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Dr. Okun

New Study: Low Contrast Visibility and Driving in PD

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Dear Forum members,

 

This is a new study by Dr. Ergun Uc and colleagues at Iowa. They have some sophisticated technology and have been studying cognition and driving and many other aspects of driving. They point out in this article that PD patients may have trouble driving in fog/twilight.

 

The abstract of the study is provided below:

 

Neurology. 2009 Oct 6;73(14):1103-10.

Driving under low-contrast visibility conditions in Parkinson disease.

 

Uc EY, Rizzo M, Anderson SW, Dastrup E, Sparks JD, Dawson JD.

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

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.

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