A Kinematic Study of Progressive Micrographia in Parkinson's Disease
Progressive micrographia is decrement in character size during writing and is commonly associated with Parkinson's disease (PD). This study has investigated the kinematic features of progressive micrographia during a repetitive writing task. Twenty-four PD patients with duration since diagnosis...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00403/full |
| _version_ | 1818977405671309312 |
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| author | Poonam Zham Sanjay Raghav Sanjay Raghav Peter Kempster Peter Kempster Sridhar Poosapadi Arjunan Kit Wong Kanae J. Nagao Dinesh K. Kumar |
| author_facet | Poonam Zham Sanjay Raghav Sanjay Raghav Peter Kempster Peter Kempster Sridhar Poosapadi Arjunan Kit Wong Kanae J. Nagao Dinesh K. Kumar |
| author_sort | Poonam Zham |
| collection | DOAJ |
| description | Progressive micrographia is decrement in character size during writing and is commonly associated with Parkinson's disease (PD). This study has investigated the kinematic features of progressive micrographia during a repetitive writing task. Twenty-four PD patients with duration since diagnosis of <10 years and 24 age-matched controls wrote the letter “e” repeatedly. PD patients were studied in defined off states, with scoring of motor function on the Unified Parkinson's Disease Rating Scale Part III. A digital tablet captured x-y coordinates and ink-pen pressure. Customized software recorded the data and offline analysis derived the kinematic features of pen-tip movement. The average size of the first and the last five letters were compared, with progressive micrographia defined as >10% decrement in letter stroke length. The relationships between dimensional and kinematic features for the control subjects and for PD patients with and without progressive micrographia were studied. Differences between the initial and last letter repetitions within each group were assessed by Wilcoxon signed-rank test, and the Kruskal-Wallis test was applied to compare the three groups. There are five main conclusions from our findings: (i) 66% of PD patients who participated in this study exhibited progressive micrographia; (ii) handwriting kinematic features for all PD patients was significantly lower than controls (p < 0.05); (iii) patients with progressive micrographia lose the normal augmentation of writing speed and acceleration in the x axis with left-to-right writing and show decrement of pen-tip pressure (p = 0.034); (iv) kinematic and pen-tip pressure profiles suggest that progressive micrographia in PD reflects poorly sustained net force; and (v) although progressive micrographia resembles the sequence effect of general bradykinesia, we did not find a significant correlation with overall motor disability, nor with the aggregate UPDRS-III bradykinesia scores for the dominant arm. |
| first_indexed | 2024-12-20T16:27:13Z |
| format | Article |
| id | doaj.art-0e38900429c44bdbb2ad8a7befaee61c |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-20T16:27:13Z |
| publishDate | 2019-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-0e38900429c44bdbb2ad8a7befaee61c2022-12-21T19:33:21ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-04-011010.3389/fneur.2019.00403445508A Kinematic Study of Progressive Micrographia in Parkinson's DiseasePoonam Zham0Sanjay Raghav1Sanjay Raghav2Peter Kempster3Peter Kempster4Sridhar Poosapadi Arjunan5Kit Wong6Kanae J. Nagao7Dinesh K. Kumar8School of Engineering, RMIT University, Melbourne, VIC, AustraliaSchool of Engineering, RMIT University, Melbourne, VIC, AustraliaDepartment of Neurosciences, Monash Medical Centre, Clayton, VIC, AustraliaDepartment of Neurosciences, Monash Medical Centre, Clayton, VIC, AustraliaDepartment of Medicine, Monash University, Clayton, VIC, AustraliaSchool of Engineering, RMIT University, Melbourne, VIC, AustraliaDepartment of Neurosciences, Monash Medical Centre, Clayton, VIC, AustraliaDepartment of Neurosciences, Monash Medical Centre, Clayton, VIC, AustraliaSchool of Engineering, RMIT University, Melbourne, VIC, AustraliaProgressive micrographia is decrement in character size during writing and is commonly associated with Parkinson's disease (PD). This study has investigated the kinematic features of progressive micrographia during a repetitive writing task. Twenty-four PD patients with duration since diagnosis of <10 years and 24 age-matched controls wrote the letter “e” repeatedly. PD patients were studied in defined off states, with scoring of motor function on the Unified Parkinson's Disease Rating Scale Part III. A digital tablet captured x-y coordinates and ink-pen pressure. Customized software recorded the data and offline analysis derived the kinematic features of pen-tip movement. The average size of the first and the last five letters were compared, with progressive micrographia defined as >10% decrement in letter stroke length. The relationships between dimensional and kinematic features for the control subjects and for PD patients with and without progressive micrographia were studied. Differences between the initial and last letter repetitions within each group were assessed by Wilcoxon signed-rank test, and the Kruskal-Wallis test was applied to compare the three groups. There are five main conclusions from our findings: (i) 66% of PD patients who participated in this study exhibited progressive micrographia; (ii) handwriting kinematic features for all PD patients was significantly lower than controls (p < 0.05); (iii) patients with progressive micrographia lose the normal augmentation of writing speed and acceleration in the x axis with left-to-right writing and show decrement of pen-tip pressure (p = 0.034); (iv) kinematic and pen-tip pressure profiles suggest that progressive micrographia in PD reflects poorly sustained net force; and (v) although progressive micrographia resembles the sequence effect of general bradykinesia, we did not find a significant correlation with overall motor disability, nor with the aggregate UPDRS-III bradykinesia scores for the dominant arm.https://www.frontiersin.org/article/10.3389/fneur.2019.00403/fullParkinson's diseasehandwritingkinematicprogressive micrographiabradykinesia |
| spellingShingle | Poonam Zham Sanjay Raghav Sanjay Raghav Peter Kempster Peter Kempster Sridhar Poosapadi Arjunan Kit Wong Kanae J. Nagao Dinesh K. Kumar A Kinematic Study of Progressive Micrographia in Parkinson's Disease Frontiers in Neurology Parkinson's disease handwriting kinematic progressive micrographia bradykinesia |
| title | A Kinematic Study of Progressive Micrographia in Parkinson's Disease |
| title_full | A Kinematic Study of Progressive Micrographia in Parkinson's Disease |
| title_fullStr | A Kinematic Study of Progressive Micrographia in Parkinson's Disease |
| title_full_unstemmed | A Kinematic Study of Progressive Micrographia in Parkinson's Disease |
| title_short | A Kinematic Study of Progressive Micrographia in Parkinson's Disease |
| title_sort | kinematic study of progressive micrographia in parkinson s disease |
| topic | Parkinson's disease handwriting kinematic progressive micrographia bradykinesia |
| url | https://www.frontiersin.org/article/10.3389/fneur.2019.00403/full |
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