Abstract
Pupllary unrest in ambient light (PUAL) is the chaotic fluctuation of pupil diameter about its mean value. The degree of fluctuation is typically measured using a pupillometer and quantified using an index that sums fluctuations in a frequency range of interest. Indices that measure PUAL show promise in predicting effects of sedative or opioid drugs. Because PUAL is mediated by the parasympathetic nervous system, it would be expected to decline with age-related decreases in parasympathetic tone. In this study we measured average PUAL in 16 subjects from age 3 to 72, with at least 3 repeated measurements on each subject, each taken for approximately 10 s, at approximately 30 frames per second, with illumination of the ipsilateral eye. PUAL was calculated using the algorithm of the Neurolight pupillometer. We found that average PUAL typically declines by approximately 1% per year, and that the standard deviation of repeated measurements is approximately 20%. We therefore conclude that repeated, averaged measurements of age-normed PUAL are likely to be much more clinically useful than single, uncorrected values.
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Acknowledgements
The authors would like to thank Thierry Bagnol of IDMED for generously loaning the pupillometer used in this study. The authors would like to thank Benten Technologies, for making personnel available to assist and participate in the research study.
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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.
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Author Neice participated in study design, data gathering, data analysis, and manuscript preparation. Authors Ma and Chang participated in data gathering and manuscript preparation.
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This study was approved by the Institutional Review Board of Legacy Health Systems, and all subjects provided written informed consent. In the case of minor subjects, their parents or legal guardians provided written informed consent.
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Author Neice holds a U.S. patent on signal processing of pupillary data. There are no licensing or financial agreements associated with this patent or this work.
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Neice, A., Ma, T. & Chang, K. Relationship between age, sex and pupillary unrest. J Clin Monit Comput 36, 1897–1901 (2022). https://doi.org/10.1007/s10877-022-00858-6
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DOI: https://doi.org/10.1007/s10877-022-00858-6