Spatial features of angular drawing movements in Parkinson’s disease patients (original) (raw)
Related papers
International Journal of Rehabilitation Research, 2009
Variances of drawing arm movements between patients with Parkinson's disease and healthy controls were compared. The aim was to determine whether differences in joint synergies or individual joint rotations affect the endpoint (hand position) variance. Joint and endpoint coordinates were measured while participants performed drawing tasks. Variances of arm configurations and endpoints were computed and statistically analyzed for 12 patients and 12 controls. The variance of arm movements for patients (both for arm configuration and endpoint) was overall higher than that for the control group. Variation was smaller for drawing a circle versus a square and for drawing with the dominant versus the nondominant hand within both groups. The ratio of arm configuration variances between groups was similar to the ratio of endpoint variances. There were significant differences in the velocity, but not in the path lengths of movements comparing the two groups. Patients presented less movement stability while drawing different figures in different trials. Moreover, the similarity of the ratios suggests that the ill-coordinated hand movement was caused by the error in the movements of individual body parts rather than by the lack of intersegmental coordination. Thus, rehabilitation may focus on the improvement of the precision of individual joint rotations.
Journal of Neurology, Neurosurgery & Psychiatry, 2003
Objectives: To systematically investigate the ability of Parkinson's disease patients to discretely and dynamically scale the size of continuous movements and to assess the impact of movement size on outcome variability. Methods: Ten patients with Parkinson's disease (mean age 72 years) were compared with 12 healthy elderly controls (mean age 70 years). The subjects wrote with a stylus on a graphics tablet. In experiment 1 they drew circles, matching the size of five target circles ranging in magnitude from a radius of 0.5 cm up to 2.5 cm. In experiment 2 they drew spirals with a radius of at least 2 cm. In both experiments the drawings were initially performed as accurately as possible then as fast and accurately as possible.
2001
Research suggests that Parkinson's Disease (PD) patients have difficulty scaling the magnitude of their movements. Longstaff et al (2001) showed that patients could continuously scale a drawing movement (spiral) up to a diameter of 5cm like elderly controls, but their trajectories were more variable and there was a smaller distance between each revolution. The present study tests the ability of patients and controls to perform a continuous drawing task with discrete scaling. Subjects were 11 idiopathic PD patients (ages 55 to 81; 8 male, 3 female; Hoehn & Yahr stages 2 and 3; off medication) and 13 elderly controls (ages 62 to 81; 5 male, 6 female). Subjects drew circles on a digitizer matching the size of target circles of diameter 1, 1.5, 2, 3 and 5cm. Five revolutions of each were drawn in the conditions accurate and fast and accurate. Both groups drew circles a similar size, increasing with target size but undershooting the larger circles. Circle size did not change with co...
Movement Disorders, 2000
Patients with basal ganglia diseases may exhibit ideomotor apraxia. To define the nature of the impairment of the action production system, we studied a repetitive gesture of slicing bread by three-dimensional computergraphic analysis in eight nondemented patients with Parkinson's disease in the "on" state, five with progressive supranuclear palsy and four with multiple system atrophy. Two patients with Parkinson's disease and two with progressive supranuclear palsy showed ideomotor apraxia for transitive movements on standard testing. A Selspott II system was used for kinematic analysis of wrist trajectories and angular motions of the shoulder and elbow joints. Patients with Parkinson's disease, progressive supranuclear palsy, and even some with multiple system atrophy exhibited kinematic deficits in the spatial precision of move-ment and velocity-curvature relationships; in addition, they failed to maintain proper angle/angle relationships and to apportion their relative joint amplitudes normally. Spatial disruption of wrist trajectories was more severe in patients with ideomotor apraxia. We posit that the basal ganglia are part of the parallel parieto-frontal circuits devoted to sensorimotor integration for object-oriented behavior. The severity and characteristics of spatial abnormalities of a transitive movement would therefore depend on the location and distribution of the pathologic process within these circuits.
Inaccuracy and instability of sequential movements in Parkinson's disease
Experimental Brain Research, 1994
Animal studies suggest that the basal ganglia (BG) provide internal cues to trigger submovements in a movement sequence, with Parkinson's disease (PD) involving a deficiency in this cueing mechanism. However, it is not clear why defective internal cues can produce slow movements, or the extent to which slow movements are indeed the basic movement abnormality or are perhaps a compensatory mechanism for some other primary deficit. In this study we examined a number of the kinematic indices of matched fast movements between PD patients and age-matched controls, performed with and without reductions in visual cues for guidance, in order to delineate the relationship between the internal cue and the kinematic characteristics of these movements. Fourteen patients with PD, and their matched controls, used an electronic pen, which sampled pen-tip position at 200 Hz, and performed a sequence of drawing movements to nine targets upon a WACOM SD 420 graphics tablet. Subjects were trained to perform the movement sequence at a fast speed and were then required to perform the same movement at the same speed with reduced visual cues. Kinematic analysis indicated that, when visual cues were reduced, movements of PD patients became spatially and temporally unstable as they were progressively performed down the sequence. The instability was associated with an abnormal force profile, increase in peak movement velocity and target overshoot, which became additive as the submovements progressed. We suggest that defective cue production is the basic deficit in parkinsonian hypokinesia. The defective cue leads to problems synchronising preparatory activity, which then results in abnormalities in movement forces which are character-
Parkinsons disease and the control of size and speed in handwriting
Neuropsychologia, 1999
This experiment investigated whether Parkinson|s disease "PD# patients experience problems in producing stroke size\ stroke duration or both\ in a handwriting task[ Thirteen PD patients and 04 elderly controls wrote four patterns of varying complexity on a digitizer tablet[ The participants were instructed to execute the writing movements] at a normal size and speed^as fast as possiblet wo times larger than normal^and two times larger and as fast as possible[ PD patients had no di.culty increasing speed while maintaining size and had no di.culty increasing size while maintaining speed[ However\ they showed signi_cantly smaller size increases in the two times larger condition as compared to the elderly controls[ The conditions were also simulated by a neural network model of normal and PD movement control that produced a stroke pattern that approximated the experimental data[ For the instructions used\ the results suggest that when patients scale speed\ they have no di.culty controlling force amplitude\ but when they scale stroke size\ they have a problem controlling force amplitude[ Thus\ PD patients may have reduced capability to maintain a given force level for the stroke time periods tested with the instructions[ Þ 0888 Elsevier Science Ltd[ All rights reserved[ Keywords] Force amplitude^Neural networks^Basal ganglia^Motor control^Wrist movements^Finger movements Corresponding author[ Tel[] ¦0 591 854 3607^fax] ¦0 591 854 7097^e!mail] vangemmertÝasu[edu
Hypometria and bradykinesia during drawing movements in individuals with Parkinson’s disease
Experimental Brain Research, 2009
To address the hypothesis that Parkinson's disease (PD) patients have deWcits in controlling acceleration, a drawing task was used in which target size, frequency, and weight of pen were manipulated. In accordance with previous results, it was found that, relative to controls, PD patients produced movements at the required frequency, but moved signiWcantly slower, produced less acceleration, and drew smaller-than-required stroke sizes. This resulted in smaller-than-required movement amplitudes, suggesting that hypometria and bradykinesia in drawing and/or handwriting are related. Patients were found to perform similarly to controls when the target size was 1 cm. However, their performance became more dissimilar at greater stroke lengths. In addition to the aforementioned eVects it was found that movement amplitude error was less when the pen was 20 times heavier than the normal pen and that the increased load may dampen abnormal limb-stiVness characteristics induced by PD.
A Kinematic Study of Progressive Micrographia in Parkinson's Disease
Frontiers in Neurology
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.
Evaluation of Graphic Gesture in Parkinson’s Disease
DAAAM International Scientific Book 2010, 2010
The quantitative analysis of graphic gesture in subjects with Parkinson's Disease (PD) was carried out with an approach based on optoelectronic systems. Graphic motor deficits are in fact strongly representative and early detectors of PD. PD subjects were asked to hand draw a spiral while in on and off medication conditions, in order to highlight the effect of levodopa treatment on the graphic performance. Since cognitive decay and dementia often occur with the developing disease the cognitive capabilities were assessed in subjects with PD and subjects with PD and dementia (PDD) by administering the clock drawing test. Markers were put on the pen and sheet and the gesture was acquired with an optoelectronic system. This system was selected as it is suitable for 3D, quantitative and multifactor evaluation of the gesture. The results highlighted the validity of graphic tests in the assessment of both motor and cognitive deficits caused by PD and, moreover, uncovered the possibility to use a new quantitative, not invasive, 3D method for quantifying the kinematic aspects of the graphic gesture. Further research is focussing on the assessment of both graphic and postural aspects during writing and drawing.