@article{ref1,
title="Driving under low-contrast visibility conditions in Parkinson disease",
journal="Neurology",
year="2009",
author="Uc, Ergun Y. and Rizzo, M. and Anderson, S. W. and Dastrup, E. and Sparks, J. D. and Dawson, J. D.",
volume="73",
number="14",
pages="1103-1110",
abstract="OBJECTIVE: To assess driving performance in Parkinson disease (PD) under low-contrast visibility conditions. METHODS: Licensed, active drivers with mild to moderate PD (n = 67, aged 66.2 +/- 9.0 years, median Hoehn-Yahr stage = 2) and controls (n = 51, aged 64.0 +/- 7.2 years) drove in a driving simulator under high- (clear sky) and low-contrast visibility (fog) conditions, leading up to an intersection where an incurring vehicle posed a crash risk in fog. RESULTS: Drivers with PD had higher SD of lateral position (SDLP) and lane violation counts (LVC) than controls during fog (p < 0.001). Transition from high- to low-contrast visibility condition increased SDLP and LVC more in PD than in controls (p < 0.01). A larger proportion of drivers with PD crashed at the intersection in fog (76.1% vs 37.3%, p < 0.0001). The time to first reaction in response to incursion was longer in drivers with PD compared with controls (median 2.5 vs 2.0 seconds, p < 0.0001). Within the PD group, the strongest predictors of poor driving outcomes under low-contrast visibility conditions were worse scores on measures of visual processing speed and attention, motion perception, contrast sensitivity, visuospatial construction, motor speed, and activities of daily living score. CONCLUSIONS: During driving simulation under low-contrast visibility conditions, drivers with Parkinson disease (PD) had poorer vehicle control and were at higher risk for crashes, which were primarily predicted by decreased visual perception and cognition; motor dysfunction also contributed. Our results suggest that drivers with PD may be at risk for unsafe driving in low-contrast visibility conditions such as during fog or twilight.<p /> <p>Language: en</p>",
language="en",
issn="0028-3878",
doi="10.1212/WNL.0b013e3181bacf6e",
url="http://dx.doi.org/10.1212/WNL.0b013e3181bacf6e"
}