Early neuropsychological tests as correlates of return to driving after traumatic brain injury

OBJECTIVE: To assess the ability of neuropsychometric tests administered during inpatient rehabilitation to predict return to driving after traumatic brain injury (TBI). DESIGN: Retrospective, matched case-controlled study. METHODS: Sixty-seven participants with TBI, drawn from an existing database, completed a questionnaire that assessed return to driving post-TBI, as measured by reinstatement of the driver's license. Drivers were individually case-matched to non-drivers on age, Glasgow Coma Scale (GCS), Disability Rating Scale (DRS) and the rehabilitation admission interval (RAI). Scores on four neuropsychological tests (Trail-Making A, Trail Making B, Digit Span-forward and Digit Span-backward), administered during the rehabilitation stay, were compared between case-matched drivers and non-drivers. OUTCOME MEASURE: Return to driving, as defined by reinstatement of the driver's license. RESULTS: Participants who had returned to driving were comparable to those who had not returned to driving with respect to demographic variables, initial injury severity and baseline functioning. Scores on two neuropsychological assessments were significantly better in participants who had returned to driving than in those who had not: Trail-making A (p < 0.01) and Trail-making B (p < 0.01). CONCLUSIONS: The results suggest that neuropsychological measures of processing speed and cognitive flexibility may predict return to driving after TBI.