Objective: The study assessed the ability of a handheld device intended to measure and analyze features of neuromuscular processes to diagnose Parkinson’s disease correctly, compared to current best practices (DaTSCAN). The overall objective is to assess the ability of the device to detect presence of disease (sensitivity) and absence of disease (specificity).

Background: An easily performed and objective test of fine motor skills would be valuable in the diagnosis of Parkinson’s disease (PD). In this study we present an innovative diagnostic pen with multiple movement sensors that patients use to complete writing and drawing tasks. A set of automatic methods allows extraction of features to quantify motor symptoms with high accuracy. 

Method: Data was recorded with a handheld device intended to measure and analyze features of neuromuscular processes, indicated for use by physicians as a diagnostic marker in Parkinson’s disease in conjunction with other clinicopathological factors. The test was administered by healthcare professionals in neurology point of care settings and compared with DaTSCAN and MDS-UPDRS scores. The analysis took place with proprietary algorithms.

Results: The classification accuracy was 80% (sensitivity 92% and specificity 74%) in 132 undiagnosed attendees with movement disorder symptoms at a movement disorders clinic, for which there was diagnostic uncertainty and DaTSCAN assessment was required for confirmation. Seventy attendees were subsequently diagnosed with idiopathic PD.
Previous validation on 92 patients with an established diagnosis resulted in classification accuracies (PD vs other tremor syndromes) of 82.0 % for essential tremor; 69.8 % for functional tremor and 72.2% for enhanced physiological tremor. The improved performance in the current study is notable, given the much more challenging clinical scenario.

Conclusion: An early and accurate diagnosis is crucial to give patients access to the range of treatments and therapies available. Early intervention can improve quality of life. The device that was validated may help specialists to decrease uncertainty of differential diagnosis, potentially avoiding the need for DaTSCAN, saving time and money. In triage, timely access for optimum treatment may be prioritized over unnecessary referrals of the worried-well.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-novel-easily-performed-objective-test-of-fine-motor-skill-in-handwriting-and-drawing-to-support-diagnosing-parkinsons-disease/