Adaptation of handwriting size under distorted visual feedback in patients with Parkinson's disease and elderly and young controls

Teulings, Hans-Leo; Contreras-Vidal, José L.; Stelmach, George E.; Adler, Charles H.

doi:10.1136/jnnp.72.3.315

Cited by 97 publications

(72 citation statements)

References 31 publications

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“…In a later study by (2002) showed that PD patients are capable of visuo-motor adaptation. The conflicting outcomes may be explained by the fact that participants were able to see their own hand movements in the study of Teulings et al (2002). The results of Contreras-Vidal et al (2002) are in line with a recent study using an adaptation task in PD (Leow et al, 2012).…”

Section: Relearning Of Writing Skills In Parkinson's Diseasesupporting

confidence: 85%

Relearning of writing skills in Parkinson's disease: A literature review on influential factors and optimal strategies

Nackaerts

Vervoort

Heremans

et al. 2013

Neuroscience & Biobehavioral Reviews

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Patients with Parkinson"s disease (PD) suffer from severe motor symptoms which can only be partly alleviated by means of dopaminergic medication. Motor rehabilitation, i.e. relearning of a known motor skill through intensive practice, can be an effective and lasting therapeutic supplement in chronic neurodegenerative diseases. Recent studies on motor learning in PD provide insights for the development of optimal motor rehabilitation strategies, with a particular focus on achieving consolidated learning and retention. In this review, findings from the last couple of years are discussed with specific interest in the potential benefits from cueing and feedback strategies as means to achieve lasting changes. In addition, current neuroscientific insights on the impact of dopamine and cognitive functioning on learning are summarized. Finally, the knowledge on these topics is combined to propose an optimal strategy for relearning of writing skills in PD, a frequently reported motor deficit also known as micrographia.

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Section: Relearning Of Writing Skills In Parkinson's Diseasesupporting

confidence: 85%

Relearning of writing skills in Parkinson's disease: A literature review on influential factors and optimal strategies

Nackaerts

Vervoort

Heremans

et al. 2013

Neuroscience & Biobehavioral Reviews

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“…In the Teulings et al (2002) experiment, the gain between the amplitude of movements of a hand-held pen and the real-time visual feedback of the vertical pen movement displayed in a displaydigitizer was either less (70%) or greater (140%) than normal (i.e., 1.0) in some trials (a display gain paradigm). Thus, subjects had to write larger-than-normal to compensate for the reduced display gain, or smaller-than-normal to compensate for the enlarged display gain.…”

Section: Comparison To Previous Studies Of Visuomotor Adaptationmentioning

confidence: 99%

“…In the study by Canavan and colleagues, subjects performed verbal and spatial IQ tests (but scores were not reported), whereas in the Fernandez-Ruiz et al study, subjects were screened for psychological disorders (but the specific test and scores were not reported either). Furthermore, in Teulings et al (2002) and Roller et al (2002), no neuropsychological testing was utilized in screening the elderly population. Finally, the content and level of detail in the task instructions varied widely across the studies; thus, the cognitive demands of the tasks may have varied as well.…”

Section: Visuomotor Adaptation In Normal Agingmentioning

confidence: 99%

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Visuomotor Adaptation in Normal Aging

Buch¹,

Young²,

2003

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Visuomotor adaptation to a gradual or sudden screen cursor rotation was investigated in healthy young and elderly subjects. Both age groups were equally divided into two subgroups; one subgroup was exposed to 11.25° step increments of visual feedback rotation, every 45 trials (up to a total of 90°), whereas a second subgroup was subjected to 90° rotation from the onset of exposure. Participants performed discrete, horizontal hand movements to virtual targets in four randomized directions. Targets appeared on a computer screen in front of them, and a board prevented vision of the hand at all times. Differential effects of aging on visuomotor adaptation were found, depending on the time course of the visual distortion. In both age groups, early exposure to the sudden visual feedback distortion resulted in typical spiral-like trajectories, which became straighter by late exposure. However, the final adaptation level was reduced in the aged group, although the aftereffects were similar. When subjects were exposed to the gradual distortion, no statistically significant differences in measures of adaptation with advancing age were found. In this case, both age groups appeared to adapt equally. However, after removal of the distortion, elderly subjects showed reduced aftereffects as compared with the young group. These findings suggest differential effects of aging on adaptation to gradual versus sudden visual feedback distortions, and may help to explain the conflicting results obtained in previous visuomotor adaptation studies

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“…[7][8][9][10][11][12] If the digitizing tablet is pressure-sensitive, it will be possible to measure the axial pressure exerted by the tip of the pencil during writing. 13,14 Though kinematic analysis of handwriting is easy to perform and can provide detailed insights into motor performance during handwriting, it is still unclear which kinematic measure is most frequently abnormal in patients with writer's cramp. In addition, it is unknown whether and how the kinematic measures of handwriting are correlated with clinical scales and reflect the severity of hand dystonia.…”

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confidence: 99%

How to assess motor impairment in writer's cramp

Zeuner¹,

Peller²,

Knutzen³

et al. 2007

Movement Disorders

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Writer's cramp is a task-specific hand dystonia affecting handwriting. Clinical scores such as the Arm Dystonia Disability Scale (ADDS) or Writer's Cramp Rating Scale (WCRS) as well as kinematic analysis of handwriting movements have been used to assess functional impairment in affected patients. In 21 patients with writer's cramp and healthy controls, we analyzed the kinematics of writing and cyclic drawing movements. We rated the severity of dystonia using the ADDS and WCRS and correlated the clinical scores with movement kinematics. Mean stroke frequency was significantly reduced in dystonic patients. Drawing movements showed more frequently a decrease in stroke frequency than handwriting movements. During circle drawing, mean vertical peak velocity was more variable in patients relative to controls, indicating an impaired ability to reproduce the same kinematic pattern over time. An increase in vertical writing pressure was only observed during handwriting but not during circle drawing and may reflect a compensatory effort to stabilize the pencil. Kinematic measures and individual ADDS and WCRS scores did not correlate with each other. The lack of correlation is not surprising as ADDS, WCRS, and kinematic analysis probe different aspects of motor impairment. The ADDS characterizes how dystonia affects a set of fine manual tasks, whereas the WCRS scores the manifestation of dystonia during handwriting. Therefore, the clinical scores and kinematic analysis of handwriting provide complementary insights into motor impairment. Future studies need to address which combination of clinical scores and kinematic measures are most appropriate to quantify impairment in writer's cramp.

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Adaptation of handwriting size under distorted visual feedback in patients with Parkinson's disease and elderly and young controls

Cited by 97 publications

References 31 publications

Relearning of writing skills in Parkinson's disease: A literature review on influential factors and optimal strategies

Relearning of writing skills in Parkinson's disease: A literature review on influential factors and optimal strategies

Visuomotor Adaptation in Normal Aging

How to assess motor impairment in writer's cramp

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