Clinical predictors of driving simulator performance in drivers with multiple sclerosis

Sarah Krasniuk; Sherrilene Classen; Sarah A Morrow; Liliana Alvarez; Wenqing He; Sivaramakrishnan Srinivasan; Miriam Monahan

doi:10.1177/1352458521992507

Clinical predictors of driving simulator performance in drivers with multiple sclerosis

Mult Scler. 2021 Nov;27(13):2085-2092. doi: 10.1177/1352458521992507. Epub 2021 Feb 10.

Authors

Sarah Krasniuk¹, Sherrilene Classen², Sarah A Morrow³, Liliana Alvarez⁴, Wenqing He⁵, Sivaramakrishnan Srinivasan⁶, Miriam Monahan⁷

Affiliations

¹ Health and Rehabilitation Sciences, University of Western Ontario, London, ON, Canada.
² Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
³ Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada/London Health Sciences Centre, London, ON, Canada.
⁴ School of Occupational Therapy, University of Western Ontario, London, ON, Canada.
⁵ Department of Statistical and Actuarial Sciences, University of Western Ontario, London, ON, Canada.
⁶ Department of Civil and Coastal Engineering, University of Florida, Gainesville, FL, USA.
⁷ Driver Rehabilitation Institute, Petaluma, CA, USA.

PMID: 33565905
DOI: 10.1177/1352458521992507

Abstract

Background: Drivers with multiple sclerosis (MS) may experience visual-cognitive impairment that affects their fitness to drive. Due to limitations associated with the on-road assessment, an alternative assessment that measures driving performance is warranted. Whether clinical indicators of on-road outcomes can also predict driving performance outcomes on a driving simulator are not fully understood.

Objective: This study examined if deficits in immediate verbal/auditory recall (California Verbal Learning Test-Second Edition; CVLT2-IR) and/or slower divided attention (Useful Field of View™; UFOV2) predicted deficits in operational, tactical, or strategic maneuvers assessed on a driving simulator, in drivers with and without MS.

Methods: Participants completed the CVLT2-IR, UFOV2, and a driving simulator assessment of operational, tactical, and strategic maneuvers.

Results: Deficits in immediate verbal/auditory recall and slower divided attention predicted adjustment to stimuli errors, pertaining to tactical maneuvers only, in 36 drivers with MS (vs 20 drivers without MS; F(3, 51) = 6.1, p = 0.001, R² = 0.3, $R_{a d j}^{2} = 0.2$ ).

Conclusion: The CVLT2-IR and UFOV2 capture the visual and verbal/auditory recall, processing speed, and divided attention required to appropriately adjust to stimuli in a simulated driving environment. Clinicians may use the CVLT2-IR and UFOV2 as precursors to driving performance deficits in drivers with MS.

Keywords: Multiple sclerosis; automobile driving; cognitive impairment; computer simulation; driving performance; outcome measurement.

MeSH terms

Attention
Automobile Driving*
Cognition
Computer Simulation
Humans
Memory, Short-Term
Multiple Sclerosis*