Driving Simulator Performance in the Acute Post-Injury Phase Following a Mild Traumatic Brain Injury Among Young Drivers

While mild traumatic brain injury (mTBI) can lead to cognitive and functional impairments, little is known about how mTBI may affect driving, especially among young drivers who are at an increased risk of mTBI and motor vehicle collisions compared to other age groups. The objective of this multisite, pilot study was to examine the feasibility of assessing driving performance acutely post-injury (i.e., mTBI sustained \u3c 2 weeks at assessment) among young drivers with and without mTBIs (N=42; nmTBI= 21; ncontrol=21) using high-fidelity driving simulators. Driving performance was hypothesized to be significantly degraded, especially under conditions of high cognitive load, among drivers with mTBI compared to matched controls. Neurocognitive measures used in clinical assessment of mTBI (i.e., Cogstate Brief Battery) were hypothesized to correlate with driving simulator performance metrics. Risk management protocols were successful (i.e., no participants withdrew due to simulator sickness) and no significant increase in post-concussion symptoms was found from pre-assessment to immediately following driving assessment. Group differences on key driving variables did not emerge; however, drivers with mTBI showed a differential pattern of driving under high cognitive load. Neurocognitive correlates of simulated driving performance suggested processing speed, attention, and working memory are important functions for driving. Implications and future directions discussed