Abstract
Background Concussion diagnosis is based on subjective assessment of several nonspecifc clinical signs and symptoms with
no objective test to aid in diagnosis. The pupillary system, in particular the pupil light refexes (PLR) has attracted plausible
consideration in this area, given its complex neural circuitry and autonomic function.
Aim To assess the reliability and validity of using the NeurOptics PLR-3000 pupilometer to measure PLR, and to determine
normative data for female athletes.
Methods A cross sectional cohort study of 33 senior elite female feld hockey athletes (aged 19–34 years) were recruited.
Three valid pupillometry readings were acquired, per eye. Measurements of nine PLR metrics were obtained. Reliability was
determined using intraclass coefcients, standard error of measurement (SEM), and minimum detectable change (MDC).
Between group diferences (concussion history vs. controls) were analysed using non-parametric tests.
Results NeurOptics PLR-3000 showed good to excellent reliability for eight PLR metrics derived from the pupilometer
[latency, average constriction velocity (ACV), peak constriction velocity (PCV), average dilation velocity (ADV), T75%max.
pupil diameter, min. pupil diameter and percent constriction]. There was no statistical diference between any of the PLR
metrics in athletes who had a history of concussion and those that had no history of concussion. The two athletes with a recent
history of concussion (<3 months) showed trends towards slowed latency, ACV, PCV and ADV when compared to controls.
Conclusion This research does not support previous research that the PLR-3000 is an accurate instrument for distinguishing
between those with and without a history of concussion. However, the ICC values for intratester reliability were good to
excellent for most PLR metrics, with data comparing favourably to normative values previously reported from other populations. Some PLR metrics may distinguish between distinct group of female athletes (recent history of concussion), but
this is a small sample size and exploratory in nature. Larger studies are required to confrm its validity and responsiveness.
no objective test to aid in diagnosis. The pupillary system, in particular the pupil light refexes (PLR) has attracted plausible
consideration in this area, given its complex neural circuitry and autonomic function.
Aim To assess the reliability and validity of using the NeurOptics PLR-3000 pupilometer to measure PLR, and to determine
normative data for female athletes.
Methods A cross sectional cohort study of 33 senior elite female feld hockey athletes (aged 19–34 years) were recruited.
Three valid pupillometry readings were acquired, per eye. Measurements of nine PLR metrics were obtained. Reliability was
determined using intraclass coefcients, standard error of measurement (SEM), and minimum detectable change (MDC).
Between group diferences (concussion history vs. controls) were analysed using non-parametric tests.
Results NeurOptics PLR-3000 showed good to excellent reliability for eight PLR metrics derived from the pupilometer
[latency, average constriction velocity (ACV), peak constriction velocity (PCV), average dilation velocity (ADV), T75%max.
pupil diameter, min. pupil diameter and percent constriction]. There was no statistical diference between any of the PLR
metrics in athletes who had a history of concussion and those that had no history of concussion. The two athletes with a recent
history of concussion (<3 months) showed trends towards slowed latency, ACV, PCV and ADV when compared to controls.
Conclusion This research does not support previous research that the PLR-3000 is an accurate instrument for distinguishing
between those with and without a history of concussion. However, the ICC values for intratester reliability were good to
excellent for most PLR metrics, with data comparing favourably to normative values previously reported from other populations. Some PLR metrics may distinguish between distinct group of female athletes (recent history of concussion), but
this is a small sample size and exploratory in nature. Larger studies are required to confrm its validity and responsiveness.
| Original language | English |
|---|---|
| Number of pages | 10 |
| Journal | Journal of Science in Sport and Exercise |
| Volume | 6 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published (in print/issue) - 8 Aug 2024 |
Bibliographical note
Publisher Copyright:© The Author(s) 2024.
Data Access Statement
The datasets generated and analysed during the current study are not publicly available due to ethical restrictions but are available from the corresponding author on reasonable requestKeywords
- pupil light reflexes
- concussion
- mild traumatic brain injury
- sports
- athletes
- Female
