Feasibility of utilizing clinical and driving simulator assessments to indicate driving performance deficits in adults with multiple sclerosis

Abstract

BACKGROUND: Drivers with Multiple Sclerosis (MS) experience visual-cognitive impairment that impact on-road driving performance. OBJECTIVE: This study examines the feasibility of utilizing visual-cognitive and driving simulator assessments to indicate driving performance deficits (operational, tactical, and strategic maneuvers) in drivers with MS. METHODS: Through an evidence-informed feasibility framework, we evaluated recruitment capability and resulting sample characteristics, data collection procedures and outcome measures, participants’ acceptability and suitability of the driving simulator, the resources and ability to implement the study, and clinical and driving simulator assessment results. RESULTS: Thirty-eight persons with MS (median age = 43 years, IQR = 19) and 21 persons without MS (median age = 41 years, IQR = 14) participated. Missing data on the driving simulator resulted from scenario complexity (13 with MS, 4 without MS) or the onset of simulator sickness (1 with MS, 1 without MS). Seven participants with MS and two participants without MS reported symptoms of simulator sickness. Participants with MS (vs without MS) made more adjustment to stimuli errors (tactical maneuvers). For participants with MS, immediate verbal/auditory recall or divided/selective attention correlated with simulated driving maneuvers. CONCLUSIONS: Study findings identified challenges (missing data, simulator sickness), but established feasibility for executing a full-scale study to predict driving simulator performance in drivers with MS.