Behavioral Inattention Testで検出されない左半側空間無視患者の自動車運転評価における特徴と運転再開に影響する要因の検討─3症例のケースシリーズ

Characteristics in driving evaluation and factors influencing resumption of driving for unilateral spatial neglect patients undetected by Behavioral Inattention Test: A case study of three patients

要旨：本研究では，半側空間無視（以下，USN）軽度3症例の自動車運転評価結果を分析し，評価中の行動面の特徴に加え，運転再開につながる要因を見出すことを目的とした．全症例のBITがカットオフ値以上を示す一方で，シミュレータ検査や実車評価での車両位置偏位，車線左への脱輪，右方向への接触などの特徴が観察された．また，再評価で運転再開可能となった症例では，運転に関する自己認識の改善がみられ，さらに全般性注意機能の改善が方向性注意機能の低下を補完した可能性が示唆された．USN軽度例の自動車運転評価では，シミュレータ検査や実車を用いて，潜在化したUSN症状のみならず，全般性注意機能の低下や病識の問題にも着目すべきである．

　The aim of this study was to find the behavioral characteristics in the driving evaluation and the factors related to resumption of driving through analysis of driving evaluations in three patients with mild- unilateral spatial neglect (USN). Based on the Behavioral Inattention Test (BIT), the patients had no signs of USN; however, the characteristics of driving behavior, such as poor lane position, running off the left side of the lane, and right side vehicle rubbing, were observed during driving simulation and on-road driving. For the patient who resumed to drive in re-evaluation, the improvement of self-awareness for his driving performance was observed, and in addition, the improvement of his generalized attention can complement his directed attention. When evaluating driving in patients with mild USN, we should not only focus on the possible presence of USN but also evaluate associated problems such as generalized attention and self-awareness by using driving simulation and on-road driving.