{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:52:37Z","timestamp":1791453157211,"version":"4.3.3"},"reference-count":69,"publisher":"American Spinal Injury Association","issue":"4","funder":[{"name":"Canadian Institutes for Health Research","award":["PJT-15603"],"award-info":[{"award-number":["PJT-15603"]}]},{"name":"Canada Foundation for Innovation and BC Knowledge Development Fund","award":["35869"],"award-info":[{"award-number":["35869"]}],"id":[{"id":"https:\/\/ror.org\/000az4664","id-type":"ROR","asserted-by":"crossref"}]},{"name":"International Spinal Research Trust","award":["GR019728"],"award-info":[{"award-number":["GR019728"]}],"id":[{"id":"https:\/\/ror.org\/042szwr56","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Rick Hansen Foundation","award":["35869 IOF"],"award-info":[{"award-number":["35869 IOF"]}],"id":[{"id":"https:\/\/ror.org\/05hd8nc86","id-type":"ROR","asserted-by":"crossref"}]},{"name":"PRAXIS Spinal Cord Institute","award":["G2021-30"],"award-info":[{"award-number":["G2021-30"]}],"id":[{"id":"https:\/\/ror.org\/03p2f7q52","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Wings for Life Research Foundation","award":["WFL-CA-20\/21"],"award-info":[{"award-number":["WFL-CA-20\/21"]}],"id":[{"id":"https:\/\/ror.org\/043zam433","id-type":"ROR","asserted-by":"crossref"}]},{"name":"US Department of Defense","award":["W81XWH-22-1-0929"],"award-info":[{"award-number":["W81XWH-22-1-0929"]}],"id":[{"id":"https:\/\/ror.org\/0447fe631","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Paralyzed Veterans of America","award":["3196"],"award-info":[{"award-number":["3196"]}],"id":[{"id":"https:\/\/ror.org\/00pfg3v73","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Rick Hansen Foundation","award":["2007-21"],"award-info":[{"award-number":["2007-21"]}],"id":[{"id":"https:\/\/ror.org\/05hd8nc86","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Michael Smith Health Research BC","award":["CANTAP-2023-03855"],"award-info":[{"award-number":["CANTAP-2023-03855"]}],"id":[{"id":"https:\/\/ror.org\/020x39229","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Michael Smith Health Research BC","award":["CTTP-2024-04574"],"award-info":[{"award-number":["CTTP-2024-04574"]}],"id":[{"id":"https:\/\/ror.org\/020x39229","id-type":"ROR","asserted-by":"crossref"}]},{"name":"The Canadian Training Platform for Trials Leveraging Existing Networks","award":["CANTAP-2023-03855"],"award-info":[{"award-number":["CANTAP-2023-03855"]}]},{"name":"the CANadian Consortium of Clinical Trial TRAINing platform","award":["CTTP-2024-04574"],"award-info":[{"award-number":["CTTP-2024-04574"]}]},{"name":"Michael Smith Foundation for Health Research","award":["RT-2022-2752"],"award-info":[{"award-number":["RT-2022-2752"]}],"id":[{"id":"https:\/\/ror.org\/020x39229","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The autonomic neural circuitry of the pupil makes it a unique target for identifying impaired autonomic regulation following spinal cord injury (SCI). This systematic review characterizes the evidence on pupillary changes after SCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic search was conducted in MEDLINE, Embase, and CINAHL. Articles were independently assessed by 2 reviewers and included studies reporting on pupillary changes (e.g., miosis, mydriasis, anisocoria) following traumatic or nontraumatic SCI at any level. Data on study design, patient demographics, injury characteristics, and pupillary changes were extracted. We used the Joanna Briggs Institute Critical Appraisal checklists for quality assessments and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We identified 486 studies, of which 37 articles (36 case reports and 1 cross-sectional study) were included and primarily of medium quality. All studies reported anisocoria, with 81% involving unilateral miosis, 16% involving unilateral mydriasis, and 3% unspecified. Pupillary dysfunction predominantly occurred in people with cervical or high thoracic SCI acutely (&lt;20 days after injury) or in the intermediate-to-chronic phase of SCI (&gt;4 months post injury).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Most studies identified in this review were case reports describing pupil abnormalities likely related to trauma of autonomic pathways\u2014either central or peripheral\u2014resulting from SCI or associated injuries (e.g., brain injury) during the acute phase. In the intermediate-to-chronic phase, autonomic dysreflexia was often reported alongside pupil changes. Larger cohorts and quantitative pupil detection technologies are needed to validate the utility of pupil data in SCI research and clinical care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.46292\/sci25-00140","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T09:23:16Z","timestamp":1791451396000},"page":"123-136","source":"Crossref","is-referenced-by-count":0,"title":["Can Pupil Changes Detect Autonomic Dysregulation After Spinal Cord Injury? A Systematic Review"],"prefix":"10.46292","volume":"32","author":[{"given":"Raza N.","family":"Malik","sequence":"first","affiliation":[{"name":"International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"},{"name":"Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Hosseinzadeh","sequence":"additional","affiliation":[{"name":"International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"},{"name":"Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulcenur","family":"Ozturan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janan","family":"Niknam","sequence":"additional","affiliation":[{"name":"International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana K.","family":"Wolak","sequence":"additional","affiliation":[{"name":"International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"},{"name":"Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiev","family":"Miller","sequence":"additional","affiliation":[{"name":"International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"},{"name":"Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Tansey","sequence":"additional","affiliation":[{"name":"Restorative Neuroscience Consulting, New Orleans, Louisiana, USA"},{"name":"United States Department of Veterans Affairs, G.V. (Sonny) Montgomery VA Medical Center, Jackson, Mississippi, USA"},{"name":"Department of Neurosurgery, University of Mississippi Medical Center, Jackson, Mississippi, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Krassioukov","sequence":"additional","affiliation":[{"name":"International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"},{"name":"Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada"},{"name":"G. F. Strong Rehabilitation Centre, Vancouver Coastal Heath, Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"issue":"1","key":"b1","series-title":"Nat Rev Dis Primers","first-page":"1","article-title":"Traumatic spinal cord injury","volume":"3","author":"Ahuja CS","year":"2017","unstructured":"Ahuja CS, Wilson JR, Nori S, et al. 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Spinal Cord. 1999;37(6):383\u2013391. doi: 10.1038\/sj.sc.3100867."},{"key":"b4","series-title":"Comprehensive Physiology","first-page":"439","article-title":"Autonomic control of the eye","author":"McDougal DH","year":"2014","unstructured":"McDougal DH, Gamlin PD. Autonomic control of the eye. In: Comprehensive Physiology. John Wiley & Sons, Ltd; 2014:439\u2013473. doi: 10.1002\/cphy.c140014."},{"key":"b5","series-title":"Front Cell Neurosci","first-page":"17","article-title":"Consequences of spinal cord injury on the sympathetic nervous system","author":"Wulf MJ","year":"2023","unstructured":"Wulf MJ, Tom VJ. Consequences of spinal cord injury on the sympathetic nervous system. Front Cell Neurosci. 2023;17. doi: 10.3389\/fncel.2023.999253."},{"issue":"2","key":"b6","series-title":"J Neurol","first-page":"139","article-title":"Dislocation of the cervical spine with Horner's syndrome and a lesion of the spinal trigeminal tract","volume":"217","author":"Itzchaki M","year":"1977","unstructured":"Itzchaki M, Herishanu Y. Dislocation of the cervical spine with Horner's syndrome and a lesion of the spinal trigeminal tract. J Neurol. 1977;217(2):139\u2013143. doi: 10.1007\/BF00312927."},{"issue":"5","key":"b7","series-title":"Eur J Orthop Surg Traumatol","first-page":"471","article-title":"A child with C3 anterior dislocation-fracture accompanying Horner's syndrome","volume":"17","author":"Watanabe H","year":"2007","unstructured":"Watanabe H, Kikkawa I, Nakama S, Hoshino Y. A child with C3 anterior dislocation-fracture accompanying Horner's syndrome. 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