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Wang Y, Zekveld AA, Wendt D, Lunner T, Naylor G, Kramer SE. Pupil light reflex evoked by light-emitting diode and computer screen: Methodology and association with need for recovery in daily life. PLoS One 2018; 13:e0197739. [PMID: 29897946 PMCID: PMC5999086 DOI: 10.1371/journal.pone.0197739] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 05/08/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Pupil light reflex (PLR) has been widely used as a method for evaluating parasympathetic activity. The first aim of the present study is to develop a PLR measurement using a computer screen set-up and compare its results with the PLR generated by a more conventional setup using light-emitting diode (LED). The parasympathetic nervous system, which is known to control the 'rest and digest' response of the human body, is considered to be associated with daily life fatigue. However, only few studies have attempted to test the relationship between self-reported daily fatigue and physiological measurement of the parasympathetic nervous system. Therefore, the second aim of this study was to investigate the relationship between daily-life fatigue, assessed using the Need for Recovery scale, and parasympathetic activity, as indicated by the PLR parameters. DESIGN A pilot study was conducted first to develop a PLR measurement set-up using a computer screen. PLRs evoked by light stimuli with different characteristics were recorded to confirm the influence of light intensity, flash duration, and color on the PLRs evoked by the system. In the subsequent experimental study, we recorded the PLR of 25 adult participants to light flashes generated by the screen set-up as well as by a conventional LED set-up. PLR parameters relating to parasympathetic and sympathetic activity were calculated from the pupil responses. We tested the split-half reliability across two consecutive blocks of trials, and the relationships between the parameters of PLRs evoked by the two set-ups. Participants rated their need for recovery prior to the PLR recordings. RESULTS PLR parameters acquired in the screen and LED set-ups showed good reliability for amplitude related parameters. The PLRs evoked by both set-ups were consistent, but showed systematic differences in absolute values of all parameters. Additionally, higher need for recovery was associated with faster and larger constriction of the PLR. CONCLUSIONS This study assessed the PLR generated by a computer screen and the PLR generated by a LED. The good reliability within set-ups and the consistency between the PLRs evoked by the set-ups indicate that both systems provides a valid way to evoke the PLR. A higher need for recovery was associated with faster and larger constricting PLRs, suggesting increased levels of parasympathetic nervous system activity in people experiencing higher levels of need for recovery on a daily basis.
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Affiliation(s)
- Yang Wang
- Section Ear & Hearing, Dept. of Otolaryngology-Head and Neck Surgery, VU University Medical Center and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark
| | - Adriana A. Zekveld
- Section Ear & Hearing, Dept. of Otolaryngology-Head and Neck Surgery, VU University Medical Center and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
- Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping and Örebro Universities, Linköping, Sweden
| | - Dorothea Wendt
- Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark
- Technical University of Denmark, Department of Electrical Engineering, Lyngby, Denmark
| | - Thomas Lunner
- Eriksholm Research Centre, Oticon A/S, Snekkersten, Denmark
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
- Linnaeus Centre HEAD, The Swedish Institute for Disability Research, Linköping and Örebro Universities, Linköping, Sweden
- Technical University of Denmark, Department of Electrical Engineering, Lyngby, Denmark
| | - Graham Naylor
- Medical Research Council/Chief Scientist Office Institute of Hearing Research—Scottish Section (Part of The University of Nottingham), Glasgow, United Kingdom
| | - Sophia E. Kramer
- Section Ear & Hearing, Dept. of Otolaryngology-Head and Neck Surgery, VU University Medical Center and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Mestanikova A, Ondrejka I, Mestanik M, Cesnekova D, Visnovcova Z, Bujnakova I, Oppa M, Calkovska A, Tonhajzerova I. Pupillary light reflex is altered in adolescent depression. Physiol Res 2018; 66:S277-S284. [PMID: 28937242 DOI: 10.33549/physiolres.933683] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Major depressive disorder is associated with abnormal autonomic regulation which could be noninvasively studied using pupillometry. However, the studies in adolescent patients are rare. Therefore, we aimed to study the pupillary light reflex (PLR), which could provide novel important information about dynamic balance between sympathetic and parasympathetic nervous system in adolescent patients suffering from major depression. We have examined 25 depressive adolescent girls (age 15.2+/-0.3 year) prior to pharmacotherapy and 25 age/gender-matched healthy subjects. PLR parameters were measured separately for both eyes after 5 min of rest using Pupillometer PLR-2000 (NeurOptics, USA). The constriction percentual change for the left eye was significantly lower in depressive group compared to control group (-24.12+/-0.87 % vs. -28.04+/-0.96 %, p<0.01). Furthermore, average constriction velocity and maximum constriction velocity for the left eye were significantly lower in depressive group compared to control group (p<0.05, p<0.01, respectively). In contrast, no significant between-groups differences were found for the right eye. Concluding, this study revealed altered PLR for left eye indicating a deficient parasympathetic activity already in adolescent major depression. Additionally, the differences between left and right eye could be related to functional lateralization of autonomic control in the central nervous system.
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Affiliation(s)
- A Mestanikova
- Department of Physiology and Biomedical Center Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia. or
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Jain M, Devan S, Jaisankar D, Swaminathan G, Pardhan S, Raman R. Pupillary Abnormalities with Varying Severity of Diabetic Retinopathy. Sci Rep 2018; 8:5636. [PMID: 29618794 PMCID: PMC5884827 DOI: 10.1038/s41598-018-24015-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 03/21/2018] [Indexed: 11/23/2022] Open
Abstract
Our aim is to study the dynamics of pupillary abnormalities in varying severity of diabetic retinopathy. A non-interventional case-control study with 405 eyes of 244 subjects with diabetes, and 41 eyes of 26 subjects with no history of diabetes was done. Diabetes group was classified according to retinopathy severity: no retinopathy, mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR and proliferative diabetic retinopathy (PDR). After dark adaptation, pupil size and flashlight response were captured with an infrared camera. Baseline Pupil Diameter (BPD), Amplitude of Pupillary Constriction (APC), Velocity of Pupillary Constriction (VPC) and Velocity of Pupillary Dilatation (VPD). Compared to controls, mean BPD decreased with increasing severity of diabetic retinopathy. Mean APC in control group was 1.73 ± 0.37 mm and reduced in mild NPDR (1.57 ± 0.39, p = 1.000), moderate NPDR (1.51 ± 0.44, p = 0.152) and found to be significant reduced in severe NPDR (1.43 ± 0.48, p = 0.001) and PDR (1.29 ± 0.43, p = 0.008). Compared to controls, mean VPC decreased progressively with increasing severity of retinopathy, with a maximal difference in the PDR group. Mean VPD as compared to the control group was significantly reduced in the no DR (p = 0.03), mild NPDR (p = 0.038), moderate NPDR (p = 0.05), PDR group (p = 0.02). We found pupillary dynamics are abnormal in early stages of diabetic retinopathy and progress with increasing retinopathy severity.
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Affiliation(s)
- Mukesh Jain
- Shri Bhagwan Mahavir Vitreoretinal services, 18, College Road, Sankara Nethralaya, Chennai, 600 006, Tamil Nadu, India
| | - Sandeep Devan
- Elite School of Optometry, 8 GST Road, Chennai, 600016, Tamil Nadu, India
| | - Durgasri Jaisankar
- Shri Bhagwan Mahavir Vitreoretinal services, 18, College Road, Sankara Nethralaya, Chennai, 600 006, Tamil Nadu, India.,Vision and Eye Research Unit (VERU), Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Gayathri Swaminathan
- Shri Bhagwan Mahavir Vitreoretinal services, 18, College Road, Sankara Nethralaya, Chennai, 600 006, Tamil Nadu, India
| | - Shahina Pardhan
- Vision and Eye Research Unit (VERU), Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal services, 18, College Road, Sankara Nethralaya, Chennai, 600 006, Tamil Nadu, India. .,Vision and Eye Research Unit (VERU), Postgraduate Medical Institute, Anglia Ruskin University, Cambridge, CB1 1PT, UK.
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Abstract
The pupillary light reflex (PLR) describes the constriction and subsequent dilation of the pupil in response to light as a result of the antagonistic actions of the iris sphincter and dilator muscles. Since these muscles are innervated by the parasympathetic and sympathetic nervous systems, respectively, different parameters of the PLR can be used as indicators for either sympathetic or parasympathetic modulation. Thus, the PLR provides an important metric of autonomic nervous system function that has been exploited for a wide range of clinical applications. Measurement of the PLR using dynamic pupillometry is now an established quantitative, non-invasive tool in assessment of traumatic head injuries. This review examines the more recent application of dynamic pupillometry as a diagnostic tool for a wide range of clinical conditions, varying from neurodegenerative disease to exposure to toxic chemicals, as well as its potential in the non-invasive diagnosis of infectious disease.
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Affiliation(s)
- Charlotte A Hall
- Research Centre for Topical Drug Delivery and Toxicology, University of Hertfordshire, Hatfield SP10 1JX, UK.
| | - Robert P Chilcott
- Research Centre for Topical Drug Delivery and Toxicology, University of Hertfordshire, Hatfield SP10 1JX, UK.
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