Pupillometry in the neuropediatric practice: theoretical and clinical aspects
Abstract
Pupillometry is a method based on the quantitative measurement of pupil diameter in dynamics. Integration of afferent signals and motor signals, both at the level of the central nervous system and at the level of peripheral nervous system, continuously affects the change in pupil diameter. The main processes that affect the regulation of pupil size include pupil reactions to light, accommodation and emotional states. Understanding these criteria is important for the diagnosis and treatment of various neurological and mental disorders. Near infrared connection technology is used to examine the pupil together with a high-resolution electrical outlet. This technique has become widespread in various fields of medicine, including pediatrics. Pupillometry provides objective information about the state of various structures of the child's nervous system and does not require significant time and financial costs. This brief review presents data on the mechanisms of pupil diameter regulation, as well as on the clinical application of this method in neuropediatric practice.
About the Authors
A. R. Isanbaeva
GBUZ RB "Republican Children's Clinical Hospital"
Russian Federation
Russian Federation
Ufa
M. A. Kutlubaev
Bashkir State Medical University Ministry of Health of Russia
Russian Federation
Russian Federation
Ufa
D. R. Shagieva
GBUZ RB "City Children's Clinical Hospital No. 17
Russian Federation
Russian Federation
Ufa
O. V. Lyutov
Bashkir State Medical University Ministry of Health of Russia
Russian Federation
Russian Federation
Ufa
References
1. Kutlubaev M.A., Shagieva D.R., Karimova G.I., Izmalkova A.I., Myachikov A.V. Pupillometry in the assessment of emotional state and cognitive functions in human. Zhurnal Vysshei Nervnoi Deyatelnosti Imeni I.P. Pavlova. 2023; 73(5):651-665. (in Russ) doi: 10.31857/S0044467723050064
2. McDougal DH, Gamlin PD. Autonomic control of the eye. Compr Physiol. 2015 Jan;5(1):439-73. (in Engl) doi: 10.1002/cphy.c140014.
3. Cherng, YG., Baird, T., Chen, JT. [et al.] Background luminance effects on pupil size associated with emotion and saccade preparation. Sci Rep 10, 15718 (2020). (in Engl) doi: 10.1038/s41598-020-72954-z
4. Szabadi E. Functional Organization of the Sympathetic Pathways Controlling the Pupil: Light-Inhibited and Light-Stimulated Pathways. Front Neurol. 2018 Dec 18;9:1069. (in Engl) doi: 10.3389/fneur.2018.01069.
5. Aston-Jones G, Waterhouse B. Locus coeruleus: From global projection system to adaptive regulation of behavior. Brain Res. 2016 Aug 15;1645:75-8. (in Engl) doi: 10.1016/j.brainres.2016.03.001.
6. Benarroch EE. The central autonomic network: functional organization, dysfunction, and perspective. Mayo Clin Proc. 1993 Oct;68(10):988-1001. (in Engl) doi: 10.1016/s0025-6196(12)62272-1.
7. Beissner F, Meissner K, Bär KJ, Napadow V. The autonomic brain: an activation likelihood estimation meta-analysis for central processing of autonomic function. J Neurosci. 2013 Jun 19;33(25):10503-11. (in Engl) doi: 10.1523/JNEUROSCI.1103-13.2013.
8. Mathôt S. Pupillometry: Psychology, Physiology, and Function. J Cogn. 2018 Feb 21;1(1):16. (in Engl) doi: 10.5334/joc.18.
9. Ferencová N, Višňovcová Z, Bona Olexová L, Tonhajzerová I. Eye pupil - a window into central autonomic regulation via emotional/cognitive processing. Physiol Res. 2021 Dec 30;70(Suppl4):S669-S682. (in Engl) doi: 10.33549/physiolres.934749.
10. Peysakhovich, V., Vachon, F., & Dehais, F. The impact of luminance on tonic and phasic pupillary responses to sustained cognitive load International Journal of Psychophysiology. 2017. 112; 40–45. (in Engl) doi: 10.1016/j.ijpsycho.2016.12.003
11. Peinkhofer C, Knudsen GM, Moretti R, Kondziella D. Cortical modulation of pupillary function : systematic review. PeerJ. 2019 May 7;7:e6882. (in Engl) doi: 10.7717/peerj.6882.
12. Meeker M, Du R, Bacchetti P, Privitera CM, Larson MD, Holland MC, Manley G. Pupil examination: validity and clinical utility of an automated pupillometer. J Neurosci Nurs. 2005 Feb;37(1):34-40. (in Engl)
13. Bleimeister IH, Avni I, Granovetter MC, Meiri G, Ilan M, Michaelovski A, Menashe I, Behrmann M, Dinstein I. Idiosyncratic pupil regulation in autistic children. Autism Res. 2024 Oct 10. (in Engl) doi: 10.1002/aur.3234.
14. Polzer L, Freitag CM, Bast N. Pupillometric measures of altered stimulus-evoked locus coeruleus-norepinephrine activity explain attenuated social attention in preschoolers with autism spectrum disorder. Autism Res. 2022 Nov;15(11):2167-2180. (in Engl) doi: 10.1002/aur.2818.
15. Bast N, Boxhoorn S, Supér H, Helfer B, Polzer L, Klein C, Cholemkery H, Freitag CM. Atypical Arousal Regulation in Children With Autism but Not With Attention-Deficit/Hyperactivity Disorder as Indicated by Pupillometric Measures of Locus Coeruleus Activity. Biol Psychiatry Cogn Neurosci Neuroimaging. 2023 Jan;8(1):11-20. (in Engl) doi: 10.1016/j.bpsc.2021.04.010.
16. Lynch GTF, James SM, Cardon TA, McPherson SM. Sensitivity and specificity of pupillary light reflex measures for ASD using monocular pupillometry. Neurol Sci. 2022 Jul;43(7):4537-4545. (in Engl) doi: 10.1007/s10072-022-05976-2.
17. Stefanelli G, Pili MP, Crifaci G, Capelli E, Beretta C, Riboldi EM, Billeci L, Cantiani C, Molteni M, Riva V. Pupillary responses for social versus non-social stimuli in autism : A systematic review and meta-analysis. Neurosci Biobehav Rev. 2024 Nov;166:105872. (in Engl) doi: 10.1016/j.neubiorev.2024.105872.
18. Jiang BSJ, Huff E, Hanna A, Gourabathini H, Bhalala U. Nursing insights on the effectiveness of automated pupillometry in two distinct pediatric intensive care units. J Pediatr Nurs. 2024 Sep-Oct;78:e398-e403. (in Engl) doi: 10.1016/j.pedn.2024.07.032. Epub 2024 Aug 3.
19. Jiang J, Sari H, Goldman R, Huff E, Hanna A, Samraj R, Gourabathini H, Bhalala U. Neurological Pupillary Index (NPi) Measurement Using Pupillometry and Outcomes in Critically Ill Children. Cureus. 2023 Oct 4;15(10):e46480. (in Engl) doi: 10.7759/cureus.46480.
20. Lovett ME, MacDonald JM, Mir M, Ghosh S, O'Brien NF, LaRovere KL. Noninvasive Neuromonitoring Modalities in Children Part I: Pupillometry, Near-Infrared Spectroscopy, and Transcranial Doppler Ultrasonography. Neurocrit Care. 2024 Feb;40(1):130-146. (in Engl) doi: 10.1007/s12028-023-01730-4.
21. Singh A, Akhileshwar, Kumar N, De RR, Bahadur R, Shekhar S. The Role of Pupillometry in the Assessment of Pain in Children Under General Anesthesia: A Prospective Single-Blinded Observational Study. Cureus. 2023 Aug 22;15(8):e43894. (in Engl) doi: 10.7759/cureus.43894.
22. de Vries LM, Amelynck S, Nyström P, van Esch L, Van Lierde T, Warreyn P, Roeyers H, Noens I, Naulaers G, Boets B, Steyaert J; TIARA Team. Investigating the development of the autonomic nervous system in infancy through pupillometry. J Neural Transm (Vienna). 2023 May;130(5):723-734. (in Engl) doi: 10.1007/s00702-023-02616-7.
23. Benitez VL, Robison MK. Pupillometry as a Window into Young Children's Sustained Attention. J Intell. 2022 Nov 16;10(4):107. (in Engl) doi: 10.3390/jintelligence10040107.
24. Sposob ob'ektivnoi ocenki vegetativnyh narushenij u podrostkov, perenesshih COVID-19 (Method for objective assessment of vegetative disorders in adolescents suffering COVID-19): patent № 2821560 Ros. Federacija; zajavl. 13. 02. 2024; opubl. 25. 06. 2024. Bjul. 18:10.
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For citations:
Isanbaeva A.R., Kutlubaev M.A., Shagieva D.R., Lyutov O.V. Pupillometry in the neuropediatric practice: theoretical and clinical aspects. Bashkortostan Medical Journal. 2024;19(5):95-100. (In Russ.)
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