Departments of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA.
Neurology. 2012 Nov 13;79(20):2067-74. doi: 10.1212/WNL.0b013e3182749e95.
The growing literature on driving in Parkinson disease (PD) has shown that driving is impaired in PD compared to healthy comparison drivers. PD is a complex neurodegenerative disorder leading to motor, cognitive, and visual impairments, all of which can affect fitness to drive. In this review, we examined studies of driving performance (on-road tests and simulators) in PD for outcome measures and their predictors. We searched through various databases and found 25 (of 99) primary studies, all published in English. Using the American Academy of Neurology criteria, a study class of evidence was assigned (I-IV, I indicating the highest level of evidence) and recommendations were made (Level A: predictive or not; B: probably predictive or not; C: possibly predictive or not; U: no recommendations). From available Class II and III studies, we identified various cognitive, visual, and motor measures that met different levels of evidence (usually Level B or C) with respect to predicting on-road and simulated driving performance. Class I studies reporting Level A recommendations for definitive predictors of driving performance in drivers with PD are needed by policy makers and clinicians to develop evidence-based guidelines.
越来越多的关于帕金森病（PD）驾驶的文献表明，与健康的对照组驾驶员相比，PD 患者的驾驶能力受损。PD 是一种复杂的神经退行性疾病，可导致运动、认知和视觉障碍，所有这些都可能影响驾驶能力。在这篇综述中，我们研究了 PD 患者驾驶表现（道路测试和模拟器）的研究，以评估其结果测量及其预测因素。我们通过各种数据库进行了搜索，发现了 25 项（99 项中的 25 项）主要研究，均为英文发表。使用美国神经病学学会的标准，对研究进行了分类（I-IV 级，I 级表示最高证据水平）并提出了建议（A 级：有预测作用或无预测作用；B 级：可能有预测作用或无预测作用；C 级：可能有预测作用或无预测作用；U 级：无推荐）。从现有的 II 级和 III 级研究中，我们确定了各种认知、视觉和运动指标，这些指标在预测道路和模拟驾驶表现方面具有不同级别的证据（通常为 B 级或 C 级）。决策者和临床医生需要进行 PD 驾驶员驾驶表现的明确预测因素的 I 级研究，以制定基于证据的指南。
