Abstract

The BRAIN test is computer software formerly run by MS-DOS, based on the alternate finger tap test and which correlates with the motor UPDRS. We have produced a new online BRAIN test, written in JavaScript, that can be self-administered. Users alternately tap two keys, 15 cm apart on a standard computer keyboard, as fast and accurately as possible, for 60 s. 19 PD patients (UK Brain Bank Criteria) from the PD Clinic at the Royal London Hospital consented to take part in this validation study. Patients followed on-screen instructions and were not assisted. Both hands were tested for each patient (total tests =38). Patients were examined according to the motor section of the UPDRS. Full ethical approval was granted. Statistics were performed in GraphPad Prism V5 for Windows. Four variables are reported: kinesia score (KS)—number of alternating key-taps in 60 s; akinesia time (AT)—mean dwell time on each key in ms; dysmetria score (DS)—weighted index using the number of incorrectly hit keys corrected for speed; arrhythmia score (AS)—variance of the time interval between keystrokes. Our preliminary results give the following means for PD patients: KS 91.6 taps, AT 169 ms, DS 2.88 and AS 4.45. Using two-tailed Pearson's tests and linear regression on the these data, significant correlations are seen between UPDRS and KS, and component UPDRS scores and KS (see figures). These correlations are comparable to those seen with the previous, observed version of the BRAIN test. The BRAIN test is a quick and now widely available objective test of upper limb movement, making it an attractive option for use in the outpatient's clinic and in clinical drugs trials.