title: Procedural learning impairments identified via predictive saccades in chronic traumatic brain injury.
abstract: OBJECTIVE
  To characterize integrity of fronto-striatal circuitry in chronic traumatic brain injury (TBI).
  
  
  BACKGROUND
  Due to both direct and indirect effects, TBI is hypothesized to affect frontal and striatal function. On the basis of elegant animal, lesion, and neuroimaging literatures, oculomotor testing can provide a useful tool for in vivo assessments of neurophysiologic function. The predictive saccade paradigm in oculomotor function is well established to provide assessment of this fronto-striatal circuit.
  
  
  METHODS
  Sixty patients with a history of chronic TBI completed 2 specific tests of oculomotor function, including a test of reflexive visually guided saccades to assess basic oculomotor function and a predictive saccade test to assess procedural learning.
  
  
  RESULTS
  TBI (mild and moderate/severe) was associated with a decrease in rates of procedural learning, with degree of impairment increasing with injury severity. This was observed as a decrease in the proportion of anticipatory saccades (primary measure of learning).
  
  
  CONCLUSIONS
  This abnormal oculomotor performance supports the hypothesis that TBI results in chronic impairment of frontal-striatal functions proportionally to injury severity and demonstrate that oculomotor testing is sensitive to all severities of closed-head injury.
authors.affiliation: Center for Cognitive Medicine and Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL 60612, USA. mkraus@psych.uic.edu
authors.forename: Marilyn F
authors.initials: MF
authors.lastname: Kraus
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Little
authors.forename: Sydney M
authors.initials: SM
authors.lastname: Wojtowicz
authors.forename: John A
authors.initials: JA
authors.lastname: Sweeney
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000523:psychology*; D020208:Brain Injury, Chronic / Q000150:complications / Q000523:psychology*; D005133:Eye Movements / Q000502:physiology; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology; D006801:Humans; D007859:Learning Disabilities / Q000209:etiology / Q000523:psychology*; D008297:Male; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology; D012438:Saccades / Q000502:physiology*; D012907:Smoking / Q000523:psychology; D012959:Socioeconomic Factors