Handwriting as an Objective Tool to Support the Identification of People With Alzheimer's Disease

NCT06483438 | Completed DMC

• 1 other identifier: CHRC2022Handwriting&Dementia
• Study Type: observational
• Target: 20
• Locations: 1 country
• Sites: 3

Brief Summary

Alzheimer's disease (AD) is the most common of dementia, and has associated cognitive and motor disorders, with consequences on daily activities, including handwriting. Handwriting has been used to study fine motor control or executive functioning in healthy and unhealthy populations. Changes in this skill are present at different stages of the clinical course of Alzheimer's Disease. The sensorimotor deterioration is observed in handwriting tasks (motion kinematics, such as movement time, speed, and profiles) and brain activity rhythms. Handwriting has been used to study fine motor control or executive functioning in healthy and unhealthy populations, and changes in this skill are present at different stages of the clinical course of dementia. From a theoretical perspective, because sensorimotor deterioration observed in handwriting tasks (motion kinematics, such as movement time, speed, and profiles). Due to the large number of brain areas related to handwriting performance, brain electrical activity analysis can be an early indicator of brain dysfunction. Although there is a lack of validation across healthy and non-healthy populations Electroencephalogram (EEG) measures have the potential for evaluating cognitive performance. This research aims to analyze the suitability of the handwriting assessment protocol, which can contribute to a more in-depth knowledge of this subject and potentially support early identification and treatment.

Conditions

Dementia

Keywords

Prevention; Electroencephalography; Handwriting; Movement

Outcome Measures

Primary Outcomes (8)

• Stroke

  A stroke is a series of lines or curves written in a single letter, i.e., the path traced by the pen on the paper. Traces are analyzed movements that unite a movement pattern. A movement pattern can be segmented using 2 segmentation methods: zero crossings of the velocity profile after the velocity peak or the minimum velocity after the velocity peak. This measure is obtained through the software Movalyzer, during the handwriting tasks.

  Baseline

• Vertical/horizontal start position

  Initial vertical/horizontal position relative to the lower limit of the digitizer area (in cm).

  Baseline

• Vertical/horizontal size

  Vertical vector difference between the start and end of a stroke (in cm).

  Baseline

• Slant

  Segment slope, which is estimated by the orientation of the line by minimizing/reducing the sum of the squares of the perpendicular distances of all pixels to the line through the gravity point (in radians).

  Baseline

• Reaction time

  Is the time from the start of the recording to the start of the trace (in sec).

  Baseline

• Duration

  Time interval between the first and last samples in a stroke/segment (in sec).

  Baseline

• Pen pressure

  Average pen pressure values along a stroke (N/m2).

  Baseline

• Brain activity

  Spectral density mean from the frequency of the three bands (theta, alpha, beta)

  Baseline

Secondary Outcomes (3)

• Handwriting legibility

  Baseline

• Handwriting speed

  Baseline

• Visuomotor integration

  Baseline

Study Arms (1)

Group 1: subjects with dementia Group 2: subjects without dementia o Group/Cohort Description [*]

Group 1: subjects over the age of 50, with a diagnosis of dementia according to DSM-5 criteria and proven by neuropsychological assessment. Group 2: subjects over the age of 50, with no cognitive impairment on the neuropsychological assessment and with no previous neurological and/or psychiatric history or other illnesses that could interfere with the collection of writing data.

Eligibility Criteria

• Age: 50 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Participants will be recruited from Municipal and Community Associations, Senior Universities and Residential Centre for the Elderly

You may qualify if:

• Over 50 years of age
• Portuguese native language

You may not qualify if:

• \- Previous neurological history (e.g. stroke, traumatic brain injury, multiple sclerosis, among others), psychiatric history or other incapacitating illnesses that could interfere with the collection of writing data. (NOTE that neurological disease is accepted in the dementia group, but co-morbidity of previous and actual neurological diseases will be excluded) Cognitively normal group
• Over 50 years of age
• At least three years of schooling
• \- Presence of neurological history (e.g., stroke, traumatic brain injury, multiple sclerosis, among others), psychiatric history, or other incapacitating illnesses that could interfere with the collection of writing data.

Sponsors & Collaborators

• University of Évora: lead
• NOVA Medical School: collaborator
• Faculdade de Motricidade Humana: collaborator
• University of Lisbon: collaborator

Study Sites (3)

Espírito Santo Hospital of Évora

Evora, 7000, Portugal

Location

Casa dos Avós Residence

Ponte de Sôr, 7400, Portugal

Location

Costa Azul Residence

Sesimbra, 2970, Portugal

Location

Related Publications (8)

• Yan JH, Rountree S, Massman P, Doody RS, Li H. Alzheimer's disease and mild cognitive impairment deteriorate fine movement control. J Psychiatr Res. 2008 Oct;42(14):1203-12. doi: 10.1016/j.jpsychires.2008.01.006. Epub 2008 Feb 15.

  PMID: 18280503 BACKGROUND

• Stergiou N, Harbourne R, Cavanaugh J. Optimal movement variability: a new theoretical perspective for neurologic physical therapy. J Neurol Phys Ther. 2006 Sep;30(3):120-9. doi: 10.1097/01.npt.0000281949.48193.d9.

  PMID: 17029655 BACKGROUND

• Palmis S, Danna J, Velay JL, Longcamp M. Motor control of handwriting in the developing brain: A review. Cogn Neuropsychol. 2017 May-Jun;34(3-4):187-204. doi: 10.1080/02643294.2017.1367654. Epub 2017 Sep 11.

  PMID: 28891745 BACKGROUND

• Morgado J, Rocha CS, Maruta C, Guerreiro M, Martins IP. Cut-off scores in MMSE: a moving target? Eur J Neurol. 2010 May;17(5):692-5. doi: 10.1111/j.1468-1331.2009.02907.x. Epub 2009 Dec 29.

  PMID: 20050900 BACKGROUND

• Harbourne RT, Stergiou N. Movement variability and the use of nonlinear tools: principles to guide physical therapist practice. Phys Ther. 2009 Mar;89(3):267-82. doi: 10.2522/ptj.20080130. Epub 2009 Jan 23.

  PMID: 19168711 BACKGROUND

• Garre-Olmo J, Faundez-Zanuy M, Lopez-de-Ipina K, Calvo-Perxas L, Turro-Garriga O. Kinematic and Pressure Features of Handwriting and Drawing: Preliminary Results Between Patients with Mild Cognitive Impairment, Alzheimer Disease and Healthy Controls. Curr Alzheimer Res. 2017;14(9):960-968. doi: 10.2174/1567205014666170309120708.

  PMID: 28290244 BACKGROUND

• Engel-Yeger B, Hus S, Rosenblum S. Age effects on sensory-processing abilities and their impact on handwriting. Can J Occup Ther. 2012 Dec;79(5):264-74. doi: 10.2182/CJOT.2012.79.5.2.

  PMID: 23539771 BACKGROUND

• Dixon RA, Kurzman D, Friesen IC. Handwriting performance in younger and older adults: age, familiarity, and practice effects. Psychol Aging. 1993 Sep;8(3):360-70. doi: 10.1037//0882-7974.8.3.360.

  PMID: 8216956 BACKGROUND

Related Links

• Neuroscript software
• Movesense

MeSH Terms

Conditions

Dementia

Condition Hierarchy (Ancestors)

Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders

Study Officials

• Ana Matias, PhD

  University of Évora

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Researcher and Assistant Professor

Study Record Dates

• First Submitted: June 7, 2024
• First Posted: July 3, 2024
• Study Start: December 2, 2023
• Primary Completion: July 30, 2024
• Study Completion: July 30, 2024
• Last Updated: August 9, 2024

Record last verified: 2024-06

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: Starting 6 months after publication
• Access Criteria: Researchers who wish to have access to IPD, should contact principal researcher. The request should be done by email, were researchers should indicate: complete name, affiliation, position, and justify their interest. After the request will be evaluated by two of the elements of the research group.

Locations

PT (3)