A paradigm for emulating the early learning stage of handwriting: Performance comparison between healthy controls and Parkinson's disease patients in drawing loop shapes

We present a novel paradigm, aimed at emulating the early stage of handwriting learning in proficient writers, by asking them to produce a familiar shape through a novel (unfamiliar) motor plan. Handwriting of beginner writers is characterized by slower movements, reduced spatial precision, lower fluency and reduced force regulation compared to those observed in the handwriting production of proficient writers. Features observed in the ink trace obtained with the novel motor plan and performance comparison of the handwriting obtained by familiar and unfamiliar motor plan suggest that the proposed paradigm is able to elicit non-automated movements in proficient writers. As that produced by beginner writers, handwriting of Parkinson's disease (PD) patients is characterized by lack of fluency, slowness and abrupt changes of direction. Furthermore, PD patients show impaired performance in learning novel motor behaviors, as well as in executing motor behaviors acquired before the onset of the disease. We used the proposed paradigm for comparing the performance achieved by healthy controls in writing a familiar shape through a novel motor plan with those obtained by PD patients performing a well-known motor plan for drawing the same shape. Our analysis points out some similarities between performance obtained by healthy controls and those obtained by PD patients, sustaining the hypothesis that the fine tuning of the motor plan parameters involved in the handwriting production is impaired by PD.