The Road to Recovery: A Pilot Study of Driving Behaviors Following Antibody-Mediated Encephalitis
Introduction: Safe driving requires integration of higher-order cognitive and motor functions, which are commonly compromised in patients with antibody-mediated encephalitis (AME) associated with N-methyl-D-aspartate receptors or leucine-rich glioma-inactivated 1 autoantibodies. How these deficits i...
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doaj-8f8e69c3ca884b949a0540faf4c2040e2020-11-25T03:04:12ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-07-011110.3389/fneur.2020.00678540709The Road to Recovery: A Pilot Study of Driving Behaviors Following Antibody-Mediated EncephalitisGregory S. Day0Gregory S. Day1Ganesh M. Babulal2Ganesh M. Babulal3Ganesh Rajasekar4Sarah Stout5Catherine M. Roe6Catherine M. Roe7The Charles F. and Joanne Knight Alzheimer Disease Research Center, St. Louis, MO, United StatesDepartment of Neurology, Washington University School of Medicine, St. Louis, MO, United StatesThe Charles F. and Joanne Knight Alzheimer Disease Research Center, St. Louis, MO, United StatesDepartment of Neurology, Washington University School of Medicine, St. Louis, MO, United StatesThe Charles F. and Joanne Knight Alzheimer Disease Research Center, St. Louis, MO, United StatesThe Charles F. and Joanne Knight Alzheimer Disease Research Center, St. Louis, MO, United StatesThe Charles F. and Joanne Knight Alzheimer Disease Research Center, St. Louis, MO, United StatesDepartment of Neurology, Washington University School of Medicine, St. Louis, MO, United StatesIntroduction: Safe driving requires integration of higher-order cognitive and motor functions, which are commonly compromised in patients with antibody-mediated encephalitis (AME) associated with N-methyl-D-aspartate receptors or leucine-rich glioma-inactivated 1 autoantibodies. How these deficits influence the return to safe driving is largely unknown. Recognizing this, we piloted non-invasive remote monitoring technology to longitudinally assess driving behaviors in recovering AME patients.Methods: Five recovering AME patients [median age, 52 years (range 29–67); two females] were recruited from tertiary care clinics at Washington University (St. Louis, MO). Trip data and aggressive actions (e.g., hard braking, sudden acceleration, speeding) were continuously recorded using a commercial Global Positioning System data logger when the patient's vehicle was driven by the designated driver. Longitudinal driving data were compared between AME patients and cognitively normal older adults (2:1 sex-matched) enrolled within parallel studies.Results: Driving behaviors were continuously monitored for a median of 29 months (range, 21–32). AME patients took fewer daily trips during the last vs. the first 6 months of observation, with a greater proportion of trips exceeding 10 miles. Compared to cognitively normal individuals, AME patients were more likely to experience hard braking events as recovery progressed. Despite this, no accidents were self-reported or captured by the data logger.Conclusion: Driving behaviors can be continuously monitored in AME patients using non-invasive means for protracted periods. Longitudinal changes in driving behavior may parallel functional recovery, warranting further study in expanded cohorts of recovering AME patients.https://www.frontiersin.org/article/10.3389/fneur.2020.00678/fullautoimmuneantibody-mediatedencephalitisN-methyl-D-aspartate (NMDA) receptorLGI1autoantibodies |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Gregory S. Day Gregory S. Day Ganesh M. Babulal Ganesh M. Babulal Ganesh Rajasekar Sarah Stout Catherine M. Roe Catherine M. Roe |
spellingShingle |
Gregory S. Day Gregory S. Day Ganesh M. Babulal Ganesh M. Babulal Ganesh Rajasekar Sarah Stout Catherine M. Roe Catherine M. Roe The Road to Recovery: A Pilot Study of Driving Behaviors Following Antibody-Mediated Encephalitis Frontiers in Neurology autoimmune antibody-mediated encephalitis N-methyl-D-aspartate (NMDA) receptor LGI1 autoantibodies |
author_facet |
Gregory S. Day Gregory S. Day Ganesh M. Babulal Ganesh M. Babulal Ganesh Rajasekar Sarah Stout Catherine M. Roe Catherine M. Roe |
author_sort |
Gregory S. Day |
title |
The Road to Recovery: A Pilot Study of Driving Behaviors Following Antibody-Mediated Encephalitis |
title_short |
The Road to Recovery: A Pilot Study of Driving Behaviors Following Antibody-Mediated Encephalitis |
title_full |
The Road to Recovery: A Pilot Study of Driving Behaviors Following Antibody-Mediated Encephalitis |
title_fullStr |
The Road to Recovery: A Pilot Study of Driving Behaviors Following Antibody-Mediated Encephalitis |
title_full_unstemmed |
The Road to Recovery: A Pilot Study of Driving Behaviors Following Antibody-Mediated Encephalitis |
title_sort |
road to recovery: a pilot study of driving behaviors following antibody-mediated encephalitis |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2020-07-01 |
description |
Introduction: Safe driving requires integration of higher-order cognitive and motor functions, which are commonly compromised in patients with antibody-mediated encephalitis (AME) associated with N-methyl-D-aspartate receptors or leucine-rich glioma-inactivated 1 autoantibodies. How these deficits influence the return to safe driving is largely unknown. Recognizing this, we piloted non-invasive remote monitoring technology to longitudinally assess driving behaviors in recovering AME patients.Methods: Five recovering AME patients [median age, 52 years (range 29–67); two females] were recruited from tertiary care clinics at Washington University (St. Louis, MO). Trip data and aggressive actions (e.g., hard braking, sudden acceleration, speeding) were continuously recorded using a commercial Global Positioning System data logger when the patient's vehicle was driven by the designated driver. Longitudinal driving data were compared between AME patients and cognitively normal older adults (2:1 sex-matched) enrolled within parallel studies.Results: Driving behaviors were continuously monitored for a median of 29 months (range, 21–32). AME patients took fewer daily trips during the last vs. the first 6 months of observation, with a greater proportion of trips exceeding 10 miles. Compared to cognitively normal individuals, AME patients were more likely to experience hard braking events as recovery progressed. Despite this, no accidents were self-reported or captured by the data logger.Conclusion: Driving behaviors can be continuously monitored in AME patients using non-invasive means for protracted periods. Longitudinal changes in driving behavior may parallel functional recovery, warranting further study in expanded cohorts of recovering AME patients. |
topic |
autoimmune antibody-mediated encephalitis N-methyl-D-aspartate (NMDA) receptor LGI1 autoantibodies |
url |
https://www.frontiersin.org/article/10.3389/fneur.2020.00678/full |
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