Comprehensive driving assessment: Neuropsychological testing and on-road evaluation of brain injured patients

The study investigates the correspondence between neuropsychological test r esults and on-road driving performance among 55 patients with a CT-verified brain damage or documented neurological disorder (cerebrovascular accident : 43, traumatic brain injury: 5, multiple sclerosis: 4, other: 3). 5 patien ts showed unimpaired test profiles and passed the on-road evaluation. 18 pa tients showed severe neuropsychological deficits contrary to driving and we re not recommended for on-road evaluation. Of the remaining 32 patients wit h some neuropsychological deficits, all 100% in the minor impaired group (n = 8) passed the driving evaluation, compared to 69% in the mildly impaired (n = 16) and 38% in the moderately impaired group (n = 8). Measures of red uced visuoconstructive ability, reaction time, visual attention, and awaren ess of cognitive impairments, were found to discriminate between groups, it is concluded that neuropsychological assessment of targeted functions prov ide an ecological valid prediction of driving skill after brain damage, but that on-road evaluation is needed as supplement in cases with ambiguous te st findings.