The bradykinesia akinesia incoordination test (BRAIN TEST (c)), an objective and user-friendly means to evaluate patients with parkinsonism

The BRAIN TEST(C), a computerized alternating finger tapping test, was perf ormed on 154 patients with parkinsonism to assess whether the test could be used as an objective tool to evaluate reliably the severity of Parkinson's disease (PD). Patients were instructed to tap two marked computer keyboard keys as fast and as accurately as possible for 60 seconds. The test genera tes the following variables: (1) kinesia score (KS)-number of keystrokes/mi n, (2) akinesia time (AT)-cumulative time that keys are depressed, (3) dysm etria score (DS)-a weighted score generated from incorrectly hit keys and c orrected for speed, and (4) arrhythmia score (AS)-variance of the time inte rval between individual keystrokes. Among parkinsonian patients, we found a significant correlation between the four test parameters and PD rating sco res of the Hoehn & Yahr, Schwab & England, and Unified PD Rating Scales (KS , AS, and AT p <0.001 and DS p <0.05). When compared with 73 parkinsonian p atients 73 age- and sex-matched control subjects showed significantly highe r KS and lower AT (p <0.001) as well as lower DS and AS (p = 0.05). The BRA IN TEST(C) is a reliable and practical tool for evaluating the severity of parkinsonism and for distinguishing subjects with parkinsonism from normal control subjects. A version of the BRAIN TEST(C) is available by FTP on the worldwide web (http://www.anaesthetist.com/software/brain.htm).