Pupil Dilation Response to Tropicamide: A Biological Test for Alzheimer's Disease?

Kurz, Alexander; Marquard, Ralf; S, Fremke; Kp, Leipert

doi:10.1055/s-2007-979476

Cited by 29 publications

(14 citation statements)

References 5 publications

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“…The peak dilatation response to 0.01% tropicamide was about 30 min in this study which was similar to other reports [17, 25, 56, 59, 60]. Pupillary response to tropicamide was previously studied to expose degenerative process in Edinger Westphal nucleus.…”

Section: Discussionsupporting

confidence: 91%

Enhancing Diagnostic Accuracy of aMCI in the Elderly: Combination of Olfactory Test, Pupillary Response Test, BDNF Plasma Level, and APOE Genotype

Turana

Ranakusuma

Purba

et al. 2014

International Journal of Alzheimer's Disease

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Background. Amnestic Mild Cognitive Impairment (aMCI) often progresses to Alzheimer's disease. There are clinical markers and biomarkers to identify the degenerative process in the brain. Objectives. To obtain the diagnostic values of olfactory test, pupillary response to tropicamide 0.01%, BDNF plasma level, and APOE ε4 in diagnosing aMCI. Methods. Cross-sectional, comparative analysis. Results. There were 109 subjects enrolled (aMCI: 51, normal cognition: 58) with age 64 ± 5.54 years. For diagnosing aMCI, cut-off point for the olfactory score was <7 out of 10 and >22% for pupil dilatation response. Low BDNF plasma level was related significantly with olfactory deficits and aMCI (P < 0.05). Four of five subjects with homozygote e4 presented with multiple-domain aMCI. This group displayed the lowest means of olfactory score and the highest means of pupillary hypersensitivity response (P < 0.0001). Combination of olfactory deficit and pupillary hypersensitivity response in detection of aMCI was beneficial with Sp 91% and PPV 87%. In conjunction with clinical markers, BDNF plasma level and presence of APOE e4+ improved Sp and PPV. Conclusions. Combination of olfactory test and pupillary response test was useful as diagnostic tool in aMCI. In conjunction with clinical markers, low level of BDNF plasma and presence of APOE e4 improved the diagnostic value.

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Section: Discussionsupporting

confidence: 91%

Enhancing Diagnostic Accuracy of aMCI in the Elderly: Combination of Olfactory Test, Pupillary Response Test, BDNF Plasma Level, and APOE Genotype

Turana

Ranakusuma

Purba

et al. 2014

International Journal of Alzheimer's Disease

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“…Some studies found no significant hypersensitivity in AD [81][82][83][84][85][86][87][88][89][90][91], or a hypersensitive response in APOE-ε4 allele carriers rather than AD [78,92], affecting carriers of this allele who are cognitively normal (although at increased risk of progressing to AD). A similar hypersensitivity has been reported in Down's syndrome subjects -who develop AD as a result of an extra copy of the AβPP gene [93], yet also in healthy young adults [87].…”

Section: (Figure 2)mentioning

confidence: 99%

Ocular Biomarkers for Early Detection of Alzheimer's Disease

Frost

Martins

Kanagasingam

2010

JAD

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Alzheimer's disease (AD) is the most common form of dementia and is characterized clinically by a progressive decline in memory, learning and executive function and neuropathologically by the presence of cerebral amyloid deposits. Despite a century of research, there is still no cure or conclusive pre-mortem diagnosis for the disease. A number of symptom-modifying drugs for AD have been developed, but their efficacy is minimal and short-lived. AD cognitive symptoms arise only after significant, irreversible neural deterioration has occurred, hence there is an urgent need to detect AD early, before the onset of cognitive symptoms. An accurate, early diagnostic test for AD would enable current and future treatments to be more effective, as well as contribute to the development of new treatments.While most AD related pathology occurs in the brain, the disease has also been reported to affect the eye, which is more accessible for imaging than the brain. AD-related proteins exist in the normal human eye and may produce ocular pathology in AD. There is some homology between the retinal and cerebral vasculatures and the retina also contains nerve cells and fibers that form a sensory extension of the brain. The eye is the only place in the body where vasculature or neural tissue is available for non-invasive optical imaging. This article presents a review of current literature on ocular morphology in AD and discusses the potential for an ocular based screening test for AD.

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“…Patients with other dementias and normals were said not to respond [44]. These results could not be confirmed by other investigators, and the "tropicamide test for Alzheimer's disease" cannot be recommended [13,15,23,28,31,34,43]. Pupils of patients with myotonic dystrophy are hypersensitive to tropicamide as well, and show additional pupillographic abnormalities [55].…”

Section: Pupillary Signs In General Disease or Systemic Medicationmentioning

confidence: 99%

Neuro-ophthalmology of pupillary function - practical guidelines

Wilhelm

1998

Journal of Neurology

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An overview how to examine pupillary function and handle pupillary abnormalities is presented. The following issues are discussed: swinging flashlight test, clinical relevance of a relative afferent pupillary defect, anisocoria with normal light reaction, diagnosis and evaluation of Homer's syndrome, differential diagnosis of impaired light reaction, tonic pupil, third nerve palsy, supranuclear pupillary disorders, iris problems, systemic disease, measurement of sleepiness, and pupillography.

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Pupil Dilation Response to Tropicamide: A Biological Test for Alzheimer's Disease?

Cited by 29 publications

References 5 publications

Enhancing Diagnostic Accuracy of aMCI in the Elderly: Combination of Olfactory Test, Pupillary Response Test, BDNF Plasma Level, and APOE Genotype

Enhancing Diagnostic Accuracy of aMCI in the Elderly: Combination of Olfactory Test, Pupillary Response Test, BDNF Plasma Level, and APOE Genotype

Ocular Biomarkers for Early Detection of Alzheimer's Disease

Neuro-ophthalmology of pupillary function - practical guidelines

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