Background: Disability in Parkinson′s disease (PD) is measured by standardised scales including the MDS-UPDRS, which are subject to high inter and intra-rater variability and fail to capture subtle motor impairment. The BRadykinesia Akinesia INcoordination (BRAIN) test is a previously validated keyboard tapping test, evaluating proximal upper-limb motor impairment. Here, a new Distal Bradykinesia Tapping (DBT) test was developed to assess distal upper-limb function. Kinetic parameters of the test include kinesia score (KS20, key taps over 20 seconds), akinesia time (AT20, mean dwell-time on each key) and incoordination score (IS20, variance of travelling time between key taps). Objective: To develop and validate a new keyboard-tapping test to assess distal motor function in PD patients. Methods: The DBT test was validated in 45 PD patients and 24 controls, alongside the BRAIN test. Test scores were compared between groups and correlated with MDS-UPDRS-III scores. 10 additional PD patients were recruited to assess the DBT test in monitoring motor fluctuations. Results: All three parameters discriminated between patients and controls, with KS20 performing best, yielding 75% sensitivity for 85% specificity; area under the receiver operating characteristic curve (AUC) = 0.87. Combination of both the DBT and BRAIN tests improved discrimination (AUC=0.91). KS20 and AT20 correlated with MDS-UPDRS-III (Pearson′s r=-0.49, p<0.001 and r=0.54, p<0.001, respectively). The DBT test detected subtle changes in motor fluctuation states, which were not reflected clearly by MDS-UPDRS-III sub-scores. Conclusion: The DBT test is a user-friendly method of assessing distal motor dysfunction in PD, possibly permitting longitudinal monitoring of PD motor complications.

中文翻译：

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开发和验证一种新的基于Web的轻拍测试，以测量帕金森氏病的远端运动迟缓

背景：帕金森氏病（PD）的残疾是通过包括MDS-UPDRS在内的标准化量表来衡量的，该量表存在较高的评分者间和评分者内变异性，无法捕获微妙的运动障碍。慢肌运动障碍运动（BRAIN）测试是先前经过验证的键盘敲击测试，用于评估近端上肢运动障碍。在这里，开发了一种新的远端运动迟缓拍击（DBT）测试，以评估远端上肢功能。测试的动力学参数包括运动学评分（KS20，超过20秒的击键），运动障碍时间（AT20，每个键的平均停留时间）和不协调得分（IS20，击键之间的行程时间变化）。目的：开发并验证一种新的键盘敲击测试，以评估PD患者的远端运动功能。方法：除45例PD患者和24例对照外，DBT检验已通过BRAIN检验。比较各组之间的考试成绩，并将其与MDS-UPDRS-III成绩相关。招募了另外10名PD患者以评估DBT测试以监测运动波动。结果：区分患者和对照组的所有三个参数，KS20表现最佳，灵敏度为75％，特异性为85％。接收器工作特性曲线（AUC）下的面积= 0.87。DBT和BRAIN测试的组合可提高分辨力（AUC = 0.91）。KS20和AT20与MDS-UPDRS-III相关（Pearson'sr = -0.49，p <0.001和r = 0.54，p <0.001）。DBT测试检测到电动机波动状态的细微变化，而MDS-UPDRS-III子分数并未清楚反映。结论：