Driving under low-contrast visibility conditions in Parkinson disease

E Y Uc; M Rizzo; S W Anderson; E Dastrup; J D Sparks; J D Dawson

doi:10.1212/wnl.0b013e3181bacf6e

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Driving under low-contrast visibility conditions in Parkinson disease

Journal article

Open access

Peer reviewed

Driving under low-contrast visibility conditions in Parkinson disease

E Y Uc, M Rizzo, S W Anderson, E Dastrup, J D Sparks and J D Dawson

Neurology, Vol.73(14), pp.1103-1110

10/06/2009

DOI: 10.1212/wnl.0b013e3181bacf6e

PMCID: PMC2764395

PMID: 19805726

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Abstract

To assess driving performance in Parkinson disease (PD) under low-contrast visibility conditions. Licensed, active drivers with mild to moderate PD (n = 67, aged 66.2 +/- 9.0 years, median Hoehn-Yahr stage = 2) and controls (n = 51, aged 64.0 +/- 7.2 years) drove in a driving simulator under high- (clear sky) and low-contrast visibility (fog) conditions, leading up to an intersection where an incurring vehicle posed a crash risk in fog. Drivers with PD had higher SD of lateral position (SDLP) and lane violation counts (LVC) than controls during fog (p < 0.001). Transition from high- to low-contrast visibility condition increased SDLP and LVC more in PD than in controls (p < 0.01). A larger proportion of drivers with PD crashed at the intersection in fog (76.1% vs 37.3%, p < 0.0001). The time to first reaction in response to incursion was longer in drivers with PD compared with controls (median 2.5 vs 2.0 seconds, p < 0.0001). Within the PD group, the strongest predictors of poor driving outcomes under low-contrast visibility conditions were worse scores on measures of visual processing speed and attention, motion perception, contrast sensitivity, visuospatial construction, motor speed, and activities of daily living score. During driving simulation under low-contrast visibility conditions, drivers with Parkinson disease (PD) had poorer vehicle control and were at higher risk for crashes, which were primarily predicted by decreased visual perception and cognition; motor dysfunction also contributed. Our results suggest that drivers with PD may be at risk for unsafe driving in low-contrast visibility conditions such as during fog or twilight.

Psychomotor Performance

Humans

Middle Aged

Male

Reaction Time

Automobile Driving - psychology

Cognition

Parkinson Disease - physiopathology

Parkinson Disease - psychology

Case-Control Studies

Accidents, Traffic - psychology

Vision, Ocular

Female

Visual Perception

Aged

Task Performance and Analysis

Accidents, Traffic - prevention & control

Contrast Sensitivity

Details

Title: Subtitle: Driving under low-contrast visibility conditions in Parkinson disease
Creators: E Y Uc - Department of Neurology, University of Iowa, Carver College of Medicine, 200 Hawkins Dr., 2RCP, Iowa City, IA 52242, USA. ergun-uc@uiowa.edu
M Rizzo
S W Anderson
E Dastrup
J D Sparks
J D Dawson
Resource Type: Journal article
Publication Details: Neurology, Vol.73(14), pp.1103-1110
DOI: 10.1212/wnl.0b013e3181bacf6e
PMID: 19805726
PMCID: PMC2764395
NLM abbreviation: Neurology
ISSN: 1526-632X
eISSN: 1526-632X
Publisher: United States
Grant note: R01 AG 15071 / NIA NIH HHS R01 AG 17717 / NIA NIH HHS R01 AG015071 / NIA NIH HHS R01 NS044930 / NINDS NIH HHS
Language: English
Date published: 10/06/2009
Academic Unit: Neurology; Public Health Administration; Biostatistics
Record Identifier: 9983997445202771

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