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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.00019

Assessment of Cognitive and Motor Skills in Parkinson’s Disease by A Robotic Object Hitting Game" as per author request

  • 1Department of Neurology, Fukushima Medical University, Japan
  • 2Department of Neurology, Faculty of Medicine, Universitas Indonesia, Indonesia
  • 3Department of Neurology, Fukushima Medical University, Japan
  • 4Kokoro Research Center, Kyoto University, Japan

Parkinson’s disease (PD) patients suffer from various symptoms including extrapyramidal motor disturbances and cognitive impairments. Presumably, both cognitive and motor impairments are causing difficulties in daily life. However, PD patients have rarely been studied under realistic task situations that require high-level interaction of cognitive and motor skills. The aim of this study was to investigate contribution of cognitive and motor factors to performance of PD patients when they are placed under high cognitive and kinematic loads. Twenty-six PD patients and 14 control subjects participated in the study. PD patients performed a task to hit targets and avoid distractors in levodopa On and Off states. A robotic manipulandum device recorded the numbers of target and distractor hit and hand kinematics, including movement area and speed. Standard cognitive batteries and MDS-UPDRS motor scores were examined. Results showed that the PD patients hit significantly fewer targets and more distractors than controls (p < 0.05). In PD patients, average hand speed was slower, and the area of hand movement was smaller as compared with the control subjects (p < 0.001). Levodopa increased the average hand speed and movement area significantly (p < 0.01), but levodopa had insignificant effect on the number of correct target hit and erroneous distractor hit. The scores of cognitive batteries predicted performance of both target hit and distractor avoidance. Our result suggests a dynamic interaction between cognitive and kinematic skills while PD patients performed a virtual reality game. Single-dose levodopa enhanced kinematic capacity and global intelligence level predicted the game performance.

Keywords: Parkinson’s disease, virtual reality, visual discrimination, executive abilities/function, kinematics, cognitive performance, Levodopa (l-dopa), decision-making

Received: 04 Sep 2018; Accepted: 07 Jan 2019.

Edited by:

Huifang Shang, Sichuan University, China

Reviewed by:

Matteo Bologna, Sapienza University of Rome, Italy
Giovanni Albani, Istituto Auxologico Italiano (IRCCS), Italy  

Copyright: © 2019 Wiratman, Kobayashi, Chang, Asano and Ugawa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Shunsuke Kobayashi, Fukushima Medical University, Department of Neurology, Fukushima, Fukushima, Japan,