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Parasympathetic Nervous System Dysfunction, as Identified by Pupil Light Reflex, and Its Possible Connection to Hearing Impairment.

Wang Y, Zekveld AA, Naylor G, Ohlenforst B, Jansma EP, Lorens A, Lunner T, Kramer SE - PLoS ONE (2016)

Bottom Line: We summarized the information in these data according to different types of parasympathetic-related diseases.Both studies reported a reduced parasympathetic activity in the hearing impaired groups.Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters.

View Article: PubMed Central - PubMed

Affiliation: Section Ear & Hearing, Dept. of Otolaryngology-Head and Neck Surgery and EMGO Institute for Health and Care Research, VU University medical center, Amsterdam, The Netherlands.

ABSTRACT

Context: Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown.

Objectives: To 1) review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2) review the evidence relating hearing impairment and parasympathetic activity and 3) seek evidence of possible connections between hearing impairment and the pupil light reflex.

Methods: Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment.

Results: Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment.

Discussion and conclusions: As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing impairment, hence further research is needed. The pupil light reflex could be a candidate measurement tool to achieve this goal.

No MeSH data available.


Related in: MedlinePlus

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pone.0153566.g004: PRISMA flow diagram showing process for filtering search results and selecting studies for inclusion.

Mentions: The full-texts of the 147 included articles were then reviewed independently by three researchers. This was done for each section according to their inclusion criteria, and this process was considered as the second screening. Seven of the 147 articles were review papers. These papers were not promoted to the data extraction stage but their reference lists were checked and they were used to extend the background knowledge. There were two studies sharing the same data, and we ruled out the one published earlier to avoid any bias. The second screening yielded 35 eligible papers in total for both sections, and by checking the reference list we found two more relevant papers. One additional study about hearing impairment and PNS was included, for which only the electronic copy of the paper was available online earlier than our cutoff date. We included it as there were so few papers in that section. Finally, there were 36 papers for PLR and PNS dysfunction, two for hearing impairment and PNS and none for hearing impairment and PLR (see Fig 4).


Parasympathetic Nervous System Dysfunction, as Identified by Pupil Light Reflex, and Its Possible Connection to Hearing Impairment.

Wang Y, Zekveld AA, Naylor G, Ohlenforst B, Jansma EP, Lorens A, Lunner T, Kramer SE - PLoS ONE (2016)

PRISMA flow diagram showing process for filtering search results and selecting studies for inclusion.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835104&req=5

pone.0153566.g004: PRISMA flow diagram showing process for filtering search results and selecting studies for inclusion.
Mentions: The full-texts of the 147 included articles were then reviewed independently by three researchers. This was done for each section according to their inclusion criteria, and this process was considered as the second screening. Seven of the 147 articles were review papers. These papers were not promoted to the data extraction stage but their reference lists were checked and they were used to extend the background knowledge. There were two studies sharing the same data, and we ruled out the one published earlier to avoid any bias. The second screening yielded 35 eligible papers in total for both sections, and by checking the reference list we found two more relevant papers. One additional study about hearing impairment and PNS was included, for which only the electronic copy of the paper was available online earlier than our cutoff date. We included it as there were so few papers in that section. Finally, there were 36 papers for PLR and PNS dysfunction, two for hearing impairment and PNS and none for hearing impairment and PLR (see Fig 4).

Bottom Line: We summarized the information in these data according to different types of parasympathetic-related diseases.Both studies reported a reduced parasympathetic activity in the hearing impaired groups.Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters.

View Article: PubMed Central - PubMed

Affiliation: Section Ear & Hearing, Dept. of Otolaryngology-Head and Neck Surgery and EMGO Institute for Health and Care Research, VU University medical center, Amsterdam, The Netherlands.

ABSTRACT

Context: Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown.

Objectives: To 1) review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2) review the evidence relating hearing impairment and parasympathetic activity and 3) seek evidence of possible connections between hearing impairment and the pupil light reflex.

Methods: Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment.

Results: Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment.

Discussion and conclusions: As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing impairment, hence further research is needed. The pupil light reflex could be a candidate measurement tool to achieve this goal.

No MeSH data available.


Related in: MedlinePlus