Early neuropsychological tests as correlates of return to driving after traumatic brain injury

Cullen, Nora; Krakowski, Aneta; Taggart, Christina

doi:10.3109/02699052.2013.849005

Cited by 28 publications

(20 citation statements)

References 34 publications

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“…Data related to associations between neuropsychological test performance and driving outcomes were also extracted and could have included mean neuropsychological test scores (and standard deviations) of driving and non-driving patients and correlations between neuropsychological test scores and driving outcomes. Five studies reported mean and standard deviations (Coleman et al, 2002;Cullen et al, 2014;Gooden et al, 2017;McKay et al, 2016;Radford et al, 2004), and six studies reported correlation r (Cyr et al, 2009, Korteling & Kaptein, 1996Novack et al, 2006;Pietrapiana et al, 2005;Schneider & Gouvier, 2005;Sommer et al, 2010).…”

Section: Data Extractionmentioning

confidence: 99%

“…Following a full-text review, a total of 16 articles were excluded for not relating neuropsychological test scores to driving outcomes (n = 5) or for including patients with acquired brain injuries such as stroke or brain tumours (n = 11). Ultimately, 11 studies met the inclusion criteria and were included in the meta-analysis, all cohort designs (Coleman et al, 2002;Cullen et al, 2014;Cyr et al, 2009;Gooden et al, 2017;Korteling & Kaptein, 1996;McKay, Liew, Schonberger, Ross, & Ponsford, 2016;Novack et al, 2006;Pietrapiana et al, 2005;Radford, Lincoln, & Murray-Leslie, 2004;Schneider & Gouvier, 2005;Sommer et al, 2010). Eight of the 11 studies scored as "moderate" on the publication quality scale, and three scored as "weak" quality (study ratings indicated in Table 1).…”

Section: Literature Searchmentioning

confidence: 99%

“…Cognitive sequelae are common after TBI, most often identified in the domains of processing speed and attention, executive functions, and memory (Dikmen, Machamer, Powell, & Tempkin, 2003;Mazaux et al, 1997;Millis et al, 2001). Consequently, patients frequently encounter significant barriers to autonomous functioning (Mazaux et al, 1997), including the ability to drive safely (e.g., Cullen, Krakowski, & Taggart, 2014;Sommer et al, 2010). In particular, safe driving behaviours depend on the ability to process visual and auditory stimuli, simultaneously attend to multiple stimuli, shift attention, react quickly to changes in the environment, and make safe decisions.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Systematic Review and Meta-Analysis on the Association Between Driving Ability and Neuropsychological Test Performances after Moderate to Severe Traumatic Brain Injury

Egeto

Badovinac

Hutchison

et al. 2019

J Int Neuropsychol Soc

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Objectives: Guidelines on return-to-driving after traumatic brain injury (TBI) are scarce. Since driving requires the coordination of multiple cognitive, perceptual, and psychomotor functions, neuropsychological testing may offer an estimate of driving ability. To examine this, a meta-analysis of the relationship between neuropsychological testing and driving ability after TBI was performed. Methods: Hedge’s g and 95% confidence intervals were calculated using a random effects model. Analyses were performed on cognitive domains and individual tests. Meta-regressions examined the influence of study design, demographic, and clinical factors on effect sizes. Results: Eleven studies were included in the meta-analysis. Executive functions had the largest effect size (g = 0.60 [0.39–0.80]), followed by verbal memory (g = 0.49 [0.27–0.71]), processing speed/attention (g = 0.48 [0.29–0.67]), and visual memory (g = 0.43 [0.14–0.71]). Of the individual tests, Useful Field of Vision (UFOV) divided attention (g = 1.12 [0.52–1.72]), Trail Making Test B (g = 0.75 [0.42–1.08]), and UFOV selective attention (g = 0.67 [0.22–1.12]) had the largest effects. The effect sizes for Choice Reaction Time test and Trail Making Test A were g = 0.63 (0.09–1.16) and g = 0.58 (0.10–1.06), respectively. Years post injury (β = 0.11 [0.02–0.21] and age (β = 0.05 [0.009–0.09]) emerged as significant predictors of effect sizes (both p < .05). Conclusions: These results provide preliminary evidence of associations between neuropsychological test performance and driving ability after moderate to severe TBI and highlight moderating effects of demographic and clinical factors.

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Section: Data Extractionmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Systematic Review and Meta-Analysis on the Association Between Driving Ability and Neuropsychological Test Performances after Moderate to Severe Traumatic Brain Injury

Egeto

Badovinac

Hutchison

et al. 2019

J Int Neuropsychol Soc

View full text Add to dashboard Cite

show abstract

“…6,36 Further investigation will be necessary to Previous studies suggest that these measures are also sensitive to driving impairments in patient populations with other neurological conditions. 38,39 The significant correlations between neuropsychological performances and driving performances in the concussed group and the lack of significant correlations in the control group may be partly explained by a greater heterogeneity (higher standard deviation in most of tests) in the concussed group than in the control group. These results provide a starting point to guide further research ultimately aimed at providing clinicians tools to guide driving recommendations based on neuropsychological performance.…”

Section: Discussionmentioning

confidence: 99%

Driving after Concussion: Is It Safe To Drive after Symptoms Resolve?

Schmidt

Hoffman

Ranchet

et al. 2017

Journal of Neurotrauma

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Post-concussion impairments may result in unsafe driving performance, but little research is available to guide consensus on when concussed individuals should return to driving. The purpose of this study was to compare driving performance between individuals with and without a concussion and to explore relationships between neuropsychological and driving performance. Fourteen participants with concussion (age 20.2 ± 0.9 years old) and 14 non-concussed age- and driving experience-matched controls (age 20.4 ± 1.1 years old) completed a graded symptom checklist, a brief neuropsychological exam, and a 20.5 km driving simulation task. Participants with a concussion completed driving simulation within 48 h of becoming asymptomatic (15.9 ± 9.0 days post-concussion). One-way analyses of variance were used to compare total number of crashes, tickets, and lane excursions, as well as standard deviation of lateral position (SDLP) and standard deviation of speed. Pearson's correlations were conducted to explore the relationship between the neuropsychological and driving performance separately by group (α = 0.05). Participants with a concussion committed more frequent lane excursions (concussed 10.9 ± 4.5; controls 7.4 ± 2.4; p = 0.017) and exhibited greater SDLP, compared with controls, during the first curve (concussed 45.7 ± 21.3 cm, controls 27.4 ± 6.1 cm; p = 0.030) and final curve (concussed 39.6 ± 24.4 cm; controls 33.5 ± 21.3 cm; p = 0.036). Poorer performance on symbol digit modalities (r = -0.54), Rey Osterrieth Complex Figure (r = -0.53), verbal memory (r = -0.77), and motor speed (r = -0.54) were correlated with more frequent lane excursions in the concussed group, but not in the control group. Despite being asymptomatic, concussed participants exhibited poorer vehicle control, especially when navigating curves. Driving impairments may persist beyond when individuals with a concussion have returned to driving. Our study provides preliminary guidance regarding which neuropsychological functions may best indicate driving impairment following concussion.

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“…In fact, driving solicits a wide range of cognitive functions typically affected by TBI, especially in the attentional domain (e.g., information processing speed, divided attention) (Brouwer et al, 2002). For instance, a recent study showed that participants with TBI who had returned to driving performed significantly better on the Trail Making Test, a widely used attention test, compared to participants who had not returned to driving (Cullen, Krakowski, & Taggart, 2014). In addition to clinical neuropsychological tests, driving simulators, presumably presenting higher ecological validity, have been used as a proxy for cognitive performance.…”

Section: Traumatic Brain Injury (Tbi) Is a Leading Cause Of Death Andmentioning

confidence: 99%

Attention following traumatic brain injury: Neuropsychological and driving simulator data, and association with sleep, sleepiness, and fatigue

Beaulieu‐Bonneau

Fortier-Brochu

Ivers

et al. 2015

Neuropsychological Rehabilitation

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The objectives of this study were to compare individuals with TBI and healthy controls on neuropsychological tests of attention, driving simulation performance, and explore their relationships with participants' characteristics, sleep, sleepiness, and fatigue. Participants were 22 adults with moderate or severe TBI (time since injury ≥ one year) and 22 matched controls.They completed three neuropsychological tests of attention, a driving simulator task, nighttime polysomnographic recordings, and subjective ratings of sleepiness and fatigue. Results showed that participants with TBI exhibited poorer performance compared to controls on measures tapping speed of information processing and sustained attention, but not on selective attention measures. On the driving simulator task, a greater variability of the vehicle lateral position was observed in the TBI group. Poorer performance on specific subsets of neuropsychological variables was associated with poorer sleep continuity in the TBI group, and with a greater increase in subjective sleepiness in both groups. No significant relationship was found between cognitive performance and fatigue. These findings add to the existing evidence that speed of information processing is still impaired several years after moderate to severe TBI. Sustained attention could also be compromised. Attention seems to be associated with sleep continuity and daytime sleepiness; this interaction needs to be explored further.

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Early neuropsychological tests as correlates of return to driving after traumatic brain injury

Abstract: The results suggest that neuropsychological measures of processing speed and cognitive flexibility may predict return to driving after TBI.

Cited by 28 publications

References 34 publications

A Systematic Review and Meta-Analysis on the Association Between Driving Ability and Neuropsychological Test Performances after Moderate to Severe Traumatic Brain Injury

A Systematic Review and Meta-Analysis on the Association Between Driving Ability and Neuropsychological Test Performances after Moderate to Severe Traumatic Brain Injury

Driving after Concussion: Is It Safe To Drive after Symptoms Resolve?

Attention following traumatic brain injury: Neuropsychological and driving simulator data, and association with sleep, sleepiness, and fatigue

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