Neurology Department. Jiménez Díaz Foundation University Hospital, Spain; Neurology Department. University Hospital San Roque. Fernando Pessoa University, Spain.
Neurology Department. Mataró Hospital, Spain.
Parkinsonism Relat Disord. 2024 Sep;126:107072. doi: 10.1016/j.parkreldis.2024.107072. Epub 2024 Jul 25.
Dysgraphia, a recognized PD motor symptom, lacks effective clinical assessment. Current evaluation relies on motor assessment scales. Computational methods introduced over the past decade offer an objective dysgraphia assessment, considering size, duration, speed, and handwriting fluency. Objective evaluation of dysgraphia may be of help for early diagnosis of PD.
Computerized assessment of dysgraphia in de novo PD patients and its correlation with clinical scales.
We evaluated 38 recently diagnosed, premedication PD patients and age-matched controls without neurological disorders. Participants wrote "La casa de Pamplona es bonita" three times on paper and once on a Wacom tablet under the paper, totaling four phrases. Writing segments of 5-10 s were analyzed. The Wacom tablet captured kinematic data, including mean velocity, mean acceleration, and pen pressure. Data were saved in.svc format and analyzed using specialized software developed by Tecnocampus Mataró. Standard clinical practice data, Hoehn & Yahr staging, and UPDRS scales were used for evaluation.
Significant kinematic differences existed; patients had lower mean speed (27 ± 12 vs. 48 ± 18, p < 0.0001) and mean acceleration (7.2 ± 3.9 vs. 15.01 ± 7, p < 0.0001) than controls. Mean speed and mean acceleration correlated significantly with UPDRS III scores (speed: r = -0.52, p < 0.0007; acceleration: r = 0.60, p < 0.0001), indicating kinematic parameters' potential in PD evaluation.
Dysgraphia is identifiable in PD patients, even de novo, indicating an early symptom and correlates with clinical scales, offering potential for objective PD patient evaluation.
书写障碍是一种公认的帕金森病（PD）运动症状，但缺乏有效的临床评估方法。目前的评估依赖于运动评估量表。过去十年引入的计算方法提供了一种客观的书写障碍评估方法，考虑了书写的大小、持续时间、速度和流畅性。客观评估书写障碍可能有助于 PD 的早期诊断。
评估初发 PD 患者的书写障碍，并与临床量表相关联。
我们评估了 38 名新诊断、未经药物治疗的 PD 患者和年龄匹配的无神经障碍对照组。参与者在纸上写“La casa de Pamplona es bonita”三遍，一次在 Wacom 平板电脑上写在纸下，总共写四遍。分析 5-10 秒的书写片段。Wacom 平板电脑记录运动学数据，包括平均速度、平均加速度和笔压。数据以.svc 格式保存，并使用马塔罗 Tecnocampus 开发的专用软件进行分析。使用标准临床实践数据、Hoehn & Yahr 分期和 UPDRS 量表进行评估。
存在显著的运动学差异；与对照组相比，患者的平均速度（27±12 与 48±18，p<0.0001）和平均加速度（7.2±3.9 与 15.01±7，p<0.0001）较低。平均速度和平均加速度与 UPDRS III 评分显著相关（速度：r=-0.52，p<0.0007；加速度：r=0.60，p<0.0001），表明运动学参数在 PD 评估中的潜力。
即使是初发 PD 患者也能识别书写障碍，这表明它是一种早期症状，并与临床量表相关，为客观评估 PD 患者提供了潜力。
