Pupillary dysfunction of multiple system atrophy: Dynamic pupillometric findings and clinical correlations

Kye Won Park; Nari Choi; Ho-Sung Ryu; Mi Sun Kim; Eun-Jae Lee; Sun Ju Chung

doi:10.1016/j.parkreldis.2019.05.003

Pupillary dysfunction of multiple system atrophy: Dynamic pupillometric findings and clinical correlations

Parkinsonism Relat Disord. 2019 Aug:65:234-237. doi: 10.1016/j.parkreldis.2019.05.003. Epub 2019 May 5.

Authors

Kye Won Park¹, Nari Choi², Ho-Sung Ryu³, Mi Sun Kim⁴, Eun-Jae Lee⁵, Sun Ju Chung⁶

Affiliations

¹ Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea. Electronic address: karabach88@gmail.com.
² Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea. Electronic address: xcarpediemx86@gmail.com.
³ Department of Neurology, Kyungpook National University School of Medicine, Daegu, 41404, South Korea. Electronic address: ryuhosung138@gmail.com.
⁴ Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea. Electronic address: caums@amc.seoul.kr.
⁵ Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea. Electronic address: eunjae.lee@amc.seoul.kr.
⁶ Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea. Electronic address: sjchung@amc.seoul.kr.

PMID: 31076267
DOI: 10.1016/j.parkreldis.2019.05.003

Abstract

Introduction: Although autonomic dysfunction is the prominent clinical feature in multiple system atrophy (MSA), little is known about the pupillary autonomic aspect of MSA. We aimed to evaluate pupillary autonomic function in MSA patients using dynamic pupillometry, which can quantify the pupillary light reflex.

Methods: Dynamic pupillometry parameters were compared in 21 MSA patients and 21 healthy controls. Pupillometric parameters were correlated with total Unified Multiple System Atrophy Rating Scale (UMSARS) scores and autonomic symptom severity.

Results: Average constriction (p = 0.034) and dilation (p = 0.003) velocities were significantly slowed in MSA patients compared with controls. Total UMSARS correlated with the average constriction (r = -0.527, p = 0.017) and maximum constriction (r = -0.658, p = 0.003) velocities. Autonomic symptom severity correlated with average constriction (r = -0.544, p = 0.013), maximum constriction (r = -0.607, p = 0.005) and average dilation (r = -0.499, p = 0.025) velocities.

Conclusion: Dynamic pupillometry may provide useful information about pupillary autonomic dysfunction, which correlated with the clinical severity, in patients with MSA.

Keywords: Autonomic dysfunction; Dynamic pupillometry; Multiple system atrophy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Autonomic Nervous System / physiopathology*
Diagnostic Techniques, Neurological
Female
Humans
Male
Middle Aged
Multiple System Atrophy / diagnosis*
Multiple System Atrophy / physiopathology*
Pupil / physiology*
Severity of Illness Index