Cognitive Impairment and Driving Skills in Youth After Concussion
- 1 June 2023
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Neurotrauma
- Vol. 40 (11-12), 1187-1196
- https://doi.org/10.1089/neu.2022.0308
Abstract
Concussions can impact cognitive processes necessary for driving. Young adults, a group who are more likely to engage in risky behaviors, have limited driving experience and a higher rate of motor vehicle collisions; they may be at higher risk for driving impairment after concussion. There are no clear guidelines for return to driving following a concussion. We sought to examine the simulated driving performance of young drivers after receiving medical care following a concussion, compared to a similar control population, to examine the association of driving performance with performance on neuropsychological tests. We evaluated 47 16 to 25 year-old drivers within 3 weeks of sustaining a concussion and 50 drivers with similar characteristics who had not sustained concussions. Participants completed demographic questionnaires, the Sport Concussion Assessment Tool-5 (SCAT-5), and a brief set of neurocognitive tests including the NIH Toolbox Cognition Battery and the Trail Making Test, and a simulated driving assessment. At various times during simulated driving, participants were asked to respond to tactile stimuli using the tactile detection response task (TDRT), a validated method of testing cognitive load during simulated driving. The concussion group reported significantly higher symptoms on the SCAT-5 than the comparison group. Performance on crystallized neurocognitive skills was similar between groups. Performance on fluid neurocognitive skills was significantly lower in the concussion than comparison group, though scores were in the normal range for both groups. Simulated driving was similar between groups, though there was a small but significant difference in variation in speed as well as TDRT miss rate with worse performance by the concussion group. Symptom report on the SCAT-5 was significantly associated with TDRT miss rate. In addition, neurocognitive test scores significantly predicted TDRT reaction time and miss count with medium to large effect sizes. Results suggest that neurocognitive screening may be a useful tool for predicting capacity to return to drive. However, further research is needed to determine guidelines for how neuropsychological tests can be used to make return to driving recommendations and to evaluate effects of concussion on real world driving.Keywords
This publication has 42 references indexed in Scilit:
- Using the NIH Toolbox in special populationsNeurology, 2013
- Cognition assessment using the NIH ToolboxNeurology, 2013
- Return-to-driving expectations following mild traumatic brain injuryBrain Injury, 2012
- Assessment of drivers' ability to anticipate traffic hazards after traumatic brain injuryJournal of Neurology, Neurosurgery & Psychiatry, 2010
- Measuring Outcome in Traumatic Brain Injury Treatment TrialsJournal of Head Trauma Rehabilitation, 2010
- Using driving simulators to assess driving safetyAccident Analysis & Prevention, 2010
- The development of a clinical outcomes survey research application: Assessment CenterSMQuality of Life Research, 2010
- Driving after concussion: The acute effect of mild traumatic brain injury on drivers' hazard perception.Neuropsychology, 2010
- Youth Risk Behavior Surveillance—United States, 2005Journal of School Health, 2006
- Simulator Sickness Questionnaire: An Enhanced Method for Quantifying Simulator SicknessThe International Journal of Aviation Psychology, 1993