Impaired navigation in drivers with Parkinson's disease
Impaired navigation in drivers with Parkinson's disease
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DOI：
10.1093/brain/awm178
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发表时间：
2007-09-01
期刊：
影响因子：
14.5
通讯作者：
Dawson, Jeffrey D.
中科院分区：
文献类型：
--
作者：
Uc, ErgunY.;Rizzo, Matthew;Dawson, Jeffrey D.
在汽车驾驶期间导航新路线会使用驾驶员的认知资源，并有可能损害帕金森病（PD）患者的驾驶能力。我们的目的是评估驾驶员在路线跟踪任务（RFT）中的导航和安全错误。77例轻度-中度PD受试者（Hoehn-Yahr分期中位数= 2.0）和152例神经系统正常的老年人，所有活跃和有执照的司机，进行了测试与电池的视觉，认知和运动能力测试。每个驾驶员还在装有仪表的车辆中在道路上执行RFT管理。主要结果变量包括：不正确转弯次数、损失时间和故障安全错误。所有组的比较都根据年龄、性别、教育程度和对该地区的熟悉程度进行了调整。与对照组相比，患有PD的驾驶员在认知、视觉和运动测试中表现明显较差，并且需要更长的时间才能完成RFT。这些驾驶员错误转弯的比例较高{PD组为53.9%，对照组为21.1%，比值比（OR）[95%置信区间（CI）] = 2.8 [1.4，5.7]，P = 0.006}，迷路（15.8%对2.0%，OR [ 95% CI] = 4.7 [1.1，20.0]，P = 0.037）或犯下的故障安全错误（84.2%对46.7%，OR [ 95% CI] = 7.5 [3.3，17.0]，P < 0.001）。在患者组中，导航和安全错误是通过认知和视觉测试的不良表现预测的，但不是通过运动功能障碍的严重程度预测的。驾驶员与PD的导航和安全错误比神经正常的驾驶员的RFT，把驾驶员的记忆，注意力，执行功能和视觉感知的要求。PD组驾驶员安全性降低，可能是由于储备有限的患者认知负荷增加。导航错误和较低的驾驶员安全性与认知和视觉功能障碍的相关性大于PD驾驶员疾病的运动严重程度。
Navigating a new route during automobile driving uses the driver's cognitive resources and has the potential to impair driving ability in people with Parkinson's disease (PD). Our aim was to assess navigation and safety errors during a route following task ( RFT) in drivers with the illness. Seventy-seven subjects with mild-moderate PD ( median Hoehn-Yahr stage = 2.0) and 152 neurologically normal elderly adults, all active and licensed drivers, were tested with a battery of visual, cognitive and motor tests of abilities. Each driver also performed a RFTadministered on the road in an instrumented vehicle. Main outcome variables included: number of incorrect turns, times lost and at-fault safety errors. All group comparisons were adjusted for age, gender, education and familiarity with the region. Drivers with PD performed significantly worse on cognitive, visual and motor tests compared to controls, and took longer to finish the RFT. Higher proportions of these drivers made incorrect turns {53.9% in PD versus 21.1% in controls, Odds Ratio ( OR) [95% Confidence Interval (CI)] = 2.8 [1.4, 5.7], P = 0.006}, got lost (15.8% versus 2.0%, OR [ 95% CI] = 4.7 [1.1, 20.0], P = 0.037), or committed at-fault safety errors (84.2% versus 46.7%, OR [ 95% CI] = 7.5 [3.3, 17.0], P < 0.001). Within the patient group, the navigational and safety errors were predicted by poor performances on cognitive and visual tests, but not by the severity of motor dysfunction. Drivers with PD made more navigation and safety errors than neurologically normal drivers on a RFT that placed demands on driver memory, attention, executive functions and visual perception. The PD group driver safety was degraded possibly due to an increase in the cognitive load in patients with limited reserves. Navigational errors and lower driver safety were associated more with impairments in cognitive and visual function than the motor severity of their disease in drivers with PD.