Parasympathetic nervous system dysfunction, as identified by pupil light reflex, and its possible connection to hearing impairment

Context Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown. Objectives To 1) review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2) review the evidence relating hearing impairment and parasympathetic activity and 3) seek evidence of possible connections between hearing impairment and the pupil light reflex. Methods Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment. Results Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment. Discussion and Conclusions As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing impairment, hence further research is needed. The pupil light reflex could be a candidate measurement tool to achieve this goal

Toward a taxonomic model of attention in effortful listening

In recent years, there has been increasing interest in studying listening effort. Research on listening effort intersects with the development of active theories of speech perception and contributes to the broader endeavor of understanding speech perception within the context of neuroscientific theories of perception, attention, and effort. Due to the multidisciplinary nature of the problem, researchers vary widely in their precise conceptualization of the catch-all term listening effort. Very recent consensus work stresses the relationship between listening effort and the allocation of cognitive resources, providing a conceptual link to current cognitive neuropsychological theories associating effort with the allocation of selective attention. By linking listening effort to attentional effort, we enable the application of a taxonomy of external and internal attention to the characterization of effortful listening. More specifically, we use a vectorial model to decompose the demand causing listening effort into its mutually orthogonal external and internal components and map the relationship between demanded and exerted effort by means of a resource-limiting term that can represent the influence of motivation as well as vigilance and arousal. Due to its quantitative nature and easy graphical interpretation, this model can be applied to a broad range of problems dealing with listening effort. As such, we conclude that the model provides a good starting point for further research on effortful listening within a more differentiated neuropsychological framework