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At least 1,063 records · Page 59Linked to original sources
PubMed2001

A functional MRI study on the neural substrates for writing.

Functional neuroanatomy of writing is relatively unknown compared to that of other linguistic processes. This study aimed at identifying brain regions crucial to the process of writing. Using functional magnetic resonance imaging (fMRI), brain hemodynamic activity was examined during three conditions that differentially engaged visual, linguistic, and/or motor functions: (1) writing names of pictures with the right index finger, (2) naming pictures silently, and (3) visually cued finger tapping. A writing minus naming comparison and a writing minus tapping comparison were performed, and brain regions commonly activated in these two contrasts were detected. Our main finding was that such common activation was observed in the anterior part of the left superior parietal lobule, the posterior part of the middle and superior frontal gyri, and the right cerebellum. The parietal and frontal regions were considered to subserve the process of writing as separated from that of naming and finger movements, which is consistent with the classical notion mainly proposed by studies of selective writing deficits called pure agraphia. The right cerebellar activation, on the other hand, was interpreted as the reflection of the execution of complex finger movements required for writing.

Adult↗
PubMed2002

Micrographia secondary to lenticular lesions.

Four patients with a stroke developed micrographia. In two patients, the condition was pure and in the two other patients it was associated with signs of writer's cramp. We conclude that infarct of the left lenticular nucleus could either mimic pure micrographia similar to that of Parkinson's disease or micrographia associated with dystonia.

Adult↗
PubMed2002

Cooling improves the writing performance of patients with writer's cramp.

Cooling of hand and forearm muscles by immersion in 15 degrees C cold water for 5 minutes improved the writing performance of patients with writer's cramp. Since abnormal processing of muscle spindle afferent discharges contributes to the pathology of writer's cramp, this effect might result from a reduction in muscle spindle activity by lowering muscle temperature. Cooling is a simple, cheap, and safe procedure, providing temporary relief for patients with writer's cramp.

Adult↗
PubMed2002

Neurophysiological investigations in patients with primary writing tremor.

The pathophysiology of primary writing tremor (PWT) is still unknown: it has been classified as a focal form of essential tremor and as a tremulous form of writer's cramp. We studied cortical and spinal excitability in patients with PWT and compared the results with published data of patients with essential tremor, and writer's cramp. We used electrical stimulation of median and radial nerve to study reciprocal inhibition of forearm antagonist muscles and paired transcranial magnetic stimulation at short and long interstimulus intervals (ISIs) to assess intracortical excitability. Both studies were conducted on patients with PWT and on control subjects. The early (presynaptic) and late (disynaptic) phases of reciprocal inhibition were normal as was intracortical excitability at short and long ISIs. Our study suggests that the pathophysiology of PWT is different from that of writer's cramp and partially also from that of essential tremor.

Aged↗
PubMed2005

John Adams' essential tremor.

John Adams (1735-1826), one of the signers of the Declaration of Independence, was the second President of the United States. Adams had tremor for many years, about which little has been written. We examined John Adams' penmanship over a 62-year period and studied his correspondence and diaries. It is not clear when Adams' tremor began, although in a diary entry dated 6 December 1760, when Adams was 25 years old, there is evidence of low-amplitude kinetic tremor. The tremor continued in his written correspondence, becoming more persistent over time. Later in life, the clarity of his written correspondence diminished, with greater decomposition of characters and a reduction in the size of individual characters. This finding raises some speculation as to whether Adams could have been developing some parkinsonism, although the evidence in favor of this is not compelling. The most likely diagnosis was essential tremor.

Essential Tremor↗
PubMed2006

Comparison of motor, cognitive, and behavioral features in progressive supranuclear palsy and Parkinson's disease.

Major clinical features and global measures were systematically evaluated and compared in progressive supranuclear palsy (PSP) and Parkinson's disease (PD). In addition to gaze palsy and early postural instability in PSP, absence of levodopa-induced dyskinesia, frontalis muscle overactivity, primitive reflexes, visuospatial impairment, and substantial frontal behavioral disturbances differentiated almost all patients with this disorder from PD. For PSP, behavioral changes related to severity of general disability, thereby challenging previous models of relationships between behavior, motor, and cognitive disturbance for this disorder.

Aged↗
PubMed1986

Parkinsonism following dystonia in three patients.

Three patients who presented initially with dystonia and subsequently developed typical idiopathic parkinsonism were evaluated. One patient presented with a writer's cramp, one with axial dystonia, and one with Meige syndrome. All three displayed amelioration of their dystonia with progression of their parkinsonism over a period of 2 to 15 years. Treatment with levodopa gave some relief of the parkinsonism symptoms in two patients but exacerbated or reactivated the dystonia. It is suggested that both the dystonia and the parkinsonism represent the changing clinical expression of the same disorder at different times in its evolution.

Adult↗
PubMed1987

A single family with writer's cramp, essential tremor, and primary writing tremor.

We studied seven members of a family who had different types of movement disorders: Two had typical essential tremor, two (twins) had typical writer's cramp, one had both essential tremor and writer's cramp, one had primary writing tremor, and one (deceased) had uncharacterized tremor. This appears to be the first report of writer's cramp in twins and in so many family members. This family links together primary writing tremor, essential tremor, and writer's cramp and may help resolve the apparent controversy about the relationship of primary writing tremor to essential tremor and writer's cramp.

Adult↗
PubMed1990

Primary writing tremor. A form of focal dystonia?

Five patients exhibited severe tremor in the upper extremity, primarily when attempting to write or draw. Electromyography was performed to determine the patterns of muscle activity that were responsible for this tremor. Tremor was measured with an accelerometer and with a digitizing tablet. Two patients had postural tremor that was indistinguishable from mild, high-frequency essential tremor. All patients exhibited a severe 5-7-Hz tremor during the acts of writing and drawing. Muscles throughout the affected extremity exhibited rhythmic 5-7-Hz bursts of motor unit discharge, and the average level of motor unit activity was tonically increased in antagonistic muscles. This abnormal coactivation of antagonistic muscles produced subtle dystonic posturing of the affected limb that was overshadowed by severe tremor. Electromyography was useful in confirming the coexistence of tremor and dystonia in our patients. The nonspecificity of dystonia and postural tremor must be considered when discussing the nosology and pathophysiology of primary writing tremor.

Adult↗
PubMed1991

Is focal hand dystonia associated with psychopathology?

The purpose of this study was to determine if patients with focal hand dystonia have any significant psychopathology. We studied 20 patients with hand cramps who were participating in a therapeutic trial of botulinum toxin injections. Patients were interviewed and administered the Minnesota Multiphasic Personality Inventory (MMPI). Beck Depression Inventory, Spielberger State-Trait Anxiety Scale, a finger tapping test, and a choice serial reaction time test. Behavioral ratings were also obtained. Group statistics indicated that all personality scale scores and performances on motor tasks were within normal limits. Four out of 20 patients demonstrated mild depression. Trait anxiety scores were higher than state anxiety scores, suggesting that receiving medical treatment had a beneficial effect on mood. The number of depressive symptoms endorsed on the MMPI was correlated with reaction time speed but not finger dexterity. None of the 20 patients reported a remarkable psychiatric history. These results indicate that hand cramps are not associated with serious psychopathology.

Adult↗
PubMed1991

Writer's cramp: treatment with botulinum toxin injections.

Twelve patients with writer's cramp were treated with injections of botulinum toxin. The overactive muscles were identified by clinical observation of the subjects while they were writing. Repeated injections were given at 2-week intervals until the optimal response was obtained. Eleven patients reported some benefit, which was considered by seven to be significant. Eight of the 10 patients who had pain reported moderate to significant relief. Five patients had local complications, consisting of disabling weakness of target or neighbouring muscles. These preliminary results suggest that this treatment can be successfully applied to many patients with writer's cramp without performing complex electromyographic recordings while the patients are writing.

Adult↗