Neurological Sciences

, Volume 39, Issue 6, pp 1057–1063 | Cite as

The difference in visuomotor feedback velocity control during spiral drawing between Parkinson’s disease and essential tremor

  • Kai-Hsiang Chen
  • Po-Chieh Lin
  • Bing-Shiang Yang
  • Yu-Jung Chen
Original Article


In a spiral task, the accuracy of the spiral trajectory, which is affected by tracing or tracking ability, differs between patients with Parkinson’s disease (PD) and essential tremor (ET). However, not many studies have analyzed velocity differences between the groups during this task. This study aimed to examine differences between the groups related to this characteristic using a tablet. Fourteen PD, 12 ET, and 12 control group participants performed two tasks: tracing a given spiral (T1) and following a guiding point (T2). A digitized tablet was used to record movements and trajectory. Effects of direct visual feedback on intergroup and intragroup velocity were measured. Although PD patients had a significantly lower T1 velocity than the control group (p < 0.05), they could match the velocity of the guiding point (3.0 cm/s) in T2. There was no significant difference in the average T1 velocity between ET and the control groups (p = 0.26); however, the T2 velocity of ET patients was significantly higher than the control group (p < 0.05). They were also unable to adjust the velocity to match the guiding point, indicating that ET patients have a poorer ability to follow dynamic guidance. When both groups of patients have similar action tremor severity, their ability to follow dynamic guidance was still significantly different. Our study combined visual feedback with spiral drawing and demonstrated differences in the following-velocity distribution in PD and ET. This method may be used to distinguish the tremor presentation of both diseases, and thus, provide accurate diagnosis.


Parkinson’s disease Essential tremor Spiral drawing Visual feedback 



This work was supported by the collaborative project between National Chiao Tung University and National Taiwan University Hospital Hsinchu Branch (grant numbers 104W970 and 105W970), and Taiwan Ministry of Science and Technology (grant number MOST 105-2628-E-009-003-MY3).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurology, Hsinchu BranchNational Taiwan University HospitalHsinchu CityTaiwan
  2. 2.Department of Mechanical EngineeringNational Chiao Tung UniversityHsinchu CityTaiwan
  3. 3.Institute of Biomedical EngineeringNational Chiao Tung UniversityHsinchu CityTaiwan

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