Objective: To compare the driving performance using a driving simulator with physical and cognitive functions as measured by the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in patients suffering from the relapsing-remitting form of multiple sclerosis (RRMS). Methods: 31 RRMS patients (18 women, 13 men, mean age 35.6 ± 8.3 years, EDSS 2.8 ± 1.4) were compared with 10 healthy controls (8 men, 2 woman, age 45.1 ± 7.8 years). Results: Compared with controls, the accident rate (5.3 ± 3.8 vs. 1.3 ± 1.5, p < 0.001) and concentration faults (21.1 ± 15.5 vs. 7.1 ± 2.6, p < 0.01) of RRMS patients using the driving simulator were increased. While there was no correlation with the EDSS score, the accident rate was correlated with the MSFC (r = –0.5, p < 0.05). Regarding the three dimensions of the MSFC, accidents were related to the number of correct answers and Z-score in the paced auditory serial addition test (PASAT) as a measure for cognitive function (r = –0.33, p < 0.05). Conclusion: The current study demonstrates the need to focus also on driving skills in MS patients. The risk of accidents should be evaluated after relapses in particular. However, there are great interindividual differences. In the MSFC, most deficits could be evaluated in the PASAT. As there was a significant correlation between the accident rate in the driving simulator and the PASAT results, accidents seem to be more influenced by cognitive decline than by physical impairment. This indicates that the MSFC is a broader, more dimensional scale than the EDSS and should be preferred in the case of driving assessment. At the present time, the driving simulator seems to be a useful instrument judging driving ability, especially in cases with ambiguous neuropsychological results.

The rates of psychological distress were higher than expected in a city considered to be safe in terms of earthquake risk. Relocation after the disaster may increase psychological distress by disrupting the social network.

MS-Patients are often not able to distinguish between fatigue and sleepiness. By using different scales judging sleepiness and fatigue significant differences could be evaluated. Fatigue is mainly linked to motoric deficits scored by the MSFC. Therefore medication with stimulants seems not to be useful in fatigue therapy.