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PubMed2000

Selective uppercase dysgraphia with loss of visual imagery of letter forms: a window on the organization of graphomotor patterns.

We report a patient who, after a left parieto-occipital lesion, showed alexia and selective dysgraphia for uppercase letters. He showed preserved oral spelling, associated with handwriting impairment in all written production; spontaneous writing, writing to dictation, real words, pseudowords, and single letters were affected. The great majority of errors were well-formed letter substitutions: most of them were located on the first position of each word, which the patient always wrote in uppercase (as he used to do before his illness). The patient also showed a complete inability to access the visual representation of letters. As demonstrated by a stroke segmentation analysis, letter substitutions followed a rule of graphomotor similarity. We propose that the patient's impairment was at the stage where selection of the specific graphomotor pattern for each letter is made and that the apparent selective disruption of capital case was due to a greater stroke similarity among letters belonging to the same case. We conclude that a visual format is necessary neither for spelling nor for handwriting.

Aged↗
PubMed1985

Early unwanted effects of fluphenazine esters related to plasma fluphenazine concentrations in schizophrenic patients.

Seven outpatients already receiving neuroleptic drugs by depot intramuscular injections were treated in two consecutive 3-week periods with 25 mg fluphenazine doses as enanthate and decanoate esters in a double-blind crossover study. They were assessed for incidence of akinesia, involuntary movement, autonomic disturbances and drowsiness, using a rating scale, and their blood pressures and pulse rates were recorded. Blood was collected for plasma fluphenazine and plasma prolactin assay. Additionally, a handwriting test was applied. A higher incidence of unwanted drug effects occurred when plasma fluphenazine concentrations were maximal, but this was not so with prolactin concentrations. No significant blood pressure changes occurred. Small increases in pulse rate and decreases in handwriting length occurred, but these changes were not associated with high fluphenazine levels.

Adult↗
PubMed1989

Left non-dominant hand mirror writing.

A 38-year-old right-handed woman, who had suffered a left cerebral hemisphere infarction, was studied. She developed right hemiparesis, motor and sensory aphasia, and left hand mirror writing. All possible brain mechanisms involved in writing, either perceptual or motor, were investigated in search of the one responsible for her mirror writing; however, no abnormality was detected. On examination of the left handwriting, in the directionality of writing tracings as related to the body midline, we detected a lack of inversion of the right handwriting motor patterns--at the moment they are transmitted from the left to the right cerebral hemisphere--implicating a motor rather than a perceptual mechanism.

Adult↗
PubMedDate not supplied

Training neural networks with heterogeneous data.

Data pruning and ordered training are two methods and the results of a small theory that attempts to formalize neural network training with heterogeneous data. Data pruning is a simple process that attempts to remove noisy data. Ordered training is a more complex method that partitions the data into a number of categories and assigns training times to those assuming that data size and training time have a polynomial relation. Both methods derive from a set of premises that form the 'axiomatic' basis of our theory. Both methods have been applied to a time-delay neural network-which is one of the main learners in Microsoft's Tablet PC handwriting recognition system. Their effect is presented in this paper along with a rough estimate of their effect on the overall multi-learner system. The handwriting data and the chosen language are Italian.

Algorithms↗
PubMed1988

Correlates of the dichotic right-ear effect.

A total of 302 subjects were tested on a verbal dichotic listening task and a variety of measures related to lateralization, including familial sinistrality, sighting eye dominance, handwriting position, and arm folding behavior. The majority of these subjects were more accurate on the right ear in the dichotic testing, and this right-ear advantage (REA) was correlated with handedness. handwriting position, arm folding, and familial sinistrality (FS), considered in isolation, were not able to improve the prediction of the REA. There was, however, a significant effect of sighting eye, and in interaction between handedness, sighting eye and FS. Left-eyes subjects, regardless of handedness, showed weaker REAs than right-eyed subjects. This effect was most obvious in FS--right-handers and in FS+ left-handers. These data suggest that knowledge of sighting eye dominance may assist in the prediction of cerebral lateralization of language functions.

Analysis of Variance↗
PubMed2002

[Wilson's disease. Clinical presentation, treatment and evolution in 21 cases].

PURPOSE: Wilson's disease is characterized by neuropsychiatric symptoms with frequent extrapyramidal and intellectual presentations. They have an insidious evolution that leads to a late diagnosis and less therapeutic effectiveness in the advanced forms. METHODS: We report 21 cases of Wilson's disease with neurological complications, emphasizing clinical semiology, diagnostic means and problems of the therapeutics in our country. RESULTS: The average age at the beginning of the disease was 17.6 years, with a female prevalence (8/13). The signs at first were mostly all neurological (71.4%), then psychiatric (19%) or hepatic (19%). The most common neurological signs were dystonia of members (81%), dysarthria (76%), tremors (76%) or disorders of motoricity (71.4%). Sometimes there were sialorrhea or disorders of the handwriting. The Kayser-Fleischer ring was present in 19 patients. Eighteen patients had clinical and/or biological hepatic involvement. The diagnosis was confirmed by biochemical examinations, which found a low rate of copper in blood, a sinking rate of ceruloplasmin and a very high rate of urinary copper. The cerebral computer tomography shows a cortical and/or subcortical atrophy (37%), and/or a low density of the central grey cores (35%). The treatment was based on D-penicillamine and/or zinc sulfate, according to the availability of the drugs. The evolution was favourable among 18 patients (85%) and not good in 42.8% of the cases. Six of the first patients had poor evolution after many years of follow-up. Finally, only 12 patients (57%) had a very good outcome. The family investigation made among 17 patients revealed 13 family cases. The only predictive factor of a poor evolution was the therapeutic noncompliance (P = 0.006). CONCLUSIONS: The neurological presentations are traditional during the Wilson's disease, but are often ignored. We must suspect the disease in children when faced with disorders of handwriting or school failures and in the adult, when faced with neurological symptoms in a patient having a hepatic disease. We must not hesitate to consider it even given purely psychiatric signs, and we had better know to seek the neurological ones.

Adolescent↗
PubMedDate not supplied

Investigating forensic document examiners' skill relating to opinions on photocopied signatures.

Many forensic document examiners are hesitant to express authorship opinions on photocopied handwriting as the photocopying process results in less feature information than original writing. This study aimed to test the accuracy of 15 examiners' opinions regarding whether photocopied questioned signatures were genuine or simulated. Each examiner received the same set of original signature exemplars, from one individual, and a set of eighty questioned photocopied signatures comprising of genuine and simulated signatures. The overall misleading (error) rate for the grouped examiners' opinions was 0.9% providing strong evidence that examiners can make accurate observations regarding the authorship of non-original handwriting.

Journal Article↗
PubMedDate not supplied

Mass data massage: an automated data processing system used for NHEXAS, Arizona. National Human Exposure Assessment Survey.

Data entry and management are critical components of all large survey projects; data quality objectives must be met and data must be quickly and readily accessible. We developed a comprehensive system for data entry and management utilizing scannable forms with bubble fields and handwriting recognition. This 'Mass Data Massage' (MDM) system had three components: (1) form creation and database definition; (2) programming of data dictionaries for documentation and preliminary logic and range checks; and (3) data entry, management and documentation using the 'Mass Data Cleaning Program' (MDCP). Scannable forms were written in Teleform, where the data field definition, variable names and ranges were defined as the form was created. Completed forms were returned from the field, subjected to final field quality control (QC) checks, and transferred to the data management section. They were batched and coded as necessary. Once a batch of data was scanned and visually verified, the operator called up the menu for the MDCP. The MDCP had 31 program modules with 500-1200 lines of code each. The operator could select and run the appropriate dictionary on each data batch 'correcting' apparent errors in responses. This process was iterative until the data batch passed all dictionary checks. Proposed 'changes' were forwarded to the data coordinator (DC) for acceptance or rejection. After all errors had been resolved, each data batch was subjected to a 10% quality assurance (QA) check. The original data batch and associated file of applied changes were archived. Time expenditure using the scanning approach varied with the number of questions and the types of responses (handwritten or bubble fields). One-page forms took 42-60% of the time needed for hand entry; forms longer than 10 pages took 35-38% of the time. Use of faster machines will further speed the process. The main advantage of the system was the reduction of systematic errors. Scanning alone reduced errors found on 995 NHEXAS Baseline Questionnaires. Overall, the dictionary identified 0.55% errors on the scanned forms. Ten percent QC checks, performed on corrected batches ready for appendage to the master database, revealed an overall error rate of 0.02%. Similar checks on a laboratory form scanned from numeric handwriting detected 0.3% errors following dictionary application and 0.2% errors during the 10% QA check. This system was faster, more accurate, and more cost-effective than hand entry of data. A batch of data that took >1 week to process using the hand entry method was processed within 1 day using MDM. Human coding of specific answers and the final verification were the most time-consuming processes.

Arizona↗
PubMed1988

[Hemianopsia and agnosia].

Hemianopsia and agnosia, the coexistence of a disorder of perception and a disorder of recognition, is exemplified by two patients chosen for their clinical similarity. These two patients each had a stroke, one of the left and the other of the right posterior cerebral artery, resulting right and left hemianopsia respectively. Primary visual functions such as visual acuity and contrast sensitivity were intact. The differences were only apparent as regards the severity of the agnostic disorders. The patient with the lesion on the left failed to recognize stylized drawings, was alexic, could not lipread and was color anomic, but could easily identify handwriting, faces, and voices. The patient with the right posterior lesion could not recognize handwriting, was prosopagnosic and topographagnosic, but had no difficulty in reading, lipreading, or in recognizing stylized drawings. The apparent double dissociation of function demonstrates the presence of two different visual processing mechanisms which are very probably peculiar to the visual system of the left hemisphere in the one case and to that of the right hemisphere in the other. The authors' findings suggest that the two cerebral hemispheres differ fundamentally in the way they process visual information.

Agnosia↗
PubMed1981

[Assessment of the course of chronic hepatic encephalopathy. Comparison of various measurements with special reference to the trail-making test].

In eight patients with hepatic cirrhosis and chronic hepatic encephalopathy stage I and II the following measurements were performed in parallel on 58 occasions over eight months: number connection test, time-linked orientation, presence of liver flap, arithmetical test, handwriting sample, electroencephalogram, and venous blood ammonia level. The number connection test correlated significantly with all other parameters apart from the ammonia level. The number connection test had the highest correlation coefficient. The electroencephalogram showed a significant but only weak correlation with each of the other parameters. Results of the arithmetical test, time-linked orientation and handwriting correlated significantly with each other and with the other tests with the exception of the ammonia level. In contrast to the EEG multiple linear correlation of all parameters allowed accurate prediction of the early stage of chronic hepatic encephalopathy if the number of connection test is taken as the measure of the stage. The number of connection test is easy to perform and shows accurate reproducibility. It gives a value as to the severity of onsetting chronic hepatic encephalopathy which is independent of the tester.

Aged↗
PubMed2003

Reduced writing and reading speed and age-related changes in verbal fluency tasks.

The present study examined the influence of age-related decline in psychomotor speed on verbal fluency tasks. Reading speed, handwriting speed, written fluency, oral fluency, vocabulary, and years of formal education were measured in a sample of healthy volunteers (N=101) ranging in age from 20 to 88 years. Multiple regression analyses revealed that reading and handwriting speed strongly predicted verbal fluency performance. These measures, together with vocabulary skills and mental status, were significant predictors of performance on the fluency tasks. Present results suggest that decrement in verbal fluency performance in the aged may, at least partially, be due to reduced psychomotor speed rather than to decline in linguistic or cognitive functions.

Adult↗
PubMed1978

Effects of sleep deprivation on short duration performance measures compared to the Wilkinson auditory vigilance task.

The effects of one night's total sleep deprivation were examined using the Wilkinson vigilance task and four 10 min duration performance tests. A repeated measures design was used in which eight male subjects experienced one night of sleep loss, the order of sleep loss being balanced across subjects. The four short duration performance tests consisted of choice reaction time, simple reaction time, short-term memory, and a motor task, handwriting. The results confirm the effects of one night's sleep deprivation on the vigilance task and also show that performance on the two reaction time tests was significantly impaired by the loss of sleep, but not at such a high level as for the vigilance. The short-term memory test failed to show any adverse effects of sleep loss and similarly for the handwriting. The experiment shows that two portable and brief (10 min) performance tests are sensitive indices of sleep loss and should be particularly useful for assessing levels of alertness in the field.

Adult↗
PubMed2006

Effective treatment of manganese-induced occupational Parkinsonism with p-aminosalicylic acid: a case of 17-year follow-up study.

OBJECTIVE: Chronic manganese (Mn) intoxication induces syndromes resembling Parkinson disease. The clinical intervention has largely been unsuccessful. We report a 17-year follow-up study of effective treatment of occupational Mn parkinsonism with sodium para-aminosalicylic acid (PAS). METHODS: The patient, female and aged 50 at the time of treatment, was exposed to airborne Mn for 21 years (1963-1984). The patient had palpitations, hand tremor, lower limb myalgia, hypermyotonia, and a distinct festinating gait. She received 6 g PAS per day through an intravenous drip infusion for 4 days and rested for 3 days as one therapeutic course. Fifteen such courses were carried out between March and June 1987. RESULTS: At the end of PAS treatment, her symptoms were significantly alleviated, and handwriting recovered to normal. Recent follow-up examination at age 67 years (in 2004) showed a general normal presentation in clinical, neurologic, brain magnetic resonance imaging, and handwriting examinations with a minor yet passable gait. CONCLUSIONS: This case study suggests that PAS appears to be an effective drug for treatment of severe chronic Mn poisoning with a promising prognosis.

Aminosalicylic Acid↗
PubMed2001

Clinical description of children with developmental coordination disorder.

Occupational therapists working within School Health Support Services are receiving increasing numbers of referrals, relative to past rates, for children who are experiencing motor problems and may have developmental coordination disorder. Based upon clinical experience, therapists indicate that these children are typically referred in the early school years and that most have handwriting difficulties; to date, however, there has been little empirical evidence to support these observations. In this paper, descriptive information is presented for 556 children who may be presumed to have developmental coordination disorder and who had been referred to school-based health services in two centres. Typical reasons for referral, co-morbidity information, and assessment practices are presented. Findings confirmed the presence of many occupational performance issues in this population, including handwriting difficulties, and challenge therapists to broaden the current scope of school health assessment and intervention practices.

Adolescent↗
PubMed1986

Disability in essential tremor: effect of treatment.

We studied 18 patients with essential tremor for difficulty with handwriting, drinking, eating, fine manipulations, and embarrassment. Propranolol and primidone reduced the amplitude of both postural and kinetic tremor. Handwriting, drinking, and eating were improved with therapy, but fine manipulations and motor performance on tapping and pegboard tests were unaltered. Embarrassment remained unchanged. Essential tremor is not a benign condition; disability can be only partly reversed with drug therapy.

Aged↗
PubMedDate not supplied

Interaction of chlorpromazine and nortriptyline in patients with schizophrenia.

Seven male inpatients suffering from acute schizophrenia were treated with chlorpromazine elixir 100mg 8-hourly for 9 weeks. Nortriptyline 50mg 8-hourly was added during weeks 4, 5 and 6. Plasma chlorpromazine concentrations, antipyrine plasma half-life, blood pressure, pulse rate, pupil size, salivation, handwriting and clinical state were measured at weekly intervals. Plasma chlorpromazine concentrations rose when nortriptyline was added, and the antipyrine plasma half-life was prolonged. Blood pressure dropped on institution of chlorpromazine and dropped further with the addition of nortriptyline. The pulse rate rose in a parallel fashion. Pupil size, salivation and handwriting were diminished by chlorpromazine, but hardly affected further by nortriptyline. The addition of nortriptyline dramatically reversed the therapeutic actions of chlorpromazine, mainly through pharmacodynamic interaction. It is concluded that this combination is potentially deleterious, and must be used with care.

Adult↗
PubMed2002

Concurrent activation of high- and low-level production processes in written composition.

Writing a text requires the coordination of multiple high-level composition processes in working memory, including planning, language generation, and reviewing, in addition to low-level motor transcription. Here, interference in reaction time (RT) for detecting auditory probes was used to measure the attentional demands of (1) copying in longhand a prepared text (transcription), (2) composing a text and pausing handwriting for longer than 250 msec (composition), and (3) composing and currently handwriting (transcription + composition). Greater interference in the transcription + composition condition than in the transcription condition implies that high-level processes are activated concurrently with motor execution, resulting in higher attentional demands. This difference was observed for adults who wrote in standard cursive, but not for children and not for adults who used an unpracticed uppercase script. Greater interference in the composition condition than in the transcription condition implies that high-level processes demand more attention than do motor processes. This difference was observed only when adults wrote with a practiced script. With motor execution being relatively automatic, adults were able to attend fully to the high-level processes required in mature, effective composition. One reason that children fail to engage in such high-level processes is that motor processes deplete available attention.

Child↗
PubMedDate not supplied

Prediction of school performance using the Miller Assessment for Preschoolers (MAP): a validity study.

OBJECTIVE: The purpose of this study was to examine the ability of the Miller Assessment for Preschoolers (MAP) to predict academic performance of Israeli preschoolers after a period of 5 to 7 years. METHOD: Thirty children who were classified according to the MAP as preschoolers at risk (n= 15) and not at risk (n= 15) for pre-academic problems were tracked after 5 to 7 years. Follow-up evaluations were done on motor, visual-motor integrative, and cognitive performance components; reading and handwriting academic performance areas; and a variety of measures taken to establish overall school functional status. RESULTS: Results indicate that children classified by the MAP as preschoolers at risk performed significantly worse 5 to 7 years later on visual-motor, cognitive, and reading and handwriting tests than those preschoolers classified not at risk and demonstrated reduced overall school functional status. CONCLUSION: The findings indicate that the MAP can predict academic performance even over a 5-year to 7-year interval. Furthermore, by linking academic performance data to performance components of children in different cultures, our investigation contributes to the overall understanding of children's functioning.

Child↗