INS NYC 2024 Program

Poster	Poster Session 03 Program Schedule 02/15/2024 09:30 am - 10:40 am Room: Shubert Complex (Posters 1-60) Poster Session 03: Neurotrauma \| Neurovascular Final Abstract #18 Beyond Diagnosis: The Cognitive Demands of Stopping and Turning Behaviors Among Drivers With and Without Multiple Sclerosis and Implications for Driving Safety Suhani Dheer, Drexel University, Philadelphia, United States Kathryn Devlin, Drexel University, Philadelphia, United States Jocelyn Ang, Drexel University, Philadelphia, United States Maria Schultheis, Drexel University, Philadelphia, United States Category: Cognitive Intervention/Rehabilitation Keyword 1: multiple sclerosis Keyword 2: cognitive functioning Keyword 3: driving Objective: The ability to drive is a significant factor of independence for persons with Multiple Sclerosis (PwMS). Prior research shows that collisions at intersections, particularly involving stops and turns, constitute a significant portion of road collisions. However, limited research has examined the impact of MS-related cognitive compromise on cognitively-demanding driving behaviors. This study used virtual reality driving simulation (VRDS) to 1) identify cognitive correlates of stopping and turning driving behaviors, 2) investigate differences in stopping/turning behavior between adults with and without MS, and 3) examine whether MS status influences these correlates. Participants and Methods: 85 adult drivers, including 48 PwMS and 37 healthy controls (HC) (ages 21-60, mean age 46.4, 79.5% women, 64.8% White). Participants completed neuropsychological assessments and a VRDS drive that included right and left turns, and stop sign intersections ranging from low to high cognitive demand. Stopping variables included failing to stop, minimum speed, distance from the stop line, and wait time. Turning variables included lane position, speed, acceleration, and braking. Neuropsychological correlates of stopping/turning behaviors were examined using Pearson and Spearman's correlations. Group differences were examined using analysis of variance, Mann-Whitney U, chi-square, and Fisher exact tests. Linear and logistic regressions evaluated interactions between MS status and neuropsychological measures on driving behavior. Results: First, analyses examining cognitive correlates of turning behaviors found that weaker visuospatial abilities, visuospatial memory, cognitive/motor speed, and time-based working memory related to greater lane position variability, sharper left turns, overly slow speed, and greater pre-turn acceleration. Cognitive correlates of stopping behaviors were mixed; cognitive/motor weaknesses were sometimes associated with less safe driving, and sometimes with safer driving. Secondly, group differences were minimal. HCs executed sharper left turns than PwMS (p=0.035, η2=.08). PwMS trended towards stopping after the line at the high-complexity stop (p=0.07, phi=0.31). Regarding cognitive/motor-function, most associations with stopping/turning did not differ by MS status. Select associations between psychomotor speed/executive function and turning behavior were present only in the MS group, while the HC group drove more safely (e.g., more consistent lane position, faster speed) regardless of these abilities. Working memory correlated with left turn lane position in the HC group, while the MS group drove more safely (less sharp turns) regardless of working memory. Conclusions: PwMS exhibited similar driving behaviors to HCs at challenging intersections, with rare exceptions. Specifically, they demonstrated increased caution in left turns and trended towards less safe stopping at high complexity stops. Cognitive/motor functions, notably selective visual attention, visuospatial ability, working memory, and psychomotor speed, were significantly associated with stopping/turning behaviors, but these correlates largely did not differ between the groups. These findings hold implications for driving recommendations, for both MS and the general populace, enhancing road safety and independence. These results emphasize the importance of evaluating cognitive and motor capabilities for driving rather than relying solely on diagnostic status. Given the mild difficulties observed in PwMS, findings may differ in other neurologic populations, which should be explored in future research.

Poster

02/15/2024
09:30 am - 10:40 am
Room: Shubert Complex (Posters 1-60)

Poster Session 03: Neurotrauma | Neurovascular

Final Abstract #18

Beyond Diagnosis: The Cognitive Demands of Stopping and Turning Behaviors Among Drivers With and Without Multiple Sclerosis and Implications for Driving Safety

Suhani Dheer, Drexel University, Philadelphia, United States
Kathryn Devlin, Drexel University, Philadelphia, United States
Jocelyn Ang, Drexel University, Philadelphia, United States
Maria Schultheis, Drexel University, Philadelphia, United States

Category: Cognitive Intervention/Rehabilitation

Keyword 1: multiple sclerosis
Keyword 2: cognitive functioning
Keyword 3: driving

Objective:

The ability to drive is a significant factor of independence for persons with Multiple Sclerosis (PwMS). Prior research shows that collisions at intersections, particularly involving stops and turns, constitute a significant portion of road collisions. However, limited research has examined the impact of MS-related cognitive compromise on cognitively-demanding driving behaviors. This study used virtual reality driving simulation (VRDS) to 1) identify cognitive correlates of stopping and turning driving behaviors, 2) investigate differences in stopping/turning behavior between adults with and without MS, and 3) examine whether MS status influences these correlates.

Participants and Methods:

85 adult drivers, including 48 PwMS and 37 healthy controls (HC) (ages 21-60, mean age 46.4, 79.5% women, 64.8% White). Participants completed neuropsychological assessments and a VRDS drive that included right and left turns, and stop sign intersections ranging from low to high cognitive demand. Stopping variables included failing to stop, minimum speed, distance from the stop line, and wait time. Turning variables included lane position, speed, acceleration, and braking. Neuropsychological correlates of stopping/turning behaviors were examined using Pearson and Spearman's correlations. Group differences were examined using analysis of variance, Mann-Whitney U, chi-square, and Fisher exact tests. Linear and logistic regressions evaluated interactions between MS status and neuropsychological measures on driving behavior.

Results:

First, analyses examining cognitive correlates of turning behaviors found that weaker visuospatial abilities, visuospatial memory, cognitive/motor speed, and time-based working memory related to greater lane position variability, sharper left turns, overly slow speed, and greater pre-turn acceleration. Cognitive correlates of stopping behaviors were mixed; cognitive/motor weaknesses were sometimes associated with less safe driving, and sometimes with safer driving. Secondly, group differences were minimal. HCs executed sharper left turns than PwMS (p=0.035, η2=.08). PwMS trended towards stopping after the line at the high-complexity stop (p=0.07, phi=0.31). Regarding cognitive/motor-function, most associations with stopping/turning did not differ by MS status. Select associations between psychomotor speed/executive function and turning behavior were present only in the MS group, while the HC group drove more safely (e.g., more consistent lane position, faster speed) regardless of these abilities. Working memory correlated with left turn lane position in the HC group, while the MS group drove more safely (less sharp turns) regardless of working memory.

Conclusions:

PwMS exhibited similar driving behaviors to HCs at challenging intersections, with rare exceptions. Specifically, they demonstrated increased caution in left turns and trended towards less safe stopping at high complexity stops. Cognitive/motor functions, notably selective visual attention, visuospatial ability, working memory, and psychomotor speed, were significantly associated with stopping/turning behaviors, but these correlates largely did not differ between the groups. These findings hold implications for driving recommendations, for both MS and the general populace, enhancing road safety and independence. These results emphasize the importance of evaluating cognitive and motor capabilities for driving rather than relying solely on diagnostic status. Given the mild difficulties observed in PwMS, findings may differ in other neurologic populations, which should be explored in future research.