Estimating photoreceptor excitations from spectral outputs of a personal light exposure measurement device

A Wrinkle in Measuring Time Use for Cognitive Health: How should We Measure Physical Activity, Sedentary Behaviour and Sleep?

One new case of dementia is detected every 4 seconds and no effective drug therapy exists. Effective behavioural strategies to promote healthy cognitive ageing are thus essential. Three behaviours related to cognitive health which we all engage in daily are physical activity, sedentary behaviour and sleep. These time-use activity behaviours are linked to cognitive health in a complex and dynamic relationship not yet fully elucidated. Understanding how each of these behaviours is related to each other and cognitive health will help determine the most practical and effective lifestyle strategies for promoting healthy cognitive ageing. In this review, we discuss methods and analytical approaches to best investigate how these time-use activity behaviours are related to cognitive health. We highlight four key recommendations for examining these relationships such that researchers should include measures which (1) are psychometrically appropriate; (2) can specifically answer the research question; (3) include objective and subjective estimates of the behaviour and (4) choose an analytical method for modelling the relationships of time-use activity behaviours with cognitive health which is appropriate for their research question.

Verification, analytical validation and clinical validation (V3) of wearable dosimeters and light loggers

Background

Light exposure is an important driver and modulator of human physiology, behavior and overall health, including the biological clock, sleep-wake cycles, mood and alertness. Light can also be used as a directed intervention, e.g., in the form of light therapy in seasonal affective disorder (SAD), jetlag prevention and treatment, or to treat circadian disorders. Recently, a system of quantities and units related to the physiological effects of light was standardized by the International Commission on Illumination (CIE S 026/E:2018). At the same time, biometric monitoring technologies (BioMeTs) to capture personalized light exposure were developed. However, because there are currently no standard approaches to evaluate the digital dosimeters, the need to provide a firm framework for the characterization, calibration, and reporting for these digital sensors is urgent.

Objective

This article provides such a framework by applying the principles of verification, analytic validation and clinical validation (V3) as a state-of-the-art approach for tools and standards in digital medicine to light dosimetry.

Results

This article describes opportunities for the use of digital dosimeters for basic research, for monitoring light exposure, and for measuring adherence in both clinical and non-clinical populations to light-based interventions in clinical trials.

Intra- and Inter-Model Variability of Light Detection Using a Commercially Available Light Sensor

The veracity of claims made by researchers and clinicians when reporting the impact of lighting on vision and other biological mechanisms is, in part, reliant on accurate and valid measurement devices. We aim to quantify the intra- and inter-watch variability of a commercially available light sensor device which has been widely used in vision and other photobiological research. Intra- and inter-watch differences were investigated between four Actiwatch Spectrum Pro devices. The devices were used to obtain measurements on two separate occasions, under three different controlled light conditions; the Gretag Macbeth Judge II lightbox was used to produce Simulated Daylight (D65), Illuminant A (A) and Cool White Fluorescent (CWF) lighting. Significant inter-watch differences were noted when considering tricolour (red, green, blue) and the white sensor outputs under each of the three illuminants (p < 0.01). A significant interaction was also found between tricolour sensor and watch used (p < 0.01). Intra-watch differences were noted for the tricolour and for the white sensor outputs under the three illuminants (≤0.05), for all but one watch which showed no significant intra-watch difference for the white 'sensor output' under the D65 illuminant. Use of spectral sensitivity devices is an evolving field. Before drawing causal relationships between light and other biological processes, researchers should acknowledge the limitations of the instruments used, their validation, and the resultant data. The outcomes of the study indicate caution must be exercised in longitudinal data collection and the mixing of watches amongst study participants should be avoided.

Shining the Light on the MotionWatch8 Light Sensor for Sleep and Aging Research: What Can We Measure and What Are We Missing?

Background

Poor sleep is common among older adults at risk for dementia and may be due to circadian dysregulation. Light is the most important external stimulus to the circadian clock and bright light therapy (BLT) has been used for >20 years to help realign circadian rhythms. However, the ability of field methods (e.g., actigraphy) to accurately determine the type and intensity of light is unknown.

Objective

We examined the ability of the MotionWatch8 (MW8) light sensor to determine: 1) light versus dark, 2) electrical light versus daylight, and 3) device-based BLT versus light which was not BLT.

Methods

We tested the MW8 under 17 daily light scenarios. Light exposure data was collected for 5 minutes during each scenario. Concurrently, we measured light exposure using the LT40 Light Meter, a sensitive measure of light intensity. We then developed individual cut-points using receiver operator characteristics analyses to determine optimal MW8 cut-points for 1) light versus dark; 2) electrical light versus daylight; and 3) light from a BLT box versus light which was not BLT. Bland-Altman plots tested the precision of the MW8 compared to the LT40.

Results

The MW8 accurately discriminated light versus dark (>32 lux), and electrical light versus daylight (<323 lux). However, the MW8 had poor accuracy for 1) discriminating BLT from light which was not BLT; and 2) low precision compared to the LT40.

Conclusion

The MW8 appears to be able to discern light versus dark and electrical light versus daylight; however, there remains a need for accurate field methods capable of measuring light exposure.

Daily and Seasonal Variation in Light Exposure among the Old Order Amish

Exposure to artificial bright light in the late evening and early night, common in modern society, triggers phase delay of circadian rhythms, contributing to delayed sleep phase syndrome and seasonal affective disorder. Studying a unique population like the Old Order Amish (OOA), whose lifestyles resemble pre-industrial societies, may increase understanding of light’s relationship with health. Thirty-three participants (aged 25–74, mean age 53.5; without physical or psychiatric illnesses) from an OOA community in Lancaster, PA, were assessed with wrist-worn actimeters/light loggers for at least 2 consecutive days during winter/spring (15 January–16 April) and spring/summer (14 May–10 September). Daily activity, sleep–wake cycles, and their relationship with light exposure were analyzed. Overall activity levels and light exposure increased with longer photoperiod length. While seasonal variations in the amount and spectral content of light exposure were equivalent to those reported previously for non-Amish groups, the OOA experienced a substantially (~10-fold) higher amplitude of diurnal variation in light exposure (darker nights and brighter days) throughout the year than reported for the general population. This pattern may be contributing to lower rates of SAD, short sleep, delayed sleep phase, eveningness, and metabolic dysregulation, previously reported among the OOA population.

Generation of a Retina Reporter hiPSC Line to Label Progenitor, Ganglion, and Photoreceptor Cell Types

Purpose

Early in mammalian eye development, VSX2, BRN3b, and RCVRN expression marks neural retinal progenitors (NRPs), retinal ganglion cells (RGCs), and photoreceptors (PRs), respectively. The ability to create retinal organoids from human induced pluripotent stem cells (hiPSC) holds great potential for modeling both human retinal development and retinal disease. However, no methods allowing the simultaneous, real-time monitoring of multiple specific retinal cell types during development currently exist.

Methods

CRISPR/Cas9-mediated homology-directed repair (HDR) in hiPSCs facilitated the replacement of the VSX2 (Progenitor), BRN3b (Ganglion), and RCVRN (Photoreceptor) stop codons with sequences encoding a viral P2A peptide fused to Cerulean, green fluorescent protein, and mCherry reporter genes, respectively, to generate a triple transgenic reporter hiPSC line called PGP1. This was accomplished by co-electroporating HDR templates and sgRNA/Cas9 vectors into hiPSCs followed by antibiotic selection. Functional validation of the PGP1 hiPSC line included the ability to generate retinal organoids, with all major retinal cell types, displaying the expression of the three fluorescent reporters consistent with the onset of target gene expression. Disaggregated organoids were also analyzed by fluorescence-activated cell sorting and fluorescent populations were tested for the expression of the targeted gene.

Results

Retinal organoids formed from the PGP1 line expressed appropriate fluorescent proteins consistent with the differentiation of NRPs, RGCs, and PRs. Organoids produced from the PGP1 line expressed transcripts consistent with the development of all major retinal cell types.

Conclusions and Translational Relevance

The PGP1 line offers a powerful new tool to study retinal development, retinal reprogramming, and therapeutic drug screening.

What is the 'spectral diet' of humans?

Our visual perception of the world — seeing form and colour or navigating the environment — depends on the interaction of light and matter in the environment. Light also has a more fundamental role in regulating rhythms in physiology and behaviour, as well as in the acute secretion of hormones such as melatonin and changes in alertness, where light exposure at short-time, medium-time and long-time scales has different effects on these visual and non-visual functions. Yet patterns of light exposure in the real world are inherently messy: we move in and out of buildings and are therefore exposed to mixtures of artificial and natural light, and the physical makeup of our environment can also drastically alter the spectral composition and spatial distribution of the emitted light. In spatial vision, the examination of natural image statistics has proven to be an important driver in research. Here, we expand this concept to the spectral domain and develop the concept of the ‘spectral diet’ of humans.

Determining Light Intensity, Timing and Type of Visible and Circadian Light From an Ambulatory Circadian Monitoring Device

During last decades, the way of life in modern societies has deeply modified the temporal adjustment of the circadian system, mainly due to the inappropriate use of artificial lighting and the high prevalence of social jet-lag. Therefore, it becomes necessary to design non-invasive and practical tools to monitor circadian marker rhythms but also its main synchronizer, the light-dark cycle under free-living conditions. The aim of this work was to improve the ambulatory circadian monitoring device (ACM, Kronowise^®) capabilities by developing an algorithm that allows to determine light intensity, timing and circadian light stimulation by differentiating between full visible, infrared and circadian light, as well as to discriminate between different light sources (natural and artificial with low and high infrared composition) in subjects under free living conditions. The ACM device is provided with three light sensors: (i) a wide-spectrum sensor (380–1100 nm); (ii) an infrared sensor (700–1100 nm) and (iii) a sensor equipped with a blue filter that mimics the sensitivity curve of the melanopsin photopigment and the melatonin light suppression curve. To calibrate the ACM device, different commercial light sources and sunlight were measured at four different standardized distances with both a spectroradiometer (SPR) and the ACM device. CIE S 026/E:2018 (2018), toolbox software was used to calculate the melanopic stimulation from data recorded by SPR. Although correlation between raw data of luminance measured by ACM and SPR was strong for both full spectrum (r = 0.946, p < 0.0001) and circadian channel (r = 0.902, p < 0.0001), even stronger correlations were obtained when light sources were clustered in three groups: natural, infrared-rich artificial light and infrared-poor artificial light, and their corresponding linear correlations with SPR were considered (r = 0.997, p < 0.0001 and r = 0.998, p < 0.0001, respectively). Our results show that the ACM device provided with three light sensors and the algorithm developed here allow an accurate detection of light type, intensity and timing for full visible and circadian light, with simultaneous monitoring of several circadian marker rhythms that will open the possibility to explore light synchronization in population groups while they maintain their normal lifestyle.

Reported light in the sleep environment: enhancement of the sleep diary

BACKGROUND

Light is the primary synchronizing cue for the circadian timing system, capable of exerting robust physiological effects, even with very dim and/or brief photic exposure. Mammals, including humans, are particularly susceptible to light at night. As such, measures of light in the sleeping environment are critical for evaluating sleep health. Sleep diaries provide inexpensive measures of sleep, but do not typically include light information.

METHODS

Four questions probing visual perception of light in the bedtime and waking environments were added to the Consensus Sleep Diary for Morning administration. As part of a lighting intervention study, 18 hospital Labor and Delivery Department personnel completed the sleep diary for 1 week in each of two experimental conditions while wearing Actiwatch devices equipped with photosensors. Diary responses were evaluated against photosensor values from the beginning and end of each rest interval (n=194 rest intervals), as well as against sleep measures, utilizing linear mixed models.

RESULTS

Responses to light questions were related to actual light measures at bedtime, controlling for shift type and experimental condition. In addition, subjective light information at bedtime and waking was related to both objective and subjective sleep parameters, with data generally indicating poorer sleep with light in the sleeping environment.

CONCLUSION

Questions addressing perception of light in the sleeping environment may provide a crude yet affordable metric of relative photic intensity. Further, as responses relate to sleep outcomes, subjective light information may yield valuable insights regarding mechanisms and outcomes of clinical significance in sleep and circadian research.

A five-primary photostimulator suitable for studying intrinsically photosensitive retinal ganglion cell functions in humans

Intrinsically photosensitive retinal ganglion cells (ipRGCs) can respond to light directly through self-contained photopigment, melanopsin. IpRGCs also receive synaptic inputs from rods and cones. Thus, studying ipRGC functions requires a novel photostimulating method that can account for all of the photoreceptor inputs. Here, we introduced an inexpensive LED-based five-primary photostimulator that can control the excitations of rods, S-, M-, L-cones, and melanopsin-containing ipRGCs in humans at constant background photoreceptor excitation levels, a critical requirement for studying the adaptation behavior of ipRGCs with rod, cone, or melanopsin input. We described the theory and technical aspects (including optics, electronics, software, and calibration) of the five-primary photostimulator. Then we presented two preliminary studies using the photostimulator we have implemented to measure melanopsin-mediated pupil responses and temporal contrast sensitivity function (TCSF). The results showed that the S-cone input to pupil responses was antagonistic to the L-, M- or melanopsin inputs, consistent with an S-OFF and (L + M)-ON response property of primate ipRGCs (Dacey et al., 2005). In addition, the melanopsin-mediated TCSF had a distinctive pattern compared with L + M or S-cone mediated TCSF. Other than controlling individual photoreceptor excitation independently, the five-primary photostimulator has the flexibility in presenting stimuli modulating any combination of photoreceptor excitations, which allows researchers to study the mechanisms by which ipRGCs combine various photoreceptor inputs.