Examining the Relationship Between Cognition and Driving Performance in Multiple Sclerosis

Schultheis, Maria T.; Weisser, Valerie; Ang, Jocelyn Y.; Elovic, Elie P.; Nead, Richard; Sestito, Nicole; Fleksher, Cassandra; Millis, Scott R.

doi:10.1016/j.apmr.2009.09.026

Cited by 75 publications

(71 citation statements)

References 32 publications

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“…Therefore, as has been shown previously (Amato, Zipoli, & Portaccio, 2006), our study demonstrated that cognitive deficits that are present from the onset of the disease may play an important role in the important task of driving because of the key role of information processing speed in the execution of this task. The observed relationship between the cognitive tests of information processing speed and working memory (SDMT and PASAT) and the driving tests (ASDE and UFOV) is consistent with the findings of Schultheis et al (2010), Marcotte et al (2008), and Kotterba et al (2003). In agreement with our results, these authors found impairments of executive functions, although the differences were not as clear as those of information processing speed and working memory.…”

Section: Discussionsupporting

confidence: 91%

“…These findings agree with previous studies that have used the UFOV test and identified information processing speed as a key factor, particularly when complex and quick responses are required. Similarly, previous studies have also identified the swift application of working memory operations, attentional switching, and rapid visual scanning as key factors (Schultheis et al, 2010). Additionally, our study revealed that visuomotor coordination is related to driving performance.…”

Section: Discussionsupporting

confidence: 82%

See 1 more Smart Citation

Driving Competences and Neuropsychological Factors Associated to Driving Counseling in Multiple Sclerosis

Badenes

Garolera

Casas

et al. 2014

J Int Neuropsychol Soc

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Multiple Sclerosis (MS) significantly impacts daily living activities, including car driving. To investigate driving difficulties experienced with MS, we compared 50 MS patients with minor or moderate disability and 50 healthy controls (HC) using computerized driving tests (the ASDE driver test and the Useful Field of View (UFOV) test) and neuropsychological tests. Inclusion criteria included being active drivers. We evaluated whether cognitive deterioration in MS is associated with the results of driving tests by comparing MS patients without cognitive deterioration with HC. The results indicated that the MS patients performed worse than the HCs in attention, information processing, working memory and visuomotor coordination tasks. Furthermore, MS patients with cognitive impairments experienced more difficulties in the driving tests than did the non-impaired MS patients. Motor dysfunction associated with MS also played an important role in this activity. The results of this study suggest that MS should be assessed carefully and that special emphasis should be placed on visuomotor coordination and executive functions because patients with minor motor disability and subtle cognitive impairments can pass measures predictive of driving safety.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 82%

Driving Competences and Neuropsychological Factors Associated to Driving Counseling in Multiple Sclerosis

Badenes

Garolera

Casas

et al. 2014

J Int Neuropsychol Soc

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“…Study limitations including sample size, lack of an independent sample to validate study findings, and the inability to generalize study findings other types of MS patients besides those with relapsing-remitting MS. Only individuals with relapsing-remitting MS were included in this preliminary study because it is the most common form of MS and they constitute the majority of individuals with MS who continue to drive. 5 Yet, when compared with the 2009 national statistics on number of discharges from hospitals of patients who had a diagnosis of MS, 40 the mean age and gender distribution of our study cohort can be said to be representative of MS population in the US. Our future plan is to conduct a larger study including different types of MS and an independent sample to confirm and validate the predictive accuracy of the model found in this study.…”

Section: Discussionmentioning

confidence: 91%

Predictors of driving in individuals with relapsing–remitting multiple sclerosis

et al. 2012

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Participants' on-road performance was more accurately predicted by the model identified in this study than using only performance on the SDSA test battery. The five psychometric/off-road tests should be used as a screening battery, after which a follow-up road test should be conducted to finally decide the fitness to drive of individuals with relapsing-remitting MS. Future studies are needed to confirm and validate the findings in this study.

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“…Strong correlations between performance in the SDMT and brain lesion volume [10,11], cerebral atrophy [12], diffusion tensor indices of normal appearing brain tissue [13] and retinal nerve fibre layer thickness [14] have been found. The SDMT has been shown to be the best cognitive predictor of driving performance [15], and recent findings suggest that compared to other well-established measures of cognitive function, it more accurately reflects the qualitative nature of self-reported cognitive impairment [16,17]. All of which has led some researchers to conclude that the SDMT is the most sensitive cognitive screening tool in clinical and research settings [18,19] and should replace the Paced Auditory Serial Addition Test (PASAT) as part of the MS functional composite scale (MSFC) [20].…”

Section: Introductionmentioning

confidence: 99%

Validity of a computerized version of the Symbol Digit Modalities Test in multiple sclerosis

et al. 2010

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The Symbol Digit Modalities Test (SDMT) is a particularly sensitive measure of cognitive dysfunction in patients with multiple sclerosis (MS). While computerized versions have been developed for use in functional magnetic resonance imaging (fMRI), none has been validated in MS patients. The aim of this study was to validate a new computerized version of the SDMT for use in MS patients. We developed a novel computerized version of the SDMT (c-SDMT) which was completed by 119 MS patients and 38 healthy controls. Our version consisted of eight timed trials of nine symbols. Both groups also underwent cognitive testing with the Brief Repeatable Battery of Neuropsychological Tests (BRB-N) which included the 90-s paper SDMT (p-SDMT) scored according to the number of correct responses per each 15-s interval. The sensitivity and specificity of the c-SDMT and p-SDMT to detect overall cognitive impairment on the BRB-N was determined. MS patients performed significantly worse than controls on both the c-SDMT (t = -6.1, p < 0.001) and p-SDMT (t = 5.7, p < 0.001). More MS patients were impaired on the c-SDMT than the p-SDMT (37% vs. 29%). The sensitivity and specificity of the SDMT was as follows: 71% and 84%, respectively, for the c-SDMT, and 67% and 95%, respectively, for the p-SDMT. Both versions detected a significant group × time effect over the course of the individual trials, although the pattern of responses differed between them. Good test-retest reliability for the c-SDMT was shown (ICC = 0.94). The results support the validity of this version of the c-SDMT as a sensitive measure of cognitive dysfunction in MS. The methodology is also fMRI compatible.

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Examining the Relationship Between Cognition and Driving Performance in Multiple Sclerosis

Cited by 75 publications

References 32 publications

Driving Competences and Neuropsychological Factors Associated to Driving Counseling in Multiple Sclerosis

Driving Competences and Neuropsychological Factors Associated to Driving Counseling in Multiple Sclerosis

Predictors of driving in individuals with relapsing–remitting multiple sclerosis

Validity of a computerized version of the Symbol Digit Modalities Test in multiple sclerosis

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