Digitized spiral drawing: A possible biomarker for early Parkinson's disease

Marta San Luciano, Cuiling Wang, Roberto A. Ortega, Qiping Yu, Sarah Boschung, Jeannie Soto-Valencia, Susan B. Bressman, Richard B. Lipton, Seth Pullman, Rachel Saunders-Pullman

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Introduction: Pre-clinical markers of Parkinson's Disease (PD) are needed, and to be relevant in pre-clinical disease, they should be quantifiably abnormal in early disease as well. Handwriting is impaired early in PD and can be evaluated using computerized analysis of drawn spirals, capturing kinematic, dynamic, and spatial abnormalities and calculating indices that quantify motor performance and disability. Digitized spiral drawing correlates with motor scores and may be more sensitive in detecting early changes than subjective ratings. However, whether changes in spiral drawing are abnormal compared with controls and whether changes are detected in early PD are unknown. Methods: 138 PD subjects (50 with early PD) and 150 controls drew spirals on a digitizing tablet, generating x, y, z (pressure) data-coordinates and time. Derived indices corresponded to overall spiral execution (severity), shape and kinematic irregularity (second order smoothness, first order zero-crossing), tightness, mean speed and variability of spiral width. Linear mixed effect adjusted models comparing these indices and cross-validation were performed. Receiver operating characteristic analysis was applied to examine discriminative validity of combined indices. Results: All indices were significantly different between PD cases and controls, except for zero-crossing. A model using all indices had high discriminative validity (sensitivity = 0.86, specificity = 0.81). Discriminative validity was maintained in patients with early PD. Conclusion: Spiral analysis accurately discriminates subjects with PD and early PD from controls supporting a role as a promising quantitative biomarker. Further assessment is needed to determine whether spiral changes are PD specific compared with other disorders and if present in pre-clinical PD.

Original languageEnglish (US)
Article numbere0162799
JournalPLoS One
Volume11
Issue number10
DOIs
StatePublished - Oct 1 2016

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Parkinson disease
Biomarkers
Parkinson Disease
biomarkers
kinematics
Biomechanical Phenomena
Kinematics
Handwriting
ROC Curve
Tablets
Pressure
Sensitivity and Specificity

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

San Luciano, M., Wang, C., Ortega, R. A., Yu, Q., Boschung, S., Soto-Valencia, J., ... Saunders-Pullman, R. (2016). Digitized spiral drawing: A possible biomarker for early Parkinson's disease. PLoS One, 11(10), [e0162799]. https://doi.org/10.1371/journal.pone.0162799

Digitized spiral drawing : A possible biomarker for early Parkinson's disease. / San Luciano, Marta; Wang, Cuiling; Ortega, Roberto A.; Yu, Qiping; Boschung, Sarah; Soto-Valencia, Jeannie; Bressman, Susan B.; Lipton, Richard B.; Pullman, Seth; Saunders-Pullman, Rachel.

In: PLoS One, Vol. 11, No. 10, e0162799, 01.10.2016.

Research output: Contribution to journalArticle

San Luciano, M, Wang, C, Ortega, RA, Yu, Q, Boschung, S, Soto-Valencia, J, Bressman, SB, Lipton, RB, Pullman, S & Saunders-Pullman, R 2016, 'Digitized spiral drawing: A possible biomarker for early Parkinson's disease', PLoS One, vol. 11, no. 10, e0162799. https://doi.org/10.1371/journal.pone.0162799
San Luciano M, Wang C, Ortega RA, Yu Q, Boschung S, Soto-Valencia J et al. Digitized spiral drawing: A possible biomarker for early Parkinson's disease. PLoS One. 2016 Oct 1;11(10). e0162799. https://doi.org/10.1371/journal.pone.0162799
San Luciano, Marta ; Wang, Cuiling ; Ortega, Roberto A. ; Yu, Qiping ; Boschung, Sarah ; Soto-Valencia, Jeannie ; Bressman, Susan B. ; Lipton, Richard B. ; Pullman, Seth ; Saunders-Pullman, Rachel. / Digitized spiral drawing : A possible biomarker for early Parkinson's disease. In: PLoS One. 2016 ; Vol. 11, No. 10.
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