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Instrumented finger-to-nose test classification in children with ataxia or developmental coordination disorder and
O Martinez-Manzanera1, T F Lawerman1, H J Blok1
1Department of Neurology, University Medical Center Groningen (UMCG), University of Groningen, Groningen, the Netherlands.
Insights
Quantitative analysis of the finger-to-nose test shows promise for diagnosing early onset ataxia in children. This objective method aids specialists in distinguishing between healthy development and certain neurological conditions.
Area of Science:
- Neurology
- Biomedical Engineering
- Pediatrics
Background:
- Childhood coordination is affected by physiological development and pathological conditions like early onset ataxia (EOA) and developmental coordination disorder (DCD).
- Current diagnoses rely on clinical specialists but lack objective reproducibility due to the absence of a gold phenotypic standard.
Purpose of the Study:
- To determine if quantitative analysis of the finger-to-nose (FNT) test can differentiate between physiological and pathological coordination issues.
- To assess the utility of inertial measurement units (IMUs) and random forest classification for analyzing FNT performance.
Main Methods:
- Participants performed the FNT, while IMUs captured upper limb movement trajectories.
- Random forests were used to classify participants into control, EOA, or DCD groups based on movement data.
Main Results:
- The model achieved 87.4% accuracy for controls, 74.4% for EOA, and 24.8% for DCD.
- Classification accuracy was good for controls and EOA, but significantly lower for DCD patients.
Conclusions:
- Quantitative FNT analysis shows potential as a reliable tool for supporting the assessment of early onset ataxia.
- The FNT's effectiveness in reflecting distinct DCD symptoms remains uncertain due to classification limitations.
Background:
During childhood, many conditions may impact coordination. Examples are physiological age-related development and pathological conditions, such as early onset ataxia and developmental coordination disorder. These conditions are generally diagnosed by clinical specialists. However, in absence of a gold phenotypic standard, objective reproducibility among specialists appears limited.
Methods:
We investigated whether quantitative analysis of an upper limb coordination task (the finger-to-nose test) could discriminate between physiological and pathological conditions impacting coordination. We used inertial measurement units to estimate movement trajectories of the participants while they executed the finger-to-nose test. We employed random forests to classify each participant in one category.
Findings:
On average, 87.4% of controls, 74.4% of early onset ataxia and 24.8% of developmental coordination disorder patients were correctly classified. The relatively good classification of early onset ataxia patients and controls contrasts with the poor classification of developmental coordination disorder patients.
Interpretation:
In absence of a gold phenotypic standard for developmental coordination disorder recognition, it remains elusive whether the finger-to-nose test in these patients represents a sufficiently accurate entity to reflect symptoms distinctive of this disorder. Based on the relatively good results in early onset ataxia patients and controls, we conclude that quantitative analysis of the finger-to-nose test can provide a reliable support tool during the assessment of phenotypic early onset ataxia.
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