Impaired Touchscreen Skills in Parkinson's Disease and Effects of Medication

Abstract

Background: Deficits in fine motor skills may impair device manipulation including touchscreens in people with Parkinson's disease (PD).

Objectives: To investigate the impact of PD and anti-parkinsonian medication on the ability to use touchscreens.

Methods: Twelve PD patients (H&Y II-III), OFF and ON medication, and 12 healthy controls (HC) performed tapping, single and multi-direction sliding tasks on a touchscreen and a mobile phone task (MPT). Task performance was compared between patients (PD-OFF, PD-ON) and HC and between medication conditions.

Results: Significant differences were found in touchscreen timing parameters, while accuracy was comparable between groups. PD-OFF needed more time than HC to perform single (P = 0.048) and multi-direction (P = 0.004) sliding tasks and to grab the dot before sliding (i.e., transition times) (P = 0.040; P = 0.004). For tapping, dopaminergic medication significantly increased performance times (P = 0.046) to comparable levels as those of HC. However, for the more complex multi-direction sliding, movement times remained slower in PD than HC irrespective of medication intake (P < 0.050 during ON and OFF). The transition times for the multi-direction sliding task was also higher in PD-ON than HC (P = 0.048). Touchscreen parameters significantly correlated with MPT performance, supporting the ecological validity of the touchscreen tool.

Conclusions: PD patients show motor problems when manipulating touchscreens, even when optimally medicated. This hinders using mobile technology in daily life and has implications for developing adequate E-health applications for this group. Future work needs to establish whether touchscreen training is effective in PD.

Keywords: Parkinson's disease; dopaminergic medication; touchscreen skills; upper limb.

FIG. 1

Tablet tasks. Tapping between two dots (left panel). Sliding a dot towards a predefined target in a single direction (middle panel). Sliding a dot towards a predefined target in multiple directions (right panel).

FIG. 2

Performance on tablet tasks. (A) Total single direction sliding time (ms). (B) Total multi‐direction sliding time (ms). (C) Transition time (ms) on the single sliding task. (D) Transition time (ms) on the multi‐direction sliding task.