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Corbo I, Favieri F, Forte G, Casagrande M. Decision-making under uncertainty in healthy and cognitively impaired aging: A systematic review and meta-analysis. Arch Gerontol Geriatr 2024; 129:105643. [PMID: 39369563 DOI: 10.1016/j.archger.2024.105643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 09/07/2024] [Accepted: 09/22/2024] [Indexed: 10/08/2024]
Abstract
Decision-making (DM) is a complex cognitive behavior that involves gathering information and assessing options to identify choices under risky and uncertain conditions. Mild Cognitive Impairment (MCI) is a construct that includes a constellation of symptoms ranging from behavioral to cognitive impairments. This cluster of symptoms is frequently associated with poor decision-making. This study aimed to examine decision-making in pathological aging, specifically MCI. Therefore, we conducted a systematic review and meta-analysis to evaluate these relationships. According to the PRISMA 2020 Statement, nine studies were selected for the systematic review and eight for the meta-analysis. The results highlighted that MCI is associated with impaired decision-making in risky and ambiguous situations. The systematic review reported that MCI was associated with impaired decision-making in ambiguous and in risky conditions. In contrast, the meta-analysis showed significant differences in overall decision-making and particularly in ambiguous conditions. This difficulty may be due to different impairments that affect MCI. The difficulty in advantageous decision-making could be due to different brain alterations in MCI, which could lead to problems in tasks requiring feedback-based responses. These findings advance our understanding of decision-making in aging and suggest how decision-making alterations in MCI would affect the totality of executive functions and daily activities.
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Affiliation(s)
- Ilaria Corbo
- Department of Dynamic and Clinical Psychology, and Health Studies - "Sapienza" University of Rome, Italy.
| | - Francesca Favieri
- Department of Dynamic and Clinical Psychology, and Health Studies - "Sapienza" University of Rome, Italy.
| | - Giuseppe Forte
- Department of Dynamic and Clinical Psychology, and Health Studies - "Sapienza" University of Rome, Italy.
| | - Maria Casagrande
- Department of Dynamic and Clinical Psychology, and Health Studies - "Sapienza" University of Rome, Italy.
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Gramkow MH, Clemmensen FK, Sjælland NS, Waldemar G, Hasselbalch SG, Frederiksen KS. Diagnostic performance of light reflex pupillometry in Alzheimer's disease. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12628. [PMID: 39086497 PMCID: PMC11289725 DOI: 10.1002/dad2.12628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 07/04/2024] [Accepted: 07/05/2024] [Indexed: 08/02/2024]
Abstract
Easily applied diagnostic tools such as digital biomarkers for Alzheimer's disease (AD) are urgently needed due to the recent approval of disease-modifying therapies. We aimed to determine the diagnostic performance of hand-held, quantitative light reflex pupillometry (qLRP) in patients with AD in a proof-of-concept, cross-sectional study. Participants underwent qLRP at a university memory clinic from August 2022 to October 2023. We fitted multivariable logistic regression models with qLRP, sex, and age as predictors evaluated with area under the receiver operating characteristics curve (AUROC). In total, 107 patients with AD, 44 patients with mixed AD and vascular cognitive dysfunction (VCD), 53 patients with dementia with Lewy bodies (DLB), and 50 healthy controls (HCs) were included. Our diagnostic models showed similar discriminatory ability (AUROC range 0.74-0.81) when distinguishing patients with AD from HCs and other dementias. The qLRP seems promising as a bedside digital biomarker to aid in diagnosing AD. Highlights We demonstrated the diagnostic performance of qLRP in Alzheimer's disease.The diagnostic models were robust in sensitivity analyses.qLRP may assist in the bedside diagnostic evaluation of Alzheimer's disease.
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Affiliation(s)
- Mathias Holsey Gramkow
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Frederikke Kragh Clemmensen
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Nikolai Sulkjær Sjælland
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Steen Gregers Hasselbalch
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Kristian Steen Frederiksen
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital ‐ RigshospitaletCopenhagenDenmark
- Department of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
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Shi L, Jin DN, Cao XJ, Liu H, Gu WJ, Zhang M, Lu Q. Assessment of sedation by automated pupillometry in critically ill patients: a prospective observational study. Br J Anaesth 2024; 132:877-885. [PMID: 38429209 DOI: 10.1016/j.bja.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Quantitative measurement of pupil change has not been assessed against the Richmond Agitation and Sedation Scale (RASS) and spectral edge frequency (SEF) during sedation. The aim of this study was to evaluate pupillometry against these measures in sedated critically ill adult patients. METHODS In ventilated and sedated patients, pupillary variables were measured by automated pupillometry at each RASS level from -5 to 0 after discontinuation of hypnotics, while processed electroencephalogram variables were displayed continuously and SEF was recorded at each RASS level. Correlations were made between percentage pupillary light reflex (%PLR) and RASS, and between %PLR and SEF. The ability of %PLR to differentiate light sedation (RASS ≥-2), moderate (RASS =-3), and deep sedation (RASS ≤-4) was assessed by areas under receiver operating characteristic (ROC) curves. RESULTS A total of 163 paired measurements were recorded in 38 patients. With decreasing sedation depth, median %PLR increased progressively from 20% (interquartile range 17-25%) to 36% (interquartile range 33-40%) (P<0.001). Strong correlations were found between %PLR and RASS (Rho=0.635) and between %PLR and SEF (R=0.641). Area under the curve (AUC) of 0.87 with a %PLR threshold of 28% differentiated moderate/light sedation from deep sedation with sensitivity of 83% and specificity of 83%. An AUC of 0.82 with a threshold of 31% distinguished light sedation from moderate/deep sedation with a sensitivity of 81% and a specificity of 75%. CONCLUSIONS Quantitative assessment of %PLR correlates with other indicators of sedation depth in critically ill patients.
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Affiliation(s)
- Lin Shi
- Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Emergency Department, The State Key Laboratory for Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China; Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, Zhejiang, China; Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, Hangzhou, Zhejiang, China
| | - Dan-Ni Jin
- Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, Zhejiang, China; Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, Hangzhou, Zhejiang, China
| | - Xia-Jing Cao
- Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, Zhejiang, China; Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, Hangzhou, Zhejiang, China
| | - Hong Liu
- Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, Zhejiang, China; Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, Hangzhou, Zhejiang, China
| | - Wen-Jie Gu
- Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, Zhejiang, China; Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, Hangzhou, Zhejiang, China
| | - Mao Zhang
- Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, Zhejiang, China; Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, Hangzhou, Zhejiang, China.
| | - Qin Lu
- Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China; Key Laboratory of The Diagnosis and Treatment of Severe Trauma and Burn of Zhejiang Province, Hangzhou, Zhejiang, China; Zhejiang Province Clinical Research Center for Emergency and Critical Care Medicine, Hangzhou, Zhejiang, China.
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Fink L, Simola J, Tavano A, Lange E, Wallot S, Laeng B. From pre-processing to advanced dynamic modeling of pupil data. Behav Res Methods 2024; 56:1376-1412. [PMID: 37351785 PMCID: PMC10991010 DOI: 10.3758/s13428-023-02098-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 06/24/2023]
Abstract
The pupil of the eye provides a rich source of information for cognitive scientists, as it can index a variety of bodily states (e.g., arousal, fatigue) and cognitive processes (e.g., attention, decision-making). As pupillometry becomes a more accessible and popular methodology, researchers have proposed a variety of techniques for analyzing pupil data. Here, we focus on time series-based, signal-to-signal approaches that enable one to relate dynamic changes in pupil size over time with dynamic changes in a stimulus time series, continuous behavioral outcome measures, or other participants' pupil traces. We first introduce pupillometry, its neural underpinnings, and the relation between pupil measurements and other oculomotor behaviors (e.g., blinks, saccades), to stress the importance of understanding what is being measured and what can be inferred from changes in pupillary activity. Next, we discuss possible pre-processing steps, and the contexts in which they may be necessary. Finally, we turn to signal-to-signal analytic techniques, including regression-based approaches, dynamic time-warping, phase clustering, detrended fluctuation analysis, and recurrence quantification analysis. Assumptions of these techniques, and examples of the scientific questions each can address, are outlined, with references to key papers and software packages. Additionally, we provide a detailed code tutorial that steps through the key examples and figures in this paper. Ultimately, we contend that the insights gained from pupillometry are constrained by the analysis techniques used, and that signal-to-signal approaches offer a means to generate novel scientific insights by taking into account understudied spectro-temporal relationships between the pupil signal and other signals of interest.
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Affiliation(s)
- Lauren Fink
- Department of Music, Max Planck Institute for Empirical Aesthetics, Grüneburgweg 14, 60322, Frankfurt am Main, Germany.
- Department of Psychology, Neuroscience & Behavior, McMaster University, 1280 Main St. West, Hamilton, Ontario, L8S 4L8, Canada.
| | - Jaana Simola
- Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
- Department of Education, University of Helsinki, Helsinki, Finland
| | - Alessandro Tavano
- Department of Cognitive Neuropsychology, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
| | - Elke Lange
- Department of Music, Max Planck Institute for Empirical Aesthetics, Grüneburgweg 14, 60322, Frankfurt am Main, Germany
| | - Sebastian Wallot
- Department of Literature, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
- Institute for Sustainability Education and Psychologyy, Leuphana University, Lüneburg, Germany
| | - Bruno Laeng
- Department of Psychology, University of Oslo, Oslo, Norway
- RITMO Centre for Interdisciplinary studies in Rhythm, Time, and Motion, University of Oslo, Oslo, Norway
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Gramkow MH, Clemmensen FK, Waldemar G, Hasselbalch SG, Frederiksen KS. Test-retest reliability and short-term variability of quantitative light reflex pupillometry in a mixed memory clinic cohort. J Neurol Sci 2024; 456:122856. [PMID: 38154247 DOI: 10.1016/j.jns.2023.122856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Quantitative light reflex pupillometry (qLRP) may be a promising digital biomarker in neurodegenerative diseases such as Alzheimer's disease (AD), as neuropathological changes have been found in the midbrain structures governing the light reflex. Studies investigating test-retest reliability and short-term, intra-subject variability of qLRP in these patient groups are missing. Our objective was therefore to investigate the test-retest reliability and short-term, intra-subject variability of qLRP in a memory clinic setting, where patients with neurodegenerative disease are frequently evaluated. METHODS Test-retest reliability study. We recruited patients from a tertiary memory clinic and qLRP was carried out at a baseline visit and then repeated on day 3-14 and on day 21-35 using a hand-held pupillometer. We evaluated the test-retest reliability of qLRP by calculating intraclass correlation coefficients (ICCs) and intra-subject, short-term variability by fitting linear mixed models. We compared ICCs for subgroups based on age, sex, disease severity (MCI vs. mild dementia), AD diagnosis, and amount of neurodegeneration (cerebrospinal fluid-total tau levels). RESULTS In total, 40 patients (mean age 72 years, 15 female, 22 with mild dementia) were included in the study. We found good-excellent reliability (ICC range 0.86-0.93) for most qLRP parameters. qLRP parameters exhibited limited intra-subject variability and we found no large sources of variability when examining subgroups. CONCLUSION qLRP was found to have acceptable test-retest reliability and the study results pave the way for research using longitudinal or cross-sectional measurements to assess the construct in identifying and prognosticating neurodegenerative diseases.
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Affiliation(s)
- Mathias Holsey Gramkow
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
| | - Frederikke Kragh Clemmensen
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Dept. of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Steen Gregers Hasselbalch
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Dept. of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Kristian Steen Frederiksen
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Dept. of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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Rattan Y, Girgla KK, Mahajan G, Prasher P. Interdevice Agreement between a Smartphone and a Commercial Pupillometer. Int J Appl Basic Med Res 2024; 14:23-28. [PMID: 38504836 PMCID: PMC10947756 DOI: 10.4103/ijabmr.ijabmr_396_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/14/2023] [Accepted: 12/15/2023] [Indexed: 03/21/2024] Open
Abstract
Background The reliability of dynamic pupillometry parameters varies from one pupillometer to another, making it difficult to standardize the values for any particular device. Hence, further studies are required to evaluate the agreement of various pupillometer devices and explore their utility in routine clinical settings. Aim This study sought to evaluate the agreement between smartphone and commercial pupillometer measurements in routine clinical settings. Methods The study included pupillary measurements obtained by a single investigator from 100 healthy participants (200 eyes) with each pupillometer. Pupillary measurements taken by a smartphone pupillometry application (reflex pupillary light reflex analyzer by Brightlamp [Indianapolis, IN, USA]) were compared with a commercial pupillometer (neurological pupil index-200, NeurOptics Inc., Irvine, USA). Results The comparison of descriptive statistics revealed a statistically significant difference between the smartphone and commercial pupillometers for various parameters, including maximum diameter, minimum diameter, constriction velocity (CV), maximum CV, and dilatation velocity (P < 0.05), except for latency (P = 0.36). The intraclass correlation coefficient revealed poor agreement between the two devices (<0.50). Conclusion The measurements by smartphone pupillometry application were found to be unreliable, indicating that they may not be an ideal substitute for commercial pupillometers in their present form in the Indian population. Further studies with larger sample size as well as improvements in the processing and interpretation of the measurements by the software, are needed to determine its utility in routine clinical settings.
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Affiliation(s)
- Yamini Rattan
- Department of Physiology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Kawalinder Kaur Girgla
- Department of Physiology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Gaurav Mahajan
- Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
| | - Pawan Prasher
- Department of Ophthalmology, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India
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Liu X, Hike D, Choi S, Man W, Ran C, Zhou XA, Jiang Y, Yu X. Mapping the bioimaging marker of Alzheimer's disease based on pupillary light response-driven brain-wide fMRI in awake mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.12.20.572613. [PMID: 38187675 PMCID: PMC10769340 DOI: 10.1101/2023.12.20.572613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Pupil dynamics has emerged as a critical non-invasive indicator of brain state changes. In particular, pupillary-light-responses (PLR) in Alzheimer's disease (AD) patients may be used as biomarkers of brain degeneration. To characterize AD-specific PLR and its underlying neuromodulatory sources, we combined high-resolution awake mouse fMRI with real-time pupillometry to map brain-wide event-related correlation patterns based on illumination-driven pupil constriction ( P c ) and post-illumination pupil dilation recovery (amplitude, P d , and time, T ). The P c -driven differential analysis revealed altered visual signal processing coupled with reduced thalamocortical activation in AD mice compared with the wild-type normal mice. In contrast, the post-illumination pupil dilation recovery-based fMRI highlighted multiple brain areas related to AD brain degeneration, including the cingulate cortex, hippocampus, septal area of the basal forebrain, medial raphe nucleus, and pontine reticular nuclei (PRN). Also, brain-wide functional connectivity analysis highlighted the most significant changes in PRN of AD mice, which serves as the major subcortical relay nuclei underlying oculomotor function. This work combined non-invasive pupil-fMRI measurements in preclinical models to identify pupillary biomarkers based on neuromodulatory dysfunction coupled with AD brain degeneration.
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Citrenbaum C, Corlier J, Ngo D, Vince-Cruz N, Wilson A, Wilke SA, Krantz D, Tadayonnejad R, Ginder N, Levitt J, Lee JH, Leuchter MK, Strouse TB, Corse A, Vyas P, Leuchter AF. Pretreatment pupillary reactivity is associated with differential early response to 10 Hz and intermittent theta-burst repetitive transcranial magnetic stimulation (rTMS) treatment of major depressive disorder (MDD). Brain Stimul 2023; 16:1566-1571. [PMID: 37863389 DOI: 10.1016/j.brs.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Repetitive Transcranial Magnetic Stimulation (rTMS) is an effective treatment for Major Depressive Disorder (MDD). Two common rTMS protocols, 10 Hz and intermittent theta burst stimulation (iTBS), have comparable rates of efficacy in groups of patients. Recent evidence suggests that some individuals may be more likely to benefit from one form of stimulation than the other. The pretreatment pupillary light reflex (PLR) is significantly associated with response to a full course of rTMS using heterogeneous stimulation protocols. OBJECTIVE To test whether the relationship between pretreatment PLR and early symptom improvement differed between subjects treated with iTBS or 10 Hz stimulation. METHODS PLR was measured in 52 subjects who received solely 10 Hz (n = 35) or iTBS (n = 17) to left dorsolateral prefrontal cortex (DLPFC) for the first ten sessions of their treatment course. Primary outcome measure was the percent change of Inventory of Depressive Symptomatology - Self Report (IDS-SR) from session 1 to session 10. RESULTS There was a positive association between normalized maximum constriction velocity (nMCV) and early improvement in subjects receiving 10 Hz stimulation (R = 0.48, p = 0.004) and a negative association in subjects receiving iTBS (R = -0.52, p = 0.03). ANOVA revealed a significant interaction between nMCV and the type of initial stimulation (p = 0.001). Among subjects with low nMCV, those initially treated with iTBS showed 2.6 times greater improvement after 10 sessions (p = 0.01) than subjects initially receiving 10 Hz stimulation. CONCLUSION nMCV may detect physiologic differences between those likely to benefit from 10 Hz or iTBS treatment. Future studies should examine whether PLR could guide prospective treatment selection.
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Affiliation(s)
- Cole Citrenbaum
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Juliana Corlier
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Doan Ngo
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Nikita Vince-Cruz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Andrew Wilson
- Cooperative Institute for Research in Environmental Sciences (CIRES), University of Colorado Boulder, Boulder, CO, USA; NOAA National Centers for Environmental Information (NCEI), Boulder, CO, USA
| | - Scott A Wilke
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - David Krantz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Reza Tadayonnejad
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA; Division of the Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Nathaniel Ginder
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Jennifer Levitt
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - John H Lee
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Michael K Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Thomas B Strouse
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Andrew Corse
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA
| | - Pooja Vyas
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Andrew F Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, 90024, USA.
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9
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Citrenbaum C, Corlier J, Ngo D, Vince-Cruz N, Wilson A, Wilke S, Krantz D, Tadayonnejad R, Ginder N, Levitt J, Lee JH, Strouse T, Corse A, Vyas P, Leuchter AF. Pretreatment pupillary reactivity is associated with outcome of Repetitive Transcranial Magnetic Stimulation (rTMS) treatment of Major Depressive Disorder (MDD). J Affect Disord 2023; 339:412-417. [PMID: 37437737 DOI: 10.1016/j.jad.2023.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/02/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
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.
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Affiliation(s)
- Cole Citrenbaum
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Juliana Corlier
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Doan Ngo
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Nikita Vince-Cruz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Andrew Wilson
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Scott Wilke
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - David Krantz
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Reza Tadayonnejad
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA; Division of the Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Nathaniel Ginder
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Jennifer Levitt
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - John H Lee
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Thomas Strouse
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | - Andrew Corse
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA
| | | | - Andrew F Leuchter
- TMS Clinical and Research Program, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90024, USA.
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10
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Chaitanuwong P, Singhanetr P, Chainakul M, Arjkongharn N, Ruamviboonsuk P, Grzybowski A. Potential Ocular Biomarkers for Early Detection of Alzheimer's Disease and Their Roles in Artificial Intelligence Studies. Neurol Ther 2023; 12:1517-1532. [PMID: 37468682 PMCID: PMC10444735 DOI: 10.1007/s40120-023-00526-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/03/2023] [Indexed: 07/21/2023] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia worldwide. Early detection is believed to be essential to disease management because it enables physicians to initiate treatment in patients with early-stage AD (early AD), with the possibility of stopping the disease or slowing disease progression, preserving function and ultimately reducing disease burden. The purpose of this study was to review prior research on the use of eye biomarkers and artificial intelligence (AI) for detecting AD and early AD. The PubMed database was searched to identify studies for review. Ocular biomarkers in AD research and AI research on AD were reviewed and summarized. According to numerous studies, there is a high likelihood that ocular biomarkers can be used to detect early AD: tears, corneal nerves, retina, visual function and, in particular, eye movement tracking have been identified as ocular biomarkers with the potential to detect early AD. However, there is currently no ocular biomarker that can be used to definitely detect early AD. A few studies that used AI with ocular biomarkers to detect AD reported promising results, demonstrating that using AI with ocular biomarkers through multimodal imaging could improve the accuracy of identifying AD patients. This strategy may become a screening tool for detecting early AD in older patients prior to the onset of AD symptoms.
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Affiliation(s)
- Pareena Chaitanuwong
- Ophthalmology Department, Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine, Rangsit University, Bangkok, Thailand
| | - Panisa Singhanetr
- Mettapracharak Eye Institute, Mettapracharak (Wat Rai Khing) Hospital, Nakhon Pathom, Thailand
| | - Methaphon Chainakul
- Ophthalmology Department, Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine, Rangsit University, Bangkok, Thailand
| | - Niracha Arjkongharn
- Ophthalmology Department, Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine, Rangsit University, Bangkok, Thailand
| | - Paisan Ruamviboonsuk
- Ophthalmology Department, Rajavithi Hospital, Ministry of Public Health, Bangkok, Thailand
- Department of Ophthalmology, Faculty of Medicine, Rangsit University, Bangkok, Thailand
| | - Andrzej Grzybowski
- Institute of Research in Ophthalmology, Foundation for Ophthalmology Development, Mickiewicza 24/3B, 60-836, Poznan, Poland.
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11
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Nieto-Escamez F, Obrero-Gaitán E, Cortés-Pérez I. Visual Dysfunction in Parkinson's Disease. Brain Sci 2023; 13:1173. [PMID: 37626529 PMCID: PMC10452537 DOI: 10.3390/brainsci13081173] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/11/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Non-motor symptoms in Parkinson's disease (PD) include ocular, visuoperceptive, and visuospatial impairments, which can occur as a result of the underlying neurodegenerative process. Ocular impairments can affect various aspects of vision and eye movement. Thus, patients can show dry eyes, blepharospasm, reduced blink rate, saccadic eye movement abnormalities, smooth pursuit deficits, and impaired voluntary and reflexive eye movements. Furthermore, visuoperceptive impairments affect the ability to perceive and recognize visual stimuli accurately, including impaired contrast sensitivity and reduced visual acuity, color discrimination, and object recognition. Visuospatial impairments are also remarkable, including difficulties perceiving and interpreting spatial relationships between objects and difficulties judging distances or navigating through the environment. Moreover, PD patients can present visuospatial attention problems, with difficulties attending to visual stimuli in a spatially organized manner. Moreover, PD patients also show perceptual disturbances affecting their ability to interpret and determine meaning from visual stimuli. And, for instance, visual hallucinations are common in PD patients. Nevertheless, the neurobiological bases of visual-related disorders in PD are complex and not fully understood. This review intends to provide a comprehensive description of visual disturbances in PD, from sensory to perceptual alterations, addressing their neuroanatomical, functional, and neurochemical correlates. Structural changes, particularly in posterior cortical regions, are described, as well as functional alterations, both in cortical and subcortical regions, which are shown in relation to specific neuropsychological results. Similarly, although the involvement of different neurotransmitter systems is controversial, data about neurochemical alterations related to visual impairments are presented, especially dopaminergic, cholinergic, and serotoninergic systems.
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Affiliation(s)
- Francisco Nieto-Escamez
- Department of Psychology, University of Almeria, 04120 Almeria, Spain
- Center for Neuropsychological Assessment and Rehabilitation (CERNEP), 04120 Almeria, Spain
| | - Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaen, Paraje Las Lagunillas s/n, 23071 Jaen, Spain;
| | - Irene Cortés-Pérez
- Department of Health Sciences, University of Jaen, Paraje Las Lagunillas s/n, 23071 Jaen, Spain;
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12
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Hsu CH, Kuo LT. Application of Pupillometry in Neurocritical Patients. J Pers Med 2023; 13:1100. [PMID: 37511713 PMCID: PMC10381796 DOI: 10.3390/jpm13071100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/25/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
Pupillary light reflex (PLR) assessment is a crucial examination for evaluating brainstem function, particularly in patients with acute brain injury and neurosurgical conditions. The PLR is controlled by neural pathways modulated by both the sympathetic and parasympathetic nervous systems. Altered PLR is a strong predictor of adverse outcomes after traumatic and ischemic brain injuries. However, the assessment of PLR needs to take many factors into account since it can be modulated by various medications, alcohol consumption, and neurodegenerative diseases. The development of devices capable of measuring pupil size and assessing PLR quantitatively has revolutionized the non-invasive neurological examination. Automated pupillometry, which is more accurate and precise, is widely used in diverse clinical situations. This review presents our current understanding of the anatomical and physiological basis of the PLR and the application of automated pupillometry in managing neurocritical patients. We also discuss new technologies that are being developed, such as smartphone-based pupillometry devices, which are particularly beneficial in low-resource settings.
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Affiliation(s)
- Chiu-Hao Hsu
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Hsin-Chu Branch, Biomedical Park Hospital, Hsin-Chu County 302, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Lu-Ting Kuo
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Yunlin 640, Taiwan
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13
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Dávila G, Torres-Prioris MJ, López-Barroso D, Berthier ML. Turning the Spotlight to Cholinergic Pharmacotherapy of the Human Language System. CNS Drugs 2023; 37:599-637. [PMID: 37341896 PMCID: PMC10374790 DOI: 10.1007/s40263-023-01017-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/22/2023]
Abstract
Even though language is essential in human communication, research on pharmacological therapies for language deficits in highly prevalent neurodegenerative and vascular brain diseases has received little attention. Emerging scientific evidence suggests that disruption of the cholinergic system may play an essential role in language deficits associated with Alzheimer's disease and vascular cognitive impairment, including post-stroke aphasia. Therefore, current models of cognitive processing are beginning to appraise the implications of the brain modulator acetylcholine in human language functions. Future work should be directed further to analyze the interplay between the cholinergic system and language, focusing on identifying brain regions receiving cholinergic innervation susceptible to modulation with pharmacotherapy to improve affected language domains. The evaluation of language deficits in pharmacological cholinergic trials for Alzheimer's disease and vascular cognitive impairment has thus far been limited to coarse-grained methods. More precise, fine-grained language testing is needed to refine patient selection for pharmacotherapy to detect subtle deficits in the initial phases of cognitive decline. Additionally, noninvasive biomarkers can help identify cholinergic depletion. However, despite the investigation of cholinergic treatment for language deficits in Alzheimer's disease and vascular cognitive impairment, data on its effectiveness are insufficient and controversial. In the case of post-stroke aphasia, cholinergic agents are showing promise, particularly when combined with speech-language therapy to promote trained-dependent neural plasticity. Future research should explore the potential benefits of cholinergic pharmacotherapy in language deficits and investigate optimal strategies for combining these agents with other therapeutic approaches.
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Affiliation(s)
- Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain.
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain.
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.
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Jiang Z, Seyedi S, Vickers KL, Manzanares CM, Lah JJ, Levey AI, Clifford GD. Disentangling visual exploration differences in cognitive impairment. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.17.23290054. [PMID: 37292683 PMCID: PMC10246124 DOI: 10.1101/2023.05.17.23290054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Objective Compared to individuals without cognitive impairment (CI), those with CI exhibit differences in both basic oculomotor functions and complex viewing behaviors. However, the characteristics of the differences and how those differences relate to various cognitive functions have not been widely explored. In this work we aimed to quantify those differences and assess general cognitive impairment and specific cognitive functions. Methods A validated passive viewing memory test with eyetracking was administered to 348 healthy controls and CI individuals. Spatial, temporal, semantic, and other composite features were extracted from the estimated eye-gaze locations on the corresponding pictures displayed during the test. These features were then used to characterize viewing patterns, classify cognitive impairment, and estimate scores in various neuropsychological tests using machine learning. Results Statistically significant differences in spatial, spatiotemporal, and semantic features were found between healthy controls and individuals with CI. CI group spent more time gazing at the center of the image, looked at more regions of interest (ROI), transitioned less often between ROI yet in a more unpredictable manner, and had different semantic preferences. A combination of these features achieved an area under the receiver-operator curve of 0.78 in differentiating CI individuals from controls. Statistically significant correlations were identified between actual and estimated MoCA scores and other neuropsychological tests. Conclusion Evaluating visual exploration behaviors provided quantitative and systematic evidence of differences in CI individuals, leading to an improved approach for passive cognitive impairment screening. Significance The proposed passive, accessible, and scalable approach could help with earlier detection and a better understanding of cognitive impairment.
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15
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Hussain A, Sheikh Z, Subramanian M. The Eye as a Diagnostic Tool for Alzheimer’s Disease. Life (Basel) 2023; 13:life13030726. [PMID: 36983883 PMCID: PMC10052959 DOI: 10.3390/life13030726] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/23/2023] [Accepted: 03/04/2023] [Indexed: 03/10/2023] Open
Abstract
Alzheimer’s disease (AD) is a progressive neurodegenerative disorder impacting cognition, function, and behavior in the elderly population. While there are currently no disease-modifying agents capable of curing AD, early diagnosis and management in the preclinical stage can significantly improve patient morbidity and life expectancy. Currently, the diagnosis of Alzheimer’s disease is a clinical one, often supplemented by invasive and expensive biomarker testing. Over the last decade, significant advancements have been made in our understanding of AD and the role of ocular tissue as a potential biomarker. Ocular biomarkers hold the potential to provide noninvasive and easily accessible diagnostic and monitoring capabilities. This review summarizes current research for detecting biomarkers of Alzheimer’s disease in ocular tissue.
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16
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Papangelou A, Boorman DW, Sharifpour M, Patel HP, Cassim T, García PS. Associations of an eye-tracking task and pupillary metrics with age and ASA physical status score in a preoperative cohort. J Clin Monit Comput 2023; 37:795-803. [PMID: 36708440 PMCID: PMC9883606 DOI: 10.1007/s10877-023-00974-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/26/2022] [Indexed: 01/29/2023]
Abstract
Advanced age, American Society of Anesthesiologists physical status (ASA) classification and the presence of cognitive impairment are associated with an elevated risk of postoperative morbidity and mortality. The visual paired comparison (VPC) task, which relies on recognition of novel images, examines declarative memory. VPC scores have demonstrated the ability to detect mild cognitive impairment and track progression of neurodegenerative disease. Quantitative pupillometry may have similar value. We evaluate for associations between these variables of interest and the feasibility of performing these tests in the preoperative clinic. Prospective data from 199 patients seen in the preoperative clinic at a tertiary academic center were analyzed. A 5 min VPC task (Neurotrack Technologies, Inc, Redwood City, CA) was administered during their scheduled preoperative clinic visit. Pupillary light reflexes were measured at the same visit (PLR-3000™, Neuroptics Corp, Irvine, California).Thirty-four percent of patients were categorized as ASA 2 and 58% as ASA 3. Median age was 57 (IQR: 44-69). Associations were demonstrated between age and ASA physical status (Mann-Whitney U Test, p < 0.0001), maximum pupil size (Spearman Rank Correlation, r = - 0.40, p < 0.0001), and maximum constriction velocity (Spearman Rank Correlation, r = - 0.39, p < 0.0001). Our data also revealed an association between VPC score and age (Spearman Rank Correlation, p = 0.0016, r = - 0.21) but not ASA score (Kruskal-Wallis Test, p = 0.14). When compared to a nonsurgical cohort with no history of memory impairment, our population scored worse on the VPC task (Mann-Whitney U Test, p = 0.0002). A preoperative 5 min VPC task and pupillometry are feasible tests in the preoperative setting and may provide a valuable window into an individual's cognition prior to elective surgery.
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Affiliation(s)
- Alexander Papangelou
- grid.189967.80000 0001 0941 6502Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA USA
| | - David W. Boorman
- grid.189967.80000 0001 0941 6502Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA USA
| | - Milad Sharifpour
- grid.50956.3f0000 0001 2152 9905Department of Anesthesiology, Cedars Sinai Medical Center, Los Angeles, CA USA
| | - Haresh P. Patel
- grid.415146.30000 0004 0455 0755Department of Internal Medicine, Wellstar Kennestone Regional Medical Center, Marietta, GA USA
| | - Tuan Cassim
- grid.21729.3f0000000419368729Department of Anesthesiology, Columbia University, New York, NY USA
| | - Paul S. García
- grid.21729.3f0000000419368729Department of Anesthesiology, Columbia University, New York, NY USA
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17
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Matsui T, Hara K, Iwata M, Hojo S, Shitara N, Endo Y, Fukuoka H, Matsui M, Kawaguchi H. Cervical muscle stiffness and parasympathetic nervous system improvements for treatment-resistant depression. BMC Musculoskelet Disord 2022; 23:907. [PMID: 36217161 PMCID: PMC9552456 DOI: 10.1186/s12891-022-05860-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although treatment-resistant depression (TRD) is a major public health problem that increases mortality due to suicides, a considerable percentage of patients do not respond adequately to variable treatments. Patients with TRD sometimes have comorbid cervical stiffness. This observational study aims to examine the association of local modulation of cervical muscles with TRD and to learn the involvement of the parasympathetic nervous system in the underlying mechanism. METHODS A total of 1103 hospitalized patients with TRD who were resistant to outpatient care were enrolled between May 2006 and October 2021. All patients underwent local modulation of the cervical muscles by physical therapy during hospitalization. The presence or absence of TRD and whole-body disorders, such as headache, dazzling, cervical stiffness, and cardiovascular and gastrointestinal disorders, was determined by the patient's subjectivity using the self-rated medical interview sheet at admission and discharge. Pupil light reflex parameters were also measured at admission and discharge using a binocular infrared pupilometer. RESULTS The improvement rate of TRD during hospitalization was 72.1%, and did not differ significantly by sex, age, and hospitalization period. The improvement of TRD showed a strong association with those of cervical stiffness and dazzling, a pupil light reflex disorder (p < 0.001: odds ratios = 12.76 and 6.39, respectively), but not with those of headache or cardiovascular and gastrointestinal disorders (p > 0.05). In the TRD-improved patients, the pupil light reflex parameters representative of the parasympathetic nervous system function ameliorated: pupil diameter decreased, while constriction rate and velocity increased during hospitalization. In contrast, little amelioration of the parameters was seen in the TRD-unimproved patients. CONCLUSIONS Cervical muscle stiffness may be associated with TRD, possibly through dysfunction of the parasympathetic nervous system. TRIAL REGISTRATION ID: UMIN000040590. First registration date: 30/05/2020.
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Affiliation(s)
- Takayoshi Matsui
- Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan ,Matsui Hospital, Kan-nonji 739, Tokyo, Kagawa 768-0013 Japan
| | - Kazuhiro Hara
- Matsui Hospital, Kan-nonji 739, Tokyo, Kagawa 768-0013 Japan
| | - Makoto Iwata
- Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
| | - Shuntaro Hojo
- Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
| | - Nobuyuki Shitara
- Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
| | - Yuzo Endo
- Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
| | - Hideoki Fukuoka
- Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
| | - Masaki Matsui
- Matsui Hospital, Kan-nonji 739, Tokyo, Kagawa 768-0013 Japan
| | - Hiroshi Kawaguchi
- Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
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Lustig-Barzelay Y, Sher I, Sharvit-Ginon I, Feldman Y, Mrejen M, Dallasheh S, Livny A, Schnaider Beeri M, Weller A, Ravona-Springer R, Rotenstreich Y. Machine learning for comprehensive prediction of high risk for Alzheimer's disease based on chromatic pupilloperimetry. Sci Rep 2022; 12:9945. [PMID: 35705601 PMCID: PMC9200977 DOI: 10.1038/s41598-022-13999-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/13/2022] [Indexed: 11/30/2022] Open
Abstract
Currently there are no reliable biomarkers for early detection of Alzheimer's disease (AD) at the preclinical stage. This study assessed the pupil light reflex (PLR) for focal red and blue light stimuli in central and peripheral retina in 125 cognitively normal middle age subjects (45-71 years old) at high risk for AD due to a family history of the disease (FH+), and 61 age-similar subjects with no family history of AD (FH-) using Chromatic Pupilloperimetry coupled with Machine Learning (ML). All subjects had normal ophthalmic assessment, and normal retinal and optic nerve thickness by optical coherence tomography. No significant differences were observed between groups in cognitive function and volumetric brain MRI. Chromatic pupilloperimetry-based ML models were highly discriminative in differentiating subjects with and without AD family history, using transient PLR for focal red (primarily cone-mediated), and dim blue (primarily rod-mediated) light stimuli. Features associated with transient pupil response latency (PRL) achieved Area Under the Curve Receiver Operating Characteristic (AUC-ROC) of 0.90 ± 0.051 (left-eye) and 0.87 ± 0.048 (right-eye). Parameters associated with the contraction arm of the rod and cone-mediated PLR were more discriminative compared to parameters associated with the relaxation arm and melanopsin-mediated PLR. Significantly shorter PRL for dim blue light was measured in the FH+ group in two test targets in the temporal visual field in right eye that had highest relative weight in the ML algorithm (mean ± standard error, SE 0.449 s ± 0.007 s vs. 0.478 s ± 0.010 s, p = 0.038). Taken together our study suggests that subtle focal changes in pupil contraction latency may be detected in subjects at high risk to develop AD, decades before the onset of AD clinical symptoms. The dendrites of melanopsin containing retinal ganglion cells may be affected very early at the preclinical stages of AD.
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Affiliation(s)
- Yael Lustig-Barzelay
- Goldschleger Eye Institute, Sheba Medical Center, 52621, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ifat Sher
- Goldschleger Eye Institute, Sheba Medical Center, 52621, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Nehemia Rubin Excellence in Biomedical Research, TELEM Program, Sheba Medical Center, Tel Hashomer, Israel
| | - Inbal Sharvit-Ginon
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Yael Feldman
- Goldschleger Eye Institute, Sheba Medical Center, 52621, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Mrejen
- Condensed Matter Physics Department, School of Physics and Astronomy, Tel-Aviv University, Tel Aviv, Israel
| | - Shada Dallasheh
- Goldschleger Eye Institute, Sheba Medical Center, 52621, Tel-Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abigail Livny
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Nehemia Rubin Excellence in Biomedical Research, TELEM Program, Sheba Medical Center, Tel Hashomer, Israel
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
- Department of Psychiatry, The Icahn School of Medicine at Mount Sinai, New York, USA
| | - Aron Weller
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
- Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Ramit Ravona-Springer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
- Memory Clinic, Sheba Medical Center, Tel Hashomer, Israel
| | - Ygal Rotenstreich
- Goldschleger Eye Institute, Sheba Medical Center, 52621, Tel-Hashomer, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
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Qian X, Yue L, Mellor D, Robbins NM, Li W, Xiao S. Reduced Peripheral Nerve Conduction Velocity is Associated with Alzheimer's Disease: A Cross-Sectional Study from China. Neuropsychiatr Dis Treat 2022; 18:231-242. [PMID: 35177907 PMCID: PMC8846612 DOI: 10.2147/ndt.s349005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/18/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Elderly individuals with degenerative diseases of the central nervous system are more likely to develop peripheral neuropathy; however, research is limited as to whether the decline in peripheral nerve conduction can be used as a biomarker of Alzheimer's disease (AD). PATIENTS AND METHODS This study enrolled 74 patients with mild cognitive impairment (MCI), 21 with AD, and 82 healthy elderly individuals. All participants underwent a peripheral nerve conduction and neuropsychological evaluation. Nicolet EDX was used to assess peripheral nerve conduction in the limbs and comparisons were made between the three cognitive groups. Furthermore, the relationship between peripheral nerve conduction and cognitive function was investigated. RESULTS A ladder-shaped difference was found in the median (p < 0.001) and common peroneal (p < 0.001) motor nerve velocity, with the control group > MCI group > AD group, even after controlling for variables. The median motor nerve amplitude in the AD group was lower than that in the control group (P = 0.017). After controlling for age, sex, education, and height, the median motor nerve velocity was positively correlated with the Montreal Cognitive Assessment (r = 0.196, p = 0.015), and the common peroneal motor nerve velocity was positively correlated with verbal fluency task-idioms (r = 0.184, p = 0.026). The median (AUC: 0.777, p < 0.001) and common peroneal motor nerve velocities (AUC: 0.862; p < 0.001) were significantly associated with the diagnosis of AD. The accuracy rate of these two motor nerve velocities to predict AD was 51.5%. CONCLUSION Our study found that peripheral motor nerve velocity may correlate with early cognitive impairment in AD. However, the accuracy of different cognitive classifications and the value of early diagnosis are not ideal when peripheral motor nerve velocity is used alone. Whether peripheral nerve function can be used as a marker for early diagnosis of AD needs further clarification but provides a new possibility for the future of biomarker research.
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Affiliation(s)
- Xinyi Qian
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - David Mellor
- School of Psychology, Deakin University, Melbourne, Australia
| | - Nathaniel M Robbins
- Department of Neurology (N.M.R.), Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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20
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Zielinska A, Ciacka P, Szkulmowski M, Komar K. Pupillary Light Reflex Induced by Two-Photon Vision. Invest Ophthalmol Vis Sci 2021; 62:23. [PMID: 34935882 PMCID: PMC8711009 DOI: 10.1167/iovs.62.15.23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Two-photon vision relies on the perception of pulsed infrared light due to two-photon absorption in visual pigments. This study aimed to measure human pupil reaction caused by a two-photon 1040-nm stimulus and compare it with pupil responses elicited by 520-nm stimuli of similar color. Methods Pupillary light reflex (PLR) was induced on 14 dark-adapted healthy subjects. Three types of fovea-centered stimuli of 3.5° diameter were tested: spirals formed by fast scanning 1040-nm (infrared [IR] laser) or 520-nm (visible [VIS] laser) laser beams and uniformly filled circle created by 520-nm LED (VIS light-emitting diode [LED]). The power of visible stimuli was determined with a dedicated procedure to obtain the same perceived brightness equivalent as for 800 µW used for two-photon stimulation. Results The minimum pupil diameter for IR laser was 88% ± 10% of baseline, significantly larger than for both VIS stimuli: 74% ± 10% (laser) and 69% ± 9% (LED). Mean constriction velocity and time to maximum constriction had significantly smaller values for IR than for both VIS stimuli. Latency times were similar for IR and VIS lasers and slightly smaller for VIS LED. Conclusions The two-photon stimulus caused a considerably weaker pupil reaction than one-photon stimuli of the same shape, brightness, and similar color. The smaller pupil response may be due to weaker two-photon stimulation of rods relative to cones as previously observed for two-photon vision. Contrary to normal vision, in a two-photon process the stray light is not perceived, which might reduce the number of stimulated photoreceptors and further weaken the PLR.
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Affiliation(s)
- Agnieszka Zielinska
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Piotr Ciacka
- International Centre for Translational Eye Research, Warsaw, Poland.,Department of Physical Chemistry of Biological Systems, Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland
| | - Maciej Szkulmowski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Katarzyna Komar
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University in Toruń, Toruń, Poland.,International Centre for Translational Eye Research, Warsaw, Poland.,Department of Physical Chemistry of Biological Systems, Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland
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21
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La Morgia C, Romagnoli M, Pizza F, Biscarini F, Filardi M, Donadio V, Carbonelli M, Amore G, Park JC, Tinazzi M, Carelli V, Liguori R, Plazzi G, Antelmi E. Chromatic Pupillometry in Isolated Rapid Eye Movement Sleep Behavior Disorder. Mov Disord 2021; 37:205-210. [PMID: 34617633 PMCID: PMC9293298 DOI: 10.1002/mds.28809] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/01/2021] [Accepted: 09/10/2021] [Indexed: 12/21/2022] Open
Abstract
Background Melanopsin retinal ganglion cell (mRGC)‐mediated pupillary light reflex (PLR) abnormalities have been documented in several neurodegenerative disorders including Parkinson's disease. Overall, isolated rapid eye movement (REM) sleep behavior disorder (iRBD) represents the strongest prodromal risk factor for impending α‐synucleinopathies. Objectives To quantitatively compare PLR and mRGC‐mediated contribution to PLR in 16 iRBD patients and 16 healthy controls. Methods iRBD and controls underwent extensive neuro‐ophthalmological evaluation and chromatic pupillometry. In iRBD, PLR metrics were correlated with clinical variables and with additional biomarkers including REM atonia index (RAI), DaTscan, and presence of phosphorylated‐α‐synuclein (p‐α‐syn) deposition in skin biopsy. Results We documented higher baseline pupil diameter and decreased rod‐transient PLR amplitude in iRBD patients compared to controls. PLR rod‐contribution correlated with RAI. Moreover, only iRBD patients with evidence of p‐α‐syn deposition at skin biopsy showed reduced PLR amplitude compared to controls. Conclusion The observed PLR abnormalities in iRBD might be considered as potential biomarkers for the risk stratification of phenoconversion of the disease. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Chiara La Morgia
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - Martina Romagnoli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - Fabio Pizza
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Francesco Biscarini
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Marco Filardi
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.,Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.,Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "Aldo Moro"- A.O. Pia Fondazione Cardinale G. Panico, Tricase, Italy
| | - Vincenzo Donadio
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - Michele Carbonelli
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Giulia Amore
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Jason C Park
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Michele Tinazzi
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, Verona, Italy
| | - Valerio Carelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Rocco Liguori
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy
| | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Antelmi
- Dipartimento di Neuroscienze, Biomedicina e Movimento, Università di Verona, Verona, Italy
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22
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You S, Hong JH, Yoo J. Analysis of pupillometer results according to disease stage in patients with Parkinson's disease. Sci Rep 2021; 11:17880. [PMID: 34504251 PMCID: PMC8429555 DOI: 10.1038/s41598-021-97599-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/20/2021] [Indexed: 11/21/2022] Open
Abstract
We performed pupillometer testing on 132 patients with Parkinson’s disease, stratified into two groups according to the disease stage. Neurological examinations and pupillometry were performed in the ON state. Patients in the Hoehn and Yahr stages 1 and 2 comprised the early group, and patients in stages 3–5 formed the late group. We performed age- and sex-matched (2:1) propensity score matching to compensate for the effect of age on pupil light reflex. Eight pupillometer parameters were measured and compared between the two groups. After the propensity score matching, the early group had 64 patients and the late group had 32 patients. The late group had a longer disease duration and took a higher levodopa equivalent dose than the early group. The constriction velocity (P = 0.006) and maximum constriction velocity (P = 0.005) were significantly faster in the early group than in the late group. Pupil size, minimum diameter, and dilation velocity were similar in both groups. The pupillary contraction velocity decreased with the disease progression, suggesting that the progression of Parkinson’s disease could be identified by the pupil constriction velocity.
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Affiliation(s)
- Sooyeoun You
- Department of Neurology, Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Jeong-Ho Hong
- Department of Neurology, Dongsan Hospital, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Joonsang Yoo
- Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin-si, Gyeonggi-do, 16995, Korea.
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23
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Kaifie A, Reugels M, Kraus T, Kursawe M. The pupillary light reflex (PLR) as a marker for the ability to work or drive - a feasibility study. J Occup Med Toxicol 2021; 16:39. [PMID: 34493308 PMCID: PMC8422642 DOI: 10.1186/s12995-021-00330-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 08/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background The PLR (pupillary light reflex) can be a marker for pathological medical conditions, such as neurodegenerative or mental health disorders and diseases as well as marker for physiological alterations, such as age, sex or iris color. PLR alterations have been described in people after alcohol consumption, as well. However, the effect of sleep deprivation on PLR parameters is still under debate. Methods The aim of this study was to investigate the feasibility of PLR measurements in sleep-deprived and alcohol-exposed participants. In addition, we wanted to identify PLR parameters that were altered by sleep deprivation and alcohol exposure. Results Altogether n = 50 participants have been included in this study. Differences in the PLR parameters initial diameter (dinit), latency (∆tlat), acceleration (∆ta), contraction velocity (ϑcon), quarter dilatation velocity (ϑ1/4dil), half dilatation time (∆t1/2), and the line integral (L(0.3500)) have been evaluated between baseline, sleep deprivation, as well as alcohol exposure. In a generalized linear mixed models design, we could observe statistically significant associations between the type of exposure and the PLR parameters half dilatation time and half dilatation time after the first light pulse (all p < 0.05). The participants’ latency showed a significant association in dependence of the type of exposure after the second light pulse (p < 0.05). Conclusion Our study delivers first promising results to further develop devices that may identify conditions that impair the ability to work or drive. Supplementary Information The online version contains supplementary material available at 10.1186/s12995-021-00330-2.
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Affiliation(s)
- Andrea Kaifie
- Institute for Occupational, Social, and Environmental Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.
| | - Martin Reugels
- Department of Medical Statistics, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Thomas Kraus
- Institute for Occupational, Social, and Environmental Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Michael Kursawe
- Institute for Occupational, Social, and Environmental Medicine, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
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24
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Al-Nuaimi AH, Blūma M, Al-Juboori SS, Eke CS, Jammeh E, Sun L, Ifeachor E. Robust EEG Based Biomarkers to Detect Alzheimer's Disease. Brain Sci 2021; 11:1026. [PMID: 34439645 PMCID: PMC8394244 DOI: 10.3390/brainsci11081026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 11/16/2022] Open
Abstract
Biomarkers to detect Alzheimer's disease (AD) would enable patients to gain access to appropriate services and may facilitate the development of new therapies. Given the large numbers of people affected by AD, there is a need for a low-cost, easy to use method to detect AD patients. Potentially, the electroencephalogram (EEG) can play a valuable role in this, but at present no single EEG biomarker is robust enough for use in practice. This study aims to provide a methodological framework for the development of robust EEG biomarkers to detect AD with a clinically acceptable performance by exploiting the combined strengths of key biomarkers. A large number of existing and novel EEG biomarkers associated with slowing of EEG, reduction in EEG complexity and decrease in EEG connectivity were investigated. Support vector machine and linear discriminate analysis methods were used to find the best combination of the EEG biomarkers to detect AD with significant performance. A total of 325,567 EEG biomarkers were investigated, and a panel of six biomarkers was identified and used to create a diagnostic model with high performance (≥85% for sensitivity and 100% for specificity).
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Affiliation(s)
- Ali H. Al-Nuaimi
- School of Engineering, Computing and Mathematics, Faculty of Science and Engineering, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK; (S.S.A.-J.); (C.S.E.); (E.J.); (L.S.); (E.I.)
- College of Education for Pure Science (Ibn Al-Haitham), University of Baghdad, Al Adhamiya, Baghdad 10053, Iraq
| | - Marina Blūma
- Department of Physiology and Pharmacology “Vittorio Erspamer”, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Shaymaa S. Al-Juboori
- School of Engineering, Computing and Mathematics, Faculty of Science and Engineering, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK; (S.S.A.-J.); (C.S.E.); (E.J.); (L.S.); (E.I.)
- College of Education for Pure Science (Ibn Al-Haitham), University of Baghdad, Al Adhamiya, Baghdad 10053, Iraq
| | - Chima S. Eke
- School of Engineering, Computing and Mathematics, Faculty of Science and Engineering, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK; (S.S.A.-J.); (C.S.E.); (E.J.); (L.S.); (E.I.)
| | - Emmanuel Jammeh
- School of Engineering, Computing and Mathematics, Faculty of Science and Engineering, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK; (S.S.A.-J.); (C.S.E.); (E.J.); (L.S.); (E.I.)
| | - Lingfen Sun
- School of Engineering, Computing and Mathematics, Faculty of Science and Engineering, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK; (S.S.A.-J.); (C.S.E.); (E.J.); (L.S.); (E.I.)
| | - Emmanuel Ifeachor
- School of Engineering, Computing and Mathematics, Faculty of Science and Engineering, University of Plymouth, Drake Circus, Plymouth PL4 8AA, UK; (S.S.A.-J.); (C.S.E.); (E.J.); (L.S.); (E.I.)
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25
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Gulcan HO, Orhan IE. A Recent Look into Natural Products that have Potential to Inhibit Cholinesterases and Monoamine Oxidase B: Update for 2010-2019. Comb Chem High Throughput Screen 2021; 23:862-876. [PMID: 31985374 DOI: 10.2174/1386207323666200127145246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 11/12/2019] [Accepted: 11/12/2019] [Indexed: 11/22/2022]
Abstract
With respect to the unknowns of pathophysiology of Alzheimer's Disease (AD)-, and Parkinson's Disease (PD)-like neurodegenerative disorders, natural product research is still one of the valid tools in order to provide alternative and/or better treatment options. At one hand, various extracts of herbals provide a combination of actions targeting multiple receptors, on the other hand, the discovery of active natural products (i.e., secondary metabolites) generally offers alternative chemical structures either ready to be employed in clinical studies or available to be utilized as important scaffolds for the design of novel agents. Regarding the importance of certain enzymes (e.g. cholinesterase and monoamine oxidase B), for the treatment of AD and PD, we have surveyed the natural product research within this area in the last decade. Particularly novel natural agents discovered within this period, concomitant to novel biological activities displayed for known natural products, are harmonized within the present study.
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Affiliation(s)
- Hayrettin O Gulcan
- Division of Pharmaceutical Chemistry, Faculty of Pharmacy, Eastern Mediterranean University, Famagusta, TR. North Cyprus, via Mersin 10, Turkey
| | - Ilkay E Orhan
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University, Ankara 06300, Turkey
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26
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Jiménez EC, Sierra-Marcos A, Romeo A, Hashemi A, Leonovych O, Bustos Valenzuela P, Solé Puig M, Supèr H. Altered Vergence Eye Movements and Pupil Response of Patients with Alzheimer's Disease and Mild Cognitive Impairment During an Oddball Task. J Alzheimers Dis 2021; 82:421-433. [PMID: 34024820 DOI: 10.3233/jad-201301] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is characterized by progressive deterioration of cognitive functions and may be preceded by mild cognitive impairment (MCI). Evidence shows changes in pupil and vergence responses related to cognitive processing of visual information. OBJECTIVE Here we test the hypothesis that MCI and AD are associated with specific patterns in vergence and pupil responses. METHODS We employed a visual oddball task. In the distractor condition (80%of the trials), a blue stimulus was presented whereas in the target condition (20%of trials) it was red. Participants (23 Controls, 33 MCI patients, and 18 AD patients) were instructed to press a button when a target appeared. RESULTS Participants briefly converged their eyes 200 ms after stimulus presentation. In controls, this transient peak response was followed by a delay response to targets but not to distractor stimuli. In the patient groups, delay responses to distractors were noticed. Consequently, the differential vergence response was strong in the control group, weak in the MCI group, and absent in the AD group. Pupils started to dilate 500-600 ms after the appearance of a target but slightly contracted after the presentation of a distractor. This differential pupil response was strongest in the AD group. CONCLUSION Our findings support the idea of a role of vergence and pupil responses in attention and reveal altered responses in MCI and AD patients. Further studies should assess the value of vergence and pupil measurements as an objective support tool for early diagnosis of AD.
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Affiliation(s)
- Elizabeth Carolina Jiménez
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.,University of Guadalajara, Jalisco, México
| | - Alba Sierra-Marcos
- Department of Neurology and Neurophysiology, Hospital Sanitas CIMA, Barcelona, Spain
| | - August Romeo
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Amin Hashemi
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Oleksii Leonovych
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.,Braingaze SL, Mataró, Spain
| | - Patricia Bustos Valenzuela
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Maria Solé Puig
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain
| | - Hans Supèr
- Department of Cognition, Development and Educational Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences of the University of Barcelona (UBNeuro), Barcelona, Spain.,Braingaze SL, Mataró, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
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27
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Kawasaki A, Ouanes S, Crippa SV, Popp J. Early-Stage Alzheimer's Disease Does Not Alter Pupil Responses to Colored Light Stimuli. J Alzheimers Dis 2021; 75:1273-1282. [PMID: 32417780 DOI: 10.3233/jad-200120] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Pathologic changes in cerebral and retinal structures governing the pupillary light reflex occur in Alzheimer's disease (AD). Analysis of pupillary responses originating from different retinal cells may allow for non-invasive detection of cerebral AD pathology. OBJECTIVE This study aimed to quantify the pupil light reflex using a portable chromatic pupillometer in patients with early stage AD and compare their responses to those of a healthy control group. METHODS Participants in this case-control pilot study were recruited from a well-characterized cohort of elderly people participating in a larger prospective study on early AD. Cognitive testing, volumetric brain imaging, and lumbar puncture were performed in all participants to define two groups: early AD, i.e., cognitively impaired subjects with biomarker-confirmed AD pathology, and control group of subjects with normal cognition and normal CSF biomarker profile. Pupil responses to red and blue light stimuli intended to activate cone photoreceptors and melanopsin ganglion cells were recorded under photopic conditions. RESULTS Sixteen patients with AD (mean age 77 years) and sixteen controls (mean age 71 years) were tested. Baseline pupil size was significantly smaller in AD patients. Pupillary contraction amplitude to all red and blue lights was also smaller in AD patients but did not reach statistical significance. The post-illumination pupillary response was the same between the two groups. CONCLUSION Compared to healthy controls, we found only a smaller resting size of the pupil in patients with early AD. The pupillary dynamics to light stimulation remained relatively preserved.
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Affiliation(s)
- Aki Kawasaki
- Hôpital Ophtalmique Jules Gonin, Fondation Asile des Aveugles, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Sami Ouanes
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.,Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar
| | - Sylvain V Crippa
- Hôpital Ophtalmique Jules Gonin, Fondation Asile des Aveugles, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Julius Popp
- Service of Old Age Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.,Centre for Gerontopsychiatric Medicine, Department of Geriatric Psychiatry, University Hospital of Psychiatry Zürich, Zürich, Switzerland
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28
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Matsui T, Hara K, Iwata M, Hojo S, Shitara N, Endo Y, Fukuoka H, Matsui M, Kawaguchi H. Possible involvement of the autonomic nervous system in cervical muscles of patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS). BMC Musculoskelet Disord 2021; 22:419. [PMID: 33952227 PMCID: PMC8101228 DOI: 10.1186/s12891-021-04293-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/23/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Patients with myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS) sometimes present with stiffness of the cervical muscles. To investigate the pathophysiology of ME/CFS, this observational study compared patients with versus without recovery from ME/CFS through local modulation of the cervical muscles. METHODS Over a period of 11 years, a total of 1226 inpatients with ME/CFS who did not respond to outpatient care were enrolled in this study. All patients received daily cervical muscle physical therapy during hospitalization. Self-rated records documenting the presence or absence of ME/CFS, as well as the representative eight symptoms that frequently accompany it at admission and discharge, were compared. Pupil diameter was also measured to examine autonomic nervous system function involvement. RESULTS The recovery rate of ME/CFS after local therapy was 55.5%, and did not differ significantly by sex, age strata, and hospitalization period. The recovery rates of the eight symptoms were variable (36.6-86.9%); however, those of ME/CFS in the symptom subpopulations were similar (52.3-55.8%). The recovery rates of all symptoms showed strong associations with that of ME/CFS (p < 0.001). The pupil diameter was more constricted in the ME/CFS-recovered patients than in the ME/CFS-unrecovered patients in the total population and the subpopulations stratified by sex, age, and hospitalization period. CONCLUSIONS There was a strong association between the recovery of ME/CFS and other related whole-body symptoms. The recovery of ME/CFS may be partly linked to amelioration of the autonomic nervous system in the cervical muscles. TRIAL REGISTRATION UMIN000036634 . Registered 1 May 2019 - Retrospectively registered.
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Affiliation(s)
- Takayoshi Matsui
- Orthopaedics and Spine Department, Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
- Matsui Hospital, Kan-nonji 739, Kagawa, Tokyo, 768-0013 Japan
| | - Kazuhiro Hara
- Matsui Hospital, Kan-nonji 739, Kagawa, Tokyo, 768-0013 Japan
| | - Makoto Iwata
- Orthopaedics and Spine Department, Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
| | - Shuntaro Hojo
- Orthopaedics and Spine Department, Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
| | - Nobuyuki Shitara
- Orthopaedics and Spine Department, Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
| | - Yuzo Endo
- Orthopaedics and Spine Department, Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
| | - Hideoki Fukuoka
- Orthopaedics and Spine Department, Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
| | - Masaki Matsui
- Matsui Hospital, Kan-nonji 739, Kagawa, Tokyo, 768-0013 Japan
| | - Hiroshi Kawaguchi
- Orthopaedics and Spine Department, Tokyo Neurological Center, Toranomon 4-1-17, Minato-ku, Tokyo, 105-0001 Japan
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Chang LYL, Palanca-Castan N, Neira D, Palacios AG, Acosta ML. Ocular Health of Octodon degus as a Clinical Marker for Age-Related and Age-Independent Neurodegeneration. Front Integr Neurosci 2021; 15:665467. [PMID: 33927598 PMCID: PMC8076605 DOI: 10.3389/fnint.2021.665467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/19/2021] [Indexed: 01/14/2023] Open
Abstract
The aging process and age-related diseases such as Alzheimer’s disease (AD), are very heterogeneous and multifactorial, making it challenging to diagnose the disease based solely on genetic, behavioral tests, or clinical history. It is yet to be explained what ophthalmological tests relate specifically to aging and AD. To this end, we have selected the common degu (Octodon degus) as a model for aging which develops AD-like signs to conduct ophthalmological screening methods that could be clinical markers of aging and AD. We investigated ocular health using ophthalmoscopy, fundus photography, intraocular pressure (IOP), and pupillary light reflex (PLR). The results showed significant presence of cataracts in adult degus and IOP was also found to increase significantly with advancing age. Age had a significant effect on the maximum pupil constriction but other pupil parameters changed in an age-independent manner (PIPR retention index, resting pupil size, constriction velocity, redilation plateau). We concluded that degus have underlying factors at play that regulate PLR and may be connected to sympathetic, parasympathetic, and melanopsin retinal ganglion cell (ipRGC) deterioration. This study provides the basis for the use of ocular tests as screening methods for the aging process and monitoring of neurodegeneration in non-invasive ways.
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Affiliation(s)
- Lily Y-L Chang
- School of Optometry and Vision Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Nicolas Palanca-Castan
- Centro Interdisciplinario de Neurociencia de Valparaíso, Universidad de Valparaíso, Santiago, Chile
| | - David Neira
- Centro Interdisciplinario de Neurociencia de Valparaíso, Universidad de Valparaíso, Santiago, Chile
| | - Adrian G Palacios
- Centro Interdisciplinario de Neurociencia de Valparaíso, Universidad de Valparaíso, Santiago, Chile
| | - Monica L Acosta
- School of Optometry and Vision Science, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,Brain Research New Zealand-Rangahau Roro Aotearoa, Auckland, New Zealand
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30
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Pinheiro HM, da Costa RM. Pupillary light reflex as a diagnostic aid from computational viewpoint: A systematic literature review. J Biomed Inform 2021; 117:103757. [PMID: 33826949 DOI: 10.1016/j.jbi.2021.103757] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 01/06/2023]
Abstract
This work presents a detailed and complete review of publications on pupillary light reflex (PLR) used to aid diagnoses. These are computational techniques used in the evaluation of pupillometry, as well as their application in computer-aided diagnoses (CAD) of pathologies or physiological conditions that can be studied by observing the movements of miosis and mydriasis of the human pupil. A careful survey was carried out of all studies published over the last 10 years which investigated, electronic devices, recording protocols, image treatment, computational algorithms and the pathologies related to PLR. We present the frontier of existing knowledge regarding methods and techniques used in this field of knowledge, which has been expanding due to the possibility of performing diagnoses with high precision, at a low cost and with a non-invasive method.
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31
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Romagnoli M, Stanzani Maserati M, De Matteis M, Capellari S, Carbonelli M, Amore G, Cantalupo G, Zenesini C, Liguori R, Sadun AA, Carelli V, Park JC, La Morgia C. Chromatic Pupillometry Findings in Alzheimer's Disease. Front Neurosci 2020; 14:780. [PMID: 32848556 PMCID: PMC7431959 DOI: 10.3389/fnins.2020.00780] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 07/02/2020] [Indexed: 12/18/2022] Open
Abstract
Intrinsically photosensitive melanopsin retinal ganglion cells (mRGCs) are crucial for non-image forming functions of the eye, including the photoentrainment of circadian rhythms and the regulation of the pupillary light reflex (PLR). Chromatic pupillometry, using light stimuli at different wavelengths, makes possible the isolation of the contribution of rods, cones, and mRGCs to the PLR. In particular, post-illumination pupil response (PIPR) is the most reliable pupil metric of mRGC function. We have previously described, in post-mortem investigations of AD retinas, a loss of mRGCs, and in the remaining mRGCs, we demonstrated extensive morphological abnormalities. We noted dendrite varicosities, patchy distribution of melanopsin, and reduced dendrite arborization. In this study, we evaluated, with chromatic pupillometry, the PLR in a cohort of mild-moderate AD patients compared to controls. AD and controls also underwent an extensive ophthalmological evaluation. In our AD cohort, PIPR did not significantly differ from controls, even though we observed a higher variability in the AD group and 5/26 showed PIPR values outside the 2 SD from the control mean values. Moreover, we found a significant difference between AD and controls in terms of rod-mediated transient PLR amplitude. These results suggest that in the early stage of AD there are PLR abnormalities that may reflect a pathology affecting mRGC dendrites before involving the mRGC cell body. Further studies, including AD cases with more severe and longer disease duration, are needed to further explore this hypothesis.
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Affiliation(s)
- Martina Romagnoli
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Ospedale Bellaria, Bologna, Italy
| | | | - Maddalena De Matteis
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Ospedale Bellaria, Bologna, Italy
| | - Sabina Capellari
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Ospedale Bellaria, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Michele Carbonelli
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Ospedale Bellaria, Bologna, Italy
| | - Giulia Amore
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Gaetano Cantalupo
- Division of Child Neuropsychiatry, Department of Surgical Sciences, Dentistry, Gynaecology and Paediatrics, University of Verona, Verona, Italy
| | - Corrado Zenesini
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Ospedale Bellaria, Bologna, Italy
| | - Rocco Liguori
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Ospedale Bellaria, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Alfredo A Sadun
- Department of Ophthalmology, Doheny Eye Institute, University of California, Los Angeles, Los Angeles, CA, United States
| | - Valerio Carelli
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Ospedale Bellaria, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Jason C Park
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Chiara La Morgia
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Ospedale Bellaria, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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32
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Giller F, Mückschel M, Ziemssen T, Beste C. A possible role of the norepinephrine system during sequential cognitive flexibility – Evidence from EEG and pupil diameter data. Cortex 2020; 128:22-34. [DOI: 10.1016/j.cortex.2020.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 12/14/2019] [Accepted: 03/09/2020] [Indexed: 01/04/2023]
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Carr DB, Grover P. The Role of Eye Tracking Technology in Assessing Older Driver Safety. Geriatrics (Basel) 2020; 5:E36. [PMID: 32517336 PMCID: PMC7345272 DOI: 10.3390/geriatrics5020036] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 12/11/2022] Open
Abstract
A growing body of literature is focused on the use of eye tracking (ET) technology to understand the association between objective visual parameters and higher order brain processes such as cognition. One of the settings where this principle has found practical utility is in the area of driving safety. METHODS We reviewed the literature to identify the changes in ET parameters with older adults and neurodegenerative disease. RESULTS This narrative review provides a brief overview of oculomotor system anatomy and physiology, defines common eye movements and tracking variables that are typically studied, explains the most common methods of eye tracking measurements during driving in simulation and in naturalistic settings, and examines the association of impairment in ET parameters with advanced age and neurodegenerative disease. CONCLUSION ET technology is becoming less expensive, more portable, easier to use, and readily applicable in a variety of clinical settings. Older adults and especially those with neurodegenerative disease may have impairments in visual search parameters, placing them at risk for motor vehicle crashes. Advanced driver assessment systems are becoming more ubiquitous in newer cars and may significantly reduce crashes related to impaired visual search, distraction, and/or fatigue.
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Affiliation(s)
- David B. Carr
- Department of Medicine and Neurology, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Prateek Grover
- Department of Neurology, Washington University School of Medicine, St Louis, MO 63110, USA;
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34
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Favre E, Bernini A, Morelli P, Pasquier J, Miroz JP, Abed-Maillard S, Ben-Hamouda N, Oddo M. Neuromonitoring of delirium with quantitative pupillometry in sedated mechanically ventilated critically ill patients. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2020; 24:66. [PMID: 32093710 PMCID: PMC7041194 DOI: 10.1186/s13054-020-2796-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 02/18/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Intensive care unit (ICU) delirium is a frequent secondary neurological complication in critically ill patients undergoing prolonged mechanical ventilation. Quantitative pupillometry is an emerging modality for the neuromonitoring of primary acute brain injury, but its potential utility in patients at risk of ICU delirium is unknown. METHODS This was an observational cohort study of medical-surgical ICU patients, without acute or known primary brain injury, who underwent sedation and mechanical ventilation for at least 48 h. Starting at day 3, automated infrared pupillometry-blinded to ICU caregivers-was used for repeated measurement of the pupillary function, including quantitative pupillary light reflex (q-PLR, expressed as % pupil constriction to a standardized light stimulus) and constriction velocity (CV, mm/s). The relationship between delirium, using the CAM-ICU score, and quantitative pupillary variables was examined. RESULTS A total of 59/100 patients had ICU delirium, diagnosed at a median 8 (5-13) days from admission. Compared to non-delirious patients, subjects with ICU delirium had lower values of q-PLR (25 [19-31] vs. 20 [15-28] %) and CV (2.5 [1.7-2.8] vs. 1.7 [1.4-2.4] mm/s) at day 3, and at all additional time-points tested (p < 0.05). After adjusting for the SOFA score and the cumulative dose of analgesia and sedation, lower q-PLR was associated with an increased risk of ICU delirium (OR 1.057 [1.007-1.113] at day 3; p = 0.03). CONCLUSIONS Sustained abnormalities of quantitative pupillary variables at the early ICU phase correlate with delirium and precede clinical diagnosis by a median 5 days. These findings suggest a potential utility of quantitative pupillometry in sedated mechanically ventilated ICU patients at high risk of delirium.
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Affiliation(s)
- Eva Favre
- Critical Care Research Unit, Centre Hospitalier Universitaire Vaudois (CHUV), University Hospital and University of Lausanne, Rue du Bugnon 46, BH08-623, CH-1011, Lausanne, Switzerland.,Department of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), University Hospital and University of Lausanne, Rue du Bugnon 46, BH 08.623, Lausanne, Switzerland.,Institute of Higher Education and Research in Healthcare - IUFRS, University of Lausanne, Lausanne, Switzerland
| | - Adriano Bernini
- Critical Care Research Unit, Centre Hospitalier Universitaire Vaudois (CHUV), University Hospital and University of Lausanne, Rue du Bugnon 46, BH08-623, CH-1011, Lausanne, Switzerland
| | - Paola Morelli
- Critical Care Research Unit, Centre Hospitalier Universitaire Vaudois (CHUV), University Hospital and University of Lausanne, Rue du Bugnon 46, BH08-623, CH-1011, Lausanne, Switzerland
| | - Jerôme Pasquier
- Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - John-Paul Miroz
- Critical Care Research Unit, Centre Hospitalier Universitaire Vaudois (CHUV), University Hospital and University of Lausanne, Rue du Bugnon 46, BH08-623, CH-1011, Lausanne, Switzerland
| | - Samia Abed-Maillard
- Critical Care Research Unit, Centre Hospitalier Universitaire Vaudois (CHUV), University Hospital and University of Lausanne, Rue du Bugnon 46, BH08-623, CH-1011, Lausanne, Switzerland
| | - Nawfel Ben-Hamouda
- Critical Care Research Unit, Centre Hospitalier Universitaire Vaudois (CHUV), University Hospital and University of Lausanne, Rue du Bugnon 46, BH08-623, CH-1011, Lausanne, Switzerland.,Department of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), University Hospital and University of Lausanne, Rue du Bugnon 46, BH 08.623, Lausanne, Switzerland
| | - Mauro Oddo
- Critical Care Research Unit, Centre Hospitalier Universitaire Vaudois (CHUV), University Hospital and University of Lausanne, Rue du Bugnon 46, BH08-623, CH-1011, Lausanne, Switzerland. .,Department of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois (CHUV), University Hospital and University of Lausanne, Rue du Bugnon 46, BH 08.623, Lausanne, Switzerland.
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35
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Mückschel M, Ziemssen T, Beste C. Properties of lower level processing modulate the actions of the norepinephrine system during response inhibition. Biol Psychol 2020; 152:107862. [PMID: 32032625 DOI: 10.1016/j.biopsycho.2020.107862] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 12/29/2019] [Accepted: 02/03/2020] [Indexed: 02/06/2023]
Abstract
We ask whether actions of the norepinephrine (NE) system during response inhibition are affected by properties of lower level sensory stimulus processing. We used a somato-sensory Go/Nogo task and combined ERP recordings with pupil diameter recordings as an index of NE system activity. The Go/Nogo task was designed to achieve processing of tactile stimuli predominantly over primary somatosensory (SI) and secondary somatosensory (SII) areas. The data show that response inhibition was better when stimuli were processed via SII, compared to SI areas. This was reflected by variations in the Nogo-N2/P3 associated with anterior cingulate structures. Correlations with the pupil diameter data, indicting modulations of the NE system during inhibitory control processes, were only evident when SI sensory areas were involved. These dissociable modulatory effects were associated with activations in the superior frontal gyrus. Actions of the NE system during response inhibition are modulated by properties of lower level processing.
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Affiliation(s)
- Moritz Mückschel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; MS Centre Dresden, Centre of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, TU Dresden, Germany
| | - Tjalf Ziemssen
- MS Centre Dresden, Centre of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany.
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36
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Wong HK, Epps J, Chen S. Automatic Pupillary Light Reflex Detection in Eyewear Computing. IEEE Trans Cogn Dev Syst 2019. [DOI: 10.1109/tcds.2018.2880664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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37
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Noufi P, Khoury R, Jeyakumar S, Grossberg GT. Use of Cholinesterase Inhibitors in Non-Alzheimer's Dementias. Drugs Aging 2019; 36:719-731. [PMID: 31201687 DOI: 10.1007/s40266-019-00685-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Non-Alzheimer's dementias constitute 30% of all dementias and present with major cognitive and behavioral disturbances. Cholinesterase inhibitors improve memory by increasing brain acetylcholine levels and are approved symptomatic therapies for Alzheimer's disease (AD). They have also been investigated in other types of dementias with potential cholinergic dysfunction. There is compelling evidence for a profound cholinergic deficit in Lewy Body dementia (LBD) and Parkinson's disease dementia (PDD), even to a greater extent than AD. However, this deficit is difficult to objectivize in vascular dementia (VaD) given the increased comorbidity with AD. Furthermore, there is minimal to no evidence for cholinergic loss in frontotemporal dementia (FTD). Although cholinesterase inhibitors showed significant improvement in cognitive, behavioral, and functional measures in both LBD and PDD clinical trials, only rivastigmine is approved for PDD, due to the heterogeneity of the scales used, the duration of trials, and the limited sample sizes impacting data interpretation. Similarly, the interpretation of findings in VaD trials are limited by the lack of pre-defined inclusion criteria for 'pure VaD' and the wide heterogeneity of patients enrolled with respect to location and extent of cerebrovascular disease. In FTD patients, cholinesterase inhibitors were mostly associated with worsening of cognitive and behavioral symptoms. In non-AD dementias, cholinesterase inhibitors were well tolerated, with increased reports of mild to moderate cholinergic side effects and a non-significant trend for increased cardio and cerebrovascular events with rivastigmine in VaD, justifying their cautious use on a case-by-case basis, especially when there is evidence for cholinergic deficit.
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Affiliation(s)
- Paul Noufi
- Department of Psychiatry, American University of Beirut, Beirut, Lebanon
| | - Rita Khoury
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 S Grand Blvd, St. Louis, MO, 63104, USA.
| | - Sajeeka Jeyakumar
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 S Grand Blvd, St. Louis, MO, 63104, USA
| | - George T Grossberg
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 S Grand Blvd, St. Louis, MO, 63104, USA
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38
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Kremen WS, Panizzon MS, Elman JA, Granholm EL, Andreassen OA, Dale AM, Gillespie NA, Gustavson DE, Logue MW, Lyons MJ, Neale MC, Reynolds CA, Whitsel N, Franz CE. Pupillary dilation responses as a midlife indicator of risk for Alzheimer's disease: association with Alzheimer's disease polygenic risk. Neurobiol Aging 2019; 83:114-121. [PMID: 31585363 PMCID: PMC6931134 DOI: 10.1016/j.neurobiolaging.2019.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/09/2019] [Accepted: 09/03/2019] [Indexed: 12/27/2022]
Abstract
Locus coeruleus (LC) tau accumulation begins early. Targeting LC (dys)function might improve early identification for Alzheimer's disease (AD) risk. Pupillary responses during cognitive tasks are driven by the LC and index cognitive effort. Despite equivalent task performance, adults with mild cognitive impairment have greater pupil dilation/effort during digit span than cognitively normal (CN) individuals. We hypothesized that AD polygenic risk scores (AD-PRSs) would be associated with pupillary responses in middle-aged CN adults. Pupillary responses during digit span tasks were heritable (h2 = 0.30-0.36) in 1119 men aged 56-66 years. In a CN subset-all with comparable span capacities (n = 539)-higher AD-PRSs were associated with greater pupil dilation/effort in a high (9-digit) cognitive load condition (Cohen's d = 0.36 for upper vs. lower quartile of AD-PRS distribution). Results held up after controlling for APOE genotype. Results support pupillary response-and by inference, LC dysfunction-as a genetically mediated biomarker of early mild cognitive impairment/AD risk. In combination with other biomarkers, task-evoked pupillary responses may provide additional information for early screening of genetically at-risk individuals even before cognitive declines.
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Affiliation(s)
- William S Kremen
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA.
| | - Matthew S Panizzon
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Jeremy A Elman
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Eric L Granholm
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; Psychology Service, VA San Diego Healthcare System, La Jolla, CA, USA
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Anders M Dale
- Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA; Department of Radiology, University of California, San Diego, La Jolla, CA, USA; Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Daniel E Gustavson
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Mark W Logue
- National Center for PTSD: Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry and Biomedical Genetics Section, Boston University School of Medicine, Boston, MA, USA; Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California, Riverside, Riverside, CA, USA
| | - Nathan Whitsel
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - Carol E Franz
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
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39
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Bower MM, Sweidan AJ, Xu JC, Stern-Neze S, Yu W, Groysman LI. Quantitative Pupillometry in the Intensive Care Unit. J Intensive Care Med 2019; 36:383-391. [PMID: 31601157 DOI: 10.1177/0885066619881124] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Quantitative pupillometry provides a noninvasive and objective assessment within the neurological examination. This review details the physiology of the pupillary light response, the clinical significance of changes in pupillary reactivity, and the variables that compose the Neurological Pupil index or NPi are discussed. This article reviews the most recent applications and advances in quantitative pupillometry for noninvasive intracranial pressure monitoring, postcardiac arrest prognostication, and subarachnoid hemorrhage. Also discussed are the limitations and confounders of quantitative pupillometry in the modern neurological intensive care unit.
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Affiliation(s)
- Matthew M Bower
- Department of Neurology, 21769University of California, Irvine, Orange, CA, USA
| | - Alexander J Sweidan
- Department of Neurology, 21769University of California, Irvine, Orange, CA, USA
| | - Jordan C Xu
- Department of Neurology, 21769University of California, Irvine, Orange, CA, USA
| | - Sara Stern-Neze
- Department of Neurology, 21769University of California, Irvine, Orange, CA, USA
| | - Wengui Yu
- Department of Neurology, 21769University of California, Irvine, Orange, CA, USA
| | - Leonid I Groysman
- Department of Neurology, 21769University of California, Irvine, Orange, CA, USA
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40
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Bueno APA, Sato JR, Hornberger M. Eye tracking - The overlooked method to measure cognition in neurodegeneration? Neuropsychologia 2019; 133:107191. [PMID: 31521634 DOI: 10.1016/j.neuropsychologia.2019.107191] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 08/26/2019] [Accepted: 09/08/2019] [Indexed: 12/11/2022]
Abstract
Eye tracking (ET) studies are becoming increasingly popular due to rapid methodological and technological advances as well as the development of cost efficient and portable eye trackers. Although historically ET has been mostly employed in psychophysics or developmental cognition studies, there is also promising scope to use ET for movement disorders and measuring cognitive processes in neurodegeneration. Particularly, ET can be a powerful tool for cognitive and neuropsychological assessments of patients with pathologies affecting motor and verbal abilities, as tasks can be adapted without requiring motor (except eye movements) or verbal responses. In this review, we will examine the existing evidence of ET methods in neurodegenerative conditions and its potential clinical impact for cognitive assessment. We highlight that current evidence for ET is mostly focused on diagnostics of cognitive impairments in neurodegenerative disorders, where it is debatable whether it has any more sensitivity or specificity than existing cognitive assessments. By contrast, there is currently a lack of ET studies in more advanced disease stages, when patients' motor and verbal functions can be significantly affected, and standard cognitive assessments are challenging or often not possible. We conclude that ET is a promising method not only for cognitive diagnostics but more importantly, for potential cognitive disease tracking in progressive neurodegenerative conditions.
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Affiliation(s)
- A P A Bueno
- - Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André, Brazil; - Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK.
| | - J R Sato
- - Center of Mathematics, Computing and Cognition, Universidade Federal do ABC, Santo André, Brazil
| | - M Hornberger
- - Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK; - Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
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Li X, Sun H, Zhang L, Liu H, Li J, Wang C, Zhang M, Bao J. Technical Note: Effects of age and confinement on pupillary light reflex in sows1. J Anim Sci 2019; 97:2009-2014. [PMID: 30906947 DOI: 10.1093/jas/skz100] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/22/2019] [Indexed: 11/15/2022] Open
Abstract
Pupillary reflex has been used as a method to examine psychological problems in human clinics and mental disease research. Intensive animal farming has been shown to lead to chronic stress resulting in depression; however, comparing with humans we lack an effective clinical method to clinically inspect these psychological problems in animals. The goal of this study was to investigate the effect of age and housing conditions (confined crates vs. group pens) on pupillary light reflex (PLR) of sows to explore whether PLR can be used as an effective way to measure the psychological state of farm animals. In total, 270 pregnant sows were selected for PLR testing and divided into 6 treatments (45 sows per treatment) of 2 different environments (group-housed pen and confined gestation crates) and 3 parities (first, third, and fifth parities). Six selected pupil parameters: 1) latency of the pupil constriction onset (LAT); 2) the percent of the constriction (CON); 3) average constriction velocity (ACV); 4) maximum constriction velocity (MCV); 5) average dilation velocity (ADV); and 6) time of 75% recovery after constriction (T75) were examined. The results showed that there was no difference found in these PLR parameters between the breeds (P > 0.05) but the significant effects were found on LAT, CON, ACV, and MCV by age (P < 0.01). The group-housed sows had significantly higher CON, ACV, and MCV than those in the confined crates (P < 0.05). In conclusion, the pupillary light reflex of the sows was not affected by breed but by age. The results also indicate that some of PLR parameters were sensitive to housing conditions and suggest that ACV and MCV have potential to be sensitive indicators in relation to the psychological problem of sows.
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Affiliation(s)
- Xiang Li
- College of Animal Science and Technology, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Hanqing Sun
- College of Animal Science and Technology, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Lei Zhang
- College of Animal Science and Technology, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Honggui Liu
- College of Animal Science and Technology, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Jianhong Li
- College of Life Science, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Chao Wang
- College of Animal Science and Technology, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Mingyue Zhang
- College of Animal Science and Technology, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Jun Bao
- College of Animal Science and Technology, Northeast Agricultural University, Harbin, Heilongjiang, China.,Key Laboratory of Swine Facilities, Ministry of Agriculture, Northeast Agricultural University, Harbin, Heilongjiang, China
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42
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Becktepe JS, Gövert F, Kasiske L, Yalaz M, Witt K, Deuschl G. Pupillary response to light and tasks in early and late onset essential tremor patients. Parkinsonism Relat Disord 2019; 66:62-67. [PMID: 31327629 DOI: 10.1016/j.parkreldis.2019.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 05/23/2019] [Accepted: 07/05/2019] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Late-onset essential tremor is characterised by shorter life expectancy and more advanced aging parameters and may therefore be an 'aging-related' tremor. Brainstem functions involved in pupillary responses are hypothesized to reflect such earlier aging. The pupillary light response (PLR) and a task evoked pupillary response (TEPR) were used to test this hypothesis in same-aged patients with early onset (EOET) and late onset (LOET) essential tremor and healthy controls. SUBJECTS AND METHODS Age related changes of the PLR and TEPR during the paced auditory serial addition test (PASAT) were tested in 57 normal subjects. Subsequently, 13 patients with LOET and 16 patients with EOET were compared with 15 age matched healthy controls. Standard parameters of PLR were recorded, amongst others the time to maximum acceleration of the PLR (T1) and the time to maximum velocity (T2). The TEPR was determined during the PASAT as the percentage change in pupil size (PCPS). Data were analysed with ANOVA and post-hoc testing. RESULTS In normal subjects the pupil diameter, latency, maximum acceleration/velocity and percentage amplitude were correlated with age. Latency of the pupillary light response was significantly longer in LOET compared to controls and EOET while no differences were found between EOET and controls. The TEPR showed no significant differences between the three groups. CONCLUSION LOET showed a prolonged latency of the PLR compared to EOET possibly indicating premature aging or rather pathophysiological differences on brainstem level. This study further supports the hypothesis of abnormal aging in LOET.
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Affiliation(s)
- Jos S Becktepe
- Department of Neurology, University Hospital Schleswig Holstein, 24105, Kiel, Germany
| | - Felix Gövert
- Department of Neurology, University Hospital Schleswig Holstein, 24105, Kiel, Germany
| | - Lisa Kasiske
- Department of Neurology, University Hospital Schleswig Holstein, 24105, Kiel, Germany
| | - Mevlüt Yalaz
- Department of Neurology, University Hospital Schleswig Holstein, 24105, Kiel, Germany
| | - Karsten Witt
- Department of Neurology, University Hospital Schleswig Holstein, 24105, Kiel, Germany; Department of Neurology and Research Center Neurosensory Science, Carl von Ossietzky University, 26122, Oldenburg, Germany
| | - Günther Deuschl
- Department of Neurology, University Hospital Schleswig Holstein, 24105, Kiel, Germany.
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Park KW, Choi N, Ryu HS, Kim MS, Lee EJ, Chung SJ. Pupillary dysfunction of multiple system atrophy: Dynamic pupillometric findings and clinical correlations. Parkinsonism Relat Disord 2019; 65:234-237. [PMID: 31076267 DOI: 10.1016/j.parkreldis.2019.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 04/26/2019] [Accepted: 05/01/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Although autonomic dysfunction is the prominent clinical feature in multiple system atrophy (MSA), little is known about the pupillary autonomic aspect of MSA. We aimed to evaluate pupillary autonomic function in MSA patients using dynamic pupillometry, which can quantify the pupillary light reflex. METHODS Dynamic pupillometry parameters were compared in 21 MSA patients and 21 healthy controls. Pupillometric parameters were correlated with total Unified Multiple System Atrophy Rating Scale (UMSARS) scores and autonomic symptom severity. RESULTS Average constriction (p = 0.034) and dilation (p = 0.003) velocities were significantly slowed in MSA patients compared with controls. Total UMSARS correlated with the average constriction (r = -0.527, p = 0.017) and maximum constriction (r = -0.658, p = 0.003) velocities. Autonomic symptom severity correlated with average constriction (r = -0.544, p = 0.013), maximum constriction (r = -0.607, p = 0.005) and average dilation (r = -0.499, p = 0.025) velocities. CONCLUSION Dynamic pupillometry may provide useful information about pupillary autonomic dysfunction, which correlated with the clinical severity, in patients with MSA.
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Affiliation(s)
- Kye Won Park
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea.
| | - Nari Choi
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea.
| | - Ho-Sung Ryu
- Department of Neurology, Kyungpook National University School of Medicine, Daegu, 41404, South Korea.
| | - Mi Sun Kim
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea.
| | - Eun-Jae Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea.
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea.
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Chougule PS, Najjar RP, Finkelstein MT, Kandiah N, Milea D. Light-Induced Pupillary Responses in Alzheimer's Disease. Front Neurol 2019; 10:360. [PMID: 31031692 PMCID: PMC6473037 DOI: 10.3389/fneur.2019.00360] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/25/2019] [Indexed: 12/25/2022] Open
Abstract
The impact of Alzheimer's disease (AD) on the pupillary light response (PLR) is controversial, being dependent on the stage of the disease and on the experimental pupillometric protocols. The main hypothesis driving pupillometry research in AD is based on the concept that the AD-related neurodegeneration affects both the parasympathetic and the sympathetic arms of the PLR (cholinergic and noradrenergic theory), combined with additional alterations of the afferent limb, involving the melanopsin expressing retinal ganglion cells (mRGCs), subserving the PLR. Only a few studies have evaluated the value of pupillometry as a potential biomarker in AD, providing various results compatible with parasympathetic dysfunction, displaying increased latency of pupillary constriction to light, decreased constriction amplitude, faster redilation after light offset, decreased maximum velocity of constriction (MCV) and maximum constriction acceleration (MCA) compared to controls. Decreased MCV and MCA appeared to be the most accurate of all PLR parameters allowing differentiation between AD and healthy controls while increased post-illumination pupillary response was the most consistent feature, however, these results could not be replicated by more recent studies, focusing on early and pre-clinical stages of the disease. Whether static or dynamic pupillometry yields useful biomarkers for AD screening or diagnosis remains unclear. In this review, we synopsize the current knowledge on pupillometric features in AD and other neurodegenerative diseases, and discuss potential roles of pupillometry in AD detection, diagnosis and monitoring, alone or in combination with additional biomarkers.
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Affiliation(s)
- Pratik S Chougule
- Department of Visual Neurosciences, Singapore Eye Research Institute, Singapore, Singapore
| | - Raymond P Najjar
- Department of Visual Neurosciences, Singapore Eye Research Institute, Singapore, Singapore.,The Ophthalmology & Visual Sciences ACP, Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore
| | - Maxwell T Finkelstein
- Department of Visual Neurosciences, Singapore Eye Research Institute, Singapore, Singapore
| | - Nagaendran Kandiah
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore.,Duke-National University of Singapore (NUS), Singapore, Singapore
| | - Dan Milea
- Department of Visual Neurosciences, Singapore Eye Research Institute, Singapore, Singapore.,The Ophthalmology & Visual Sciences ACP, Duke-National University of Singapore (NUS) Medical School, Singapore, Singapore.,Singapore National Eye Centre, Singapore, Singapore
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45
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Pertermann M, Mückschel M, Adelhöfer N, Ziemssen T, Beste C. On the interrelation of 1/ f neural noise and norepinephrine system activity during motor response inhibition. J Neurophysiol 2019; 121:1633-1643. [PMID: 30811254 DOI: 10.1152/jn.00701.2018] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Several lines of evidence suggest that there is a close interrelation between the degree of noise in neural circuits and the activity of the norepinephrine (NE) system, yet the precise nexus between these aspects is far from being understood during human information processing and cognitive control in particular. We examine this nexus during response inhibition in n = 47 healthy participants. Using high-density EEG recordings, we estimate neural noise by calculating "1/f noise" of those data and integrate these EEG parameters with pupil diameter data as an established indirect index of NE system activity. We show that neural noise is reduced when cognitive control processes to inhibit a prepotent/automated response are exerted. These neural noise variations were confined to the theta frequency band, which has also been shown to play a central role during response inhibition and cognitive control. There were strong positive correlations between the 1/f neural noise parameter and the pupil diameter data within the first 250 ms after the Nogo stimulus presentation at centro-parietal electrode sites. No such correlations were evident during automated responding on Go trials. Source localization analyses using standardized low-resolution brain electromagnetic tomography show that inferior parietal areas are activated in this time period in Nogo trials. The data suggest an interrelation of NE system activity and neural noise within early stages of information processing associated with inferior parietal areas when cognitive control processes are required. The data provide the first direct evidence for the nexus between NE system activity and the modulation of neural noise during inhibitory control in humans. NEW & NOTEWORTHY This is the first study showing that there is a nexus between norepinephrine system activity and the modulation of neural noise or scale-free neural activity during inhibitory control in humans. It does so by integrating pupil diameter data with analysis of EEG neural noise.
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Affiliation(s)
- Maik Pertermann
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden , Germany
| | - Moritz Mückschel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden , Germany.,MS Centre Dresden, Centre of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, TU Dresden, Dresden , Germany
| | - Nico Adelhöfer
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden , Germany
| | - Tjalf Ziemssen
- MS Centre Dresden, Centre of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, TU Dresden, Dresden , Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden , Germany.,Faculty of Psychology, School of Science, TU Dresden, Dresden , Germany
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46
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Kourtis LC, Regele OB, Wright JM, Jones GB. Digital biomarkers for Alzheimer's disease: the mobile/ wearable devices opportunity. NPJ Digit Med 2019; 2:9. [PMID: 31119198 PMCID: PMC6526279 DOI: 10.1038/s41746-019-0084-2] [Citation(s) in RCA: 157] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 02/01/2019] [Indexed: 12/14/2022] Open
Abstract
Alzheimer's Disease (AD) represents a major and rapidly growing burden to the healthcare ecosystem. A growing body of evidence indicates that cognitive, behavioral, sensory, and motor changes may precede clinical manifestations of AD by several years. Existing tests designed to diagnose neurodegenerative diseases, while well-validated, are often less effective in detecting deviations from normal cognitive decline trajectory in the earliest stages of the disease. In the quest for gold standards for AD assessment, there is a growing interest in the identification of readily accessible digital biomarkers, which harness advances in consumer grade mobile and wearable technologies. Topics examined include a review of existing early clinical manifestations of AD and a path to the respective sensor and mobile/wearable device usage to acquire domain-centric data towards objective, high frequency and passive digital phenotyping.
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Affiliation(s)
- Lampros C. Kourtis
- Clinical & Translational Science Institute, Tufts University Medical Center, 800 Washington St, Boston, MA 02111 USA
- Evidation Health, 167 2nd Ave, San Mateo, CA 94401 USA
- Cambridge Innovation Center, Eli Lilly and Company, 450 Kendall, Cambridge, MA 02142 USA
| | - Oliver B. Regele
- Cambridge Innovation Center, Eli Lilly and Company, 450 Kendall, Cambridge, MA 02142 USA
- Present Address: Massachusetts Institute of Technology, Cambridge, MA USA
| | - Justin M. Wright
- Cambridge Innovation Center, Eli Lilly and Company, 450 Kendall, Cambridge, MA 02142 USA
- Present Address: Novartis Pharmaceuticals, East Hanover, NJ USA
| | - Graham B. Jones
- Clinical & Translational Science Institute, Tufts University Medical Center, 800 Washington St, Boston, MA 02111 USA
- Present Address: Novartis Pharmaceuticals, East Hanover, NJ USA
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47
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Adelhöfer N, Mückschel M, Teufert B, Ziemssen T, Beste C. Anodal tDCS affects neuromodulatory effects of the norepinephrine system on superior frontal theta activity during response inhibition. Brain Struct Funct 2019; 224:1291-1300. [PMID: 30701308 DOI: 10.1007/s00429-019-01839-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 01/21/2019] [Indexed: 12/27/2022]
Abstract
Medial and superior frontal theta oscillations are important for response inhibition. The norepinephrine (NE) system has been shown to modulate these oscillations possibly via gain control mechanisms, which depend on the modulation of neuron membrane potentials. Because the latter are also modulated by tDCS, the interrelation of tDCS and NE effects on superior frontal theta band activity needs investigation. We test the hypothesis that anodal tDCS affects modulatory effects of the NE system on theta band activity during inhibitory control in superior frontal regions. Using EEG beamforming, theta band activity in the superior frontal gyrus (SFG) was integrated (correlated) with the pupil diameter data as an indirect index of NE activity. In a within-subject design, healthy participants completed a response inhibition task in two sessions in which they received 2 mA anodal tDCS over the vertex, or sham stimulation. There were no behavioral effects of anodal tDCS. Yet, tDCS affected correlations between SFG theta band activity time course and the pupil diameter time course. Correlations were evident after sham stimulation (r = .701; p < .004), but absent after anodal tDCS. The observed power of this dissociation was above 95%. The data suggest that anodal tDCS may eliminate neuromodulatory effects, likely of the NE system, on theta band activity during response inhibition in a structure of the response inhibition network. The NE system and tDCS seem to target similar mechanisms important for cognitive control in the prefrontal cortex. The results provide a hint why tDCS often fails to induce overt behavioral effects and shows that neurobiological systems, which may exert similar effects as tDCS on neural processes should closely be monitored in tDCS experiments.
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Affiliation(s)
- Nico Adelhöfer
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Moritz Mückschel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.,Department of Neurology, Faculty of Medicine, MS Centre Dresden, TU Dresden, Dresden, Germany
| | - Benjamin Teufert
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Tjalf Ziemssen
- Department of Neurology, Faculty of Medicine, MS Centre Dresden, TU Dresden, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
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Meng D, Li X, Bauer M, Taylor JP, Auer DP. Altered Nucleus Basalis Connectivity Predicts Treatment Response in Mild Cognitive Impairment. Radiology 2018; 289:775-785. [PMID: 30204076 PMCID: PMC6283326 DOI: 10.1148/radiol.2018180092] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 07/03/2018] [Accepted: 07/18/2018] [Indexed: 11/11/2022]
Abstract
Purpose To determine whether functional connectivity (FC) mapping of nucleus basalis of Meynert (NBM) cholinergic network (hereafter, NBM FC) could provide a biomarker of central cholinergic deficits with predictive potential for response to cholinesterase inhibitor (ChEI) treatment. Materials and Methods The Alzheimer's Disease Neuroimaging Initiative (ADNI) was approved by the institutional review boards of all participating sites. All participants and their representatives gave written informed consent prior to data collection. NBM FC was examined in 33 healthy control participants, 102 patients with mild cognitive impairment (MCI), and 33 patients with AD by using resting-state functional MRI data from the ADNI database. NBM FC was compared between groups before and after 6 months of ChEI treatment in MCI. Associations between baseline NBM FC and baseline cognitive performance as well as cognitive outcomes after treatment were investigated. Results Compared with the healthy control group, NBM FC was decreased in patients with untreated MCI and increased in patients with AD treated with ChEI (corrected P ˂ .05). Global cognition (Alzheimer's Disease Assessment Scale-Cognitive subscale score) was associated with NBM FC (r = -0.349; P ˂ .001). NBM FC was higher 6 months after ChEI compared with before ChEI in treated MCI (corrected P ˂ .05), but did not change at 6 months in patients with untreated MCI (corrected P ˂ .05). Baseline NBM FC in MCI strongly predicted cognitive outcomes 6 months after ChEI (R2 = 0.458; P = .001). Conclusion Functional dissociation of the nucleus basalis of Meynert from a cortical network may explain the cognitive deficits in dementia and allow for the selection of individuals who are more likely to respond to cholinesterase inhibitors at early disease stages. © RSNA, 2018 Online supplemental material is available for this article.
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Affiliation(s)
- Dewen Meng
- From the Sir Peter Mansfield Imaging Centre, School of Medicine
(D.M., X.L., D.P.A.), and School of Psychology (M.B.), University of Nottingham,
Nottingham, England; NIHR Nottingham Biomedical Research Centre, Queen’s
Medical Centre, University of Nottingham, Derby Rd, Nottingham NG7 2UH, England
(D.M., X.L., D.P.A.); and Institute of Neuroscience, Newcastle University,
Campus for Ageing and Vitality, Newcastle upon Tyne, England (J.P.T.)
| | - Xingfeng Li
- From the Sir Peter Mansfield Imaging Centre, School of Medicine
(D.M., X.L., D.P.A.), and School of Psychology (M.B.), University of Nottingham,
Nottingham, England; NIHR Nottingham Biomedical Research Centre, Queen’s
Medical Centre, University of Nottingham, Derby Rd, Nottingham NG7 2UH, England
(D.M., X.L., D.P.A.); and Institute of Neuroscience, Newcastle University,
Campus for Ageing and Vitality, Newcastle upon Tyne, England (J.P.T.)
| | - Markus Bauer
- From the Sir Peter Mansfield Imaging Centre, School of Medicine
(D.M., X.L., D.P.A.), and School of Psychology (M.B.), University of Nottingham,
Nottingham, England; NIHR Nottingham Biomedical Research Centre, Queen’s
Medical Centre, University of Nottingham, Derby Rd, Nottingham NG7 2UH, England
(D.M., X.L., D.P.A.); and Institute of Neuroscience, Newcastle University,
Campus for Ageing and Vitality, Newcastle upon Tyne, England (J.P.T.)
| | - John-Paul Taylor
- From the Sir Peter Mansfield Imaging Centre, School of Medicine
(D.M., X.L., D.P.A.), and School of Psychology (M.B.), University of Nottingham,
Nottingham, England; NIHR Nottingham Biomedical Research Centre, Queen’s
Medical Centre, University of Nottingham, Derby Rd, Nottingham NG7 2UH, England
(D.M., X.L., D.P.A.); and Institute of Neuroscience, Newcastle University,
Campus for Ageing and Vitality, Newcastle upon Tyne, England (J.P.T.)
| | - Dorothee P. Auer
- From the Sir Peter Mansfield Imaging Centre, School of Medicine
(D.M., X.L., D.P.A.), and School of Psychology (M.B.), University of Nottingham,
Nottingham, England; NIHR Nottingham Biomedical Research Centre, Queen’s
Medical Centre, University of Nottingham, Derby Rd, Nottingham NG7 2UH, England
(D.M., X.L., D.P.A.); and Institute of Neuroscience, Newcastle University,
Campus for Ageing and Vitality, Newcastle upon Tyne, England (J.P.T.)
| | - For the Alzheimer's Disease Neuroimaging Initiative
- From the Sir Peter Mansfield Imaging Centre, School of Medicine
(D.M., X.L., D.P.A.), and School of Psychology (M.B.), University of Nottingham,
Nottingham, England; NIHR Nottingham Biomedical Research Centre, Queen’s
Medical Centre, University of Nottingham, Derby Rd, Nottingham NG7 2UH, England
(D.M., X.L., D.P.A.); and Institute of Neuroscience, Newcastle University,
Campus for Ageing and Vitality, Newcastle upon Tyne, England (J.P.T.)
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Guo L, Normando EM, Shah PA, De Groef L, Cordeiro MF. Oculo-visual abnormalities in Parkinson's disease: Possible value as biomarkers. Mov Disord 2018; 33:1390-1406. [DOI: 10.1002/mds.27454] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 05/16/2018] [Accepted: 05/18/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- Li Guo
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
| | - Eduardo M. Normando
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
- Western Eye Hospital, Imperial College Healthcare National Health Service Trust; London UK
- Imperial College Ophthalmology Research Group, Department of Surgery and Cancer, Imperial College London; London UK
| | - Parth Arvind Shah
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
| | - Lies De Groef
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
- Neural Circuit Development and Regeneration Research Group, Department of Biology; University of Leuven; Leuven Belgium
| | - M. Francesca Cordeiro
- Glaucoma and Retinal Degenerative Disease Research Group, Institute of Ophthalmology; University College London; London UK
- Western Eye Hospital, Imperial College Healthcare National Health Service Trust; London UK
- Imperial College Ophthalmology Research Group, Department of Surgery and Cancer, Imperial College London; London UK
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50
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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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