Pupillary responses to single and sinusoidal light stimuli in diabetic patients
Pupillary responses to single and sinusoidal light stimuli in diabetic patients
复制标题
糖尿病患者的瞳孔对单一和正弦光刺激的反应
作者：
W. Zangemeister;T. Gronow;U. Grzyska
我们研究了糖尿病（DM）对瞳孔光反射（PLR）的影响。对52例糖尿病患者和21例对照受试者检测了对单次光刺激（200毫秒）的相位性瞳孔反应（pPLR）以及对四种不同频率（0.1、0.3、0.7、1.3Hz）的连续正弦刺激的瞳孔反应（cPLR）。我们提出疑问：与仅检测pPLR相比，对cPLR进行记录和频率分析以及对pPLR进行短时傅里叶（STFT）分析是否能更好地区分糖尿病患者和正常受试者？糖尿病组的初始瞳孔直径显著减小。对于pPLR，在那些同时表现出糖尿病自主神经病变（DNP）体征的患者中，最大收缩速度（Vmax）、再扩张1的Vmax、反射幅度和pPLR潜伏期均显著降低。动态瞳孔光反射（cPLR）测试显示，所有糖尿病患者在较低频率下的增益均显著降低。在DNP组中，瞳孔相位滞后在0.1和0.3Hz时更大，在0.7和1.3Hz时更小（p<0.001）。对5例DNP患者和5例受试者的单次pPLR记录进行短时快速傅里叶（STFT）分析比较，发现从健康受试者的低频成分到DNP患者的高频成分有特征性变化。只有当出现自主神经病变症状时，才能发现糖尿病患者PLR的显著变化。交感神经系统和副交感神经系统均受到糖尿病自主神经病变的影响。只有记录cPLR以及对pPLR进行STFT分析才能在单个病例中识别出瞳孔控制的显著病理缺陷。
We examined effects of diabetes mellitus (DM) on the pupillary light reflex (PLR). Phasic pupillary response to a single light stimulus (200 ms) (pPLR) and to continuous sinusoidal stimuli with four different frequencies (0.1, 0.3, 0.7, 1.3Hz) (cPLR) were examined in 52 DM patients and 21 control subjects. We asked: does recording and frequency analysis of cPLR together with short time fourier [STFT] analysis of pPLR differentiate better between DM patients and normal subjects than pPLR only? Initial pupil diameter was significantly decreased in the DM group. For pPLR. maximal contraction velocity (Vmax), Vmax of redilation 1, reflex-amplitude and pPLR latency were significantly reduced in those patients who also showed signs of diabetic autonomic neuropathy (DNP). Tests of dynamic pupillary light reflex (cPLR) revealed that all DM patients had a significantly reduced gain at lower frequencies. Pupil phase lag was greater at 0.1 and 0.3Hz and smaller at 0.7 and 1.3 Hz in the DNP group (p<0.001). Comparison of single pPLR recordings of 5 DNP patients with 5 subjects using short time fast fourier (STFT) analysis revealed a characteristic change from low frequency content in healthy subjects to high frequency content in DNP patients. Significant changes in the PLR in DM can be found only when symptoms of autonomic neuropathy have been shown. Both sympathetic and the parasympathetic nervous systems are affected by diabetic autonomic neuropathy. Only recording of cPLR, together with STFT of pPLR can identify significant pathological deficits of pupillary control in single cases.
影响因子：
1.5
作者：
Fyvie, MJ;Murray, JAH;Kilby, NJ
通讯作者：
Kilby, NJ