Driving ability and predictors for driving performance in Multiple Sclerosis: A systematic review.

Area of Science:

• Neurology
• Rehabilitation Medicine
• Transportation Safety

Background:

• Multiple sclerosis (MS) is a progressive neurological disorder affecting millions worldwide.
• Assessing driving ability in people with MS (PwMS) is crucial for public safety and individual independence.
• Existing evidence on MS-related driving impairments requires synthesis to inform clinical practice and policy.

Approach:

• A systematic review was conducted following PRISMA guidelines to analyze studies on driving ability in PwMS.
• Databases were screened, and experts were consulted to identify relevant research.
• Formal driving assessments, including on-road tests and driving simulators, were used to evaluate driving performance.

Key Points:

• Twenty-four publications involving 806 PwMS were analyzed.
• 6% to 38% of PwMS failed on-road driving tests, indicating significant driving difficulties.
• Driving simulators also revealed impairments in PwMS, with cognitive and visual deficits being major contributors, though evidence remains inconsistent.

Conclusions:

• A substantial proportion of PwMS may not be able to drive safely, highlighting an urgent need for standardized clinical guidelines.
• While on-road tests are considered a gold standard, their heterogeneity poses challenges.
• Driving simulators offer standardization but require consistent protocols for reliable comparisons.