A - 86 Using Virtual Reality Driving Simulation to Determine Cognitive Correlates of Turning Behaviors among Drivers with and without Multiple Sclerosis.

Abstract

This study uses a virtual reality driving simulator (VRDS) to 1) compare turning behavior between adults with or without MS; 2) identify cognitive correlates of turning behavior. 64 community-dwelling adult drivers, including 38 people with MS (PwMS) and 26 healthy controls (HCs) (ages 21-60, 78% women, 69% White), completed neuropsychological and VRDS assessments. Key VRDS turning variables were lane position, speed, acceleration, and braking. Cross-sectional analyses included 1) analysis of variance and chi-square tests; 2) Pearson and Spearman's correlations. HCs took sharper left turns than PwMS (p < 0.05, η2 = 0.08). There were no other between-group differences. Weaker visuospatial functioning [r = -0.301, 95% CI = (-0.512,-0.050), p = 0.018], and slower gait [r = 0.0328, CI = (0.063,0.55), p = 0.014], manual motor speed [r = 0.378, CI = (0.130,0.582), p = 0.03], and psychomotor speed [r = -0.334, CI = (-0.545,-0.077), p = 0.011] were associated with greater lane position variability. Greater relative acceleration before the turn was linked to worse performance in psychomotor speed [r = 0.397, CI = (0.148,0.593), p = 0.002], time-based working memory [r = 0.452, CI = (0.221,0.631), p < 0.001], and visuoperceptual judgment time [r = -0.482, CI = (-0.660,-0.244), p < 0.001]. Slower cognitive/motor speed and poorer visuospatial abilities/memory were associated with slower driving and more braking (all p < 0.05). Drivers with and without MS exhibited similar turning behavior, but PwMS were more cautious during left turns, possibly reflecting a compensatory strategy. Despite few group differences, several cognitive domains commonly affected by MS were associated with turning behaviors. Slower cognitive/motor speed and worse visuospatial abilities were associated with less smooth control of spatial position and less safe turn preparation, but slower driving. Future studies will include larger samples and other clinical populations and may inform clinical driving recommendations.