Multimodal Neurocognitive Screening of Military Personnel With a History of Mild Traumatic Brain Injury Using the Bethesda Eye & Attention Measure

Objective: To evaluate a neurocognitive eye tracking task, the Bethesda Eye & Attention Measure (BEAM), for use in cognitive screening of patients with a history of mild traumatic brain injury (TBI). Setting: US military TBI rehabilitation clinic. Design/Participants: Cross-sectional study of 191 military personnel receiving outpatient services related to history of mild TBI. Main measures: BEAM; neuropsychological screening measures of attention, processing speed, executive function, and memory. Results: Medium effect sizes were found for partial correlations (controlling for age) between key BEAM metrics and neuropsychological screening tests. Linear regression analyses demonstrated that BEAM saccadic eye movements and manual (button press) metrics each provided complementary value in measurement of cognitive performance, above and beyond effects of demographic factors and clinical characteristics. Conclusion: This study provides initial support for the use of BEAM neurocognitive eye tracking in cognitive screening of adults with a history of mild TBI. BEAM saccadic metrics appear to be particularly well-suited for the assessment of visual attention. Study findings also highlight opportunities for greater cognitive sensitivity or testing efficiency that may be missed by tests measuring only one response modality at a time.