Van Gemmert A W A, Adler C H, Stelmach G E
Motor Control Laboratory, Department of Kinesiology, Arizona State University, Tempe, AZ 85287-0404, USA.
J Neurol Neurosurg Psychiatry. 2003 Nov;74(11):1502-8. doi: 10.1136/jnnp.74.11.1502.
Previous research suggested that people with Parkinson's disease are able to increase handwriting stroke size up to 1.5 cm without an increase of stroke duration; whereas age matched individuals in normal health are able to modulate stroke size without changes in stroke duration for sizes up to 2 cm. This study was designed to test this finding by examining whether sizes larger than 1.5 cm show different relationships with stroke duration for patients with Parkinson's disease as compared with age matched controls.
The study included 13 subjects with Parkinson's disease and 13 age matched controls. Participants were required to write a cursive "llllllll" pattern, or a cursive "lililili" pattern without the dots, at a comfortable speed and also as fast as possible, in five different sizes (1.0, 1.5, 2.0, 3.0, and 5.0 cm). The participants wrote with a ballpoint pen on a digitiser tablet. The target pattern was displayed at its required size on a screen, but disappeared as soon as the pen touched the surface of the digitiser tablet. Online visual monitoring of the hand was prevented by a cover over the digitiser. After each trial, the recorded movement of the tip of the pen was displayed with two lines to indicate whether the size requirement had been met. The writing conditions were presented in random order and consisted of 12 trials for each participant.
The results demonstrated that stroke size and duration produced by the participants with Parkinson's disease were independently modulated up to 1.5 cm; sizes over 1.5 cm resulted in progressive undershooting by patients with Parkinson's disease (PD). It was also shown that these participants modulated acceleration measures inefficiently as compared with controls.
The findings suggest that individuals with Parkinson's disease writing at speed produce inadequate stroke sizes when these should equal or exceed 1.5 cm.
先前的研究表明，帕金森病患者能够在不增加笔画时长的情况下，将手写笔画大小增加至1.5厘米；而年龄匹配的健康个体能够在不改变笔画时长的情况下，将笔画大小调节至2厘米。本研究旨在通过检查与年龄匹配的对照组相比，大于1.5厘米的笔画大小对于帕金森病患者而言，是否与笔画时长呈现不同的关系，来验证这一发现。
该研究纳入了13名帕金森病患者和13名年龄匹配的对照组。参与者被要求以舒适的速度以及尽可能快的速度，用圆珠笔在数位板上书写连笔的“llllllll”图案，或不带点的连笔“lililili”图案，共有五种不同大小（1.0、1.5、2.0、3.0和5.0厘米）。目标图案以所需大小显示在屏幕上，但一旦笔接触数位板表面就会消失。通过数位板上的盖子防止对手部进行在线视觉监测。每次试验后，用笔尖记录的运动显示为两条线，以表明是否满足大小要求。书写条件以随机顺序呈现，每位参与者进行12次试验。
结果表明，帕金森病患者产生的笔画大小和时长在1.5厘米以内是独立调节的；超过1.5厘米的大小会导致帕金森病患者逐渐书写不足。还表明，与对照组相比，这些参与者调节加速度测量的效率较低。
研究结果表明，帕金森病患者在快速书写时，如果笔画大小应等于或超过1.5厘米，会产生不足的笔画大小。
