Pupillometric assessment of autonomic nervous system in children with functional enuresis

Dündaröz, Ruşen; Türkbay, Tümer; Erdem, Üzeyir; Cöngöloğlu, Ayhan; Sakallıoğlu, Onur; Tascilar, Emre

doi:10.1007/s11255-008-9481-1

Cited by 14 publications

(16 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It provides precise measurements of pupil size under different lighting conditions [19]. Pupillometry by OPD may also provide relevant information on the autonomic nervous system [20]. We found that pupil size in smokers was larger than nonsmokers in photopic conditions.…”

Section: Discussionmentioning

confidence: 78%

The Effect of Chronic Smoking on the Pupil and Photostress Recovery Time

et al. 2012

View full text Add to dashboard Cite

Purpose: To determine the effect of chronic smoking on the pupil and photostress recovery time. Methods: Macular adaptation to photostress condition, and mesopic and photopic pupillary responses were measured using automated perimetry (Humprey®), and an OPD device (Nidek), respectively. Forty heavy smokers (smoking ≥1 box/day for the past 5 years at least), and 40 age- and sex-matched nonsmokers were enrolled. All the subjects had full vision and no ocular problems. Results: The baseline foveal threshold value (FTV) before photostress was similar in both groups (p = 0.75). Although photostress recovery times (7.1 ± 1.1 and 7.4 ± 1.3 min) were similar in smokers and nonsmokers (p = 0.30), FTV measured at the first minute after photostress was statistically higher in smokers (36.05 ± 0.98 dB) than nonsmokers (34.7 ± 1.03 dB; p = 0.018). Scotopic pupil sizes in smokers (6.73 ± 0.82 mm) and nonsmokers (6.55 ± 0.62 mm) were similar (p = 0.28); however, photopic pupil size in smokers (5.36 ± 0.73 mm) was different from nonsmokers (4.73 ± 0.58 mm; p = 0.001). Conclusions: Chronic smoking may dilate the pupil, and increases macular FTV immediately after photostress.

show abstract

Section: Discussionmentioning

confidence: 78%

The Effect of Chronic Smoking on the Pupil and Photostress Recovery Time

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Pupillometry offers noninvasive, rapid, and objective measurements of pupillary function; these measurements serve as an ideal instrument to quantify ophthalmologic-specific ANSD. Pupillometry has been successfully used to evaluate ANSD in autonomic neuropathies (14)(15)(16), pediatric enuresis (17), heart failure (18), and familial dysautonomia (19) and has the potential for use in other pediatric disorders of respiratory and autonomic dysregulation. Although multiple factors can influence pupil diameter and response, with standardized conditions and intact afferent pathways, pupillometry allows for insight into efferent ANS pathways (14).…”

Section: Ongenital Central Hypoventilation Syndrome (Cchs) Ismentioning

confidence: 99%

Pupillometry in congenital central hypoventilation syndrome (CCHS): quantitative evidence of autonomic nervous system dysregulation

et al. 2012

View full text Add to dashboard Cite

INTRODUCTION: congenital central hypoventilation syndrome (cchs) is characterized by alveolar hypoventilation, autonomic nervous system (aNs) dysregulation (aNsD), and mutations in the paired-like homeobox 2B (PHOX2B) gene. aNsD in cchs affects multiple systems and includes ophthalmologic abnormalities. We hypothesized that quantitative pupil measures, obtained using pupillometry, would vary between cases with cchs and controls and within those with cchs by PHOX2B genotype. RESULTS: Measures known to be illustrative of sympathetic and parasympathetic response (prestimulus, maximum pupil diameter, percentage of pupil constriction after light stimulus, and average constriction and dilation velocities) were significantly reduced in those with cchs as compared with controls (all P < 0.05). DISCUSSION: These reductions are indicative of both sympathetic and parasympathetic deficits in cchs, which is in keeping with the role of PHOX2B in aNs development. an inverse linear relationship was apparent in pupil diameter and velocity measurements among the cases with cchs with the most common heterozygous PHOX2B polyalanine expansion repeat mutations, suggesting a graded phenotype/genotype dose response based on polyalanine repeat length. These results confirm our central hypotheses while offering the first objective measures of pupillary dysfunction and ophthalmologicspecific aNsD in cchs. METHODS: a total of 316 monocular measurements were taken under dark-adapted conditions with a fixed light stimulus from 22 PHOX2B mutation-confirmed cases with cchs and 68 healthy controls. C ongenital central hypoventilation syndrome (CCHS) ischaracterized by central alveolar hypoventilation with autonomic nervous system dysregulation (ANSD) and is diagnosed in the absence of primary pulmonary, cardiac, or neuromuscular disease or a brainstem lesion that can account for the full phenotype (1). Discovery of the CCHS disease-defining gene, pairedlike homeobox 2B (PHOX2B) (2-4), and appreciation of its role in both embryologic development and regulatory function of the autonomic nervous system (ANS) (5-7), has broadened the understanding of the CCHS phenotype. The majority of individuals with CCHS are heterozygous for PHOX2B polyalanine repeat expansion mutations (PARMs), with a range of 24-33 alanine bases on the affected allele (20 repeats is normal; normal genotype is 20/20). Missense, nonsense, frameshift, and stop codon mutations in the PHOX2B gene, referred to as nonpolyalanine repeat expansion mutations (NPARMs), account for the remaining mutations in CCHS. Quantitative assessment of the respiratory control and ANSD features of CCHS by PHOX2B genotype has identified a graded genotype-phenotype relationship between mutation repeat length and ventilatory requirements (3,4), Hirschsprung disease (8,9), neural crest tumors (8,9), and cardiac sinus pauses (10).Detailed understanding of the ANSD features in CCHS requires targeted investigation with objective measures of all organ systems served by the ANS. Ophthalmologic abnormalities th...

show abstract

“…The symptom score with Akbal's questionnaire was median 17 minimum 9, maximum 26 and mean score was 16.5 in the study group. The cutoff value is 8.5 in Akbal's questionnaire for lower urinary tract dysfunction .…”

Section: Resultsmentioning

confidence: 79%

“…Effectiveness of anticholinergic medications in enuretic children supports this hypothesis. Autonomic system and enuresis studies have been carried out in children with monosymptomatic nocturnal enuresis (MNE) . But study concerning autonomic dysfunction in children with OAB have not yet been published.…”

Section: Discussionmentioning

confidence: 99%