Abstract Details

Title Identifying Reliable Measures of Impairment in Focal Hand Dystonia Patients

Topic Movement Disorders

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-020

Objective

To determine reliable quantitative measures of focal hand dystonia.

Background Focal hand dystonia is a common task specific dystonia presenting with intermittent muscle contractions and/or abnormal postures of the hand during the task of handwriting. There are currently examiner-based rating scales, patient-reported disability scales and software measures of writing kinematics. The relative sensitivity and correlations between these measures for evaluating severity of dystonia remains unclear and presents a challenge for selecting outcome measures for interventional studies and for comparing across therapeutic studies. In this study, we evaluated symptoms and signs of dystonia across these three data categories to identify reliable and meaningful measures to capture disability in writer’s cramp dystonia.

Design/Methods

Right-handed writer’s cramp subjects and healthy controls performed a sentence writing task on a digital tablet. Measures of computer-based writing kinematics were compared to a patient-reported disability scale and to examiner-rated dystonia scales.

Results We found both subjective and objective measures that could discriminate writer’s cramp patients from healthy volunteers, including a novel handwriting interpretability measure. Additionally, our preliminary analysis identifies a subset of handwriting kinematic measures that most strongly correlate with subjective pain in right hand during handwriting. Lastly, we found that, in contrast to prior studies, axial pen pressure was not as sensitive of an outcome measure in our study.

Conclusions These data help identify reliable markers for assessment of interventions to treat writer’s cramp dystonia. These measures include a novel handwriting interpretability measure using widely accessible software. Future work is aimed at increasing sample size, replicating these findings and understanding the relationships between these measures.

Authors/Disclosures
Noreen Bukhari-Parlakturk, MD, PhD (Duke University School of Medicine) PRESENTER	No disclosure on file
Joyce En-Hua Wang	No disclosure on file
Nicole Calakos, MD (Duke University Medical Center)	No disclosure on file

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