Dataset Information

Learning More from Finger Tapping in Parkinson's Disease: Up and Down from Dyskinesia to Bradykinesia.

ABSTRACT: The finger tapping test evaluates bradykinesia, focusing on decrement in rate, amplitude, or both with repetitive action. Vertical positioning of the hands during this task may also be clinically relevant. We developed a "TAP score," measuring the vertical level above the lap where the patient performs the finger tapping ranging from 1 (task performed with the hand close to the lap) to 4 (above the head). In this pilot study, we retrospectively applied the TAP score in addition to usual motor scales during acute levodopa challenge in 123 PD patients (of whom 88 presented l-dopa-induced dyskinesia [LID]). TAP ON was higher than TAP OFF. Patients with LID presented higher TAP ON. TAP ON was related to LID severity, whereas TAP OFF was inversely related to the OFF motor symptoms. The TAP score may be a measure of proximal movement amplitude representing an easy method to evaluate defective or excessive motor output in patients with advanced disease.

SUBMITTER: Picillo M

PROVIDER: S-EPMC6353362 | biostudies-literature | 2016 Mar-Apr

REPOSITORIES: biostudies-literature

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Learning More from Finger Tapping in Parkinson's Disease: Up and Down from Dyskinesia to Bradykinesia.

Picillo Marina M Vincos Gustavo B GB Kern Drew S DS Fox Susan H SH Lang Anthony E AE Fasano Alfonso A

Movement disorders clinical practice 20151027 2

The finger tapping test evaluates bradykinesia, focusing on decrement in rate, amplitude, or both with repetitive action. Vertical positioning of the hands during this task may also be clinically relevant. We developed a "TAP score," measuring the vertical level above the lap where the patient performs the finger tapping ranging from 1 (task performed with the hand close to the lap) to 4 (above the head). In this pilot study, we retrospectively applied the TAP score in addition to usual motor sc ...[more]

PMID: 30713911

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Project description:BackgroundFluctuations in motor function in Parkinson's Disease (PD) are frequent and cause significant disability. Frequently device assisted therapies are required to treat them. Currently, fluctuations are self-reported through diaries and history yet frequently people with PD do not accurately identify and report fluctuations. As the management of fluctuations and the outcomes of many clinical trials depend on accurately measuring fluctuations a means of objectively measuring time spent with bradykinesia or dyskinesia would be important. The aim of this study was to present a system that uses wearable sensors to measure the percentage of time that bradykinesia or dyskinesia scores are above a target as a means for assessing levels of treatment and fluctuations in PD.MethodsData in a database of 228 people with Parkinson's Disease and 157 control subjects, who had worn the Parkinson's Kinetigraph ((PKG, Global Kinetics Corporation™, Australia) and scores from the Unified Parkinson's Disease Rating Scale (UPDRS) and other clinic scales were used. The PKG's provided score for bradykinesia and dyskinesia every two minutes and these were compared to a previously established target range representing a UPDRS III score of 35. The proportion of these scores above target over the 6 days that the PKG was worn were used to derive the percent time in bradykinesia (PTB) and percent time in dyskinesia (PTD). As well, a previously describe algorithm for estimating the amplitude of the levodopa response was used to determine whether a subject was a fluctuator or non-fluctuator.ResultsUsing this approach, a normal range of PTB and PTD based on Control subject was developed. The level of PTB and PTD experienced by people with PD was compared with their levels of fluctuation. There was a correlation (Pearson's ρ = 0.4) between UPDRS II scores and PTB: the correlation between Parkinson Disease Questionnaire scores and UPDRS Total scores and PTB and slightly lower. PTB and PTD fell in response to treatment for bradykinesia or dyskinesia (respectively) with greater sensitivity than clinical scales.ConclusionsThis approach provides an objective assessment of the severity of fluctuations in Parkinson's Disease that could be used in in clinical trials and routine care.

Project description:BackgroundMovement Disorder Society-Unified Parkinson's Rating Scale Part III (MDS-UPDRS III) is the gold standard for assessing medication effects in patients with Parkinson's disease (PD). However, short and rater-independent measurements would be ideal for future trials.ObjectivesTo assess the ability of 3 different finger tapping tasks to detect levodopa/carbidopa-induced changes over time and to determine their correlation and compare their discriminatory power with MDS-UPDRS III.MethodsThis was a randomized, double-blind, crossover study in 20 patients with PD receiving levodopa/carbidopa and placebo capsules after overnight medication withdrawal. Pre- and up to 3.5 hours postdose, MDS-UPDRS III and tapping tasks were performed. Tasks included 2 touchscreen-based alternate finger tapping tasks (index finger versus index-middle finger tapping) and a thumb-index finger task using a goniometer.ResultsIn the alternate index finger tapping task, levodopa/carbidopa compared with placebo resulted in significantly faster (total taps: 12.5 [95% confidence interval, CI, 6.7-18.2]) and less accurate tapping (total spatial error: 240 mm [95% CI, 123-357 mm]) with improved rhythm (intertap interval standard deviation [SD], -16.3% [95% CI, -29.9% to 0.0%]). In the thumb-index finger task, tapping was significantly faster (mean opening velocity, 151 degree/s [64-237 degree/s]), with a higher mean amplitude (8.4 degrees [3.7-13.0 degrees]) and improved rhythm (intertap interval SD, -46.4% [95% CI, -63.7% to -20.9%]). The speed-related endpoints showed a moderate-to-strong correlation with the MDS-UPDRS III (r = 0.45-0.70). The effect sizes of total taps and spatial error in the alternate index finger tapping task and opening velocity in the thumb-index finger task were comparable with the MDS-UPDRS III. In contrast, the MDS-UPDRS III performed better than the alternate index-middle finger task.ConclusionThe alternate index finger and the thumb-index finger tapping tasks provide short, rater-independent measurements that are sensitive to levodopa/carbidopa effects with a similar effect size as the MDS-UPDRS III.

Dataset Information

Learning More from Finger Tapping in Parkinson's Disease: Up and Down from Dyskinesia to Bradykinesia.

Publications

Learning More from Finger Tapping in Parkinson's Disease: Up and Down from Dyskinesia to Bradykinesia.

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