Slowed driving-reaction time following concussion-symptom resolution

摘要

Background:Concussed patients have impaired reaction time(RT)and cognition following injury that may linger and impair driving performance.Limited research has used direct methods to assess driving-RT post-concussion.Our study compared driving RT during simulated scenarios between concussed and control individuals and examined driving-RT’s relationship with traditional computerized neurocognitive testing(CNT)domains.Methods:We employed a cross-sectional study among 14 concussed(15.9±9.8 days post-concussion,mean±SD)individuals and 14 healthy controls matched for age,sex,and driving experience.Participants completed a driving simulator and CNT(CNS Vital Signs)assessment within 48 h of symptom resolution.A driving-RT composite(ms)was derived from 3 simulated driving scenarios:stoplight(green to yellow),evasion(avoiding approaching vehicle),and pedestrian(person running in front of vehicle).The CNT domains included verbal and visual memory;CNT-RT(simple-,complex-,Stroop-RT individually);simple and complex attention;motor,psychomotor,and processing speed;executive function;and cognitive flexibility.Independent t tests and Hedge d effect sizes assessed driving-RT differences between groups,Pearson correlations(r)examined driving RT and CNT domain relationships among cohorts separately,and p values were controlled for false discovery rate via Benjamini-Hochberg procedures(a=0.05).Results:Concussed participants demonstrated slower driving-RT composite scores than controls(mean difference=292.86 ms;95%confidence interval(95%CI):70.18515.54;p=0.023;d=0.992).Evasion-RT(p=0.054;d=0.806),pedestrian-RT(p=0.258;d=0.312),and stoplight-RT(p=0.292;d=0.585)outcomes were not statistically significant after false-discovery rate corrections but demonstrated medium to large effect sizes for concussed deficits.Among concussed individuals,driving-RT outcomes did not significantly correlate with CNT domains(r-range:0.51 to 0.55;p>0.05).No correlations existed between driving-RT outcomes and CNT domains among control participants either(r-range:0.52 to 0.72;p>0.05).Conclusion:Slowed driving-RT composite scores and large effect sizes among concussed individuals when asymptomatic signify lingering impairment and raise driving-safety concerns.Driving-RT and CNT-RT measures correlated moderately but not statistically,which indicates that CNT-RT is not an optimal surrogate for driving RT.