瞳孔测量辅助孤独症儿童筛查诊断的方法原理及机制
Methodological principles and mechanisms of pupillometry-assisted screening and diagnosis in children with autism
骆红 1祁亚培 2谢超香1
作者信息
- 1. 广西师范大学教育学部心理系;广西认知科学与心理健康实验室
- 2. 江西师范大学教育学院
- 折叠
摘要
孤独症谱系障碍（ASD）是一种常见的神经发育障碍性疾病, 早期诊断对其干预及预后至关重要。瞳孔测量作为一种评估无意识神经反应的技术, 可在行为特征显现前评估儿童异常的神经反应。孤独症儿童存在非典型的瞳孔反应模式：在瞳孔光反射任务中, 其收缩潜伏期较长、相对收缩幅度较小; 在复杂视觉刺激任务中, 其对社会性刺激的瞳孔扩张较小, 对非社会性刺激的瞳孔扩张较大或与典型发育儿童无差异; 在注意定向任务中, 其瞳孔扩张较大。以上结果提示孤独症儿童存在副交感神经调控功能较弱, 蓝斑-去甲肾上腺素系统的紧张性-相位性动态耦合失调等问题。瞳孔参数不仅能有效区分已确诊的孤独症儿童与典型发育儿童, 且部分参数还与孤独症的核心症状存在关联; 婴幼儿时期采集的瞳孔参数对后续确诊时的症状严重程度也具有预测价值。未来研究应重点开展高风险婴幼儿群体的纵向追踪, 建立标准化的多模态评估体系, 以明确瞳孔测量在孤独症行为症状显现前的早期预测功能, 并推动其向临床辅助筛查工具转化。
Abstract
Autism spectrum disorder (ASD) is a prevalent neurodevelopmental disorder, and early diagnosis is critical for intervention and prognosis. Pupillometry is an objective, non-invasive, and rapid technique that can detect atypical neural responses in children before behavioral symptoms emerge. Evidence indicates that children with ASD exhibit atypical pupillary response patterns. In the pupillary light reflex, they show prolonged contraction latency and reduced relative contraction amplitude, suggesting weakened parasympathetic regulation. In complex visual stimulation tasks, they show reduced pupil dilation in response to social stimuli, whereas their responses to non-social stimuli are either enhanced or comparable to those of typically developing children. In attentional orienting tasks, they show exaggerated pupil dilation, suggesting impaired dynamic coupling between the tonic and phasic components of the locus coeruleus-norepinephrine system. Pupillary parameters not only distinguish children with ASD from typically developing children but are also associated with core symptom domains of ASD. Importantly, pupillary measures collected during infancy and early childhood predict later symptom severity at the time of diagnosis. Future research should prioritize longitudinal follow-up of high-risk infant and toddler cohorts and the establishment of standardized multimodal assessment frameworks, with the aim of clarifying the early predictive utility of pupillometry before the emergence of behavioral symptoms and facilitating its translation into clinical screening tools.关键词
孤独症谱系障碍/瞳孔测量/筛查诊断/早期预测/自主神经系统Key words
children with autism spectrum disorder/pupillometry/screening and diagnosis/early prediction/autonomic nervous system引用本文复制引用
骆红,祁亚培,谢超香.瞳孔测量辅助孤独症儿童筛查诊断的方法原理及机制[EB/OL].(2026-08-18)[2026-08-24].https://chinaxiv.org/abs/202608.00012.学科分类
神经病学、精神病学
