Differential Contributions of Selective Attention and Sensory Integration to Driving Performance in Healthy Aging and Alzheimer's Disease.
Differential Contributions of Selective Attention and Sensory Integration to Driving Performance in Healthy Aging and Alzheimer's Disease.
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选择性注意力和感觉统合对健康老龄化和阿尔茨海默氏病驾驶表现的不同贡献。
DOI：
10.1017/s1355617717001291
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Heindel,WilliamC
中科院分区：
文献类型：
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作者：
Venkatesan,UmeshM;Festa,ElenaK;Ott,BrianR;Heindel,WilliamC
目的 阿尔茨海默病 (AD) 患者表现出跨皮质特征结合的缺陷，这与年龄相关的选择性注意力变化不同。鉴于其对多感官集成的要求，这可能会对驾驶性能产生影响。我们检查了早期 AD 患者和老年对照 (EC) 患者的视觉空间搜索和绑定与驾驶的关系。方法参与者 (42 AD; 37 EC) 完成了需要亮度-运动 (L-M) 或颜色-运动 (C-M) 绑定的搜索任务，分别类似于视觉处理流内和跨视觉处理流绑定。与临床筛查措施一起收集标准化道路测试（RIRT）和自然驾驶数据（CDAS）。结果患者在大多数认知和驾驶指数上的表现比对照组差。视觉搜索和临床测量与不同群体的驾驶行为存在不同的相关性。 L-M 搜索和轨迹制作测试 (TMT-B) 与对照组的 RIRT 表现相关，而 C-M 结合、TMT-B 错误和时钟绘图与患者的 CDAS 表现相关。在控制了人口统计和临床预测因素后，L-M 反应时间显着预测了对照组的 RIRT 表现。在患者中，C-M 结合对 CDAS 的贡献远远超出了人口统计和临床预测因素。 RIRT 和 C-M 结合测量解释了患者 CDAS 表现差异的 51%。 结论 尽管选择性注意与 EC 中的驾驶行为相关，但跨皮质结合似乎对 AD 中的驾驶最为敏感。后一种关系可能只出现在自然环境中，它更好地反映了患者的驾驶行为。视觉整合可以提供对驾驶行为的独特见解，因此对评估早期 AD 的驾驶能力具有重要意义。 (JINS, 2018, 24, 486–497)
ObjectivesPatients with Alzheimer’s disease (AD) demonstrate deficits in cross-cortical feature binding distinct from age-related changes in selective attention. This may have consequences for driving performance given its demands on multisensory integration. We examined the relationship of visuospatial search and binding to driving in patients with early AD and elderly controls (EC).MethodsParticipants (42 AD; 37 EC) completed search tasks requiring either luminance-motion (L-M) or color-motion (C-M) binding, analogs of within and across visual processing stream binding, respectively. Standardized road test (RIRT) and naturalistic driving data (CDAS) were collected alongside clinical screening measures.ResultsPatients performed worse than controls on most cognitive and driving indices. Visual search and clinical measures were differentially related to driving behavior across groups. L-M search and Trail Making Test (TMT-B) were associated with RIRT performance in controls, while C-M binding, TMT-B errors, and Clock Drawing correlated with CDAS performance in patients. After controlling for demographic and clinical predictors, L-M reaction time significantly predicted RIRT performance in controls. In patients, C-M binding made significant contributions to CDAS above and beyond demographic and clinical predictors. RIRT and C-M binding measures accounted for 51% of variance in CDAS performance in patients.ConclusionsWhereas selective attention is associated with driving behavior in EC, cross-cortical binding appears most sensitive to driving in AD. This latter relationship may emerge only in naturalistic settings, which better reflect patients’ driving behavior. Visual integration may offer distinct insights into driving behavior, and thus has important implications for assessing driving competency in early AD. (JINS, 2018, 24, 486–497)