{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T20:54:23Z","timestamp":1773694463711,"version":"3.50.1"},"reference-count":43,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The autonomic nervous system plays a crucial role in the maintenance of homeostasis. Neurogenic inflammation due to decreased stability of tear film may induce changes in autonomic nerve activity, which could be associated with symptom expression.This study aimed to measure biological parameters that represent autonomic nerve activity in dry eye (DE)s caused by tear film dysfunction and investigate their relationship with symptom intensity. This prospective, cross-sectional, comparative study evaluated 34 eyes of 34 participants (mean age: 52.5 \u00b1 13.4 years; range: 20\u201381 years) without keratoconjunctival damage. Nineteen eyes in the DE group showed DE symptoms and tear break-up time (TBUT) of \u22645 seconds (short TBUT DE); the 15 eyes in the non-DE group showed no DE symptoms. Autonomic nerve activity was measured for 10 minutes\u2014starting and ending 5 minutes before and after instilling ophthalmic solution\u2014and evaluated using the low-frequency component (LF) to the high-frequency component (HF) ratio of heart rate variability (autonomic balance). The pre-ophthalmic solution administration LF\/HF ratio was not significantly different (<jats:italic>P<\/jats:italic> = 0.59) between the two groups, however, the standard deviation of the LF\/HF ratio (LF\/HF-SD) tended to be higher in the DE group than that in the non-DE group (<jats:italic>P<\/jats:italic> = 0.086). The DE symptom intensity was significantly related to LF\/HF-SD (<jats:italic>P<\/jats:italic> = 0.005), which significantly decreased after ophthalmic solution administration in the DE group (<jats:italic>P<\/jats:italic> = 0.04). The large fluctuations in autonomic balance may be key for the understanding of the mechanism underlying DE symptoms.<\/jats:p>","DOI":"10.1371\/journal.pone.0276945","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T18:24:51Z","timestamp":1668623091000},"page":"e0276945","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Variability of autonomic nerve activity in dry eye with decreased tear stability"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5604-5847","authenticated-orcid":true,"given":"Minako","family":"Kaido","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reiko","family":"Arita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5575-8589","authenticated-orcid":true,"given":"Yasue","family":"Mitsukura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reiko","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8874-7111","authenticated-orcid":true,"given":"Kazuo","family":"Tsubota","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,11,16]]},"reference":[{"issue":"8","key":"pone.0276945.ref001","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1097\/01.ico.0000133997.07144.9e","article-title":"The lack of association between signs and symptoms in patients with dry eye disease","volume":"23","author":"KK Nichols","year":"2004","journal-title":"Cornea"},{"key":"pone.0276945.ref002","doi-asserted-by":"crossref","first-page":"e005296","DOI":"10.1136\/bmjopen-2014-005296","article-title":"Discrepancy between subjectively reported symptoms and objectively measured clinical findings in dry eye: a population based analysis","volume":"4","author":"R Hua","year":"2014","journal-title":"BMJ Open"},{"issue":"5","key":"pone.0276945.ref003","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1097\/ICO.0b013e318225415a","article-title":"Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study","volume":"31","author":"MA Lemp","year":"2012","journal-title":"Cornea"},{"issue":"2","key":"pone.0276945.ref004","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1016\/j.clae.2018.10.005","article-title":"Clinical subtypes of dry eye in youthful clinical sample in Ghana","volume":"42","author":"K Asiedu","year":"2019","journal-title":"Cont Lens Anterior Eye"},{"issue":"1","key":"pone.0276945.ref005","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jtos.2016.09.003","article-title":"New perspectives on dry eye definition and diagnosis: a consensus report by the Asia Dry Eye Society","volume":"15","author":"K Tsubota","year":"2017","journal-title":"Ocul Surf"},{"issue":"4","key":"pone.0276945.ref006","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/j.ajo.2014.12.019","article-title":"Importance of tear film instability in dry eye disease in office workers using visual display terminals: the Osaka study","volume":"159","author":"N Yokoi","year":"2015","journal-title":"Am J Ophthalmol"},{"issue":"2","key":"pone.0276945.ref007","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/S0161-6420(95)31024-X","article-title":"Dry eye with only decreased tear break-up time is sometimes associated with allergic conjunctivitis","volume":"102","author":"I Toda","year":"1995","journal-title":"Ophthalmology"},{"issue":"14","key":"pone.0276945.ref008","doi-asserted-by":"crossref","first-page":"DES64","DOI":"10.1167\/iovs.17-23746","article-title":"Short tear film breakup time-type dry eye","volume":"59","author":"K. 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