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The Trail Making test (TMT) has been identified as predictor of driving ability in patients with Parkinson’s disease (PD). However, previous research has not explored the effectiveness of an alternative version of the TMT, namely of the Comprehensive Trail Making Test (CTMT; Reynolds, 2002) to show associations with measures related to driving fitness. Main objective of the current work was to evaluate the capacity of the CTMT to detect associations with fitness to drive related measures in patients with PD. Inclusion criteria were the presence of a valid driver’s license, regular car driving, a CDR score ≤ 0.5, and a Hoehn & Yahr score between 1 and 3. Twelve individuals with PD (Age: Mean = 63.75, SD = 10.50) and 12 cognitively intact individuals (Age: Mean = 63.50, SD = 10.43) were introduced in the study. Collection of data included a comprehensive neurological/neuropsychological assessment and a driving simulation experiment. Certain subtests of the CTMT were more strongly associated with a variety of driving indexes in individuals with PD as compared to the original TMT. In addition, according to the stepwise regression models that were applied, the CTMT was recognized as a more effective predictor of driving behavior than the TMT. The pattern of findings that was observed supports the usefulness of CTMT on detecting associations with fitness to drive related-measures in patients with PD. Underlying factors that may explain the effectiveness of the CTMT could be related to the greater variety of set shifting and inhibition processes that this alternative option integrates as compared to the original TMT.

Objectives In-vehicle distraction is considered to be an important cause of road accidents. Drivers with Mild Cognitive Impairment (MCI), because of their attenuated cognitive resources, may be vulnerable to the effects of distraction; however, previous relevant research is lacking. The main objective of the current study was to explore the effect of in-vehicle distraction on the driving performance of MCI patients, by assessing their reaction time at unexpected incidents and accident probability. Methods Thirteen patients with MCI (age: 64.5 ± 7.2) and 12 cognitively intact individuals (age: 60.0 ± 7.7), all active drivers were introduced in the study. The driving simulator experiment included three distraction conditions: (a) undistracted driving, (b) conversing with passenger and (c) conversing through a hand-held mobile phone. Results The mixed ANOVA models revealed a greater effect of distraction on MCI patients. Specifically, the use of mobile phone induced a more pronounced impact on reaction time and accident probability in the group of patients, as compared to healthy controls. On the other hand, in the driving condition “conversing with passenger” the interaction effects regarding reaction time and accident probability were not significant. Notably, the aforementioned findings concerning the MCI patients in the case of the mobile phone were observed despite the effort of the drivers to apply a compensatory strategy by reducing significantly their speed in this driving condition. Conclusion Overall, the current findings indicate, for the first time, that a common driving practice, such as the use of mobile phone, may have a detrimental impact on the driving performance of individuals with MCI.

The objective of this study is to examine and present the most critical parameters that can assess and predict the driving performance of individuals having some kind of cerebral disease. The cerebral diseases that have been studied are: Mild Cognitive Impairment (MCI), Alzheimer's disease (AD) and Parkinson's disease (PD). For that purpose an extended literature review was extracted in order to investigate the critical parameters which are examined in the scientific field of driving performance of drivers with brain pathologies. Methods of assessing driving, including on-road driving experiments, driving simulator experiments, neurological and neuropsychological tests etc., and related results of the literature are presented and assessed. Initially, the role of neurological and neuropsychological tests in assessing driving behaviour of patients with cerebral diseases is examined. Then, the role of on-road assessments and the role of driving simulator experiments, in evaluating the driving performance are thoroughly investigated. Twenty-eight studies examining driving parameters that could predict and assess the driving performance of patients suffering a brain pathology (MCI, AD and PD) are reviewed. All these studies concern recent research and report quantitative results. In this framework, the respective driving performance measures are recorded with the aim to investigate which ones are the most promising and in which way they are analyzed. Overall, the critical driving performance measures in which the group of patients with cerebral diseases had significant differences from the control group, were: driving errors, speed, lateral position, reaction time, accident risk, headway distance, left turns, and time to collision. However, the diversity in the measures used, in combination with the diversity in the design of the experiments (i.e. road/traffic factors examined, number/duration of trials) often complicates the synthesis of the results. In conclusion, the analysis of the driving performance of drivers with cerebral diseases may allow the identification of measures that can improve driving safety, such as restrictive measures, training and licensing, information campaigns, medical and neuropsychological monitoring.

Frontotemporal dementia (FTD) is a heterogeneous group of neurodegenerative syndromes associated with several causative and susceptibility genes. Herein, we aimed to determine the incidence of the most common causative dementia genes in a cohort of 118 unrelated Greek FTD spectrum patients. We also screened for novel possible disease-associated variants in additional 21 genes associated with FTD or amyotrophic lateral sclerosis. Pathogenic or likely pathogenic variants were identified in 16 cases (13.6%). These included repeat expansions in C9orf72 and loss-of-function GRN variants, and likely pathogenic variants in TARDBP, MAPT, and PSEN1. We also identified 14 variants of unknown significance in other rarer FTD or amyotrophic lateral sclerosis genes that require further segregation and functional analysis. Our genetic screen revealed a high genetic burden in familial Greek FTD cases (30.4%), whereas only two of the sporadic cases (3.5%) carried a likely pathogenic variant. A substantial number of familial cases still remain without an obvious causal variant, suggesting the existence of other FTD genetic causes besides those currently screened in clinical routine.