Reliability of smooth pursuit, fixation, and saccadic eye movements

The Standardized Field Sobriety Tests: a review of scientific and legal issues

This article details the history and development of the National Highway and Safety Administration's Standardized Field Sobriety Tests. They are reviewed in terms of relevant scientific, psychometric, and legal issues. It is concluded that the research that supports their use is limited, important confounding variables have not been thoroughly studied, reliability is mediocre, and that their developers and prosecution-oriented publications have oversold the tests. Further, case law since their development has severed the tests from their validation data, so that they are not admissible on the criterion for which they were validated (blood alcohol concentration), and admissible for a criterion for which they were not (mental, physical, or driving impairment). Directions for further research are presented.

Non-cholinergic modulation of antisaccade performance: a modafinil-nicotine comparison

INTRODUCTION

The antisaccade task provides a powerful tool with which to investigate the cognitive and neural systems underlying goal-directed behaviour, particularly in situations when the correct behavioural response requires the suppression of a prepotent response. Antisaccade errors (failures to suppress reflexive prosaccades towards sudden-onset targets) are increased in patients with damage to the dorsolateral prefrontal cortex, and in patients with schizophrenia. Nicotine has been found to improve antisaccade performance in patients with schizophrenia and healthy controls. This performance enhancing effect may be due to direct effects on the cholinergic system, but there has been no test of this hypothesis.

MATERIALS AND METHODS

In a double blind, double dummy, placebo-controlled design, we compared the effect of nicotine and modafinil, a putative indirect noradrenergic agonist, on antisaccade performance in healthy non-smokers.

RESULTS AND DISCUSSION

Both compounds reduced latency for correct antisaccades, although neither reduced antisaccade errors. These findings are discussed with reference to the pharmacological route of performance enhancement on the antisaccade task and current models of antisaccade performance.

Test-retest reliability of fMRI activation during prosaccades and antisaccades

Various studies have investigated reproducibility of fMRI results. Whereas group results can be highly reproducible, individual activity maps tend to vary across sessions. Individual reliability is of importance for the application of fMRI in endophenotype research, where brain activity is linked to genetic polymorphisms. In this study, the test-retest reliability of activation maps during the antisaccade paradigm was assessed for individual and group results. Functional MRI images were acquired during two sessions of prosaccades and antisaccades in twelve healthy subjects using an event-related fMRI design. Reliability was assessed for both individual and group-wise results. In addition, the reliability of differences between subjects was established in predefined regions of interest. The reliability of group activation maps was high for prosaccades and antisaccades, but only moderate for antisaccades vs. prosaccades, probably as a result of low statistical power of individual results. Reproducibility of individual subject maps was highly variable, indicating that reliable results can be obtained in some but not all subjects. Reliability of individual activity maps was largely explained by individual differences in the global temporal signal to noise ratio (SNR). As the global SNR was stable over sessions, it explained a large portion of the differences between subjects in regional brain activation. A low SNR in some subjects may be dealt with either by improving the statistical sensitivity of the fMRI procedure or by subject exclusion. Differences in the global SNR between subjects should be addressed before using regional brain activation as phenotype in genetic studies.

Neurophysiological endophenotypes of schizophrenia: the viability of selected candidate measures

In an effort to reveal susceptibility genes, schizophrenia research has turned to the endophenotype strategy. Endophenotypes are characteristics that reflect the actions of genes predisposing an individual to a disorder, even in the absence of diagnosable pathology. Individual endophenotypes are presumably determined by fewer genes than the more complex phenotype of schizophrenia and would, therefore, reduce the complexity of genetic analyses. Unfortunately, despite there being rational criteria to define a viable endophenotype, the term is sometimes applied indiscriminately to characteristics that are deviant in affected individuals. Schizophrenia patients exhibit deficits in several neurophysiological measures of information processing that have been proposed as candidate endophenotypes. Successful processing of sensory inputs requires the ability to inhibit intrinsic responses to redundant stimuli and, reciprocally, to facilitate responses to less frequent salient stimuli. There is evidence to suggest that both these processes are "impaired" in schizophrenia. Measures of inhibitory failure include prepulse inhibition of the startle reflex, P50 auditory evoked potential suppression, and antisaccade eye movements. Measures of impaired deviance detection include mismatch negativity and the P300 event-related potential. The purpose of this review is to systematically evaluate the endophenotype candidacy of these key neurophysiological abilities. For each candidate, we describe typical experimental procedures, the current understanding of the underlying neurobiology, the nature of the abnormality in schizophrenia, the reliability, stability and heritability of the measure, and any reported gene associations. We conclude with a discussion of the few studies thus far that have employed a multivariate approach with these candidates.

Different extraretinal neuronal mechanisms of smooth pursuit eye movements in schizophrenia: An fMRI study

Smooth pursuit eye movements (SPEM) are necessary to follow slowly moving targets while maintaining foveal fixation. In about 50% of schizophrenic patients SPEM velocity is reduced. In this study we were interested in identifying the cortical mechanisms associated with extraretinal processing of SPEM in schizophrenic patients. During condition A, patients and healthy subjects had to pursue a constantly visible target (10 degrees /s). During condition B the target was blanked out for 1000 ms while subjects were instructed to continue SPEM. Eye movement data were assessed during scanning sessions by a limbus tracker. During condition A, reduced SPEM velocity in patients was associated with reduced activation of the right ventral premotor cortex and increased activation of the left dorsolateral prefrontal cortex, the right thalamus and the Crus II of the left cerebellar hemisphere. During condition B, SPEM velocity was reduced to a similar extent in both groups. While in patients a decrease in activation was observed in the right cerebellar area VIIIA, the activation of the right anterior cingulate, the right superior temporal cortex, and the bilateral frontal eye fields was increased. The results implicate that schizophrenic patients employ different strategies during SPEM both with and without target blanking than healthy subjects. These strategies predominantly involve extraretinal mechanisms.

Successful multi-site measurement of antisaccade performance deficits in schizophrenia

The antisaccade task is a promising schizophrenia endophenotype; it is stable over time and reflects neurophysiological deficits present in both schizophrenia subjects and their first-degree relatives. Meaningful genetic research requires large sample sizes that are best ascertained using multi-site study designs. To establish the criterion validity of the antisaccade task in a multi-site design, the Consortium on the Genetics of Schizophrenia (COGS) examined whether seven sites could detect previously reported antisaccade deficits in schizophrenia subjects. Investigators presented 3 blocks of 20 antisaccade stimuli to 143 schizophrenia subjects and 195 comparison subjects. Frequent collaborator communication, standardized training, and ongoing quality assurance optimized testing uniformity. Data were discarded from only 1.2% of subjects due to poor quality, reflecting the high fidelity of data collection and scoring methods. All sites detected a significant difference in the proportion of correct antisaccades between schizophrenia and comparison subjects (p<.02 at all sites); group differences in gain and latency were less robust. Regression analyses to adjust for the effects of group, site, age, gender, smoking, and parental education on the proportion of correct antisaccades revealed a significant effect of group, site, and age but no effect of gender, smoking, or parental education, and no group-by-site interactions. Intraclass correlations between proportion of correct antisaccades across the blocks of stimuli ranged from 0.87 to 0.93, demonstrating good within-session reliability at sites. These results confirm previous findings of antisaccade deficits in schizophrenia subjects and support the use of the antisaccade task as a potential schizophrenia endophenotype in multi-site genetic studies.

The antisaccade task as an index of sustained goal activation in working memory: modulation by nicotine

INTRODUCTION

The antisaccade task provides a laboratory analogue of situations in which execution of the correct behavioural response requires the suppression of a more prepotent or habitual response. Errors (failures to inhibit a reflexive prosaccade towards a sudden onset target) are significantly increased in patients with damage to the dorsolateral prefrontal cortex and patients with schizophrenia. Recent models of antisaccade performance suggest that errors are more likely to occur when the intention to initiate an antisaccade is insufficiently activated within working memory. Nicotine has been shown to enhance specific working memory processes in healthy adults.

MATERIALS AND METHODS

We explored the effect of nicotine on antisaccade performance in a large sample (N = 44) of young adult smokers. Minimally abstinent participants attended two test sessions and were asked to smoke one of their own cigarettes between baseline and retest during one session only.

RESULTS AND CONCLUSION

Nicotine reduced antisaccade errors and correct antisaccade latencies if delivered before optimum performance levels are achieved, suggesting that nicotine supports the activation of intentions in working memory during task performance. The implications of this research for current theoretical accounts of antisaccade performance, and for interpreting the increased rate of antisaccade errors found in some psychiatric patient groups are discussed.

The antisaccade task as a research tool in psychopathology: a critical review

The antisaccade task is a measure of volitional control of behavior sensitive to fronto-striatal dysfunction. Here we outline important issues concerning antisaccade methodology, consider recent evidence of the cognitive processes and neural mechanisms involved in task performance, and review how the task has been applied to study psychopathology. We conclude that the task yields reliable and sensitive measures of the processes involved in resolving the conflict between volitional and reflexive behavioral responses, a key cognitive deficit relevant to a number of neuropsychiatric conditions. Additionally, antisaccade deficits may reflect genetic liability for schizophrenia. Finally, the ease and accuracy with which the task can be administered, combined with its sensitivity to fronto-striatal dysfunction and the availability of suitable control conditions, may make it a useful benchmark tool for studies of potential cognitive enhancers.

Prepulse inhibition of the acoustic startle reflex and oculomotor control

Prepulse inhibition and the suppression of reflexive saccades on the antisaccade task are thought to tap inhibitory function. Reports of a lack of association between these measures suggest that they reflect different facets of inhibition. This study aimed to reexamine this relationship in a large sample and investigate the association of prepulse inhibition with oculomotor tasks that require inhibition of a reflexive saccade with lower concurrent processing demands than antisaccades, namely the oculomotor delayed response and fixation with distractors tasks. One hundred and seven healthy volunteers took part. Prepulse inhibition was uncorrelated with oculomotor performance. The error rate was highest for antisaccades, intermediate for the delayed response task, and lowest for fixation with distractors, and was correlated across tasks. These findings provide no evidence of a relationship between prepulse inhibition and oculomotor inhibition. Failure in suppressing reflexive saccades toward a peripheral target may represent a common inhibitory component underlying these oculomotor tasks.

Poor antisaccade performance in schizophrenia: an inhibition deficit?

The antisaccade task appears to be particularly suitable for analyzing processes involved in executive control of action. Schizophrenic patients show enhanced rates of erroneous reflexive saccades in this task. This is commonly interpreted as a failure of inhibitory mechanisms. The role of volitional saccade generation is largely neglected in these accounts. In this study, experimental variations of the antisaccade task were applied to manipulate the contribution of volitional processes on antisaccade performance. Fifteen patients with a diagnosis of schizophrenia and 15 healthy control participants performed antisaccade tasks requiring them to look to the mirror location of a peripheral visual stimulus at the onset of this stimulus (standard antisaccade task) or after a brief delay (delayed antisaccade task). As expected, schizophrenic patients showed more reflexive saccade errors than controls. In the delay conditions, reflexive errors decreased, and this effect was significantly stronger in schizophrenic patients. Latencies of correct antisaccades tended to be longer in patients than in control participants. The results suggest that the generation of voluntary saccades is at least in part responsible for the antisaccade deficit in schizophrenic patients. More comprehensive models to account for executive deficits in the antisaccade task must be considered.

Lack of association between prepulse inhibition and antisaccadic deficits in chronic schizophrenia: implications for identification of schizophrenia endophenotypes

Individuals with schizophrenia, compared to healthy individuals, are known to exhibit deficient prepulse inhibition (PPI) of the startle response as well as reduced performance on the antisaccade task. There is evidence for genetic transmission of both PPI and antisaccadic abnormalities in schizophrenia. It has been suggested that PPI and antisaccade measures identify separate endophenotypes, on the basis of a lack of relationship between PPI and antisaccade deficits in patients with schizotypal personality disorder. However, given that patients with schizotypal personality disorder are unlikely to manifest all the abnormalities associated with schizophrenia, it is important to determine that there is no relationship present between these two abnormalities in people affected with schizophrenia. The main objective of this investigation therefore was to establish the lack of the association between PPI and antisaccade deficits in schizophrenia in two independent studies. Study 1 involved 39 patients with schizophrenia and 14 healthy controls and study 2 involved 35 patients with schizophrenia and 22 healthy controls. PPI (uninstructed paradigm) of the acoustically elicited startle (eye blink) was measured electromyographically. Antisaccadic eye movements (standard, non-overlap version) were measured using infrared oculography. Patients displayed reduced PPI and a lower percentage of correct antisaccades relative to healthy controls in both studies. As expected, no relationship occurred between PPI and the percentage of correct antisaccade responses in either group. It is concluded that PPI and antisaccade abnormalities in schizophrenia represent separate endophenotypes, reflecting the functions of different genetic aetiologies and different or only partially overlapping neural systems.

Instrumental and test–retest reliability of saccadic measures

Little is known about the reliabilities of the various measures of saccade control that can be derived from pro- and anti-saccade tasks. This paper presents correlational results of 2 different studies comprising altogether 446 psychiatrically and neurologically healthy participants in the range of 6-88 years. Saccades were elicited under different stimulation conditions and during task blocks of 100 or 200 trials. Odd-even and split-half correlations determined for study 1 (N = 327, age 9-88 years) were found to be good to excellent (.60 < or = r < or = .97) for most measures and generalisable over the entire life-span. The 19-month test-retest correlations obtained in study 2 (N = 117, age 6-18 years) ranged between .43 and .66 after controlling for age, and suggest moderate stability of individual differences over time during childhood and adolescence. Hence, these parameters are very useful for concurrent validity studies at every age, but less so for predictive validity studies with children and adolescents.

Saccadic performance in questionnaire-identified schizotypes over time

In the present study, 121 young adults (mean age=19 years), hypothesized to be at varying levels of risk for psychosis on the basis of their psychometric profiles, were administered saccadic (antisaccade and refixation) tasks at two separate assessments. At Time 1, individuals posited to be at heightened risk for the later development of schizophrenia-spectrum disorders (i.e., those individuals with elevated Social Anhedonia Scale [SAS] scores) produced significantly more antisaccade task errors than the controls. Despite apparent improvement in antisaccade task performance from initial testing to the follow-up (mean test-retest interval=59 months) across all groups, the Social Anhedonia (SocAnh) group continued to produce significantly more errors than the control group. The antisaccade task performance of the control group showed good temporal stability (Pearson's r=0.70, ICC=0.52), and the SocAnh group's performance showed excellent temporal stability (Pearson's r=0.85, ICC=0.83). The results of this investigation are twofold: First, antisaccade task performance is temporally stable, even in psychometrically identified schizotypes over long test-retest intervals; and secondly, Social Anhedonia Scale scores as well as Time 1 antisaccade task accuracy accounted for much of the variability in Time 2 antisaccade task performance. These findings add to the growing body of literature suggesting that antisaccade task deficits may serve as an endophenotypic marker of a schizophrenia diathesis.

Structural neural correlates of prosaccade and antisaccade eye movements in healthy humans

We previously reported that prosaccade amplitude gain and antisaccade error rate are correlated with cerebellar and posterior frontal grey matter volume, respectively. This study sought to replicate and extend these findings in a sample of 32 right-handed, healthy volunteers (14 males, 18 females). Participants underwent structural magnetic resonance imaging (MRI) at 1.5 T and an off-line eye movement assessment using infrared oculography at 500 Hz. Separate blocks of prosaccades and antisaccades were carried out (60 trials each). Optimised volumetric voxel-based morphometry (VBM) implemented in SPM99 was used to investigate the relationship of saccadic performance measures to regional grey matter volume, covarying for age. A significant negative correlation was obtained between prosaccade spatial error and grey matter volume in the right inferior cerebellar lobe (lobule VIIIB, extending into the vermis, centred at x = 11; y = -64; z = -61), indicating that more grey matter volume in this area was associated with better spatial accuracy. On the antisaccade task, the error rate was significantly negatively correlated with grey matter volume in the right middle frontal gyrus (Brodmann area 6) in an area anterior to the frontal eye field (centred at x = 27; y = 18; z = 50), indicating that more grey matter volume in this area was associated with fewer antisaccade errors. These findings extend our previous observations by identifying the relationship between brain structure and saccadic performance on a spatially highly localised scale and support the validity of structural neuroimaging methods in delineating the neural mechanisms underlying human oculomotor control.

Saccadic eye movements, schizotypy, and the role of neuroticism

We investigated the relationships of anti- and prosaccades with psychometric schizotypy. One aim was to estimate the role of negative emotionality and general psychopathology (i.e. neuroticism) in this relationship. 115 non-clinical volunteers underwent infrared oculographic assessment of antisaccades and prosaccades. Schizotypy was assessed with the Personality Syndrome Questionnaire (PSQ-80), the Rust Inventory of Schizotypal Cognitions (RISC), and Eysenck Personality Questionnaire-Revised (EPQ-R) Psychoticism. Higher positive schizotypy scores predicted increased antisaccade errors (RISC) and greater prosaccade spatial error (PSQ-80 Unreality). Greater thought disorder (PSQ-80 Activity) predicted shorter prosaccade latencies. EPQ-R Neuroticism was substantially correlated with schizotypy but was not related to saccadic measures and did not account for their relationship with schizotypy. We conclude that saccadic performance patterns in schizotypy are not due to negative emotionality or general psychopathology, but specific to schizophrenia spectrum signs and symptoms.

Behavioral plasticity of antisaccade performance following daily practice

The ability to change behavior to adapt to the environment, known as behavioral plasticity, is an important part of daily life. In the present study subjects' performances on antisaccade tasks were manipulated by training them on one of three different eye movement tasks (antisaccade, prosaccade, and fixation). Thirty subjects were tested at three time points over a 2-week period and practiced their assigned task every day between test sessions. Subjects who trained on antisaccades significantly decreased their error rates, while maintaining their reaction time, suggesting that accuracy did not improve at the expense of speed. Subjects who practiced the prosaccade task made more errors on the antisaccade task on subsequent test sessions, while those who practiced the fixation task showed no change across test sessions. These results suggest that deliberate practice of eye movement tasks can alter antisaccade performance, and that the direction of the effect is dependent upon the type of practice in which the subject engages.

Effects of procyclidine on eye movements in schizophrenia

Smooth pursuit eye movement (SPEM) and antisaccade deficits are observed in the schizophrenia spectrum and have been used to study the pathophysiology as well as the genetic basis of this condition. The neurotransmitter acetylcholine has been implicated in a number of cognitive processes thought to underlie SPEM and antisaccade performance. This study investigates effects on eye movements of procyclidine, an anticholinergic drug often administered to schizophrenic patients. A total of 13 patients completed a double-blind placebo-controlled crossover design, receiving 15 mg procyclidine and placebo. Seven participants received procyclidine first and placebo second, six participants were tested in the reverse order. SPEM and antisaccade (as well as fixation and prosaccade) eye movements were recorded using infrared oculography. Results showed that procyclidine overall, relative to placebo, mildly worsened SPEM performance, as indicated by nonsignificantly reduced gain (p=0.08) and increased frequency of intrusive anticipatory saccades during pursuit (p=0.06). A significant interaction of group and order of administration indicated that procyclidine increased the rate of antisaccade reflexive errors only when administered first; the opposite pattern was observed when placebo was administered first, likely due to the operation of practice effects at second assessment. These findings indicate that acute administration of a clinically relevant dose of procyclidine leads to mild impairments in eye movement performance in schizophrenic patients, suggesting the need to consider this compound in oculomotor studies in schizophrenia. The action of this anticholinergic drug on oculomotor performance is consistent with the hypothesized role of the cholinergic system in the cognitive mechanisms of attention and working memory, processes thought to underlie SPEM and antisaccade performance. Effects of order of administration and practice on the antisaccade task suggest that these factors need to be taken into consideration in future pharmacological studies.