Digitized Spiral Drawing Metrics in Patients with Subcortical Vascular Cognitive Impairment (Preprint)

BACKGROUND Damage to subcortical structures and prefrontal-cortical circuits can affect motor skills along with cognitive abilities. OBJECTIVE In this study, we identified the kinematic indicators, pen pressure, speed, and deviation (degree of deviation from the target line), which can be observed in drawing performance in patients with subcortical vascular cognitive impairment (SVCI). METHODS A total of 24 patients with SVCI (16 patients with subcortical vascular mild cognitive impairment and 8 patients with subcortical vascular dementia) and 26 healthy adults (HC) were subjected to digitized drawing along straight lines and spiral drawing (drawing along spiral lines, free spiral drawing). RESULTS First, in the drawing along straight lines, the SVCI group showed a greater deviation than the HC group. Second, in the drawing along spiral lines and free spiral drawing tasks, the SVCI group showed greater pen pressure and deviation than the HC group. Third, in the free spiral drawing task, the deviation of the SVCI group increased as the wheels of the spiral increased. CONCLUSIONS The SVCI group showed greater pressure to hold and press pencils during drawing compared to HC due to damage to cognitive and motor skills, and deviated from the provided target line. These results may be due to complex cognitive-motor deficits, motor patterns (tremor), or impaired motor termination and conversion following damage to the frontal-subcortical circuit. These indices may contribute to the early diagnosis of SVCI.