Driving issues in Parkinson's disease

Abstract

People living with Parkinson's disease are stuck in the driving issues in Japan. Parkinson's disease is the most common movement disorder, in which dopamine replacement therapy (DRT) can relieve the severity of motor symptoms. There are two independent aspects in the driving problems, such as driving skills associating with motor deficits and sudden onset of sleep at the wheel associating with DRT. Instead of on road assessment of driving fitness, a driving simulator is increasingly used for clinical research and practice, which is expected supplying novel practical evidences. In contrast, DRT associating sleep problems are clinically delicate because DRT is essential for treatment of Parkinson's disease and is uneasy to be withdrawn even if sudden onset sleepiness was induced. Alternatively, people living with Parkinson's disease who need to drive in their daily lives are not so rare. There is neither legal restrictions in their driving nor practical guidelines of driving in Japan. This review summarizes such conflicting problems of the driving issues surrounding Parkinson's disease in Japan.