Cognitive Alterations Related to Driving Performance in Parkinson’s Disease: A Cross-Sectional Proof-of-Concept Study Using a Driving Simulator

Driving ability in individuals with Parkinson’s disease (PD) can be compromised early in the course of the illness, even before clear cognitive deficits emerge on standard neuropsychological tests. This study investigated subtle driving impairments in a group of non-demented people with PD using a high-fidelity driving simulator. Seven PD participants and seven healthy controls, matched for age and sex, completed cognitive assessments, reaction time tasks, and five simulated driving scenarios that measured lane keeping, steering control, and reaction to events. While most cognitive scores were comparable between groups, PD participants exhibited slower response times in basic tasks and showed reduced lane control, particularly during left turns. These difficulties were associated with disease severity and medication dosage. The simulator proved more sensitive than conventional tests in detecting early impairments related to attention and visuospatial processing. These findings suggest that driving simulators may play a key role in improving the assessment of driving competence in PD, providing insight into real-world challenges faced by this population.