By Michelle Jaffee
A new study by University of Florida and Northwestern University researchers found that an assessment using a simple and inexpensive pegboard provided objective, reliable data in tracking motor-symptom progression of Parkinson’s disease as well as atypical Parkinsonian disorders. The study was published online on June 5 in the journal npj Parkinson’s disease.
The study included participants between the ages of 38 and 81 who had been previously diagnosed by movement disorder specialists at UF and Northwestern. Of the participants, 164 had Parkinson’s, 39 had progressive supranuclear palsy and 23 had multiple system atrophy, in addition to 53 healthy controls.
All participants were evaluated using the Purdue Pegboard Test, or PPT, in which pegs and washers are placed onto a board with a single hand or both hands simultaneously in tests of manual dexterity and coordination. Participants with disease had a marked decline in performance on the pegboard test after one year, while healthy controls did not.
In addition, the study found a significant correlation between decline in PPT score and progression of motor symptoms as measured by the Movement Disorders Society Unified Parkinson’s Disease Rating Scale Part III, the current clinical standard for tracking motor changes in Parkinson’s disease.
“This study provides good evidence that we can use this common task as a reliable and objective stand-in for subjective rating scales or much more expensive objective tests, like PET imaging, to look at decline in Parkinson’s as part of clinical trials, where we might not have access to more expensive methods,” said Bradley J. Wilkes, Ph.D., a UF research assistant professor who co-led the paper with David Vaillancourt, Ph.D., a professor and Orchid Endowed Chair of UF’s department of applied physiology & kinesiology.
The research team also reported that PPT performance at the one-year follow-up could be predicted using a biomarker, specifically a diffusion MRI scan that shows the amount of baseline “free-water,” or fluid unconstrained by brain tissue. Increasing levels of free-water can indicate degeneration of brain tissue, and this imaging method — discovered and validated by the Vaillancourt lab —has gained traction as a reliable, non-invasive biomarker in Parkinsonism.
The pegboard test differs from commonly used rating scales for motor-symptom progression in that the pegboard is objective, versus subjective, in nature, Wilkes said, adding that the pegboard test could provide key data in multi-site research studies.
“When you’re trying to find a new drug to help people with Parkinson’s or atypical Parkinsonism and you’re testing it at sites all over the world, you want something that’s really objective and simple to look at those effects,” he said.
Read the paper in npj Parkinson’s disease.
