Effects of cerebral diseases on driver distraction Dimosthenis Pavlou 1 , Ion Beratis 2 , Athanasia Liozidou 2 , Nikolaos Andronas 2 , George Yannis 1 , Alexandra Economou 2 and Sokratis Papageorgiou 2 1 National Technical University of Athens, Greece 2 National and Kapodistrian University of Athens, Greece Abstract The objective of this paper is to review the literature on the ability of individuals having some kind of cerebral disease to drive, especially while being distracted. Driver distraction, defined as the diversion of attention away from activities critical for safe driving toward a competing activity, is found to be an important cause of road accidents. Driver distraction effects may interfere with several cerebral diseases with high prevalence in the general population, such as cerebral incidents, Parkinson’s, Alzheimer’s, Mild Dementia and Mild Cognitive Impairment. These diseases affect driver’s attention and other cognitive functions and cause degradation in driving performance, which might in turn translate into increased accident risk, especially at the presence of additional (external) distractors. Overall, the literature review confirms that the interaction between driver distraction and cerebral diseases downgrades the driving performance. The degree to which these clinical conditions affect accident risk, especially when unexpected incidents take place, and the driver’s response, need further investigation. Introduction Road accidents constitute a major social problem in modern societies around the world, accounting for more than 1.25 million fatalities per year worldwide (World Health Organization 2010) and 30.000 in Europe (ERSO 2008). Road traffic casualties presented a constantly decreasing trend during the last years. However, the number of fatalities in road accidents in several countries is still unacceptable and illustrates the need for even greater efforts with respect to better driving performance and increased road safety (OECD 2008). Driving is a complex activity, requiring several tasks to be performed simultaneously, and attention and perception are key determinants of the driving performance. This is not surprising, as complex driving situations require the simultaneous processing of numerous pieces of information and the taking of quick decisions. Unfortunately, the consequences of an error of judgment when driving can be major, even fatal. A number of cerebral diseases may affect driving performance in the general population, particularly the elderly. Older drivers generally exhibit a higher risk of involvement in a road accident (Baldock et al. 2007, OECD 2008). Simulated driving tasks have shown that older adults have greater difficulty in dividing attention than do younger adults (Brouwer et al. 1991, Ponds et al. 1988). More specifically, diseases affecting a person's brain functioning may significantly impair the person's driving performance, especially when unexpected incidents occur (Wood et al. 2005, Cordell et