Parkinson disease and driving

Abstract

The growing literature on driving in Parkinson disease (PD) has shown that driving is impaired in PD compared to healthy comparison drivers. PD is a complex neurodegenerative disorder leading to motor, cognitive, and visual impairments, all of which can affect fitness to drive. In this review, we examined studies of driving performance (on-road tests and simulators) in PD for outcome measures and their predictors. We searched through various databases and found 25 (of 99) primary studies, all published in English. Using the American Academy of Neurology criteria, a study class of evidence was assigned (I-IV, I indicating the highest level of evidence) and recommendations were made (Level A: predictive or not; B: probably predictive or not; C: possibly predictive or not; U: no recommendations). From available Class II and III studies, we identified various cognitive, visual, and motor measures that met different levels of evidence (usually Level B or C) with respect to predicting on-road and simulated driving performance. Class I studies reporting Level A recommendations for definitive predictors of driving performance in drivers with PD are needed by policy makers and clinicians to develop evidence-based guidelines. Neurology

National Randomized Controlled Trial of Virtual House Calls for People with Parkinson's Disease: Interest and Barriers

“…12 Individuals have Parkinson's disease for approximately 14-16 years after diagnosis, 13,14 and it leads to progressive disability, cognitive impairment, limited mobility, 15 and impaired driving ability. 16 Parkinson's disease also burdens caregivers, 17 frequently requires institutional care, [18][19][20] generates high healthcare costs, 21,22 and benefits from specialty care. [23][24][25][26] However, over 40% of Medicare beneficiaries with Parkinson's disease do not receive care from a neurologist within the first 4 years after diagnosis, 26 and those who do not have worse health outcomes, including a 22% increased risk of death within 6 years.…”

Could deep brain stimulation help with driving for patients with Parkinson’s?

“…It is an important but difficult medical challenge to advice the patient regarding his fitness to drive. Unfortunately, there is no onsite diagnostic tool or test battery predictive of driving competence [4] and patients often do not see own limitations [3,5]. However, drivers with PD stop driving more often than controls of comparable age [6] and as active drivers they might self-restrict their driving by driving smaller distances, avoiding nighttime driving [7] or rush hours [2].…”

Rensheng ShouWu Protects Against Neuronal Injury by Inhibiting the Apoptosis Induced by Hypoxia and Reoxygenation

“…In stroke, AD, and PD, abnormal brain metabolism caused by decreased cerebral blood flow is the cause of early pathological changes in hypoxic-ischemic encephalopathy and appears in pathophysiological responses that occur mainly in neuronal apoptosis [2][3][4][5]. Several studies have indicated that cell apoptosis is closely associated with oxidative stress.…”

“…These health problems have become a heavier burden over the years to families and society, as the average lifespan has continued to increase. However, combating stroke and neurodegenerative disease has proven to be an enormous challenge [1][2][3].…”

“…These health problems have become a heavier burden over the years to families and society, as the average lifespan has continued to increase. However, combating stroke and neurodegenerative disease has proven to be an enormous challenge [1][2][3].Oxidative stress has been implicated in the progression of stroke and neurodegenerative diseases, such as Alzheimer's Disease (AD), Parkinson's Disease (PD) and Amyotrophic Lateral Sclerosis (ALS) [4][5][6]. Oxidative stress is the result of an imbalance in pro-oxidant/ antioxidant homeostasis that leads to the generation of toxic Reactive Oxygen Species (ROS).…”