Pupillometry: Psychology, Physiology, and Function

Do Different Types of Microphones Affect Listening Effort in Cochlear Implant Recipients? A Pupillometry Study

BACKGROUND

It is known that subjects with a cochlear implant (CI) need to exert more listening effort to achieve adequate speech recognition compared to normal hearing subjects. One tool for assessing listening effort is pupillometry. The aim of this study is to evaluate the effectiveness of adaptive directional microphones in reducing listening effort for CI recipients.

METHODS

We evaluated listening in noise and listening effort degree (by pupillometry) in eight bimodal subjects with three types of CI microphones and in three sound configurations.

RESULTS

We found a correlation only between sound configurations and listening in noise score (p-value 0.0095). The evaluation of the microphone types shows worse scores in listening in noise with Opti Omni (+3.15 dB SNR) microphone than with Split Dir (+1.89 dB SNR) and Speech Omni (+1.43 dB SNR). No correlation was found between microphones and sound configurations and within the pupillometric data.

CONCLUSIONS

Different types of microphones have different effects on the listening of CI patients. The difference in the orientation of the sound source is a factor that has an impact on the listening effort results. However, the pupillometry measurements do not significantly correlate with the different microphone types.

Changes in attentional breadth scale with the demands of Kanizsa-figure object completion-evidence from pupillometry

The present study investigated whether the integration of separate parts into a whole-object representation varies with the amount of available attentional resources. To this end, two experiments were performed, which required observers to maintain central fixation while searching in peripheral vision for a target among various distractor configurations. The target could either be a "grouped" whole-object Kanizsa figure, or an "ungrouped" configuration of identical figural parts, but which do not support object completion processes to the same extent. In the experiments, accuracies and changes in pupil size were assessed, with the latter reflecting a marker of the covert allocation of attention in the periphery. Experiment 1 revealed a performance benefit for grouped (relative to ungrouped) targets, which increased with decreasing distance from fixation. By contrast, search for ungrouped targets was comparably poor in accuracy without revealing any eccentricity-dependent variation. Moreover, measures of pupillary dilation mirrored this eccentricity-dependent advantage in localizing grouped targets. Next, in Experiment 2, an additional attention-demanding foveal task was introduced in order to further reduce the availability of attentional resources for the peripheral detection task. This additional task hampered performance overall, alongside with corresponding pupil size changes. However, there was still a substantial benefit for grouped over ungrouped targets in both the behavioral and the pupillometric data. This shows that perceptual grouping scales with the allocation of attention even when only residual attentional resources are available to trigger the representation of a complete (target) object, thus illustrating that object completion operates in the "near absence" of attention.

Linking vestibular, tactile, and somatosensory rhythm perception to language development in infancy

First experiences with rhythm occur in the womb, with different rhythmic sources being available to the human fetus. Among sensory modalities, vestibular, tactile, and somatosensory perception plays a crucial role in early processing. However, a limited number of studies so far have specifically focused on VTS rhythms in language development. The present work investigated VTS rhythmic abilities and their role in language acquisition through two experiments with 45 infants (21 females, sex assigned at birth; M age = 661.6 days, SD = 192.6) with middle/high socioeconomic status. Specifically, 37 infants from the original sample completed Experiment 1, assessing VTS rhythmic abilities through a vibrotactile tool for music perception. In Experiment 2, linguistic abilities were evaluated in 40 participants from the same cohort, specifically testing phonological and prosodic processing. Discrimination abilities for rhythmic and linguistic stimuli were inferred from changes in pupil diameter to contingent visual stimuli over time, through a Tobii X-60 eye-tracker. The predictive effect of VTS rhythmic abilities on linguistic processing and the developmental changes occurring across ages were explored in the 32 infants who completed both Experiments 1 and 2 by means of generalized, additive and linear, mixed-effect models. Results are discussed in terms of cross-sensory (i.e., haptic to hearing) and cross-domain (i.e., music to language) effects of rhythm on language acquisition, with implications for typical and atypical development.

How the eyes respond to sounds

Eye movements have been extensively studied with respect to visual stimulation. However, we live in a multisensory world, and how the eyes are driven by other senses has been explored much less. Here, we review the evidence on how audition can trigger and drive different eye responses and which cortical and subcortical neural correlates are involved. We provide an overview on how different types of sounds, from simple tones and noise bursts to spatially localized sounds and complex linguistic stimuli, influence saccades, microsaccades, smooth pursuit, pupil dilation, and eye blinks. The reviewed evidence reveals how the auditory system interacts with the oculomotor system, both behaviorally and neurally, and how this differs from visually driven eye responses. Some evidence points to multisensory interaction, and potential multisensory integration, but the underlying computational and neural mechanisms are still unclear. While there are marked differences in how the eyes respond to auditory compared to visual stimuli, many aspects of auditory-evoked eye responses remain underexplored, and we summarize the key open questions for future research.

Linear integration of multisensory signals in the pupil

The pupil of the eye responds to various salient signals from different modalities, but there is no consensus on how these pupillary responses are integrated when multiple signals appear simultaneously. Both linear and nonlinear integration have been found previously. The current study aimed to reexamine the nature of pupillary integration, and specifically focused on the early, transient pupillary responses due to its close relationship with orienting. To separate the early pupillary responses out of the pupil time series, we adopted a pupil oscillation paradigm in which sensory stimuli were periodically presented. The simulation analysis confirmed that the amplitude of the pupil oscillation, induced by stimuli repeatedly presented at relatively high rates, can precisely reflect the early, transient pupillary responses without involving the late and sustained pupillary responses. The experimental results then showed that the amplitude of pupil oscillation induced by a series of simultaneous audiovisual stimuli equaled to a linear summation of the oscillatory amplitudes when unisensory stimuli were presented alone. Moreover, the tonic arousal levels, indicated by the baseline pupil size, cannot shift the summation from linear to nonlinear. These findings together support the additive nature of multisensory pupillary integration for the early, orienting-related pupillary responses. The additive nature of pupillary integration further implies that multiple pupillary responses may be independent of each other, irrespective of their potential cognitive and neural drivers.

A mammal and bird's-eye-view of the pupil during sleep and wakefulness

Besides regulating the amount of light that reaches the retina, fluctuations in pupil size also occur in isoluminant conditions during accommodation, during movement and in relation to cognitive workload, attention and emotion. Recent studies in mammals and birds revealed that the pupils are also highly dynamic in the dark during sleep. However, despite exhibiting similar sleep states (rapid eye movement [REM] and non-REM [NREM] sleep), wake and sleep state-dependent changes in pupil size are opposite between mammals and birds, due in part to differences in the type (striated vs. smooth) and control of the iris muscles. Given the link between pupil dynamics and cognitive processes occurring during wakefulness, sleep-related changes in pupil size might indicate when related processes are occurring during sleep. Moreover, the divergent pupillary behaviour observed between mammals and birds raises the possibility that changes in pupil size in birds are a readout of processes not reflected in the mammalian pupil.

Decoupling of the pupillary light response during internal attention: The modulating effect of luminance intensity

In a world full of sensory stimuli, attention guides us between the external environment and our internal thoughts. While external attention involves processing sensory stimuli, internal attention is devoted to self-generated representations such as planning or spontaneous mind wandering. They both draw from common cognitive resources, thus simultaneous engagement in both often leads to interference between processes. In order to maintain internal focus, an attentional mechanism known as perceptual decoupling takes effect. This mechanism supports internal cognition by decoupling attention from the perception of sensory information. Two previous studies of our lab investigated to what extent perceptual decoupling is evident in voluntary eye movements. Findings showed that the effect is mediated by the internal task modality and workload (visuospatial > arithmetic and high > low, respectively). However, it remains unclear whether it extends to involuntary eye behavior, which may not share cognitive resources with internal activities. Therefore, the present experiment aimed to further elucidate attentional dynamics by examining whether internal attention affects the pupillary light response (PLR). Specifically, we consistently observed that workload and task modality of the internal task reduced the PLR to luminance changes of medium intensity. However, the PLR to strong luminance changes was less or not at all affected by the internal task. These results suggest that perceptual decoupling effects may be less consistent in involuntary eye behavior, particularly in the context of a salient visual stimulus.

Synchronous functional magnetic resonance eye imaging, video ophthalmoscopy, and eye surface imaging reveal the human brain and eye pulsation mechanisms

The eye possesses a paravascular solute transport pathway that is driven by physiological pulsations, resembling the brain glymphatic pathway. We developed synchronous multimodal imaging tools aimed at measuring the driving pulsations of the human eye, using an eye-tracking functional eye camera (FEC) compatible with magnetic resonance imaging (MRI) for measuring eye surface pulsations. Special optics enabled integration of the FEC with MRI-compatible video ophthalmoscopy (MRcVO) for simultaneous retinal imaging along with functional eye MRI imaging (fMREye) of the BOLD (blood oxygen level dependent) contrast. Upon optimizing the fMREye parameters, we measured the power of the physiological (vasomotor, respiratory, and cardiac) eye and brain pulsations by fast Fourier transform (FFT) power analysis. The human eye pulsated in all three physiological pulse bands, most prominently in the respiratory band. The FFT power means of physiological pulsation for two adjacent slices was significantly higher than in one-slice scans (RESP1 vs. RESP2; df = 5, p = 0.045). FEC and MRcVO confirmed the respiratory pulsations at the eye surface and retina. We conclude that in addition to the known cardiovascular pulsation, the human eye also has respiratory and vasomotor pulsation mechanisms, which are now amenable to study using non-invasive multimodal imaging of eye fluidics.

Investigating pupillometry to detect preoperative anxiety: a pilot study

Guidelines from the European Society of Anesthesia (ESA) insist on the importance of preoperative anxiety management. However, its assessment currently relies on questionnaires that are long to submit and sometimes difficult to interpret. Exploring the balance between sympathetic and parasympathetic neural systems through the use of pupillometry is a promising path to identify anxiety and thus provides an objective and reproducible assessment tool. A single-center prospective observational study was conducted in a population of ambulatory ophthalmological surgery patients. Preoperative anxiety was assessed using the Surgical Fear Questionnaire (SFQ). Measurements were taken using an Algiscan® (IDMed) type pupillometer before, during, and after insertion of the peripheral IV catheter. A statistical correlation test was carried out between the different evaluations of anxiety and the coefficient of variation of the pupillary diameter (VCPD). A total of 71 patients were included in the study between July 2020 and February 2021, with a median SFQ score of 23 [IQR 11-34]. No significant statistical correlation was found between the baseline pupillary diameter, or VCPD, and preoperative anxiety levels. Similarly, the pupillometric variables did not differ significantly when adjusting for the level of anxiety during and after painful stimulation due to canulation. More studies are necessary to explore the potential correlation between preoperative anxiety and pupillometry.

Broadening of attention dilates the pupil

Inconclusive evidence suggests that the pupil is more dilated when the breadth of attention is broad compared to narrow. To further investigate this relationship, we recorded pupil size from healthy volunteers while inducing trial-wise changes in breadth of attention using a shape-discrimination task where participants had to remember the location of a gap in a small or a large circle. A visual search task with targets presented at different distances from the centre of the screen was used to behaviourally assess the success of the manipulation of breadth of attention. Data were analysed using a generalised additive mixed model to test the experimental effects on pupil size after controlling for the effects of gaze location and eye vergence. The results showed that the pupil was more dilated in the broad-breadth-of-attention condition compared to the narrow-breadth-of-attention condition. However, the effect of attentional breadth on visual search performance was not mediated by pupil size, suggesting that more research is needed to understand the functional role of pupil dilation in relation to breadth of attention.

Dynamic Pupillary Response in Multiple Sclerosis Patients with and without Optic Neuritis

Multiple sclerosis (MS) is a neurodegenerative disease that affects the central nervous system which produces abnormalities in visual function, as disturbed pupillary responses, even after an episode of optic neuritis (ON). The aim was to assess different parameters of the pupillary response in MS subjects with and without ON. Therefore, 24 eyes of healthy age-matched subjects were included, 22 eyes of subjects with MS (MS group), and 13 subjects with MS with previous ON (MSON group). Pupillary parameters (ratio pupil max/min; latency; velocity and duration; contraction and dilation; and amplitude of contraction) were recorded with the MYAH topographer. Statistical analysis was performed by IBM SPSS Statistics, and parametrical or non-parametrical tests were used according to the normality of the data. MS patients did not significantly differ from healthy patients in any of the parameters analyzed (p > 0.05). Only patients with previous ON were different from healthy patients in the amplitude (40.71 ± 6.73% vs. 45.22 ± 3.29%, respectively) and latency of contraction (0.35 ± 0.13 s vs. 0.26 ± 0.05 s, respectively). The time to recover 75% of the initial diameter was abnormal in 9% of the MS subjects and 12% of MSON subjects. Based on the results of this study, the contraction process, especially latency and amplitude, was found to be affected in subjects with MS and previous ON. The degree of disability and the relation of the decrease in pupil response with other indicators of MS disease should be further investigated considering other comorbidities such as ON in the affection.

Pupil responses to colorfulness are selectively reduced in healthy older adults

The alignment between visual pathway signaling and pupil dynamics offers a promising non-invasive method to further illuminate the mechanisms of human color perception. However, only limited research has been done in this area and the effects of healthy aging on pupil responses to the different color components have not been studied yet. Here we aim to address this by modelling the effects of color lightness and chroma (colorfulness) on pupil responses in young and older adults, in a closely controlled passive viewing experiment with 26 broad-spectrum digital color fields. We show that pupil responses to color lightness and chroma are independent from each other in both young and older adults. Pupil responses to color lightness levels are unaffected by healthy aging, when correcting for smaller baseline pupil sizes in older adults. Older adults exhibit weaker pupil responses to chroma increases, predominantly along the Green-Magenta axis, while relatively sparing the Blue-Yellow axis. Our findings complement behavioral studies in providing physiological evidence that colors fade with age, with implications for color-based applications and interventions both in healthy aging and later-life neurodegenerative disorders.

Effort cost of harvest affects decisions and movement vigor of marmosets during foraging

Our decisions are guided by how we perceive the value of an option, but this evaluation also affects how we move to acquire that option. Why should economic variables such as reward and effort alter the vigor of our movements? In theory, both the option that we choose and the vigor with which we move contribute to a measure of fitness in which the objective is to maximize rewards minus efforts, divided by time. To explore this idea, we engaged marmosets in a foraging task in which on each trial they decided whether to work by making saccades to visual targets, thus accumulating food, or to harvest by licking what they had earned. We varied the effort cost of harvest by moving the food tube with respect to the mouth. Theory predicted that the subjects should respond to the increased effort costs by choosing to work longer, stockpiling food before commencing harvest, but reduce their movement vigor to conserve energy. Indeed, in response to an increased effort cost of harvest, marmosets extended their work duration, but slowed their movements. These changes in decisions and movements coincided with changes in pupil size. As the effort cost of harvest declined, work duration decreased, the pupils dilated, and the vigor of licks and saccades increased. Thus, when acquisition of reward became effortful, the pupils constricted, the decisions exhibited delayed gratification, and the movements displayed reduced vigor.

Effects of pupil size as manipulated through ipRGC activation on visual processing

The size of the eyes' pupils determines how much light enters the eye and also how well this light is focused. Through this route, pupil size shapes the earliest stages of visual processing. Yet causal effects of pupil size on vision are poorly understood and rarely studied. Here we introduce a new way to manipulate pupil size, which relies on activation of intrinsically photosensitive retinal ganglion cells (ipRGCs) to induce sustained pupil constriction. We report the effects of both experimentally induced and spontaneous changes in pupil size on visual processing as measured through EEG. We compare these to the effects of stimulus intensity and covert visual attention, because previous studies have shown that these factors all have comparable effects on some common measures of early visual processing, such as detection performance and steady-state visual evoked potentials; yet it is still unclear whether these are superficial similarities, or rather whether they reflect similar underlying processes. Using a mix of neural-network decoding, ERP analyses, and time-frequency analyses, we find that induced pupil size, spontaneous pupil size, stimulus intensity, and covert visual attention all affect EEG responses, mainly over occipital and parietal electrodes, but-crucially-that they do so in qualitatively different ways. Induced and spontaneous pupil-size changes mainly modulate activity patterns (but not overall power or intertrial coherence) in the high-frequency beta range; this may reflect an effect of pupil size on oculomotor activity and/ or visual processing. In addition, spontaneous (but not induced) pupil size tends to correlate positively with intertrial coherence in the alpha band; this may reflect a non-causal relationship, mediated by arousal. Taken together, our findings suggest that pupil size has qualitatively different effects on visual processing from stimulus intensity and covert visual attention. This shows that pupil size as manipulated through ipRGC activation strongly affects visual processing, and provides concrete starting points for further study of this important yet understudied earliest stage of visual processing.

Pupillometry reveals differences in cognitive demands of listening to face mask-attenuated speech

Face masks offer essential protection but also interfere with speech communication. Here, audio-only sentences spoken through four types of masks were presented in noise to young adult listeners. Pupil dilation (an index of cognitive demand), intelligibility, and subjective effort and performance ratings were collected. Dilation increased in response to each mask relative to the no-mask condition and differed significantly where acoustic attenuation was most prominent. These results suggest that the acoustic impact of the mask drives not only the intelligibility of speech, but also the cognitive demands of listening. Subjective effort ratings reflected the same trends as the pupil data.

Autonomic nervous system dysfunction in pediatric sport-related concussion: a systematic review

Objective

To identify, appraise and synthesize the evidence of autonomic nervous system (ANS) dysfunction following sport-related concussion in pediatric populations.

Methods

A literature search was conducted using MEDLINE (Ovid), SportDiscus (EBSCO), CINAHL (EBSCO), EMBASE (Ovid) and PsycINFO (Ovid). Studies were selected and appraised using the Joanna Briggs Institute (JBI) critical appraisal tools. Data was extracted from the included studies and qualitatively synthesized.

Results

Eleven studies were included in the synthesis. There was variability in the methods used to measure ANS function between studies, and sample populations and time to assessment following concussion varied considerably. There was also variability in the direction of change of ANS function between some studies.

Conclusion

This systematic review identifies that concussion is associated with dysregulation of ANS function in pediatric athletes. We identified some weaknesses in the extant literature which may be due to existing logistical and financial barriers to implementing valid ANS measurements in clinical and sports settings.

Attentional, emotional, and behavioral response toward spiders, scorpions, crabs, and snakes provides no evidence for generalized fear between spiders and scorpions

Spiders are among the animals evoking the highest fear and disgust and such a complex response might have been formed throughout human evolution. Ironically, most spiders do not present a serious threat, so the evolutionary explanation remains questionable. We suggest that other chelicerates, such as scorpions, have been potentially important in the formation and fixation of the spider-like category. In this eye-tracking study, we focused on the attentional, behavioral, and emotional response to images of spiders, scorpions, snakes, and crabs used as task-irrelevant distractors. Results show that spider-fearful subjects were selectively distracted by images of spiders and crabs. Interestingly, these stimuli were not rated as eliciting high fear contrary to the other animals. We hypothesize that spider-fearful participants might have mistaken crabs for spiders based on their shared physical characteristics. In contrast, subjects with no fear of spiders were the most distracted by snakes and scorpions which supports the view that scorpions as well as snakes are prioritized evolutionary relevant stimuli. We also found that the reaction time increased systematically with increasing subjective fear of spiders only when using spiders (and crabs to some extent) but not snakes and scorpions as distractors. The maximal pupil response covered not only the attentional and cognitive response but was also tightly correlated with the fear ratings of the picture stimuli. However, participants' fear of spiders did not affect individual reactions to scorpions measured by the maximal pupil response. We conclude that scorpions are evolutionary fear-relevant stimuli, however, the generalization between scorpions and spiders was not supported in spider-fearful participants. This result might be important for a better understanding of the evolution of spider phobia.

Daytime autonomic nervous system functions differ among adults with and without insomnia symptoms

STUDY OBJECTIVES

We gathered data to determine whether daytime assays of the autonomic nervous system would differ between persons with no vs modest insomnia symptoms and would correlate with the severity of insomnia symptoms in patients.

METHODS

This report is composed of 2 studies. Study 1 conducted pupillary light reflex (PLR) measurements in community volunteers who were not seeking medical care. Study 2 contrasted PLR and heart rate variability in a different sample of community volunteers and a comparison sample of adults seeking outpatient care for insomnia and psychiatric problems. All measurements were taken between 3 and 5 pm.

RESULTS

In Study 1, volunteers with modest insomnia symptom severity had a more rapid PLR average constriction velocity compared with those with no symptoms. In Study 2, lower heart rate variability, indicating higher levels of physiologic arousal, generally were in agreement with faster PLR average constriction velocity, both of which indicate higher levels of arousal. Insomnia symptom severity was highly correlated with faster average constriction velocity in the patient sample.

CONCLUSIONS

These studies suggest that (1) daytime measurements of the autonomic nervous system differ between persons with modest vs no insomnia symptoms and (2) insomnia symptom severity is highly correlated with PLR. Daytime measurement of autonomic nervous system activity might allow for daytime point-of-care measurement to characterize the level of physiologic arousal to define a hyperarousal subtype of insomnia disorder.

CITATION

McCall WV, Looney SW, Zulfiqar M, et al. Daytime autonomic nervous system functions differ among adults with and without insomnia symptoms. J Clin Sleep Med. 2023;19(11):1885-1893.

Vagal sensory neurons mediate the Bezold-Jarisch reflex and induce syncope

Visceral sensory pathways mediate homeostatic reflexes, the dysfunction of which leads to many neurological disorders1. The Bezold-Jarisch reflex (BJR), first described2,3 in 1867, is a cardioinhibitory reflex that is speculated to be mediated by vagal sensory neurons (VSNs) that also triggers syncope. However, the molecular identity, anatomical organization, physiological characteristics and behavioural influence of cardiac VSNs remain mostly unknown. Here we leveraged single-cell RNA-sequencing data and HYBRiD tissue clearing4 to show that VSNs that express neuropeptide Y receptor Y2 (NPY2R) predominately connect the heart ventricular wall to the area postrema. Optogenetic activation of NPY2R VSNs elicits the classic triad of BJR responses-hypotension, bradycardia and suppressed respiration-and causes an animal to faint. Photostimulation during high-resolution echocardiography and laser Doppler flowmetry with behavioural observation revealed a range of phenotypes reflected in clinical syncope, including reduced cardiac output, cerebral hypoperfusion, pupil dilation and eye-roll. Large-scale Neuropixels brain recordings and machine-learning-based modelling showed that this manipulation causes the suppression of activity across a large distributed neuronal population that is not explained by changes in spontaneous behavioural movements. Additionally, bidirectional manipulation of the periventricular zone had a push-pull effect, with inhibition leading to longer syncope periods and activation inducing arousal. Finally, ablating NPY2R VSNs specifically abolished the BJR. Combined, these results demonstrate a genetically defined cardiac reflex that recapitulates characteristics of human syncope at physiological, behavioural and neural network levels.

The pupil collaboration: A multi-lab, multi-method analysis of goal attribution in infants

The rise of pupillometry in infant research over the last decade is associated with a variety of methods for data preprocessing and analysis. Although pupil diameter is increasingly recognized as an alternative measure of the popular cumulative looking time approach used in many studies (Jackson & Sirois, 2022), an open question is whether the many approaches used to analyse this variable converge. To this end, we proposed a crowdsourced approach to pupillometry analysis. A dataset from 30 9-month-old infants (15 girls; Mage = 282.9 days, SD = 8.10) was provided to 7 distinct teams for analysis. The data were obtained from infants watching video sequences showing a hand, initially resting between two toys, grabbing one of them (after Woodward, 1998). After habituation, infants were shown (in random order) a sequence of four test events that varied target position and target toy. Results show that looking times reflect primarily the familiar path of the hand, regardless of target toy. Gaze data similarly show this familiarity effect of path. The pupil dilation analyses show that features of pupil baseline measures (duration and temporal location) as well as data retention variation (trial and/or participant) due to different inclusion criteria from the various analysis methods are linked to divergences in findings. Two of the seven teams found no significant findings, whereas the remaining five teams differ in the pattern of findings for main and interaction effects. The discussion proposes guidelines for best practice in the analysis of pupillometry data.

The next frontier: Moving human fear conditioning research online

Fear conditioning is a significant area of research that has featured prominently among the topics published in Biological Psychology over the last 50 years. This work has greatly contributed to our understanding of human anxiety and stressor-related disorders. While mainly conducted in the laboratory, recently, there have been initial attempts to conduct fear conditioning experiments online, with around 10 studies published on the subject, primarily in the last two years. These studies have demonstrated the potential of online fear conditioning research, although challenges to ensure that this research meets the same methodological standards as in-person experimentation remain, despite recent progress. We expect that in the coming years new outcome measures will become available online including the measurement of eye-tracking, pupillometry and probe reaction time and that compliance monitoring will be improved. This exciting new approach opens new possibilities for large-scale data collection among hard-to-reach populations and has the potential to transform the future of fear conditioning research.

Age- and glaucoma-induced changes to the ocular glymphatic system

The ocular glymphatic system supports bidirectional fluid transport along the optic nerve, thereby removes metabolic wastes including amyloid-β. To better understand this biological process, we examined the distributions of intravitreally and intracisternally infused tracers in full-length optic nerves from different age groups of mice. Aging was linked to globally impaired ocular glymphatic fluid transport, similar to what has seen previously in the brain. Aging also reduced the pupillary responsiveness to light stimulation and abolished light-induced facilitation in anterograde ocular glymphatic flow. In contrast to normal aging, in the DBA/2 J model of glaucoma, we found a pathological increase of glymphatic fluid transport to the anterior optic nerve that was associated with dilation of the perivascular spaces. Thus, aging and glaucoma have fundamentally different effects on ocular glymphatic fluid transport. Manipulation of glymphatic fluid transport might therefore present a new target for the treatment of glaucoma.

Autogenous cerebral processes: an invitation to look at the brain from inside out

While external stimulation can reliably trigger neuronal activity, cerebral processes can operate independently from the environment. In this study, we conceptualize autogenous cerebral processes (ACPs) as intrinsic operations of the brain that exist on multiple scales and can influence or shape stimulus responses, behavior, homeostasis, and the physiological state of an organism. We further propose that the field should consider exploring to what extent perception, arousal, behavior, or movement, as well as other cognitive functions previously investigated mainly regarding their stimulus-response dynamics, are ACP-driven.

Pretreatment pupillary reactivity is associated with outcome of Repetitive Transcranial Magnetic Stimulation (rTMS) treatment of Major Depressive Disorder (MDD)

BACKGROUND

Pre-treatment biomarkers for outcome of repetitive Transcranial Magnetic Stimulation (rTMS) treatment of Major Depressive Disorder (MDD) have proven elusive. One promising family of biomarkers involves the autonomic nervous system (ANS), which is dysregulated in individuals with MDD.

METHODS

We examined the relationship between the pre-treatment pupillary light reflex (PLR) and rTMS outcome in 51 MDD patients. Outcome was measured as the percent change in the 30-item Inventory of Depressive Symptomatology Self Rated (IDS-SR) score from baseline to treatment 30.

RESULTS

Patients showed significant improvement with rTMS treatment. There was a significant correlation between baseline pupillary Constriction Amplitude (CA) and clinical improvement over the treatment course (R = 0.41, p = 0.003).

LIMITATIONS

We examined a limited number of subjects who received heterogeneous treatment protocols. Almost all patients in the study received psychotropic medications concomitant with rTMS treatment.

CONCLUSION

PLR measured before treatment may be a predictive biomarker for clinical improvement from rTMS in subjects with MDD.

Microsaccade rate activity during the preparation of pro- and antisaccades

Microsaccades belong to the category of fixational micromovements and may be crucial for image stability on the retina. Eye movement paradigms typically require fixational control, but this does not eliminate all oculomotor activity. The antisaccade task requires a planned eye movement in the direction opposite of an onset, allowing separation of planning and execution. We build on previous studies of microsaccades in the antisaccade task using a combination of fixed and mixed pro- and antisaccade blocks. We hypothesized that microsaccade rates may be reduced prior to the execution of antisaccades as compared with regular saccades (prosaccades). In two experiments, we measured microsaccades in four conditions across three trial blocks: one block each of fixed prosaccade and antisaccade trials, and a mixed block where both saccade types were randomized. We anticipated that microsaccade rates would be higher prior to antisaccades than prosaccades due to the need to preemptively suppress reflexive saccades during antisaccade generation. In Experiment 1, with monocular eye tracking, there was an interaction between the effects of saccade and block type on microsaccade rates, suggesting lower rates on antisaccade trials, but only within mixed blocks. In Experiment 2, eye tracking was binocular, revealing suppressed microsaccade rates on antisaccade trials. A cluster permutation analysis of the microsaccade rate over the course of a trial did not reveal any particular critical time for this difference in microsaccade rates. Our findings suggest that microsaccade rates reflect the degree of suppression of the oculomotor system during the antisaccade task.

Evidence that pupil dilation and cardiac afferent signalling differentially impact the processing of emotional intensity and racial bias

Interoceptive cardiac arousal signals (e.g., from baroreceptor firing at ventricular systole compared to diastole) have been found to enhance perception of fearful versus neutral faces. They have also been found to amplify racially biased misidentification of tools as weapons when preceded by facial images of Black versus White individuals. Since pupil size is strongly coupled to arousal, we tested if experimental manipulation of pupil size influences fear processing in emotional judgement and racial bias tasks involving measurement of cardiac signals. In a sample of 22 non-clinical participants in an emotional intensity judgement task, pupil size did not affect emotional intensity ratings. Nor did it interact with differential effects of cardiac systole versus diastole on intensity judgements of fearful and neutral faces, replicated here. In a sample of 25 non-clinical participants in a weapons identification task, larger pupil size resulted in faster response times and lower accuracy when identifying tools and weapons. However, pupil size did not interact with weapon versus tool identification, race of prime, or cardiac timing. We nevertheless replicated the observed increase in racially biased misidentification of tools as weapons following Black face primes presented at cardiac systole. Together our findings indicate that pupil dilation does not directly influence the processing of fear cues or perceived threat (as in racial bias) yet affects task performance by decreasing response times and accuracy. These findings contrast with the established effect of cardiac arousal signals on threat processing and may help focus interventions to mitigate related decision errors in high-pressure occupations.

Emphasis on peripheral vision is accompanied by pupil dilation

People are best able to detect stimuli in peripheral vision when their pupils are large, and best able to discriminate stimuli in central vision when their pupils are small. However, it is unclear whether our visual system makes use of this by dilating the pupils when attention is directed towards peripheral vision. Therefore, throughout three experiments (N = 100), we tested whether pupil size adapts to the "breadth" of attention. We found that pupils dilate with increasing attentional breadth, both when attention is diffusely spread and when attention is directed at specific locations in peripheral vision. Based on our results and others, we propose that cognitively driven pupil dilation is not an epiphenomenal marker of locus coeruleus activity, as is often assumed, but rather is an adaptive response that reflects an emphasis on peripheral vision.

Different rules for binocular combination of luminance flicker in cortical and subcortical pathways

How does the human brain combine information across the eyes? It has been known for many years that cortical normalization mechanisms implement 'ocularity invariance': equalizing neural responses to spatial patterns presented either monocularly or binocularly. Here, we used a novel combination of electrophysiology, psychophysics, pupillometry, and computational modeling to ask whether this invariance also holds for flickering luminance stimuli with no spatial contrast. We find dramatic violations of ocularity invariance for these stimuli, both in the cortex and also in the subcortical pathways that govern pupil diameter. Specifically, we find substantial binocular facilitation in both pathways with the effect being strongest in the cortex. Near-linear binocular additivity (instead of ocularity invariance) was also found using a perceptual luminance matching task. Ocularity invariance is, therefore, not a ubiquitous feature of visual processing, and the brain appears to repurpose a generic normalization algorithm for different visual functions by adjusting the amount of interocular suppression.

Acceleration of inferred neural responses to oddball targets in an individual with bilateral amygdala lesion compared to healthy controls

Detecting unusual auditory stimuli is crucial for discovering potential threat. Locus coeruleus (LC), which coordinates attention, and amygdala, which is implicated in resource prioritization, both respond to deviant sounds. Evidence concerning their interaction, however, is sparse. Seeking to elucidate if human amygdala affects estimated LC activity during this process, we recorded pupillary responses during an auditory oddball and an illuminance change task, in a female with bilateral amygdala lesions (BG) and in n = 23 matched controls. Neural input in response to oddballs was estimated via pupil dilation, a reported proxy of LC activity, harnessing a linear-time invariant system and individual pupillary dilation response function (IRF) inferred from illuminance responses. While oddball recognition remained intact, estimated LC input for BG was compacted to an impulse rather than the prolonged waveform seen in healthy controls. This impulse had the earliest response mean and highest kurtosis in the sample. As a secondary finding, BG showed enhanced early pupillary constriction to darkness. These findings suggest that LC-amygdala communication is required to sustain LC activity in response to anomalous sounds. Our results provide further evidence for amygdala involvement in processing deviant sound targets, although it is not required for their behavioral recognition.

Methods in cognitive pupillometry: Design, preprocessing, and statistical analysis

Cognitive pupillometry is the measurement of pupil size to investigate cognitive processes such as attention, mental effort, working memory, and many others. Currently, there is no commonly agreed-upon methodology for conducting cognitive-pupillometry experiments, and approaches vary widely between research groups and even between different experiments from the same group. This lack of consensus makes it difficult to know which factors to consider when conducting a cognitive-pupillometry experiment. Here we provide a comprehensive, hands-on guide to methods in cognitive pupillometry, with a focus on trial-based experiments in which the measure of interest is the task-evoked pupil response to a stimulus. We cover all methodological aspects of cognitive pupillometry: experimental design, preprocessing of pupil-size data, and statistical techniques to deal with multiple comparisons when testing pupil-size data. In addition, we provide code and toolboxes (in Python) for preprocessing and statistical analysis, and we illustrate all aspects of the proposed workflow through an example experiment and example scripts.

Look into my eyes: What can eye-based measures tell us about the relationship between physical activity and cognitive performance?

BACKGROUND

There is a growing interest to understand the neurobiological mechanisms that drive the positive associations of physical activity and fitness with measures of cognitive performance. To better understand those mechanisms, several studies have employed eye-based measures (e.g., eye movement measures such as saccades, pupillary measures such as pupil dilation, and vascular measures such as retinal vessel diameter) deemed to be proxies for specific neurobiological mechanisms. However, there is currently no systematic review providing a comprehensive overview of these studies in the field of exercise-cognition science. Thus, this review aimed to address that gap in the literature.

METHODS

To identify eligible studies, we searched 5 electronic databases on October 23, 2022. Two researchers independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX scale, for interventional studies) and the critical appraisal tool from the Joanna Briggs Institute (for cross-sectional studies).

RESULTS

Our systematic review (n = 35 studies) offers the following main findings: (a) there is insufficient evidence available to draw solid conclusions concerning gaze-fixation-based measures; (b) the evidence that pupillometric measures, which are a proxy for the noradrenergic system, can explain the positive effect of acute exercise and cardiorespiratory fitness on cognitive performance is mixed; (c) physical training- or fitness-related changes of the cerebrovascular system (operationalized via changes in retinal vasculature) are, in general, positively associated with cognitive performance improvements; (d) acute and chronic physical exercises show a positive effect based on an oculomotor-based measure of executive function (operationalized via antisaccade tasks); and (e) the positive association between cardiorespiratory fitness and cognitive performance is partly mediated by the dopaminergic system (operationalized via spontaneous eye-blink rate).

CONCLUSION

This systematic review offers confirmation that eye-based measures can provide valuable insight into the neurobiological mechanisms that may drive positive associations between physical activity and fitness and measures of cognitive performance. However, due to the limited number of studies utilizing specific methods for obtaining eye-based measures (e.g., pupillometry, retinal vessel analysis, spontaneous eye blink rate) or investigating a possible dose-response relationship, further research is necessary before more nuanced conclusions can be drawn. Given that eye-based measures are economical and non-invasive, we hope this review will foster the future application of eye-based measures in the field of exercise-cognition science.

Racially fair pupillometry measurements for RGB smartphone cameras using the far red spectrum

Pupillometry is a measurement of pupil dilation commonly performed as part of neurological assessments. Prior work have demonstrated the potential for pupillometry in screening or diagnosing a number of neurological disorders including Alzheimer's Disease, Schizophrenia, and Traumatic Brain Injury. Unfortunately, the expense and inaccessibility of specialized pupilometers that image in the near infrared spectrum limit the measurement to high resource clinics or institutions. Ideally, this measurement could be available via ubiquitous devices like smartphones or tablets with integrated visible spectrum imaging systems. In the visible spectrum of RGB cameras, the melanin in the iris absorbs light such that it is difficult to distinguish the pupil aperature that appears black. In this paper, we propose a novel pupillometry technique to enable smartphone RGB cameras to effectively differentiate the pupil from the iris. The proposed system utilizes a 630 nm long-pass filter to image in the far red (630-700 nm) spectrum, where the melanin in the iris reflects light to appear brighter in constrast to the dark pupil. Using a convolutional neural network, the proposed system measures pupil diameter as it dynamically changes in a frame by frame video. Comparing across 4 different smartphone models, the pupil-iris contrast of N = 12 participants increases by an average of 451% with the proposed system. In a validation study of N = 11 participants comparing the relative pupil change in the proposed system to a Neuroptics PLR-3000 Pupillometer during a pupillary light response test, the prototype system acheived a mean absolute error of 2.4%.

Cognitive effort investment: Does disposition become action?

Contrary to the law of less work, individuals with high levels of need for cognition and self-control tend to choose harder tasks more often. While both traits can be integrated into a core construct of dispositional cognitive effort investment, its relation to actual cognitive effort investment remains unclear. As individuals with high levels of cognitive effort investment are characterized by a high intrinsic motivation towards effortful cognition, they would be less likely to increase their effort based on expected payoff, but rather based on increasing demand. In the present study, we measured actual effort investment on multiple dimensions, i.e., subjective load, reaction time, accuracy, early and late frontal midline theta power, N2 and P3 amplitude, and pupil dilation. In a sample of N = 148 participants, we examined the relationship of dispositional cognitive effort investment and effort indices during a flanker and an n-back task with varying demand and payoff. Exploratorily, we examined this relationship for the two subdimensions cognitive motivation and effortful-self-control as well. In both tasks, effort indices were sensitive to demand and partly to payoff. The analyses revealed a main effect of cognitive effort investment for accuracy (n-back task), interaction effects with payoff for reaction time (n-back and flanker task) and P3 amplitude (n-back task) and demand for early frontal midline theta power (flanker task). Taken together, our results partly support the notion that individuals with high levels of cognitive effort investment exert effort more efficiently. Moreover, the notion that these individuals exert effort regardless of payoff is partly supported, too. This may further our understanding of the conditions under which person-situation interactions occur, i.e. the conditions under which situations determine effort investment in goal-directed behavior more than personality, and vice versa.

Dogs Rely On Visual Cues Rather Than On Effector-Specific Movement Representations to Predict Human Action Targets

The ability to predict others' actions is one of the main pillars of social cognition. We investigated the processes underlying this ability by pitting motor representations of the observed movements against visual familiarity. In two pre-registered eye-tracking experiments, we measured the gaze arrival times of 16 dogs (Canis familiaris) who observed videos of a human or a conspecific executing the same goal-directed actions. On the first trial, when the human agent performed human-typical movements outside dogs' specific motor repertoire, dogs' gaze arrived at the target object anticipatorily (i.e., before the human touched the target object). When the agent was a conspecific, dogs' gaze arrived to the target object reactively (i.e., upon or after touch). When the human agent performed unusual movements more closely related to the dogs' motor possibilities (e.g., crawling instead of walking), dogs' gaze arrival times were intermediate between the other two conditions. In a replication experiment, with slightly different stimuli, dogs' looks to the target object were neither significantly predictive nor reactive, irrespective of the agent. However, when including looks at the target object that were not preceded by looks to the agents, on average dogs looked anticipatorily and sooner at the human agent's action target than at the conspecific's. Looking times and pupil size analyses suggest that the dogs' attention was captured more by the dog agent. These results suggest that visual familiarity with the observed action and saliency of the agent had a stronger influence on the dogs' looking behaviour than effector-specific movement representations in anticipating action targets.

Trigeminal Stimulation and Visuospatial Performance: The Struggle between Chewing and Trigeminal Asymmetries

Chewing improves visuospatial performance through locus coeruleus (LC) activation. The effects of bilateral and unilateral mastication were investigated in subjects showing different degrees of asymmetry in masseter electromyographic (EMG) activity during clenching and in pupil size at rest (anisocoria), which is a proxy of LC imbalance. Correlations between performance changes and asymmetry values were found in males, but not in females. Among males, subjects with low asymmetry values (balanced-BAL) were more sensitive than those with high asymmetry values (imbalanced-IMB) to bilateral and unilateral chewing on the side with higher EMG activity (hypertonic). The opposite was true for hypotonic side chewing. BAL subjects were sensitive to unilateral chewing on both sides, while in IMB subjects, hypertonic side chewing did not influence performance in either males or females. Bilateral chewing elicited larger effects in BAL subjects than in IMB subjects, exceeding the values predicted from unilateral chewing in both groups. Finally, pupil size and anisocoria changes elicited by chewing were correlated with asymmetry values, independent of sex. Data confirmed the facilitation of visuospatial performance exerted by chewing. Trigeminal asymmetries modulate the chewing effects, making occlusal rebalancing an appropriate strategy to improve performance.

Virtual reality for assessing stereopsis performance and eye characteristics in Post-COVID

In 2019, we faced a pandemic due to the coronavirus disease (COVID-19), with millions of confirmed cases and reported deaths. Even in recovered patients, symptoms can be persistent over weeks, termed Post-COVID. In addition to common symptoms of fatigue, muscle weakness, and cognitive impairments, visual impairments have been reported. Automatic classification of COVID and Post-COVID is researched based on blood samples and radiation-based procedures, among others. However, a symptom-oriented assessment for visual impairments is still missing. Thus, we propose a Virtual Reality environment in which stereoscopic stimuli are displayed to test the patient's stereopsis performance. While performing the visual tasks, the eyes' gaze and pupil diameter are recorded. We collected data from 15 controls and 20 Post-COVID patients in a study. Therefrom, we extracted features of three main data groups, stereopsis performance, pupil diameter, and gaze behavior, and trained various classifiers. The Random Forest classifier achieved the best result with 71% accuracy. The recorded data support the classification result showing worse stereopsis performance and eye movement alterations in Post-COVID. There are limitations in the study design, comprising a small sample size and the use of an eye tracking system.

Eye Movements Decrease during Effortful Speech Listening

Hearing impairment affects many older adults but is often diagnosed decades after speech comprehension in noisy situations has become effortful. Accurate assessment of listening effort may thus help diagnose hearing impairment earlier. However, pupillometry-the most used approach to assess listening effort-has limitations that hinder its use in practice. The current study explores a novel way to assess listening effort through eye movements. Building on cognitive and neurophysiological work, we examine the hypothesis that eye movements decrease when speech listening becomes challenging. In three experiments with human participants from both sexes, we demonstrate, consistent with this hypothesis, that fixation duration increases and spatial gaze dispersion decreases with increasing speech masking. Eye movements decreased during effortful speech listening for different visual scenes (free viewing, object tracking) and speech materials (simple sentences, naturalistic stories). In contrast, pupillometry was less sensitive to speech masking during story listening, suggesting pupillometric measures may not be as effective for the assessments of listening effort in naturalistic speech-listening paradigms. Our results reveal a critical link between eye movements and cognitive load, suggesting that neural activity in the brain regions that support the regulation of eye movements, such as frontal eye field and superior colliculus, are modulated when listening is effortful.SIGNIFICANCE STATEMENT Assessment of listening effort is critical for early diagnosis of age-related hearing loss. Pupillometry is most used but has several disadvantages. The current study explores a novel way to assess listening effort through eye movements. We examine the hypothesis that eye movements decrease when speech listening becomes effortful. We demonstrate, consistent with this hypothesis, that fixation duration increases and gaze dispersion decreases with increasing speech masking. Eye movements decreased during effortful speech listening for different visual scenes (free viewing, object tracking) and speech materials (sentences, naturalistic stories). Our results reveal a critical link between eye movements and cognitive load, suggesting that neural activity in brain regions that support the regulation of eye movements are modulated when listening is effortful.

The Costs of Paying Overt and Covert Attention Assessed With Pupillometry

Attention can be shifted with or without an accompanying saccade (i.e., overtly or covertly, respectively). Thus far, it is unknown how cognitively costly these shifts are, yet such quantification is necessary to understand how and when attention is deployed overtly or covertly. In our first experiment (N = 24 adults), we used pupillometry to show that shifting attention overtly is more costly than shifting attention covertly, likely because planning saccades is more complex. We pose that these differential costs will, in part, determine whether attention is shifted overtly or covertly in a given context. A subsequent experiment (N = 24 adults) showed that relatively complex oblique saccades are more costly than relatively simple saccades in horizontal or vertical directions. This provides a possible explanation for the cardinal-direction bias of saccades. The utility of a cost perspective as presented here is vital to furthering our understanding of the multitude of decisions involved in processing and interacting with the external world efficiently.

Dogs' expectations about occlusion events: from expectancy violation to exploration

Previous research on human infants has shown that violations of basic physical regularities can stimulate exploration, which may represent a type of hypothesis testing aimed at acquiring knowledge about new causal relationships. In this study, we examined whether a similar connection between expectancy violation and exploration exists in nonhuman animals. Specifically, we investigated how dogs react to expectancy violations in the context of occlusion events. Throughout three experiments, dogs exhibited longer looking times at expectancy-inconsistent events than at consistent ones. This finding was further supported by pupil size analyses in the first two eye-tracking experiments. Our results suggest that dogs expect objects to reappear when they are not obstructed by a screen and consider the size of the occluding screen in relation to the occluded object. In Experiment 3, expectancy violations increased the dogs' exploration of the target object, similar to the findings with human infants. We conclude that expectancy violations can provide learning opportunities for nonhuman animals as well.

The Pupil Knows: Pupil Dilation Indexes and Their Inhibitory Ability in Normal Aging

Pupil dilation is considered an index of cognitive effort, as the pupil typically dilates as the cognitive load increases. In this paper, we evaluated whether older adults demonstrate increased pupil size when performing tasks requiring cognitive inhibition. We invited 44 older and 44 younger adults to perform the Stroop task while their pupil dilation was recorded with eye-tracking glasses. The dependent variables were the number of accurate responses on the Stroop task as well as pupil size in the three conditions of the task (i.e., color naming, word reading, and the interference condition). The results demonstrated less accurate responses in the interference condition than in the color-naming or word-reading conditions, in both older and younger adults. Critically, larger pupil dilation was observed in the interference condition than in the color-naming and word-reading conditions, in both older and younger adults. This study demonstrates that pupil dilation responds to cognitive effort in normal aging, at least in the interference condition of the Stroop task.

Prediction of cognitive scores by joint use of movie-watching fMRI connectivity and eye tracking via Attention-CensNet

Background

Brain functional connectivity under the naturalistic paradigm has been shown to be better at predicting individual behaviors than other brain states, such as rest and doing tasks. Nevertheless, the state-of-the-art methods have found it difficult to achieve desirable results from movie-watching paradigm functional magnetic resonance imaging (mfMRI) -induced brain functional connectivity, especially when there are fewer datasets. Incorporating other physical measurements into the prediction method may enhance accuracy. Eye tracking, becoming popular due to its portability and lower expense, can provide abundant behavioral features related to the output of human's cognition, and thus might supplement the mfMRI in observing participants' subconscious behaviors. However, there are very few studies on how to effectively integrate the multimodal information to strengthen the performance by a unified framework.

Objective

A fusion approach with mfMRI and eye tracking, based on convolution with edge-node switching in graph neural networks (CensNet), is proposed in this article.

Methods

In this graph model, participants are designated as nodes, mfMRI derived functional connectivity as node features, and different eye-tracking features are used to compute similarity between participants to construct heterogeneous graph edges. By taking multiple graphs as different channels, we introduce squeeze-and-excitation attention module to CensNet (A-CensNet) to integrate graph embeddings from multiple channels into one.

Results

The proposed model outperforms those using a single modality and single channel, and state-of-the-art methods.

Conclusions

The results indicate that brain functional activities and eye behaviors might complement each other in interpreting trait-like phenotypes.

State-of-the-Art Evaluation of Acute Adult Disorders of Consciousness for the General Intensivist

OBJECTIVES

To provide a concise review of knowledge and practice pertaining to the diagnosis and initial management of unanticipated adult patient disorders of consciousness (DoC) by the general intensivist.

DATA SOURCES

Detailed search strategy using PubMed and OVID Medline for English language articles describing adult patient acute DoC diagnostic evaluation and initial management strategies including indications for transfer.

STUDY SELECTION

Descriptive and interventional studies that address acute adult DoC, their evaluation and initial management, indications for transfer, as well as outcome prognostication.

DATA EXTRACTION

Relevant descriptions or studies were reviewed, and the following aspects of each manuscript were identified, abstracted, and analyzed: setting, study population, aims, methods, results, and relevant implications for adult critical care practice.

DATA SYNTHESIS

Acute adult DoC may be categorized by etiology including structural, functional, infectious, inflammatory, and pharmacologic, the understanding of which drives diagnostic investigation, monitoring, acute therapy, and subsequent specialist care decisions including team-based local care as well as intra- and inter-facility transfer.

CONCLUSIONS

Acute adult DoC may be initially comprehensively addressed by the general intensivist using an etiology-driven and team-based approach. Certain clinical conditions, procedural expertise needs, or resource limitations inform transfer decision-making within a complex care facility or to one with greater complexity. Emerging collaborative science helps improve our current knowledge of acute DoC to better align therapies with underpinning etiologies.

The nonlinearity of pupil diameter fluctuations in an insight task as criteria for detecting children who solve the problem from those who do not

Insights, characterized by sudden discoveries following unsuccessful problem-solving attempts, are fascinating phenomena. Dynamic systems perspectives argue that insight arises from self-organizing perceptual and motor processes. Entropy and fractal scaling are potential markers for emerging new and effective solutions. This study investigated whether specific features associated with self-organization in dynamical systems can distinguish between individuals who succeed and those who fail in solving insight tasks. To achieve this, we analyzed pupillary diameter fluctuations of children aged 6 to 12 during the 8-coin task, a well-established insight task. The participants were divided into two groups: successful (n = 24) and unsuccessful (n = 43) task completion. Entropy, determinism, recurrence ratio, and the β scaling exponent were estimated using Recurrence Quantification and Power Spectrum Density analyses. The results indicated that the solver group exhibited more significant uncertainty and lower predictability in pupillary diameter fluctuations before finding the solution. Recurrence Quantification Analysis revealed changes that went unnoticed by mean and standard deviation measures. However, the β scaling exponent did not differentiate between the two groups. These findings suggest that entropy and determinism in pupillary diameter fluctuations can identify early differences in problem-solving success. Further research is needed to determine the exclusive role of perceptual and motor activity in generating insights and investigate these results' generalizability to other tasks and populations.

Detection of Relative Afferent Pupillary Defects Using Eye Tracking and a VR Headset

Purpose

The purpose of this study was to assess the feasibility of detecting relative afferent pupillary defects (RAPDs) using a commercial virtual reality headset equipped with an eye tracker.

Methods

This is a cross-sectional study in which we compare the new computerized RAPD test with the traditional clinical standard using the swinging flashlight test. Eighty-two participants including 20 healthy volunteers aged 10 to 88 years were enrolled in this study. We present a bright/dark stimulus alternating between the eyes every 3 seconds using a virtual reality headset, and we simultaneously record changes in pupil size. To determine the presence of an RAPD, we developed an algorithm analyzing the pupil size differences. For the assessment of the performance of the automated and the manual measurement a post hoc impression based on all available data is created. The accuracy of the manual clinical evaluation and the computerized method is compared using confusion matrices and the gold standard of the post hoc impression. The latter is based on all available clinical information.

Results

We found that the computerized method detected RAPD with a sensitivity of 90.2% and an accuracy of 84.4%, as compared to the post hoc impression. This was not significantly different from the clinical evaluation with a sensitivity of 89.1% and an accuracy of 88.3%.

Conclusions

The presented method offers an accurate, easy to use, and fast method to measure an RAPD. In contrast to today's clinical practice, the measures are quantitative and objective.

Translational Relevance

Computerized testing of Relative Afferent Pupillary Defects (RAPD) using a VR-headset and eye-tracking reaches non-inferior performance compared with senior neuro-ophthalmologists.

Coherence and divergence in autonomic-subjective affective space

A central tenet of many theories of emotion is that emotional states are accompanied by distinct patterns of autonomic activity. However, experimental studies of coherence between subjective and autonomic responses during emotional states provide little evidence of coherence. Crucially, previous studies investigating coherence have either adopted univariate approaches or made limited use of multivariate analytic approaches by investigating subjective and autonomic responses separately. The current study addressed this question using a multivariate dimensional approach to build a common autonomic-subjective affective space incorporating subjective responses and three different autonomic signals (heart rate, skin conductance response, and pupil diameter), measured during an emotion-inducing task, in 51 participants. Results showed that autonomic and subjective responses could be adequately described in a two-dimensional affective space. The first dimension included contributions from subjective and autonomic responses, indicating coherence, while contributions to the second dimension were almost exclusively of autonomic covariance. Thus, while there was a degree of coherence between autonomic and subjective emotional responses, there was substantial structure in autonomic responses that did not covary with subjective emotional experience. This study, therefore, contributes new insights into the relationship between subjective and autonomic emotional responses, and provides a framework for future multimodal emotion research, enabling both hypothesis- and data-driven testing.

Warning signals only support the first action in a sequence

Acting upon target stimuli from the environment becomes faster when the targets are preceded by a warning (alerting) cue. Accordingly, alerting is often used to support action in safety-critical contexts (e.g., honking to alert others of a traffic situation). Crucially, however, the benefits of alerting for action have been established using laboratory tasks assessing only simple choice reactions. Real-world actions are considerably more complex and mainly consist of sensorimotor sequences of several sub-actions. Therefore, it is still unknown if the benefits of alerting for action transfer from simple choice reactions to such sensorimotor sequences. Here, we investigated how alerting affected performance in a sequential action task derived from the Trail-Making-Test, a well-established neuropsychological test of cognitive action control (Experiment 1). In addition to this task, participants performed a classic alerting paradigm including a simple choice reaction task (Experiment 2). Results showed that alerting sped up responding in both tasks, but in the sequential action task, this benefit was restricted to the first action of a sequence. This was the case, even when multiple actions were performed within a short time (Experiment 3), ruling out that the restriction of alerting to the first action was due to its short-lived nature. Taken together, these findings reveal the existence of an interface between phasic alertness and action control that supports the next action.

Combining Multiple Psychophysiological Measures of Listening Effort: Challenges and Recommendations

About one-third of all recently published studies on listening effort have used at least one physiological measure, providing evidence of the popularity of such measures in listening effort research. However, the specific measures employed, as well as the rationales used to justify their inclusion, vary greatly between studies, leading to a literature that is fragmented and difficult to integrate. A unified approach that assesses multiple psychophysiological measures justified by a single rationale would be preferable because it would advance our understanding of listening effort. However, such an approach comes with a number of challenges, including the need to develop a clear definition of listening effort that links to specific physiological measures, customized equipment that enables the simultaneous assessment of multiple measures, awareness of problems caused by the different timescales on which the measures operate, and statistical approaches that minimize the risk of type-I error inflation. This article discusses in detail the various obstacles for combining multiple physiological measures in listening effort research and provides recommendations on how to overcome them.

Salient omissions-pupil dilation in response to unexpected omissions of sound and touch

Introduction

Recent theories describe perception as an inferential process based on internal predictive models adjusted by means of prediction violations (prediction error). To study and demonstrate predictive processing in the brain the use of unexpected stimulus omissions has been suggested as a promising approach as the evoked brain responses are uncontaminated by responses to stimuli. Here, we aimed to investigate the pupil's response to unexpected stimulus omissions in order to better understand surprise and orienting of attention resulting from prediction violation. So far only few studies have used omission in pupillometry research and results have been inconsistent.

Methods

This study adapted an EEG paradigm that has been shown to elicit omission responses in auditory and somatosensory modalities. Healthy adults pressed a button at their own pace, which resulted in the presentation of sounds or tactile stimuli in either 88%, 50% or 0% (motor-control) of cases. Pupil size was recorded continuously and averaged to analyze the pupil dilation response associated with each condition.

Results

Results revealed that omission responses were observed in both modalities in the 88%-condition compared to motor-control. Similar pupil omission responses were observed between modalities, suggesting modality-unspecific activation of the underlying brain circuits.

Discussion

In combination with previous omission studies using EEG, the findings demonstrate predictive models in brain processing and point to the involvement of subcortical structures in the omission response. Our pupillometry approach is especially suitable to study sensory prediction in vulnerable populations within the psychiatric field.

Pupillary motility responses to affectively salient stimuli in individuals with depression or elevated risk of depression: A systematic review and meta-analysis

Elaborative affective processing is observed in depression, and pupillary reactivity, a continuous, sensitive, and reliable indicator of physiological arousal and neurocognitive processing, is increasingly utilized in studies of depression-related characteristics. As a first attempt to quantitively summarize existing evidence on depression-related pupillary reactivity alterations, this review and meta-analysis evaluated the direction, magnitude, and specificity of pupillary indices of affective processing towards positively, negatively, and neutrally-valenced stimuli among individuals diagnosed with depression or with elevated risk of depression. Studies on pupillary responses to affective stimuli in the target groups were identified in PsycINFO and PubMed databases. Twenty-two articles met inclusion criteria for the qualitative review and 16 for the quantitative review. Three-level frequentist and Bayesian models were applied to summarize pooled effects from baseline-controlled stimuli-induced average changes in pupillary responses. In general, compared to non-depressed individuals, individuals with depression or elevated risk of depression exhibited higher pupillary reactivity (d =0.15) towards negatively-valenced stimuli during affective processing. Pupillary motility towards negatively-valenced stimuli may be a promising trait-like marker for depression vulnerability.