further includes a temperature acquisition unit that acquires the temperature of the stimulation surface, and the inspection execution unit is designated in advance by the reference adjustment unit with respect to the temperature of the stimulation surface in a state where the temperature of the stimulation surface matches the temperature of the inspection site. It is also possible to adopt a configuration in which the temperature of the stimulation surface is increased or decreased to the temperature obtained by adding the temperature difference.
　さらに、以上の皮膚感覚刺激装置は、刺激面の温度を取得する温度取得部と、被験者が温覚、冷覚、又は痛覚を自覚した時点の刺激面の温度と、基準調整部により刺激面の温度と検査部位の温度とが一致した状態における刺激面の温度との差、あるいは、被験者が痛覚を自覚した時点の刺激面の温度と、被験者が温覚又は冷覚を自覚した時点の刺激面の温度との差を感覚閾値として算出する演算部とをさらに備える構成を採用することもできる。また、上述の予め指定された熱流束の範囲が－５０Ｗ／ｍ２以上かつ＋５０Ｗ／ｍ２以下である構成を採用することもできる。 Furthermore, the skin sensory stimulation device described above includes a temperature acquisition unit that acquires the temperature of the stimulation surface, the temperature of the stimulation surface when the subject is aware of warm sensation, cold sensation, or pain sensation, and the reference adjustment unit. The difference between the temperature of the stimulation surface when the temperature and the temperature of the examination site match, or the temperature of the stimulation surface when the subject is aware of pain sensation and the stimulation surface when the subject is aware of warm or cold sensation It is also possible to employ a configuration further including a calculation unit that calculates a difference from the temperature as a sensory threshold value. It is also possible range of predesignated heat flux described above to employ a configuration is -50 W / m 2 or more and + 50 W / m 2 or less.
　一方、他の観点では、本発明は、被験者の皮膚面の検査部位に対して熱刺激を付与した際の感覚閾値の計測方法を提供することもできる。すなわち、本発明に係る感覚閾値の計測方法では、まず、検査部位に熱刺激を付与する刺激面を通過する熱流束を検知する熱流センサにより検知される熱流束が予め指定された範囲内となる状態に刺激面の温度を上昇又は下降させる温度調整素子を制御することにより、刺激面の温度と検査部位の温度とを一致させる。次いで、刺激面の温度と検査部位の温度とが一致した状態から温度調整素子を制御することにより刺激面の温度を上昇又は下降させる。そして、被験者が温覚、冷覚、又は痛覚を自覚した時点の刺激面の温度と、刺激面の温度と検査部位の温度とが一致した状態における刺激面の温度との差、あるいは、被験者が痛覚を自覚した時点の刺激面の温度と、被験者が温覚又は冷覚を自覚した時点の刺激面の温度との差が感覚閾値として算出される。 On the other hand, in another aspect, the present invention can also provide a method for measuring a sensory threshold when a thermal stimulus is applied to an examination site on the skin surface of a subject. That is, in the sensory threshold value measuring method according to the present invention, first, the heat flux detected by the heat flow sensor that detects the heat flux that passes through the stimulation surface that applies the thermal stimulus to the examination site is within a predetermined range. By controlling the temperature adjusting element that raises or lowers the temperature of the stimulation surface according to the state, the temperature of the stimulation surface matches the temperature of the examination site. Next, the temperature of the stimulation surface is raised or lowered by controlling the temperature adjustment element from the state where the temperature of the stimulation surface and the temperature of the examination site match. And the difference between the temperature of the stimulation surface when the subject is aware of warm sensation, cold sensation, or pain sensation, and the temperature of the stimulation surface in a state where the temperature of the stimulation surface and the temperature of the examination site match, A difference between the temperature of the stimulation surface at the time when the pain sensation is recognized and the temperature of the stimulation surface at the time when the subject is aware of the warm sensation or the cold sensation is calculated as a sensory threshold value.
　本発明に係る皮膚感覚刺激装置及び感覚閾値の計測方法によれば、短時間で高精度に刺激面の温度と検査部位の温度とを一致させることができる。その結果、定量的でより再現性の高い検査をより短時間で実現することができる。 According to the skin sensory stimulation device and sensory threshold measurement method of the present invention, the temperature of the stimulation surface and the temperature of the examination site can be matched with high accuracy in a short time. As a result, quantitative and more reproducible inspection can be realized in a shorter time.
図１は、本発明の一実施形態における皮膚感覚刺激装置の構成を示す概略構成図である。FIG. 1 is a schematic configuration diagram showing a configuration of a skin sensation stimulating device according to an embodiment of the present invention. 図２（ａ）から図２（ｄ）は、本発明の一実施形態における熱刺激を例示する模式図である。FIG. 2A to FIG. 2D are schematic views illustrating thermal stimulation in one embodiment of the present invention. 図３は、本発明の一実施形態における感覚閾値の計測方法の一例を示すフロー図である。FIG. 3 is a flowchart showing an example of a sensory threshold measurement method according to an embodiment of the present invention. 図４は、本発明の一実施形態における熱刺激を例示する模式図である。FIG. 4 is a schematic view illustrating thermal stimulation in one embodiment of the present invention. 図５は、本発明の一実施形態における感覚閾値の計測方法の一例を示すフロー図である。FIG. 5 is a flowchart showing an example of a sensory threshold measurement method according to an embodiment of the present invention. 図６は、本発明の一実施形態における感覚閾値の計測方法と温度センサを用いた計測方法との比較例を示す図である。FIG. 6 is a diagram illustrating a comparative example of a sensory threshold value measurement method and a measurement method using a temperature sensor according to an embodiment of the present invention. 図７は、本発明の一実施形態における熱刺激を例示する模式図である。FIG. 7 is a schematic view illustrating thermal stimulation in one embodiment of the present invention. 図８は、本発明の一実施形態における感覚閾値の計測方法の一例を示すフロー図である。FIG. 8 is a flowchart showing an example of a sensory threshold measurement method according to an embodiment of the present invention.
　以下、本発明の実施形態について、図面を参照しながらより詳細に説明する。図１は、本発明の一実施形態における皮膚感覚刺激装置の構成を示す概略構成図である。本実施形態の皮膚感覚刺激装置１００は、被験者の皮膚面の検査部位（以下、単に、検査部位ともいう。）に対して熱刺激を付与する。 Hereinafter, embodiments of the present invention will be described in more detail with reference to the drawings. FIG. 1 is a schematic configuration diagram showing a configuration of a skin sensation stimulating device according to an embodiment of the present invention. Skin sensation stimulating apparatus 100 of the present embodiment applies thermal stimulation to an inspection site (hereinafter also simply referred to as an inspection site) on the skin surface of a subject.
　なお、熱刺激を使用する皮膚感覚検査では、温覚、冷覚、痛覚が評価される。温覚を評価する場合、皮膚温度よりも高い温度の熱刺激が検査部位に付与され、被験者が温覚を自覚した閾値が取得される。冷覚を評価する場合、皮膚温度よりも低い温度の熱刺激が検査部位に付与され、被験者が冷覚を自覚した閾値が取得される。また、被験者が温覚を自覚した状態でさらに高い温度の熱刺激が付与された場合や、被験者が冷覚を自覚した状態でさらに低い温度の熱刺激が付与された場合、被験者は痛覚を自覚するようになる。このとき、被験者が温覚を自覚した閾値が取得することで痛覚を評価することができる。なお、温覚側の痛覚はＣ線維を伝わるslow painに関係し、冷覚側の痛覚はＡδ線維を伝わるfast painに関係する。 In the skin sensory test using thermal stimulation, warm sensation, cold sensation, and pain sensation are evaluated. When evaluating the sense of warmth, a thermal stimulus having a temperature higher than the skin temperature is applied to the examination site, and a threshold value at which the subject is aware of the sense of warmth is acquired. When evaluating cold sensation, a thermal stimulus having a temperature lower than the skin temperature is applied to the examination site, and a threshold at which the subject is aware of cold sensation is acquired. In addition, when a subject is given a higher temperature thermal stimulus while the subject is aware of warm sensation, or when a subject is given a lower temperature thermal stimulus while being aware of cold sensation, the subject becomes aware of the pain sensation To come. At this time, pain sensation can be evaluated by acquiring a threshold value at which the subject is aware of warm sensation. The pain on the warm side is related to slow pain transmitted through the C fiber, and the pain on the cold side is related to fast pain transmitted through the Aδ fiber.
　図１に示すように、本実施形態の皮膚感覚刺激装置１００は、プローブ１０と本体２０とを備える。まず、プローブ１０の構成について説明する。プローブ１０は、熱流センサ１１、温度調整素子１２、及び冷却ユニット１３を備える。本実施形態では、温度調整素子１２はペルチェ素子により構成されている。当該ペルチェ素子の第１面に当接して冷却ユニット１３が配置され、ペルチェ素子の第２面に当接して熱流センサ１１が配置されている。なお、冷却ユニット１３は第１面が発熱状態にあるときに当該熱を吸収可能な構成であればよく、冷却ユニット１３の構成は特に限定されない、例えば、空冷式ヒートシンクや水冷式ヒートシンクを使用することができる。 As shown in FIG. 1, the skin sensation stimulating device 100 of this embodiment includes a probe 10 and a main body 20. First, the configuration of the probe 10 will be described. The probe 10 includes a heat flow sensor 11, a temperature adjustment element 12, and a cooling unit 13. In the present embodiment, the temperature adjustment element 12 is configured by a Peltier element. The cooling unit 13 is disposed in contact with the first surface of the Peltier element, and the heat flow sensor 11 is disposed in contact with the second surface of the Peltier element. The cooling unit 13 may be configured to absorb the heat when the first surface is in a heat generating state, and the configuration of the cooling unit 13 is not particularly limited. For example, an air-cooled heat sink or a water-cooled heat sink is used. be able to.
　公知のように、熱流センサ１１は、平板状の形態を有し、厚さ方向を通過する熱流束の大きさを検知する。本実施形態では、熱流センサ１１において、温度調整素子１２の当接面と反対側の面が刺激面１１ａを構成している。したがって、熱流センサ１１は、刺激面１１ａを通過する熱流束を検知することになる。なお、熱流センサ１１の厚みは０．４ｍｍ程度である。 As is well known, the heat flow sensor 11 has a flat plate shape and detects the size of the heat flux passing through the thickness direction. In the present embodiment, in the heat flow sensor 11, the surface opposite to the contact surface of the temperature adjusting element 12 constitutes the stimulation surface 11a. Therefore, the heat flow sensor 11 detects the heat flux passing through the stimulation surface 11a. The thickness of the heat flow sensor 11 is about 0.4 mm.
　皮膚感覚検査時に、刺激面１１ａは、検査部位に対向し、検査部位と接触する状態で配置される。当該状態で、温度調整素子１２であるペルチェ素子の第２面を発熱状態にすると、刺激面１１ａの温度が上昇し、検査部位に温熱刺激が付与される。また、ペルチェ素子の第２面を吸熱状態にすると、刺激面１１ａの温度が下降し、検査部位に冷熱刺激が付与される。 At the time of skin sensory inspection, the stimulation surface 11a is disposed in a state of facing the inspection part and in contact with the inspection part. In this state, when the second surface of the Peltier element, which is the temperature adjusting element 12, is brought into a heat generating state, the temperature of the stimulation surface 11a rises and thermal stimulation is applied to the examination site. Moreover, when the 2nd surface of a Peltier device is made into an endothermic state, the temperature of the stimulation surface 11a will fall and a cold stimulation will be provided to a test | inspection site | part.
　特に限定されないが、本実施形態のプローブ１０は、刺激面１１ａを上方に向けてテーブル等に設置される。当該状態で、例えば、被験者の指先等の検査部位を刺激面１１ａに当接させた状態で熱刺激が付与される。なお、図１では、一例として、被験者の指先を検査部位３０として破線で示している。 Although not particularly limited, the probe 10 of the present embodiment is installed on a table or the like with the stimulation surface 11a facing upward. In this state, for example, thermal stimulation is applied in a state where an examination site such as a fingertip of the subject is in contact with the stimulation surface 11a. In addition, in FIG. 1, the test subject's fingertip is shown with the broken line as the test | inspection site | part 30 as an example.
　次いで、本体２０について説明する。本体２０は、熱流取得部２１、温度取得部２２、温度制御部２３、入力部２４、演算部２５を備える。熱流取得部２１は、熱流センサ１１の出力値に基づいて刺激面を通過する熱流束の大きさを取得する。温度取得部２２は、刺激面１１ａの温度を取得する。本実施形態では、温度取得部２２は、ペルチェ素子の第２面の平面視中央に配置された温度センサ１４により刺激面１１ａの温度を取得している。 Next, the main body 20 will be described. The main body 20 includes a heat flow acquisition unit 21, a temperature acquisition unit 22, a temperature control unit 23, an input unit 24, and a calculation unit 25. The heat flow acquisition unit 21 acquires the size of the heat flux passing through the stimulation surface based on the output value of the heat flow sensor 11. The temperature acquisition unit 22 acquires the temperature of the stimulation surface 11a. In the present embodiment, the temperature acquisition unit 22 acquires the temperature of the stimulation surface 11a by the temperature sensor 14 disposed in the center of the second surface of the Peltier element in plan view.
　温度制御部２３は、基準調整部２３ａ、検査実施部２３ｂ、及び電源部２３ｃを備える。基準調整部２３ａは、熱流センサ１１により検知される熱流束の大きさが予め指定された範囲内となる状態に温度調整素子１２を制御することにより、刺激面１１ａの温度と検査部位の温度とを一致させる。基準調整部２３ａは、熱流取得部２１から熱流束の大きさを取得する。本実施形態では、上述の予め指定された熱流束の範囲は－５０Ｗ／ｍ２以上かつ＋５０Ｗ／ｍ２以下である。当該範囲外であると、後述のように、自覚皮膚温度及び自覚熱流束が安定して計測できなくなるため好ましくない。特に限定されないが、本実施形態では、熱が検査部位から刺激面に流れる方向を正としている。 The temperature control unit 23 includes a reference adjustment unit 23a, an inspection execution unit 23b, and a power supply unit 23c. The reference adjustment unit 23a controls the temperature adjustment element 12 so that the magnitude of the heat flux detected by the heat flow sensor 11 falls within a range specified in advance, whereby the temperature of the stimulation surface 11a and the temperature of the examination site are determined. To match. The reference adjustment unit 23a acquires the size of the heat flux from the heat flow acquisition unit 21. In this embodiment, pre-specified range of heat flux above is -50 W / m 2 or more and + 50 W / m 2 or less. Outside the range, as described later, the subjective skin temperature and the subjective heat flux cannot be stably measured, which is not preferable. Although not particularly limited, in this embodiment, the direction in which heat flows from the examination site to the stimulation surface is positive.
　基準調整部２３ａは、温度調整素子１２に動作電力を供給する電源部２３ｃの通電量を調整することにより、温度調整素子１２の発熱量又は吸熱量を調整し、刺激面１１ａの温度と検査部位の温度とを一致させる。 The reference adjusting unit 23 a adjusts the amount of heat generated or absorbed by the temperature adjusting element 12 by adjusting the energization amount of the power supply unit 23 c that supplies operating power to the temperature adjusting element 12. To match the temperature.
　検査実施部２３ｂは、基準調整部２３ａにより刺激面１１ａの温度と検査部位の温度とが一致した状態から温度調整素子１２を制御することにより刺激面１１ａの温度を上昇又は下降させる。検査実施部２３ｂも、基準調整部２３ａと同様に、電源部２３ｃの通電量を調整することにより温度調整素子１２の発熱量又は吸熱量を調整し、刺激面１１ａの温度を上昇又は下降させる。 The examination execution unit 23b raises or lowers the temperature of the stimulation surface 11a by controlling the temperature adjustment element 12 from a state in which the temperature of the stimulation surface 11a and the temperature of the examination site coincide with each other by the reference adjustment unit 23a. Similarly to the reference adjustment unit 23a, the inspection execution unit 23b also adjusts the amount of heat generation or heat absorption of the temperature adjustment element 12 by adjusting the energization amount of the power supply unit 23c, and increases or decreases the temperature of the stimulation surface 11a.
　入力部２４は、被験者が温覚、冷覚、又は痛覚を自覚した旨を入力するために使用される。特に限定されないが、本実施形態では、入力部２４は、押ボタン式のスイッチにより構成されている。被験者が押ボタンを押下して当該スイッチをオフ状態からオン状態に切り変えると、温覚、冷覚、又は痛覚を自覚した旨が入力される。 The input unit 24 is used to input that the subject is aware of warm sensation, cold sensation, or pain sensation. Although not particularly limited, in the present embodiment, the input unit 24 is configured by a pushbutton switch. When the subject presses the push button to switch the switch from the off state to the on state, the fact that he / she has sensed warm sensation, cold sensation, or pain sensation is input.
　演算部２５は、皮膚感覚の評価値である感覚閾値を算出する。感覚閾値は、温覚閾値、冷覚閾値、痛覚閾値を含む。温覚閾値は、被験者が温覚を自覚したこと定量的に示す値である。冷覚閾値は、被験者が冷覚を自覚したこと定量的に示す値である。痛覚閾値は、被験者が痛覚を自覚したこと定量的に示す値である。本実施形態では、演算部２５は、被験者が温覚、冷覚、又は痛覚を自覚した時点の刺激面１１ａの温度と、基準調整部２３ａにより刺激面１１ａの温度と検査部位の温度とが一致した状態における刺激面１１ａの温度との差を感覚閾値として算出する。なお、以下では、基準調整部２３ａにより刺激面１１ａの温度と検査部位の温度とが一致した状態における刺激面１１ａの温度を、適宜、ベース温度という。ここでは刺激面１１ａの温度を取得しているが、刺激面１１ａの温度と検査部位の温度とは一致しているため、実質的に検査部位の温度を取得していることになる。 The calculation unit 25 calculates a sensory threshold value that is an evaluation value of the skin sensation. The sensory threshold includes a warm threshold, a cold threshold, and a pain threshold. The warmth threshold is a value that quantitatively indicates that the subject is aware of warmth. The cold threshold value is a value that quantitatively indicates that the subject is aware of cold sensation. The pain sensation threshold is a value that quantitatively indicates that the subject has noticed pain sensation. In the present embodiment, the calculation unit 25 matches the temperature of the stimulation surface 11a at the time when the subject is aware of warm sensation, cold sensation, or pain sensation, and the temperature of the stimulation surface 11a and the temperature of the examination site by the reference adjustment unit 23a. The difference with the temperature of the stimulation surface 11a in the performed state is calculated as a sensory threshold value. Hereinafter, the temperature of the stimulation surface 11a in a state in which the temperature of the stimulation surface 11a matches the temperature of the examination site by the reference adjustment unit 23a is appropriately referred to as a base temperature. Here, the temperature of the stimulation surface 11a is acquired. However, since the temperature of the stimulation surface 11a and the temperature of the examination site coincide with each other, the temperature of the examination site is substantially acquired.
　続いて、以上の構成を有する皮膚感覚刺激装置１００が実施する感覚閾値の計測方法について説明する。図２（ａ）から図２（ｄ）、図４、図７は、皮膚感覚刺激装置１００が出力する熱刺激を例示する模式図である。図２（ａ）から図２（ｄ）、図４、図７において、横軸は経過時間に対応し、縦軸は温度に対応する。まず、図２（ａ）に示すような、連続的に温度が上昇する熱刺激を付与する状況下で感覚閾値を計測する事例（すなわち、温覚閾値を計測する事例）について説明する。 Subsequently, a method for measuring a sensory threshold performed by the skin sensory stimulation device 100 having the above configuration will be described. 2 (a) to 2 (d), FIG. 4, and FIG. 7 are schematic views illustrating thermal stimulation output by the skin sensation stimulating device 100. FIG. 2A to 2D, 4, and 7, the horizontal axis corresponds to the elapsed time, and the vertical axis corresponds to the temperature. First, a case where a sensory threshold is measured under a situation where a thermal stimulus in which the temperature continuously rises as shown in FIG. 2A is applied (that is, a case where a temperature threshold is measured) will be described.
　図３は、当該感覚閾値の計測方法を示すフロー図である。当該フローは、被験者の検査部位が刺激面１１ａに接触された状態で、図示しない検査開始ボタンを通じて本体２０に検査開始指示が入力されたことをトリガとして進行する。 FIG. 3 is a flowchart showing the sensory threshold measurement method. The flow proceeds as a trigger when a test start instruction is input to the main body 20 through a test start button (not shown) in a state where the test site of the subject is in contact with the stimulation surface 11a.
　検査開始指示が入力されると、基準調整部２３ａは、刺激面１１ａの温度と検査部位の温度とを一致させる（図３　ステップＳ３０１Ｎｏ）。例えば、熱流取得部２１により取得された熱流束の大きさが正の値であった場合、刺激面１１ａの温度よりも検査部位の温度の方が高い状態にある。そのため、基準調整部２３ａは、温度調整素子１２であるペルチェ素子への電源部２３ｃによる通電量を調整してペルチェ素子の第２面の発熱量を増大させる。これにより、熱流取得部２１により取得される熱流束の大きさは次第に小さくなる。また、熱流取得部２１により取得される熱流束の大きさがオーバーシュートにより小さくなり過ぎた場合、基準調整部２３ａは、ペルチェ素子への通電量を調整してペルチェ素子の第２面の発熱量を増大させる。このような制御を繰り返すことにより、熱流取得部２１は刺激面１１ａの温度と検査部位の温度とを一致させる。なお、上述のように、本実施形態では、熱流センサ１１により検知される熱流束が予め指定された範囲内（ここでは、－５０Ｗ／ｍ２以上かつ＋５０Ｗ／ｍ２以下）となる状態であれば、刺激面１１ａの温度と検査部位の温度とが一致していると定義している。 When the inspection start instruction is input, the reference adjusting unit 23a matches the temperature of the stimulation surface 11a with the temperature of the inspection site (No in step S301 in FIG. 3). For example, when the magnitude of the heat flux acquired by the heat flow acquisition unit 21 is a positive value, the temperature of the examination site is higher than the temperature of the stimulation surface 11a. Therefore, the reference adjustment unit 23a increases the amount of heat generated on the second surface of the Peltier element by adjusting the amount of current supplied by the power supply unit 23c to the Peltier element that is the temperature adjustment element 12. Thereby, the magnitude | size of the heat flux acquired by the heat flow acquisition part 21 becomes small gradually. In addition, when the size of the heat flux acquired by the heat flow acquisition unit 21 becomes too small due to overshoot, the reference adjustment unit 23a adjusts the energization amount to the Peltier element to generate the amount of heat generated on the second surface of the Peltier element. Increase. By repeating such control, the heat flow acquisition unit 21 matches the temperature of the stimulation surface 11a with the temperature of the examination site. As described above, in the present embodiment, the range of heat flux that is detected by the heat flow sensor 11 is designated in advance (here, -50 W / m 2 or more and + 50 W / m 2 or less) there become a state In other words, it is defined that the temperature of the stimulation surface 11a matches the temperature of the examination site.
　以上の処理が完了すると、基準調整部２３ａは、検査実施部２３ｂ及び演算部２５に処理が完了した旨を通知する（図３　ステップＳ３０１Ｙｅｓ）。このとき、演算部２５は、温度取得部２２を通じて刺激面１１ａの温度をベース温度Ｔ０として取得する。熱流センサ１１の検出結果に応じてペルチェ素子への通電量を調整する構成では、温度センサに基づく温度調整に必要な各種処理（検出値を温度に変換する処理、変換した温度と予め取得した皮膚温度とを比較する処理、当該比較結果に応じて通電量を決定する処理等）が不要であるとともに、温度計測位置が熱平衡状態になるまでの待ち時間も不要であるため、温度のオーバーシュートも短時間で収束する。その結果、温度センサを使用して刺激面１１ａの温度と検査部位の温度とを一致させる構成と比較しても、短時間かつ高精度で刺激面１１ａの温度と検査部位の温度とを一致させることができる。 When the above process is completed, the reference adjustment unit 23a notifies the inspection execution unit 23b and the calculation unit 25 that the process is completed (step S301 Yes in FIG. 3). At this time, the arithmetic unit 25 acquires the temperature of the stimulation surface 11a as a base temperature T 0 through temperature acquiring unit 22. In the configuration in which the energization amount to the Peltier element is adjusted according to the detection result of the heat flow sensor 11, various processes necessary for temperature adjustment based on the temperature sensor (process for converting the detected value to temperature, converted temperature and previously acquired skin) Temperature comparison and temperature determination processing is not necessary, and there is no need to wait until the temperature measurement position is in thermal equilibrium. Converge in a short time. As a result, even when compared with a configuration in which the temperature of the stimulation surface 11a is matched with the temperature of the examination site using a temperature sensor, the temperature of the stimulation surface 11a is matched with the temperature of the examination site in a short time and with high accuracy. be able to.
　基準調整部２３ａから上述の通知が入力された検査実施部２３ｂは、刺激面１１ａの温度を上昇させる（図３　ステップＳ３０２）。刺激面１１ａの温度が上昇する過程で、被験者が温覚を自覚した場合、被験者は入力部２４を通じて本体２０に対して温覚を自覚した旨を通知する（図３　ステップＳ３０３Ｎｏ、Ｓ３０３Ｙｅｓ）。なお、温度上昇時の温度変化率が大きいと、被験者が温覚を自覚したときの温度の分解能が低下することになる。そのため、温度上昇時の温度の変化率は、必要な温度分解能が得られる値に設定する必要がある。特に限定されないが、温度上昇時の温度の変化率は、例えば、毎秒０．１～１０度の範囲内（例えば、毎秒０．３度）とすることができる。 The examination execution unit 23b to which the above notification is input from the reference adjustment unit 23a increases the temperature of the stimulation surface 11a (step S302 in FIG. 3). When the subject becomes aware of the temperature sensation in the process of increasing the temperature of the stimulation surface 11a, the subject notifies the main body 20 of the sense of temperature sensation through the input unit 24 (steps S303 No and S303 Yes in FIG. 3). In addition, if the temperature change rate at the time of temperature rise is large, the resolution | decomposability of temperature when a test subject will be aware of temperature sensation will fall. Therefore, it is necessary to set the rate of change in temperature when the temperature rises to a value that provides the necessary temperature resolution. Although not particularly limited, the rate of change in temperature when the temperature rises can be, for example, within a range of 0.1 to 10 degrees per second (for example, 0.3 degrees per second).
　温覚の自覚が通知されると、演算部２５は、温度取得部２２を通じて刺激面１１ａの温度を取得する。そして、演算部２５は、被験者が温覚を自覚した時点の刺激面１１ａの温度と、上述のベース温度Ｔ０との差を感覚閾値（ここでは、温覚閾値）として算出する（図３　ステップＳ３０４）。 When the awareness of the warm sense is notified, the calculation unit 25 acquires the temperature of the stimulation surface 11 a through the temperature acquisition unit 22. Then, the arithmetic unit 25, and the temperature of the stimulation surface 11a at the time the subject was aware of warmth (here, Warm threshold) difference sensory threshold and base temperature T 0 of the above is calculated as (Figure 3 step S304).
　演算部２５は、例えば、図示しない表示部に表示したり、図示しないＵＳＢ（Universal Serial Bus）ポートを通じてＵＳＢメモリ等の可搬記憶媒体にデータ送信したりすることで算出した感覚閾値を出力する。また、温覚の自覚が通知されると、検査実施部２３ｂは、温度調整素子１２への電力の供給を停止する。 The calculation unit 25 outputs the sensory threshold value calculated by, for example, displaying on a display unit (not shown) or transmitting data to a portable storage medium such as a USB memory through a USB (Universal Serial Bus) port (not shown). Further, when the awareness of the temperature sensation is notified, the examination execution unit 23b stops the supply of power to the temperature adjustment element 12.
　以上のように、本実施形態では、熱流センサ１１により検知される熱流束に基づいて、刺激面１１ａの温度と検査部位の温度とを一致させている。本構成では、短時間で高精度に刺激面の温度と検査部位の温度とを一致させることができる。その結果、定量的でより再現性の高い検査をより短時間で実現することができる。 As described above, in this embodiment, based on the heat flux detected by the heat flow sensor 11, the temperature of the stimulation surface 11a and the temperature of the examination site are matched. In this configuration, the temperature of the stimulation surface and the temperature of the examination site can be matched with high accuracy in a short time. As a result, quantitative and more reproducible inspection can be realized in a shorter time.
　ここで、上述の予め指定された熱流束の範囲と感覚閾値の測定結果の関係について説明する。表１は、熱刺激付与を開始する際の、熱流センサ１１により検知される熱流束の大きさを変化させ、それぞれについて温覚閾値を計測した結果を示している。表１では、熱刺激付与を開始する際の熱流束の大きさの設定値（熱流束条件）、熱刺激の付与を開始する際の皮膚温度（開始皮膚温度）、熱刺激の付与を開始する際の実際の熱流束の大きさ（開始熱流束）、被験者が温覚を自覚した際の皮膚温度（自覚皮膚温度）、被験者が温覚を自覚した際の熱流束の大きさ（自覚熱流束）、熱刺激付与開始から被験者が温覚を自覚するまでの時間（自覚時間）、開始皮膚温度と自覚皮膚温度との温度差をそれぞれ示している。 Here, the relationship between the above-specified heat flux range and the sensory threshold measurement result will be described. Table 1 shows the results of changing the magnitude of the heat flux detected by the heat flow sensor 11 when starting the thermal stimulation application and measuring the temperature threshold value for each. In Table 1, the setting value (heat flux condition) of the size of heat flux when starting thermal stimulation application, the skin temperature (starting skin temperature) when applying thermal stimulation, and the application of thermal stimulation are started. Actual heat flux size (starting heat flux), skin temperature when subject is aware of temperature sensation (subject skin temperature), size of heat flux when subject is aware of temperature sensation (subject heat flux) ), The time from the start of applying thermal stimulation to the time when the subject becomes aware of the temperature (awareness time), and the temperature difference between the starting skin temperature and the recognized skin temperature.
　表１から、開始熱流束が大きくなるにつれて（すなわち、皮膚温度と刺激面の温度との差が大きくなるにつれて）、自覚皮膚温度及び自覚熱流束が小さくなっていることが理解できる。一方、開始熱流束が５０Ｗ／ｍ２以下になると、自覚皮膚温度及び自覚熱流束が安定して計測できることが理解できる。 From Table 1, it can be seen that the subjective skin temperature and the subjective heat flux decrease as the starting heat flux increases (ie, as the difference between the skin temperature and the stimulation surface temperature increases). On the other hand, when the starting heat flux is 50 W / m 2 or less, it can be understood that the subjective skin temperature and the subjective heat flux can be stably measured.
Figure JPOXMLDOC01-appb-T000001
  
Figure JPOXMLDOC01-appb-T000001
  
　なお、上述のように、被験者が温覚を自覚した状態でさらに高い温度の熱刺激が付与された場合、被験者は痛覚を自覚するようになる。したがって、検査実施部２３ｂが、刺激面１１ａの温度を上昇させる過程で、被験者が入力部２４を通じて本体２０に対して痛覚を自覚した旨を通知する構成とすることで、痛覚閾値を取得することが可能になる。この場合、演算部２５は、被験者が痛覚を自覚した時点の刺激面１１ａの温度と、上述のベース温度Ｔ０との差を感覚閾値（ここでは、痛覚閾値）として算出する。 Note that, as described above, when a thermal stimulus at a higher temperature is applied while the subject is aware of the sense of temperature, the subject becomes aware of pain. Therefore, the test execution unit 23b obtains the pain threshold value by configuring the subject to notify the main body 20 of pain perception through the input unit 24 in the process of increasing the temperature of the stimulation surface 11a. Is possible. In this case, the arithmetic unit 25 subjects the temperature of the stimulation surface 11a at the time of conscious of pain, the difference sensation threshold of (in this case, the pain threshold) and base temperature T 0 of the above is calculated as.
　また、以上のような感覚閾値は、上述のベース温度Ｔ０を基準とした算出により、より安定した値として取得することができる。表２及び表３は、感覚閾値である温覚閾値及びと痛覚閾値を計測した結果を示している。ここでは、感覚障害のない４人の被験者に対して、連続的に温度が上昇する熱刺激を付与している。表２では、熱刺激の付与を開始する際に、刺激面１１ａの温度と検査部位の温度とを一致させている。表３では、熱刺激の付与を開始する際に、刺激面１１ａの温度を特定の温度（ここでは３０℃）としている。表２では、熱刺激付与を開始する際の検査部位の温度（開始皮膚温度）、熱刺激を付与する過程で温覚を自覚したときの刺激面１１ａの温度（温覚自覚温度）、熱刺激を付与する過程で痛覚を自覚したときの刺激面１１ａの温度（痛覚自覚温度）、温覚自覚温度と開始皮膚温度との差、痛覚自覚温度と開始皮膚温度との差をそれぞれ示している。同様に、表３では、熱刺激付与を開始する際の刺激面１１ａの温度（開始温度）、熱刺激を付与する過程で温覚を自覚したときの刺激面１１ａの温度（温覚自覚温度）、熱刺激を付与する過程で痛覚を自覚したときの刺激面１１ａの温度（痛覚自覚温度）、温覚自覚温度と開始温度との差、痛覚自覚温度と開始温度との差をそれぞれ示している。 Furthermore, sensory threshold, such as described above, the calculated relative to the base temperature T 0 of the above, it is possible to obtain a more stable value. Tables 2 and 3 show the results of measurement of the sensation threshold and the pain threshold. Here, thermal stimulation in which the temperature rises continuously is given to four subjects without sensory impairment. In Table 2, when the application of thermal stimulation is started, the temperature of the stimulation surface 11a is matched with the temperature of the examination site. In Table 3, when the application of thermal stimulation is started, the temperature of the stimulation surface 11a is set to a specific temperature (here, 30 ° C.). In Table 2, the temperature of the test site (starting skin temperature) when applying thermal stimulation, the temperature of the stimulation surface 11a when detecting thermal sensation in the process of applying thermal stimulation (temperature consciousness temperature), and thermal stimulation 3 shows the temperature of the stimulation surface 11a (pain perception temperature), the difference between the temperature perception temperature and the start skin temperature, and the difference between the perception perception temperature and the start skin temperature, respectively. Similarly, in Table 3, the temperature (starting temperature) of the stimulation surface 11a at the start of applying the thermal stimulus, and the temperature of the stimulation surface 11a when the thermal sense is sensed in the process of applying the thermal stimulus (temperature consciousness temperature). , The temperature of the stimulation surface 11a (pain perception temperature), the difference between the perception temperature and the start temperature, and the difference between the perception temperature and the start temperature, respectively, when the pain sensation is recognized in the process of applying thermal stimulation. .
　表２及び表３から、温覚自覚温度の計測値や痛覚自覚温度の計測値は、いずれの場合についても同程度のばらつきを有していることが理解できる。一方、表２における温覚自覚温度と開始皮膚温度との差は、表３における温覚自覚温度と開始温度との差よりも、各被験者についての値のばらつきが小さくなっていることが理解できる。同様に、表２における痛覚自覚温度と開始皮膚温度との差は、表３における痛覚自覚温度と開始温度との差よりも、各被験者についての値のばらつきが小さくなっていることが理解できる。 From Table 2 and Table 3, it can be understood that the measured value of the temperature perception temperature and the value of the temperature perception temperature have the same degree of variation in any case. On the other hand, it can be understood that the difference between the temperature perception temperature and the starting skin temperature in Table 2 is smaller in the variation of values for each subject than the difference between the temperature perception temperature and the starting temperature in Table 3. . Similarly, it can be understood that the difference between the perceived pain temperature and the starting skin temperature in Table 2 is smaller than the difference between the perceived pain temperature and the starting temperature in Table 3 for each subject.
　以上の結果は、上述のベース温度Ｔ０を基準として温覚閾値や痛覚閾値を算出することで、各被験者間でばらつきの少ないより安定した値を取得できることを示している。また、別の見方をすれば、温覚閾値、痛覚閾値のばらつきが少ないということは、付与された熱刺激を各被験者が同程度の刺激として自覚していることになる。したがって、特定の温度を基準とした温度差を熱刺激として設定する場合に比べて、開始皮膚温度を基準とした温度差を熱刺激として設定する方が、感覚障害のない被験者が同程度の温覚刺激や痛覚刺激として感じる刺激をより安定して付与できるといえる。 As a result, by calculating the Warm threshold and pain threshold relative to the base temperature T 0 of the above show that it is possible to obtain a stable value with less variation among subjects. From another viewpoint, the fact that the variation in the warmth threshold and the pain threshold is small means that each subject is aware of the applied thermal stimulus as a similar stimulus. Therefore, compared to setting a temperature difference based on a specific temperature as a thermal stimulus, a subject with no sensory impairment has a similar temperature when setting a temperature difference based on the starting skin temperature as a thermal stimulus. It can be said that a stimulus that is felt as a sensation stimulus or a pain sensation can be applied more stably.
Figure JPOXMLDOC01-appb-T000002
Figure JPOXMLDOC01-appb-T000002
Figure JPOXMLDOC01-appb-T000003
Figure JPOXMLDOC01-appb-T000003
　また、以上では、検査部位の温度と刺激面１１ａの温度とを一致させた上で、検査部位の温度から連続的に温度が上昇する熱刺激を付与する構成について説明したが、図２（ｂ）に示すような、検査部位の温度から連続的に温度が下降する熱刺激を付与する構成とすることもできる。この構成では、検査実施部２３ｂが、刺激面１１ａの温度を下降させる過程で、被験者が入力部２４を通じて本体２０に対して冷覚を自覚した旨を通知する構成とすることで、冷覚閾値を取得することが可能になる。この場合、演算部２５は、被験者が冷覚を自覚した時点の刺激面１１ａの温度と、上述のベース温度Ｔ０との差を冷覚閾値として算出する。同様に、検査実施部２３ｂが、刺激面１１ａの温度を下降させる過程で、被験者が入力部２４を通じて本体２０に対して痛覚を自覚した旨を通知する構成とすることで、痛覚閾値を取得することが可能になる。この場合、演算部２５は、上述のベース温度Ｔ０と被験者が痛覚を自覚した時点の刺激面１１ａの温度との差を痛覚閾値として算出する。なお、上述の説明では、連続的に温度が上昇又は下降する熱刺激の単位時間あたりの温度変化率を一定としたが、単位時間あたりの温度変化率が経過時間とともに増大する、あるいは、単位時間あたりの温度変化率が経過時間とともに減少する熱刺激を用いてもよい。 In the above description, the configuration is described in which the temperature of the examination site is matched with the temperature of the stimulation surface 11a, and then the thermal stimulation is applied in which the temperature continuously rises from the temperature of the examination site. It is also possible to apply a thermal stimulus in which the temperature continuously decreases from the temperature of the examination site as shown in FIG. In this configuration, the test execution unit 23b notifies the main body 20 that the subject has sensed cold through the input unit 24 in the process of lowering the temperature of the stimulation surface 11a, whereby the cold threshold is set. It becomes possible to get. In this case, the arithmetic unit 25 calculates the temperature of the stimulation surface 11a at the time the subject was aware of the cold sensation, the difference between the base temperature T 0 of the above as a cold sensation threshold. Similarly, the test execution unit 23b obtains a pain threshold by notifying the main body 20 that the subject has noticed pain through the input unit 24 in the process of lowering the temperature of the stimulation surface 11a. It becomes possible. In this case, the calculation unit 25 calculates the difference between the above-described base temperature T 0 and the temperature of the stimulation surface 11a at the time when the subject senses pain as a pain threshold. In the above description, the temperature change rate per unit time of thermal stimulation in which the temperature continuously rises or falls is constant, but the temperature change rate per unit time increases with the elapsed time or unit time A thermal stimulus in which the rate of change in temperature per hour decreases with time may be used.
　また、検査実施部２３ｂが、図２（ａ）、図２（ｂ）に示すような、温度が連続的に上昇又は下降する熱刺激はではなく、図２（ｃ）、図２（ｄ）に示すような、温度が段階的に上昇又は下降する熱刺激を付与する構成であってもよい。段階的に温度上昇する熱刺激は、例えば、ベース温度Ｔ０に対して予め指定された温度差を順次加算した複数の設定温度を算出し、刺激面１１ａの温度を、予め指定された時間の間ずつ、算出した各温度で維持することで実現可能である。同様に、段階的に温度下降する熱刺激は、例えば、ベース温度Ｔ０から予め指定された温度差を順次減算した複数の設定温度を算出し、刺激面１１ａの温度を、予め指定された時間の間ずつ、算出した各温度で維持することで実現可能である。なお、図２（ｃ）、図２（ｄ）では、ベース温度Ｔ０に対して順次加算又は減算する温度差が同一である例を示しているが、順次加算又は順次減算する温度差が異なってもよい。また、加算と減算とが混在する構成（すなわち、温度上昇と温度下降が混在する構成）であってもよい。同様に、図２（ｃ）、図２（ｄ）では、刺激面１１ａの温度を算出されたそれぞれの温度に維持する時間が同一である例を示しているが、温度を維持する時間が異なってもよい。以上のような、設定温度の演算は演算部２５が実施する構成を採用すればよい。 In addition, the examination execution unit 23b does not perform thermal stimulation in which the temperature continuously rises or falls as shown in FIGS. 2A and 2B, but FIGS. 2C and 2D. The structure which gives the thermal stimulus which temperature rises or falls in steps as shown in FIG. For example, the thermal stimulation in which the temperature rises stepwise calculates, for example, a plurality of set temperatures obtained by sequentially adding a predetermined temperature difference with respect to the base temperature T 0 , and the temperature of the stimulation surface 11 a is determined for a predetermined time. This can be achieved by maintaining the calculated temperatures at intervals. Similarly, for the thermal stimulation in which the temperature falls stepwise, for example, a plurality of set temperatures obtained by sequentially subtracting a temperature difference designated in advance from the base temperature T 0 are calculated, and the temperature of the stimulation surface 11a is calculated for a time designated in advance. This can be achieved by maintaining each calculated temperature at each temperature. 2C and 2D show examples in which the temperature difference sequentially added or subtracted with respect to the base temperature T 0 is the same, but the temperature difference sequentially added or subtracted is different. May be. Further, a configuration in which addition and subtraction are mixed (that is, a configuration in which a temperature increase and a temperature decrease are mixed) may be employed. Similarly, FIGS. 2C and 2D show examples in which the time for maintaining the temperature of the stimulation surface 11a at the calculated temperatures is the same, but the time for maintaining the temperature is different. May be. A configuration in which the calculation unit 25 performs the calculation of the set temperature as described above may be employed.
　このように、ベース温度Ｔ０を基準とした温度差として熱刺激を設定することで、上述のように、各被験者の検査部位に対して被験者が同程度と感じる刺激をより安定して付与することが可能となる。 In this way, by setting the thermal stimulus as a temperature difference with reference to the base temperature T 0 , the stimulus that the subject feels to the same degree is more stably applied to the test site of each subject as described above. It becomes possible.
　次いで、図４に示すような、連続的に温度が上昇する熱刺激と連続的に温度が下降する熱刺激とを繰り返し付与する状況下で感覚閾値を計測する事例（すなわち、温覚閾値と冷覚閾値とを交互に複数回続けて計測する事例）について説明する。 Next, as shown in FIG. 4, a sensory threshold is measured in a situation where a thermal stimulus with a continuously rising temperature and a thermal stimulus with a continuously decreasing temperature are repeatedly applied (that is, a warm threshold and a cold threshold). A case in which the sensation threshold value is measured alternately and continuously will be described.
　図５は、当該感覚閾値の計測方法を示すフロー図である。当該フローは、被験者の検査部位が刺激面１１ａに接触された状態で、図示しない検査開始ボタンを通じて本体２０に検査開始指示が入力されたことをトリガとして進行する。 FIG. 5 is a flowchart showing the sensory threshold measurement method. The flow proceeds as a trigger when a test start instruction is input to the main body 20 through a test start button (not shown) in a state where the test site of the subject is in contact with the stimulation surface 11a.
　検査開始指示が入力されると、基準調整部２３ａは、上述した手法により、刺激面１１ａの温度と検査部位の温度とを一致させる（図５　ステップＳ５０１Ｎｏ）。当該処理が完了すると、基準調整部２３ａは、検査実施部２３ｂ及び演算部２５にその旨を通知する（図５　ステップＳ５０１Ｙｅｓ）。このとき、演算部２５は、温度取得部２２を通じて刺激面１１ａの温度をベース温度Ｔ０として取得する。 When the examination start instruction is input, the reference adjusting unit 23a matches the temperature of the stimulation surface 11a with the temperature of the examination site by the above-described method (No in step S501 in FIG. 5). When the process is completed, the reference adjustment unit 23a notifies the inspection execution unit 23b and the calculation unit 25 (Yes in step S501). At this time, the arithmetic unit 25 acquires the temperature of the stimulation surface 11a as a base temperature T 0 through temperature acquiring unit 22.
　基準調整部２３ａから上述の通知が入力された検査実施部２３ｂは、刺激面１１ａの温度を上昇させる（図５　ステップＳ５０２）。刺激面１１ａの温度が上昇する過程で、被験者が温覚を自覚した場合、被験者は入力部２４を通じて本体２０に対して温覚を自覚した旨を通知する（図５　ステップＳ５０３Ｎｏ、Ｓ５０３Ｙｅｓ）。 The examination execution unit 23b to which the above notification is input from the reference adjustment unit 23a increases the temperature of the stimulation surface 11a (step S502 in FIG. 5). When the subject becomes aware of warm sensation in the process of increasing the temperature of the stimulation surface 11a, the subject notifies the main body 20 that he / she has sensed warm sensation through the input unit 24 (No in steps S503 and S503 in FIG. 5).
　温覚の自覚が通知されると、演算部２５は、温度取得部２２を通じて刺激面１１ａの温度を取得する。そして、演算部２５は、被験者が温覚を自覚した時点の刺激面１１ａの温度と上述のベース温度Ｔ０との差を温覚閾値として算出する（図５　ステップＳ５０４）。 When the awareness of the warm sense is notified, the calculation unit 25 acquires the temperature of the stimulation surface 11 a through the temperature acquisition unit 22. Then, the arithmetic unit 25 calculates the difference between the base temperatures T 0 temperature above the stimulation surface 11a at the time the subject was aware of Warm as Warm threshold (Fig. 5 step S504).
　また、温覚の自覚が通知されると、検査実施部２３ｂは、刺激面１１ａの温度を温度上昇から温度下降に切り替える（図５　ステップＳ５０５、Ｓ５０６Ｎｏ）。刺激面１１ａの温度が下降する過程で、被験者が冷覚を自覚した場合、被験者は入力部２４を通じて本体２０に対して冷覚を自覚した旨を通知する（図５　ステップＳ５０３Ｎｏ、Ｓ５０３Ｙｅｓ）。 In addition, when the awareness of the temperature sensation is notified, the examination execution unit 23b switches the temperature of the stimulation surface 11a from the temperature increase to the temperature decrease (No in steps S505 and S506 in FIG. 5). When the subject is aware of cold sensation in the process of the temperature of the stimulation surface 11a decreasing, the subject notifies the main body 20 of the sense of cold through the input unit 24 (No in steps S503 and S503 in FIG. 5).
　冷覚の自覚が通知されると、演算部２５は、温度取得部２２を通じて刺激面１１ａの温度を取得する。そして、演算部２５は、上述のベース温度Ｔ０と被験者が冷覚を自覚した時点の刺激面１１ａの温度との差を冷覚閾値として算出する（図５　ステップＳ５０４）。 When notified of the cold sensation, the calculation unit 25 acquires the temperature of the stimulation surface 11 a through the temperature acquisition unit 22. Then, the arithmetic unit 25 calculates the difference between the temperature of the stimulation surface 11a at which the base temperature T 0 and the subject described above is aware of cold sensation as cold sensation threshold (Fig. 5 step S504).
　また、冷覚の自覚が通知されると、検査実施部２３ｂは、刺激面１１ａの温度を温度下降から温度上昇に切り替える（図５　ステップＳ５０５、Ｓ５０６Ｎｏ）。刺激面１１ａの温度が上昇する過程で、被験者が温覚を自覚した場合、被験者は入力部２４を通じて本体２０に対して温覚を自覚した旨を通知する（図５　ステップＳ５０３Ｎｏ、Ｓ５０３Ｙｅｓ）。 In addition, when notification of cold sensation is notified, the examination execution unit 23b switches the temperature of the stimulation surface 11a from a temperature decrease to a temperature increase (No in steps S505 and S506 in FIG. 5). When the subject becomes aware of warm sensation in the process of increasing the temperature of the stimulation surface 11a, the subject notifies the main body 20 that he / she has sensed warm sensation through the input unit 24 (No in steps S503 and S503 in FIG. 5).
　温覚の自覚が通知されると、演算部２５は、温度取得部２２を通じて刺激面１１ａの温度を取得し、上述のとおり温覚閾値を算出する（図５　ステップＳ５０４）。 When the awareness of the warm sense is notified, the calculation unit 25 acquires the temperature of the stimulation surface 11a through the temperature acquisition unit 22, and calculates the temperature threshold value as described above (step S504 in FIG. 5).
　検査実施部２３ｂは、以上のような、連続的な温度上昇の熱刺激と、連続的な温度下降の熱刺激との切替を予め指定された回数だけ実施する。切替回数が予め指定された回数に到達した場合、検査実施部２３ｂは、温度調整素子１２への電力供給を停止する（図５　ステップＳ５０５、Ｓ５０６Ｙｅｓ）。 The inspection execution unit 23b performs switching between the continuous thermal increase thermal stimulation and the continuous thermal decrease thermal stimulation as described above a predetermined number of times. When the number of times of switching reaches the number of times designated in advance, the inspection execution unit 23b stops the power supply to the temperature adjustment element 12 (steps S505 and S506 in FIG. 5).
　以上のように、この事例では、検査実施部２３ｂは、基準調整部２３ａにより刺激面１１ａの温度と検査部位の温度とが一致した状態から温度調整素子１２を制御することにより刺激面１１ａの温度を上昇又は下降させた後、入力部２４を通じて被験者による入力がなされる都度、刺激面１１ａの温度上昇と温度下降とを切り替える。このような一連の熱刺激により検査部位が熱刺激に慣れた状態での感覚閾値を取得することができる。 As described above, in this case, the examination execution unit 23b controls the temperature adjustment element 12 from the state in which the temperature of the stimulation surface 11a and the temperature of the examination site coincide with each other by the reference adjustment unit 23a. After raising or lowering, each time an input is made by the subject through the input unit 24, the temperature of the stimulation surface 11a is switched between increasing and decreasing. By such a series of thermal stimulations, it is possible to acquire a sensory threshold value in a state where the examination site is used to the thermal stimulation.
　この種の検査では、熱刺激の付与を開始する時点で検査部位の温度と刺激面１１ａの温度とに温度差があると、計測した温覚閾値及び冷覚閾値のばらつきが大きくなる傾向（温覚閾値の平均値と冷覚閾値の平均値との差が大きくなる傾向）にある。ばらつきが大きい場合、定量性が低下する上、温覚閾値と冷覚閾値の差が大きくなる結果、検査時間も長くなってしまう。 In this type of examination, if there is a temperature difference between the temperature of the examination site and the temperature of the stimulation surface 11a at the start of applying thermal stimulation, the measured warm threshold and cold threshold tend to vary widely (warm temperature). The difference between the average value of the sensation threshold and the average value of the cold sensation threshold tends to increase). When the variation is large, the quantitative property is lowered, and the difference between the warm threshold and the cold threshold is increased, resulting in a longer examination time.
　図６は、本実施形態における感覚閾値の計測方法と温度センサを使用した計測方法との比較例を示す図である。図６において横軸が経過時間に対応し、縦軸が温度に対応する。本実施形態における感覚閾値の計測方法を実線で示し、温度センサを使用した計測方法を破線及び一点鎖線で示している。図６の例では、温覚閾値の計測と冷覚閾値の計測とを５回繰り返している。なお、ここでは、熱刺激の付与を開始する時点で検査部位の温度と刺激面１１ａの温度とに温度差の影響を説明するため、温度センサを使用した計測方法では、当該温度差を大きくしている。図６より、比較例は、本実施形態における感覚閾値の計測方法に比べて被験者が自覚した感覚閾値のばらつきが大きく、本実施形態における感覚閾値の計測方法に比べて検査時間が長くなっていることが理解できる。すなわち、本実施形態における感覚閾値の計測方法は、温度センサを使用した計測方法に比べて、検査部位の温度と刺激面１１ａの温度とを一致させる際の時間と、検査時間自体が短くなり、かつ、ばらつきの少ない安定した計測ができるといえる。 FIG. 6 is a diagram showing a comparative example of the sensory threshold measurement method and the measurement method using a temperature sensor in the present embodiment. In FIG. 6, the horizontal axis corresponds to the elapsed time, and the vertical axis corresponds to the temperature. The sensory threshold measurement method in the present embodiment is indicated by a solid line, and the measurement method using a temperature sensor is indicated by a broken line and a one-dot chain line. In the example of FIG. 6, the measurement of the warm threshold and the measurement of the cold threshold are repeated five times. Here, in order to explain the influence of the temperature difference on the temperature of the examination site and the temperature of the stimulation surface 11a at the time when the application of thermal stimulation is started, in the measurement method using the temperature sensor, the temperature difference is increased. ing. From FIG. 6, in the comparative example, the variation of the sensory threshold perceived by the subject is larger than the sensory threshold measurement method in the present embodiment, and the examination time is longer than the sensory threshold measurement method in the present embodiment. I understand that. That is, the sensory threshold value measurement method in the present embodiment has a shorter time for matching the temperature of the examination site and the temperature of the stimulation surface 11a than the measurement method using the temperature sensor, and the examination time itself. In addition, it can be said that stable measurement with little variation is possible.
　続いて、図７に示すような、連続的に温度が上昇する熱刺激の付与を複数回実施した後、連続的に温度が下降する熱刺激の付与を複数回実施する状況下で感覚閾値を計測する事例（すなわち、温覚閾値を複数回続けて計測した後、冷覚閾値を複数回続けて計測する事例）について説明する。 Subsequently, as shown in FIG. 7, the sensory threshold value is set in a situation where the thermal stimulation is continuously applied with the temperature rising a plurality of times, and then the thermal stimulation is continuously applied with the temperature decreasing a plurality of times. A case where measurement is performed (that is, a case where the cold threshold is continuously measured a plurality of times after the temperature threshold is continuously measured a plurality of times) will be described.
　図８は、当該感覚閾値の計測方法を示すフロー図である。当該フローは、被験者の検査部位が刺激面１１ａに接触された状態で、図示しない検査開始ボタンを通じて本体２０に検査開始指示が入力されたことをトリガとして進行する。 FIG. 8 is a flowchart showing the sensory threshold measurement method. The flow proceeds as a trigger when a test start instruction is input to the main body 20 through a test start button (not shown) in a state where the test site of the subject is in contact with the stimulation surface 11a.
　検査開始指示が入力されると、基準調整部２３ａは、上述した手法により、刺激面１１ａの温度と検査部位の温度とを一致させる（図８　ステップＳ８０１Ｎｏ）。当該処理が完了すると、基準調整部２３ａは、検査実施部２３ｂ及び演算部２５にその旨を通知する（図８　ステップＳ８０１Ｙｅｓ）。このとき、演算部２５は、温度取得部２２を通じて刺激面１１ａの温度をベース温度Ｔ０として取得する。 When the examination start instruction is input, the reference adjusting unit 23a matches the temperature of the stimulation surface 11a with the temperature of the examination site by the above-described method (No in step S801 in FIG. 8). When the processing is completed, the reference adjustment unit 23a notifies the inspection execution unit 23b and the calculation unit 25 (Yes in step S801 in FIG. 8). At this time, the arithmetic unit 25 acquires the temperature of the stimulation surface 11a as a base temperature T 0 through temperature acquiring unit 22.
　基準調整部２３ａから上述の通知が入力された検査実施部２３ｂは、刺激面１１ａの温度を上昇させる（図８　ステップＳ８０２）。刺激面１１ａの温度が上昇する過程で、被験者が温覚を自覚した場合、被験者は入力部２４を通じて本体２０に対して温覚を自覚した旨を通知する（図８　ステップＳ８０３Ｎｏ、Ｓ８０３Ｙｅｓ）。 The examination execution unit 23b to which the above notification is input from the reference adjustment unit 23a increases the temperature of the stimulation surface 11a (step S802 in FIG. 8). When the subject becomes aware of the temperature sensation in the process of increasing the temperature of the stimulation surface 11a, the subject notifies the main body 20 of the sense of temperature sensation through the input unit 24 (No in steps S803 and S803 in FIG. 8).
　温覚の自覚が通知されると、演算部２５は、温度取得部２２を通じて刺激面１１ａの温度を取得する。そして、演算部２５は、被験者が温覚を自覚した時点の刺激面１１ａの温度と上述のベース温度Ｔ０との差を温覚閾値として算出する（図８　ステップＳ８０４）。 When the awareness of the warm sense is notified, the calculation unit 25 acquires the temperature of the stimulation surface 11 a through the temperature acquisition unit 22. Then, the arithmetic unit 25 calculates the difference between the temperature of the stimulation surface 11a at the time the subject was aware of the warmth and base temperature T 0 of the above as Warm threshold (FIG. 8 step S804).
　また、温覚の自覚が通知されると、検査実施部２３ｂは、基準調整部２３ａに刺激面１１ａの温度を検査部位の温度と一致させるように指示する。当該指示を受けた基準調整部２３ａは、上述した手法により、刺激面１１ａの温度と検査部位の温度とを一致させる（図８　ステップＳ８０５Ｎｏ、Ｓ８０１Ｎｏ）。当該処理が完了すると、基準調整部２３ａは、検査実施部２３ｂ及び演算部２５にその旨を通知する（図８　ステップＳ８０１Ｙｅｓ）。このとき、演算部２５は、温度取得部２２を通じて刺激面１１ａの温度を新たなベース温度Ｔ０として取得する。 In addition, when the awareness of the warm sense is notified, the examination execution unit 23b instructs the reference adjustment unit 23a to match the temperature of the stimulation surface 11a with the temperature of the examination site. Receiving the instruction, the reference adjusting unit 23a matches the temperature of the stimulation surface 11a with the temperature of the examination site by the above-described method (steps S805 No and S801 No in FIG. 8). When the processing is completed, the reference adjustment unit 23a notifies the inspection execution unit 23b and the calculation unit 25 (Yes in step S801 in FIG. 8). At this time, the arithmetic unit 25 acquires the temperature of the stimulation surface 11a as a new base temperature T 0 through temperature acquiring unit 22.
　基準調整部２３ａから上述の通知が入力された検査実施部２３ｂは、刺激面１１ａの温度を上昇させる（図８　ステップＳ８０２）。この過程で、被験者が温覚を自覚した場合、被験者は入力部２４を通じて本体２０に対して温覚を自覚した旨を通知する（図８　ステップＳ８０３Ｎｏ、Ｓ８０３Ｙｅｓ）。 The examination execution unit 23b to which the above notification is input from the reference adjustment unit 23a increases the temperature of the stimulation surface 11a (step S802 in FIG. 8). In this process, when the subject is aware of the temperature sensation, the subject notifies the main body 20 of the sense of temperature sensation through the input unit 24 (No in steps S803 and S803 in FIG. 8).
　温覚の自覚が通知されると、演算部２５は、温度取得部２２を通じて刺激面１１ａの温度を取得する。そして、演算部２５は、被験者が温覚を自覚した時点の刺激面１１ａの温度と上述の新たなベース温度Ｔ０との差を温覚閾値として算出する（図８　ステップＳ８０４）。 When the awareness of the warm sense is notified, the calculation unit 25 acquires the temperature of the stimulation surface 11 a through the temperature acquisition unit 22. Then, the arithmetic unit 25 calculates the difference between subjects and temperature stimuli surface 11a at the time of conscious of warmth as a new base temperature T 0 of the above as Warm threshold (FIG. 8 step S804).
　検査実施部２３ｂは、以上のような、温覚閾値の計測を予め指定された回数だけ実施する。予め指定された回数に到達した場合、検査実施部２３ｂは、熱刺激をベース温度から連続的に温度が下降する熱刺激を用いた同様の手法により、冷覚閾値の計測を予め指定された回数だけ実施する。予め指定された回数に到達した場合、温度調整素子１２への電力供給を停止する（図８　ステップＳ８０５Ｙｅｓ）。 The examination execution unit 23b performs the temperature threshold measurement as described above for the number of times designated in advance. When the number of times specified in advance is reached, the examination execution unit 23b performs the number of times specified in advance to measure the cold sensation threshold by the same method using the heat stimulation in which the temperature continuously decreases from the base temperature. Just implement. When the number of times designated in advance is reached, the power supply to the temperature adjustment element 12 is stopped (FIG. 8, step S805 Yes).
　以上のように、この事例では、基準調整部２３ａは、入力部２４を通じて被験者による入力がなされる都度、熱流センサ１１により検知される熱流束が予め指定された範囲内となる状態に温度調整素子１２を制御することにより、刺激面１１ａの温度と検査部位の温度とを一致させる。このような一連の熱刺激により、温覚閾値及び冷覚閾値をそれぞれ複数回計測する検査を短時間で実施することが可能となる。 As described above, in this case, the reference adjustment unit 23a is configured so that the heat flux detected by the heat flow sensor 11 is within a predesignated range each time input by the subject is made through the input unit 24. 12 is made to match the temperature of the stimulation surface 11a with the temperature of the examination site. By such a series of thermal stimulation, it is possible to perform a test in which the warm threshold and the cold threshold are measured a plurality of times in a short time.
　以上説明したように、皮膚感覚刺激装置１００では、熱流センサ１１により検知される熱流束に基づいて、刺激面１１ａの温度と検査部位の温度とを同一にしている。本構成では、短時間で高精度に刺激面１１ａの温度と検査部位の温度とを一致させることができる。その結果、定量的でより再現性の高い検査をより短時間で実現することができる。 As described above, in the skin sensation stimulating device 100, the temperature of the stimulation surface 11a and the temperature of the examination site are made the same based on the heat flux detected by the heat flow sensor 11. In this configuration, the temperature of the stimulation surface 11a and the temperature of the examination site can be matched with high accuracy in a short time. As a result, quantitative and more reproducible inspection can be realized in a shorter time.
　なお、上述した実施形態は本発明の技術的範囲を制限するものではなく、既に記載したもの以外でも、本発明の範囲内で種々の変形や応用が可能である。例えば、上記実施形態では、演算部２５は、痛覚閾値を、被験者が痛覚を自覚した時点の刺激面の温度とベース温度Ｔ０との差により算出する構成を例示したが、被験者が痛覚を自覚した時点の刺激面の温度と、被験者が温覚又は冷覚を自覚した時点の刺激面の温度との差を痛覚閾値として算出してもよい。すなわち、図２（ａ）に示すような、連続的に温度が上昇する熱刺激を付与する状況下では、被験者が入力部２４を通じて本体２０に対して温覚を自覚した旨を通知した後も温度上昇を継続し、被験者が入力部２４を通じて本体２０に対して痛覚を自覚した旨を通知する構成とする。そして、演算部２５は、被験者が痛覚を自覚した時点の刺激面１１ａの温度と、被験者が温覚を自覚した時点の刺激面１１ａの温度との差を痛覚閾値として算出する。このような構成によれば、Ｃ線維を伝わるslow painについて、自覚可能な刺激を基準として痛みを感じる刺激の大きさを定量的に評価することができる。 The above-described embodiments do not limit the technical scope of the present invention, and various modifications and applications other than those already described are possible within the scope of the present invention. For example, in the above embodiment, the calculation unit 25 exemplifies a configuration in which the pain threshold is calculated based on the difference between the temperature of the stimulation surface when the subject is aware of pain and the base temperature T 0 , but the subject is aware of pain. The difference between the temperature of the stimulation surface at the time of the stimulation and the temperature of the stimulation surface when the subject is aware of the warm or cold sensation may be calculated as the pain threshold. That is, under the situation where a thermal stimulus that continuously increases in temperature as shown in FIG. 2A is applied, even after the subject has notified the main body 20 of the sense of temperature through the input unit 24. The temperature rise is continued, and the subject notifies the main body 20 of the pain perception through the input unit 24. And the calculating part 25 calculates the difference of the temperature of the stimulation surface 11a when a test subject is aware of pain sensation, and the temperature of the stimulation surface 11a when a test subject is aware of warm sense as a pain threshold value. According to such a configuration, the magnitude of a stimulus that feels pain can be quantitatively evaluated with respect to the slow pain transmitted through the C fiber based on a stimulus that can be perceived.
　同様に、図２（ｂ）に示すような、連続的に温度が下降する熱刺激を付与する状況下では、被験者が入力部２４を通じて本体２０に対して冷覚を自覚した旨を通知した後も温度下降を継続し、被験者が入力部２４を通じて本体２０に対して痛覚を自覚した旨を通知する構成とする。そして、演算部２５は、被験者が痛覚を自覚した時点の刺激面１１ａの温度と、被験者が冷覚を自覚した時点の刺激面１１ａの温度との差を痛覚閾値として算出する。このような構成によれば、Ａδ線維を伝わるfast painについて、自覚可能な刺激を基準として痛みを感じる刺激の大きさを定量的に評価することができる。 Similarly, after applying a thermal stimulus to the main body 20 through the input unit 24 in a situation in which a thermal stimulus in which the temperature continuously decreases as shown in FIG. In addition, the temperature continues to decrease, and the subject notifies the main body 20 of the pain through the input unit 24. And the calculating part 25 calculates the difference of the temperature of the stimulation surface 11a when a test subject is aware of pain sensation, and the temperature of the stimulation surface 11a when a test subject is aware of cold sensation as a pain threshold value. According to such a configuration, it is possible to quantitatively evaluate the magnitude of a stimulus that feels pain on the basis of a stimulus that can be perceived with respect to fast pain transmitted through Aδ fibers.
　また、上記実施形態では、特に好ましい形態として、演算部２５を備える構成としたが、演算部２５を備えることは必須ではない。例えば、被験者が温覚、冷覚、又は痛覚を自覚したときの刺激面１１ａの温度のみを出力する構成とし、感覚閾値を算出する演算を別途行う構成であってよい。さらに、入力部２４を備えることも必須ではない。この場合、例えば、本体２０に刺激面１１ａの温度を表示する表示部を設けるとともに、被験者が温覚、冷覚、又は痛覚を自覚したときに、表示部に表示されている温度を試験者（オペレータ）が記録する構成とすることができる。また、表示部に特定の温度、あるいは、ベース温度Ｔ０と特定の温度差を有する温度が表示されているときに、被験者が温覚、冷覚、又は痛覚の程度を口頭で回答する構成とすることもできる。 Moreover, in the said embodiment, although it was set as the structure provided with the calculating part 25 as a particularly preferable form, providing the calculating part 25 is not essential. For example, it may be configured to output only the temperature of the stimulation surface 11a when the subject is aware of warm sensation, cold sensation, or pain sensation, and may be configured to separately perform a calculation for calculating a sensory threshold. Furthermore, it is not essential to provide the input unit 24. In this case, for example, a display unit that displays the temperature of the stimulation surface 11a is provided on the main body 20, and when the subject is aware of warm sensation, cold sensation, or pain sensation, the temperature displayed on the display unit is determined by the tester ( It is possible to adopt a configuration in which an operator) records. In addition, when a specific temperature or a temperature having a specific temperature difference from the base temperature T 0 is displayed on the display unit, the test subject verbally answers the degree of warm sensation, cold sensation, or pain sensation You can also
　また、図３、図５、図８に示すフロー図は、等価な作用を奏する範囲において各ステップの順序を適宜変更可能である。例えば、図５、図８に示すフロー図では、被験者による入力部を通じた入力がある度に感覚閾値を算出する構成としたが、感覚閾値を算出する演算は任意のタイミングで一括して行ってもよい。 In addition, in the flowcharts shown in FIGS. 3, 5, and 8, the order of the steps can be changed as appropriate within the range where the equivalent action is achieved. For example, in the flowcharts shown in FIGS. 5 and 8, the sensory threshold value is calculated every time there is an input by the subject through the input unit. However, the calculation for calculating the sensory threshold value is performed collectively at an arbitrary timing. Also good.
　さらに、図４、図７に示す熱刺激のプロファイルはあくまで例示であり、例えば、図２（ａ）から図２（ｄ）に例示したそれぞれのプロファイルを図４、図７に示す各回の熱刺激のプロファイルとして使用することも可能である。 Further, the thermal stimulation profiles shown in FIGS. 4 and 7 are merely examples. For example, the respective profiles illustrated in FIGS. 2A to 2D are represented by the thermal stimulations shown in FIGS. It is also possible to use as a profile.
　本発明によれば、定量的でより再現性の高い検査をより短時間で実現することができ、皮膚感覚刺激装置及び感覚閾値の計測方法として有用である。 According to the present invention, a quantitative and more reproducible test can be realized in a shorter time, which is useful as a skin sensory stimulation device and a sensory threshold measurement method.
　１０　プローブ
　１１　熱流センサ
　１１ａ　刺激面
　１２　温度調整素子
　２１　熱流取得部
　２２　温度取得部
　２３　温度制御部
　２３ａ　基準調整部
　２３ｂ　検査実施部
　２３ｃ　電源部
　２４　入力部
　２５　演算部
　３０　検査部位 DESCRIPTION OF SYMBOLS 10 Probe 11 Heat flow sensor 11a Stimulation surface 12 Temperature adjustment element 21 Heat flow acquisition part 22 Temperature acquisition part 23 Temperature control part 23a Reference adjustment part 23b Inspection execution part 23c Power supply part 24 Input part 25 Calculation part 30 Inspection part

Claims (7)

  1. 　被験者の皮膚面の検査部位に対して熱刺激を付与する皮膚感覚刺激装置であって、
    　前記検査部位に対向して配置され、前記検査部位に前記熱刺激を付与する刺激面と、
    　前記刺激面を通過する熱流束を検知する熱流センサと、
    　前記刺激面の温度を上昇又は下降させる温度調整素子と、
    　前記熱流センサにより検知される熱流束が予め指定された範囲内となる状態に前記温度調整素子を制御することにより、前記刺激面の温度と前記検査部位の温度とを一致させる基準調整部と、
    　前記基準調整部により前記刺激面の温度と前記検査部位の温度とが一致した状態から前記温度調整素子を制御することにより前記刺激面の温度を上昇又は下降させる検査実施部と、
    を備える皮膚感覚刺激装置。     A skin sensation stimulating device that applies thermal stimulation to an examination site on the skin surface of a subject,
    A stimulation surface that is disposed opposite to the examination site and that applies the thermal stimulation to the examination site;
    A heat flow sensor for detecting a heat flux passing through the stimulation surface;
    A temperature adjusting element for increasing or decreasing the temperature of the stimulation surface;
    A reference adjustment unit that matches the temperature of the stimulation surface and the temperature of the examination site by controlling the temperature adjustment element so that the heat flux detected by the heat flow sensor falls within a predetermined range; and
    An examination execution unit that raises or lowers the temperature of the stimulation surface by controlling the temperature adjustment element from a state in which the temperature of the stimulation surface and the temperature of the examination site coincide with each other by the reference adjustment unit;
    A skin sensation stimulator comprising:
  2. 　前記被験者が温覚、冷覚、又は痛覚を自覚した旨を入力する入力部をさらに備え、
    　前記検査実施部は、前記基準調整部により前記刺激面の温度と前記検査部位の温度とが一致した状態から前記温度調整素子を制御することにより前記刺激面の温度を上昇又は下降させた後、前記入力部を通じて前記被験者による入力がなされる都度、前記刺激面の温度上昇と温度下降とを切り替える、請求項１記載の皮膚感覚刺激装置。     Further comprising an input unit for inputting that the subject is aware of warm sensation, cold sensation, or pain sensation,
    The examination execution unit increases or decreases the temperature of the stimulation surface by controlling the temperature adjustment element from a state in which the temperature of the stimulation surface and the temperature of the examination site coincide with each other by the reference adjustment unit, The skin sensation stimulation device according to claim 1, wherein each time an input is made by the subject through the input unit, a temperature increase and a temperature decrease of the stimulation surface are switched.
  3. 　前記被験者が温覚、冷覚、又は痛覚を自覚した旨を入力する入力部をさらに備え、
    　前記基準調整部は、前記入力部を通じて前記被験者による入力がなされる都度、前記熱流センサにより検知される熱流束が予め指定された範囲内となる状態に前記温度調整素子を制御することにより、前記刺激面の温度と前記検査部位の温度とを一致させる、請求項１記載の皮膚感覚刺激装置。     Further comprising an input unit for inputting that the subject is aware of warm sensation, cold sensation, or pain sensation,
    The reference adjustment unit controls the temperature adjustment element so that the heat flux detected by the heat flow sensor is within a predetermined range each time an input is made by the subject through the input unit. The skin sensation stimulating apparatus according to claim 1, wherein the temperature of the stimulation surface is matched with the temperature of the examination site.
  4. 　前記刺激面の温度を取得する温度取得部と、
    　前記被験者が温覚、冷覚、又は痛覚を自覚した時点の前記刺激面の温度と、前記基準調整部により前記刺激面の温度と前記検査部位の温度とが一致した状態における前記刺激面の温度との差、あるいは前記被験者が痛覚を自覚した時点の前記刺激面の温度と、前記被験者が温覚又は冷覚を自覚した時点の前記刺激面の温度との差を感覚閾値として算出する演算部と、
    をさらに備える、請求項１から請求項３のいずれか１項に記載の皮膚感覚刺激装置。     A temperature acquisition unit for acquiring the temperature of the stimulation surface;
    The temperature of the stimulation surface when the temperature of the stimulation surface coincides with the temperature of the stimulation surface when the subject is aware of warm sensation, cold sensation, or pain sensation, and the reference adjustment unit. Or the difference between the temperature of the stimulation surface when the subject is aware of pain and the temperature of the stimulation surface when the subject is aware of warm or cold as a sensory threshold When,
    The skin sensation stimulator according to any one of claims 1 to 3, further comprising:
  5. 　前記刺激面の温度を取得する温度取得部をさらに備え、
    　前記検査実施部は、前記基準調整部により前記刺激面の温度と前記検査部位の温度とが一致した状態における前記刺激面の温度に対して予め指定された温度差を加算した温度に前記刺激面の温度を上昇又は下降させる、請求項１記載の皮膚感覚刺激装置。     A temperature acquisition unit for acquiring the temperature of the stimulation surface;
    The examination execution unit adds the temperature difference specified in advance to the temperature of the stimulation surface in a state where the temperature of the stimulation surface matches the temperature of the examination site by the reference adjustment unit. The skin sensation stimulating device according to claim 1, wherein the temperature of the skin is raised or lowered.
  6. 　前記予め指定された熱流束の範囲が－５０Ｗ／ｍ２以上かつ＋５０Ｗ／ｍ２以下である、請求項１から請求項５のいずれか１項に記載の皮膚感覚刺激装置。 The pre-specified range of the heat flux is -50 W / m 2 or more and + 50 W / m 2 or less, cutaneous sense stimulation device according to any one of claims 1 to 5.
  7. 　被験者の皮膚面の検査部位に対して熱刺激を付与した際の感覚閾値の計測方法であって、
    　前記検査部位に前記熱刺激を付与する刺激面を通過する熱流束を検知する熱流センサにより検知される熱流束が予め指定された範囲内となる状態に前記刺激面の温度を上昇又は下降させる温度調整素子を制御することにより、前記刺激面の温度と前記検査部位の温度とを一致させるステップと、
    　前記刺激面の温度と前記検査部位の温度とが一致した状態から前記温度調整素子を制御することにより前記刺激面の温度を上昇又は下降させるステップと、
    　前記被験者が温覚、冷覚、又は痛覚を自覚した時点の前記刺激面の温度と、前記刺激面の温度と前記検査部位の温度とが一致した状態における前記刺激面の温度との差、あるいは、前記被験者が痛覚を自覚した時点の前記刺激面の温度と、前記被験者が温覚又は冷覚を自覚した時点の前記刺激面の温度との差を感覚閾値として算出するステップと、
    を有する感覚閾値の計測方法。     A method for measuring a sensory threshold when a thermal stimulus is applied to an examination site on a skin surface of a subject,
    A temperature that raises or lowers the temperature of the stimulation surface so that the heat flux detected by the heat flow sensor that detects the heat flux passing through the stimulation surface that gives the thermal stimulation to the examination site is within a predetermined range. Adjusting the temperature of the stimulation surface and the temperature of the examination site by controlling an adjustment element;
    Increasing or decreasing the temperature of the stimulation surface by controlling the temperature adjustment element from a state in which the temperature of the stimulation surface and the temperature of the examination site coincide with each other;
    The difference between the temperature of the stimulation surface when the subject is aware of warm, cold, or pain sensation, and the temperature of the stimulation surface in a state where the temperature of the stimulation surface matches the temperature of the examination site, or Calculating the difference between the temperature of the stimulation surface when the subject is aware of pain and the temperature of the stimulation surface when the subject is aware of warm or cold as a sensory threshold;
    A method for measuring a sensory threshold value.
PCT/JP2019/002732 2018-01-31 2019-01-28 Cutaneous sensation stimulation apparatus and method for measuring sensory threshold WO2019151181A1 (en)

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WO2023223920A1 (en) * 2022-05-16 2023-11-23 国立研究開発法人物質・材料研究機構 Peltier element provided with heat flow sensor

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JPH10179591A (en) * 1996-10-29 1998-07-07 Kyoto Electron Mfg Co Ltd Measuring method and device for temperature sense evaluation
WO1999063888A1 (en) * 1998-06-11 1999-12-16 Bo Johansson Device for measurements of thermal perception in body cavities

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