Handwriting Analysis in Movement Disorders.

Movement disorders are a group of neurological conditions that cause problems with movement, either in the form of excessive, reduced, or slow movements. Some commonly known movement disorders include Parkinson disease, dystonia, ataxia, and Tourette syndrome. Multiple movement disorders have unique handwriting characteristics that can be measured using an inkless pen and a digitalized tablet. Handwriting is a complex skill that requires a combination of cognition, motor planning, and visuomotor integration. Handwriting deteriorates in patients with neurodegenerative diseases.

This study aims to discern variations in the kinematics (movement patterns) involved in handwriting between individuals with movement disorders and healthy controls. Participants will be invited to carry out a series of handwriting tasks. The pen motions will be captured using an inkless pen and a digitizing tablet linked to a laptop. The entire set of tasks is designed to be completed within 30 minutes. The data will then be collected, processed, and analyzed utilizing a handwriting analysis software.

Study Overview

• Status: Not yet recruiting
• Conditions: Movement Disorders

Detailed Description

Background: Handwriting is a complex skill that requires a combination of cognition, motor planning, and visuomotor integration. Various brain structures including the cerebral cortex, basal ganglia, and cerebellum are involved in learning and performing handwriting. Many neurological disorders impact these brain structures in unique ways, leading to distinct effects on handwriting. Changes in handwriting performance are a prominent feature of Parkinson disease (PD), ataxias, and other movement disorders. Handwriting analysis can serve as a tool to distinguish and monitor the progression of movement disorders. Patients suffering from PD exhibit impairments of previously learned motor skills, including handwriting. It has been demonstrated that patients in the early stages of Parkinson disease exhibit variations in handwriting when compared to healthy individuals. The current research will investigate kinematics, visuospatial adaptation, and learning in different movement disorders through handwriting analysis.

Data collection and Measurement techniques: The subject will be seated comfortably at a table with the digitalized tablet positioned to allow a natural writing position for the subject. Pen movements will be recorded using a non-inking pen and Wacom Cintiq 16-inch digitizing tablet connected to a laptop. A practice session will be provided to each participant to familiarize them with the inkless writing pen and tablet. Before each task, participants will be given instructions on how to perform the task. Participants will be instructed to complete several writing exercises aimed at evaluating various aspects of their handwriting skills. Each task will be repeated multiple times and the entire set of handwriting exercises will be completed within 30 minutes.

• Study Type: Observational
• Enrollment (Estimated): 100

Contacts and Locations

• Study Contact: Name: Aditya Murgai; Phone Number: 33121 519-685-8500; Email: aditya.murgai@lhsc.on.ca

Study Locations

• Canada
  • Ontario
    • London, Ontario, Canada, N6A5A5
      • Aditya Murgai
      • Contact: Aditya Murgai, MBBS, MD, DM; Phone Number: 5196633121; Email: amurgai@uwo.ca

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Movement disorder patients will be recruited from the London Movement Disorder Clinic.

Description

Inclusion Criteria:

(1) Diagnosed with a movement disorder.

Exclusion Criteria:

1. Action tremor or weakness in the dominant hand interfering with writing task.
2. Unable to write or understand English

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Control; Healthy controls
Cases; Diagnosed with a movement disorder

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Primary handwriting kinematic parameter (velocity)	Average absolute vertical velocity (cm/s)	Day 1

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Secondary handwriting kinematic parameter (acceleration)	Average absolute vertical acceleration (cm/s²)	Day 1
Secondary handwriting kinematic parameter (duration)	Average stroke duration (msec)	Day 1
Pen pressure	Average pen pressure (levels)	Day 1

Collaborators and Investigators

• Sponsor: Western University, Canada

Study record dates

Study Major Dates

• Study Start (Estimated): January 1, 2025
• Primary Completion (Estimated): July 1, 2029
• Study Completion (Estimated): July 1, 2030

Study Registration Dates

• First Submitted: May 6, 2024
• First Submitted That Met QC Criteria: May 26, 2024
• First Posted (Actual): May 31, 2024

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: January 21, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Central Nervous System Diseases; Nervous System Diseases; Movement Disorders
• Other Study ID Numbers: 123953

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No