Digital Handwriting Reveals Motor Impairment, Dopaminergic Response, and Progression in Parkinson's Disease
Lola Díaz‐Feliz, Marcos Faundez‐Zanuy, Andrea Gennari, Alexia Sánchez‐Reyes, Pilar Sanz‐Cartagena, José Arbelo‐González, Miguel Ángel García‐Cabezas, Pedro García‐RuizAbstract
Background
Digital handwriting distinguishes PD patients from healthy controls but is rarely assessed quantitatively.
Objectives
To evaluate digital handwriting as an objective tool to assess motor impairment, dopaminergic response, and progression in PD.
Methods
Participants (Healthy Controls, n = 52; De Novo PD Patients assessed at baseline and after 7 weeks, n = 50; PD Patients in OFF–ON states following inhaled levodopa, n = 26; PD Progression Patients, n = 60) wrote a standard sentence on a digitizing tablet.
Results
De Novo PD Patients showed reduced handwriting speed and increased in‐air time. Acute dopaminergic stimulation in OFF–ON states was associated with shorter in‐surface and in‐air time. Longer disease duration was associated with increased variability in speed and acceleration. Higher MDS‐UPDRS Part III scores were associated with lower speed and acceleration.
Conclusions
Digital handwriting is an objective digital biomarker for quantifying PD dysgraphia and its response to dopaminergic treatment.