{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:48:29Z","timestamp":1790113709553,"version":"4.0.1"},"reference-count":39,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T00:00:00Z","timestamp":1582761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Hallym University Research Fund","award":["HRF-201902-015"],"award-info":[{"award-number":["HRF-201902-015"]}]},{"name":"the Brain Research Program of the National Research Foundation of Korea","award":["2017M3A9F1030063"],"award-info":[{"award-number":["2017M3A9F1030063"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>We implemented a mobile phone application of the pentagon drawing test (PDT), called mPDT, with a novel, automatic, and qualitative scoring method for the application based on U-Net (a convolutional network for biomedical image segmentation) coupled with mobile sensor data obtained with the mPDT. For the scoring protocol, the U-Net was trained with 199 PDT hand-drawn images of 512 \u00d7 512 resolution obtained via the mPDT in order to generate a trained model, Deep5, for segmenting a drawn right or left pentagon. The U-Net was also trained with 199 images of 512 \u00d7 512 resolution to attain the trained model, DeepLock, for segmenting an interlocking figure. Here, the epochs were iterated until the accuracy was greater than 98% and saturated. The mobile senor data primarily consisted of x and y coordinates, timestamps, and touch-events of all the samples with a 20 ms sampling period. The velocities were then calculated using the primary sensor data. With Deep5, DeepLock, and the sensor data, four parameters were extracted. These included the number of angles (0\u20134 points), distance\/intersection between the two drawn figures (0\u20134 points), closure\/opening of the drawn figure contours (0\u20132 points), and tremors detected (0\u20131 points). The parameters gave a scaling of 11 points in total. The performance evaluation for the mPDT included 230 images from subjects and their associated sensor data. The results of the performance test indicated, respectively, a sensitivity, specificity, accuracy, and precision of 97.53%, 92.62%, 94.35%, and 87.78% for the number of angles parameter; 93.10%, 97.90%, 96.09%, and 96.43% for the distance\/intersection parameter; 94.03%, 90.63%, 92.61%, and 93.33% for the closure\/opening parameter; and 100.00%, 100.00%, 100.00%, and 100.00% for the detected tremor parameter. These results suggest that the mPDT is very robust in differentiating dementia disease subtypes and is able to contribute to clinical practice and field studies.<\/jats:p>","DOI":"10.3390\/s20051283","type":"journal-article","created":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T09:30:36Z","timestamp":1582882236000},"page":"1283","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Automatic, Qualitative Scoring of the Interlocking Pentagon Drawing Test (PDT) Based on U-Net and Mobile Sensor Data"],"prefix":"10.3390","volume":"20","author":[{"given":"Ingyu","family":"Park","sequence":"first","affiliation":[{"name":"Department of Electronic Engineering, Hallym University, Chuncheon 24252, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Joong","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Hallym University, Anyang 14068, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeo Jin","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Chuncheon Sacred Heart hospital, Hallym University College of Medicine, Chuncheon 24252, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Unjoo","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Electronic Engineering, Hallym University, Chuncheon 24252, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"Mini-mental state: A practical method for grading the cognitive state of patients for the clinician","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/s00702-016-1517-6","article-title":"MMSE and MoCA in Parkinson\u2019s disease and dementia with Lewy bodies: A multicenter 1-year follow-up study","volume":"123","author":"Biundo","year":"2016","journal-title":"J. Neural Transm."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"B\u0142aszczyk, J.W. (2016). Parkinson\u2019s Disease and Neurodegeneration: GABA-Collapse Hypothesis. Front. Neurosci., 10.","DOI":"10.3389\/fnins.2016.00269"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1002\/mds.21956","article-title":"The Sydney Multicenter Study of Parkinson\u2019s Disease: The Inevitability of Dementia at 20 years","volume":"23","author":"Hely","year":"2008","journal-title":"Mov. Disord."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1155\/2013\/728158","article-title":"The qualitative scoring MMSE pentagon test (QSPT): A new method for differentiating dementia with Lewy Body from Alzheimer\u2019s Disease","volume":"27","author":"Caffarraa","year":"2013","journal-title":"Behav. Neurol."},{"key":"ref_6","first-page":"21","article-title":"Pentagon Drawing Test: Some data from Alzheimer\u2019s disease, Paraphrenia and Obsessive compulsive disorder in elderly patients","volume":"13","author":"Cecato","year":"2016","journal-title":"Perspect. Psicol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1136\/jnnp.70.4.483","article-title":"Pentagon copying is more impaired in dementia with Lewy bodies than in Alzheimer\u2019s disease","volume":"70","author":"Ala","year":"2001","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_8","first-page":"314","article-title":"The modified Mini-Mental State (3-MS) Examination","volume":"48","author":"Teng","year":"1987","journal-title":"J. Clin. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1590\/1980-57642018dn12-010008","article-title":"Performance of the Pentagon Drawing test for the screening of older adults with Alzheimer\u2019s dementia","volume":"12","author":"Martinelli","year":"2018","journal-title":"Dement. Neuropsychol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Lam, M.W.Y., Liu, X., Meng, H.M.L., and Tsoi, K.K.F. (2018, January 1). Drawing-Based Automatic Dementia Screening Using Gaussian Process Markov Chains. Proceedings of the 51st Hawaii International Conference on System Sciences, Hilton Waikoloa Village, HI, USA.","DOI":"10.24251\/HICSS.2018.353"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1086\/302633","article-title":"Cognitive and behavioral genetics \u201999 visuospatial construction","volume":"65","author":"Mervis","year":"1999","journal-title":"Am. J. Hum. Genet."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1001\/archneurol.2009.158","article-title":"Longitudinal study of the transition from healthy aging to Alzheimer disease","volume":"66","author":"Johnson","year":"2009","journal-title":"Arch. Neurol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1590\/S1980-57642009DN30200002","article-title":"The clock drawing test: A review of its accuracy in screening for dementia","volume":"3","author":"Aprahamian","year":"2009","journal-title":"Dement. Neuropsychol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"McGee, S. (2018). Evidence-Based Physical Diagnosis, Elsevier. [4th ed.].","DOI":"10.1016\/B978-0-323-39276-1.00001-9"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1590\/1980-57642016dn11-010003","article-title":"Scoring systems for the Clock Drawing Test, A historical review","volume":"11","author":"Spenciere","year":"2017","journal-title":"Dement. Neuropsychol"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/IJPSYM.IJPSYM_244_17","article-title":"The Clock Drawing Test versus Mini-mental Status Examination as a Screening Tool for Dementia: A Clinical Comparison","volume":"40","author":"Palsetia","year":"2018","journal-title":"Indian J. Psychol. Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"M\u00fcller, S., Preische, O., Heymann, P., Elbing, U., and Laske, C. (2017). Increased Diagnostic Accuracy of Digital vs. Conventional Clock Drawing Test for Discrimination of Patients in the Early Course of Alzheimer\u2019s Disease from Cognitively Healthy Individuals. Front. Aging Neurosci., 9.","DOI":"10.3389\/fnagi.2017.00101"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Harbi, Z., Hicks, Y., and Setchi, R. (, January September). Clock Drawing Test Interpretation System. Proceedings of the International Conference on Knowledge Based and Intelligent Information and Engineering Systems, KES2017, Marseille, France.","DOI":"10.1016\/j.procs.2017.08.259"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1007\/s10994-015-5529-5","article-title":"Learning Classification Models of Cognitive Conditions from Subtle Behaviors in the Digital Clock Drawing Test","volume":"102","author":"Davis","year":"2016","journal-title":"Mach. Learn."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3543","DOI":"10.1038\/s41598-019-40010-0","article-title":"Diagnostic value of digital clock drawing test in comparison with CERAD neuropsychological battery total score for discrimination of patients in the early course of Alzheimer\u2019s disease from healthy Individuals","volume":"9","author":"Herde","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_21","first-page":"286","article-title":"Filetest de copie d\u2019une figure complex: Contribution a l\u2019etude de la perception et de la memoire The test of copying a complex figure: A contribution to the study of perception and memory","volume":"30","author":"Osterrieth","year":"1944","journal-title":"Arch. Psychol."},{"key":"ref_22","unstructured":"Canham, R.O., Smith, S.L., and Tyrrell, A.M. (2000, January 5\u20137). Automated Scoring of a Neuropsychological Test: The Rey Osterrieth Complex Figure. Proceedings of the 26th Euromicro Conference. EUROMICRO 2000. Informatics: Inventing the Future, Maastricht, The Netherlands."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.3389\/fpsyg.2017.01629","article-title":"Visual-Constructional Ability in Individuals with Severe Obesity: Rey Complex Figure Test Accuracy and the Q-Score","volume":"8","author":"Sargenius","year":"2017","journal-title":"Front. Psychol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1093\/arclin\/acz035.04","article-title":"Automated scoring of the Rey-Osterrieth Complex Figure Test using a deep-learning algorithm","volume":"34","author":"Vogt","year":"2019","journal-title":"Arch. Clin. Neuropsychol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1002\/gps.930100811","article-title":"A comparison of clock and pentagon drawing in Alzheimer\u2019s disease","volume":"10","author":"Bourke","year":"1995","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.jcgg.2013.11.001","article-title":"Intersecting pentagon copying and clock drawing test in mild and moderate Alzheimer\u2019s disease","volume":"5","author":"Nagaratnam","year":"2014","journal-title":"J. Clin. Gerontol. Geriatr."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Fountoulakis, K.N., Siamouli, M., Panagiotidis, P.T., Magiria, S., Kantartzis, S., Terzoglou, V.A., and Oral, T. (2011). The standardised copy of pentagons test. Ann. Gen. Psychiatry.","DOI":"10.1186\/1744-859X-10-13"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"141","DOI":"10.12779\/dnd.2012.11.4.141","article-title":"Anatomical Correlates of Interlocking Pentagon Drawing","volume":"11","author":"Lee","year":"2012","journal-title":"Dement. Neurocogn. Disord."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1002\/gps.1094","article-title":"Pentagon drawing and neuropsychological performance in Dementia with Lewy Bodies, Alzheimer\u2019s disease, Parkinson\u2019s disease and Parkinson\u2019s disease with dementia","volume":"19","author":"Cormack","year":"2004","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.neuropsychologia.2019.107174","article-title":"Two distinct pathological substrates associated with MMSE-pentagons item deficit in DLB and AD","volume":"133","author":"Beretta","year":"2019","journal-title":"Neuropsychologia"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1159\/000490045","article-title":"The Pentagon Copying Test and the Clock Drawing Test as Prognostic Markers in Dementia with Lewy Bodies","volume":"45","author":"Vergouw","year":"2018","journal-title":"Dement. Geriatr. Cogn. Disord."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Navab, N., Hornegger, J., Wells, W., and Frangi, A. (2015). U-Net: Convolutional Networks for Biomedical Image Segmentation. Medical Image Computing and Computer-Assisted Intervention\u2014MICCAI 2015, Springer.","DOI":"10.1007\/978-3-319-24571-3"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1007\/s11682-016-9532-7","article-title":"Early dysfunctions of fronto-parietal praxis networks in Parkinson\u2019s disease","volume":"11","author":"Matt","year":"2017","journal-title":"Brain Imaging Behav."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Potgieser, A.R.E., van der Hoorn, A., and de Jong, B.M. (2015). Cerebral Activations Related to Writing and Drawing with Each Hand. PLoS ONE.","DOI":"10.1371\/journal.pone.0126723"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/j.1460-9568.2011.07937.x","article-title":"The anterior superior parietal lobule and its interactions with language and motor areas during writing","volume":"35","author":"Segal","year":"2012","journal-title":"Eur. J. Neurosci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/S0926-6410(02)00302-6","article-title":"Both parietal lobes are involved in drawing: A functional MRI study and implications for constructional apraxia","volume":"16","author":"Makuuchi","year":"2003","journal-title":"Cogn. Brain Res."},{"key":"ref_37","first-page":"312","article-title":"The genesis of closing-in in alzheimer disease and vascular dementia: A comparative clinical and experimental study","volume":"28","author":"Grossi","year":"2014","journal-title":"Neurophysiology"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"251","DOI":"10.17340\/jkna.2019.3.2","article-title":"New Classification of Tremors: 2018 International Parkinson and Movement Disorder Society","volume":"37","author":"Ryu","year":"2019","journal-title":"J. Korean Neurol. Assoc."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1002\/mds.22506","article-title":"Cognitive Impairment in Parkinson\u2019s Disease: Tools for Diagnosis and Assessment","volume":"24","author":"Kulisevsky","year":"2009","journal-title":"Mov. Disord."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/5\/1283\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:02:10Z","timestamp":1760173330000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/5\/1283"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,27]]},"references-count":39,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,3]]}},"alternative-id":["s20051283"],"URL":"https:\/\/doi.org\/10.3390\/s20051283","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,2,27]]}}}