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Cognitive functions in drivers with brain injury: Anticipation and adaption
Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The purpose of this thesis was to improve the understanding of what cognitive functions are important for driving performance, investigate the impact of impaired cognitive functions on drivers with brain injury, and study adaptation strategies relevant for driving performance after brain injury. Finally, the predictive value of a neuropsychological test battery was evaluated for driving performance.

Main results can be summarized in the following conclusions: (a) Cognitive functions in terms of attentional and dynamic working memory-related functions are relevant for driving performance. (b) Neuropsychological impairments in information processing speed, divided and focused attention, requiring working memory, are associated to limitations in driving performance. In addition, qualitative aspects of driving problems especially impaired anticipatory attention appeared to constrain driving performance. (c) A neuropsychological test battery assessing speed of information processing and attention in terms of working memory predicted driving performance. In addition, cognitive factors are relevant for interpretation of driving problems qualitatively. (d) Driving speed adjustment and anticipatory attention were adaptive strategies for driving after brain injury. Interest in driving, motivation for driving safely, and driving experience appeared also relevant for driving after brain injury. (e) Collaboration between medical, neuropsychological and driving expertise is recommended for a total evaluation of driving performance after brain injury.

Anticipatory attention was considered a working memory based attentional system, directing the processing resources flexibly and appropriately between the different information processing components. Thus, anticipatory attention demonstrated qualitatively that working memory is a prominent function in a real driving context.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2001. , 101 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 678Studies from the Swedish Institute for Disability Research, ISSN 1650-1128 ; 2
Keyword [en]
Brain injury, cognitive impairment, anticipatory attention, driving
National Category
Social Work
Identifiers
URN: urn:nbn:se:liu:diva-5159ISBN: 91-7219-967-9 (print)OAI: oai:DiVA.org:liu-5159DiVA: diva2:21067
Public defence
2001-05-30, Berzeliussalen, Campus US, Linköpings universitet, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2001-06-30 Created: 2001-06-30 Last updated: 2012-01-24Bibliographically approved
List of papers
1. Neuropsychological aspects of driving after brain lesion: Simulator study and on-road driving
Open this publication in new window or tab >>Neuropsychological aspects of driving after brain lesion: Simulator study and on-road driving
Show others...
1997 (English)In: Applied Neuropsychology, Vol. 4, no 4, 220-230 p.Article in journal (Refereed) Published
Identifiers
urn:nbn:se:liu:diva-13618 (URN)
Available from: 2001-06-30 Created: 2001-06-30
2. Neuropsychological aspects of driving after a stroke: in the simulator and on the road
Open this publication in new window or tab >>Neuropsychological aspects of driving after a stroke: in the simulator and on the road
2000 (English)In: Applied Cognitive Psychology, ISSN 0888-4080, Vol. 14, no 2, 135-150 p.Article in journal (Refereed) Published
Abstract [en]

Thirty patients with stroke and 30 matched controls participated in the study (mean age 68 years, mean interval since stroke onset 8.6 months). The patients performed significantly worse on cognitive and attentional processing measured by a neuropsychological test battery. The patients had significantly greater difficulty in allocating processing resources to a secondary information processing task during driving in an advanced simulator. The patients performed worse driving in real traffic, and had less driving skill; fifty per cent did not pass the driving test. The neuropsychological test battery showed a pattern with three factors: (1) attentional processing (2) executive capacity, and (3) cognitive processing. Regression models based on simulator driving variables and neuropsychological test variables respectively, overall classified correctly in 85% and 83% of the cases with respect to driving skill. Decreased cognitive and attentional processing were suggested to be associated with an overall speed impairment.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13619 (URN)
Available from: 2001-06-30 Created: 2001-06-30 Last updated: 2009-08-19
3. Driving problems and adaptive driving behavior after brain injury: A Qualitative Assessment
Open this publication in new window or tab >>Driving problems and adaptive driving behavior after brain injury: A Qualitative Assessment
2001 (English)In: Neuropsychological Rehabilitation, ISSN 0960-2011, Vol. 11, no 2, 171-185 p.Article in journal (Refereed) Published
Abstract [en]

One professional driving expert was interviewed after each of 22 on-road driving occasions with brain-injured patients. Driving problems were found in five prescribed qualitative dimensions: speed, manoeuvring, position, attention, and traffic behaviour. In addition, three non-prescribed qualitative dimensions were found: orientation, decision-making, and confidence. Also, adaptive aspects important for safe driving despite brain injury were identified: anticipatory attention, slowing down speed, interest and motivation for safe driving, and driving experience. The results are discussed in terms of a hierarchical model of driving performance. In addition, driving problems and adaptive aspects are discussed in relation to attention and information processing. Anticipatory attention is considered a working memory-based attention system, which is essential for driving quality. Practical implications are outlined, for example, educational practice for driving evaluators and adaptive driving behaviour for patients facilitating driving practice as a part of the rehabilitation programme.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13620 (URN)10.1080/09602010042000240 (DOI)
Available from: 2001-06-30 Created: 2001-06-30
4. Neuropsychological aspects of driving characteristics
Open this publication in new window or tab >>Neuropsychological aspects of driving characteristics
2001 (English)In: Brain Injury, ISSN 0269-9052, Vol. 15, no 11, 981-984 p.Article in journal (Refereed) Published
Abstract [en]

Brain injury often causes impairments of cognitive functions, which may affect driving performance. The question of whether the brain-injured patient can resume car driving or not generally comes up during rehabilitation. The medical clinical examination, covering neurological status, screening of cognitive functions, and affective state, is insufficient in assessing relevant functions required for driving performance. A neuropsychological assessment and a driving test are additional parts of the driving assessment besides the medical examination. In this paper, neuropsychological test results and driving test results from four patients with brain injury are presented. The paper demonstrates the complementary value of neuropsychological assessment and a driving test: the relevance of cognitive factors for interpretation of driving problems, but also the relevance of a driving test to show compensatory capacity in some drivers with brain injury. Thus, collaboration between medical, neuropsychological and driving expertise can promote and deepen the total assessment of driving performance after brain injury.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-13621 (URN)
Available from: 2001-06-30 Created: 2001-06-30

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Lundqvist, Anna

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