Skip to main content

Advertisement

SpringerLink
Log in

Driving ability in patients with dizziness: a systematic review

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this systematic review was to identify and evaluate studies dealing with driving performance of dizzy patients or patients with a vestibular disorder.

Methods

A systematic review was performed according to the preferred reporting items for systematic reviews and meta-analysis guidelines. (1) PubMed, Embase, and Cochrane library. (2) Study selection: articles about driving ability and reported driving difficulties in patients with dizziness, or a diagnosed vestibular disorder, were included. (3) Data extraction was performed by two independent authors using predefined data fields: patient’s characteristics, diagnostic criteria, sample size, and type of evaluation of driving ability and outcome of the study.

Results

Eight out of 705 articles matched the inclusion criteria but varied widely regarding the study population, study design, and outcome measures. The majority of studies reported a negative impact of dizziness and/or vestibular disorders on self-reported driving ability and car accidents. Yet several studies could not identify any impairment of driving ability.

Conclusions

Driving ability was negatively affected by dizziness or a vestibular disorder in the majority of included studies with low risk of bias. This systematic review revealed a significant heterogeneity in studies reporting driving performance and contradictory results. We were, therefore, unable to identify a causal relationship between dizziness and driving ability. There is a need for prospective studies in populations with different vestibular disorders using subjective and objective outcome measures that have been validated to evaluate driving performance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Availability of data and material

The authors declare that all data and materials support the published claims and comply with field standards.

Code availability

The study is registered online at the PROSPERO.

References

  1. Michon J (1985) chater A critical view of driver behavior models: what do we know, what should we do? In: Evans L, Schwing RC (eds) Human behavior and traffic safety. Plenum Press, New York, pp 485–520

    Chapter  Google Scholar 

  2. Neuhauser HK (2016) The epidemiology of dizziness and vertigo. Hand Clin Neurol 137:67–82. https://doi.org/10.1016/B978-0-444-63437-5.00005-4

    Article  CAS  Google Scholar 

  3. Newman-Toker DE, Edlow JA (2015) TiTrATE: a novel, evidence-based approach to diagnosing acute dizziness and vertigo. Neurol Clin 33(3):577–599. https://doi.org/10.1016/j.ncl.2015.04.011

    Article  PubMed  PubMed Central  Google Scholar 

  4. Huppert D, Straumann D, Magnusson M, Pyykko I, Brandt T (2018) Dizziness in Europe: from licensed fitness to drive to licence without fitness to drive. J Neurol 265(Suppl 1):9–17. https://doi.org/10.1007/s00415-018-8806-y

    Article  PubMed  Google Scholar 

  5. Sinnott JD, Mahoney H, Wilkinson AS, Broomfield SJ (2019) Dizziness, driving, and the driver and vehicle licensing agency: audit of advice given to patients, and design of a patient information leaflet. J Laryngol Otol 133:1–3. https://doi.org/10.1017/S0022215119001713

    Article  Google Scholar 

  6. Evans A, Eng CY (2006) Driving and otolaryngology: do we know the rules? J Laryngol Otol 120(3):181–184. https://doi.org/10.1017/S0022215105006663

    Article  PubMed  Google Scholar 

  7. Zwergal A, Grill E, Lopez C, Dieterich M (2019) DIZZYNET 2019: approaching the future of vestibular research. J Neurol 266(Suppl 1):1–2

    Article  PubMed  Google Scholar 

  8. Ji Kwon N, Han E (2019) A review of drug abuse in recently reported cases of driving under the influence of drugs (DUID) in Asia, USA, and Europe. Forensic Sci Int 302:109854. https://doi.org/10.1016/j.forsciint.2019.06.012

    Article  PubMed  Google Scholar 

  9. Overton TL, Rives TE, Hecht C, Shafi S, Gandhi RR (2015) Distracted driving: prevalence, problems, and prevention. Int J Inj Contr Saf Promot 22(3):187–192. https://doi.org/10.1080/17457300.2013.879482

    Article  PubMed  Google Scholar 

  10. Mazzariol B, Pastorini A, di Luca A, di Luca NM (2019) Recent medico-legal developments on the issue of epilepsy and driver’s license requirements in the Italian and European legislation. Behav Neurol 2019:7127956. https://doi.org/10.1155/2019/7127956

    Article  PubMed  PubMed Central  Google Scholar 

  11. Moher D, Liberati A, Tetzlaff J, Altman DG (2010) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8(5):336–341

    Article  PubMed  Google Scholar 

  12. Ward BK, Agrawal Y, Hoffman HJ, Carey JP, Della Santina CC (2013) Prevalence and impact of bilateral vestibular hypofunction: results from the 2008 US National Health Interview Survey. JAMA Otolaryngol Head Neck Surg 139(8):803–810. https://doi.org/10.1001/jamaoto.2013.3913

    Article  PubMed  PubMed Central  Google Scholar 

  13. Wei EX, Agrawal Y (2018) Association between vestibular vertigo and motor vehicle accidents: data from the 2016 National Health Interview Survey. Ear Hear 39(6):1232–1235. https://doi.org/10.1097/AUD.0000000000000602

    Article  PubMed  Google Scholar 

  14. Wei EX, Agrawal Y (2017) Vestibular dysfunction and difficulty with driving: data from the 2001–2004 National Health and Nutrition Examination Surveys. Front Neurol 8:557. https://doi.org/10.3389/fneur.2017.00557

    Article  PubMed  PubMed Central  Google Scholar 

  15. MacDougall HG, Moore ST, Black RA, Jolly N, Curthoys IS (2009) On-road assessment of driving performance in bilateral vestibular-deficient patients. Ann N Y Acad Sci 1164:413–418. https://doi.org/10.1111/j.1749-6632.2008.03733.x

    Article  PubMed  Google Scholar 

  16. Huppert D, Straube A, Albers L, von Kries R, Obermeier V (2019) Risk of traffic accidents after onset of vestibular disease assessed with a surrogate marker. J Neurol 266(Suppl 1):3–8. https://doi.org/10.1007/s00415-019-09300-5

    Article  PubMed  Google Scholar 

  17. Sindwani R, Parnes LS, Goebel JA, Cass SP (1999) Approach to the vestibular patient and driving: A patient perspective. Otolaryngol Head Neck Surg 121(1):13–17. https://doi.org/10.1016/S0194-5998(99)70115-4

    Article  CAS  PubMed  Google Scholar 

  18. Cohen HS, Wells J, Kimball KT, Owsley C (2003) Driving disability and dizziness. J Safety Res 34(4):361–369. https://doi.org/10.1016/j.jsr.2003.09.009

    Article  PubMed  Google Scholar 

  19. Pyykko I, Manchaiah V, Zou J, Levo H, Kentala E (2019) Driving habits and risk of traffic accidents among people with Meniere’s disease in Finland. J Int Adv Otol 15(2):289–295. https://doi.org/10.5152/iao.2019.5915

    Article  PubMed  PubMed Central  Google Scholar 

  20. Dobbels B, Mertens G, Gilles A et al (2020) The virtual morris water task in 64 patients with bilateral vestibulopathy and the impact of hearing status. Front Neurol 11:710. https://doi.org/10.3389/fneur.2020.00710

    Article  PubMed  PubMed Central  Google Scholar 

  21. Dobbels B, Lucieer F, Mertens G et al (2020) Prospective cohort study on the predictors of fall risk in 119 patients with bilateral vestibulopathy. PLoS ONE 15(3):e0228768. https://doi.org/10.1371/journal.pone.0228768

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Lucieer FMP, Van Hecke R, van Stiphout L et al (2020) Bilateral vestibulopathy: beyond imbalance and oscillopsia. J Neurol. https://doi.org/10.1007/s00415-020-10243-5

    Article  PubMed  PubMed Central  Google Scholar 

  23. Taylor JE, Connolly MJ, Brookland R, Samaranayaka A (2018) Understanding driving anxiety in older adults. Maturitas 118:51–55. https://doi.org/10.1016/j.maturitas.2018.10.008

    Article  PubMed  Google Scholar 

  24. Danneels M, Van Hecke R, Keppler H et al (2020) Psychometric properties of cognitive-motor dual-task studies with the aim of developing a test protocol for persons with vestibular disorders: a systematic review. Ear Hear 41(1):3–16. https://doi.org/10.1097/AUD.0000000000000748

    Article  PubMed  Google Scholar 

  25. Cuenen A, Jongen EM, Brijs T et al (2015) Does attention capacity moderate the effect of driver distraction in older drivers? Accid Anal Prev 77:12–20. https://doi.org/10.1016/j.aap.2015.01.011

    Article  PubMed  Google Scholar 

  26. Dobbels B, Mertens G, Gilles A et al (2019) Cognitive function in acquired bilateral vestibulopathy: a cross-sectional study on cognition, hearing, and vestibular loss. Front Neurosci 13:340. https://doi.org/10.3389/fnins.2019.00340

    Article  PubMed  PubMed Central  Google Scholar 

  27. Dobbels B, Peetermans O, Boon B, Mertens G, Van de Heyning P, Van Rompaey V (2019) Impact of bilateral vestibulopathy on spatial and nonspatial cognition: a systematic review. Ear Hear 40(4):757–765. https://doi.org/10.1097/AUD.0000000000000679

    Article  PubMed  Google Scholar 

  28. Lacroix E, Deggouj N, Salvaggio S, Wiener V, Debue M, Edwards MG (2016) The development of a new questionnaire for cognitive complaints in vertigo: the neuropsychological vertigo inventory (NVI). Eur Arch Otorhinolaryngol 273(12):4241–4249. https://doi.org/10.1007/s00405-016-4135-x

    Article  PubMed  Google Scholar 

  29. Guidetti G, Guidetti R, Manfredi M, Manfredi M (2020) Vestibular pathology and spatial working memory. J Acta Otorhinolaryngol Ital 40(1):72–78. https://doi.org/10.14639/0392-100X-2189

    Article  Google Scholar 

  30. Ross V, Jongen E, Brijs T, Ruiter R, Brijs K, Wets G (2015) The relation between cognitive control and risky driving in young novice drivers. Appl Neuropsychol Adult 22(1):61–72. https://doi.org/10.1080/23279095.2013.838958

    Article  PubMed  Google Scholar 

  31. Ross V, Jongen EMM, Brijs K, Brijs T, Wets G (2016) Investigating risky, distracting, and protective peer passenger effects in a dual process framework. Accid Anal Prev 93:217–225. https://doi.org/10.1016/j.aap.2016.05.007

    Article  PubMed  Google Scholar 

  32. Ross V, Vossen AY, Smulders FTY et al (2018) Measuring working memory load effects on electrophysiological markers of attention orienting during a simulated drive. Ergonomics 61(3):429–443. https://doi.org/10.1080/00140139.2017.1353708

    Article  PubMed  Google Scholar 

  33. Miyata A, Iwamoto K, Kawano N et al (2018) Driving performance of stable outpatients with depression undergoing real-world treatment. Psychiatry Clin Neurosci 72(6):399–408. https://doi.org/10.1111/pcn.12648

    Article  PubMed  Google Scholar 

  34. Brunnauer A, Laux G, Geiger E, Soyka M, Moller HJ (2006) Antidepressants and driving ability: results from a clinical study. J Clin Psychiatry 67(11):1776–1781. https://doi.org/10.4088/jcp.v67n1116

    Article  CAS  PubMed  Google Scholar 

  35. Brunnauer A, Laux G (2017) Driving under the influence of antidepressants: a systematic review and update of the evidence of experimental and controlled clinical studies. Pharmacopsychiatry 50(5):173–181. https://doi.org/10.1055/s-0043-113572

    Article  CAS  PubMed  Google Scholar 

  36. Cameron DH, Rapoport MJ (2016) Antidepressants and driving in older adults: a systematic review. Can J Aging 35(Suppl 1):7–14. https://doi.org/10.1017/S0714980816000064

    Article  PubMed  Google Scholar 

  37. Urlings JHJ, Cuenen A, Brijs T, Lutin M, Jongen EMM (2018) Aiding medical professionals in fitness-to-drive screenings for elderly drivers: development of an office-based screening tool. Int Psychogeriatr 30(8):1211–1225. https://doi.org/10.1017/S1041610217002678

    Article  PubMed  Google Scholar 

Download references

Funding

The authors did not receive support from any organization for the submitted work.

Author information

Authors and Affiliations

  1. Departments of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium

    Marie-Hélène Uwents, Cathérine Jorissen, Bieke Dobbels, Marc Lammers, Olivier Vanderveken & Vincent Van Rompaey

  2. Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium

    Marie-Hélène Uwents, Cathérine Jorissen, Angelique Van Ombergen, Bieke Dobbels, Sebastien Janssens de Varebeke, Olivier Vanderveken & Vincent Van Rompaey

  3. Departments of Otorhinolaryngology and Head and Neck Surgery, Jessa Hospital, Hasselt, Belgium

    Sebastien Janssens de Varebeke

  4. European Space Agency, Noordwijk, The Netherlands

    Angelique Van Ombergen

  5. Department of Otorhinolaryngology and Head and Neck Surgery, Division of Balance Disorders, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands

    Raymond van de Berg

  6. Faculty of Physics, Tomsk State Research University, Tomsk, Russian Federation

    Raymond van de Berg

  7. School of Transportation Sciences, UHasselt, Transportation Research Institute (IMOB), Agoralaan, Diepenbeek, Belgium

    Veerle Ross & Tom Brijs

Authors
  1. Marie-Hélène Uwents
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cathérine Jorissen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Angelique Van Ombergen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bieke Dobbels
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Raymond van de Berg
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sebastien Janssens de Varebeke
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marc Lammers
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Veerle Ross
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Olivier Vanderveken
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Tom Brijs
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Vincent Van Rompaey
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors made substantial contributions to the work.

Corresponding author

Correspondence to Vincent Van Rompaey.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The protocol (ID 178086) is available online at PROSPERO (www.crd.york.ac.uk/prospero).

Appendix 1

Appendix 1

The following search strategy was used: (("vertigo"[MeSH Terms] OR "vertigo"[All Fields]) OR ("vertigo"[MeSH Terms] OR "vertigo"[All Fields] OR "dizziness"[All Fields] OR "dizziness"[MeSH Terms]) OR vestibular[All Fields]) AND (("drive"[MeSH Terms] OR "drive"[All Fields]) OR ("automobile driving"[MeSH Terms] OR ("automobile"[All Fields] AND "driving"[All Fields]) OR "automobile driving"[All Fields] OR "driving"[All Fields]) OR (fitness[All Fields] AND ("drive"[MeSH Terms] OR "drive"[All Fields]))).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Uwents, MH., Jorissen, C., Van Ombergen, A. et al. Driving ability in patients with dizziness: a systematic review. Eur Arch Otorhinolaryngol 279, 1813–1829 (2022). https://doi.org/10.1007/s00405-021-06881-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-021-06881-8

Keywords

Search

Navigation