Graphical tasks to aid in diagnosing and monitoring Parkinson s disease

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1 Graphical tasks to aid in diagnosing and monitoring Parkinson s disease Esther J. Smits

2 The studies described in this thesis were part of the DiPAR project for which funding was received from the EC in the FP7-SME programme (grant agreement ). The intellectual property is owned by Manus Neurodynamica Ltd, who designed the concept of the measurement setup (patent WO/2011/141734). The studies were conducted at the University Medical Center Groningen, University of Groningen in the Netherlands and the Dublin Neurological Institute in Ireland. Printing of this thesis was financially supported by: the University of Groningen, the University Medical Center Groningen, the Graduate school for Behavioural and Cognitive Neurosciences, Manus Neurodynamica Ltd, Neuroscript and de Parkinson-vereniging. ISBN ISBN Paranimfen: (printed version) (electronic version) Sanne Meles Marieke Wouters Cover: The topic of this thesis, graphical tasks, represented by climbing equipment, because rock climbing is one of the favourite activities of the author of this thesis. Cover and Lay out: Printed by: E.J. Smits & J.C.M. Kistemaker Ipskamp Dukkers BV, Enschede Copyright E.J. Smits, 2015 All rights reserved. No part of this book may be reproduced in any form, by print, photocopying, or otherwise, without prior written permission of the copyright owner.

3 Graphical tasks to aid in diagnosing and monitoring Parkinson's disease Proefschrift ter verkrijging van de graad van doctor aan de Rijksuniversiteit Groningen op gezag van de rector magnificus prof. dr. E. Sterken en volgens besluit van het College voor Promoties. De openbare verdediging zal plaatsvinden op woensdag 20 januari 2016 om uur door Esther Josefina Smits geboren op 22 maart 1986 te Winterswijk

4 Promotores Prof. dr. ir. N.M. Maurits Prof. dr. M.A.J. de Koning-Tijssen Beoordelingscommissie Prof. dr. R.B. Reilly Prof. dr. E. Otten Prof. dr. ir. P.H. Veltink

5 TABLE OF CONTENTS LIST OF ABBREVIATIONS 7 CHAPTER 1. GENERAL INTRODUCTION 9 CHAPTER 2. THE DIPAR PROJECT 29 CHAPTER 3. STANDARDIZED HANDWRITING TO ASSESS BRADYKINESIA, MICROGRAPHIA AND TREMOR IN PARKINSON S DISEASE 41 CHAPTER 4. REPRODUCIBILITY OF STANDARDIZED FINE MOTOR CONTROL TASKS AND AGE EFFECTS IN HEALTHY ADULTS 59 CHAPTER 5. TREMOR PRESENCE AND MOVEMENT TIME MEASURES HELP IN DISTINGUISHING BETWEEN ESSENTIAL TREMOR AND PARKINSON S DISEASE 81 CHAPTER 6. GRAPHICAL TASKS TO MEASURE UPPER LIMB FUNCTION IN PATIENTS WITH PARKINSON S DISEASE: VALIDITY AND RESPONSE TO DOPAMINERGIC MEDICATION 101 CHAPTER 7. DISCUSSION AND FUTURE DIRECTIONS 121 APPENDICES 135 NEDERLANDSE SAMENVATTING 149 CURRICULUM VITAE 157 LIST OF PUBLICATIONS AND PRESENTATIONS 159 DANKWOORD 163

6

7 LIST OF ABBREVIATIONS Acc AMC ANOVA CNS DiPAR DNI EMG EPT ET FT H&Y HC ICC ID iqr MD MDS-UPDRS MMSE MT NFB PD PDtd PF PPT PSD R&D RBD ROC RP RTD sd SME TA UMCG UPDRS UPDRS-III WFB Accuracy Amsterdam Medical Center Analysis of Variance Central Nervous System Diagnosing Parkinson s disease by neuromuscular function evaluation Dublin Neurological Institute Electromyography Enhanced Physiological Tremor Essential Tremor Functional Tremor Hoehn and Yahr scale Healthy Control Intraclass Correlation Coefficient Index of Difficulty interquartile range Movement Disorder Movement Disorder Society revision of the UPDRS Mini Mental State Examination Movement Time No Feedback Parkinson s disease Tremor dominant Parkinson s disease Peak Frequency Purdue Pegboard Test Power Spectral Density Research and Development REM Sleep Behaviour Disorder Receiver Operator Curve Relative Power Research and Technology Development standard deviation Small Medium Enterprise Tremor Amplitude University Medical Center Groningen Unified Parkinson s Disease Rating Scale The motor part (part III) of the UPDRS With Feedback 7

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