• James Q Truong and Kenneth J Ciuffreda.
• a Department of Biological and Vision Sciences , SUNY College of Optometry , New York , NY , USA.
• Brain Inj. 2016 Jan 1; 30 (11): 1378-1389.

PurposeTo determine if mTBI adversely affects the pupillary light reflex (PLR).MethodsThe PLR was evaluated in mTBI and compared to normal individuals under a range of test conditions. Nine pupil parameters (maximum, minimum and final pupil diameter, latency, amplitude and peak and average constriction and dilation velocities) and six stimulus conditions (dim pulse, dim step, bright pulse, bright step, bright red step and bright blue step) were assessed in 32 adults with mTBI (21-60 years of age) and compared to 40 normal (22-56 years of age). The Neuroptics, infrared, DP-2000 binocular pupillometer was used (30 Hz sampling rate; 0.05 mm resolution) with binocular stimulation and recording.ResultsDifferent test conditions allowed for discrimination of different parameters. For any of the given six test conditions, five-to-eight of the nine pupillary parameters were statistically different (p < 0.05) between the two diagnostic groups. The most promising parameters for diagnostic differentiation were constriction latency, all pupillary diameters, average constriction velocity and peak dilation velocity.ConclusionsMTBI adversely affects the PLR. This suggests an impairment of the autonomic nervous system. The findings suggest the potential for quantitative pupillary dynamics to serve as an objective mTBI biomarker.

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