Bruce I Gaynes1,2, Adnaan Zaffer3, Raman Yousefzai3, Mario Chazaro-Cortes3, Kalea Colletta3, Sandra L Kletzel3, Mary Beth Jost3, Youngsook Park3, Jasvinder Chawla3,4, Mark V Albert5, Ting Xiao6. 1. Edward Hines Jr. VA Medical Center, Hines, IL, USA. bgaynes@luc.edu. 2. Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA. bgaynes@luc.edu. 3. Edward Hines Jr. VA Medical Center, Hines, IL, USA. 4. Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA. 5. Biomedical Engineering, Computer Science and Engineering, University of North Texas, Denton, TX, USA. 6. Computer Science and Engineering, University of North Texas, Denton, TX, USA.
Abstract
OBJECTIVES: Ascertain and quantify abnormality of the melanopsin-derived portion of the pupillary light reflex (PLR) in patients with Parkinson's disease (PD) and parkinsonism features based on a statistical predictive modeling strategy for PLR classification. METHODS: Exploratory cohort analysis of pupillary kinetics in non-disease controls, PD subjects, and subjects with parkinsonism features using chromatic pupillometry. Receiver operating characteristic (ROC) curve interpretation of pupillary changes consistent with abnormality of intrinsically photosensitive retinal ganglion cells (ipRGCs) was employed using a thresholding algorithm to discriminate pupillary abnormality between study groups. RESULTS: Twenty-eight subjects were enrolled, including 17 PD subjects (age range 64-85, mean 70.65) and nine controls (age range 48-95, mean 63.89). Two subjects were described as demonstrating parkinsonism symptoms due to presumed Lewy body dementia and motor system atrophy (MSA) respectively. On aggregate analysis, PD subjects demonstrated abnormal but variable pupillary dynamics suggestive of ipRGC abnormality. Subjects with parkinsonism features did not demonstrate pupillary changes consistent with ipRGC abnormality. There was no relationship between levodopa equivalent dosage or PD severity and ipRGC abnormality. The pupillary test sensitivity in predicting PD was 0.75 and likelihood ratio was 1.2. CONCLUSIONS: ipRGC deficit is demonstrated in PD subjects; however, the degree and constancy of abnormality appear variable.
OBJECTIVES: Ascertain and quantify abnormality of the melanopsin-derived portion of the pupillary light reflex (PLR) in patients with Parkinson's disease (PD) and parkinsonism features based on a statistical predictive modeling strategy for PLR classification. METHODS: Exploratory cohort analysis of pupillary kinetics in non-disease controls, PD subjects, and subjects with parkinsonism features using chromatic pupillometry. Receiver operating characteristic (ROC) curve interpretation of pupillary changes consistent with abnormality of intrinsically photosensitive retinal ganglion cells (ipRGCs) was employed using a thresholding algorithm to discriminate pupillary abnormality between study groups. RESULTS: Twenty-eight subjects were enrolled, including 17 PD subjects (age range 64-85, mean 70.65) and nine controls (age range 48-95, mean 63.89). Two subjects were described as demonstrating parkinsonism symptoms due to presumed Lewy body dementia and motor system atrophy (MSA) respectively. On aggregate analysis, PD subjects demonstrated abnormal but variable pupillary dynamics suggestive of ipRGC abnormality. Subjects with parkinsonism features did not demonstrate pupillary changes consistent with ipRGC abnormality. There was no relationship between levodopa equivalent dosage or PD severity and ipRGC abnormality. The pupillary test sensitivity in predicting PD was 0.75 and likelihood ratio was 1.2. CONCLUSIONS: ipRGC deficit is demonstrated in PD subjects; however, the degree and constancy of abnormality appear variable.
Authors: N E Rosenthal; D A Sack; J C Gillin; A J Lewy; F K Goodwin; Y Davenport; P S Mueller; D A Newsome; T A Wehr Journal: Arch Gen Psychiatry Date: 1984-01
Authors: Jessica Rodgers; Steven Hughes; Carina A Pothecary; Laurence A Brown; Doron G Hickey; Stuart N Peirson; Mark W Hankins Journal: Hum Mol Genet Date: 2018-08-01 Impact factor: 6.150