| Publication Abstract Display | | Type: Published Abstract | | Title: Neuropsychological performance as a predictor of driving ability among individuals infected with Hepatitis C Virus. | | Authors: Sakamoto M, Marcotte TD, Hilsabeck RC, Perry W, Carlson M, Barakat F, Hassanein T | | Year: 2011 | | Publication: UCSD Psychiatry Symposium 4/11/11 | | Volume: Issue: Pages: | | Abstract:Hepatitis C virus (HCV) is a leading cause of chronic liver disease. Patients with HCV frequently demonstrate cognitive impairments in attention, learning/memory, visuospatial construction, and psychomotor speed. Driving is an important everyday activity that can be affected by the cognitive deficits. However, little is known about the relationship between cognitive function and driving performance among patients with HCV. The aims of this study were to assess 1) whether cognitive function measured by neuropsychological (NP) tests could predict driving performance, and if so, 2) which NP tests were the most sensitive predictors of driving behaviors. Twenty-four HCV-infected liver patients (16 males, 8 females; mean age = 51.2 ± 7.4 years) participated in this study. The underlying etiology for the participants’
liver disease included HCV only (n= 14), HCV and alcohol (n= 8), HCV and Hepatitis B virus (n= 2). All participants completed 9 NP tests [Brief Visual Memory Test-revised (BVMT-R), Symbol Search (SS) and Block Design (BD) subtest from Wechsler Adult Intelligent Scale-3rd version (WAIS-III), Trail Making Test A & B, (TMT-A & TMT-B), Symbol Digit Modalities Test (SDMT), Controlled Oral Word Association Test (COWAT), Grooved Pegboard Test (GPT), and Finger Tapping Test (FTT)]. For the NP summary variable, we used the Global Deficit Score (GDS), which summarizes one’s overall NP performance and the severity of deficits, if there are any. In addition to NP tests, the participants completed a driving simulator test in which they were to drive through city and country landscapes and perform both common driving tasks (e.g., passing a car) and crash avoidance maneuvers (e.g., avoid a pedestrian stepping into the roadway). A summary weighted error variable was developed (crashes yield 3 points, traffic light violations 2 points, and speeding tickets 1 point). Bivariate analysis was conducted to identify individual predictors of driving errors, including demographics, medical and psychiatric history, lab results, and NP tests. GDS, age, cirrhosis, and platelet count met the initial cut-point of p ≤ .15, but the most parsimonious regression model (p= .019) included only GDS (p=.019) and age (p=.056) and predicted 32% of the variance in driving performance. Among NP tests, measures of visuospatial learning/memory (BVMT), visual attention (SS), psychomotor speed (SDMT), visuospatial construction (BD), and fine motor dexterity (GPT) were sensitive to driving errors. Clinicians should be aware that driving ability can be affected by HCV, and that NP testing may help identify individuals who are at risk for poor driving. |
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