Neuropsychological Aspects of Driving After Brain Lesion: Simulator Study and On-Road Driving

Abstract

Twenty-nine patients with brain lesion and 29 matched controls participated in the study. The patients were socially well recovered with a high rate of employment. Compared with the controls, they performed significantly worse on a neuropsychological test battery, especially on executive and cognitive functions. Patients drove as well as controls in predictable situations in the advanced simulator used. In unpredictable situations, they demonstrated longer reaction times and safety margins, as well as difficulties in allocating processing resources to a secondary task. The patients showed significantly less attention, worse traffic behavior, and less risk awareness when driving in real traffic. Forty-one percent of the patients did not pass the driving test. The neuropsychological test battery was factor analyzed into four factors: executive capacity, cognitive capacity, automatic attentional capacity, and simple perceptual-motor capacity. The second factor was the mast significant with a simultaneous capacity test predicting driving performance with 78% confidence.

Older drivers: On-road and off-road test results

“…A discrepancy between the participants' subjective driving skills and actual driving behaviour was found, a finding further supported by other studies confirming that drivers generally have overly positive beliefs in their own driving skills (Freund et al, 2005;Lundqvist et al, 1997;Patomella et al, 2008). As a matter of fact, self ratings tend to be severely biased in favour of the person's own driving performance, as confirmed by our results.…”

Driving problems and adaptive driving behaviour after brain injury: A qualitative assessment

“…Based on previous research (Lundqvist et al, 1997(Lundqvist et al, , 2000 and for clinical practice we have already adapted a minimal test battery. The Trail Making Test B (TMTB) and three computerised tests (Levander, 1988) containing a Complex Reaction Time test (a reaction speed test also requiring reaction inhibition), a K test (a focused attention test), and a Simultaneous Capacity test (a divided attention test).…”

“…We have used a quantitative, multi-factorial approach in two former studies to estimate the consequences of attention and cognitive impairments on driving performance (Lundqvist et al, 1997;Lundqvist, Gerdle, & Rönnberg, 2000). The evaluations required neuropsychological tests to identify relevant functions and impairments.…”

Off-Road and On-Road Driving Assessments Methods, What Do They Say? A Clinical Sample

“…Many studies have been published on the determination of the driving potential for different diagnostic groups (for example : Hunt, 1993;Lundqvist et al, 1997;McKenna, Jefferies, Dobson, & Frude, 2004;Schanke & Sundet, 2000). The focus has been on correlations between neuro psychological tests and on-road test outcomes, but few of these neuro psychological tests are developed specially for driving.…”