Dataset Information

Standardized handwriting to assess bradykinesia, micrographia and tremor in Parkinson's disease.

ABSTRACT:

Objective

To assess whether standardized handwriting can provide quantitative measures to distinguish patients diagnosed with Parkinson's disease from age- and gender-matched healthy control participants.

Design

Exploratory study. Pen tip trajectories were recorded during circle, spiral and line drawing and repeated character 'elelelel' and sentence writing, performed by Parkinson patients and healthy control participants. Parkinson patients were tested after overnight withdrawal of anti-Parkinsonian medication.

Setting

University Medical Center Groningen, tertiary care, the Netherlands.

Participants

Patients with Parkinson's disease (n?=?10; mean age 69.0 years; 6 male) and healthy controls (n?=?10; mean age 68.1 years; 6 male).

Interventions

Not applicable.

Main outcome measures

Movement time and velocity to detect bradykinesia and the size of writing to detect micrographia. A rest recording to investigate the presence of a rest-tremor, by frequency analysis.

Results

Mean disease duration in the Parkinson group was 4.4 years and the patients were in modified Hoehn-Yahr stages 1-2.5. In general, Parkinson patients were slower than healthy control participants. Median time per repetition, median velocity and median acceleration of the sentence task and median velocity of the elel task differed significantly between Parkinson patients and healthy control participants (all p<0.0014). Parkinson patients also wrote smaller than healthy control participants and the width of the 'e' in the elel task was significantly smaller in Parkinson patients compared to healthy control participants (p<0.0014). A rest-tremor was detected in the three patients who were clinically assessed as having rest-tremor.

Conclusions

This study shows that standardized handwriting can provide objective measures for bradykinesia, tremor and micrographia to distinguish Parkinson patients from healthy control participants.

SUBMITTER: Smits EJ

PROVIDER: S-EPMC4031150 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Standardized handwriting to assess bradykinesia, micrographia and tremor in Parkinson's disease.

Smits Esther J EJ Tolonen Antti J AJ Cluitmans Luc L van Gils Mark M Conway Bernard A BA Zietsma Rutger C RC Leenders Klaus L KL Maurits Natasha M NM

PloS one 20140522 5

<h4>Objective</h4>To assess whether standardized handwriting can provide quantitative measures to distinguish patients diagnosed with Parkinson's disease from age- and gender-matched healthy control participants.<h4>Design</h4>Exploratory study. Pen tip trajectories were recorded during circle, spiral and line drawing and repeated character 'elelelel' and sentence writing, performed by Parkinson patients and healthy control participants. Parkinson patients were tested after overnight withdrawal ...[more]

PMID: 24854199

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Project description:Motivational influence on bradykinesia in Parkinson's disease may be observed in situations of emotional and physical stress, a phenomenon known as paradoxical kinesis. However, little is known about motivational modulation of movement speed beyond these extreme circumstances. In particular, it is not known if motivational factors affect movement speed by improving movement preparation/initiation or execution (or both) and how this effect relates to the patients' medication state. In the present study, we tested if provision of motivational incentive through monetary reward would speed-up movement initiation and/or execution in Parkinson's disease patients and if this effect depended on dopaminergic medication. We studied the effect of monetary incentive on simple reaction time in 11 Parkinson's disease patients both "off" and "on" dopaminergic medication and in 11 healthy participants. The simple reaction time task was performed across unrewarded and rewarded blocks. The initiation time and movement time were quantified separately. Anticipation errors and long responses were also recorded. The prospect of reward improved initiation times in Parkinson's disease patients both "off" and "on" dopaminergic medication, to a similar extent as in healthy participants. However, for "off" medication, this improvement was associated with increased frequency of anticipation errors, which were eliminated by dopamine replacement. Dopamine replacement had an additional, albeit small effect, on reward-related improvement of movement execution. Motivational strategies are helpful in overcoming bradykinesia in Parkinson's disease. Motivational factors may have a greater effect on bradykinesia when patients are "on" medication, as dopamine appears to be required for overcoming speed-accuracy trade-off and for improvement of movement execution. Thus, medication status should be an important consideration in movement rehabilitation programmes for patients with Parkinson's disease.

Dataset Information

Standardized handwriting to assess bradykinesia, micrographia and tremor in Parkinson's disease.

Objective

Design

Setting

Participants

Interventions

Main outcome measures

Results

Conclusions

Publications

Standardized handwriting to assess bradykinesia, micrographia and tremor in Parkinson's disease.

Similar Datasets

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