Parkinson's Disease Spiral Drawing

April 14, 2020 ; 94 (15 Supplement) Tuesday, April 28

Archimedes Spiral Drawing in Idiopathic Parkinson's Disease Patients Showed More Variability in Jerkiness in Patients with Freezing of Gait (4882)

First published April 14, 2020,

Abstract

Objective: To determine if objective measurements of Archimedes spiral drawing can be used as a marker for idiopathic Parkinson's disease (PD) with freezing of gait (FOG).

Background: Archimedes spiral analysis can help in the clinical setting to differentiate healthy individuals from those with PD. PD patients subjectively have a smaller spiral size (with more revolutions in the same space), skew in spiral angle, and tremor. Motor blocks have been demonstrated during during writing tasks in patients with freezing of gait (FOG) yet no objective analysis of spiral characteristics has been reported in FOG patients.

Design/Methods: PD patients with FOG and without (noFOG), and healthy controls (HC) were consented after IRB approval. Subjects performed Archimedes spirals in a defined space using an inking Pen (Wacom) on paper affixed to a WaCOM Intous pro tablet (Portland, OR) and data was collected and analyzed using Movalyzer software (Neuroscript, Tempe, AZ) for 23 pre-defined features.

Results: 22 HC and 29 PD patients (17 noFOG and 12 FOG) were enrolled and analyzed. Analysis of right and left hand spiral drawing showed no significant difference between HC and PD patients. Re-analysis grouping by side of disease dominance or non-dominance based on the right/left ratio of items on UPDRS scale also showed no difference between PD patients and HC. Splitting the PD group into FOG and noFOG, the variability in right side normalized jerk was significantly higher in FOG compared to noFOG (107±78 FOG vs. 47±16 no FOG, p=0.022 Kruskal-Wallis) corrected for multiple comparisons. However while normalized jerk variability was still higher when comparing dominantly effected hands (79±56 FOG vs. 52±16 no FOG) this did not reach statistical significance.

Conclusions: Increased variability in spiral jerkiness may help differentiate PD FOG from noFOG subjects. Larger cohorts are needed to confirm these findings.

Disclosure: Dr. Pillai has nothing to disclose. Dr. Glover has nothing to disclose. Dr. Syeda has nothing to disclose. Dr. Virmani has nothing to disclose.