Objective: To examine the effects of adding a secondary cognitive task to performing motor tasks on a touchscreen in Parkinson’s disease (PD) and healthy controls (HC).

Background: Previous work showed that touchscreen skills in single task (ST), as well as dual task (DT) walking is hampered in PD. Particularly, during daily life, the use of smartphones and tablets requires motor-cognitive dual task integration, but the impact of combining these demands is still unclear in PD.

Method: Thirteen PD patients (H&Y II-III, age 66±7) and 12 HC (age 69±7) with similar MoCA scores (p>0.12) performed touchscreen movements on a tablet in ST and DT condition when ON medication. Tests included tapping between two dots and sliding a dot towards a predefined goal in single or multiple directions. The secondary cognitive task consisted of counting either high- or low-pitched tones. Outcomes were timing and accuracy on the tablet outcomes, as well as tone counting scores. DT-costs were defined as ((DT-ST)/ST)*100 for both motor (DTm) and cognitive tasks (DTc). Comparisons were made between groups, and between motor and cognitive components.

Results: As DTm and DTc did not differ between groups, data were pooled for further analyses. Tapping was slower in DT compared to ST (p=0.034), while tone counting was comparable (p=0.739). In contrast, the Single and Multi Sliding tasks were performed faster in DT compared to ST (p<0.050). However, the secondary task deteriorated in DT versus ST (p<0.010), suggesting a different impact on the three tasks. Direct comparison of DTm and DTc across tasks confirmed a negative effect on the motor component of DT tapping (p=0.001) and on the cognitive component of DT sliding (p=0.002). When comparing DTm and DTc directly for each task separately, DT had a greater impact on the cognitive than the motor component in both sliding tasks (p<0.010).

Conclusion: PD patients ON medication and HC with comparable age and cognitive capacity revealed a similar impact of adding a secondary task to touchscreen manipulations. Differences were mainly related to task, i.e. low (tapping) and high (sliding) task load, pointing to the fact that sliding requires more attention and leaves little capacity for dealing with cognitive load. These results suggest that E-Health apps better refrain from sliding movements and that rehabilitation should focus on improving these skills in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/motor-cognitive-interference-during-touchscreen-manipulations-in-parkinsons-disease/