Assessing Cognitive Effort in Ménière's Disease: Pupillometry As a Novel Tool for Postural Control

Overview

Journal J Int Adv Otol

Publisher Aves

Specialty Otorhinolaryngology

Date 2024 Mar 7

PMID 38454292

Authors

Beatrice Francavilla

Gianluca Velletrani

Carlo Chiaramonte

Stefano Di Girolamo

Pier Giorhio Giacomini

Affiliations

Soon will be listed here.

Abstract

Background: This study aimed to investigate the utility of pupillometry as a measure of cognitive effort in individuals with Ménière's disease experiencing chronic postural destabilization. By integrating pupillometry with static posturography, we sought to gain deeper insights into the cognitive demands and arousal levels associated with postural control in this specific patient population.

Methods: The study included 36 patients who met the diagnostic criteria for Ménière's disease and a control group comprising 36 healthy volunteers. We performed static posturography using a computerized static posturography platform to objectively assess postural imbalance. Additionally, pupillometry was recorded using infrared video-oculoscopy. Pupil dilation was measured before and after participants walked for 7 steps on-site with their vision obscured.

Results: Baseline tonic pupil size showed no significant difference between healthy controls and Ménière's patients. However, after walking stimulation, Ménière's patients exhibited highly significant abnormal walking-induced pupil dilation. This suggests increased arousal in response to the challenging task of walking with closed eyes, linked to static upright stance imbalance as correlated with posturography parameters.

Conclusion: Pupillometry holds promise as an objective tool to assess cognitive effort and arousal during postural control in Ménière's disease. Implementing pupillometry in clinical practice could enhance the management of postural instability in these patients. Our findings contribute to the understanding of cognitive aspects in balance control and open new avenues for further investigations in vestibular dysfunction.

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