ST. PAUL, MN - People who suffer from cognitive difficulties related to Multiple Sclerosis (MS) have a slower driving reaction time and increased risk of accidents, according to a study in the April 24 issue of Neurology, the scientific journal of the American Academy of Neurology.
"This is the first study to provide direct evidence that cognitive difficulties among people with MS can influence driving," said Maria T. Schultheis, PhD, of Kessler Medical Rehabilitation Research & Education Corporation in New Jersey. "Previous studies have only looked at physical problems resulting from MS in relation to driving capabilities, not cognitive difficulties."
The study looked at 13 people with MS who exhibited cognitive difficulties and 15 people with MS who did not exhibit cognitive difficulties based on several neuropsychological tests. Seventeen people without MS were also compared. Based on two computerized driving tests, those with MS who exhibited cognitive difficulties had a slower response time by 1,721 milliseconds than the other MS participants. In addition, 29 percent of these people tested as high risk for accident involvement.
According to Schultheis, the prevalence of cognitive difficulties in MS has only been recently recognized. Estimates of those cognitive difficulties range from approximately 43 to 65 percent. However, the severity and impact of these cognitive difficulties on everyday life varies. As such, more research is needed to further understand how these problems affect people with MS in their everyday lives.
"Hopefully, this study will alert clinicians to consider cognitive factors in relation to MS when they are evaluating an individual's driving capabilities, and provide a more comprehensive evaluation for people," said Schultheis. "The goal of understanding the demands of driving is not to minimize or restrict driving privileges, but to provide better evaluations and maintain safe drivers on the road."
The single session of driving tests examined attention span and the driver's ability to process rapidly presented information, to calculate the driver's risk of accident. Another test examined driving ability through self-evaluation questions, simulated driving tests and scenarios, and visual field assessments. Although a difference in reaction time was found between the two groups of MS participants, there was little difference in reaction time between people without MS and people with MS who did not experience cognitive difficulties.
"Many participants expressed concerns regarding their driving ability, but were unsure about with whom they should discuss their concerns, or if their concerns, in fact, were related to changes from MS," said Schultheis. "Hopefully, for these individuals, this study can serve to support their concerns and create awareness with clinicians, giving them a place to voice their concerns."
Schultheis looks to future studies that broaden the research to examine how cognitive and physical difficulties in MS relate to driving capabilities and include more "real life" driving scenarios.
"The more we understand about driving, the more we improve our evaluation process and help people living with MS stay on the road safely and enjoy a more independent lifestyle," said Schultheis.
The American Academy of Neurology, an association of more than 17,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research.
For more information about the American Academy of Neurology, visit its web site at www.aan.com.
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