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Keywords = pupillary hippus

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21 pages, 402 KB  
Review
Pupillary Hippus as a Biomarker: Spectral Signatures and Complexity Approaches in Autonomic and Clinical Contexts
by Vincenzo Rizzuto, Marco Laurino, Roberto Montanari, Angelo Gemignani, Michele Figus, Giuseppe Covello, Niccolò Candelise, Davide Borroni, Guna Laganovska and Luca Mesin
Bioengineering 2025, 12(12), 1376; https://doi.org/10.3390/bioengineering12121376 - 18 Dec 2025
Cited by 1 | Viewed by 1589
Abstract
Pupillary hippus, i.e., the spontaneous bilateral oscillation of pupil diameter under constant illumination, provides a non-invasive window into autonomic and central nervous system dynamics. Despite decades of research, a unified framework linking its spectral features, physiological underpinnings, and analytical complexity is still missing. [...] Read more.
Pupillary hippus, i.e., the spontaneous bilateral oscillation of pupil diameter under constant illumination, provides a non-invasive window into autonomic and central nervous system dynamics. Despite decades of research, a unified framework linking its spectral features, physiological underpinnings, and analytical complexity is still missing. In this narrative review, we synthesize spectral and nonlinear pupillometry studies to propose a paradigm-aware taxonomy of hippus frequency bands that integrates evidence from autonomic tests and cognitive-arousal paradigms. Across the literature, low-frequency components tend to covary with respiratory/vasomotor autonomic rhythms, while higher-frequency fluctuations and complexity indices are more sensitive to cognitive load, visual fatigue, and pathological states but remain methodologically heterogeneous. Finally, we explore contexts in which hippus-based biomarkers show clinical potential, with a main focus on glaucoma as an emerging translational model, while underscoring the methodological and translational gaps that currently hinder their validation and routine clinical adoption. Physiology, spectral metrics, and complexity-based analyses are integrated to lay the foundations of a coherent framework. Full article
(This article belongs to the Section Biosignal Processing)
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7 pages, 457 KB  
Article
“The Pupillary (Hippus) Nystagmus”: A Possible Clinical Hallmark to Support the Diagnosis of Vestibular Migraine
by Mauro Gufoni and Augusto Pietro Casani
J. Clin. Med. 2023, 12(5), 1957; https://doi.org/10.3390/jcm12051957 - 1 Mar 2023
Cited by 9 | Viewed by 5150
Abstract
(1) Background: Hippus (which in this paper will be called “Pupillary nystagmus”) is a well-known phenomenon which has never been related to any specific pathology, so much so that it can be considered physiological even in the normal subject, and is characterized by [...] Read more.
(1) Background: Hippus (which in this paper will be called “Pupillary nystagmus”) is a well-known phenomenon which has never been related to any specific pathology, so much so that it can be considered physiological even in the normal subject, and is characterized by cycles of dilation and narrowing of the pupil under constant lighting conditions. The aim of this study is to verify the presence of pupillary nystagmus in a series of patients suffering from vestibular migraine. (2) Methods: 30 patients with dizziness suffering from vestibular migraine (VM), diagnosed according to the international criteria, were evaluated for the presence of pupillary nystagmus and compared with the results obtained in a group of 50 patients complaining of dizziness that was not migraine-related. (3) Results: Among the 30 VM patients, only two cases were found to be negative for pupillary nystagmus. Among the 50 non-migraineurs dizzy patients, three had pupillary nystagmus, while the remaining 47 did not. This resulted in a test sensitivity of 0.93% and a specificity of 0.94%. (4) Conclusion: we propose the consideration of the presence of pupillary nystagmus as an objective sign (present in the inter-critical phase) to be associated with the international diagnostic criteria for the diagnosis of vestibular migraine. Full article
(This article belongs to the Special Issue Recent Advances in Diagnosis and Treatment of Vestibular Disorders)
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