Impaired Touchscreen Skills in Parkinson's Disease and Effects of Medication

Abstract

BackgroundBackground: Deficits in fine motor skills may impair device manipulation including touchscreens in people with Parkinson's disease (PD). Objectives Objectives: To investigate the impact of PD and anti-parkinsonian medication on the ability to use touchscreens. Methods Methods: Twelve PD patients (H&Y II-III), OFF and ON medication, and 12 healthy controls (HC) performed tapping, single and multi-direction sliding tasks on a touchscreen and a mobile phone task (MPT). Task performance was compared between patients (PD-OFF, PD-ON) and HC and between medication conditions. Results Results: Significant differences were found in touchscreen timing parameters, while accuracy was comparable between groups. PD-OFF needed more time than HC to perform single (P = 0.048) and multi-direction (P = 0.004) sliding tasks and to grab the dot before sliding (i.e., transition times) (P = 0.040; P = 0.004). For tapping, dopaminergic medication significantly increased performance times (P = 0.046) to comparable levels as those of HC. However, for the more complex multi-direction sliding, movement times remained slower in PD than HC irrespective of medication intake (P < 0.050 during ON and OFF). The transition times for the multidirection sliding task was also higher in PD-ON than HC (P = 0.048). Touchscreen parameters significantly correlated with MPT performance, supporting the ecological validity of the touchscreen tool. Conclusions Conclusions: PD patients show motor problems when manipulating touchscreens, even when optimally medicated. This hinders using mobile technology in daily life and has implications for developing adequate Ehealth applications for this group. Future work needs to establish whether touchscreen training is effective in PD.

Reply to: Touchscreen Smartphone Interaction in Parkinson's Disease and Healthy Subjects on Out‐Patient Clinics

“…Similar to our findings, timing parameters did not differ between groups when tapping and sliding in a single direction. 2 In contrast, we found a significantly slower performance when sliding in multiple directions in PD patients compared to HC even when on medication and increased slowing of specific tasks when off. Moreover, PD patients had a worse tapping accuracy than HC on medication, similar to previous work.…”

“…1 Although neither study found between-group differences in inter-tap interval time and single sliding time when on medication, we expect that, particularly when off, PD patients will be hampered when turning off alarm clocks or medication reminders. 2 When off medication, Wissel et al 4 demonstrated a significantly slower inter-tap interval time than HC in PD patients with worse disease severity than included in our study. This predicts that more affected patients will experience even greater problems.…”

“…We did not suggest that on the basis of our findings touchscreen technology should be disregarded in PD. 2 Instead, we claimed that even basic touchscreen skills cannot be assumed to remain unaffected by the disease and that this needs to be taken into account. As medication only had limited effects, we also recommended developing training programs targeting touchscreen manipulations, which may become even more functionally useful than writing training programs with time.…”

“…We thank L opez-Blanco et al 1 for their interest in our recent findings on touchscreen skills in patients with Parkinson's disease (PD), 2 highlighting the importance of this topic and the increased use of touchscreen devices in current society and in healthcare. In their own study, the authors did not find differences in touchscreen performance between PD patients on medication and healthy control subjects (HC) despite a variety of tasks used.…”

A Placebo‐Controlled Study to Assess the Sensitivity of Finger Tapping to Medication Effects in Parkinson's Disease

“…Such a trade-off between speed and accuracy has previously been described in patients with PD, 6,15 although not consistently. 8 Different results between studies might have been obtained due to differences in the test set-up as well as in how accuracy was calculated (eg, on a continuous scale vs. inside/outside target). In the alternate index finger tapping task, rhythm was also significantly improved (ie, lower geometric mean of intertap interval SD) after levodopa/carbidopa compared with placebo, albeit with a lower effect size than the speed and accuracy endpoints.…”