This review critically examines the contributions of pupillometry to memory research, primarily focusing on its enhancement of our understanding of memory encoding and retrieval mechanisms mainly investigated with the recognition memory paradigm. The evidence supports a close link between pupil response and memory formation, notably influenced by the type of novelty detected. This proposal reconciles inconsistencies in the literature regarding pupil response patterns that may predict successful memory formation, and highlights important implications for encoding mechanisms. The review also discusses the pupil old/new effect and its significance in the context of recollection and in reflecting brain signals related to familiarity or novelty detection. Additionally, the capacity of pupil response to serve as a true memory signal and to distinguish between true and false memories is evaluated. The evidence provides insights into the nature of false memories and offers a novel understanding of the cognitive mechanisms involved in memory distortions. When integrated with rigorous experimental design, pupillometry can significantly refine theoretical models of memory encoding and retrieval. Furthermore, combining pupillometry with neuroimaging and pharmacological interventions is identified as a promising direction for future research.

Eye movements have been extensively studied with respect to visual stimulation. However, we live in a multisensory world, and how the eyes are driven by other senses has been explored much less. Here, we review the evidence on how audition can trigger and drive different eye responses and which cortical and subcortical neural correlates are involved. We provide an overview on how different types of sounds, from simple tones and noise bursts to spatially localized sounds and complex linguistic stimuli, influence saccades, microsaccades, smooth pursuit, pupil dilation, and eye blinks. The reviewed evidence reveals how the auditory system interacts with the oculomotor system, both behaviorally and neurally, and how this differs from visually driven eye responses. Some evidence points to multisensory interaction, and potential multisensory integration, but the underlying computational and neural mechanisms are still unclear. While there are marked differences in how the eyes respond to auditory compared to visual stimuli, many aspects of auditory-evoked eye responses remain underexplored, and we summarize the key open questions for future research.

Training in healthcare skills can be affected by trainees\' workload when completing a task. Due to cognitive processing demands being negatively correlated to clinical performance, assessing mental workload through objective measures is crucial. This study aimed to investigate task-evoked changes in pupil size as reliable markers of mental workload and clinical performance. A sample of 49 nursing students participated in a cardiac arrest simulation-based practice. Measurements of cognitive demands (NASA-Task Load Index), physiological parameters (blood pressure, oxygen saturation, and heart rate), and pupil responses (minimum, maximum, and difference diameters) throughout revealed statistically significant differences according to performance scores. The analysis of a multiple regression model produced a statistically significant pattern between pupil diameter differences and heart rate, systolic blood pressure, workload, and performance (R2 = 0.280; F (6, 41) = 2.660; p < 0.028; d = 2.042). Findings suggest that pupil variations are promising markers to complement physiological metrics for predicting mental workload and clinical performance in medical practice.

Perception is modulated by reward value, an effect elicited not only by stimuli that are predictive of performance-contingent delivery of reward (PC) but also by stimuli that were previously rewarded (PR). PC and PR cues may engage different mechanisms relying on goal-driven versus stimulus-driven prioritization of high value stimuli, respectively. However, these two modes of reward modulation have not been systematically compared against each other. This study employed a behavioral paradigm where participants\' visual orientation discrimination was tested in the presence of task-irrelevant visual or auditory reward cues. In the first phase (PC), correct performance led to a high or low monetary reward dependent on the identity of visual or auditory cues. In the subsequent phase (PR), visual or auditory cues were not followed by reward delivery anymore. We hypothesized that PC cues have a stronger modulatory effect on visual discrimination and pupil responses compared to PR cues. We found an overall larger task-evoked pupil dilation in PC compared to PR phase. Whereas PC and PR cues both increased the accuracy of visual discrimination, value-driven acceleration of reaction times (RTs) and pupillary responses only occurred for PC cues. The modulation of pupil size by high reward PC cues was strongly correlated with the modulation of a combined measure of speed and accuracy. These results indicate that although value-driven modulation of perception can occur even when reward delivery is halted, stronger goal-driven control elicited by PC reward cues additionally results in a more efficient balance between accuracy and speed of perceptual choices.

Detection of novel stimuli that violate statistical regularities in the sensory scene is of paramount importance for the survival of biological organisms. Event-related potentials, phasic increases in pupil size, and evoked changes in oscillatory power have been proposed as markers of sensory novelty detection. However, how conscious access to novelty modulates these different brain responses is not well understood. Here, we studied the neural responses to sensory novelty in the auditory modality with and without conscious access. We identified individual thresholds for conscious auditory discrimination and presented to our participants sequences of tones, where the last stimulus could be another standard, a subthreshold target or a suprathreshold target. Participants were instructed to report whether the last tone of each sequence was the same or different from those preceding it. Results indicate that attentional orientation to behaviorally relevant stimuli and overt decision-making mechanisms, indexed by the P3 event-related response and reaction times, best predict whether a novel stimulus will be consciously accessed. Theta power and pupil size do not predict conscious access to novelty, but instead reflect information maintenance and unexpected sensory uncertainty. These results highlight the interplay between bottom-up and top-down mechanisms and how the brain weights neural responses to novelty and uncertainty during perception and goal-directed behavior.

OBJECTIVE: To assess the pupil response with a new handheld pupillometer in healthy subjects.
METHODS: Sixty-four eyes of 32 healthy subjects (mean age 21.2 years) were tested. After dark adaptation for 10 min, pupil responses to 1 s red and blue light stimuli at 100 cd/m2 were measured in the order from right to left eyes with a 1 min interval. The initial pupil size (D1, mm), minimum pupil size (D2, mm), and constriction rate (CR, %) were obtained. Intra-examiner reproducibility was examined using the coefficient of variation (CV, %) and the Bland-Altman plot. Inter-examiner consistency was examined using the interclass correlation coefficient (ICC) and the agreements with a conventional device, by Pearson\'s correlation coefficient (r).
RESULTS: The CV of all parameters have high reproducibility in the red (11.0-20.7%) and blue (5.5-12.1%) light stimuli. Bland-Altman plot analysis showed no bias with both light stimuli. \"Almost perfect\" and \"substantial\" correlations between the examiners were obtained in the red (ICC = 0.78-0.94) and blue (ICC = 0.71-0.89) light stimuli. \"Excellent\" and \"good\" correlations between the devices were obtained, except for the CR parameter in the red (D1: r = 0.90; p < 0.001, D2: 0.72; p < 0.001, and CR: 0.08; p = 0.631, respectively) and blue (D1: r = 0.87; p < 0.001, D2: 0.70; p < 0.001, and CR: 0.19; p = 0.274, respectively) light stimuli.
CONCLUSIONS: The novel pupillometer is useful for assessing pupil response. However, because of their different constructions, the CR values cannot be compared directly between the devices.

UNASSIGNED: The discovery of an accommodative response to ocular surface stimulation could inform clinicians and patients that optical effects may occur due to ocular discomfort and perhaps an assessment of the accommodative system after carrying out interventions impacting the ocular surface, may be warranted.
UNASSIGNED: There have been no previous reports evaluating the effect of noxious stimulation on accommodation. Here, the accommodative response of healthy participants after the application of noxious corneal stimulation is characterised.
UNASSIGNED: A computerised Belmonte pneumatic esthesiometer was used to determine detection thresholds (using ascending method of limits), and to randomly deliver mechanical and chemical stimuli from levels of detection threshold to twice the threshold in 50% steps, to the central cornea of 15 healthy subjects. For each suprathreshold stimulus, accommodative and pupil responses were measured with a validated eccentric infrared photorefractor. Quantitative differences in accommodative/pupil response, stimulus modality/intensity and left/right eye were analysed using repeated measures ANOVA. Tukey HSD tests were used for all post hoc analyses.
UNASSIGNED: Accommodation increased from baseline as the corneal apical stimulus intensity increased. This happened regardless of whether mechanical or chemical stimulation occurred (ANOVA, p < 0.05). At 200% threshold, accommodative response was greater than all stimulus intensities (Tukey HSD, all p < 0.05). There was no difference in pupil response between the stimulation intensities (100%, 150% and 200% threshold). There was no difference in accommodative response between the left and right eye for mechanical (ANOVA, p > 0.05) and chemical stimulation (ANOVA, p > 0.05).
UNASSIGNED: Noxious stimulation of the cornea seems to produce a dose-dependent increase in the accommodative response in the eyes but not a dose-dependent pupil response.

Novel and unexpected stimuli are often prioritised in memory, given their inherent salience. Nevertheless, not all forms of novelty show such an enhancement effect. Here, we discuss the role expectation plays in modulating the way novelty affects memory processes, circuits, and subsequent performance. We first review independent effects of expectation on memory, and then consider how different types of novelty are characterised by expectation. We argue that different types of novelty defined by expectation implicate differential neurotransmission in memory formation brain regions and may also result in the creation of different types of memory. Contextual novelty, which is unexpected by definition, is often associated with better recollection, supported by dopaminergic-hippocampal interactions. On the other hand, expected stimulus novelty is supported by engagement of medial temporal cortices, as well as the hippocampus, through cholinergic modulation. Furthermore, when expected stimulus novelty results in enhanced memory, it is predominantly driven by familiarity. The literature reviewed here highlights the complexity of novelty-sensitive memory systems, the distinction between types of novelty, and how they are differentially affected by expectancy.

The purpose of this study was to determine whether postural control would differ under various gaze tasks while standing in a wide or narrow stance between healthy young and old people, and also investigate whether postural sway and cognitive workload are affected by dual-task balance. Ten young and 10 healthy old people participated in this study. Each participant stood upright under four gaze conditions (fixation, saccade, pursuit, vestibular-ocular reflex) and two stance conditions (wide and narrow stance) in a total of 16 trials. Postural sway was measured by the mean sway amplitude of the center of pressure in the medial-lateral and anteriorposterior directions. Cognitive workload was measured through pupil response as an index of cognitive activity (ICA) by using Eye tracking system and Eyeworks. The results showed that postural sway significantly reduced when performing saccadic eye movement in both groups but greater postural sway was evoked in vestibular-ocular reflex condition. In addition, although old people had a significant increase in ICA compared to the young, there were no significant differences among all the gaze conditions in old people. These results confirmed that saccadic eye movements are the most beneficial for reducing postural sway regardless of aging and also provide some insight that pupil response represents an indicator of cognitive workload during dual-task balance context. These findings suggest that eye movement exercises may be considered as an effective intervention to improve postural control so a fall prevention program applying eye movement should be extended to individuals who are at risk of falling.

Recently we showed that higher reward results in increased pupil dilation during listening (listening effort). Remarkably, this effect was not accompanied with improved speech reception. Still, increased listening effort may reflect more in-depth processing, potentially resulting in a better memory representation of speech. Here, we investigated this hypothesis by also testing the effect of monetary reward on recognition memory performance. Twenty-four young adults performed speech reception threshold (SRT) tests, either hard or easy, in which they repeated sentences uttered by a female talker masked by a male talker. We recorded the pupil dilation response during listening. Participants could earn a high or low reward and the four conditions were presented in a blocked fashion. After each SRT block, participants performed a visual sentence recognition task. In this task, the sentences that were presented in the preceding SRT task were visually presented in random order and intermixed with unfamiliar sentences. Participants had to indicate whether they had previously heard the sentence or not. The SRT and sentence recognition were affected by task difficulty but not by reward. Contrary to our previous results, peak pupil dilation did not reflect effects of reward. However, post-hoc time course analysis (GAMMs) revealed that in the hard SRT task, the pupil response was larger for high than low reward. We did not observe an effect of reward on visual sentence recognition. Hence, the current results provide no conclusive evidence that the effect of monetary reward on the pupil response relates to the memory encoding of speech.