SYSTEMATIC ANALYSIS OF REAL-WORLD DRIVING BEHAVIOR FOLLOWING FOCAL BRAIN LESIONS.

Many patients with circumscribed brain injuries, such as those caused by stroke or focal trauma, return to driving after a period of acute recovery. These persons often have chronic residual cognitive deficits that may impact on driving safety, but little is known about their driving behavior in the real world. Extant studies tend to rely on driving simulators or controlled on-road drives. These methods of observation are not able to capture the complexities of the typical driving environment, and may not accurately represent a driver's usual behavior on the road. The current study used a video event-activated data recorder (VEADR) system to observe drivers with focal brain lesions in their normal daily driving environment over a three-month period. In the context of primarily safe driving behavior, we were able to document a number of relatively infrequent and hitherto unobserved high risk behaviors and traffic violations. These findings demonstrate the feasibility and value of sampling real-world driving in neurologic patient populations such as those with focal brain lesions, and highlight the critical importance of evaluating unsafe driving behaviors which may occur with insufficient frequency to be captured by relatively brief simulator or controlled on-road evaluations.