MOTOR PHENOMENON MEASUREMENT

• US 20100152622A1
• Filed: 05/16/2008
• Published: 06/17/2010
• Est. Priority Date: 05/16/2007
• Status: Abandoned Application

• Current Assignee: Johannes Leonardus Hermanus Maria Teulings
• Original Assignee: Johannes Leonardus Hermanus Maria Teulings
• Inventors: Teulings, Johannes Leonardus Hermanus Maria
• Application Number:
  US12/600,464
• Publication Number:
  US 20100152622A1
• Time in Patent Office: Days
• US Class Current: 600/595
• CPC Class Codes: A61B 2560/0418 Pen-shaped housings
• CPC Class Codes: A61B 5/1101 Detecting tremor
• CPC Class Codes: A61B 5/16 Devices for psychotechnics using teaching or educational appliances G09B1/00 - G09B7/00; Testing reaction times ; Devices for evaluating the psychological state
• CPC Class Codes: A61B 5/4082 Diagnosing or monitoring movement diseases, e.g. Parkinson, Huntington or Tourette
• CPC Class Codes: A61B 5/6826 Finger
• CPC Class Codes: A61B 5/6838 Clamps or clips
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising

Abstract

Motor phenomena are measured by using a pen-and-tablet digitizer and a personal computer to instruct, prompt and make a data record of a human patient'"'"'s performance of a handwriting task, analyze the data record, and report features of the patient'"'"'s performance. Examples of reported features are measures of dysfluency and measures of velocity scaling. Reported features are correlated with information about the patient'"'"'s state of health (especially schizophrenia), medication (especially antipsychotic and neuroleptic) as a superior alternative to scales based on clinical observation for detecting motor effects of a medication, comparing side effects of medications, adjusting dosages, and observing the course of motor disturbances such as Parkinsonism and tardive dyskinesia.

Claims

1. A method of assessing a degree of severity of a motor sign directly mediated by a pharmacological agent in a human patient, comprising the steps of:

a. establishing a recording of the patient'"'"'s performance of a motor task;

b. deriving from said recording a measure selected from the group including a measure of dysfluency and a measure of bradykinesia; and

c. inferring a degree of the motor sign from said measure.

3. The method of claim 1, wherein said motor task is a handwriting task comprising writing a handwriting-like pattern selected from the group containing overlaying circles, continuous loops, complex loops, and a sentence.

23. The method of claim 1, wherein said measure of dysfluency is computed as the number of acceleration peaks per stroke in said recording and said measure is used to infer a movement side effect.

25. The method of claim 1, wherein step b further comprises

identifying in said recording a stroke corresponding to a movement performed by the patient;

identifying with reference to said stroke a stroke duration, a first velocity peak, and an end;

identifying between said first velocity peak and said end a first negative-to-positive zero crossing of acceleration;

determining the time elapsed between said zero crossing and said end; and

deriving said measure from a quotient of said time elapsed divided by the stroke duration.

26. The method of claim 1, wherein step b further comprises

identifying in said recording a stroke corresponding to a movement performed by the patient;

determining with reference to said stroke a stroke duration and a stroke size;

computing with reference to said stroke an integral, across the entirety of said stroke, of the third time derivative of said stroke;

obtaining the product of said integral multiplied by the fifth power of said duration;

obtaining the quotient of said product divided by the second power of said stroke size; and

deriving said measure from said quotient, thereby obtaining the measure known as normalized jerk.

2. (canceled)

4. A method of assessing a motor si n in a human patient, comprising the steps of:

a. establishing a recording of the patient'"'"'s performance of a motor task;

b. deriving from said recording a vertical or horizontal movement component in the writing plane; and

c. inferring a degree of the motor sign from said measure.

5. A method of assessing a motor sign in a human patient, comprising the steps of:

a. establishing recording of the patient'"'"'s performance of a motor task;

b. deriving from said recording a measure of dysfluency or a measure of bradykinesia; and

c. inferring a degree of the motor sign from said measure,

wherein said step of establishing said recording further comprises prompting the patient to write predetermined content with a writing instrument on a writing surface and acquiring recorded data as the patient does so.

6. A method of assessing a motor sign in a human patient, comprising the steps of:

a. establishing a recording of the patient'"'"'s performance of a motor task, said task comprising a handwriting task of drawing a plurality of figures of different sizes;

b. deriving a peak velocity increase and a vertical size increase in the writing plane from said recording; and

c. inferring a degree of the motor sign from said peak velocity increase and said vertical size increase.

7. (canceled)

8. A method of assessing a motor sign in a human patient, comprising the steps of

a. establishing a recording the patient'"'"'s performance of motor task, said task comprising hand-writing a plurality of figures of different sizes;

b. deriving a measure of velocity scaling from said recording; and

c. inferring a degree of the motor sign from said measure of velocity scaling,

wherein the figures have loops with vertical sizes between approximately one centimeter and approximately four centimeters.

9. The method of claim 8, wherein said plurality of figures comprise at least one figure selected from the group containing overlaying circles, continuous loops, complex loops, and sentences.

10. A method of assessing a motor sign in a human patient, comprising the steps of:

a. establishing a recording of the patient'"'"'s performance of a motor task, said task comprising a handwriting task of drawing a plurality of figures of different sizes;

b. deriving a measure of velocity scaling from said recording; and

c. inferring a degree of the motor sign from said measure of velocity scaling,

wherein said step of establishing said recording further comprises prompting the patient to write predetermined content with a writing instrument on a writing surface and recording data as the patient does so.

11. (canceled)

12. A method of detecting a drug side effect in a human patient, comprising the steps of:

a. ascertaining the patient'"'"'s medication status with reference to a drug;

b. establishing a recording of the patient'"'"'s performance of a handwriting task;

c. deriving from said recording at least one measure selected from the group containing a measure of dysfluency and a measure of bradykinesia;

d. establishing a plurality of recordings of performances of said handwriting task by a plurality of patients in a population of patients, each such patient having known medication status with reference to said drug;

e. deriving from said plurality of recordings at least one measure selected from the group containing a measure of dysfluency and a measure of bradykinesia;

f. making a first comparison of said at least one measure derived from said recording of the patient'"'"'s performance with said at least one measure derived from said recordings of said performances by said plurality of patients in said population;

g. making a second comparison of the patient'"'"'s medication status to said medication status of said plurality of patients; and

h. inferring a degree of the drug side effect of said drug in the patient from said first comparison and said second comparison.

13. The method of claim 12, wherein said handwriting task comprises writing a plurality of figures of different sizes and said measure is a measure of velocity scaling.

14. The method of claim 13, wherein said measure is computed with reference to size increase in different ones of figures drawn in said task of drawing a plurality of figures of different sizes.

24. The method of claim 12, wherein said measure of dysfluency is computed as the number of acceleration peaks per stroke in said recording and said measure is used to infer a movement side effect.

27. The method of claim 12, wherein step c comprises determining with reference to said recording a duration of a task performed by the patient;

step e comprises determining with reference to said plurality of recordings by said plurality of patients a plurality of durations; and

step f comprises deriving a measure of bradykinesia by comparing said duration with said plurality of durations.

28. The method of claim 12, wherein step c comprises determining with reference to said recording a stroke size of a task performed by the patient;

step e comprises determining with reference to said plurality of recordings by said plurality of patients a plurality of stroke sizes;

step f comprises said stroke duration with said plurality of stroke sizes in said population.

15. Apparatus for assessing a motor sign in a human patient, comprising:

a. a handwriting recording device comprising a handwriting instrument and a handwriting surface; and

b. a computer operatively coupled to said handwriting recording device and programmed to input data therefrom and to compute from said data and report a measure of a motor sign indicating dysfluency or bradykinesia.

16. Apparatus as set forth in claim 15, wherein said computer is programmed to identify one or more submovements as represented by said recording and to derive from said identified submovements at least one measure selected from the group of measures including measures comprising Relative Duration and Relative Size of the Primary Submovement, Secondary Submovement Frequency, Duration, Vertical Size, Peak Vertical Velocity, Peak Vertical Acceleration, Relative Time To Peak Vertical Velocity, Absolute Size, Average Absolute Velocity, Roadlength, Absolute Jerk, and Number Of Peak Acceleration Points.

17. A method of assessing a motor sign in a human patient, the method comprising the steps of:

a. with a data processing apparatus, interacting with the patient to communicate to the patient a task and prompting the patient to perform said task;

b. with the data processing apparatus interacting with the patient, establishing a recording over a first time period having an end defined as cessation of movement or as the expiration of a predetermined time period;

c. with the data processing apparatus, testing said recording for a condition that said recorded performance is consistent with said communicated task;

d. with the data processing apparatus, unless said condition is true, rejecting said recording and again prompting the patient to perform said communicated task;

e. accepting said recording and appending said recording to a collection of data;

f. repeating the aforementioned steps of communicating, prompting, establishing, testing and accepting until said recording has been established and accepted a predetermined number of times;

g. deriving from said collection of recorded data a measure selected from the group containing a measure of dysfluency and a measure of bradykinesia; and

h. inferring a degree of the motor sign from said measure.

18. The method of claim 17, wherein said degree of the motor sign is a degree of severity that is directly mediated by a pharmacological agent.

19. The method of claim 17, wherein said motor task is a handwriting task comprising writing a handwriting-like pattern selected from the group containing overlaying circles, drawing continuous loops, complex loops, and a sentence.

20. The method of claim 17, further comprising the steps of identifying one or more submovements as represented by said recording;

and deriving, from said recording and with reference to said one or more submovements, at least one measure selected from the group of submovement parameters consisting of Relative Duration and Relative Size of the Primary Submovement, Secondary Submovement Frequency, Duration, Vertical Size, Peak Vertical Velocity, Peak Vertical Acceleration, Relative Time To Peak Vertical Velocity, Absolute Size, Average Absolute Velocity, Roadlength, Absolute Jerk, Normalized Jerk, Average Normalized Jerk, and Number Of Peak Acceleration Points; and

inferring a degree of the motor sign from said measure.

21. A method of monitoring a patient'"'"'s compliance with a medication regimen, comprising the steps of:

a. establishing a recording of the patient'"'"'s performance of a motor task, said task comprising hand writing a plurality of figures of different sizes;

b. deriving from said recording a plurality of peak values selected from the group containing velocity values and duration values, each with respect to one or more figures of different sizes;

c. computing a quotient by dividing said peak values by corresponding ones of different sizes;

d. comparing said quotient with one or more values of said quotient obtained from a reference set, said reference set being selected from the group containing a set of quotient values obtained from a population of patients and a set of quotient values obtained from the same patient at different times, said reference set being associated with data pertaining to compliance with a medication regimen; and

e. inferring the patient'"'"'s compliance status from said comparison.

22. A method of monitoring a patient'"'"'s compliance with a medication regimen, comprising the steps of:

a. establishing a recording of the patient'"'"'s performance of a motor task, said task comprising hand writing a plurality of figures of different sizes;

b. deriving from said recording a plurality of relative duration values each with respect to one or more figures of different sizes;

c. computing a quotient by dividing said relative duration values by corresponding ones of different sizes;

d. comparing said quotient with one or more values of said quotient obtained from a reference set, said reference set being selected from the group containing a set of quotient values obtained from a population of patients and a set of quotient values obtained from the same patient at different times, said reference set being associated with data pertaining to compliance with a medication regimen; and

e. inferring the patient'"'"'s compliance status from said comparison.

29. A method of assessing a motor sign in a human patient, comprising the steps of:

a. establishing a recording of the patient'"'"'s performance of a motor task entailing drawing a plurality of figures of different sizes;

b. deriving a peak velocity increase and a vertical size increase from said recording; and

c. inferring a degree of the motor sign from said peak velocity increase and said vertical size increase.

30. A method of assessing a motor sign in a human patient, comprising the steps of:

a. establishing a recording of the patient'"'"'s performance of a motor task;

b. deriving a measure of dysfluency from said recording; and

c. inferring a degree of the motor sign from said measure of dysfluency, wherein said measure of dysfluency is derived with reference to a computation of average normalized jerk.

31. The method of claim 30, wherein step b further comprises deriving a movement component from said recording and computing said measure of average normalized jerk from a horizontal movement component, a vertical movement component, and a resultant movement component.

32. (canceled)

33. A method of assessing a motor sign in a human patient, comprising the steps of:

a. establishing a recording of the patient'"'"'s performance of a motor task entailing drawing plurality of figures of different sizes;

b. deriving a measure of velocity scaling from said recording; and

c. inferring a degree of the motor sign from said measure of velocity scaling,

wherein step a further comprises drawing loops having vertical sizes between approximately one centimeter and approximately four centimeters.