Quantitative measurements of alternating finger tapping in Parkinson's disease correlate with UPDRS motor disability and reveal the improvement in fine motor control from medication and deep brain stimulation.
The Unified Parkinson's Disease Rating Scale (UPDRS) is the primary outcome measure in most clinical trials of Parkinson's disease (PD) therapeutics. Each subscore of the motor section (UPDRS III) compresses a wide range of motor performance into a coarse-grained scale from 0 to 4; the assessment of performance can also be subjective. Quantitative digitography (QDG) is an objective, quantitative assessment of digital motor control using a computer-interfaced musical keyboard. In this study, we show that the kinematics of a repetitive alternating finger-tapping (RAFT) task using QDG correlate with the UPDRS motor score, particularly with the bradykinesia subscore, in 33 patients with PD. We show that dopaminergic medication and an average of 9.5 months of bilateral subthalamic nucleus deep brain stimulation (B-STN DBS) significantly improve UPDRS and QDG scores but may have different effects on certain kinematic parameters. This study substantiates the use of QDG to measure motor outcome in trials of PD therapeutics and shows that medication and B-STN DBS both improve fine motor control.
Taylor Tavares
Ana Lisa
AL
Department of Neurology and Neurological Sciences, Stanford University, Stanford, California 94305-5327, USA.
Jefferis
Gregory S X E
GS
Koop
Mandy
M
Hill
Bruce C
BC
Hastie
Trevor
T
Heit
Gary
G
Bronte-Stewart
Helen M
HM
D001696:Biomechanical Phenomena; D001921:Brain / Q000503:physiopathology / Q000601:surgery; D046690:Deep Brain Stimulation / Q000379:methods*; D004185:Disability Evaluation; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004567:Electrodes, Implanted; D004576:Electromyography / Q000295:instrumentation; D005385:Fingers / Q000503:physiopathology*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D010507:Periodicity; D011182:Postoperative Care; D011300:Preoperative Care; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014584:User-Computer Interface
D018491:Dopamine Agonists; D007980:Levodopa