Assessment Of Anti-saccades Within 24 To 48 Hours Post-concussion

Abstract

Over 30% of concussed athletes report visual issues after injury, with saccade (rapid eye movement) deficits being the most prominent oculomotor impairment. Anti-saccades are saccade deficits that are readily recorded and their neural substrates are well understood. Assessments of anti-saccades may provide a fast, accurate, and reliable way to screen for concussion. However, little research quantitatively explores anti-saccades post-concussion. PURPOSE: To investigate anti-saccades, involuntary reflexive gaze deviations from a fixed point or area of interest, between NCAA Division I athletes 24 to 48 hours post-concussion (PC) and healthy athletes (NC) during a dynamic postural task, the Nintendo Wii Fit Soccer Heading game (WFS). METHODS: 6 PC (2 female, 4 male; age: 19.8 ± 0.8 years) and 6 position and gender matched NC (2 female, 4 male; age: 18.5 ± 0.8 years) wore a monocular eye tracking device (240Hz) while performing 2 trials of the 60-second WFS. During play, participants were instructed to not deviate their gaze from the center fixed area of interest. Ocular raw point of gaze coordinates were tracked during play for specific areas of interest (left, right, and center) to determine gaze deviations away from the center fixed area of interest. RESULTS: One-way ANOVAs revealed significantly greater anti-saccades (p=0.031) in the PC group (15.2 ± 7.1) when compared to the NC group (5.4 ± 5.2), significantly greater anti-saccade duration (p=0.023) in the PC group (11.2 ± 8.8 sec) when compared to the NC group (1.2 ± 1.3 sec), and significantly greater average anti-saccade duration (p<0.001) in the PC group (0.671 ± 0.2 sec) when compared to the NC group (0.13 ± 0.04 sec). CONCLUSIONS: These results suggest a considerable oculomotor impairment, demonstrated by the amount and duration of anti-saccades within 24-48 hours post-concussion. These deficits may indicate that PC do not have sufficient gaze stability to adequately navigate through their environment immediately post-injury. These findings could be a novel objective marker for oculomotor impairment post-concussion. Further research needs to track these deficits longitudinally and compare oculomotor recovery with current neuropsychological and postural stability measures.