title: Evaluating the driving ability in patients with Parkinson's disease using a driving simulator.
abstract: OBJECTIVE
  For patients with Parkinson's disease (PD), driving is challenging due to an impaired motor function and decreased attention capabilities. This study assessed the driving capacity in PD patients by comparing neurological signs.
  
  
  METHODS
  The driving ability of PD patients was evaluated using a driving simulator (Safety Master NT-932) that tested the reaction time in response to traffic signals and steering wheel errors. We studied the correlations between the total Unified Parkinson's Disease Rating Scale (UPDRS) score, the UPDRS part III score, the subscores of the UPDRS part III score, age, PD disease duration, braking reaction time, steering wheel errors and total scores for driving safety test results. 'On' state regular PD licensed drivers (n=42; mean age: 63 years) in Hoehn and Yahr stages II-III participated after their cognitive status was confirmed using mini-mental state examinations.
  
  
  RESULTS
  The UPDRS scores, the UPDRS part III scores and the postural instability subscores exhibited significant (p<0.05) correlations with the number of steering wheel errors but not with the braking reaction time or the total safety scores of the test results.
  
  
  CONCLUSIONS
  The UPDRS is an established evaluation method used to estimate PD signs, although it is not sufficient alone for deciding whether PD patients should be allowed to drive. Our findings suggest that determining the driving ability using a driving simulator might be a useful adjunct to UPDRS scores in the assessment of PD patients who are active drivers. Estimating the driving ability requires complex measurements, including motor performance with perception of stimuli and attention.
authors.affiliation: Department of Neurology and Clinical Pharmacology, Ehime University Graduate School of Medicine, Japan.
authors.forename: Win
authors.initials: W
authors.lastname: Thiri Kyaw
authors.forename: Noriko
authors.initials: N
authors.lastname: Nishikawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Moritoyo
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Tsujii
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Iwaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nomoto
mesh_terms: D000368:Aged; D001334:Automobile Driving / Q000523:psychology*; D015331:Cohort Studies; D003198:Computer Simulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000523:psychology*; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology; D011930:Reaction Time / Q000502:physiology*