Neuropsychological aspects of driving after a stroke - in the simulator and on the road

Thirty patients with stroke and 30 matched controls participated in the stu dy (mean age 68 years, mean interval since stroke onset 8.6 months). The pa tients performed significantly worse on cognitive and attentional processin g measured by a neuropsychological test battery. The patients had significa ntly greater difficulty in allocating processing resources to a secondary i nformation processing task during driving in an advanced simulator. The pat ients performed worse driving in real traffic, and had less driving skill; fifty per cent did not pass the driving test. The neuropsychological test b attery showed a pattern with three factors: (1) attentional processing (2) executive capacity, and (3) cognitive processing. Regression models based o n simulator driving variables and neuropsychological test variables respect ively, overall classified correctly in 85% and 83% of the cases with respec t to driving skill. Decreased cognitive and attentional processing were sug gested + to be associated with an overall speed impairment. Copyright (C) 2 000 John Wiley & Sons, Ltd.