Dr. Gabriel Leonard
Dr. Leonard is putting a new twist on established technology to produce a superior device for testing motor skills in patients with neuromuscular or neurological disease. The prototype is testing well and commercial development is anticipated in 2010-2011.

Tapping, 1, 2, 3, 4.

Rapid tapping with a stylus on a metal plate is a test often used to evaluate motor speed and coordination in patients with a neurological disease such as Multiple Sclerosis. Many years ago, a research team at the MNI led by Dr. Gabriel Leonard demonstrated that rapid repetitive tapping with one hand is mainly sensitive to primary motor brain areas and the corresponding motor pathways.

The team applied more intricate tapping tasks for one and two hands that contributed much more sensitive measures of disability. This test has become widely used at the MNI and also in several large-scale studies.

“The trouble is these are still mechanical tests, and accurate reporting is difficult,” says Leonard. “The only record of performance is by the person giving the test, who has to remember and note all the incorrect sequences.”

Leonard now has addressed the need for a reliable and accurate tapping apparatus capable of creating an objective record. Working with a programmer and hardware designer, his team has built a prototype computer interface, together with software, that is less cumbersome and that accurately reports all scores.

Significant advances include:

  • It documents all errors made, including misses, perseverances, and sequential errors
  • It delivers objective scores for four subsets of test pattern using each hand and both hands, permitting wider ranging analysis
  • It will compare test scores to a representative (normal) control group
  • It will also provide mean scores for subjects with neurological illnesses, e.g. MS, epilepsy, post concussion syndrome, etc.

“It’s basically the same process that Gabriel originally used in 1988,” says research associate Dr. Joelle Crane. “But putting it on a computer creates a vastly superior tool. It’s a big advance.”

The test has many applications. Together with imaging it could provide insight to the surgeon as to the location of brain damage, or the extent of injury in an accident. It is a means of accurately measuring progress in rehabilitation or of objectively assessing effects of a specific drug or treatment.

The test can be administered by clinical assistants or a General Practitioner. It can be employed for diverse measurements such as assessing dexterity following carpal tunnel damage or determining whether the effects of aging are augmented by a brain deficiency.

Leonard believes the potential for commercialization is high and has already received interest from colleagues locally and abroad. There are no commercially available tests to measure sequencing of arm and hand movements, including out-ofphase coordinated bi-manual movements.

PROGRESS

The first year of the project has seen completion and validation of the prototype. Some 50 pilot subjects have been tested to confirm the correct operation of the tapping machine and several user-friendly internet forms have been designed (e.g., medical and handedness questionnaires).


OUTLOOK

The major task ahead is the data collection and recording the performance of healthy people. The normative study will require data from approximately 2,000 subjects ranging in age from 6 to 90, the usual number used in commercially available neuropsychology tests.

The data gathering, followed by statistical analyses, software adjustments and a published paper, will take two years to complete. Leonard hopes to announce the new tapping test in mid-year 2010 at selected international neuroscience gatherings to communicate the potential to other neuroscientists, clinicians and representatives of pharmacological companies.