“Examining the relationship between virtual reality driving and cognitive demands of driving after brain injury”

Objective: This study examined the relationship between driving performance measures generated by a clinical virtual reality driving simulator (VRDS) and driving performance determined by a) a behind-the-wheel driving (BTW) evaluation and b) cognitive tasks relevant to driving. Methods: This study was conducted at an outpatient research setting and included twenty eight individuals: 18 with acquired brain injury (BI) and 10 healthy controls (HC). Individuals underwent cognitive testing, participated in the VRDS, and some received a BTW evaluation. Driving performance on the BTW was examined both at the global level (i.e., pass/fail) and specific level (i.e., rating on individual behaviors) VRDS variables were consistent with BTW measures and included both specific behaviors and three global measures: 1) VRDS lane management, 2) VRDS speed control and 3) VRDS turning/tracking. Cognitive tests specific to driving performance included: TMT, Visual Cancellation Test, PASAT, Block Design. Results: Bivariate correlations between VRDS measures and cognitive tests revealed significant relationships. However, after a Hommel correction, only VRDS ‘lane management’ was significantly correlated with a measure of working memory (PASAT; p=.025). Due to the small sample size, only an exploratory analyses was conducted examining the relationship between VRDS and BTW measures. Bivariate correlations revealed no significant relationship between the global VR and BTW measures, though significant relationships existed between the VR and BTW subcomponents. VR speed control was significantly related to BTW speed control (p<.05). Additionally, the BTW ‘road law’ subcomponent was significantly (p<.05) related to the VR lane deviation, head turning standard deviation, average distance from stop sign, and deceleration. Discussion: Although exploratory the current findings may be suggestive of the possible sensitivity that is offered by VR driving performance measures. Although additional research is needed, the use of VR driving simulators may offer clinicians a new method to better define and assess the components of driving following brain injury.