Predicting Driver Safety in Parkinson's Disease

预测帕金森病患者的驾驶员安全

• 批准号: 7087839
• 负责人: ERGUN Y UC
• 金额: $ 33.31万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7087839
• 关键词: Parkinson' s disease; arousal; behavior prediction; behavioral /social science research tag; clinical research; cognition; human subject; judgment; longitudinal human study; neuropsychological tests; performance; psychomotor function; transportation /recreation safety; vehicular accident

DESCRIPTION (provided by applicant): Automobile driving is a crucial aspect of everyday life, yet vehicular crashes pose a serious public health problem. Drivers with Parkinson's disease (PD) are at special risk for a crash due to progressive impairments of motor function, cognition, and daytime arousal. Some drivers with PD are especially likely to drive while impaired because they are not aware of performance impairments, and neither are their physicians. Judgments on fitness to drive in at-risk drivers with PD should rely upon empirical observations of performance, because decisions based on medical diagnosis or age alone may unfairly deny patients their mobility or unwisely authorize licensure in unfit drivers. We propose to expand the available knowledge of driving safety in PD by testing a set of hypotheses in experiments that will assess (1) motor function using standardized measures of parkinsonism, (2) cognitive functions using standardized neuropsychological tests (of attention, perception, memory, and executive functions), (3) daytime arousal (standard self-ratings of sleepiness and monitoring of lid closure), and (4) driving performance as measured in an instrumented vehicle and a state-of-the-art interactive driving simulator. Our pilot study of drivers with PD shows the feasibility of this approach. Simulators make it possible to observe driver errors with optimal stimulus and response control in an environment that is challenging yet safe for the driver and tester. Participants in this project will be 115 legally licensed drivers with PD and an equal number of control drivers without neurological disease. Allowing for attrition, 100 of these 115 drivers with PD will be re-tested two years after the initial driving assessment to measure effects of PD progression on driver safety. Our goal is to increase understanding of the role of PD-related motor dysfunction, cognitive impairment, and daytime arousal disorders in driving safety errors. A better understanding of how driving performance deteriorates in PD and whether drivers are even aware of their impairment is a necessary step in the rational development of interventions that could help prevent crashes by patients with PD. The techniques used in this study could ultimately be adapted to develop future tools for screening, identifying, advising, and alerting drivers with PD who are at greater risk for impaired driving. Fair and accurate means of detecting unfit drivers with PD will help mitigate the tragedy of motor vehicle crashes caused by these impaired individuals.

描述（由申请人提供）：汽车驾驶是日常生活的一个重要方面，但车辆碰撞事故却造成了严重的公共健康问题。患有帕金森病 (PD) 的驾驶员由于运动功能、认知和日间觉醒的进行性损伤而面临特别的撞车风险。一些患有帕金森病的驾驶员特别有可能在受损的情况下驾驶，因为他们没有意识到性能障碍，他们的医生也没有意识到。对患有帕金森病的高危驾驶员是否适合驾驶的判断应依赖于对表现的经验观察，因为仅基于医疗诊断或年龄的决定可能会不公平地剥夺患者的行动能力或不明智地向不适合的驾驶员授予驾驶执照。我们建议通过在实验中测试一组假​​设来扩展帕金森驾驶安全的现有知识，这些假设将评估（1）使用帕金森氏症标准化测量的运动功能，（2）使用标准化神经心理学测试（注意力，感知，记忆和执行功能）的认知功能，（3）日间唤醒（睡意的标准自我评估和眼睑关闭的监测），以及（4）驾驶表现 仪表车辆和最先进的交互式驾驶模拟器。我们对患有 PD 的驾驶员进行的试点研究表明了这种方法的可行性。模拟器可以在对驾驶员和测试人员来说具有挑战性但安全的环境中通过最佳刺激和响应控制来观察驾驶员错误。该项目的参与者将包括 115 名患有 PD 的合法驾照驾驶员和同等数量的没有神经系统疾病的对照驾驶员。考虑到自然减员，这 115 名患有 PD 的驾驶员中的 100 名将在初次驾驶评估两年后重新接受测试，以衡量 PD 进展对驾驶员安全的影响。我们的目标是加深对 PD 相关运动功能障碍、认​​知障碍和日间觉醒障碍在驾驶安全错误中的作用的了解。更好地了解帕金森病患者的驾驶表现如何恶化以及驾驶员是否意识到自己的损伤是合理制定干预措施的必要步骤，这有助于预防帕金森病患者发生碰撞事故。这项研究中使用的技术最终可以用于开发未来的工具，用于筛查、识别、建议和提醒患有帕金森病的驾驶员，这些驾驶员的驾驶风险更大。公平、准确地检测患有 PD 的不合格驾驶员将有助于减轻这些受损人士造成的机动车事故悲剧。