, Volume 19, Issue 5, pp 364-371
Date: 25 Jul 2013

Pupil reaction to light in Alzheimer’s disease: evaluation of pupil size changes and mobility

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Aims: The aim of the study is to assess pupil size changes and mobility evaluation as a diagnostic marker in patients with probable Alzheimer’s disease (AD). Material and methods: Twenty-three control subjects and 23 patients with probable AD entered the study. The latter patients had been under observation for 2 years and had undergone all necessary examinations to verify their initial diagnosis. A full record of the pupil’s reaction to light was registered. Ten parameters from these data were measured, reported and then compared in both group of subjects. Results: Patients with probable AD had abnormal pupillary function compared with such function in healthy aging. All pupillary light reflex (PLR) variables differed significantly between the two groups (p<0.005) except baseline pupil diameter (D1) and minimum pupil diameter (D2). Maximum constriction acceleration (ACmax) was the best predictor in classifying a subject as normal or as AD with perfect classification ability (area under the curve =1, p<0.001). In addition, the correlation between the percentage recovery-redilatation (%D1) and ACmax was highly negative in the group of AD patients (r=−0.808, p<0.005). Conclusions: Pupil size changes and mobility examination may be a fast, non-invasive and efficient additional diagnostic marker in AD diagnosis.