Abstract
Driving requires multiple cognitive functions including visuospatial perception and recruits widespread brain networks. Recently, traffic accidents in dementia, particularly in Alzheimer disease spectrum (ADS), have increased and become an urgent social problem. Therefore, it is necessary to develop the objective and reliable biomarkers for driving ability in patients with ADS. Interestingly, even in the early stage of the disease, patients with ADS are characterized by the impairment of visuospatial function such as radial optic flow (OF) perception related to self-motion perception. For the last decade, we have studied the feasibility of event-related potentials (ERPs) in response to radial OF in ADS and proposed that OF-ERPs provided an additional information on the alteration of visuospatial perception in ADS (1, 2). Hence, we hypothesized that OF-ERPs can be a possible predictive biomarker of driving ability in ADS. In this review, the recent concept of neural substrates of driving in healthy humans are firstly outlined. Second, we mention the alterations of driving performance and its brain network in ADS. Third, the current status of assessment tools for driving ability is stated. Fourth, we describe ERP studies related to driving ability in ADS. Further, the neural basis of OF processing and OF-ERPs in healthy humans are mentioned. Finally, the application of OF-ERPs to ADS is described. The aim of this review was to introduce the potential use of OF-ERPs for assessment of driving ability in ADS.
Highlights
Driving is a complicated skill that needs to integrate multiple cognitive, perceptual and motor abilities [3], and is supported by widely distributed brain network responsible for these complex processes [4,5,6,7,8]
We have studied the feasibility of event-related potentials (ERPs) in response to radial optic flow (OF) in AD spectrum (ADS) and proposed that OF-ERPs provided an additional information on the alteration of visuospatial perception in ADS [1, 2]
The impaired OF perception was correlated with poor performance of the spatial navigation test [19]. These findings suggest that the deficits of OF perception is responsible for the impairment of spatial navigation including the driving performance in Alzheimer’s disease (AD) patients
Summary
Driving is a complicated skill that needs to integrate multiple cognitive, perceptual and motor abilities [3], and is supported by widely distributed brain network responsible for these complex processes [4,5,6,7,8]. Neuropsychological tests can evaluate various aspects of brain function including attention, executive function and visuospatial abilities known to be impaired in patients with ADS. Other systematic review and meta-analysis have demonstrated that executive function, attention, visuospatial function and global cognition revealed by neuropsychological tests may be predictive of driving performance in patients with MCI and AD. The authors concluded that significant correlations between vehicular driving scores and N200 amplitudes supported the role of extrastriate cortical dysfunction in impaired driving capacity and that the potential use of ERPs as screening tools for selective functional impairments and as biomarkers of AD These two studies [37, 38] suggest that OF-ERPs (sensory N200 component) may be useful for evaluation of driving ability in AD.
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