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Published on: November 21, 2013
Digital Handwriting Reveals Motor Impairment, Dopaminergic Response, and Progression in Parkinson's Disease
Lola Díaz-Feliz1,2,3,4,5, Marcos Faundez-Zanuy6, Andrea Gennari4
1Department of Anatomy, Histology, and Neuroscience, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
Background:
Digital handwriting distinguishes PD patients from healthy controls but is rarely assessed quantitatively.
Objectives:
To evaluate digital handwriting as an objective tool to assess motor impairment, dopaminergic response, and progression in PD.
Methods:
Participants (Healthy Controls, n = 52; De Novo PD Patients assessed at baseline and after 7 weeks, n = 50; PD Patients in OFF-ON states following inhaled levodopa, n = 26; PD Progression Patients, n = 60) wrote a standard sentence on a digitizing tablet.
Results:
De Novo PD Patients showed reduced handwriting speed and increased in-air time. Acute dopaminergic stimulation in OFF-ON states was associated with shorter in-surface and in-air time. Longer disease duration was associated with increased variability in speed and acceleration. Higher MDS-UPDRS Part III scores were associated with lower speed and acceleration.
Conclusions:
Digital handwriting is an objective digital biomarker for quantifying PD dysgraphia and its response to dopaminergic treatment.
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