EFFECTS OF PHENYTOIN ON DRIVING SAFETY

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 汽车驾驶是日常生活中的一个重要方面，但车祸却是一个严重的公共卫生问题。癫痫患者发生车祸的风险更高，给个人造成了巨大的痛苦，给社会带来了经济成本。大多数涉及癫痫司机的碰撞与癫痫发作无关，而可能是由于癫痫和抗癫痫药物(AEDs)对驾驶性能的认知影响。数百万美国司机服用AEDs除了治疗癫痫外，还可能面临认知障碍的风险，这些认知障碍可能会降低驾驶性能。AEDs对驾驶性能影响的经验证据将有助于制定驾驶指南，从而降低汽车碰撞的损害性风险；然而，目前缺乏这种证据。我们项目的总体目标是通过随机、双盲、安慰剂对照、交叉研究评估服用苯妥英钠的神经学正常志愿者的驾驶表现和认知能力，以确定最常用的AED苯妥英钠的具体效果。我们建议的实验将评估：(1)使用标准化神经心理测试(注意力、知觉、记忆和执行功能)的认知功能，(2)在服用苯妥英和安慰剂期间的驾驶表现，以及(3)与苯妥英相关的认知表现对驾驶表现的影响。为了测量驾驶性能，我们将使用最先进的固定基数交互式驾驶模拟器，使我们能够在对驾驶员和测试员具有挑战性但又安全的环境中，在最佳刺激和响应控制的条件下观察驾驶员的错误。这项对30名接受苯妥英钠和安慰剂治疗的司机的研究结果将增加对AED相关认知障碍在驾驶安全错误中所起作用的理解。更好地了解AEDs对驾驶性能的影响，对于合理制定干预措施，帮助预防接受AEDs治疗的司机发生撞车事故是必要的。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Automobile driving is a crucial aspect of everyday life, yet vehicular crashes represent a serious public health problem. Patients with epilepsy are at elevated risk for automobile crashes, causing great personal suffering and financial costs to society. Most collisions involving epileptic drivers are not seizure related but may instead result from cognitive effects upon driving performance of epilepsy and antiepileptic drugs (AEDs). Several million American drivers take AEDs for treatment of medical conditions besides epilepsy and may also be at risk for cognitive impairments that can reduce driving performance. Empirical evidence of the effects of AEDs on driving performance would enable development of driving guidelines that could lower the risk of injurious motor vehicle collisions; however, this evidence is currently lacking. The broad goal of our project is to determine the specific effects of the most commonly utilized AED, phenytoin, by assessing driving performance and cognitive abilities in neurologically normal volunteers taking phenytoin in a randomized, double-blind, placebo-controlled, crossover study. Our proposed experiments will assess: (1) cognitive functions using standardized neuropsychological tests (of attention, perception, memory, and executive functions), (2) driving performance during phenytoin and placebo administration, and (3) the effects of phenytoin-related cognitive performance upon driving performance. To measure driving performance, we will use a state-of-the-art fixed-base interactive driving simulator that allows us to observe driver errors in an environment that is challenging yet safe for the driver and tester, under conditions of optimal stimulus and response control. The results of this study of 30 drivers treated with phenytoin and placebo will increase the understanding of the role of AED-related cognitive impairment on driving safety errors. A better understanding of the impact of AEDs upon driving performance is necessary to rationally develop interventions that could help prevent crashes by drivers treated with AEDs.