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Bosten JM, Lawrance-Owen AJ, Bargary G, Goodbourn PT, Mollon JD. 13q32.1 as a candidate region for physiological anisocoria. Br J Ophthalmol 2023; 107:1730-1735. [PMID: 35273018 DOI: 10.1136/bjophthalmol-2021-319936] [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: 06/23/2021] [Accepted: 02/15/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Physiological anisocoria is an asymmetry of pupil size in the absence of pathology. METHODS Images of the pupils under standard illumination were collected in the course of a whole-genome association study of a range of visual functions in 1060 healthy adults. DNA for each participant was extracted from saliva samples. RESULTS We found no relationship between anisocoria and the difference in refraction between the eyes, nor between anisocoria and difference in acuity. There was a small but significant relationship with lightness of the iris, in that the eye with the smaller pupil was associated with the lighter iris. There was a strong association between anisocoria and a local region of chromosome 13 (13q32.1), a region lying between the genes GPR180 and SOX21. The strongest association was with the single-nucleotide polymorphism rs9524583. CONCLUSION The very specific region associated with anisocoria is one where microdeletions (or microduplications) are known to lead to abnormal development of pupil dilator muscle and hence to the autosomal dominant condition of microcoria. It is possible that alterations at 13q32.1 act by altering the expression of SOX21, which encodes a nuclear transcription factor.
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Affiliation(s)
- Jenny M Bosten
- School of Psychology, University of Sussex, Brighton, UK
| | | | - Gary Bargary
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Patrick T Goodbourn
- School of Psychology, University of Melbourne, Melbourne, Victoria, Australia
| | - John D Mollon
- Department of Psychology, University of Cambridge, Cambridge, UK
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2
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Schaefer M, Edwards S, Nordén F, Lundström JN, Arshamian A. Inconclusive evidence that breathing shapes pupil dynamics in humans: a systematic review. Pflugers Arch 2023; 475:119-137. [PMID: 35871662 PMCID: PMC9816272 DOI: 10.1007/s00424-022-02729-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 01/31/2023]
Abstract
More than 50 years ago, it was proposed that breathing shapes pupil dynamics. This widespread idea is also the general understanding currently. However, there has been no attempt at synthesizing the progress on this topic since. We therefore conducted a systematic review of the literature on how breathing affects pupil dynamics in humans. We assessed the effect of breathing phase, depth, rate, and route (nose/mouth). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and conducted a systematic search of the scientific literature databases MEDLINE, Web of Science, and PsycInfo in November 2021. Thirty-one studies were included in the final analyses, and their quality was assessed with QualSyst. The study findings were summarized in a descriptive manner, and the strength of the evidence for each parameter was estimated following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. The effect of breathing phase on pupil dynamics was rated as "low" (6 studies). The effect of breathing depth and breathing rate (6 and 20 studies respectively) were rated as "very low". Breathing route was not investigated by any of the included studies. Overall, we show that there is, at best, inconclusive evidence for an effect of breathing on pupil dynamics in humans. Finally, we suggest some possible confounders to be considered, and outstanding questions that need to be addressed, to answer this fundamental question. Trial registration: This systematic review has been registered in the international prospective register of systematic reviews (PROSPERO) under the registration number: CRD42022285044.
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Affiliation(s)
- Martin Schaefer
- Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden.
| | - Sylvia Edwards
- Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Frans Nordén
- Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
| | - Johan N Lundström
- Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden
- Monell Chemical Senses Center, Philadelphia, PA, 19104, USA
- Stockholm University Brain Imaging Centre, Stockholm University, 11415, Stockholm, Sweden
| | - Artin Arshamian
- Department of Clinical Neuroscience, Karolinska Institutet, 17177, Stockholm, Sweden.
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3
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Zhang J, Park S, Cho A, Whang M. Significant Measures of Gaze and Pupil Movement for Evaluating Empathy between Viewers and Digital Content. SENSORS 2022; 22:s22051700. [PMID: 35270846 PMCID: PMC8914938 DOI: 10.3390/s22051700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/07/2022] [Accepted: 02/18/2022] [Indexed: 11/16/2022]
Abstract
The success of digital content depends largely on whether viewers empathize with stories and narratives. Researchers have investigated the elements that may elicit empathy from viewers. Empathic response involves affective and cognitive processes and is expressed through multiple verbal and nonverbal modalities. Specifically, eye movements communicate emotions and intentions and may reflect an empathic status. This study explores feature changes in eye movements when a viewer empathizes with the video’s content. Seven feature variables of eye movements (change of pupil diameter, peak pupil dilation, very short, mid, over long fixation duration, saccadic amplitude, and saccadic count) were extracted from 47 participants who viewed eight videos (four empathic videos and four non-empathic videos) distributed in a two-dimensional emotion axis (arousal and valence). The results showed that viewers’ saccadic amplitude and peak pupil dilation in the eigenvalues of eye movements increased in the empathic condition. The fixation time and pupil size change showed limited significance, and whether there were asymmetric pupil responses between the left and right pupils remained inconclusive. Our investigation suggests that saccadic amplitude and peak pupil dilation are reliable measures for recognizing whether viewers empathize with content. The findings provide physiological evidence based on eye movements that both affective and cognitive processes accompany empathy during media consumption.
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Affiliation(s)
- Jing Zhang
- Department of Emotion Engineering, Sangmyung University, Seoul 03016, Korea; (J.Z.); (S.P.); (A.C.)
| | - Sung Park
- Department of Emotion Engineering, Sangmyung University, Seoul 03016, Korea; (J.Z.); (S.P.); (A.C.)
| | - Ayoung Cho
- Department of Emotion Engineering, Sangmyung University, Seoul 03016, Korea; (J.Z.); (S.P.); (A.C.)
| | - Mincheol Whang
- Department of Human-Centered Artificial Intelligence, Sangmyung University, Seoul 03016, Korea
- Correspondence: ; Tel.: +82-2-2287-5293
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Sillevis R, Trincado G, Shamus E. The immediate effect of a single session of pain neuroscience education on pain and the autonomic nervous system in subjects with persistent pain, a pilot study. PeerJ 2021; 9:e11543. [PMID: 34131526 PMCID: PMC8174152 DOI: 10.7717/peerj.11543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 05/10/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The autonomic nervous system is a system that operates at the subconscious level and has been associated with neurobehavioral aspects of pain. Overall, persistent pain has a stimulating effect on the sympathetic nervous system. A promising emerging nonpharmacological treatment to manage persistent pain is neuroscience-based pain education. The overarching goal of neuroscience-based pain education is to change cognitions about pain and the pain experience through education. The aim was to determine the immediate and short-term impact of a neuroscience-based pain education video on the autonomic nervous system and pain in a subgroup of individuals with persistent pain. METHODS A convenience sample of 26 subjects were recruited for this study. Each subject indicated their pain level at the time of testing using a Visual Analogue Scale. Automated pupillometry was utilized to measure pupil diameter. After two minutes of accommodation to the goggles, the pupil was measured continuously for 60 s. Following this a 5-minute video presentation "Understanding Pain" was watched, followed by a continuous pupil measurement for 60 s. Three minutes after this measure, the final pupil diameter measurement was taken for 60 s. After completing the final pupil measure, the subject was asked to fill out a second Visual Analogue Scale and a Global Rate of Change. OUTCOMES Each subject completed a Global Rating of Change Scale and the mean score was 1.14 (SD = 1.61 and a SEM = 0.), supporting the hypothesis of an overall self-perceived benefit from the intervention. There was a statistically significant difference in pain following the video, P < 0.01. A significant correlation was observed between the self-perceived decrease in pain level and the Global Rating of Change score, p = 0.02. There was no statistically significant difference in the mean pupil diameter following the video with p = 0.76 for the right eye and p = 0.250 for the left eye. DISCUSSION This pilot study demonstrated that a 5-minute neuroscience-based pain education video reduced perceived pain in a small sample of subjects with persistent pain. Watching the neuroscience-based pain education video did not seem to result in an immediate generalized autonomic nervous system response. However, it resulted in a different reaction on each eye. This unequal response might be the result of the hemispheric lateralization of the ANS. This study supports the fact that the pain experience is determined by the balance between conscious cognitive processes and subconscious processes based on previous psychological experiences.
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Affiliation(s)
- Rob Sillevis
- Rehabilitations Sciences, Florida Gulf Coast University, Ft. Myers, FL, United States of America
| | - Gabriel Trincado
- Rehabilitations Sciences, Florida Gulf Coast University, Ft. Myers, FL, United States of America
| | - Eric Shamus
- Rehabilitations Sciences, Florida Gulf Coast University, Ft. Myers, FL, United States of America
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5
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Identification of attention-deficit hyperactivity disorder based on the complexity and symmetricity of pupil diameter. Sci Rep 2021; 11:8439. [PMID: 33875772 PMCID: PMC8055872 DOI: 10.1038/s41598-021-88191-x] [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: 12/05/2020] [Accepted: 04/06/2021] [Indexed: 02/02/2023] Open
Abstract
Adult attention-deficit/hyperactivity disorder (ADHD) frequently leads to psychological/social dysfunction if unaddressed. Identifying a reliable biomarker would assist the diagnosis of adult ADHD and ensure that adults with ADHD receive treatment. Pupil diameter can reflect inherent neural activity and deficits of attention or arousal characteristic of ADHD. Furthermore, distinct profiles of the complexity and symmetricity of neural activity are associated with some psychiatric disorders. We hypothesized that analysing the relationship between the size, complexity of temporal patterns, and asymmetricity of pupil diameters will help characterize the nervous systems of adults with ADHD and that an identification method combining these features would ease the diagnosis of adult ADHD. To validate this hypothesis, we evaluated the resting state hippus in adult participants with or without ADHD by examining the pupil diameter and its temporal complexity using sample entropy and the asymmetricity of the left and right pupils using transfer entropy. We found that large pupil diameters and low temporal complexity and symmetry were associated with ADHD. Moreover, the combination of these factors by the classifier enhanced the accuracy of ADHD identification. These findings may contribute to the development of tools to diagnose adult ADHD.
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6
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Nobukawa S, Shirama A, Takahashi T, Takeda T, Ohta H, Kikuchi M, Iwanami A, Kato N, Toda S. Pupillometric Complexity and Symmetricity Follow Inverted-U Curves Against Baseline Diameter Due to Crossed Locus Coeruleus Projections to the Edinger-Westphal Nucleus. Front Physiol 2021; 12:614479. [PMID: 33643064 PMCID: PMC7905168 DOI: 10.3389/fphys.2021.614479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 01/19/2021] [Indexed: 11/13/2022] Open
Abstract
In addition to photic reflex function, the temporal behavior of the pupil diameter reflects levels of arousal and attention and thus internal cognitive neural activity. Recent studies have reported that these behaviors are characterized by baseline activity, temporal complexity, and symmetricity (i.e., degree of symmetry) between the right and left pupil diameters. We hypothesized that experimental analysis to reveal relationships among these characteristics and model-based analysis focusing on the newly discovered contralateral projection from the locus coeruleus (LC) to the Edinger-Westphal nucleus (EWN) within the neural system for controlling pupil diameter could contribute to another dimension of understanding of complex pupil dynamics. In this study, we aimed to validate our hypothesis by analyzing the pupillary hippus in the healthy resting state in terms of sample entropy (SampEn), to capture complexity, and transfer entropy (TranEn), to capture symmetricity. We also constructed a neural model embedded with the new findings on neural pathways. The following results were observed: first, according to surrogate data analysis, the complexity and symmetricity of pupil diameter changes reflect a non-linear deterministic process. Second, both the complexity and the symmetricity are unimodal, peaking at intermediate pupil diameters. Third, according to simulation results, the neural network that controls pupil diameter has an inverted U-shaped profile of complexity and symmetricity vs. baseline LC activity; this tendency is enhanced by the contralateral synaptic projections from the LCs to the EWNs. Thus, we characterized the typical relationships between the baseline activity and the complexity and symmetricity of the pupillometric data in terms of SampEn and TranEn. Our evaluation method and findings may facilitate the development of estimation and diagnostic tools for exploring states of the healthy brain and psychiatric disorders based on measurements of pupil diameter.
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Affiliation(s)
- Sou Nobukawa
- Department of Computer Science, Chiba Institute of Technology, Chiba, Japan
| | - Aya Shirama
- National Center of Neurology and Psychiatry, Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, Tokyo, Japan
| | - Tetsuya Takahashi
- Research Center for Child Mental Development, Kanazawa University, Ishikawa, Japan.,Department of Neuropsychiatry, University of Fukui, Fukui, Japan.,Uozu Shinkei Sanatorium, Uozu, Japan
| | | | - Haruhisa Ohta
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
| | - Mitsuru Kikuchi
- Department of Psychiatry & Behavioral Science, Kanazawa University, Ishikawa, Japan
| | - Akira Iwanami
- Department of Psychiatry, School of Medicine, Showa University, Tokyo, Japan
| | - Nobumasa Kato
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
| | - Shigenobu Toda
- Department of Psychiatry & Behavioral Science, Kanazawa University, Ishikawa, Japan.,Department of Psychiatry, Showa University East Hospital, Showa University, Tokyo, Japan
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7
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Fernández-Rodríguez LJ, Bardales-Zuta VH, San-Martín M, Delgado Bolton RC, Vivanco L. Empathy Enhancement Based on a Semiotics Training Program: A Longitudinal Study in Peruvian Medical Students. Front Psychol 2020; 11:567663. [PMID: 33192851 PMCID: PMC7658416 DOI: 10.3389/fpsyg.2020.567663] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 10/08/2020] [Indexed: 12/30/2022] Open
Abstract
Background Empathy, as a core element of medical professionalism, is part of leadership in medicine. This attribute, predominantly cognitive, involves understanding and communication capacity. Empathy can be enhanced with courses on medical semiotics. It appears adequate to apply this enhancement in the early stages of professional training. Based on this, this study was performed with the purpose of demonstrating the positive effect that an academic course on medical semiotics has on the development of empathy in medical students. Methods A quasi-experimental study was conducted in one School of Medicine in Peru, where medical students had to attend a 17-week course on medical semiotics as part of their regular training. The sample, composed by 269 students, included two cohorts of third-year medical students. As main measures, the Jefferson Scales of Empathy (JSE), inter-professional collaboration (JSAPNC), and lifelong learning (JeffSPLL), were used. In addition, students’ scores evaluating theoretical and practical aspects of the course were collected once the course was finished. Pre- and post-tests were administered in week 1 and in week 17. Analyses compared measures in both moments and in time. Inter-professional collaboration and lifelong learning scores and empathy scores were used as discriminant and convergent validity measures of students’ course scores, respectively. Results Gender differences on empathy appeared, but only at the beginning. In the entire sample, empathy enhancement was confirmed in time (p < 0.001), with a large effect size (r = 0.45). This effect was also observed in both gender groups, separately. On the contrary, no changes appeared in inter-professional collaboration and in lifelong learning abilities in time. In addition, a positive correlation was observed among empathy, inter-professional collaboration and lifelong learning abilities at the beginning and at the end, confirming that the improvement observed was specific for empathy and explained by the educational intervention assessed. Conclusion These findings bring empiric evidence supporting the positive effect that training in medical semiotics has on empathy. In addition, these findings highlight some gender differences in the development of empathy in medical students.
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Affiliation(s)
| | | | | | - Roberto C Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro, Logroño, Spain.,Platform of Bioethics and Medical Education, Centre for Biomedical Research of La Rioja (CIBIR), Logroño, Spain.,National Centre of Documentation on Bioethics, Rioja Health Foundation, Logro o, Spain
| | - Luis Vivanco
- Platform of Bioethics and Medical Education, Centre for Biomedical Research of La Rioja (CIBIR), Logroño, Spain.,National Centre of Documentation on Bioethics, Rioja Health Foundation, Logro o, Spain
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8
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Cagiltay NE, Menekse Dalveren GG. Are Left- and Right-Eye Pupil Sizes Always Equal? J Eye Mov Res 2019; 12:10.16910/jemr.12.2.1. [PMID: 33828724 PMCID: PMC7881883 DOI: 10.16910/jemr.12.2.1] [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] [Indexed: 11/23/2022] Open
Abstract
Eye movements provide very critical information about the cognitive load and behaviors of human beings. Earlier studies report that under normal conditions, the left- and right-eye pupil sizes are equal. For this reason, most studies undertaking eye-movement analysis are conducted by only considering the pupil size of a single eye or taking the average size of both eye pupils. This study attempts to offer a better understanding concerning whether there are any differences between the left- and right-eye pupil sizes of the right-handed surgical residents while performing surgical tasks in a computer-based simulation environment under different conditions (left-hand, right-hand and both hands). According to the results, in many cases, the right-eye pupil sizes of the participants were larger than their left-eye pupil sizes while performing the tasks under right-hand and both hands conditions. However, no significant difference was found in relation to the tasks performed under left-hand condition in all scenarios. These results are very critical to shed further light on the cognitive load of the surgical residents by analyzing their left-eye and right-eye pupil sizes. Further research is required to investigate the effect of the difficulty level of each scenario, its appropriateness with the skill level of the participants, and handedness on the differences between the leftand right-eye pupil sizes.
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Affiliation(s)
- Nergiz Ercil Cagiltay
- Atilim University, Faculty of Engineering, Department of Software Engineering, Ankara, Turkey
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Tényi D, Bóné B, Horváth R, Komoly S, Illés Z, Beier CP, Kelemen A, Kovács N, Darnai G, Janszky J. Ictal piloerection is associated with high-grade glioma and autoimmune encephalitis-Results from a systematic review. Seizure 2018; 64:1-5. [PMID: 30497014 DOI: 10.1016/j.seizure.2018.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 11/15/2018] [Accepted: 11/18/2018] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To comprehensively analyze ictal piloerection (IP) in a large number of subjects. METHODS We performed a systematic review on case report studies of patients diagnosed with IP (1929-2017) with additional cases included from the Department of Neurology of University of Pécs, the National Institute of Clinical Neurosciences, and Odense University Hospital. Each included case was characterized regarding patient history, IP seizure characteristics, diagnostic work-up, and therapy. Comparative analyses were also carried out based on sex and pathology. RESULTS Altogether, 109 cases were included. We observed a strong male predominance (p < 0.001). The mean age at onset of epilepsy was 39.5 ± 20.7 years (median: 38, IQR:24-57). The seizure onset zone was temporal (p < 0.001), and was lateralized to the ipsilateral hemisphere in unilateral localization (p = 0.001). The seizure was accompanied by cold shiver in 53%, and by other autonomic symptoms in 47% of cases. In 53% of patients, IP never progressed into complex partial or generalized tonic-clonic seizure; 16% of the patients reported occasional, and 31% regular generalization. Seizure frequency was higher among females (median:25/day, IQR:3-60) than among males (median:3/day, IQR:1-11) (p = 0.017). The two most common underlying pathologies were limbic encephalitis (23%) and astrocytoma (23%, among them 64% WHO III-IV astrocytoma). CONCLUSION IP was particularly associated with autoimmune encephalitis and high-grade glioma, suggesting IP's particular clinical importance in directing diagnostic work-up.
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Affiliation(s)
- Dalma Tényi
- Department of Neurology, University of Pécs, H-7623, Rét u. 2., Pécs, Hungary
| | - Beáta Bóné
- Department of Neurology, University of Pécs, H-7623, Rét u. 2., Pécs, Hungary
| | - Réka Horváth
- Department of Neurology, University of Pécs, H-7623, Rét u. 2., Pécs, Hungary
| | - Sámuel Komoly
- Department of Neurology, University of Pécs, H-7623, Rét u. 2., Pécs, Hungary
| | - Zsolt Illés
- Department of Neurology, University of Pécs, H-7623, Rét u. 2., Pécs, Hungary; Department of Neurology, Odense University Hospital, Odense, and Department for Clinical Research, University of Southern Denmark, Odense C, DK-5000, Winsløwparken 19, Denmark
| | - Christoph P Beier
- Department of Neurology, Odense University Hospital, Odense, and Department for Clinical Research, University of Southern Denmark, Odense C, DK-5000, Winsløwparken 19, Denmark
| | - Anna Kelemen
- National Institute of Clinical Neurosciences, H-1145, Amerikai út 57, Budapest, Hungary
| | - Norbert Kovács
- Department of Neurology, University of Pécs, H-7623, Rét u. 2., Pécs, Hungary; PTE-MTA Clinical Neuroscience MR Research Group, H-7623, Rét u. 2, Hungary
| | - Gergely Darnai
- Department of Neurology, University of Pécs, H-7623, Rét u. 2., Pécs, Hungary
| | - József Janszky
- Department of Neurology, University of Pécs, H-7623, Rét u. 2., Pécs, Hungary; PTE-MTA Clinical Neuroscience MR Research Group, H-7623, Rét u. 2, Hungary.
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Myers JS, Kahya M, Mitchell M, Dai J, He J, Moon S, Hamilton K, Valla M, O'Dea A, Klemp J, Kurylo M, Akinwuntan A, Devos H. Pupillary response: cognitive effort for breast cancer survivors. Support Care Cancer 2018; 27:1121-1128. [PMID: 30097791 DOI: 10.1007/s00520-018-4401-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 08/03/2018] [Indexed: 01/17/2023]
Abstract
PURPOSE The purpose of this cross-sectional comparative pilot study was to evaluate cognitive effort, indexed by pupillary response (PR), for breast cancer survivors (BCS) with complaints of cognitive dysfunction following chemotherapy. STUDY AIMS Compare the cognitive effort employed by BCS to healthy controls (HC) during neuropsychological tests (NPT) for memory, sustained attention, verbal fluency, visuospatial ability, processing speed and executive function; and Investigate the relationship between PR-indexed cognitive effort and participants' self-report of cognitive function. METHODS Self-report of cognitive function was collected from 23 BCS and 23 HC. PR was measured during NPT. Independent two-sample t tests or Wilcoxon rank sum tests were used to compare group scores. Between-group effect size (Cohen's d) was calculated for each outcome. Correlation between mean self-report scores and PR values, as well as 95% confidence intervals, was calculated. RESULTS No group differences were demonstrated for NPT performance. BCS reported more issues with cognitive function than HC (p < .0001). A group effect for BCS was seen with PR-indexed cognitive effort for components of most NPT (p < .05). PR was correlated with most self-report measures of cognitive function (r = 0.33-0.45). CONCLUSIONS PR sensitivity to cognitive effort across a variety of NPT and correlation with self-report of cognitive function was demonstrated. The portability, affordability, and "real-time" aspects of PR are attractive for potential use in the clinic setting to assess cognitive function. A larger study is needed to confirm these results. Prospective investigation of PR in BCS is needed to demonstrate sensitivity to cognitive function changes over time.
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Affiliation(s)
- Jamie S Myers
- Office of Grants and Research, University of Kansas School of Nursing, MS 4043, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA.
| | - Melike Kahya
- Department of Physical Therapy and Rehabilitation Science, University of Kansas School of Health Professions, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Melissa Mitchell
- Department of Radiation Oncology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Junqiang Dai
- Department of Biostatistics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Jianghua He
- Department of Biostatistics, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Sanghee Moon
- Department of Physical Therapy and Rehabilitation Science, University of Kansas School of Health Professions, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Kevin Hamilton
- Department of Physical Therapy and Rehabilitation Science, University of Kansas School of Health Professions, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Mary Valla
- North Kansas City Hospital, 2750 Clay Edwards Drive, North Kansas City, MO, 64116, USA
| | - Anne O'Dea
- Department of Medical Oncology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Jennifer Klemp
- University of Kansas Cancer Center, 2650 Shawnee Mission Pkwy, Westwood, KS, 66205, USA
| | - Monica Kurylo
- Department of Psychiatry & Behavioral Sciences, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Abiodun Akinwuntan
- Department of Physical Therapy and Rehabilitation Science, University of Kansas School of Health Professions, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
| | - Hannes Devos
- Department of Physical Therapy and Rehabilitation Science, University of Kansas School of Health Professions, 3901 Rainbow Blvd, Kansas City, KS, 66160, USA
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