Driving after concussion: Do symptom clusters predict driving performance within 72 hours of concussion?

Research Objectives: To determine whether concussion symptom clusters uniquely relate to simulated driving performance in participants evaluated within 72-hours following concussion, relative to control participants.

Design: A cross-sectional comparative study.

Setting: Concussion Research Laboratory.

Participants: 28 concussed athletes (18.93±0.94 years) and 46 non-concussed control participants (19.50±1.50 years).

Interventions: Each participant completed a self-reported symptom checklist and a driving simulation assessment within 72 hours following a concussion.

Main Outcome Measures: Concussion symptoms were classified into four clusters: vestibular-cognitive, migrainous, cognitive-fatigue, and affective. Driving performance was assessed using a driving simulator and included the following outcomes: pedestrian hits, speed exceedances, light tickets, stop signs missed, centerline cross, road edge excursion, total drive time, percent time over the speed limit, and percent time out of the lane. A series of linear mixed regression models were conducted with group effect, symptom cluster effects, and interaction predictors and fit using either a Poisson or normal distribution. This abstract focuses on the interactions between group and symptom cluster.

Results: The concussion group had 2.8 times (p=0.029, 95%CI;1.1-7.0) greater probability of committing speed exceedance for each 1-point increase in migrainous symptom reported, relative to the control group. The concussion group had 1.7 times (p=0.013, 95%CI;1.1-2.5) greater probability of committing road edge excursion for each 1-point increase in affective symptom reported, relative to the control group. The concussion group had 1.2 times (p=0.031, 95%CI;1.0-1.4) higher number of stop signs missed for each 1-point increase in vestibular-cognitive symptom reported, relative to control group.

Conclusions: The study demonstrated that migrainous, affective symptoms, and vestibular-cognitive were uniquely associated with post-concussion driving behaviors. Our results indicate that assessing specific symptom clusters, specifically migrainous, affective, and vestibular-cognitive symptoms, may be valuable in determining an individual’s readiness to return to driving after concussion.

Author(s) Disclosures: Research reported in this abstract was supported by Andee’s Army Foundation and the National Center for Advancing Translational Sciences of the NIH under Award Number UL1TR002378. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.