Blink rate in childhood-onset schizophrenia: comparison with normal and attention-deficit hyperactivity disorder controls

Blink-sensing glasses: A flexible iontronic sensing wearable for continuous blink monitoring

Blink reflex has long been considered closely related to physiological states, from which abundant information on ocular health and activities can be revealed. In this study, a smart glasses wearable has been developed, incorporating a flexible and sensitive pressure sensor, to monitor blink patterns by continuously detecting ocular muscular movements, referred to as blink-sensing glasses. By applying the emerging flexible iontronic sensing (FITS) sensor with the sensitivity of 340 pF/mmHg, the skin pressure variations induced by movements of the orbicularis oculi muscles can be monitored in real time. The blink-sensing glasses can successfully capture blink patterns with a high accuracy of 96.3% and have been used to differentiate the blink features from both dry-eye subjects and healthy controls. This device can be potentially used as a new clinical and research monitoring tool for continuous eye blink analysis, while providing patients with high comfortableness in long-term ambulatory and home settings.

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Blink-sensing glasses can capture blink patterns with clinical-grade high accuracy

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A FITS sensor is applied to monitor the blink by detecting the muscle movement

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Blink-sensing glasses can be of potential use to prognose the dry eye

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The glasses are a continuous detection manner with immunity to ambient lights

Intraindividual and Interindividual Differences in Spontaneous Eye Blinking: Relationships to Working Memory Performance and Frontal EEG Asymmetry

The rate and timing of spontaneous eye blinking (SB) may be used to explore mechanisms of cognitive activity in infancy. In particular, SB rate is believed to reflect some dimensions of dopamine function; therefore, we hypothesized that SB rate would relate to working memory performance and to frontal electroencephalogram (EEG) asymmetry. Forty, 10-mo-old infants completed an A-not-B task while SB and EEG were measured throughout. We found that SB rate varied across phases of the task, variability in SB rate was positively related to working memory performance, and frontal EEG asymmetry was related to individual differences in the rate of SB. Results provide indirect, but convergent support for the hypothesis that SB rate reflects dopamine function early in human development. As such, these results have implications for understanding the tonic and phasic effects of dopamine on cognitive activity early in human development.

Blink rate and blink timing in children with ADHD and the influence of stimulant medication

Spontaneous eye blink rate is modulated by task demands and internal state, and is demonstrated to reflect central dopamine activity. Also, spontaneous eye blinks are strategically timed around salient stimuli. This study investigates whether children with attention deficit hyperactivity disorder (ADHD) show reduced blink rates, blink modulation and blink timing, and whether this is influenced by stimulant medication. The electrooculogram was measured in 18 typically developing children, 16 children with ADHD off methylphenidate (Mph), and 16 children with ADHD on Mph during a rest period and during performance of a 60-min visual selective attention task. Blink rate and timing was extracted from the electrooculogram. No evidence was found for aberrant blink rate or blink modulation in children with ADHD off Mph. All groups increased blink rates from rest to task, and no group differences were found in blink rate during rest and task, or in the modulation of blink rate from rest to task. Time-on task resulted in a similar increase in blink rates in all three groups. Stimulant medication appeared not to influence blink rate and blink modulation, except that in the ADHD off Mph group the blink rate was enhanced only under conditions with performance feedback. All groups inhibited blinks before stimulus presentation and strategically timed their blinks after the stimulus. Children with ADHD off Mph showed reduced blink inhibition before the stimulus; however, given the low incidence (<1 % of the trials) and long latency this is not likely to impair their visual intake.

An Overview of the Association between Schizotypy and Dopamine

Schizotypy refers to a constellation of personality traits that are believed to mirror the subclinical expression of schizophrenia in the general population. Evidence from pharmacological studies indicates that dopamine (DA) is involved in the etiology of schizophrenia. Based on the assumption of a continuum between schizophrenia and schizotypy, researchers have begun investigating the association between DA and schizotypy using a wide range of methods. In this article, we review published studies on this association from the following areas of work: (1) experimental investigations of the interactive effects of dopaminergic challenges and schizotypy on cognition, motor control, and behavior (2), dopaminergically supported cognitive functions (3), studies of associations between schizotypy and polymorphisms in genes involved in dopaminergic neurotransmission, and (4) molecular imaging studies of the association between schizotypy and markers of the DA system. Together, data from these lines of evidence suggest that DA is important to the expression and experience of schizotypy and associated behavioral biases. An important observation is that the experimental designs, methods, and manipulations used in this research are highly heterogeneous. Future studies are required to replicate individual observations, to enlighten the link between DA and different schizotypy dimensions (positive, negative, cognitive disorganization), and to guide the search for solid DA-sensitive behavioral markers. Such studies are important in order to clarify inconsistencies between studies. More work is also needed to identify differences between dopaminergic alterations in schizotypy compared to the dysfunctions observed in schizophrenia.

Sensitivity of the rate of spontaneous eye blinking to type of stimuli in young infants

Although progress has been made toward understanding the mechanisms of spontaneous eye blinking (SB), few reports focus on the ontogeny of SB. The purpose of the present work was to investigate SB in infants by attempting to manipulate SB and examine potential correlates of SB. Fifty-two infants were observed in a quiet baseline condition then presented with either moving stimuli or a social stimulus. SB, eye movement, body movement and various background variables were measured. Results demonstrate that SB can be manipulated and that SB rate is differentially sensitive to the type of stimulus presented. Eye and body movements did not systematically relate to the rate of SB. Implications for mechanisms of SB regulation are discussed.

Spontaneous Eye Blink Rates vary according to individual differences in generalized control perception

This study tested the hypothesis that individual differences in generalized control perception for 43 undergraduate adults may be reflected in Spontaneous Eye Blink Rates during conversation in an interview. Control perception was assessed by means of Rotter's internal-external Locus of Control questionnaires, while Spontaneous Eye Blink Rates were computed from filmed videos of interviews consisting of a series of questions which could presumably have triggered different mental states. Pearson correlations and linear regression analyses indicated that the individual differences in Spontaneous Eye Blink Rates did not differ significantly across different questions, but that Spontaneous Eye Blink Rates measured over the entire interview correlated positively and significantly with an internal Locus of Control (r = .26). This could be interpreted as modest but corroborative evidence that a personality trait reflecting control perception may have a biological component. The possible roles of dopamine neurotransmission and frontal cortex involvement in higher cognition and Locus of Control are discussed.

Blinking and schizotypal thinking

Spontaneous eye blink rate (SBR) is thought to be a biological marker for cerebral dopamine (DA) activity. Accordingly, positive psychotic symptoms have been found to be associated with an increased SBR and negative psychotic symptoms with a decreased SBR. However, modulations of the DA system in patient populations also result from prior neuroleptic treatment. Here, we tested the possible relationship between SBR and positive and negative schizotypal thought. To test the direct influence of DA on SBR in general and as a function of schizotypy, half of a sample of 40 healthy men received levodopa and the other half placebo in a double-blind procedure. SBR did not differ between substance groups suggesting that a pharmacologically induced DA increase in healthy individuals does not generally increase SBR. However, in the levodopa group, increasing SBR correlated with increasing negative schizotypy scores, while no relationship was found between SBR and (1) negative schizotypy in the placebo group, or (2) positive schizotypy in either substance group. We conjecture that a pre-existing hypodopaminergic state in high negative schizotypy scorers, made these individuals susceptible to an increased DA concentration, as it has been observed in Parkinson's disease. Furthermore, the absence of any relationship in the placebo group might suggest that variations in DA concentration as a function of schizotypy are too subtle to influence SBR. Finally, the lack of any association of SBR with positive schizotypy might indicate that SBR and positive schizotypy are mediated by functionally distinct neural circuits.

Blink rate in boys with fragile X syndrome: preliminary evidence for altered dopamine function

BACKGROUND

Dopamine, a neurotransmitter involved in motor and cognitive functioning, can be non-invasively measured via observation of spontaneous blink rates. Blink rates have been studied in a number of clinical conditions including schizophrenia, autism, Parkinsons, and attention deficit/hyperactivity disorder with results implicating either hyper or hypo dopaminergic states.

METHODS

This study examined spontaneous blink rate in boys with fragile X syndrome (FXS). Blink rates of boys (4-8 years old) with FXS (n = 6) were compared with those of age-matched typically developing boys (n = 6) during active and passive tasks. Blink rates (blinks per minute) for each task were compared between the two groups. Then, the relation between blink measures and core FXS-related features [problem behaviours, arousal, fmr 1 protein (FMRP)] were examined within the group of boys with FXS.

RESULTS

Blink rate in boys with FXS was significantly higher than typically developing boys during passive tasks. Within the FXS group, there were significant correlations between blink rate and problem behaviours and physiological arousal (i.e. heart activity) but not with FMRP.

CONCLUSIONS

Observed differences in spontaneous blink rate between boys with and without FXS and the relation between blink rate and physiological and behavioural measures in boys with FXS suggests that further work examining dopamine dysfunction as a factor in the pathophysiology of FXS may be warranted.

Spontaneous eye blinking in human infants: a review

Spontaneous eye blinking has been studied in clinical and neuropharmacological research in adult humans and nonhuman primates as a putative index of central dopamine system activity. One purpose of this review is to provide a general overview of the research on spontaneous eye blinking with an emphasis on the relationship between spontaneous eye blinking and central dopamine systems. We suggest that the body of research from human (adults, children, and infants) and nonhuman primates supports the continued empirical investigation of spontaneous eye blinking in human infants. A second purpose is to present approaches for empirical work to further investigate the development, correlates, and mechanisms of spontaneous eye blinking in human infants. The results of further investigation may reveal new insights into relationships between the central nervous system activity and behavior in early human development.

Systematic temporal variation in the rate of spontaneous eye blinking in human infants

The rate of spontaneous eye blinking, a putative index of central dopamine activity based on neuropharmacological and clinical research, has been linked to cognitive activity and behavioral state. Although many species have been studied, few researchers have examined spontaneous eye blinking in human infants. Human infants between 10 and 12 weeks of age were observed before, during, and after a feeding or during attention to visual stimuli. Infants blinked spontaneously several times per minute, and their blinking rate increased during feeding and after the appearance of new visual stimuli. These systematic changes in the rate of spontaneous blinking under controlled conditions suggest that spontaneous blinking rate may reflect reliable variation in central nervous system activity that underlies behavioral and cognitive responses to salient or novel stimuli.

Prestimulus modification of the startle reflex: relationship to personality and physiological markers of dopamine function

Prepulse inhibition (PPI), a measure of sensorimotor gating, is regulated by dopamine (DA) in rodents. We examined the relationship of PPI in humans to putative markers of brain DA function: (1) novelty seeking (NS; Cloninger's Tridimensional Personality Questionnaire (TPQ)), which is associated with specific DA receptor subtypes, and is reduced in Parkinson's Disease; (2) blink rate, which is increased in primates by DA agonists, and is reduced in Parkinson's Disease. PPI, TPQ and blink rate were measured in 79 normal adult males. A significant negative correlation was observed between resting blink rate and mean PPI, but not between NS and PPI. Blink rate correlated positively with resting EMG level, but this did not account for the relationship between blink rate and PPI. In normal male humans, PPI is inversely related to a physiological marker of resting DA tone (blink rate), but not to a putatively DA-linked personality trait (high NS).

Blink rate variability in patients with panic disorder: new trial using audiovisual stimulation

Several lines of evidence have implicated central dopaminergic pathways in the modulation of spontaneous blink rate (BR). Furthermore, previous studies have indicated a relationship between spontaneous BR and anxiety and/or depression. However, to our knowledge, there is no report on the examination of BR in a group of patients with panic disorder (PD). During the conditions of rest and with audiovisual stimulation, exposed to a video of imaginary experiences, such as driving a motor vehicle or diving into the sea, BR was examined in 11 male patients with PD and compared with the BR of 16 age-matched normal controls. The BR was significantly higher in PD patients relative to normal controls under both conditions. In particular, the PD group had a higher BR score during the sea scene as relaxation compared with the normal controls. In conclusion, although the sample size was small the present preliminary study, these findings suggest that BR may have potential for application in the assessment of anxiety state, which is consistent with previous studies.

Excessive blinking in childhood: a prospective evaluation of 99 children

OBJECTIVE

To determine the characteristics and causes of excess blinking in children and to determine outcomes after treatment.

DESIGN

Prospective, noncomparative, consecutive case series.

PARTICIPANTS

Ninety-nine consecutive children who presented for evaluation of excessive blinking over a 2 year period.

METHODS

Children less than 16 years of age who had excessive blinking as their sole or major chief complaint underwent detailed history and ophthalmologic examination. Treatment was recommended based on clinical examination findings. Follow-up evaluations were performed at least 2 months after initial examination.

MAIN OUTCOME MEASURES

Etiology of excess blinking and patient characteristics in each diagnostic group.

RESULTS

The majority (89%) of children presented with bilateral excessive blinking. Boys outnumbered girls at a ratio of almost 2:1. The most common etiologies were anterior segment and/or lid abnormalities (37%), habit tics (23%), uncorrected refractive errors (14%), intermittent exotropia (11%), and psycogenic blepharospasm (10%). A history of neurologic disease was present in 22% of the patients but was not causally related to the excessive blinking in most cases. Vision-threatening disease was noted in 6% and was easily detected on standard clinical examination. Life-threatening disease was the cause in 4% of the children, but the presence of life-threatening disease was already known in all such patients.

CONCLUSIONS

Excessive blinking in children can occur because of a large number of potential problems. Most cases are caused by benign and/or self-limiting conditions. The cause can usually be determined after careful history and clinical examination and routine neurologic evaluation and neuroimaging is unnecessary.

Childhood-onset schizophrenia/autistic disorder and t(1;7) reciprocal translocation: identification of a BAC contig spanning the translocation breakpoint at 7q21

Childhood-onset schizophrenia (COS) is defined by the development of first psychotic symptoms by age 12. While recruiting patients with COS refractory to conventional treatments for a trial of atypical antipsychotic drugs, we discovered a unique case who has a familial t(1;7)(p22;q21) reciprocal translocation and onset of psychosis at age 9. The patient also has symptoms of autistic disorder, which are usually transient before the first psychotic episode among 40-50% of the childhood schizophrenics but has persisted in him even after the remission of psychosis. Cosegregating with the translocation, among the carriers in the family available for the study, are other significant psychopathologies, including alcohol/drug abuse, severe impulsivity, and paranoid personality and language delay. This case may provide a model for understanding the genetic basis of schizophrenia or autism. Here we report the progress toward characterization of genomic organization across the translocation breakpoint at 7q21. The polymorphic markers, D7S630/D7S492 and D7S2410/D7S646, immediately flanking the breakpoint, may be useful for further confirming the genetic linkage for schizophrenia or autism in this region. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 96:749-753, 2000. Published 2000 Wiley-Liss, Inc.

Quantification and rejection of ocular artifacts in auditory evoked fields in schizophrenics

RESULTS

In a magnetoencephalographic investigation of the auditory evoked field (AEF) in 17 schizophrenics and 17 controls, 37% of the schizophrenics and 12% of the controls showed eye artifacts in every second trial or even more frequently. In the uncorrected average fields, the ratio between the power of artifacts and the power of the magnetoencephalogram (MEG) exceeded the value of 0.1 for 48% of the schizophrenics and for 29% of the controls. Ocular artifacts biased the locations of equivalent current dipoles of the M100 component towards deeper positions. A regression algorithm for the correction of ocular artifacts in raw data and an identification technique of ocular artifacts based on the topography of transmission coefficients is described.

CONCLUSIONS

A linear dependence of ocular artifacts in AEF on the electrooculogram (EOG) was confirmed. Possible errors introduced by the correction are discussed. Transmission coefficients should be calculated for several individual trials with the same type of artifact. Errors due to evoked potentials in the EOG were found to be comparable in amplitude to noise in the AEF. Examples of transmission coefficients from the EOG to the MEG are given.