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

Nackaerts, Evelien; Vervoort, Griet; Heremans, Elke; Smits-Engelsman, B.C.M.; Swinnen, Stephan P.; Nieuwboer, Alice

doi:10.1016/j.neubiorev.2013.01.015

Cited by 34 publications

(23 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although writing can be considered a visually controlled motor task, it also consists highly automatically performed features, including writing size (Gross, 1975; Longstaff and Heath, 1997; Nackaerts et al, 2013). Some findings support the assumption that impaired automaticity is a reason underlying micrographia.…”

Section: Micrographiamentioning

confidence: 99%

Motor automaticity in Parkinson's disease

Hallett

Chan

2015

Neurobiology of Disease

285

255

View full text Add to dashboard Cite

Bradykinesia is the most important feature contributing to motor difficulties in Parkinson’s disease (PD). However, the pathophysiology underlying bradykinesia is not fully understood. One important aspect is that PD patients have difficulty in performing learned motor skills automatically, but this problem has been generally overlooked. Here we review motor automaticity associated motor deficits in PD, such as reduced arm swing, decreased stride length, freezing of gait, micrographia and reduced facial expression. Recent neuroimaging studies have revealed some neural mechanisms underlying impaired motor automaticity in PD, including less efficient neural coding of movement, failure to shift automated motor skills to the sensorimotor striatum, instability of the automatic mode within the striatum, and use of attentional control and/or compensatory efforts to execute movements usually performed automatically in healthy people. PD patients lose previously acquired automatic skills due to their impaired sensorimotor striatum, and have difficulty in acquiring new automatic skills or restoring lost motor skills. More investigations on the pathophysiology of motor automaticity, the effect of L-dopa or surgical treatments on automaticity, and the potential role of using measures of automaticity in early diagnosis of PD would be valuable.

show abstract

Section: Micrographiamentioning

confidence: 99%

Motor automaticity in Parkinson's disease

Hallett

Chan

2015

Neurobiology of Disease

285

255

View full text Add to dashboard Cite

show abstract

“…It has been well documented that handwriting is affected in Parkinsons disease [12], [13], and some preliminary data suggest that handwriting might serve as a diagnostic marker for PD [14], [15]. Today there are wide range of high precision tablets and touch screen devices that make the acquisition and evaluation of handwriting signals very feasible.…”

Section: Introductionmentioning

confidence: 99%

Decision Support Framework for Parkinson’s Disease Based on Novel Handwriting Markers

Drotár

Mekyska

Rektorová

et al. 2015

IEEE Trans. Neural Syst. Rehabil. Eng.

147

View full text Add to dashboard Cite

Parkinson's disease (PD) is a neurodegenerative disorder which impairs motor skills, speech, and other functions such as behavior, mood, and cognitive processes. One of the most typical clinical hallmarks of PD is handwriting deterioration, usually the first manifestation of PD. The aim of this study is twofold: (a) to find a subset of handwriting features suitable for identifying subjects with PD and (b) to build a predictive model to efficiently diagnose PD. We collected handwriting samples from 37 medicated PD patients and 38 age- and sex-matched controls. The handwriting samples were collected during seven tasks such as writing a syllable, word, or sentence. Every sample was used to extract the handwriting measures. In addition to conventional kinematic and spatio-temporal handwriting measures, we also computed novel handwriting measures based on entropy, signal energy, and empirical mode decomposition of the handwriting signals. The selected features were fed to the support vector machine classifier with radial Gaussian kernel for automated diagnosis. The accuracy of the classification of PD was as high as 88.13%, with the highest values of sensitivity and specificity equal to 89.47% and 91.89%, respectively. Handwriting may be a valuable marker as a diagnostic and screening tool.

show abstract

“…Writing a sentence requires the dynamic is affected in Parkinson's disease (PD) and micrographia occurs in about 63% of PD patients as an early motor feature [2]. It is characterized by decreased letter size and by changes in kinematic aspects of movements [3,4].…”

Section: Introductionmentioning

confidence: 99%