Clinical Autonomic Research

, Volume 1, Issue 1, pp 55–58 | Cite as

Disordered pupil reactivity in Parkinson's disease

  • Giuseppe Micieli
  • Cristina Tassorelli
  • Emilia Martignoni
  • Claudio Pacchetti
  • Patrizia Bruggi
  • Marco Magri
  • Giuseppe Nappi
Research Paper


Different varieties of pupillary abnormalities have been described in Parkinson's disease but it is not clear if this is due to the disease itself or to the pharmacological treatment. In this study, pupil reactivity to various stimuli (dark/light adaptation, light reflex, near vision reaction and electrical sural stimulation) was investigated in 23de novo parkinsonian patients (not on drugs) to assess pupillary abnormalities and investigate their pathophysiological mechanisms. Parkinsonian patients exhibited larger pupil diameter after light adaptation, as well as a reduced amplitude of contraction and a prolonged contraction time at light reflex. The data obtained confirmed the existence in Parkinson's disease of a pupillary imbalance mainly involving the parasymapathetic system.

Key words

Parkinson's disease Pupil reactivity 


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  1. 1.
    Lowenstein O, Westphal C.Experimentelle und Klinische Studien zur Physiologie und Pathologie der Pupillenbewegungen mit Besonderer Berenksichtigung der Schizoprenie. Berlin: Springer, Karger Verlag. 1933.Google Scholar
  2. 2.
    Hassler R. Extrapyramidal-motorische Sindrome und Erkrankungen. In: Mohr L. Staehelin R. eds.Handbuch der inneren Medizin. Berlin: Springer-Verlag, 1931: 676–81.Google Scholar
  3. 3.
    Kyrieleis W. Die Augenveranderungenbei den entzundlichen Erkrankungen des Zentralnervensystems. In: Schiek J, Brukner H, eds.Kurzes Handbuch der Ophthalmologie. Berlin: Springer, 1931: 423–9.Google Scholar
  4. 4.
    Lowenstein O. Pupillography. Method and diagnostic system.Arch Ophthalmol 1956;35: 565–71.Google Scholar
  5. 5.
    Korczyn AD. Autonomic nervous system dysfunction in Parkinson's disease. In: Calne DB, Comi G, Crippa D, Horowski R, Trabucchi M, eds.Parkinsonism and Aging. New York: Raven Press, 1989: 211–19.Google Scholar
  6. 6.
    Lowenstein O, Lowenfield IE. Electronic pupillography. A new instrument and some clinical applications.Arch Ophthalmol 1958;59: 352–9.Google Scholar
  7. 7.
    Micieli G, Magri M, Sandrini G,et al. Electronic pupillometry for investigating pupil reactivity to different exteroceptive stimuli: applications and limits.Funct Neurol 1987;4: 529–38.Google Scholar
  8. 8.
    Micieli G, Magri M, Sandrini G, Tassorelli C, Nappi G. Pupil responsiveness in cluster headache: a dynamic TV pupillometric evaluation.Cephalalgia 1988;8: 193–201.PubMedGoogle Scholar
  9. 9.
    Sandrini G, Micieli G, Magri M, Alfonsi E, Pacchetti C, Nappi G. Pupillary response to nociceptive stimuli in cluster headache. In: Sicuteri Fet al., eds.Trends in Cluster Headache. Amsterdam: Excerpta Medica, 1987: 197–206.Google Scholar
  10. 10.
    Lowenstein O, Lowenfield IE. Mutual role of sympathetic and parasympathetic in shaping the pupillary reflex to light.Arch Neurol Psychiat 1950;64: 41–312.Google Scholar
  11. 11.
    Nisada I, Okada H. The activity of pupilloconstrictor centers.Jpn J Physiol 1969;10: 64–72.Google Scholar
  12. 12.
    Lowenfield IE. Mechanisms of reflex dilatation of the pupil.Doc Ophthalmol 1958;12: 185–448.Google Scholar
  13. 13.
    Lowenstein O, Friedman ED. Pupillographic studies: I. Present state of pupillography; its method and diagnostic significance.Arch Ophthalmol 1942;27: 969–93.Google Scholar
  14. 14.
    Lowenstein O, Lowenfield IE. Role of sympathetic and parasympathetic systems in reflex dilation of the pupil.Arch Neurol 1950;64: 313–40.Google Scholar
  15. 15.
    Sillito AM, Zbrozyna AW. Activity characteristics of preganglionic pupilloconstrictor neurones.J Physiol 1970;211: 767–9.PubMedGoogle Scholar
  16. 16.
    Zinn KM. The pupil. In: Thomas CC, ed. Springfield: Illinois, 1972.Google Scholar
  17. 17.
    Sugiyama T, Utsumi T. Pupillary dynamics in Parkinson's disease.Neuroophthalmology 1990;10: 1–7.Google Scholar
  18. 18.
    Loewy AD. Neural regulation of the pupil. In: Brooks C McC, Koisumi K. Sato A, eds.Integrative Functions of the Nervous System. Amsterdam: University of Tokyo Press and Elsevier/North Holland Biomedical Press. 1979: 131–44.Google Scholar
  19. 19.
    Grossiord A, Held JP, Odievre M, Martin M. Mydriase par excitation nociceptive sous-lesionelle chez les tetraplegiques.Rev Neurol 1961;104: 310–14.PubMedGoogle Scholar
  20. 20.
    Johnson RH, Spalding JMK. Disorders of the autonomic nervous system. Philadelphia: Blackwell Science, 1974.Google Scholar

Copyright information

© Rapid Communications of Oxford Ltd. 1991

Authors and Affiliations

  • Giuseppe Micieli
    • 1
  • Cristina Tassorelli
    • 1
  • Emilia Martignoni
    • 1
  • Claudio Pacchetti
    • 1
  • Patrizia Bruggi
    • 1
  • Marco Magri
    • 1
  • Giuseppe Nappi
    • 1
  1. 1.Autonomic Unit, Department of Neurology, "C. Mondino" FoundationUniversity of PaviaPaviaItaly

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