Digital Handwriting Analysis of Characters in Chinese Patients with Mild Cognitive Impairment

Summary

This study proposed a digital handwriting analysis of characters in individuals with mild cognitive impairment to find more information than is revealed by traditional pencil–paper handwriting analysis.

Abstract

An increasing amount of evidence shows that cognitive deficits and movement dysfunctions are not separated. Patients with mild cognitive impairment (MCI) can manifest fine motor disorders of the upper extremities. Handwriting is a complex and unique human activity involving both motor and cognitive coordination. Researchers from western countries have discovered that patients with MCI have abnormal handwriting features. However, no relevant studies have been conducted in the Chinese population. Owing to the cross-culture phenomenon of handwriting, the aim of this study is to find new handwriting tasks to demonstrate the differences in handwriting features between elderly patients with MCI and age-matched healthy individuals.

Introduction

Mild cognitive impairment (MCI) is considered as a transitional but progressively degenerative cognitive phase that precedes the onset of Alzheimer’s disease (AD)¹. It has been reported that the AD progression rate per year is 15% while nearly 75% of moderate and severe MCI cases might remain undiagnosed². Recent studies have reported that patients with MCI have difficulty in some aspects of fine motor tasks³, and those patients who showed motor disorders, such as slow gait, had a high risk of dementia⁴.

Handwriting is a complex human activity th....

Protocol

Our study was approved by the Academic Ethics Committee of the Biological Sciences Division of the Chinese PLA General Hospital in Beijing, China.

1. General aspects of method development

1. Use a USB digitizer (e.g., Wacom Cintiq Pro 16) and a handheld stylus pen for the handwriting movements. The detailed specifications of the digitizer are as follows: external dimensions (width x depth x height) 410 x 265 x 17.5 mm, spatial resolution 3840 x 2160 dots, pixel size 0.090 x 0.090 mm, temporal resolution 30 ms, and a pressure level of 8,192.
2. Connect a laptop PC to the digitizer to collect and exhibit the handwriting traces....

Results

The demographic data of the subjects demonstrated that all the groups matched well in age, gender, educational level, dominant hand, and other parameters.

As shown in Table 1, during the writing of the Chinese character “”, elderly subjects with MCI exhibited a lower average abso.......

Discussion

The critical steps in the protocol confirm the legibility of “”. In detail, within an entire character, the ^#3 stroke needs to be shorter than the other horizonal strokes, and the ^#4 stroke needs to be shorter than the ^#2 stroke. More specifically, more attentional resources are needed durin.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
	Microsoft	Surface Pro 2	computer
	MovAlyeR	3.4	software
	WACOM	Cintiq	digitizer