Antisaccades and remembered saccades in mild traumatic brain injury

The most common site of focal lesions after mild traumatic brain injury (MTBI) is the frontal lobe. This lobe, however, is difficult to examine clinically. Neuroimaging is not performed routinely and usually shows normal results in uncomplicated trauma. Antisaccades (AS) and remembered saccades (RS) are neuro-ophthalmological tests of frontal function. This study examined whether there are disturbances of latency time or error rate of AS and RS in patients within 24 h after MTBI. Eye movements were studied with infrared-oculography. Data were obtained prospectively from 25 patients. An additional group of 6 patients with MTBI and alcohol intoxication were also examined. No statistical differences in AS or RS, either for errors or for latency time, were found between a group of age-matched controls and the patients, except in the group of alcohol-intoxicated MTBI patients. Our findings indicate that visual reflex inhibition and initiation of voluntary saccades were not disturbed in the nonintoxicated patients. It is hypothesized that the responsible frontal area was not affected. It is concluded that error rate and latency time of AS and RS are inappropriate measures for evaluating acute MTBI. Received: 27 July 1998/Received in revised form: 8 February 1999/Accepted: 6 September 1999