Kinematic Parameters of Hand as Quantitative Markers of Disability and Cognition in Multiple Sclerosis

Neurological diseases such as multiple sclerosis (MS) frequently lead to impairments in fine motor function, highlighting the need for objective assessment methods. In this study, we developed a stereo-visual hand-tracking system that enables 3D reconstruction of the trajectories of 21 anatomical landmarks of the hand during the Nine-Hole Peg Test (NHPT). Based on the reconstructed movements, kinematic parameters were computed and clinically evaluated in a cohort of 162 patients with MS by analyzing their associations with the Expanded Disability Status Scale (EDSS) and the CogEval cognitive assessment. Higher neurological disability was most strongly associated with prolonged NHPT completion time and with altered thumb movement patterns, characterized by increased movement linearity and reduced jerkiness. With respect to cognitive status, task execution speed emerged as the key contributing factor. The proposed approach is non-invasive and cost-effective, providing a detailed insight into movement quality and representing a promising tool for the objective and scalable monitoring of motor changes in MS.