Pupillary Light Reflex in Children with ADHD

Abstract

Attention deficit/hyperactivity disorder (ADHD) is one of the most frequently seen mental disorders in children with an increasing risk for other mental disorders. ADHD represents a primary biological dysfunction of the central nervous system, such as dysregulation of frontal-subcortical-cerebellar catecholaminergic circuits and imbalances in the dopaminergic system. However, autonomic nervous system, comprised of two primary branches - sympathetic and parasympathetic nervous systems that are normally in dynamic balance, plays an essential role in the regulation of body functions. Although it is generally assumed that the autonomic regulation is impaired during ADHD the information related to this dysregulation is limited. One of the options to observe changes of autonomic balance in ADHD is pupillary light reflex (PLR). Pupillometric evaluation can be used for the assessment of functioning of both autonomic nervous system branches and certain parameters of pupil responsivity can be helpful as a tool for medical diagnostic and treatment. In conclusion, these findings suggest the pupillometry as a non-invasive method that can indicate abnormalities in the complex central autonomic network regulating PLR.

Emotional and sensory dysregulation as a possible missing link in attention deficit hyperactivity disorder: A review

“…Table 2 describes potential objective, physiological diagnostic tests for emotional dysregulation, sensory dysregulation, and attentional dysregulation found in ADHD. The pupil reflex test, correlates pupil constriction and subsequent dilation in response to light to attentional dysregulation (Wainstein et al, 2017) and autonomic dysfunction (Hamrakova et al, 2019(Hamrakova et al, , 2020Bellato et al, 2021) in ADHD. Additionally, if we further explore the relation between emotional and sensory dysregulation and the classical ADHD symptoms, more potential diagnostic practices may arise.…”

At-Home Pupillometry using Smartphone Facial Identification Cameras

“…For this, there are a large number of available applications. With just the pupillary light reflex test and digit span recall test, there are possibilities for investigating links to Alzheimer’s disease, ADHD, Parkinson’s Disease, schizophrenia, and more [ 17 ] [ 8 ] [ 31 ] [ 25 ] [ 6 ] [ 13 ].…”

“…From Alzheimer’s and Parkinson’s Disease screening in older adults to ADHD detection in children, previous research indicates that pupillometry has the potential to make a significant impact on the screening and care for a number of neurological diseases [ 6 ] [ 8 ] [ 17 ] [ 6 ] [ 13 ] [ 10 ]. Unfortunately, clinical grade pupillometers that work on a wide variety of eye colors and at an approachable cost are not widely available and much of the findings cannot be translated towards end-consumer and at-home patient use.…”