Longitudinal Executive Changes in Drivers with Parkinson's Disease: Study Using Neuropsychological and Driving Simulator Tasks

Background/Aims: (1) To investigate how specific executive functions change over 2 years in drivers with Parkinson's disease (PD) compared to controls, using both neuropsychological and driving simulator tasks; and (2) to explore the association between the decline of specific executive functions and changes in driving habits in PD. Methods: Sixteen PD patients and 21 controls underwent neuropsychological testing twice and performed tasks on a driving simulator, with an interval of approximately 2 years. Questions on participants' self-perception of their driving ability were administered. Results: A significant decline was observed in shift cost over time (Plus Minus Test) in patients (p = 0.008). This decline was greater in patients than in controls (p = 0.008). No significant change emerged over time in the flexibility cost of PD patients on a simulator (p = 0.158). Significant correlations were found between the decline in shift cost over time and driving question outcomes (p < 0.05). Conclusion: This study reveals a differential course of executive functions in PD. Over time, patients displayed significant decline in flexibility associated with modifications in their driving. Flexibility seems to be affected as the disease progresses. This research opens new avenues in cognitive and driving rehabilitation. (C) 2016 S. Karger AG, Basel