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Neurology. 2009 Oct 6;73(14):1103-10. doi: 10.1212/WNL.0b013e3181bacf6e.

Driving under low-contrast visibility conditions in Parkinson disease.

Author information

  • 1Department of Neurology, University of Iowa, Carver College of Medicine, 200 Hawkins Dr., 2RCP, Iowa City, IA 52242, USA. ergun-uc@uiowa.edu

Erratum in

  • Neurology. 2010 Feb 16;74(7):616.

Abstract

OBJECTIVE:

To assess driving performance in Parkinson disease (PD) under low-contrast visibility conditions.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

PMID:
19805726
[PubMed - indexed for MEDLINE]
PMCID:
PMC2764395
Free PMC Article

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