Bradykinesia-Akinesia Incoordination Test: Validating an Online Keyboard Test of Upper Limb Function

Noyce, Alastair J.; Nagy, Anett; Acharya, Siddharth; Hadavi, Shahrzad; Bestwick, Jonathan P.; Fearnley, Julian; Lees, Andrew J.; Giovannoni, Gavin

doi:10.1371/journal.pone.0096260

Cited by 53 publications

(58 citation statements)

References 17 publications

(21 reference statements)

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“…Here, we report data using the BRAIN test, which address outstanding questions from earlier assessments . We demonstrate a new measure for bradykinesia (sequence effect) using the VS that captures a decrement in repetitive movement as opposed to the previous measures, which looked at speed of alternate tapping (KS) and dwell time (AT).…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8][9][10][11][12] The BRadykinesia Akinesia Incoordination (BRAIN) test is a freely available, online keyboard finger-tapping test that is based on the alternate finger-tapping task. 13,14 It has previously been shown to differentiate patients with PD from healthy controls and has been used for the longitudinal monitoring of motor function in the PREDICT-PD study, a large cohort of healthy older individuals stratified for future risk of PD. 15 In the present study, we focused on 3 main aspects.…”

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confidence: 99%

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The BRadykinesia Akinesia INcoordination (BRAIN) Tap Test: Capturing the Sequence Effect

Hasan

Burrows

Hellman³

et al. 2019

Movement Disord Clin Pract

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Background The BRadykinesia Akinesia INcoordination (BRAIN) tap test is an online keyboard tapping task that has been previously validated to assess upper limb motor function in Parkinson's disease (PD). Objectives To develop a new parameter that detects a sequence effect and to reliably distinguish between PD patients on and off medication. In addition, we sought to validate a mobile version of the test for use on smartphones and tablet devices. Methods The BRAIN test scores in 61 patients with PD and 93 healthy controls were compared. A range of established parameters captured number and accuracy of alternate taps. The new velocity score recorded the intertap speed. Decrement in the velocity score was used as a marker for the sequence effect. In the validation phase, 19 PD patients and 19 controls were tested using different hardware including mobile devices. Results Quantified slopes from the velocity score demonstrated bradykinesia (sequence effect) in PD patients (slope cut‐off −0.002) with 58% sensitivity and 81% specificity (discovery phase of the study) and 65% sensitivity and 88% specificity (validation phase). All BRAIN test parameters differentiated between on and off medication states in PD. Differentiation between PD patients and controls was possible on all hardware versions of the test. Conclusion The BRAIN tap test is a simple, user‐friendly, and free‐to‐use tool for the assessment of upper limb motor dysfunction in PD, which now includes a measure of bradykinesia.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The BRadykinesia Akinesia INcoordination (BRAIN) Tap Test: Capturing the Sequence Effect

Hasan

Burrows

Hellman³

et al. 2019

Movement Disord Clin Pract

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“…The number of key taps in 30 seconds was recorded. Scores less than 10 and ≥100 were excluded 30. The average score for both hands was calculated.…”

Section: Methodsmentioning

confidence: 99%

Assessing cognitive dysfunction in Parkinson's disease: An online tool to detect visuo‐perceptual deficits

et al. 2018

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Background: People with Parkinson's disease (PD) who develop visuo‐perceptual deficits are at higher risk of dementia, but we lack tests that detect subtle visuo‐perceptual deficits and can be performed by untrained personnel. Hallucinations are associated with cognitive impairment and typically involve perception of complex objects. Changes in object perception may therefore be a sensitive marker of visuo‐perceptual deficits in PD. Objective: We developed an online platform to test visuo‐perceptual function. We hypothesised that (1) visuo‐perceptual deficits in PD could be detected using online tests, (2) object perception would be preferentially affected, and (3) these deficits would be caused by changes in perception rather than response bias. Methods: We assessed 91 people with PD and 275 controls. Performance was compared using classical frequentist statistics. We then fitted a hierarchical Bayesian signal detection theory model to a subset of tasks. Results: People with PD were worse than controls at object recognition, showing no deficits in other visuo‐perceptual tests. Specifically, they were worse at identifying skewed images (P < .0001); at detecting hidden objects (P = .0039); at identifying objects in peripheral vision (P < .0001); and at detecting biological motion (P = .0065). In contrast, people with PD were not worse at mental rotation or subjective size perception. Using signal detection modelling, we found this effect was driven by change in perceptual sensitivity rather than response bias. Conclusions: Online tests can detect visuo‐perceptual deficits in people with PD, with object recognition particularly affected. Ultimately, visuo‐perceptual tests may be developed to identify at‐risk patients for clinical trials to slow PD dementia. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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“…Cut‐off values for smell loss, RBD, and tapping speed based on the 15th centile for each intermediate marker using UPSIT, RBDSQ, and KS were identified (scores of ≤27, ≥5, and ≤44, respectively). These were similar to those in the published literature . A chi‐square test for trend was used to compare the frequency of genetic variants between the higher, middle, and lower risk groups.…”

Section: Methodsmentioning

confidence: 57%

PREDICT-PD: An online approach to prospectively identify risk indicators of Parkinson's disease

et al. 2017

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BackgroundA number of early features can precede the diagnosis of Parkinson's disease (PD).ObjectiveTo test an online, evidence‐based algorithm to identify risk indicators of PD in the UK population.MethodsParticipants aged 60 to 80 years without PD completed an online survey and keyboard‐tapping task annually over 3 years, and underwent smell tests and genotyping for glucocerebrosidase (GBA) and leucine‐rich repeat kinase 2 (LRRK2) mutations. Risk scores were calculated based on the results of a systematic review of risk factors and early features of PD, and individuals were grouped into higher (above 15th centile), medium, and lower risk groups (below 85th centile). Previously defined indicators of increased risk of PD (“intermediate markers”), including smell loss, rapid eye movement–sleep behavior disorder, and finger‐tapping speed, and incident PD were used as outcomes. The correlation of risk scores with intermediate markers and movement of individuals between risk groups was assessed each year and prospectively. Exploratory Cox regression analyses with incident PD as the dependent variable were performed.ResultsA total of 1323 participants were recruited at baseline and >79% completed assessments each year. Annual risk scores were correlated with intermediate markers of PD each year and baseline scores were correlated with intermediate markers during follow‐up (all P values < 0.001). Incident PD diagnoses during follow‐up were significantly associated with baseline risk score (hazard ratio = 4.39, P = .045). GBA variants or G2019S LRRK2 mutations were found in 47 participants, and the predictive power for incident PD was improved by the addition of genetic variants to risk scores.ConclusionsThe online PREDICT‐PD algorithm is a unique and simple method to identify indicators of PD risk. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Bradykinesia-Akinesia Incoordination Test: Validating an Online Keyboard Test of Upper Limb Function

Cited by 53 publications

References 17 publications

The BRadykinesia Akinesia INcoordination (BRAIN) Tap Test: Capturing the Sequence Effect

The BRadykinesia Akinesia INcoordination (BRAIN) Tap Test: Capturing the Sequence Effect

Assessing cognitive dysfunction in Parkinson's disease: An online tool to detect visuo‐perceptual deficits

PREDICT-PD: An online approach to prospectively identify risk indicators of Parkinson's disease

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