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Symbol digit modalities test predicts decline of off-road driving ability in Japanese patients with multiple
Manami Maeta1, Masanori Mizuno1, Satoru Okubo2
1Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, 1-1-1 Idaidori, Yahaba, Shiwa, Iwate 0283694, Japan.
Background:
Multiple sclerosis (MS) is a chronic progressing neurological disease with exacerbations and remissions. Patients with MS can show a variety of neurological symptoms. Cognitive decline is noticed as one of them and is related with deterioration of daily life quality in a clinical practice. Driving a car is one of the common activities required in daily life and is also an important issue in MS patients.
Methods:
To clarify the relationship between cognitive function and driving ability in MS patients, the symbol digit modalities test (SDMT) and a driving simulator were evaluated. We enrolled 24 patients with MS (5 males, 19 females, 39.04 ± 8.27 years old) and age- and sex-matched 24 healthy controls (5 males, 19 females, 40.54 ± 9.78 years old) in this study. They underwent the SDMT and also used a driving simulator to measure a total of 12 response values related to driving ability. In order to evaluate the relationship between SDMT and driving ability, MS patients were divided into two groups according to the median SDMT score: group A (SDMT 51 or more) and group B (SDMT less than 51). The data were statistically analyzed among control group, MS group A, and MS group B using Jonkheere-Terpstra trend test and Bonferroni's multiple comparison test.
Results:
The group with higher scores on the SDMT tended to have significantly higher driving performance. Multiple comparison analysis among three groups showed that the reaction values for speed of response behavior were significantly higher in MS group B than control group.
Conclusion:
This study revealed a relationship between driving abilities and SDMT scores. Clinical evaluation using the SDMT may help to detect cognitive decline and to make a decision on driving a car in patients with MS.
