Exploring the association between working memory and driving performance in Parkinson's disease

Objective: The aim of this study was to explore whether varying levels of operational and tactical driving task demand differentially affect drivers with Parkinson's disease (PD) and control drivers in their sign recall.
Methods: Study participants aged between 50 and 70 years included a group of drivers with PD (n = 10) and a group of age- and sex-matched control drivers (n = 10). Their performance in a sign recall task was measured using a driving simulator.
Results: Drivers in the control group performed better than drivers with PD in a sign recall task, but this trend was not statistically significant (P =.43). In addition, regardless of group membership, subjects' performance differed according to varying levels of task demand. Performance in the sign recall task was more likely to drop with increasing task demand (P =.03). This difference was significant when the variation in task demand was associated with a cognitive task; that is, when drivers were required to apply the instructions from working memory.
Conclusions: Although the conclusions drawn from this study are tentative, the evidence presented here is encouraging with regard to the use of a driving simulator to examine isolated cognitive functions underlying driving performance in PD. With an understanding of its limitations, such driving simulation in combination with functional assessment batteries measuring physical, visual, and cognitive abilities could comprise one component of a multitiered system to evaluate medical fitness to drive.

研究目的：本研究旨在探究不同程度的操作型与战术型驾驶任务负荷，是否会对帕金森病（Parkinson's disease, PD）患者驾驶员与健康对照驾驶员的交通标志记忆召回表现产生差异化影响。
研究方法：本研究的受试对象年龄介于50至70岁之间，包含PD患者驾驶员组（n=10）以及年龄、性别匹配的健康对照驾驶员组（n=10）。研究采用驾驶模拟器对受试者的交通标志记忆召回任务表现进行量化测评。
研究结果：在交通标志记忆召回任务中，健康对照组驾驶员的表现优于PD患者组，但该组间差异未达到统计学显著性水平（P=0.43）。此外，无论受试组别归属如何，受试者的任务表现均随任务负荷水平的变化而存在差异。随着任务负荷升高，交通标志记忆召回任务的表现更易出现下降（P=0.03）。当任务负荷变化与认知任务相关联时，即要求驾驶员调用工作记忆中的指令完成操作时，该表现差异具有统计学显著性。
研究结论：尽管本研究得出的结论尚属初步，但本研究提供的证据表明，利用驾驶模拟器评估PD患者驾驶行为背后的孤立认知功能具有积极前景。若能充分认知其局限性，此类驾驶模拟结合针对躯体、视觉与认知能力的功能评估成套测验，可构成多维度驾驶医疗适配性评估体系的组成部分之一。