Prodromal Diagnosis of Lewy Body Diseases Based on the Assessment of Graphomotor and Handwriting Difficulties

To this date, studies focusing on the prodromal diagnosis of Lewy body diseases (LBDs) based on quantitative analysis of graphomotor and handwriting difficulties are missing. In this work, we enrolled 18 subjects diagnosed with possible or probable mild cognitive impairment with Lewy bodies (MCI-LB), 7 subjects having more than 50% probability of developing Parkinson's disease (PD), 21 subjects with both possible/probable MCI-LB and probability of PD > 50%, and 37 age- and gender-matched healthy controls (HC). Each participant performed three tasks: Archimedean spiral drawing (to quantify graphomotor difficulties), sentence writing task (to quantify handwriting difficulties), and pentagon copying test (to quantify cognitive decline). Next, we parameterized the acquired data by various temporal, kinematic, dynamic, spatial, and task-specific features. And finally, we trained classification models for each task separately as well as a model for their combination to estimate the predictive power of the features for the identification of LBDs. Using this approach we were able to identify prodromal LBDs with 74% accuracy and showed the promising potential of computerized objective and non-invasive diagnosis of LBDs based on the assessment of graphomotor and handwriting difficulties.

Exploration of Various Fractional Order Derivatives in Parkinson's Disease Dysgraphia Analysis

Parkinson's disease (PD) is a common neurodegenerative disorder with a prevalence rate estimated to 2.0% for people aged over 65 years. Cardinal motor symptoms of PD such as rigidity and bradykinesia affect the muscles involved in the handwriting process resulting in handwriting abnormalities called PD dysgraphia. Nowadays, online handwritten signal (signal with temporal information) acquired by the digitizing tablets is the most advanced approach of graphomotor difficulties analysis. Although the basic kinematic features were proved to effectively quantify the symptoms of PD dysgraphia, a recent research identified that the theory of fractional calculus can be used to improve the graphomotor difficulties analysis. Therefore, in this study, we follow up on our previous research, and we aim to explore the utilization of various approaches of fractional order derivative (FD) in the analysis of PD dysgraphia. For this purpose, we used the repetitive loops task from the Parkinson's disease handwriting database (PaHaW). Handwritten signals were parametrized by the kinematic features employing three FD approximations: Gr\"unwald-Letnikov's, Riemann-Liouville's, and Caputo's. Results of the correlation analysis revealed a significant relationship between the clinical state and the handwriting features based on the velocity. The extracted features by Caputo's FD approximation outperformed the rest of the analyzed FD approaches. This was also confirmed by the results of the classification analysis, where the best model trained by Caputo's handwriting features resulted in a balanced accuracy of 79.73% with a sensitivity of 83.78% and a specificity of 75.68%.