Driving with distraction in Parkinson disease

Area of Science:

• Neurology
• Transportation Safety

Background:

• Parkinson disease (PD) affects motor control and cognition, potentially impacting driving.
• Auditory-verbal distraction is a common real-world driving challenge.

Purpose of the Study:

• To evaluate the impact of auditory-verbal distraction on driving performance in individuals with mild-to-moderate Parkinson disease (PD).
• To compare driving performance under distraction between PD drivers and healthy controls.

Main Methods:

• Mild-to-moderate PD drivers (n=71) and elderly controls (n=147) completed cognitive, visual, and motor tests.
• Driving performance was assessed on a freeway using an instrumented vehicle, measuring at-fault safety errors and vehicle control during a Paced Auditory Serial Addition Task (PASAT) and baseline conditions.

Main Results:

• PD drivers committed more errors and exhibited slower speeds with higher variability during distraction compared to controls.
• While average distraction effects were similar, PD drivers showed heterogeneous responses: 28.2% had increased errors (vs. 15.8% in controls).
• Cognitive flexibility, verbal memory, postural control deficits, and sleepiness predicted worsened driving performance under distraction in PD.

Conclusions:

• The overall quantitative effect of auditory distraction on driving was not significantly different between PD and control groups.
• A larger proportion of PD drivers experienced a decline in driving safety errors during distraction.
• Cognitive, motor, and sleepiness measures are crucial predictors of how distraction affects driving in PD individuals.