Predicting Driver Safety in Parkinson's Disease

预测帕金森病患者的驾驶员安全

• 批准号: 7087839
• 负责人: ERGUN Y UC
• 金额: $ 33.31万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2008-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7087839
• 关键词: Parkinson' s disease; arousal; behavior prediction; behavioral /social science research tag; clinical research; cognition; human subject; judgment; longitudinal human study; neuropsychological tests; performance; psychomotor function; transportation /recreation safety; vehicular accident

DESCRIPTION (provided by applicant): Automobile driving is a crucial aspect of everyday life, yet vehicular crashes pose a serious public health problem. Drivers with Parkinson's disease (PD) are at special risk for a crash due to progressive impairments of motor function, cognition, and daytime arousal. Some drivers with PD are especially likely to drive while impaired because they are not aware of performance impairments, and neither are their physicians. Judgments on fitness to drive in at-risk drivers with PD should rely upon empirical observations of performance, because decisions based on medical diagnosis or age alone may unfairly deny patients their mobility or unwisely authorize licensure in unfit drivers. We propose to expand the available knowledge of driving safety in PD by testing a set of hypotheses in experiments that will assess (1) motor function using standardized measures of parkinsonism, (2) cognitive functions using standardized neuropsychological tests (of attention, perception, memory, and executive functions), (3) daytime arousal (standard self-ratings of sleepiness and monitoring of lid closure), and (4) driving performance as measured in an instrumented vehicle and a state-of-the-art interactive driving simulator. Our pilot study of drivers with PD shows the feasibility of this approach. Simulators make it possible to observe driver errors with optimal stimulus and response control in an environment that is challenging yet safe for the driver and tester. Participants in this project will be 115 legally licensed drivers with PD and an equal number of control drivers without neurological disease. Allowing for attrition, 100 of these 115 drivers with PD will be re-tested two years after the initial driving assessment to measure effects of PD progression on driver safety. Our goal is to increase understanding of the role of PD-related motor dysfunction, cognitive impairment, and daytime arousal disorders in driving safety errors. A better understanding of how driving performance deteriorates in PD and whether drivers are even aware of their impairment is a necessary step in the rational development of interventions that could help prevent crashes by patients with PD. The techniques used in this study could ultimately be adapted to develop future tools for screening, identifying, advising, and alerting drivers with PD who are at greater risk for impaired driving. Fair and accurate means of detecting unfit drivers with PD will help mitigate the tragedy of motor vehicle crashes caused by these impaired individuals.

描述（由申请人提供）：汽车驾驶是日常生活的关键方面，但是车辆撞车事故构成了严重的公共卫生问题。患有帕金森氏病（PD）的驾驶员由于运动功能，认知和白天唤醒的逐渐损害而面临崩溃的特殊风险。一些患有PD的驾驶员在受损时尤其可能是因为他们不了解绩效障碍，而且医生也不是。关于适合驾驶PD的高危驾驶员的适应性的判断应依赖于对绩效的经验观察，因为仅基于医学诊断或年龄的决定可能会不公平地否认患者的活动能力或不明智地授权在不适合驾驶员中获得许可。 We propose to expand the available knowledge of driving safety in PD by testing a set of hypotheses in experiments that will assess (1) motor function using standardized measures of parkinsonism, (2) cognitive functions using standardized neuropsychological tests (of attention, perception, memory, and executive functions), (3) daytime arousal (standard self-ratings of sleepiness and monitoring of lid closure), and (4) driving performance as measured in仪器和最先进的互动驾驶模拟器。我们对使用PD的驾驶员的试点研究显示了这种方法的可行性。模拟器使在对驾驶员和测试人员既有挑战又安全的环境中观察驱动程序错误和响应控制。该项目的参与者将是115名具有PD的合法许可驾驶员，并且没有神经疾病的控制驱动因素。允许消耗性的115个带有PD的驱动程序中的100个将在初步驾驶评估后两年重新测试，以衡量PD进展对驾驶员安全的影响。我们的目标是增加对PD相关运动功能障碍，认知障碍和白天唤醒疾病在驱动安全错误中的作用的了解。更好地理解驱动驾驶性能如何在PD中如何恶化以及驾驶员是否知道其损害是理性发展干预措施的必要步骤，这可以帮助防止PD患者崩溃。本研究中使用的技术最终可以改编成开发未来的工具，以筛查，识别，建议和提醒PD驾驶员的驾驶员面临更大风险的驾驶风险。通过PD检测不合适的驾驶员的公平准确手段将有助于减轻这些受损个人造成的机动车坠毁的悲剧。