Sensory Discrimination Research Articles

Auditory aversive generalization learning prompts threat-specific changes in alpha-band activity.

Pairing a neutral stimulus with aversive outcomes prompts neurophysiological and autonomic changes in response to the conditioned stimulus (CS+), compared to cues that signal safety (CS-). One of these changes-selective amplitude reduction of parietal alpha-band oscillations-has been reliably linked to processing of visual CS+. It is, however, unclear to what extent auditory conditioned cues prompt similar changes, how these changes evolve as learning progresses, and how alpha reduction in the auditory domain generalizes to similar stimuli. To address these questions, 55 participants listened to three sine wave tones, with either the highest or lowest pitch (CS+) being associated with a noxious white noise burst. A threat-specific (CS+) reduction in occipital-parietal alpha-band power was observed similar to changes expected for visual stimuli. No evidence for aversive generalization to the tone most similar to the CS+ was observed in terms of alpha-band power changes, aversiveness ratings, or pupil dilation. By-trial analyses found that selective alpha-band changes continued to increase as aversive conditioning continued, beyond when participants reported awareness of the contingencies. The results support a theoretical model in which selective alpha power represents a cross-modal index of continuous aversive learning, accompanied by sustained sensory discrimination of conditioned threat from safety cues.

Cortical astrocyte N-methyl-D-aspartate receptors influence whisker barrel activity and sensory discrimination in mice

Astrocytes express ionotropic receptors, including N-methyl-D-aspartate receptors (NMDARs). However, the contribution of NMDARs to astrocyte-neuron interactions, particularly in vivo, has not been elucidated. Here we show that a knockdown approach to selectively reduce NMDARs in mouse cortical astrocytes decreases astrocyte Ca2+ transients evoked by sensory stimulation. Astrocyte NMDAR knockdown also impairs nearby neuronal circuits by elevating spontaneous neuron activity and limiting neuronal recruitment, synchronization, and adaptation during sensory stimulation. Furthermore, this compromises the optimal processing of sensory information since the sensory acuity of the mice is reduced during a whisker-dependent tactile discrimination task. Lastly, we rescue the effects of astrocyte NMDAR knockdown on neurons and improve the tactile acuity of the animal by supplying exogenous ATP. Overall, our findings show that astrocytes can respond to nearby neuronal activity via their NMDAR, and that these receptors are an important component for purinergic signaling that regulate astrocyte-neuron interactions and cortical sensory discrimination in vivo.

The reliability and applicability of the Ten Test in hand injuries: A systematic review.

The Ten Test (TT) is a touch threshold test that quantifies sensory discrimination by comparing an injured area with a contralateral uninjured area. It's quick, simple, equipment-free and repeatable. However, as a subjective measure, the TT's reliability and applicability need further investigation. This review aimed to investigate if the TT has superior inter- and intra-examiner reliability compared to the widely accepted Weinstein Enhanced Sensory Test (WEST) in a human population of all ages. A systematic search was conducted on major databases from January 1997 to September 2023 and adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. Outcomes were assessed with a narrative approach. The included articles were critically appraised according to the Quality Assessment of Diagnostic Accuracy Studies two tool. This review included five articles. High inter-examiner reliability was demonstrated with intraclass correlation coefficient (ICC) values of 0.91 and 0.95, alongside a kappa statistic of 1, as reported by three distinct studies. Intra-examiner reliability displayed some variance, with one study reporting a significant ICC value in four out of six instances. Two studies corroborated that the TT results corresponded with the findings of WEST, each presenting a Spearman rank coefficient of -0.71. Our findings underscore the TT's high inter-examiner reliability, though its intra-examiner reliability exhibited some inconsistencies. Interestingly, certain studies claimed its superiority over the WEST. To validate the TT's use in the clinical setting, more rigorous studies, particularly those comparing pre-operative TT outcomes with intraoperative nerve damage evaluations, are essential.

Clinical Diagnosis and Management of Fetal Alcohol Spectrum Disorder and Sensory Processing Disorder in Children.

Fetal alcohol spectrum disorder (FASD) is commonly misdiagnosed because of the complexity of presentation and multiple diagnostic criteria. FASD includes four categorical entities (fetal alcohol syndrome, partial fetal alcohol syndrome, alcohol related neurodevelopmental disorder, and alcohol related birth defects). The four FASD diagnostic criteria are facial dysmorphology, growth deficiency, central nervous system dysfunction, and prenatal alcohol exposure. Sensory processing disorders (SPDs) are common in FASD and are observed as inappropriate behavioral responses to environmental stimuli. These can be either a sensory-based motor disorder, sensory discrimination disorder, or sensory modulation disorder. A child with SPD may experience challenges with their fine motor coordination, gross motor coordination, organizational challenges, or behavioral regulation impairments. FASD requires a multidimensional approach to intervention. Although FASD cannot be cured, symptoms can be managed with sleep-based therapies, sensory integration, and cognitive therapies. This paper reviews SPDs in FASD and the interventions that can be used by practitioners to help improve their therapeutic management, although it is unlikely that any single intervention will be the right choice for all patients.

Bi-Manual Sensory Discrimination: A Kinesthetic Study.

The ability of humans to perceive and differentiate kinesthetic sensory information significantly influences our daily activities and motor control. This study examines the impact of asynchronous bi-manual discrimination tasks compared to uni-manual discrimination tasks on kinesthetic perception. Our study aims to reveal the relationship between kinesthetic perception of haptic signals by examining perceptual thresholds in three different scenarios using (i) the dominant hand, (ii) the non-dominant hand, and (iii) both hands simultaneously to differentiate between two successive signals. Subjects exposed to force signals in these three situations conveyed their perceptions of alterations in signal magnitude after each trial. Subsequently, we applied psychometric functions to the collected responses to determine perceptual thresholds. Our results indicate a substantial difference in threshold values between bi-manual and uni-manual scenarios, with the bi-manual scenario exhibiting higher thresholds, indicating inferior perceptual ability when both hands are simultaneously utilized in two separate discrimination tasks. Furthermore, our investigation reveals distinct perception thresholds between the dominant and non-dominant hands, owing to differences in the perceptual capability of the two hands. These findings provide substantial insight into how the nature of tasks may alter kinesthetic perception, offering implications for the development of haptic interfaces in practical applications.

Somatotopically Evoked Tactile Sensation via Transcutaneous Electrical Nerve Stimulation Improves Prosthetic Sensorimotor Performance.

Sensory feedback provides critical interactive information for the effective use of hand prostheses. Non-invasive neural interfaces allow convenient access to the sensory system, but they communicate a limited amount of sensory information. This study examined a novel approach that leverages a direct and natural sensory afferent pathway, and enables an evoked tactile sensation (ETS) of multiple digits in the projected finger map (PFM) of participants with forearm amputation non-invasively. A bidirectional prosthetic interface was constructed by integrating the non-invasive ETS-based feedback system into a commercial prosthetic hand. The pressure information of five fingers was encoded linearly by the pulse width modulation range of the buzz sensation. We showed that simultaneous perception of multiple digits allowed participants with forearm amputation to identify object length and compliance by using information about contact patterns and force intensity. The ETS enhanced the grasp-and-transport performance of participants with and without prior experience of prosthetic use. The functional test of transport-and-identification further revealed improved execution in classifying object size and compliance using ETS-based feedback. Results demonstrated that the ETS is capable of communicating somatotopically compatible information to participants efficiently, and improves sensory discrimination and closed-loop prosthetic control. This non-invasive sensory interface may establish a viable way to restore sensory ability for prosthetic users who experience the phenomenon of PFM.

Reduced Cortico-Cortical Resting-State Connectivity in Sensory Systems Related to Bodily Pain in Juvenile Fibromyalgia.

Juvenile-onset fibromyalgia (JFM) is a paradigmatic chronic pain condition for which the underlying neurobiological substrates are poorly understood. This study examined, for the first time, data-driven resting-state functional connectivity (rsFC) alterations in 37 female adolescents with JFM compared with 43 healthy female adolescents and identified associations with bodily pain. Whole-brain voxel-wise rsFC alterations were assessed using the intrinsic connectivity contrast, a measure of node centrality at each voxel, and seed-based analyses for interpretability. We studied the relationship between rsFC alterations in somatosensory systems and the location and extension of bodily pain. Adolescents with JFM had voxel-wise rsFC reductions in the paracentral lobule (PCL)/primary somatosensory cortex (S1) (T=4.89, family-wise error corrected p-value (pFWE)< 0.001) and left midcingulate cortex (T=4.67, pFWE=0.043). Post hoc analyses revealed reduced rsFC spanning major cortical sensory hubs (T > 4.4, pFWE < 0.030). Cortico-cortical rsFC reductions within PCL/S1 in JFM occurred in locations innervated by bodily areas where the pain was most frequent (F=3.15; positive false discovery rate=0.029) and predicted widespread pain (T > 4.4, pFWE < 0.045). Conversely, adolescents with JFM had increases in PCL/S1-thalamus (T=4.75, pFWE=0.046) and PCL/S1-anterior insula rsFC (T=5.13, pFWE=0.039). Reduced cortico-cortical sensory integration involving PCL/S1 and spanning the sensory systems may underly critical pain sensory features in youth with JFM. Reduced sensory integration is paralleled by augmented cross-talk between sensory and affective/salience-processing regions, potentially indicating a shift toward more affectively colored sensory experiences to the detriment of specific sensory discrimination.

The Impact of Aging on Neurological Function and Cognitive Decline

This comprehensive analysis delves into the multifaceted impact of aging on neurological function and cognitive decline, incorporating insights from studies on music, video games, and mindfulness. It explores significant alterations in the peripheral nervous system (PNS) as individuals age, highlighting changes in nerve fibers, signal transmission, muscle strength, and sensory discrimination. The study also examines the brain's structural and functional evolution with age, particularly in the hippocampus and frontal lobe, and the resultant effects on cognitive abilities. It discusses the concept of brain resistance and resilience in the context of Alzheimer's disease, suggesting that certain individuals show a heightened ability to withstand or adapt to neurological pathologies. Investigating various lifestyle factors, the hypothesis presented is that an active lifestyle and specific activities, including musical engagement and video game training, can mitigate age-related cognitive decline. The study finds that musical activities improve mood, memory, and quality of life in people with dementia, while customized video games enhance multitasking abilities and cognitive control in older adults. However, mindfulness-based interventions, such as stress reduction and exercise, did not show significant improvement in cognitive functions in older adults. Intriguingly, cognitive abilities are impacted differently by age, with certain functions like vocabulary improving, while others such as memory and processing speed decline. The study also contrasts brain aging in humans with chimpanzees, revealing significant differences in brain structure changes over the lifespan, likely due to longer human lifespans. This research underscores the complex interplay of genetic, lifestyle, health, and intervention factors in aging and emphasizes the importance of tailored interventions such as using music therapy, video games, and life style changes to preserve neurological and cognitive health in older adults.

Bortezomib-induced neuropathy is in part mediated by the sensitization of TRPV1 channels

TRPV1 is an ion channel that transduces noxious heat and chemical stimuli and is expressed in small fiber primary sensory neurons that represent almost half of skin nerve terminals. Tissue injury and inflammation result in the sensitization of TRPV1 and sustained activation of TRPV1 can lead to cellular toxicity though calcium influx. To identify signals that trigger TRPV1 sensitization after a 24-h exposure, we developed a phenotypic assay in mouse primary sensory neurons and performed an unbiased screen with a compound library of 480 diverse bioactive compounds. Chemotherapeutic agents, calcium ion deregulators and protein synthesis inhibitors were long-acting TRPV1 sensitizers. Amongst the strongest TRPV1 sensitizers were proteasome inhibitors, a class that includes bortezomib, a chemotherapeutic agent that causes small fiber neuropathy in 30–50% of patients. Prolonged exposure of bortezomib produced a TRPV1 sensitization that lasted several days and neurite retraction in vitro and histological and behavioral changes in male mice in vivo. TRPV1 knockout mice were protected from epidermal nerve fiber loss and a loss of sensory discrimination after bortezomib treatment. We conclude that long-term TRPV1 sensitization contributes to the development of bortezomib-induced neuropathy and the consequent loss of sensation, major deficits experienced by patients under this chemotherapeutic agent.

Logistic regression in threshold detection in replicated discrimination sensory tests

Sensory discrimination tests often consider the possibility that each assessor performs a test more than once, that is, they are performed with replications. However, these experiments are generally analyzed as if there were no repetitions or as if all judgments came from different assessors, which the usual analysis assumes that the probability of success is the same for all of them. It is emphasized the importance of considering possible differences in the perception of the assessors, which is consistent with Thurstone's psychological ideas about perception and decision processes. In this article it is suggested a mixed generalized linear model that considers the random effect of the assessor. Particularly in dose-response experiments it is showed that this model allows estimating detection thresholds for several treatments simultaneously. The results allowed to conclude that the proposed model presents good results and can be used in the analysis of replicated sensory tests. We will assume that the variation in the assessor' responses can be modeled as a random effect in a mixed generalized linear model. This model should be able to produce a better analysis, with the ability to detect differences between treatments with greater power and produce narrower confidence intervals for the estimates.

Invited Session I: 30 years of normalization in the visual system: Spatiotemporal fluctuations in E/I balance & their impact on perception.

The Normalization Model has helped illuminate our understanding of neural computations in a wide variety of contexts. Here, I will describe our recent efforts to understand how intrinsic fluctuations in the ratio of excitatory to inhibitory conductances play out in space and time, and how these fluctuations impact perception. We find that spontaneous cortical activity is organized into traveling waves that traverse visual cortex several times per second. Recording in Area MT of the common marmoset, we find that these intrinsic traveling waves (iTWs) regulate both the gain of the stimulus-evoked spiking response and the monkey's perceptual sensitivity. A large-scale spiking network model recapitulates the properties of iTWs measured in vivo and explains the observed fluctuations in response gain as resulting from momentary fluctuations in E/I balance. The model predicts that iTWs are sparse, in the sense that only a small fraction of the neural population participates in any individual iTW. As a result, iTWs can occur without inducing correlated variability, which we have found, in separate experiments, can impair sensory discrimination. We thus refer to the model as the sparse-wave model of iTWs. Taken together, these findings lead to the conclusion that traveling waves strongly modulate neural and perceptual sensitivity.

Auditory central pathways in children and adolescents with multiple sclerosis.

Multiple sclerosis (MS) is an inflammatory demyelinating disease. Auditory evoked potential studies have demonstrated conduction and neural processing deficits in adults with MS, but little is known about the electrophysiological responses in children and adolescents. to evaluate the central auditory pathway with brainstem auditory evoked potentials (BAEP) and long-latency auditory evoked potentials (LLAEP) in children and adolescents with MS. The study comprised 17 individuals with MS, of both sexes, aged 9 to 18 years, and 17 healthy volunteers, matched for age and sex. All individuals had normal hearing and no middle ear impairments. They were assessed with click-BAEP and LLAEP through oddball paradigm and tone-burst stimuli. Abnormal responses were observed in 60% of electrophysiologic assessments of individuals with MS. In BAEP, 58.82% of MS patients had abnormal responses, with longer wave V latency and therefore longer III-V and I-V interpeak latencies than healthy volunteers. In LLAEP, 52.94% of MS patients had abnormal responses. Although statistical differences were found only in P2-N2 amplitude, MS patients had longer latencies and smaller amplitudes than healthy volunteers in all components. Children and adolescents with MS had abnormal BAEP responses, with delayed neural conduction between the cochlear nucleus and the lateral lemniscus. Also, abnormal LLAEP results suggest a decrease in neural processing speed and auditory sensory discrimination response.

Thurstonian model for the four-interval oddity task

The four-interval oddity task is an extension of the Triangle method, which is the three-interval oddity task and is one of the most broadly used conventional sensory discrimination methods. It is a special case of the m-interval oddity task or the m-alternative odd-man-out task where m = 4. It is also a special situation of the unspecified ‘M + N’ with M = 3 and N = 1. Some new forms of the analytical psychometric function for the four-interval oddity task based on a normal distribution function, a bivariate normal distribution function, and a non-central F-distribution function are provided originally in this paper. The performance of the four-interval oddity task in both difference testing and similarity/equivalence testing is explored and compared with some unspecified forced-choice sensory discrimination methods including the Triangle. Tables and R codes are presented and provided for estimations of the probability of correct response, Pc, Thurstonian discriminal distance δ or d´, and the B value for estimating the variance of d´ for the four-interval oddity task.

Circuit-level theories for sensory dysfunction in autism: convergence across mouse models.

Individuals with autism spectrum disorder (ASD) exhibit a diverse range of behavioral features and genetic backgrounds, but whether different genetic forms of autism involve convergent pathophysiology of brain function is unknown. Here, we analyze evidence for convergent deficits in neural circuit function across multiple transgenic mouse models of ASD. We focus on sensory areas of neocortex, where circuit differences may underlie atypical sensory processing, a central feature of autism. Many distinct circuit-level theories for ASD have been proposed, including increased excitation-inhibition (E-I) ratio and hyperexcitability, hypofunction of parvalbumin (PV) interneuron circuits, impaired homeostatic plasticity, degraded sensory coding, and others. We review these theories and assess the degree of convergence across ASD mouse models for each. Behaviorally, our analysis reveals that innate sensory detection behavior is heightened and sensory discrimination behavior is impaired across many ASD models. Neurophysiologically, PV hypofunction and increased E-I ratio are prevalent but only rarely generate hyperexcitability and excess spiking. Instead, sensory tuning and other aspects of neural coding are commonly degraded and may explain impaired discrimination behavior. Two distinct phenotypic clusters with opposing neural circuit signatures are evident across mouse models. Such clustering could suggest physiological subtypes of autism, which may facilitate the development of tailored therapeutic approaches.

Thurstonian models for three variants (specified, unspecified, and unspecified with forgiveness) of the Two‐Out‐of‐Five method

AbstractThe Two‐Out‐of‐Five method is one of the basic sensory discrimination methods. It is a special case of the ‘M+N’ method with M = 3 and N = 2. Three variants of the method are discussed in the paper: specified, unspecified, and unspecified with forgiveness. Analytical and simulation‐derived psychometric functions for all three variants of the Two‐Out‐of‐Five method are derived and produced. The performance of the method in both difference and similarity/equivalence tests are explored. It is shown that both difference and similarity/equivalence testing powers for the specified Two‐Out‐of‐Five are larger than those for the 2‐AFC and 3‐AFC. Both difference and similarity/equivalence testing powers for the unspecified Two‐Out‐of‐Five are larger than those for the Triangle and Duo‐trio. Both difference and similarity/equivalence testing powers for the unspecified with forgiveness Two‐Out‐of‐Five are larger than those for the conventional unspecified Two‐Out‐of‐Five and unspecified Tetrads. Tables and R codes are presented and provided for estimations of the probability of correct response, Pc, Thurstonian discriminal distance or d', and the B value for estimating the variance of d' for the three variants of the Two‐Out‐of‐Five method.Practical ApplicationsThe Two‐Out‐of‐Five method is a powerful sensory discrimination method. However, this method has not been used widely in sensory and consumer research, partly since the method has not been explored adequately in the literature. This paper explores the Two‐Out‐of‐Five method and shows that the method has potential for wide application. The Two‐Out‐of‐Five method involves a larger number of samples (5) and sensory fatigue may be of concern. Hence, the method may not be suitable for taste and smell tests with strong stimuli. The method is particularly suitable for manual and visual inspection testing where sensory fatigue is of a lesser concern.

Association between flavor composition and sensory profile in thermally processed mandarin juices by multidimensional gas chromatography and multivariate statistical analysis.

Thermal pasteurization decreases the sensory quality of mandarin juice. Flavor composition was determined in four fresh-squeezed and heat-processed mandarin juice varieties using molecular sensory science approaches. The relationships between odorants and sensory profiles were analyzed, and markers for flavor deterioration were screened by multivariate statistical analysis. Seventy-four volatiles were identified, among which 36 odorants with flavor dilution factors ranging from 2 to 128 were detected by multidimensional gas chromatography-mass spectrometry/olfactometry (MDGC-MS/O) coupled with aroma extract dilution analysis (AEDA). Higher intensities of cooked and off-flavor notes were observed in the heated mandarin juice, which was related to the concentration changes of the methional, methanethiol, dimethyl sulfide, and carbon disulfide by partial least squares (PLS) analysis. Ten potential markers (methional, methanethiol, dimethyl sulfide, hydrogen sulfide, β-damascenone, camphene, trans-β-ionone, decanal, d-limonene, and α-pinene) were responsible for the sensory discrimination of fresh-squeezed and heated mandarin juices.

ARQUITETURA ESCOLAR SENSÍVEL AO PROCESSAMENTO SENSORIAL DOS AUTISTAS: estudo do conforto visual por meio da APO da E. M. Luiza Terra de Andrade – RJ

This research analyzes E. M. Luiza Terra de Andrade, with the objective of verifying if this school unit has a physical structure, focusing on visual comfort, capable of serving students with Autism Spectrum Disorder (ASD). The aim is to create design parameters for the construction of schools sensitive to the characteristics of autistic people, since the Sensory Discrimination Disorders (SDD) of these people in-terfere in the way they extract visual information from the built environments. Using the correlational method, the relationships between TDS and autistic behaviors with the visual aspects of environments were examined. The qualitative method allowed the appropriation of information on neurodevelopment and environmental psychology. Through the experiential research, it was possible to structure the pos-t-occupancy evaluation (POA) carried out. Thus, it was found that the analyzed School, with regard to aspects of visual comfort, does not meet the particularities of autistic people, impacting the care of these students.

Neuroscience: Hacking development to understand sensory discrimination

Fine sensory discrimination abilities are enabled by specific neural circuit architectures. A new study reveals how manipulating particular network parameters in the fly's memory centre, the mushroom body, alters sensory coding and discrimination.

Delayed Surgical Treatment in Patients with Chronic Carpal Tunnel Syndrome Is Still Effective in the Improvement of Hand Function.

Background and Objectives: Severe carpal tunnel syndrome (CTS) is the most common compression neuropathy in the upper extremities treated conservatively; later, when advanced, CTS is treated mostly surgically. The most prevalent symptoms comprise numbness, as well as sensation loss in the thumb, index, and middle finger, and thenar muscle strength loss, resulting in impaired daily functioning for patients. Data on the results of CTS treatment in patients with delayed surgical intervention are scarce. The aim of this study was to determine the postoperative results of chronic carpal tunnel syndrome treatment in patients with symptoms lasting for at least 5 years. Materials and Methods: A total of 86 patients (69 females, 17 males) with a mean age of 58 years reporting symptoms of CTS for at least 5 years (mean: 8.5 years) were prospectively studied. The average follow-up time was 33 months. All patients underwent the surgical open decompression of the median nerve at the wrist. A preoperative observation was composed of an interview and a clinical examination. The subjects completed the DASH (the Disabilities of the Arm, Shoulder, and Hand), PRWE (Patient-Rated Wrist Evaluation), and self-report questionnaires. Global grip strength, sensory discrimination, characteristic symptoms of CTS, and thenar muscle atrophy were examined. Postoperatively, clinical and functional examinations were repeated, and patients expressed their opinions by completing a BCTQ (Boston Carpal Tunnel Syndrome Questionnaire). Results: We found improvements in daily activities and hand function postoperatively. Overall, 88% of patients were satisfied with the outcome of surgery. DASH scores decreased after surgery from 44.82 to 14.12 at p < 0.001. PRWE questionnaire scores decreased from 53.34 to 15.19 at p < 0.001. The mean score of the BCTQ on the scale regarding the severity of symptoms was 1.48 and 1.62 on the scale regarding function after surgery. No significant differences were found in the scores between the male and female groups or between age groups (p > 0.05). A significant increase in global grip strength from 16.61 kg to 21.91 kg was observed postoperatively at p < 0.001. No significant difference was detected in the measurement of sensory discrimination (6.02 vs. 5.44). In most of the examined patients, night numbness and wrist pain subsided after surgery at p < 0.001. Thenar muscle atrophy diminished after surgery at p < 0.001. Conclusions: Most patients were satisfied with the results of CTS surgery regarding the open decompression of the median nerve even after 5 years of ineffective conservative treatment. Significant improvement of the hand function was confirmed in the functional studies.

A Combination Effect of Sensory Motor Training and Proprioceptive Neuromuscular Facilitation in a Case of Peripheral Polyneuropathy Manifested by Foot Drop in Type II Diabetes Mellitus – A Case Study

Peripheral neuropathy is one of the common complications in patients with diabetes Mellitus (DM) which leads to disrupting the peripheral nervous system resulting in reduce sensory inputs and motor outputs. Patients with foot drop (FD) will have weakness in dorsiflexor muscles of ankle and toe and sensory loss due to disruption of small myelinated and unmyelinated nerve fibers. Sensory motor training (SMT) will facilitate sensory inputs, correcting muscle imbalance, and ensuring correct program at the level of central nervous system whereas Proprioceptive Neuromuscular facilitation techniques (PNF) not only helps facilitating the weaker group of muscles also improve strength . Hence the purpose of the study to combine the effect on use of SMT along with PNF in a case of peripheral polyneuropathy manifested by foot drop in patient with type II DM. The case report study of 72 year old male patient diagnosed with diabetic polyneuropathy manifested by foot drop in type II diabetes mellitus on medication. Intervention of patient received Sensory motor training and Proprioceptive Neuromuscular Facilitation in foot drop for 5 days a week for 4 weeks and outcome measures used were Stanmore Assessment Questionnaire (SAQ) , Diabetic Neuropathy Examination (DNE) score for diabetic neuropathy which were taken on day one and after 4 weeks of intervention and results shown improved on both the outcome measures which concluded that on combination of SMT and PNF techniques have shown efficacy on improving ankle range of motion and strength , sensory discrimination , thereby implementing these combination techniques, will reduce functional dependence and improve quality of life.