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Ocular Motor Control and Cognitive Function in Military Veterans With Chronic Mild Traumatic Brain Injury.

Jeffrey R Hebert¹, Brandie D Wagner, Christopher M Filley

¹Marcus Institute for Brain Health (JRH, CMF, KLC, DR, CHJ-B, AVM, PSS), University of Colorado School of Medicine, Aurora, Colorado; Department of Physical Medicine & Rehabilitation (JRH, CHJ-B), University of Colorado School of Medicine, Aurora, Colorado; Department of Biostatistics & Informatics (BDW), University of Colorado-Colorado School of Public Health, Aurora, Colorado; Department of Neurology (CMF), Behavioral Neurology Section, University of Colorado School of Medicine, Aurora, Colorado; Department of Family Medicine (KLC), University of Colorado School of Medicine, Aurora, Colorado; Department of Neurology (DR, AVM, PSS), University of Colorado School of Medicine, Aurora, Colorado; Department of Radiology (DR, RK), University of Colorado School of Medicine, Aurora, Colorado; Department of Ophthalmology (SMM, PSS), University of Colorado School of Medicine, Aurora, Colorado; Department of Neurosurgery (PSS), University of Colorado School of Medicine, Aurora, Colorado; and Division of Ophthalmology (Department of Surgery) (PSS), Uniformed Services University of the Health Sciences, Bethesda, Maryland.

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society

|January 21, 2026

Summary

Military Veterans with mild traumatic brain injury (mTBI) show persistent ocular motor control (OMC) and cognitive deficits years after injury. These issues, including impaired attention and eye movement control, are detectable in chronic mTBI patients.

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Area of Science:

Neuroscience
Traumatic Brain Injury Research
Ophthalmology

Background:

Mild traumatic brain injury (mTBI) frequently results in persistent ocular motor control (OMC) and cognitive dysfunction in Service Members.
These deficits can be subtle and only manifest under stress, complicating diagnosis long after the initial injury.
Limited understanding exists regarding the relationship between OMC and cognitive function in chronic mTBI.

Purpose of the Study:

To investigate the persistent relationship between ocular motor control (OMC) and cognitive dysfunction in Veterans with chronic mild traumatic brain injury (mTBI).
To identify clinical tools capable of detecting these co-occurring deficits in a chronic mTBI population.
To explore the potential OMC-cognition axis in the chronic stage of mTBI.

Main Methods:

A cross-sectional observational study comparing Military Veterans with chronic mTBI (n=38) to controls (n=40).
Utilized computerized King-Devick (K-D) test, eye-tracking for antisaccade tasks, Conners' Continuous Performance Test (CPT), and FAS verbal fluency test.
Assessed post-traumatic stress symptoms using the PTSD Checklist for DSM-5 (PCL-5).

Main Results:

Veterans with chronic mTBI exhibited significantly more errors and longer completion times on the K-D test compared to controls.
Increased antisaccade latencies and error rates were observed in the mTBI group across various paradigms.
The mTBI group also showed higher PCL-5 scores, worse FAS test performance, and more CPT errors, with correlations found between time since TBI and specific OMC errors.

Conclusions:

Ocular motor control (OMC) and cognitive performance deficits are persistent, co-occurring problems in Veterans with chronic mild traumatic brain injury (mTBI).
These deficits are detectable even 11 years after injury, suggesting an OMC-cognition axis in chronic mTBI.
Cognitive correlates of OMC tasks were identified, aiding clinical interpretation for chronic mTBI assessment.