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Micrographia and related deficits in Parkinson's disease: a cross-sectional study
Wagle Shukla A, Ounpraseuth S, Okun MS, Gray V, Schwankhaus J, Metzer WS.. BMJ open, 2012-06-25
Topic: Brain proteins, microglia and lab models
Objectives To determine the prevalence and clinical features associated with micrographia in Parkinson's Disease (PD). Setting This study was conducted at a Movement Disorders clinic located in a Veteran Administration Hospital. Participants PD subjects were included only if they satisfied UK Parkinson's Disease Society criteria for diagnosis. Subjects with history of severe tremors, dystonia, dyskinesia, strokes, peripheral neuropathy and dementia were excluded. Design This was a case-control study where PD subjects were prospectively enrolled and their demographics, Hoehn & Yahr stage, Unified Parkinson's Disease Rating Scale and Mini Mental Status examination (MMSE) scores were recorded. All subjects were specifically asked for micrographia on history and the handwritings were quantitatively documented. Bradykinesia was determined by history and quantified by a finger tap, Purdue pegboard and a timed walk test. Similarly, hypophonia was determined by history and the volume of speech quantified using a decibel meter. Controls were enrolled for validation of handwriting test scores and decibel meter recordings. Primary outcome measures Prevalence of micrographia in the PD cohort and the clinical factors that correlate with micrographia. Results 68 subjects with PD were enrolled (68 men; mean age 72.3 years). Micrographia was identified in 63.2% of the cohort on verbal history and in 50% of the cohort when the handwriting test was used for ascertainment. Micrographia ascertained on history correlated significantly with disease severity (Hoehn & Yahr stage), motor impairment (Unified Parkinson's Disease Rating Scale), cognitive impairment (MMSE) and both bradykinesia and hypophonia determined by history and quantitative testing. Micrographia on handwriting test correlated with age (p=0.02), MMSE testing (p=0.04), hypophonia by history (p=0.01) and bradykinesia by quantitative testing (p=0.04). Conclusion Micrographia was found in nearly half of the PD cohort. Disease severity and impaired cognition were important clinical correlates. Micrographia had a significant relationship with bradykinesia and hypophonia, suggesting a possible overlap in their pathophysiology.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Wagle Shukla, A., Ounpraseuth, S., Okun, M. S., Gray, V., Schwankhaus, J., & Metzer, W. S. (2012). Micrographia and related deficits in Parkinson's disease: a cross-sectional study. BMJ open. https://doi.org/10.1136/bmjopen-2011-000628
Vancouver
Wagle Shukla A, Ounpraseuth S, Okun MS, Gray V, Schwankhaus J, Metzer WS. Micrographia and related deficits in Parkinson's disease: a cross-sectional study. BMJ open. 2012. doi:10.1136/bmjopen-2011-000628. PMID: 22734114.
BibTeX
@article{wagleshukla2012-22734114,
author = {Wagle Shukla, A. and Ounpraseuth, S. and Okun, M. S. and Gray, V. and Schwankhaus, J. and Metzer, W. S.},
title = {{Micrographia and related deficits in Parkinson's disease: a cross-sectional study}},
journal = {BMJ open},
year = {2012},
doi = {10.1136/bmjopen-2011-000628},
pmid = {22734114},
url = {https://doi.org/10.1136/bmjopen-2011-000628}
}
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Key findings
- Objectives To determine the prevalence and clinical features associated with micrographia in Parkinson's Disease (PD).
- Results 68 subjects with PD were enrolled (68 men; mean age 72.3 years).
- Micrographia ascertained on history correlated significantly with disease severity (Hoehn & Yahr stage), motor impairment (Unified Parkinson's Disease Rating Scale), cognitive impairment (MMSE) and both bradykinesia and hypophonia determined by history and quantitative testing.
- Micrographia had a significant relationship with bradykinesia and hypophonia, suggesting a possible overlap in their pathophysiology.
Why it matters
In 68 men with Parkinson's disease, micrographia was identified in 63.2% and correlated significantly with disease severity, motor impairment, cognitive impairment, bradykinesia and hypophonia. This case-control study describes a clinical feature and does not test treating, curing or preventing Alzheimer's disease.
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Study details
- Study designcase-control study
- Participants68
- Effect size63.2%
- Evidence strengthModerate
How this study scored 55/100
Published in a peer-reviewed journal, and it is a case-control study. Scored zero for randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMJ open) |
| Journal's citation record | 2 / 4 | BMJ Open: journal h-index 240 (OpenAlex, 2026-10-29) |
| Study design | 6 / 12 | A case-control study |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2012 — within 20 year(s) of the newest study here |
| Sample size | 1 / 4 | 68 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 112 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 7.0 citations a year over 16 year(s) since 2012 |
| Impact for its field and year | 3 / 6 | Cited 4.1× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 2 / 4 | Cited 21 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author W. Steven Metzer: h-index 10 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Florida: institution h-index 1,303 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 22734114) |
| Free to read | 2 / 2 | Free to read |
| Total | 55 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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