Computational analysis of open loop handwriting movements in Parkinson's disease: A rapid method to detect dopamimetic effects

Abstract

We used a computational analysis of open loop handwriting movements and a clinical rating scale for monitoring the effect of apomorphine in 16 patients with early untreated parkinsonism [subsequently L-DOPA responsive, probable Parkinson's disease (PD)], six patients with long-standing PD with L-DOPA associated motor fluctuations, and seven patients with known L-DOPA unresponsive parkinsonism. Subjects were instructed to write fluently concentric circles of approximately 12 mm in diameter. Movements were recorded for two periods of 3 s each, using a digitizing tablet. Mean peak velocity (Vmax) and mean peak acceleration (Amax) were determined. In addition, two sensitive indices describing the degree of automation of handwriting were derived: (a) NCV, calculated as the mean Number of Changes in direction of Velocity per half circle, and (b) NCA, the mean Number of Changes in the direction of Acceleration. Clinical rating was performed according to the Unified Parkinson's Disease Rating Scale part III (UPDRS III). After apomorphine injection, the patients with early untreated probable PD showed significant improvement of Vmax, Amax, NCV, NCA, and UPDRS III scores. Likewise, the patients with long-standing PD improved significantly in all kinematic parameters and UPDRS III scores. Patients with L-DOPA unresponsive parkinsonism failed to change significantly in any of the parameters tested. These observations suggest that the computer-assisted analysis of automated handwriting movements can be used as an objective quick method for quantifying dopamimetic effects on the kinematics of handwriting movements in parkinsonian patients.

Handwriting speed and size in individuals with Parkinson’s disease compared to healthy controls: the possible effect of cueing

“…In addition, our study confirmed that individuals with PD write slower than healthy controls [4,6,13]. The writing speed was not affected by writing on different types of paper in neither of groups.…”

Pathological Voice Signal Analysis Using Machine Learning Based Approaches

“…The speech sounds from 23 patients with PD and 8 healthy people were collected, then the classification was performed using support vector machine, where the accuracy was 91.4%. (Eichhorn et al, 1996) performed detection of PD through kinematic parameters analysis of handwriting movements. Subjects were asked to draw concentric circles using a digitizing tablet, then changes of different parameters such as mean peak acceleration and mean peak velocity were tested.…”

A Method to Assess Hand Motor Blocks in Parkinson's Disease with Digitizing Tablet

“…Giladi et al proposed that, in PD, MBs are the abnormal retrieval or execution of complex motor tasks that can occur as a result of disease progression or as short or long-term side effects of levodopa treatment. Freezing is mostly linked to gait (freezing of gait -FOG) (Giladi et al 1992(Giladi et al , 2001(Giladi et al , 1997Lamberti et al 1997;Hausdorff et al 2003), but it is also associated with other rhythmic and internally cued repetitive movements (Lamberti et al 1997) such as speech (Ackermann et al 1993), handwriting (Eichhorn et al 1996), and tapping (Nagasaki et al 1988;Ziv et al 1999;Yahalom et al 2004). One mode of freezing may be correlated to another (Ziv et al 1999).…”

“…Various methods of measuring the classical symptoms of PD in an objective and quantitative way have been proposed (Ghika et al 1993;Jobbagy et al 1998), specifically for tapping test (Ziv et al 1999;Yahalom et al 2004), the quantification of rigidity (Patrick et al 2001), handwriting (Eichhorn et al 1996), to evaluate FOG (Han et al 2003;Moore et al 2008), or to assess MBs in hand movements (Popovic et al 2002). Ghika et al (1993) designed portable system based upon a PC to measure tremor, bradikinezia, and muscle tone.…”

“…Tremor was detected by accelerometers, bradikinezia was detected using a panel that detects release and depression of switches in response to auditory and visual signals, and strapping the upper extremity to a lightweight low-friction cradle and then passively moving the cradle with the instrumented handle detected tone at the elbow. Eichhorn et al (1996) used a computational analysis of open loop handwriting and a clinical rating scale for monitoring the effect of apomorphine. PD patients were instructed to write fluently concentric circles while movements were recorded using a digitized tablet.…”