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Pupillometric assessment of autonomic nervous system in children with functional enuresis
Rusen Dundaroz1, Tumer Turkbay, Uzeyir Erdem
1Division of Pediatrics, Gulhane Military Academy of Medicine, Etlik-Ankara, Turkey.
Insights
Children with functional enuresis show larger pupil diameters, suggesting autonomic nervous system imbalance. This study evaluated autonomic nervous system functions in enuretic children using pupil measurements.
Area of Science:
- Pediatrics
- Autonomic Nervous System Research
- Ophthalmology
Background:
- Functional enuresis is involuntary urination in children over 5 years old, excluding medical causes.
- Autonomic nervous system dysregulation is a suspected cause of functional enuresis.
Purpose of the Study:
- To assess autonomic nervous system function in children with functional enuresis.
- To investigate pupil diameter as a biomarker for autonomic dysfunction in enuresis.
Main Methods:
- Pupil diameter measurements were taken in 17 children with functional enuresis and 34 healthy controls.
- Measurements were conducted under both photopic (bright light) and mesopic (dim light) conditions using a pupillometer.
Main Results:
- Enuretic children exhibited significantly larger mean photopic pupil diameters compared to controls (4.47 mm vs. 4.03 mm, P = 0.03).
- This finding suggests a link between ocular autonomic function and functional enuresis.
Conclusions:
- Autonomic nervous system imbalance, specifically affecting the ocular system, may contribute to functional enuresis in children.
- Pupil diameter measurement could serve as a non-invasive tool to evaluate autonomic dysregulation in pediatric enuresis.
Abstract:
Functional enuresis is defined as repeated voiding of urine into bed or clothes in children after 5 years of age following the exclusion of major somatic diseases. Autonomic nervous system dysregulation has been proposed as a pathophysiologic mechanism in the etiopathogenesis. The objective of this study was to evaluate autonomic nervous system functions with pupil diameter measurement in enuretic children. The study group consisted of 17 children with functional enuresis (ten boys, seven girls), and the control group consisted of 34 healthy children (20 boys, 14 girls). Pupil diameter measurements were performed under photopic and mesopic lighting conditions by using a pupillometer. Mean photopic pupil diameter was found to be larger in the enuretic children than in the healthy controls (4.47 +/- 0.52 mm vs. 4.03 +/- 0.75 mm; P = 0.03). Autonomic nervous system imbalance of the ocular system is considered to be part of the autonomic nervous system dysregulation in functional enuretic children.
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