Hazard Perception Skill and Driver Behavior in Patients With Functional Neurologic Disorders

Driving in patients with Functional Neurological Disorders (FND) is a major concern, but current guidelines (where they exist) are based on expert consensus only, due to a lack of relevant empirical evidence. The present study aimed to provide such evidence by comparing drivers with FND and healthy controls on aspects of driving performance and behaviour important to crash risk, including hazard perception skill.Participants completed validated self-report questionnaires of driving behaviours (assessing lapses, errors, violations, and attentional issues), and two computer-based measures of hazard perception skill (both known to be associated with crash risk).We compared 43 patients who experience dissociative attacks or functional motor symptoms and 43 healthy controls. The FND patients self-reported significantly more driving lapses and driving errors compared to healthy controls. However, there were no significant between-groups differences in self-reports of ordinary violations, aggressive violations, or attention-related errors. Participants in the FND group and healthy controls exhibited similar performance on a response-timehazard perception test(6.27 vs. 5.51 seconds,p= .245). However, FND participants significantly outperformed the controls in the number of plausible predictions they made in a verbal-responsehazard prediction test(1.55 vs. 1.18 predictions per clip,p= .006).Our findings suggest that the ability of FND drivers to predict traffic hazards in between attacks or flares is not worse than that of healthy individuals, with the possibility that it might even be better under some circumstances. Further studies with various populations are needed to replicate our findings.