The "floating door sign" in Parkinson's disease

O. Kulkarni; Kathrin LaFaver; D. Tarsy

doi:10.1016/j.parkreldis.2013.04.013

The "floating door sign" in Parkinson's disease

O. Kulkarni, Kathrin LaFaver, D. Tarsy^*

^*Corresponding author for this work

Neurology

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

Individuals with Parkinson's disease (PD) display micrographia. We report a new method to elicit micrographic drawing in individuals with PD and compare this to drawing in individuals with essential tremor (ET). We asked 81 individuals with PD and 19 individuals with ET to draw a house and write a sentence. We examined house height and whether vertical lines of the door connected to the house floor. If both vertical door lines failed to reach the floor by more than 1mm we designated this a "floating door sign". House height of <5cm and letter height of <5mm were considered micrographic drawing and writing. 45 of 81 PD patients displayed a "floating door sign" compared with only 4 of 19 ET patients (p=0.0103). 24 of 81 PD patients compared with 1 of 19 ET patients had micrographic writing (p=0.0224). 60 of 81 PD patients compared with 9 of 19 ET patients had micrographic drawing (p=0.00526). The "floating door sign" correlated with micrographic writing (p=0.0275) but not micrographic drawing. The "floating door sign" had a positive predictive value for PD but not ET. We believe it correlates with hypometeric hand movements which cause inadequate stroke size, a phenomenon described in PD.

Original language	English (US)
Pages (from-to)	825-826
Number of pages	2
Journal	Parkinsonism and Related Disorders
Volume	19
Issue number	9
DOIs	https://doi.org/10.1016/j.parkreldis.2013.04.013
State	Published - Sep 2013

Funding

Full financial disclosure for previous 12 months: O. Kulkarni: Nothing to report; K. LaFaver: Nothing to report. D. Tarsy has received research grant support from Phytopharm PLC and Michael J. Fox, patient education grants from Allergan , UCB , Teva , and Ipsen , unrestricted grants for fellowship support from Allergan and Teva, personal compensation as a consultant for Neurocrine Biosciences, Genzyme, Best Doctors, and Advance Medical, royalties from UpToDate and Springer, foundation support from National Parkinson Foundation, and honoraria from the Movement Disorders Society.

Keywords

Essential tremor
Figuredrawing
Floating door
Micrographia
Parkinson's disease
Visuospatial skills

ASJC Scopus subject areas

Geriatrics and Gerontology
Clinical Neurology
Neurology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.parkreldis.2013.04.013

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title = "The {"}floating door sign{"} in Parkinson's disease",

abstract = "Individuals with Parkinson's disease (PD) display micrographia. We report a new method to elicit micrographic drawing in individuals with PD and compare this to drawing in individuals with essential tremor (ET). We asked 81 individuals with PD and 19 individuals with ET to draw a house and write a sentence. We examined house height and whether vertical lines of the door connected to the house floor. If both vertical door lines failed to reach the floor by more than 1mm we designated this a {"}floating door sign{"}. House height of <5cm and letter height of <5mm were considered micrographic drawing and writing. 45 of 81 PD patients displayed a {"}floating door sign{"} compared with only 4 of 19 ET patients (p=0.0103). 24 of 81 PD patients compared with 1 of 19 ET patients had micrographic writing (p=0.0224). 60 of 81 PD patients compared with 9 of 19 ET patients had micrographic drawing (p=0.00526). The {"}floating door sign{"} correlated with micrographic writing (p=0.0275) but not micrographic drawing. The {"}floating door sign{"} had a positive predictive value for PD but not ET. We believe it correlates with hypometeric hand movements which cause inadequate stroke size, a phenomenon described in PD.",

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author = "O. Kulkarni and Kathrin LaFaver and D. Tarsy",

note = "Funding Information: Full financial disclosure for previous 12 months: O. Kulkarni: Nothing to report; K. LaFaver: Nothing to report. D. Tarsy has received research grant support from Phytopharm PLC and Michael J. Fox, patient education grants from Allergan , UCB , Teva , and Ipsen , unrestricted grants for fellowship support from Allergan and Teva, personal compensation as a consultant for Neurocrine Biosciences, Genzyme, Best Doctors, and Advance Medical, royalties from UpToDate and Springer, foundation support from National Parkinson Foundation, and honoraria from the Movement Disorders Society.",

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N1 - Funding Information: Full financial disclosure for previous 12 months: O. Kulkarni: Nothing to report; K. LaFaver: Nothing to report. D. Tarsy has received research grant support from Phytopharm PLC and Michael J. Fox, patient education grants from Allergan , UCB , Teva , and Ipsen , unrestricted grants for fellowship support from Allergan and Teva, personal compensation as a consultant for Neurocrine Biosciences, Genzyme, Best Doctors, and Advance Medical, royalties from UpToDate and Springer, foundation support from National Parkinson Foundation, and honoraria from the Movement Disorders Society.

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AB - Individuals with Parkinson's disease (PD) display micrographia. We report a new method to elicit micrographic drawing in individuals with PD and compare this to drawing in individuals with essential tremor (ET). We asked 81 individuals with PD and 19 individuals with ET to draw a house and write a sentence. We examined house height and whether vertical lines of the door connected to the house floor. If both vertical door lines failed to reach the floor by more than 1mm we designated this a "floating door sign". House height of <5cm and letter height of <5mm were considered micrographic drawing and writing. 45 of 81 PD patients displayed a "floating door sign" compared with only 4 of 19 ET patients (p=0.0103). 24 of 81 PD patients compared with 1 of 19 ET patients had micrographic writing (p=0.0224). 60 of 81 PD patients compared with 9 of 19 ET patients had micrographic drawing (p=0.00526). The "floating door sign" correlated with micrographic writing (p=0.0275) but not micrographic drawing. The "floating door sign" had a positive predictive value for PD but not ET. We believe it correlates with hypometeric hand movements which cause inadequate stroke size, a phenomenon described in PD.

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The "floating door sign" in Parkinson's disease

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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