Hashida Kumiko, Drattell Julia, Devos Hannes, Gore Russell, Lynall Robert, Schmidt Julianne
UGA Concussion Research Laboratory, Department of Kinesiology, University of Georgia, Athens, GA.
Mobility Core, University of Kansas Center for Community Access, Rehabilitation Research, Education, and Service (KU-CARES), University of Kansas Medical Center, Kansas City, KS.
Med Sci Sports Exerc. 2025 May 1;57(5):912-920. doi: 10.1249/MSS.0000000000003623. Epub 2024 Dec 9.
This study aimed to identify clinical concussion assessment outcomes that uniquely capture simulated driving performance among acutely concussed individuals, relative to controls.
Cross-sectional design. Twenty-eight college students within 72 hours of concussion and 46 non-concussed controls participated in the study. We collected the following clinical concussion assessment outcomes: four concussion symptom clusters, seven computerized neurocognitive domain scores, Standardized Assessment of Concussion total score, Balance Error Scoring System total score, and tandem gait completion time. The following simulated driving outcomes were included (count): total collisions, speed exceedances, centerline crossings, and road edge excursions. We used separate generalized linear mixed regression models fit using a Poisson distribution with group, assessment, and interaction effects.
Higher migrainous symptoms ( P < 0.001), cognitive-fatigue symptoms ( P = 0.041), poorer visual memory ( P = 0.015), and slower reaction time ( P = 0.023) in concussion group were associated with higher risk of committing speed exceedances, relative to controls. Conversely, better performance on the continuous performance test ( P = 0.046) and Standardized Assessment of Concussion ( P = 0.045) in concussion group was associated with higher risk of committing speed exceedances relative to controls. Poorer performance on psychomotor speed ( P = 0.001), reaction time ( P = 0.031), cognitive flexibility ( P = 0.004), and executive function ( P = 0.003) was associated with higher risk of committing centerline crossings in concussion group, relative to controls. Conversely, better performance on the continuous performance test ( P = 0.035) and higher affective symptoms ( P = 0.013) were associated with higher risk of committing centerline crossings and road edge excursions, respectively, relative to controls.
Our results highlight key symptom clusters and computerized neurocognitive outcomes that uniquely inform poorer simulated driving performance in acutely concussed individuals. Symptom clusters and computerized neurocognitive function might be helpful when discussing with patients about return to driving decisions post-concussion.
本研究旨在确定相对于对照组而言，能够独特地反映急性脑震荡个体模拟驾驶表现的临床脑震荡评估结果。
采用横断面设计。28名在脑震荡后72小时内的大学生和46名未发生脑震荡的对照组参与了本研究。我们收集了以下临床脑震荡评估结果：四个脑震荡症状群、七个计算机化神经认知领域得分、脑震荡标准化评估总分、平衡误差评分系统总分以及串联步态完成时间。纳入了以下模拟驾驶结果（计数）：总碰撞次数、超速次数、越过中心线次数和偏离道路边缘次数。我们使用了单独的广义线性混合回归模型，采用泊松分布拟合，纳入组、评估及交互效应。
相对于对照组，脑震荡组中较高的偏头痛症状（P < 0.001）、认知疲劳症状（P = 0.041）、较差的视觉记忆（P = 0.015）以及较慢的反应时间（P = 0.023）与超速风险较高相关。相反，相对于对照组，脑震荡组在持续操作测试（P = 0.046）和脑震荡标准化评估（P = 0.045）中表现较好与超速风险较高相关。相对于对照组，脑震荡组在心理运动速度（P = 0.001）、反应时间（P = 0.031）、认知灵活性（P = 0.004）和执行功能（P = 0.003）方面表现较差与越过中心线风险较高相关。相反，相对于对照组，在持续操作测试中表现较好（P = 0.035）和较高的情感症状（P = 0.013）分别与越过中心线和偏离道路边缘风险较高相关。
我们的结果突出了关键症状群和计算机化神经认知结果，这些结果独特地表明急性脑震荡个体模拟驾驶表现较差。在与患者讨论脑震荡后恢复驾驶的决策时，症状群和计算机化神经认知功能可能会有所帮助。
