Exploring Asymmetric Fine Motor Impairment Trends in Early Parkinson's Disease via Keystroke Typing

Background: The nQiMechPD algorithm transforms natural typing data into a numerical index that characterizes motor impairment in people with Parkinson's Disease (PwPD). Objectives: Use nQiMechPD to compare asymmetrical progression of PD-related impairment in dominant (D-PD) versus non-dominant side onset (ND-PD) de-novo patients.Methods: Keystroke data were collected from 53 right-handed participants (15 D-PD, 13 ND-PD, 25 controls). We apply linear mixed effects modeling to evaluate participants' right, left, and both hands nQiMechPD relative change by group.Results: The 6-month nQiMechPD trajectories of right (**P = 0.002) and both (*P = 0.043) hands showed a significant difference in nQiMechPD trends between D-PD and ND-PD participants. Left side trends were not significantly different between these two groups (P = 0.328).Conclusions: Significant differences between D-PD and ND-PD groups were observed, likely driven by contrasting dominant hand trends. Our findings suggest disease onset side may influence motor impairment progression, medication response, and functional outcomes in PwPD.