Atypical Pupillary Light Reflex and Heart Rate Variability in Children with Autism Spectrum Disorder

We investigated pupillary light reflex (PLR) in 152 children with ASD, 116 typically developing (TD) children, and 36 children with non-ASD neurodevelopmental disorders (NDDs). Heart rate variability (HRV) was measured simultaneously to study potential impairments in the autonomic nervous system (ANS) associated with ASD. The results showed that the ASD group had significantly longer PLR latency, reduced relative constriction amplitude, and shorter constriction/redilation time than those of the TD group. Similar atypical PLR parameters were observed in the NDD group. A significant age effect on PLR latency was observed in children younger than 9 years in the TD group, but not in the ASD and NDD groups. Atypical HRV parameters were observed in the ASD and NDD groups. A significant negative correlation existed between the PLR constriction amplitude and average heart rate in children with an ASD, but not in children with typical development.