Validity of spiral analysis in early Parkinson's disease

Abstract

Spiral analysis is an objective, easy to administer noninvasive test that has been proposed to measure motor dysfunction in Parkinson disease (PD). We compared overall Unified Parkinson Disease Rating Scale Part III scores to selected indices derived from spiral analysis in seventy-four patients with early PD (mean duration of disease 2.4 +/- 1.7 years, mean age 61.5 +/- 9.7 years). Of the spiral indices, degree of severity, first order zero crossing, second order smoothness, and mean speed were best correlated with total motor Unified Parkinson's Disease Rating Scale (UPDRS) score (all P < 0.01), and these indices showed a gradient across worsening tertiles of UPDRS (P < 0.05). Spiral indices also correlated with UPDRS ratings for the worst side and worst arm scores as well. The domains of bradykinesia, rigidity, and action tremor were correlated with first order crossing, second order smoothness, and mean speed, where as rest tremor was most highly correlated with degree of severity. This suggests that the spiral analysis may supplement motor assessment in PD, although further analysis of spiral metrics, a larger sample and longitudinal data should be evaluated.

Variant ataxia-telangiectasia presenting as primary-appearing dystonia in Canadian Mennonites

“…Brain pathology reports were available for one subject (family A) and 2 previously deceased family members (from family C). C:301 had extensive testing after the diagnosis of A-T, including neuro-ophthalmologic examination and quantitative motor physiology testing (tremor analysis 18 and spiral analysis 19 ). No individuals harbored either a DYT1 or DYT6 mutation.…”

Evaluation of Graphic Gesture in Parkinson’s Disease

“…These studies demonstrate that the pathology causes a worsening in the graphic movement execution and therefore PD patients are impaired in the execution of the automatic movements of writing and drawing (Caligiuri et al, 2006;Lange et al, 2006;Tucha et al, 2006). Spirography is a standard method to test the presence of PD symptoms, such as micrographia or tremor, or to study the strategies adopted by the patients in order to partially counter their deficit (Saunders-Pullman et al, 2008;Longstaff et al, 2006;Longstaff et al, 2003). In particular, hand-drawn spirals allow the study of micrographia and of the motor strategies adopted by the subjects [5,[7][8], because the subjects can freely choose the dimensions of the spiral and their drawing velocity.…”

“…In particular, hand-drawn spirals allow the study of micrographia and of the motor strategies adopted by the subjects [5,[7][8], because the subjects can freely choose the dimensions of the spiral and their drawing velocity. Several studies, in fact, observed that during a spiral hand-drawing task the spiral radius was shorter for the PD subjects than for the healthy subjects, leading to spirals of smaller dimensions (Saunders-Pullman et al, 2008).…”

“…The subjects were asked to hand draw a spiral, starting from the centre and with at least five revolutions (Saunders-Pullman et al, 2008;Balàs et al, 2006). During the execution the subjects were not allowed to rest their forearm on the table, so that movements could be of larger amplitude (Stanley et al, 2010;Ondo et al, 2005).…”

Human Tremor: Origins, Detection and Quantification

“…By using this property this device can detect the movement of a subject following standard drawing patterns placed on it [27; 49; 50; 51; 52; 53; 54; 55; 56] Subjectively interpreted in previous decades, nowadays the digital spirography can provide quantitative data of the movement control [57]. The spirography has been considered valid and reliable to diagnose early Parkinson's disease [58], essential tremor [59] and to distinguish tremulous parkinsonian patients with normal presynaptic dopaminergic imaging from tremulous patients with Parkinson's disease [60]. In general, the signals are recorded and stored for posterior analysis.…”