Abstract Details

Title Digitized Spiral Drawing Analysis Discriminates Parkinson Disease from Control

Topic Movement Disorders

Presentation(s) P04 - (-)

Poster/Presentation
Number 191

Objective

Background BACKGROUND: Spiral analysis is a clinical non-invasive test that objectively characterizes kinematic and physiologic features using calculated indices derived from hand-drawn spiral shape and motor execution. While it correlates with Unified Parkinson's Disease Rating Scale motor scores in PD, and may be more sensitive in detecting early changes in motor performance, its ability to discriminate PD from controls has not been established.

Design/Methods DESIGN/METHODS: 139 PD subjects and 155 controls drew ten spirals with each hand on a digitizing tablet. Spiral analysis derived indices included: (1) global degree of severity score (DOS), a measure of overall spiral execution and spatial irregularity, (2) second order smoothness (SOS), (3) first order Z crossing (ZCR), (4) tightness, (5) mean speed and (6) spiral width variability index (SWVI). Linear mixed effect and logistic models adjusting for age, gender and handedness comparing these indices between cases and controls, and a three-fold cross-validation study were performed. Receiver operating characteristic (ROC) was applied to examine the discriminative ability of the combined indices for PD.

Results RESULTS: All spiral indices except ZCR were significantly different between cases and controls (DOS: p<0.001, SOS: p<0.001, ZCR: p=0.87, tightness: p=<0.001, mean speed: p=0.015, SWVI: p<0.001). A model using all the combined indices had the best classification accuracy in distinguishing PD from controls (AUC=0.8860, optimal sensitivity=0.877 and specificity=0.799), and this was maintained in the validation study (AUCaverage=0.8276). The AUC score in classifying early PD (duration<5 years) from control was 0.8425 and was maintained in cross-validation.

Conclusions CONCLUSIONS: Spiral analysis accurately discriminates PD and early PD from controls , and may be useful as a biomarker in discerning PD. Further assessment is needed to determine its discriminatory abilities in differentiating tremor disorders such as ET from PD.

Authors/Disclosures
Marta San Luciano, MD, FAAN (University of California San Francisco) PRESENTER	Dr. San Luciano has received research support from NIH (NINDS). Dr. San Luciano has received research support from Raynor Cerebellum Project.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Kaili Stanley (Beth Israel)	No disclosure on file
Susan B. Bressman, MD, FAAN (Mount Sinai Health System)	The institution of Dr. Bressman has received research support from Michael J Fox Foundation . The institution of Dr. Bressman has received research support from NIH .
Richard B. Lipton, MD, FAAN (Albert Einstein College of Medicine)	Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Biohaven. Dr. Lipton has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Lundbeck. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for GlaxoSmithKline. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Vedanta. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Grifols. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axon. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Satsuma. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cool Tech. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BDSI. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Axsome. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Clexio. Dr. Lipton has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Lipton has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan/Abbvie. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eli Lilly. Dr. Lipton has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lundbeck. Dr. Lipton has or had stock in Biohaven.Dr. Lipton has or had stock in Manistee.Dr. Lipton has or had stock in Axon.Dr. Lipton has or had stock in CoolTech. The institution of Dr. Lipton has received research support from Teva. The institution of Dr. Lipton has received research support from Amgen. The institution of Dr. Lipton has received research support from Allergan/Abbvie. The institution of Dr. Lipton has received research support from Gammacore. The institution of Dr. Lipton has received research support from Axsome. The institution of Dr. Lipton has received research support from Charleston Labs. The institution of Dr. Lipton has received research support from Eli Lilly. The institution of Dr. Lipton has received research support from Satsuma. The institution of Dr. Lipton has received research support from NIH . The institution of Dr. Lipton has received research support from Veterans Administration. Dr. Lipton has received publishing royalties from a publication relating to health care.
Seth L. Pullman, MD, FAAN (Columbia University)	No disclosure on file
Rachel J. Saunders-Pullman, MD (Mount Sinai Beth Israel, Neurology, Downtown Union Square)	The institution of Dr. Saunders-Pullman has received research support from NIH, Bigglesworth Family Foundation, Empire Clinical Research Investigatory Program.

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