Computer keyboard interaction as an indicator of early Parkinson's disease.

L Giancardo,J A Obeso,I Butterworth,M L Gray,A Sánchez-Ferro,T Arroyo-Gallego,P Montero,M Matarazzo,R San José Estépar,C S Mendoza

doi:10.1038/srep34468

Abstract

Parkinson’s disease (PD) is a slowly progressing neurodegenerative disease with early manifestation of motor signs. Objective measurements of motor signs are of vital importance for diagnosing, monitoring and developing disease modifying therapies, particularly for the early stages of the disease when putative neuroprotective treatments could stop neurodegeneration. Current medical practice has limited tools to routinely monitor PD motor signs with enough frequency and without undue burden for patients and the healthcare system. In this paper, we present data indicating that the routine interaction with computer keyboards can be used to detect motor signs in the early stages of PD. We explore a solution that measures the key hold times (the time required to press and release a key) during the normal use of a computer without any change in hardware and converts it to a PD motor index. This is achieved by the automatic discovery of patterns in the time series of key hold times using an ensemble regression algorithm. This new approach discriminated early PD groups from controls with an AUC = 0.81 (n = 42/43; mean age = 59.0/60.1; women = 43%/60%;PD/controls). The performance was comparable or better than two other quantitative motor performance tests used clinically: alternating finger tapping (AUC = 0.75) and single key tapping (AUC = 0.61).

Highlights

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Receivers operating characteristic (ROC) curves are used to compare the metrics. neuroQWERTY index (nQi) showed the best classification performance with an Area under the Receiving Operating Characteristic Curve (AUC) of 0.81 (0.72–0.88 95% CI, p-value = 0.001), alternating finger tapping had a lower performance with an Area Under the ROC curve (AUC) = 0.75 (0.64–0.83 95% CI, p-value < 0.001) and single key tapping with
Compound clinical scores are limited by the frequency of the measurements and the subjectivity of these assessments

Summary

Introduction

The MIT Faculty has made this article openly available. Please share how this access benefits you. The current standard to evaluate motor signs is the Unified Parkinson’s Disease Rating Scale part III (UPDRS-III)[11], a compound clinical score that ascertain various motor aspects of the disease, such as rigidity, resting tremors, speech and facial expression among others. This scale requires trained medical personnel and attendance of the patient in the clinic, limiting the ease and frequency with which it can be administered. Each unit in the ensemble regression includes a linear Support Vector Regression step trained on the Unified Parkinson’s disease rating scale part III (UPDRS-III), the clinical score for evaluating PD motor symptoms.

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