Monday, 16 June 2014

Watch out when you drive

Dehning M, Kim J, Nguyen CM, Shivapour E, Denburg N. Neuropsychological Performance, Brain Imaging, and Driving Violations in Multiple Sclerosis. Arch Phys Med Rehabil. 2014 Jun 11. pii: S0003-9993(14)00418-3. doi: 10.1016/j.apmr.2014.05.022. [Epub ahead of print]OBJECTIVE:

To examine the relationship between third ventricular width (TVW), a measure of thalamic brain atrophy, and motor vehicle violation type and frequency in a cohort of patients with multiple sclerosis.
PARTICIPANTS: Thirty-five individuals with clinically-confirmed relapsing-remitting multiple sclerosis and 35 age-, sex-, and education-matched community-dwelling healthy comparisons. Participants were between 25 and 65 years of age.
MAIN OUTCOME MEASURE(S):Motor vehicle violations were obtained from an on-line database (Iowa Courts Online). The violations were categorized as follows: 1) speeding; 2)non-moving safety; 3) administrative; 4) alcohol-related offense; 5) moving safety violation; and 6) total violations. Neuropsychological performance in all major cognitive domains was obtained. Thalamic atrophy for the MS patients was determined via third ventricular width measurement.
RESULTS:The MS group had a greater number of overall violations, administrative violations, and non-moving safety violations. The groups differed on neuropsychological tasks measuring visuospatial skills, speeded language, learning, and executive functioning, after controlling for affective symptomatology. TVW was associated with total violations as well as moving safety violations. Finally, TVW accounted for significant variance in driving violation frequency above and beyond demographic variables and neuropsychological factors.
CONCLUSIONS: There is an increased frequency of motor vehicle violations among patients with multiple sclerosis, and number of violations can be predicted by thalamic brain atrophy.
So MSers get more driving violations. This is related,but may not be causal, to changes (Shrinkage) in the Thalamus, situated between the cerebral cortex and the midbrain. Some of its functions are the relaying of sensory and motor (movement) signals to the cerebral cortex, and the regulation of consciousness, sleep, and alertness.  


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