title: Tests of manual dexterity and speed in Parkinson's disease: Not all measure the same.
abstract: Timed performance tests were introduced to overcome the disadvantages of subjective evaluation of bradykinesia in Parkinson's disease (PD). We aimed to verify their discriminative properties and compare them with the motion capture analysis of finger tapping.
  
  
  
  We included 22 PD patients (10 M, 12 F), mean age 64 (range 48-82) yrs, Hoehn & Yahr stage 2 (1-2.5) and 22 (10 M, 12 F) normal controls, mean age 66 (41-82) yrs. The key tapping subtest of the Halstead-Reitan battery, the Purdue Pegboard test, and the Bradykinesia-Akinesia Incoordination (BRAIN) test were performed according to the test manuals. The finger tapping subtest of the UPDRS-III, item 23 was recorded using a contactless 3D motion capture system Optitrack-V120. Average frequency (AvgFrq), maximum opening velocity (MaxOpV) and amplitude decrement (AmpDec) were computed and simultaneous video recordings of finger tapping were rated by two experts.
  
  
  
  The AmpDec and MaxOpV motion capture measures best differentiated between PD patients and controls (AUC = 0.87 and 0.81). Of the instrumental tests, only the Purdue Pegboard attained significance in differentiating PD patients from controls (AUC = 0.80). In PD patients, MaxOpV correlated with the finger tapping ratings and BRAIN test, and AvgFrq correlated with the BRAIN and Halstead-Reitan test scores. Moreover, correlations were found between the Purdue Pegboard and finger tapping ratings.
  
  
  
  Contactless 3D motion capture of finger tapping allowed an independent analysis of individual components of bradykinesia, demonstrating the amplitude decrement and maximum opening velocity as the most powerful discriminators between PD patients and controls.
authors.affiliation: Dept. of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Kateřinská 30, CZ-120 00, Prague, Czech Republic. Electronic address: eruzi@lf1.cuni.cz.
authors.forename: Evžen
authors.initials: E
authors.lastname: Růžička
authors.affiliation: Dept. of Biomedical Informatics, Czech Technical University in Prague, Faculty of Biomedical Engineering, Sítná sq. 3105, CZ-272 01, Kladno, Czech Republic. Electronic address: radim.krupicka@gmail.com.
authors.forename: Radim
authors.initials: R
authors.lastname: Krupička
authors.affiliation: Dept. of Neurology, Charles University in Prague, 2nd Faculty of Medicine and Motol University Hospital, V Úvalu 84, CZ-150 06, Prague, Czech Republic. Electronic address: katzar@centrum.cz.
authors.forename: Kateřina
authors.initials: K
authors.lastname: Zárubová
authors.affiliation: Dept. of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Kateřinská 30, CZ-120 00, Prague, Czech Republic. Electronic address: rusz.mz@gmail.com.
authors.forename: Jan
authors.initials: J
authors.lastname: Rusz
authors.affiliation: Dept. of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Kateřinská 30, CZ-120 00, Prague, Czech Republic. Electronic address: jech@cesnet.cz.
authors.forename: Robert
authors.initials: R
authors.lastname: Jech
authors.affiliation: Dept. of Biomedical Informatics, Czech Technical University in Prague, Faculty of Biomedical Engineering, Sítná sq. 3105, CZ-272 01, Kladno, Czech Republic. Electronic address: szabozol@fbmi.cvut.cz.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szabó
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005385:Fingers; D006801:Humans; D018476:Hypokinesia / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology*; D011597:Psychomotor Performance / Q000502:physiology*
keywords: 3D motion capture; BRAIN test; Bradykinesia; Finger tapping test; Parkinson’s disease; Purdue pegboard test