scholarly journals Central Autonomic Regulation Assessed by Pupillary Light Reflex is Impaired in Children With Attention Deficit Hyperactivity Disorder

2021 ◽  
pp. S513-S521
Author(s):  
A HAMRAKOVA ◽  
I ONDREJKA ◽  
N SEKANINOVA ◽  
L BONA OLEXOVA ◽  
Z VISNOVCOVA ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Pupil Diameter ◽  
Light Stimulus ◽  
Autonomic Regulation ◽  
Pupillary Light Reflex ◽  
Light Reflex ◽  
Hyperactivity Disorder ◽  
Non Invasive ◽  
Pupillary Light

It is assumed that the Attention Deficit Hyperactivity Disorder is associated with the central autonomic dysregulation, however, the studies are rare. Analysis of pupillary light reflex represents a non-invasive tool to provide information related to the central autonomic regulation; thus, we aimed to evaluate potential disturbances in the central autonomic integrity using pupillary light reflex examination in Attention Deficit Hyperactivity Disorder. We have examined 20 children with Attention Deficit Hyperactivity Disorder (10 boys, 13.0±2.3 years) and 20 age/gender-matched healthy subjects. Pupillary light reflex was examined at rest for both eyes using Pupillometer PLR-2000 (NeurOptics, USA). Evaluated parameters were: diameter of the pupil before the application of light stimulus and after illumination at the peak of the constriction, the percentual change of the pupil diameter during constriction, average constriction velocity, maximum constriction velocity and average dilation velocity. We found significantly lower percentual change of the pupil diameter during constriction for both eyes in Attention Deficit Hyperactivity Disorder group compared to controls (right eye: -25.81±1.23 % vs. -30.32±1.31 %, p<0.05, left eye: -25.44±1.65 % vs. -30.35±0.98 %, p˂0.05). The average constriction velocity and maximum constriction velocity were significantly shortened in left eye in Attention Deficit Hyperactivity Disorder group compared to controls (p˂0.05). Our findings revealed altered pupillary light reflex indicating abnormal centrally-mediated autonomic regulation characterized by parasympathetic underactivity associated with relative sympathetic predominance in children suffering from Attention Deficit Hyperactivity Disorder.

scholarly journals THE UTILITY OF PUPILLARY LIGHT REFLEX AS AN OBJECTIVE BIOMARKER OF ACUTE CONCUSSION IN THE ADOLESCENT ATHLETE

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0015
Author(s):  
Olivia E. Podolak ◽  
Nabin Joshi ◽  
Kenneth Ciuffreda ◽  
Fairuz Mohamed ◽  
Shelly Sharma ◽  
...  
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Pupil Diameter ◽  
Light Stimulus ◽  
Pupillary Light Reflex ◽  
Post Injury ◽  
Light Reflex ◽  
Autonomic Nervous ◽  
Pupillary Light ◽  
Over Time

Background: Visual deficits and autonomic dysfunction have been well recognized following pediatric concussion. Testing of the pupillary light reflex (PLR) is a simple, non-invasive, and objective approach to examine the autonomic nervous system by accessing the brain pathways. The aim of this study was to objectively evaluate adolescent pupillary responses to a light stimulus after a physician-diagnosed concussion and compare them to baseline responses. Methods: In this prospective cohort study, PLR was assessed in 135 adolescent athletes (ages 14-18) during their sport pre-season. All of the athletes were not recovering from a concussion at the time of their baseline assessment. Within this cohort, seven athletes (ages 14-17) sustained a concussion during their sport season and had longitudinal post-injury assessments of PLR through their recovery. The PLR was obtained in response to a brief step-input (0.8 seconds) white light stimulus using a hand-held pupillometer (stimulus recording duration= 5 seconds, light intensity= 150 lux). Pre-set and automated device-generated parameters used for analysis include the minimum and maximum pupil diameter, response amplitude and latency, mean constriction and dilation velocities and the maximum constriction velocity of the eye in response to a light stimulus. During each assessment, three monocular trials were performed in each eye alternatively, and the responses for each eye were subsequently averaged. Results: Six out of the seven concussed adolescents showed response enhancement of about 20% (IQR 11-33%). Enhancement was noted in the steady state diameter with a mean of 24% (median 18%), minimum pupil diameter mean of 17% (median 11%) and maximum constriction velocity mean of 28% (median 33%) following concussion, which decreased during the recovery process (days to weeks post-injury) to pre-injury or below initial pre-injury baseline measurements. Pupillary responsivity was found to be significantly enhanced after concussion compared to baseline measurements, waning over time. Maximum constriction velocity better highlighted the enhancement compared to the baseline pupil diameter. Conclusions/Significance: Pupil responsivity was found to be significantly enhanced after concussion compared to baseline measurements which waned over time during recovery. Assessment of dynamic PLR responses has potential utility as an objective biomarker to aid in concussion diagnosis on the sidelines or in the office, allowing physicians to quantify function (and dysfunction) of the autonomic nervous system under parasympathetic and sympathetic control after concussion.

scholarly journals Using Pupillometry to Assess the Atypical Pupillary Light Reflex and LC-NE System in ASD

2018 ◽  
Vol 8 (11) ◽  
pp. 108 ◽  
Author(s):  
Georgina Lynch
Keyword(s):  
Pupil Diameter ◽  
Pupillary Response ◽  
Autism Spectrum ◽  
Pupillary Light Reflex ◽  
Clinical Population ◽  
Experimental Conditions ◽  
Light Reflex ◽  
Pupillary Light ◽  
Rigorous Study ◽  
Future Work

With recent advances in technology, there has been growing interest in use of eye-tracking and pupillometry to assess the visual pathway in autism spectrum disorder (ASD). Within emerging literature, an atypical pupillary light reflex (PLR) has been documented, holding potential for use as a clinical screening biomarker for ASD. This review outlines dominant theories of neuropathology associated with ASD and integrates underlying neuroscience associated with the atypical PLR through a reciprocal model of brainstem involvement and cortical underconnectivity. This review draws from animal models of ASD demonstrating disruption of cranial motor nuclei and brain imaging studies examining arousal and the influence of the locus coeruleus norepinephrine (LC-NE) system on the pupillary response. Pupillometry methods are explained in relation to existing data examining the PLR in ASD and pupillary parameters of constriction latency and tonic pupil diameter as key parameters for investigation. This focused review provides preliminary data toward future work developing pupillometry metrics and offers direction for studies aimed at rigorous study replication using pupillometry with the ASD population. Experimental conditions and testing protocol for capturing pupil parameters with this clinical population are discussed to promote clinical research and translational application.

Yoga as an Intervention for Students With Attention Deficit Hyperactivity Disorder

2021 ◽  
pp. 347-360
Author(s):  
Pauline Jensen
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Adjuvant Treatment ◽  
Attention Deficit ◽  
Psychosocial Functioning ◽  
Yoga Practice ◽  
Behavioural Disorders ◽  
Secondary Symptom ◽  
Hyperactivity Disorder ◽  
Non Invasive

Research conducted in both the field of yoga and the field of behavioural disorders in children and adolescents leads to the speculation that the benefits of yoga practice demonstrated with respect to physiological, psychological, emotional, and psychosocial functioning may be applicable to the impairments evidenced in these areas in behavioural disorders. The intervention—20 weekly one-hour sessions of yoga—required a large commitment for the participants, their families, and the yoga instructor. The results suggested that yoga appears to exert its impact on stabilising the emotions (a secondary symptom) and reducing oppositional behaviour, frequently co-morbid (40%) with attention deficit hyperactivity disorder (ADHD). Given the limitations of this study, the results do indicate some significant changes in the behaviour of some of the boys with ADHD. In conclusion, yoga shows promise as a non-invasive, inexpensive, adjuvant treatment for boys with ADHD.

Characteristics of the Pupillary Light Reflex in the Alert Rhesus Monkey

2003 ◽  
Vol 89 (6) ◽  
pp. 3179-3189 ◽  
Author(s):  
Robert J. Clarke ◽  
Hongyu Zhang ◽  
Paul D. R. Gamlin
Keyword(s):  
Rhesus Monkey ◽  
Neural Control ◽  
Pupil Diameter ◽  
Sympathetic Innervation ◽  
Experimental Studies ◽  
Pupillary Light Reflex ◽  
Light Reflex ◽  
Pupillary Light ◽  
Pupillary Responses ◽  
Dilator Muscle

This study investigated the static and dynamic characteristics of the pupillary light reflex (PLR) in the alert rhesus monkey. Temporal characteristics of the PLR were investigated with Maxwellian viewing during sinusoidal changes in illumination of a 36° stimulus in both monkeys and humans. Bode plots of the PLR response were fitted by a linear model composed of a delay combined with a cascaded first- and second-order filter. The Bode magnitude plots conformed to this model with a sharp roll-off above 1.3 Hz for the human PLR and 1.9 Hz for the monkey PLR. Bode phase angle plots were fitted by this model with a delay of 280 ms for humans and 160 ms for monkeys. To investigate the influence of the sympathetic innervation of the iris on steady-state pupil diameter, dynamics of pupillary responses, and the latency of the PLR, we blocked this innervation pharmacologically with a selective alpha-1 adrenoreceptor antagonist. Although there was a resultant miosis (decrease in pupil diameter) from the relaxation of the pupil dilator muscle, no other measures of the PLR, including the dynamics and latency, were significantly affected by this treatment. We examined the pupillary responses evoked by visual stimuli presented either binocularly or monocularly at various locations on a 80 × 60° tangent screen. These pupillomotor fields revealed that, as has been reported for humans, stimuli at the fovea and surrounding macular region of monkeys produce substantially larger pupillary responses than more peripheral stimuli and that binocular responses are substantially greater than can be accounted for by the linear summation of binocular retinal illuminance. In conclusion, we found that the spatial characteristics of the PLR of the rhesus monkey are very similar, in all important aspects, to those reported for humans and that the temporal responses of the PLR are comparable between the two species. The rhesus monkey thus provides an excellent model for experimental studies of the neural control of the pupil.

scholarly journals Identification of attention-deficit hyperactivity disorder based on the complexity and symmetricity of pupil diameter

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sou Nobukawa ◽  
Aya Shirama ◽  
Tetsuya Takahashi ◽  
Toshinobu Takeda ◽  
Haruhisa Ohta ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Neural Activity ◽  
Attention Deficit ◽  
Adult Adhd ◽  
Pupil Diameter ◽  
Temporal Complexity ◽  
Hyperactivity Disorder ◽  
Adult Participants ◽  
Receive Treatment ◽  
The Relationship

AbstractAdult 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.

scholarly journals Consensual Pupillometry for robotic emotional recognition

2015 ◽  
Vol 2 (1-2.) ◽  
Author(s):  
Róbert Tamás Fekete ◽  
Levente Raj ◽  
Tamas Neumer
Keyword(s):  
Eye Tracking ◽  
Basic Principle ◽  
Physical State ◽  
Pupil Diameter ◽  
Light Stimulus ◽  
Pupillary Reflex ◽  
Measuring Device ◽  
Light Reflex ◽  
Pupillary Light ◽  
Tracking Devices

The main contribution of this research is to develop of a new measuring device for measuring direct- and consensual light reflex of human pupil. In this case the pupillary light reflex means changing of diameter of pupil due to constant light stimulus as a function of time. Researches certify that the pupil diameter and its change reflects the person’s mental or physical state. There are several “eye tracking” devices available on the market, however, none of these are able to perform a proper consensual measurement. The basic principle of the consensual pupil measurement is that while only one of the eyes is stimulated, reactions of both eyes are being recorded and analyzed. The aim of this project was to develop a software, applicable to an existing prototype device in order to carry out “consensual pupillary reflex” measurements.

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