Handwriting movements for assessment of motor symptoms in schizophrenia spectrum disorders and bipolar disorder

Abstract

The main aim of the present study was to explore the value of several measures of handwriting in the study of motor abnormalities in patients with bipolar or psychotic disorders. 54 adult participants with a schizophrenia spectrum disorder or bipolar disorder and 44 matched healthy controls, participated in the study. Participants were asked to copy a handwriting pattern consisting of four loops, with an inking pen on a digitizing tablet. We collected a number of classical, non-linear and geometrical measures of handwriting. The handwriting of patients was characterized by a significant decrease in velocity and acceleration and an increase in the length, disfluency and pressure with respect to controls. Concerning non-linear measures, we found significant differences between patients and controls in the Sample Entropy of velocity and pressure, Lempel-Ziv of velocity and pressure, and Higuchi Fractal Dimension of pressure. Finally, Lacunarity, a measure of geometrical heterogeneity, was significantly greater in handwriting patterns from patients than from controls. We did not find differences in any handwriting measure on function of the specific diagnosis or the antipsychotic dose. Results indicate that participants with a schizophrenia spectrum disorder or bipolar disorder exhibit significant motor impairments and that these impairments can be readily quantified using measures of handwriting movements. Besides, they suggest that motor abnormalities are a core feature of several mental disorders and they seem to be unrelated to the pharmacological treatment.

Graphology: An Interface Between Biology, Psychology and Neuroscience

“…In a more recent paper, Crespo et al investigated the use of handwriting in the study of motor abnormalities in patients suffering from bipolar or psychotic disorders. Outcomes demonstrated that individuals affected by schizophrenia spectrum disorder or bipolar disorder manifested significant motor impairments [65]. The handwriting of patients was distinguished by a significant decrease in velocity and acceleration and an increase in the length, disfluency and pressure with respect to controls.…”

Exploring the Relationship of Transdiagnostic Mood and Psychosis Symptom Domains with Motor Dysfunction

“…Bolbecker et al [28] reported balance impairments in euthymic individuals with bipolar disorder during a static task, while Kang et al [29] reported impaired balance in depressed but not euthymic individuals with bipolar disorder during a dynamic task. Dyskinesia has also been reported in bipolar disorder [30,31], including one study of euthymic individuals [32], as has Parkinsonism [30].…”

Online Handwriting, Signature and Touch Dynamics: Tasks and Potential Applications in the Field of Security and Health

“…This kind of task is especially challenging for those people affected by cognitive impairment, such as dementia, mild cognitive impairment, etc. This is the case of the house drawing Archimedean spiral, meanders and straight lines -Parkinson's disease [86,85] -Huntington's disease [7] -essential tremor [63,80,70,27] -developmental dysgraphia [31] -fatigue [34] -brachial dystonia [81] Single or overlapped circles -Huntington's disease [7] -schizophrenia [9] Spring task -fatigue [34] -developmental dysgraphia [31,103] -schizophrenia [9,14] -bipolar disorder [14] -Parkinson's disease [93] -Huntington's disease [7] Rainbow task -developmental dysgraphia [31,67] Saw task -developmental dysgraphia [31] Drawing Tasks Security (user identification and verification)…”