Preliminary observations on MRI correlates of driving independence and performance in persons with heart failure

Alosco, Michael L.; Penn, Marc S.; Brickman, Adam M.; Spitznagel, Mary Beth; Cleveland, Mary Jo; Griffith, Erica Y.; Narkhede, Atul; Gunstad, John

doi:10.3109/00207454.2014.945643

Cited by 6 publications

(4 citation statements)

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“…Additional mechanisms by which increased cerebral venous pressure may promote cognitive decline include decreases of cerebral blood flow, microhemorrhages (Ungvari et al 2018(Ungvari et al , 2017b, and altered cerebrospinal fluid absorption (Fulop et al 2019). Heart failure patients are also frequently diagnosed with white matter hyperintensities (WMHs, a radiological finding showing damage in the white matter regions of the brain near the lateral ventricles on T2/ FLAIR MRI sequences) (Alosco et al 2013), which predict poorer attention and executive function (Alosco et al 2015). In addition to tissue ischemia (Makedonov et al 2013), increased cerebral venous pressure has been causally linked to the pathogenesis of WMHs (Fulop et al 2019;Moody et al 1995;Chung and Hu 2010).…”

Section: Discussionmentioning

confidence: 99%

Cerebral venous congestion promotes blood-brain barrier disruption and neuroinflammation, impairing cognitive function in mice

et al. 2019

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Section: Discussionmentioning

confidence: 99%

Cerebral venous congestion promotes blood-brain barrier disruption and neuroinflammation, impairing cognitive function in mice

et al. 2019

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“…Across three driving simulator studies, Alosco and colleagues (2013, 2015a, 2015b) found that older adults with heart failure (n = 18) had (1) poorer performance on attention/executive function tests and simulated driving compared to younger adults [35], (2) more WMH and reduced whole brain volume were associated with poor driving performance [36] and (3) decreased physical fitness was associated with poor driving performance [37]. During the simulation scenarios, collisions and missed stop signs were consistent markers of impaired driving performance.…”

Section: Heart Failurementioning

confidence: 99%

A Systematic Review Examining Associations between Cardiovascular Conditions and Driving Outcomes among Older Drivers

Babulal

Kolady²,

Stout

et al. 2020

Geriatrics

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There is a vast literature on stroke as a cardiovascular disease and driving outcomes, however little is known about other cardiovascular conditions and driving. The purpose of this review is to examine the literature for studies assessing the effect of non-stroke, vascular conditions on daily driving, reported crash risk and driving decline in older adult drivers as captured by naturalistic methodologies. A systematic review of Embase, Ovid and Scopus Plus examined articles on driving and vascular conditions among older adults. A search yielded 443 articles and, following two screenings, no articles remained that focused on non-stroke, vascular conditions and naturalistic driving. As a result, this review examined non-stroke, vascular conditions in nine driving studies of older adults that used road testing, driving simulators and self-report measures. These studies fell into three categories—heart failure, vascular dementia and white matter hyperintensities/leukoaraiosis. The combined findings of the studies suggest that heart failure, vascular dementia and white matter hyperintensities (WMH) negatively impact driving performance and contribute to driving cessation among older adults. Future research should examine cardiovascular risk factors like hypertension, hypercholesterolemia, myocardial infraction or atherosclerosis using naturalistic driving measurement, as well as traditional measures, in order to more fully characterize how these conditions impact older adult driving.

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“…Poor simulated driving performance in HF has been theorized to largely involve the negative impact of cardiac dysfunction on the brain and subsequent cognitive dysfunction [4,5]. In particular, cognitive impairment in domains important for safe driving (e.g., attention/executive function) is prevalent in HF [4,6] and is correlated with poorer driving simulation performance in this population [3].…”

Section: Introductionmentioning

confidence: 99%

“…The associations among depressive symptoms, cognitive function, and objectively measured driving abilities in persons with HF is unclear. We sought to expand upon previous work from our group [3,5] and examine the relationship between depressive symptoms and driving simulation performance in older adults with HF. We hypothesized that greater depressive symptoms would negatively impact driving simulation performance, and cognitive dysfunction may offer one possible explanation for this phenomenon.…”

Section: Introductionmentioning

confidence: 99%

Preliminary Investigation on the Association between Depressive Symptoms and Driving Performance in Heart Failure

et al. 2015

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Heart failure (HF) patients commit many errors on driving simulation tasks and cognitive dysfunction appears to be one important contributor to impaired driving in HF. Clinical modifiers of cognition may also play a key role. In particular, depression is common in HF patients, linked with cognitive dysfunction, and contributes to reduced driving fitness in non-HF samples. However, the associations among depressive symptoms, cognition, and driving in HF are unclear. Eighteen HF patients completed a validated simulated driving scenario, the Beck Depression Inventory-II (BDI-II), and a cognitive test battery. Partial correlations controlling for demographic and medical confounds showed higher BDI-II score correlated with greater number of collisions, centerline crossings, and % time out of lane. Increased depressive symptoms correlated with lower attention/executive function, and reduced performance in this domain was associated with a greater number of collisions, centerline crossing, and % time out of lane. Depressive symptoms may be related to poorer driving performance in HF, perhaps through association with cognitive dysfunction. However, larger studies with on-road testing are needed to replicate our preliminary findings before recommendations for clinical practice can be made.

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Preliminary observations on MRI correlates of driving independence and performance in persons with heart failure

Abstract: Reduced structural brain integrity is associated with poorer reported and simulated driving in persons with heart failure. Larger prospective studies that employ on-road testing are needed to clarify brain changes and risk for unsafe driving in heart failure.

Cited by 6 publications

References 43 publications

Cerebral venous congestion promotes blood-brain barrier disruption and neuroinflammation, impairing cognitive function in mice

Cerebral venous congestion promotes blood-brain barrier disruption and neuroinflammation, impairing cognitive function in mice

A Systematic Review Examining Associations between Cardiovascular Conditions and Driving Outcomes among Older Drivers

Preliminary Investigation on the Association between Depressive Symptoms and Driving Performance in Heart Failure

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