Objective: Computerized assessment of dysgraphia to evaluate dopaminergic medication effects on the handwriting of newly diagnosed PD patients.

Background: Dysgraphia is a common motor symptom in PD that can be difficult to assess. Currently, motor assessment scales are used in clinical evaluations of dysgraphia. However, analyzing size and duration parameters can differentiate PD from controls. Additionally, the use of measures of writing speed and fluency allows one to distinguish between patients and controls as well as between those taking medication and those who do not.

Method: A total of 38 patients with newly diagnosed PD met the UK Brain Bank criteria before and one and a half months after dopaminergic treatment. Epidemiological data, H&Y, and UPDRS scales were used. Patients typed a standardized phrase on a Wacom tablet to obtain kinematic data. Analyses included mean velocity and mean acceleration (in G) on basal and following medication.

Results: We included 38 patients with PD who had not yet received dopaminergic medication (16 females and 22 males, mean age: 66.6 ± 9.07 years), 36 of these patients were on rasagiline, and 2 with levodopa. 12 age-matched controls were also included (64.0 ± 10.8 years).

Patients and controls showed significant kinematic differences. Patients had a slower mean speed compared to the controls (27 ± 12 vs 48 ± 18, p < 0.0001, t-test), as well as a slower mean acceleration (7.2 ± 3.9 vs 15.01 ± 7, t-test, p < 0.0001).

We found a correlation between the UPDRS III scores and both mean speed (r = -0.52, p < 0.0007, Spearman) and mean acceleration (r =0.60, p < 0.0001, Spearman), indicating that these kinematic parameters may be useful in evaluating the motor symptoms of PD. However, the difference in mean speed between the PD group without medication (27 ± 12) and the post-treatment group (29.6 ± 12) did not reach statistical significance, with a p-value of 0.056.

Likewise, there was no significant difference in mean acceleration between the PD group without medication (7.2 ± 3.9) and the post-treatment group (7.8 ± 3), with a p-value of 0.2.

Conclusion: The results of this study suggest that kinematic measures such as mean speed and mean acceleration may be useful in evaluating the motor symptoms of PD. Additionally, treatment with rasagiline and levodopa may lead to improvements in these kinematic measures, although further research is needed to confirm these findings.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/computerized-assessment-of-handwriting-in-parkinsons-disease-before-and-after-dopaminergic-medication/