Graphical Tasks to Measure Upper Limb Function in Patients With Parkinson's Disease: Validity and Response to Dopaminergic Medication

IEEE J Biomed Health Inform. 2017 Jan;21(1):283-289. doi: 10.1109/JBHI.2015.2503802. Epub 2015 Nov 25.

Abstract

The most widely used method to assess motor functioning in Parkinson's disease (PD) patients is the unified Parkinson's disease rating scale-III (UPDRS-III). The UPDRS-III has limited ability to detect subtle changes in motor symptoms. Alternatively, graphical tasks can be used to provide objective measures of upper limb motor dysfunction. This study investigated the validity of such graphical tasks to assess upper limb function in PD patients and their ability to detect subtle changes in performance. Fourteen PD patients performed graphical tasks before and after taking dopaminergic medication. Graphical tasks included figure tracing, writing, and a modified Fitts' task. The Purdue pegboard test was performed to validate these graphical tasks. Movement time (MT), writing size, and the presence of tremor were assessed. MT on the graphical tasks correlated significantly with performance on the Purdue pegboard test (Spearman's ρ > 0.65; p < 0.05). MT decreased significantly after the intake of dopaminergic medication. Tremor power decreased after taking dopaminergic medication in most PD patients who suffered from tremor. Writing size did not correlate with performance on the Purdue pegboard test, nor did it change after taking medication. Our set of graphical tasks is valid to assess upper limb function in PD patients. MT proved to be the most useful measure for this purpose. The response on dopaminergic medication was optimally reflected by an improved MT on the graphical tasks in combination with a decreased tremor power, whereas writing size did not respond to dopaminergic treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dopamine Agents / pharmacology*
  • Dopamine Agents / therapeutic use
  • Female
  • Handwriting
  • Humans
  • Hypokinesia / physiopathology
  • Image Processing, Computer-Assisted / methods*
  • Male
  • Middle Aged
  • Motor Skills / drug effects*
  • Parkinson Disease / classification
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / drug therapy
  • Parkinson Disease / physiopathology*
  • Reproducibility of Results
  • Task Performance and Analysis
  • Upper Extremity / physiopathology*

Substances

  • Dopamine Agents