However, the pupil dilator muscle, which is innervated by the sympathetic nervous system and is generally considered as a major regulator of pupil dilation, is not involved in rapid pupil dilation, but was involved in long-lasting pupil dilation. NEW & NOTEWORTHY By pharmacologically manipulating the pupil dilator and constrictor muscles of human eye separately, we found that the pupil constrictor muscle is a primary controller of rapid pupil dilation upon brain arousal. However, the iris dilator muscle receives signals from the neuromodulator system with a slow latency and is involved in maintaining sustained pupil dilation. These results suggest that the iris sphincter muscle, which is under the control of the parasympathetic pathway, is quickly modulated by the neuromodulator system and plays a major role in rapid pupil dilation. In contrast, when the iris dilator muscle was continuously stimulated with phenylephrine, the latency and magnitude of rapid pupil dilation did not differ from the untreated control eye, but sustained pupil dilation was reduced until the end of movement. When the iris sphincter muscle was blocked with tropicamide, the latency of pupil dilation was delayed and the magnitude of pupil dilation was reduced during movement. The present study compared temporal patterns of pupil dilation during movement when each muscle was pharmacologically manipulated in the human eye. However, it remains unclear how the neuromodulator systems control the activity of the iris sphincter (constrictor) and dilator muscles to change the pupil size. doi: 10.1021/ diameter fluctuates in association with changes in brain states induced by the neuromodulator systems. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. Potential neurological symptoms of COVID-19. Wang HY, Li XL, Yan ZR, Sun XP, Han J, Zhang BW. Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19. Ni W, Yang X, Yang D, Bao J, Li R, Xiao Y, Hou C, Wang H, Liu J, Yang D, Xu Y, Cao Z, Gao Z. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin W, Li H, Liu M, Xiao Y, Gao H, Li Guo, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and corona virus disease-2019 (COVID-19): the epidemic and the challenges. Lai C-C, Shih T-P, Ko W-C, Tang H-J, Hsueh P-R. The Author(s), under exclusive licence to Springer Nature B.V. Pupil responses were found significantly different in COVID-19 cases when compared with the measurements taken three months later. The average dilation speed measurements at every second measured were lower in during COVID-19 infection than the 3rd months later (p = 0.001 p < 0.01 for each). The mean pupil diameter was significantly lower during COVID-19 infection at the 1st, 2nd, 4th, 6th, 8th and 10th seconds (p < 0.01, for each). No statistically significant difference was found in the mean photopic pupil diameter and the mean pupil diameter at 0 s between measurements (p > 0.05, p = 0.734 respectively). The mean scotopic and mesopic pupil diameter value of during COVID-19 infection was found lower than the 3rd month post-infection. Pupil responses measured during COVID-19 infection and 3 months later were compared. The average dilation speed was calculated at the 1st, 2nd, 4th, 6th, 8th, and 10th seconds. Pupil diameters were noted at the 0, 1st, 2nd, 4th, 6th, 8th, and 10th seconds in reflex pupil dilation after the termination of a light. The scotopic, mesopic and photopic diameters were noted. This study included 58 COVID-19 cases (mean age 47.23 ± 1.1 years). To compare pupillary responses in patients with Coronavirus disease-2019 (COVID-19) during active infection and at 3rd months post-infection.
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