# Driving after Concussion: Examination of the Adolescent Brain and Behaviors

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2022 · $596,458

## Abstract

Each year, over 1.9 million children sustain a concussion, with adolescents accounting for over 50% of these
mild traumatic brain injuries. A concussion can affect cognition, concentration, processing speed, and
oculomotor function. Driving requires integration of these functions, including assessment of the visual scene,
processing of environmental risks, and execution of complex skills in rapid succession. Adolescents are at
greatest risk for a motor vehicle crash (MVC), and the neurofunctional decrements due to concussion impairs
abilities integral to safe driving. However, there are no evidence-based guidelines for return to drive
recommendations for adolescents, and little research has specifically examined returning to drive after a
concussion in adolescents. The long-term goal of this R01 is to establish the evidence base for return to drive
recommendations for adolescents after a concussion. The objective is to examine the neurophysiological
functioning of the recovering concussed adolescent brain while managing driving tasks, the association
between their neurophysiological functioning and clinical assessments, and the nature of concussed
adolescents' engagement in risky driving behaviors. The innovation of this R01 includes 1) Discovery, 2)
Translation and 3) Real-world Assessment. In the synergy of the three Aims, this R01 will employ driving
simulation, fNIRS, and pupillometry as measures of neurophysiological function; examine the association of
these objective measures with clinical assessments; and prospectively quantify driving behaviors of concussed
adolescents with objective on-road in-vehicle monitoring and ecological momentary monitoring (EMA) of
concussion symptoms. Taken together these aims form the foundational science necessary for evidence-
based recommendations for return to drive after concussion. In a driving simulated study for Aim 1 (Discovery),
cognitive workload measured with functional near-infrared spectroscopy and autonomic function measured
with pupillometry will be compared for concussed and non-concussed adolescents. In Aim 2 (Translation), we
will evaluate the relationship between the objective measures of neurophysiology collected the simulated
driving study with standard concussion assessments used in the clinical setting. In Aim 3 (Real-world
Assessment), data on real-time, on-road, driving behaviors will objectively measure risky driving behaviors of
concussed and non-concussed adolescents, while integrating EMA assessment of concussion symptoms.
Each aim helps delineate important facets of returning to drive after concussion for adolescents, including what
is happening in the concussed adolescent brain, how it relates to clinical assessments, and how concussed
adolescents engage in driving behaviors that place them at most risk for an MVC. Across the three aims, this
innovative approach will provide the scientific foundation to establish evidence-based clinical guidelines that
can promote health and wel...

## Key facts

- **NIH application ID:** 10336524
- **Project number:** 5R01NR018425-03
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Catherine Claire McDonald
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $596,458
- **Award type:** 5
- **Project period:** 2020-04-03 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10336524

## Citation

> US National Institutes of Health, RePORTER application 10336524, Driving after Concussion: Examination of the Adolescent Brain and Behaviors (5R01NR018425-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10336524. Licensed CC0.

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