Abstract Details

Title Clinical Evaluation of Fitness To Drive in Huntington Disease

Topic Movement Disorders

Presentation(s) S20 - (-)

Poster/Presentation
Number 004

Background Clinical screening tools may aid neurologists to determine fitness to drive in HD.

Objective

Design/Methods This study included 30 patients with manifest HD (8 women). Mean age was 50±13 years, mean disease duration was 24±12 months, and mean Total Functional Capacity score was 11±2. The official fitness to drive evaluation included visual, neuropsychological and on-road tests. Drivers were allocated into: (1) fit to drive without restrictions; (2) fit to drive with restrictions; or (3) unfit to drive. The blinded neurologist's judgment was based on a standard clinical examination and compared with the official decision using the weighted kappa (kw) statistic. The in-clinic test battery comprised a driving history questionnaire, the Unified Huntington Disease Rating Scale, Trail Making Tests (TMT) A and B, and the Mini Mental State Examination. Logistic regression analysis was performed to determine the best clinical predictors. The fitness to drive decision was dichotomized to a pass (no restrictions) or fail (restrictions or unfit) outcome.

Results Fifteen (50%) HD patients were fit to drive without restrictions, 8 (27%) fit to drive with restrictions, and 7 (23%) unfit to drive following the official driving evaluation. There was a moderate agreement between the neurologist's judgment and the official decision (kw=0.36, p=0.009). The neurologist correctly classified 21 (70%) patients into the pass or fail groups. The symbol digit modalities test, Stroop word reading, and TMT B yielded the best model of fitness to drive and correctly classified 26 (87%) patients.

Conclusions Half of active drivers with HD show impaired driving skills that require further evaluation at a driving center. A clinical screening battery may help neurologists to determine fitness to drive in HD.

Authors/Disclosures
Hannes Devos (Georgia Regents University) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Wim Vandenberghe (Dept. Neurology, University Hospital Leuven)	Dr. Vandenberghe has nothing to disclose.
Dileep R. Yavagal, MD, FAAN (University of Miami Miller School of Medicine)	Dr. Yavagal has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vascular Dynamics. Dr. Yavagal has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Guidepoint. The institution of Dr. Yavagal has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG. Dr. Yavagal has received personal compensation in the range of $0-$499 for serving as a Consultant for Medtronic. Dr. Yavagal has received personal compensation in the range of $0-$499 for serving as a Consultant for Cerenovus/Johnson & Johnson. Dr. Yavagal has received personal compensation in the range of $0-$499 for serving as a Consultant for Stryker. Dr. Yavagal has received personal compensation in the range of $0-$499 for serving as a Consultant for Poseydon. Dr. Yavagal has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Athersys. Dr. Yavagal has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gravity Medical Technology. Dr. Yavagal has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Poseydon. Dr. Yavagal has stock in Poseydon. Dr. Yavagal has stock in Galaxy Therapeutics. Dr. Yavagal has stock in Stentrode. Dr. Yavagal has stock in Gravity Medical. Dr. Yavagal has stock in Gravity Medical Technology. Dr. Yavagal has stock in Athersys. Dr. Yavagal has stock in Rapid Medical . Dr. Yavagal has received intellectual property interests from a discovery or technology relating to health care. Dr. Yavagal has received personal compensation in the range of $5,000-$9,999 for serving as a Medicolegal Expert with Royal Carribean Cruise Line. Dr. Yavagal has received personal compensation in the range of $5,000-$9,999 for serving as a Medicolegal Consultant with Carnival Cruise Line.

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