Driving performance acutely after mTBI among young drivers

Abstract

Objective: Mild traumatic brain injury (mTBI) can impair executive function, learning, and memory, which can negatively impact driving ability. However, little is known how the driving performance of young drivers may be impacted acutely after mTBI. This study aimed to evaluate simulated driving within 96 h of mTBI among young drivers as compared to matched healthy controls, and assess the effects of increased cognitive load on driving performance.

Methods: Injured young drivers ages 16 to 24 with physician-confirmed mTBI were enrolled from two sites (University of Alabama at Birmingham and Ohio State University) and completed the assessment on a high-fidelity driving simulator within 96 h of injury. Matched healthy controls were young drivers without mTBIs matched with an index mTBI by age, sex, athlete status, and driving experience. Participants drove four scenarios in a 2x2 design: with/without cognitive load and with/without critical events. Linear mixed models were used to compare the driving outcomes between mTBI drivers and healthy controls.

Results: A total of 38 participants were included, with 25 cases and 13 controls. Standard deviation of lateral position, following distance and reaction time were analyzed. The preliminary findings indicated that mTBI drivers tended to maintain more distance to the car in front of them than healthy controls. High cognitive load was associated with slower reaction time regardless of TBI status.

Conclusions: This study is the first to assess simulated driving performance among young drivers with mTBI acutely post-injury. The findings will have important clinical implications on when young drivers may return to driver post-mTBI and at what conditions. Additional research is warranted to confirm these results.