The Eyes are the Mirror of the Brain: Pupilometry and Its Applications in Psychology

Abstract

The increase in the clinical application areas of radiological imaging methods and the introduction of new imaging methods in recent years, has revolutionized brain physiology, functions and etiology of psychopathologies and inves- tigating of the responses of these pathologies to different treatment models. The introduction of these methods in the field of mental health, scientific psychiatry, psychology and psychotherapy; in accordance with the methodology of science, contributed to the observation and measure qualities. Although the use of high-tech devices method such as functional magnetic resonance imaging (FMRI) has managed to obtain specific data in psychopathologies, the high cost of such devices and the difficulties of accessing these devices have brought the need for cheaper, easily accessible methods such as pupillometry. Pupil is a smooth round opening in the middle of the iris in the structure of the eye. Stimulation of the pupil with au- tonomic nerves and pupil response to this stimulus are important in evaluating the activity of the sympathetic and parasympathetic systems. Pupil rulers or pupillometer devices can be used to evaluate the pupillary diameter.Studies based on the measurement of pupillometry and eye movements have been increasing in recent years, es- pecially in the fields of medicine and psychology. Pupil diameter; It can be an indicator of a person’s emotional state, mental activity, and decision-making processes. Pupil functions, in the field of mental health as well; It has been reported that it can be used in many areas such as understanding the information processing styles of the patients and choosing the appropriate treatment model. In our article, we aimed to reveal the neurobiological relationship between pupil and eye functions with mind and emotions, and to make a compilation of studies regarding this subject.

Keywords

• Pupil
• Pupilometry
• Neurobiology
• Psychopathology

Gözler Beynin Aynasıdır. Pupilometri ve Psikolojideki Uygulamaları

Abstract

Son yıllarda radyolojik görüntüleme yöntemlerinin klinik uygulama alanlarının artması ve yeni görüntüleme yöntemlerinin uygulamaya girmesi; beyin fizyolojisinin, fonksiyonlarının ve psikopatolojilerin etiyolojilerinin belirlenmesi ve bu patolojilerin farklı tedavi modellerine cevaplarının araştırılması yönünden çığır açmıştır. Ruh sağlığı alanında bu yöntemlerin kullanıma girmesi, bilimsel anlamda psikiyatri, psikoloji ve psikoterapi alanlarının; bilim metodolojisine uygun olarak, gözlemlenip, ölçülebilir olma niteliklerine katkıda bulunmuştur. Fonksiyonel manyetik rezonans görüntüleme (FMRI) yöntemi gibi yüksek teknolojik cihazların kullanımı, psikopatolojilerde somut verilerin elde edilmesini sağlamış olsa da, bu tip cihazların yüksek maliyetleri ve bu cihazlara erişim zorluklarının bulunması, pupillometri gibi daha ucuz, kolay erişilebilir yöntemlere ihtiyacı gündeme getirmiştir. Pupil (göz bebeği), gözün yapısında bulunan irisin ortasında düzgün yuvarlak açıklıktır. Pupilin otonom sinirlerle uyarımı ve bu uyarıya pupil cevabı, sempatik ve parasempatik sistem aktivitesini değerlendirmede önemlidir. Pupil çapının değerlendirmesinde, pupil cetvelleri ya da pupillometre cihazları kullanılabilir. Pupilometri ve göz hareketlerinin ölçümlerine dayalı çalışmalar, başta tıp ve psikoloji alanlarında olmak üzere son yıllarda giderek daha fazla yer artmaktadır. Pupil çapı; kişinin duygusal durumunun, mental aktivitesinin ve karar verme süreçlerinin bir göstergesi olabilir. Pupil fonksiyonlarının, ruh sağlığı alanında da; hastaların bilgi işleme tarzlarını anlamak, kişiye uygun tedavi modelini seçmek gibi birçok alanda kullanılabileceği yönünde çalışmalar bildirilmektedir. Yazımızda pupil ve göz fonksiyonlarının zihin ve duygularla ilişkisini nörobiyolojik yönden ortaya koyup, bu konuda yapılmış çalışmaların bir derlemesini yapmayı amaçladık.

Keywords

• psikopatoloji
• pupil
• pupillometre
• nörobiyoloji

References

1. Aston-Jones, G., ve Cohen, J. D. (2005). An integrative theory of locus coeruleus-norepinephrine function: adaptive gain and optimal performance. Annual Reviews Neuroscience, 28, 403-450.
2. Beatty, J. (1982). Task-evoked pupillary responses, processing load, and the structure of processing resources. Psychological bulletin, 91(2), 276.
3. Benarroch EE (2009). “The locus ceruleus norepinephrine system: functional organization and potential clinical significance”. Neurology. 73 (20): 1699-704.
4. Bertinotti, L., Pietrini, U., Del Rosso, A., Casale, R., Colangelo, N., Zoppi, M., and Matucci Cerinic, M. (2002). Theuse of pupillometry in joint and connective tissue diseases. Annals of the New York Academy of Sciences, 966: 446-455.
5. Bradley M. M., Sapigao R. G., Lang P. J. (2017). Sympathetic ANS modulation of pupil diameter in emotional scene perception: Effects of hedoniccontent, brightness, andcontrast. Psychophysiology,54, 1419–1435.
6. Burley, Daniel T., andStephanie HM Van Goozen. (2020). “Pupil response to affective stimuli: a biomarker of early conduct prob- lems in youngchildren.” Journal of abnormal child psychology 48.5: 693-701.Ciuffreda KJ., Joshi NR., Truong JQ. (2017). Understanding the effects of mild traumatic brain injury on the pupillary light reflex. Concussion 2(3), CNC36.
7. Cortes, M. X., Siaron, K. B., Nadim, H. T., Ahmed, K. M., & Romito, J. W. (2021). Neurological Pupil index as an indicator of irrever- sible cerebral edema: a case series. Journal of Neuroscience Nursing, 53(3), 145-148.
8. Daniel T. Burley, , Nicola S. Gray, and Robert J.(2019). Emotional Modulation of the Pupil Response in Psychopathy.Snowden, Personal Disord.; 10(4): 365–375.

9. Fu, C. H., Williams, S. C., Cleare, A. J., Scott, J., Mitterschiffthaler, M. T., Walsh, N. D.,Murray, R. M. (2008). Neural responses to sad facial expressions in major depression following cognitive behavioral therapy. Biologicalpsychiatry, 64(6), 505-512.
10. Ginton, Lee.(2017) Investigating pupillometry as a novel mechanism for detecting emotional regulation difficulties in individuals with PTSD. MS thesis. University of Cape Town.
11. Granholm, E. E., Steinhauer, S. R. (2004). Pupillometric measures of cognitive and emotional processes. International Journal of Psychophysiology.
12. Heneka MT., Nadrigny F., Regen T., Martinez-Hernandez A., Dumitrescu-Ozimek L., Terwel D., Jardanhazi-Kurutz D., Walter J., Kir- chhoff F., Hanisch UK., Kummer MP. (2010). “Locus ceruleus controls Alzheimer’s disease pathology by modulating microglial functions through norepinephrine”. ProcNatlAcadSci U S A. 107 (13): 6058–6063.
13. Hess, E. H., Polt, J. M. (1960). Pupil size as related to interest value of visual stimuli. Science, 1960,132, 349–350.
14. Hollon SD, Thase ME, Markowitz JC.(2002). Treatment and Prevention of Depression. Psychological Science in the Public Inte- rest. 3(2):39–77.
15. Jones, N. P., Siegle, G. J., Muelly, E. R., Haggerty, A., Ghinassi, F.(2010). Poor performance on cognitive tasks in depression: Doing too much or not enough?. Cognitive, Affective, &Behavioral Neuroscience, 10(1), 129-140.
16. Joshi, S.Li, Y., Kalwani, R. M., Gold, J. I. (2016). Relationships between pupil diameter and neuronal activity in the locus coeruleus, colliculi, and cingulate cortex. Neuron, 89(1), 221-234.
17. Kreibig, S. D. (2010). Autonomic nervous system activity in emotion: A review. Biological psychology, 84(3), 394-421. Lussier, B. L., Stutzman, S. E., Atem, F., Venkatachalam, A. M., Perera, A. C., Barnes, A., ... & Olson, D. M. (2019).
18. Distributions and reference ranges for automated pupillometer values in neurocritical care patients. Journal of Neuroscience Nursing, 51(6), 335-340.
19. Mathôt, S. (2018). Pupillometry: Psychology, physiology, and function. Journal of Cognition, 1(1).
20. McDougal, D. H., Gamlin, P. D. (2015). Autonomic control of the eye. Comprehensive physiology, 5(1), 439.
21. Mestanikova, A., Ondrejka, I., Mestanik, M., Cesnekova, D., Visnovcova, Z., Bujnakova, I., ... Tonhajzerova, I. (2017). Pupillary light reflex is altered in adolescent depression. Physiological research, 66.
22. Murphy, P. R., Vandekerckhove, J., Nieuwenhuis, S. (2014). Pupil-linked arousal determines variability in perceptual decision ma- king. PLoS computational biology, 10(9), e1003854.
23. Oathes, DJ., Siegle, GJ., Ray WJ. (2011). Chronic worry and the temporal dynamics of emotional processing. Emotion 11(1):101- 114.
24. Sambataro, F., Doerig, N., Hänggi, J., Wolf, R. C., Brakowski, J., Holtforth, M. G., Seifritz E., and Spinelli, S. (2018). Anterior cingula- te volume predicts response to psychotherapy and functional connectivity with the inferior parietal cortex in major depressive disorder. European neuropsychopharmacology, 28(1), 138-148.
25. Schriver, B. J., Perkins, S. M., Sajda, P., Wang, Q. (2020). Interplay between components of pupil-linked phasic arousal and its role in driving behavioral choice in Go/No-Go perceptual decision-making. Psychophysiology, 57(8), e13565.
26. Scott, L. N., Zalewski, M., Beeney, J. E., Jones, N. P., Stepp, S. D. (2017). Pupillary and affective responses to maternal feed back and the development of borderline personality disorder symptoms. Development andpsychopatholog, 29(3), 1089-1104.
27. Siegle, G. J., Thompson, W. K., Collier, A., Berman, S. R.,Feldmiller, J., Thase, M. E., Friedman, E. S. (2012). Toward clinically useful neuroimaging in depression treatment: prognosticutility of subgenual cingulate activity for determining depression outcome in cognitive therapy across studies, scanners, and patient characteristics. Archives of general psychiatry, 69(9), 913-924.
28. Silk JS., Dahl RE., Ryan ND., Forbes EE., Axelson DA., Birmaher B., Siegle GJ. (2007). Pupillary reactivity to emotiona lin- formation in child and adolescent depression: Links to clinical and ecological measures. American Journal of Psychi- atry.164(12):1873-1880.
29. The pupillary response in cognitive psychophysiology and schizophrenia. Annals of the New York Academy of Sciences, 658(1), 182-204.
30. Turi,M., Turi., Burr, DC., and Binda, P. (2018) Pupillometry reveals perceptual differences that are tightly linked to autistic traits in typical adults. eLife. 7: e32399. Van Dijk, A. E., van Lien, R., van Eijsden, M., Gemke, R. J., Vrijkotte, T. G., & de Geus, E. J. (2013). Measuring cardiac autonomic nervous system (ANS) activity in children. JoVE (Journal of Visualized Experiments), (74), e50073.
31. Vincent D Costa. , Peter H Rudebeck. (2016). More than meets the eye: the relationship between pupil size and Locus Coeruleus activity. Neuron. 89(1):8-10.