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The impact of visual and visual-cognitive impairments on fitness to drive in persons with multiple sclerosis (PwMS) are not well studied. We quantified visual correlates of fitness to drive in 30 PwMS. PwMS completed visual ability and visual attention assessments, and a standardized on-road assessment, and were compared with 145 older volunteer drivers. PwMS (vs. older volunteer drivers) made more total ( W = 12,139, p = .03) and critical driving errors (predictive of crashes) in adjustment to stimuli ( W = 11,352, p < .0001), vehicle positioning ( W = 11,449, p < .0001), and wide lane turns ( W = 9,932, p < .0001). PwMS who failed (vs. passed) made more total ( W = 325, p = .04), adjustment to stimuli ( W = 321.5, p = .02), and gap acceptance errors ( W = 333, p = .03). For PwMS, adjustment to stimuli errors moderately correlated with visual acuity (ρ = .50, p = .006), and gap acceptance errors moderately correlated with visual processing speed (ρ = .40, p = .03). Visual-cognitive impairments may be indicative of critical driving errors and help identify PwMS at-risk for fitness to drive.

Objective: To standardize a method to measure cognitive fatigue in patients with multiple sclerosis (MS)., Background: Many patients with MS complain of cognitive fatigue, defined as a decline in cognitive performance during a task requiring sustained activity. Until now there has not been a standardized way to detect cognitive fatigue or determine its severity., Methods: We administered the Paced Auditory Serial Addition Test (PASAT) to 130 normal controls and 100 randomly selected patients with MS, and compared the number of correct responses between the first third and last third of the test., Results: The controls averaged 2 more correct responses in the last third of the PASAT than in the first third. The patients with MS averaged 2 to 3 fewer correct responses in the last third than the first third., Conclusions: Our study showed that comparing responses between the first and last thirds of the PASAT is a reliable method to measure cognitive fatigue in patients with MS. We also present normative data to be used to determine whether patients with MS have cognitive fatigue.