Giménez-Roldán S, Dobato J L, Mateo D
Servicio de Neurología, Hospital General Universitario Gregorio Marañón, Madrid.
Neurologia. 1998 Jan;13(1):13-21.
The aim of this study was to evaluate features of the disease, habits patterns at the wheel, and reasons to give up driving motor vehicles in subjects with Parkinson's disease (PD). Prospective study using a semistructured questionnaire comparing current or former drivers with PD patients and a control group matched for age, sex and social background. In a PD and movement disorders clinic in an university hospital. Sixty-two out of 166 PD subjects interviewed owned a driving licence. Only 19.2% of PD subjects were currently active drivers. Compared to parkinsonian ex-drivers, they were 6 years younger on average, most were in disease stage II, and were less often under antidepressant medication. Nevertheless, disabling motor fluctuations and dyskinesias were present in 19% of the patients. A 47% of the active drivers reported no difficulty at the wheel; the remaining declared to experience a wide range of difficulties, particularly to manage pedals or to assess distances properly. PD itself lead to driving withdrawal in 80% of ex-drivers in contrast to 6% of controls who stop driving due to other illness. Only 40% of PD subjects were driving 5 years after diagnosis. Medical advice was influential in deciding to stop driving in a single patient. Disease onset in early adulthood often allowed to keep driving for 10 years or longer. Most subjects with PD give up driving during the first 5 years following disease onset, most due to the disease itself. Most active drivers adapt themselves to their physical circumstances, either by reducing the number of hours at the wheel or reducing speed. They are usually in early stages of the disease, despite which many experience subjective motor and visuospatial difficulties during driving. A minority keep on driving despite disabling fluctuations. This subset presumably represent a group at risk to suffer an increased rate of traffic accidents and in whom medical advice would be desirable.
本研究旨在评估帕金森病（PD）患者的疾病特征、驾车习惯模式以及放弃驾驶机动车的原因。采用半结构化问卷进行前瞻性研究，比较现职或曾经的驾驶员PD患者与年龄、性别和社会背景相匹配的对照组。研究在一所大学医院的PD和运动障碍诊所进行。在接受访谈的166名PD患者中，62人拥有驾驶执照。目前仍在积极驾车的PD患者仅占19.2%。与曾经驾车的帕金森病患者相比，他们平均年轻6岁，大多数处于疾病II期，且较少服用抗抑郁药物。然而，19%的患者存在致残性运动波动和异动症。47%的现职驾驶员表示驾车时没有困难；其余驾驶员则称遇到了各种各样的困难，尤其是操控踏板或正确判断距离方面。与6%因其他疾病而停止驾驶的对照组相比，80%的曾经驾车的PD患者因PD本身而停止驾驶。确诊后5年，只有40%的PD患者仍在驾车。在决定一名患者是否停止驾驶时，医疗建议具有影响力。成年早期发病的患者通常能够继续驾车10年或更长时间。大多数PD患者在疾病发作后的头5年内放弃驾驶，多数是由于疾病本身。大多数现职驾驶员会根据自身身体状况进行调整，要么减少驾车时长，要么降低车速。他们通常处于疾病早期，尽管如此，许多人在驾车时仍会经历主观的运动和视觉空间困难。少数患者尽管存在致残性波动仍继续驾车。这部分人群可能是交通事故发生率较高的风险群体，因此需要医疗建议。
