Objective: Computerized assessment of dysgraphia in PD de novo patients and correlation with UPDRS III.

Background: Dysgraphia is a well-known motor symptom of PD, but its assessment is often difficult. Currently, the clinical assessment of dysgraphia is based on motor assessment scales.
During the last decade, computational methods have been introduced that can be used to analyze various writing parameters and evaluate dysgraphia objectively. Four parameters have been established: size, duration, speed, and fluency. Patients with PD can be distinguished from controls using the first two variables. Comparatively, the kinematic variables, speed, and fluency of writing allow differentiation between patients and controls and on- and off-medication treatment situations.

Method: Our study evaluated 34 patients recently diagnosed with PD consistent with the UK Brain Bank Criteria without dopaminergic treatment. A standard phrase was typed into a Wacom tablet and kinematic data (including mean velocity and mean acceleration (in G) was obtained from the patients. Age-matched control subjects without neurological disorders were compared to these data. Controls were assessed identically to patients. We evaluated the patients using standard clinical practice, epidemiological data, Hoehn & Yahr, and UPDRS scales.

Results: We included 34 patients with PD without dopaminergic medication (16 females, 18 males; mean age: 66,5 ±9,2 years) and 12 age-matched controls: 64,0±10,8 years.
UPDRS III score in patients with PD: 16,18 ± 5,6.
There were significant kinematic differences including slower mean speed in patients compared to controls (27,9 ±13 vs 48.2±18 p<0.0005 t-test) and slower mean writing acceleration (7.1± 4,0 vs 15.01±7,7 t-test) P< 0.001.
UPDRS III was correlated with mean speed (r:-0.54; p<0.0008 Spearman) and with mean acceleration (r:-0.59; p<0.0002, Spearman)

Conclusion: Dysgraphia is an easily identifiable abnormality in patients with PD, even in de novo patients, and probably one of the initial symptoms.
Dysgraphia correlates with clinical scales and can be useful for assessing parkinsonian patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/computerized-assessment-of-handwriting-in-parkinsons-disease-and-its-relation-to-motor-symptoms/