In a spin

simple drawing test” that might detect Parkinson’s early. The test uses a large (A3) digital tablet and pen to measure the speed and pressure with which the subject completes a spiral indicated with dots on a paper overlay

Around a week ago (obviously when I wasn’t paying attention), there was a flurry of media attention over a “simple drawing test” that might detect Parkinson’s early. The test uses a large (A3) digital tablet and pen to measure the speed and pressure with which the subject completes a spiral indicated with dots on a paper overlay. A person with Parkinson’s is likely to be slower and to apply less pressure.

According to the Telegraph:

Scientists already knew that symptoms that appear early in the disease can interfere with a person’s ability to write or sketch.

I can’t say I have noticed that, personally. But it would probably depend on a number of factors, including the patient’s handedness and which side is primarily affected by the Parkinson’s. I think that how someone tends to use drawing and writing materials might be important, too; I understand that creativity uses a different part of the brain to more mundane activties, and so people’s associations with pen use might vary.

The Telegraph article continues:

A spiral is considered a sound test because, unlike writing words, the quality is less likely to be influenced by a patient’s education.

Unless, say, they are an artist? I wonder if the researchers took that sort of possibility into account.

It should be added that the research was conducted using a small sample: 55 people (27 diagnosed with Parkinson’s, 28 not), all in their sixties and seventies. With a cohort that size, it makes no sense to include younger sufferers, and perhaps artists, calligraphers and draughtspeople were similarly excluded, not to mention fountain pen users (who will be less likely to press hard than those who use ballpoint pens).

Anyway. It seems pointless for me to comment further on this without actually trying to replicate the test (as illustrated in the BBC’s article and in the research journals own blog, but without the technology and on A4 paper).

I have software that will draw a neat, accurate spiral in a dotted line, and I have traditional drawing materials that are pressure sensitive (I wavered over extreme dip pens but they are sensitive to direction and would need several dips in the ink pot to get around the whole spiral, so in the end I decided on the humble graphite pencil in a generous 6B flavour). It seemed to me that this would give me the basic feel of the test.

Here is my spiral:

For the record, I started in the middle (I always draw spirals from the centre out) and I didn’t worry about hitting every dot – I was aiming for a smooth curve. It was, I think,  a confident and reasonably rapid line, despite the fact that my left hand was a bit jittery at the time (I’m right-handed and I was drawing with my right hand).

I was fully aware of the pressure and speed measurements that might be taken if the test was for real, and of my own scepticism about the suggestion that this might be some absolute test (my scepticism is based in part on not wanting to lose my abilities and confidence in drawing). I do wonder if the knowledge (combined with the doubt) might somehow invalidate the test…

The research paper was published in Frontiers of Neurology by a team from RMIT University in Melborne, Australia. It is  based on previous work that has already established drawing a spiral as a test for Parkinson’s; this new study is about the tehnology that can be used to automate the test analysis, instead of relying on an expert humann observer.

Note: The press seemed happy to report that the device used in the test was a “tablet computer”. The illustrated device looks more like a peripheral to a computer – an input device, such as the Wacom Intuos. It doesn’t really matter, of course; it should be possible to administer the test on any tablet computer or a computer interface tablet that has the requisite sensitivity.

Also, and perhaps of much greater import, the press are reporting that early diagnosis is important because it allows for “preventative” treatment to be administered sooner. As far as I am aware, there is no proven preventative treatment; what we have at the current time may slow progression, but even that is uncertain. The BBC even state, in a picture caption, that “ Treatment options are effective only when the disease is diagnosed early “, which I am certain is not true.

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