Exploring Asymmetric Fine Motor Impairment Trends in Early Parkinson's Disease via Keystroke Typing

Abstract

Background: The nQiMechPD algorithm transforms natural typing data into a numerical index that characterizes motor impairment in people with Parkinson's Disease (PwPD).

Objectives: Use nQiMechPD to compare asymmetrical progression of PD-related impairment in dominant (D-PD) versus non-dominant side onset (ND-PD) de-novo patients.

Methods: Keystroke data were collected from 53 right-handed participants (15 D-PD, 13 ND-PD, 25 controls). We apply linear mixed effects modeling to evaluate participants' right, left, and both hands nQiMechPD relative change by group.

Results: The 6-month nQiMechPD trajectories of right (**P = 0.002) and both (*P = 0.043) hands showed a significant difference in nQiMechPD trends between D-PD and ND-PD participants. Left side trends were not significantly different between these two groups (P = 0.328).

Conclusions: Significant differences between D-PD and ND-PD groups were observed, likely driven by contrasting dominant hand trends. Our findings suggest disease onset side may influence motor impairment progression, medication response, and functional outcomes in PwPD.

Keywords: Parkinson's disease; asymmetry; disease progression; motor control; typing.

Figure 1

(A) presents the group mean and standard deviation of the nQiMechPD score measured on each hand (right, left, both) over time. (B) presents regressed line fitted to the relative change from baseline in the nQiMechPD score measured on each hand (right, left, both) over time. Shaded areas represent the 95% confidence interval for each regression line.