Beyond Executive Dysfunction: The Precuneus as an Introspective Monitoring Hub for Driving Safety

Unsafe driving is a public health concern, yet its neural basis in the general population remains poorly understood. Research on attention-deficit/hyperactivity disorder (ADHD) traditionally attributes crash risk to executive dysfunction and fronto-striatal abnormalities, but these models do not explain unsafe driving among healthy individuals. Here, we synthesize structural and functional neuroimaging evidence to propose a precuneus-centered framework of driving safety. Reduced precuneus gray matter volume is associated with ADHD trait dimensions and crash history in healthy adults, while functional neuroimaging indicates precuneus involvement during driving-related hazard appraisal. Together, these findings suggest that crash vulnerability may be associated with impaired metacognitive awareness of internal states rather than primary executive deficits. The framework proposes that introspective monitoring may facilitate subsequent executive regulation, while recognizing that this temporal ordering remains a conceptual hypothesis. By conceptualizing the precuneus as an introspective monitoring hub within a broader distributed neurocognitive network, this framework links default mode network research with safety-critical behavior and offers a neurobiological perspective on driving risk.