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PubMed1989

Performance of subgroups of left-handers and right-handers.

Fifty-three left-handers with consistent left-hand preferences (CLH), 65 left-handers with inconsistent hand preferences (ILH), and 57 right-handers (RH) were given unimanual and bimanual performance tests involving skill, speed, and strength as well as tests of articulatory speed and verbal fluency. Contrary to claims in the current literature (Ponton, 1987), CLHs and ILHs do not differ in quality and speed of performance, but, in some tests, they do show asymmetries in opposite directions. Thus, when left-handers are treated as a combined group, the faulty impression of a lack of between-hand asymmetries arises. The results suggest that a distinction between CLHs and ILHs yields subgroups with reliably different and distinctive performance patterns which are not trivially attributable to differences in strength of lateralization. CLHs behave much like mirror image RHs, whereas ILHs show a dissociation between strength, fine manual skill, attentional asymmetries.

Adult↗
PubMed2003

Neural regions essential for writing verbs.

Functional imaging data collected during cognitive tasks show which brain regions are active during those tasks, but do not necessarily indicate which regions are essential for those tasks. Here, in a study of two cases of selectively impaired written naming of verbs after focal brain ischemia, we combined imaging and behavioral testing to unambiguously identify brain regions that are crucial for a specific cognitive process. We used magnetic resonance perfusion imaging to show that the selective impairment in each case was due to hypoperfusion (low blood flow) in left posterior inferior frontal gyrus (PIFG) and precentral gyrus (PrG); the impairment was immediately reversed when blood flow was restored to these regions, indicating that parts of the left frontal lobe are crucial for representing and processing verbs.

Aged↗
PubMed1994

Plasma homovanillic acid and performance on motor and cognitive tasks in community-dwelling elderly: MacArthur studies of successful aging.

To investigate the dopaminergic correlates of the aging-related motor and cognitive deficits, the dopamine metabolite homovanillic acid (HVA) in plasma was studied in a community-dwelling elderly cohort (n = 141). The results showed that hand-signature time (HST), a measure of bradykinesia, correlated negatively with plasma HVA (r = -0.24, p < .007). Similarities task performance showed a trend-level positive correlation with plasma HVA (r = 0.15, p = .08). Because plasma HVA is derived from several sources including central dopaminergic neurons and both central and peripheral noradrenergic neurons, the noradrenergic metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) in plasma was also measured to indirectly estimate the relationships, with HVA originating from noradrenergic metabolism. Plasma MHPG significantly correlated with similarities scores (r = 0.34, p < .001) but not with HST. The results suggested that the association of HVA with prolonged HST may be related to central dopamine metabolism, but its association with similarities scores may be due to noradrenergic metabolism. The results raise the possibility that prolonged HST may be an indicator of preclinical brain dopamine loss in the elderly.

Aged↗
PubMed2006

An observational study of laterality errors in a sample of clinical records.

BACKGROUND: Confusing left with right eyes can have a potentially serious adverse outcome. The most extreme occurrence is wrong site surgery but even potentially less serious errors can undermine patient confidence in their medical care. This study was designed to look into how often this could be detected in clinical notes. METHODS: An observational study conducted in an ophthalmic hospital. Hundred patients were randomly selected and their clinical notes retrieved. Notes were analysed for the number of left/right transpositions, which part of the notes they were found and whether they were corrected. RESULTS: Forty-four transposition errors were found in 32 sets on notes. The commonest error was drawing the eye on the wrong side of the page. The commonest place where errors were found was in the written outpatient notes. Nineteen of the errors had evidence of later correction. Three consent forms had the incorrect eye denoted and one patient was listed for surgery on the wrong side although this error was corrected before the operation. CONCLUSION: As far as we are aware, this study is the first to look at how often, in standard clinical notes, left/right transposition occurs. Although a direct link cannot made between their occurrence and later wrong side surgery, intuitively it would be reasonable to think it could increase the likelihood if other defences were to fail. We make a number of recommendations that might reduce this confusion and therefore more serious consequences.

Handwriting↗
PubMed1999

Generalized freezing in Hallervorden-Spatz syndrome: case report.

We report the case of a female patient who was exhibiting slowly progressive, severe, generalized freezing of voluntary movement and disequilibrium. Brain magnetic resonance imaging showed a very low signal intensity in both pallidal nuclei, with a high signal intensity in the central portion, the so called 'eye-of-the-tiger' sign. Despite the unusual clinical features, we believe that this is a case of Hallervorden-Spatz syndrome, although without neuropathological examination we were unable to confirm the diagnosis with certainty. This case further demonstrates the complex role of the pallidum in voluntary movement.

Adult↗
PubMed2003

A case of micrographia after subcortical infarction: possible involvement of frontal lobe function.

Most reports of micrographia associated with focal brain lesions have related this finding to damage in the left basal ganglia. Here we describe the case of a 68-year-old man presenting with reversible micrographia accompanied by hypophonia in the absence of extrapyramidal signs after cerebral infarction in the left subcortical region. At the time of the patient's admission, diffusion-weighted magnetic resonance imaging sequence showed the lesion to principally involve the corona radiata, with some involvement of the putamen. Neurologically, mild right-sided brachiofacial hemiparesis and grasp reflexes - a frontal lobe sign - were observed. As his micrographia and hypophonia improved, the patient's grasp reflexes improved in parallel. In addition, recovery of regional cerebral blood flow in the left frontal lobe was confirmed by single photon emission computed tomography (technetium-99 m HMPAO). The present case suggests the possibility that the function of frontal-subcortical circuit might also be involved in the production and improvement of micrographia and that micrographia and hypophonia may share a common pathophysiology.

Aged↗
PubMed2005

Manganese-induced Parkinsonism in a patient undergoing maintenance hemodialysis.

We report a rare case of manganese (Mn)-induced parkinsonism in a patient on maintenance hemodialysis therapy who complained of gait disturbance and dysarthria. His symptoms and abnormal magnetic resonance imaging (MRI) findings of the brain were thought to be caused, at least in part, by long-term ingestion of a health supplement (Chlorella extract) that contained 1.7 mg of Mn in the usual daily dose. Elevated serum and cerebrospinal fluid Mn levels were detected, and brain MRI showed areas of abnormal intensity in the bilateral basal ganglia (low intensity on T1-weighted images and high intensity on T2-weighted images). Edetic acid infusion therapy dramatically improved the MRI abnormalities, after which his symptoms gradually improved 4 months later.

Apiaceae↗
PubMed1978

Open study with bromperidol (C-C 2489), a new neuroleptic, for the determination of the neuroleptic threshold and the neuroleptic-therapeutic range.

In an open study involving 30 schizophrenic patients the neuroleptic threshold dose (measured via Haase's graphopathological test), the maximum dose, and the maintenance dose were determined. The neuroleptic threshold dose was 5.6 mg/day (0.08 mg/kg body weight); the maximum dose was 11 mg/day (0.16 mg/kg body weight); and the maintenance dose was 6 mg/day (0.09 mg/kg body weight). With reference to the effectiveness, good to very good results were obtained in 19 cases. Regarding side effects 15 patients complained of extrapyramidal disturbances, this was to be expected in view of the study design aiming at the determination of the maximum dose level. When administered in one single dose in the evening, bromperidol influenced the night sleep positively, so that sleep-inducing drugs could be reduced, and, in some cases, even dispensed with.

Adolescent↗
PubMed1989

[Writer's cramp--focal dystonia or psychogenic movement disorder? A critical literature study].

For more than 100 years there has been a discussion as to whether writer's cramp is caused by a disease of the central nervous system, or if it is to be considered as a disturbance of psychogenic origin. Whereas before 1982 there seemed to be a lot of evidence for the psychogenic theory many authors now tend to stress the opinion of Sheehy and Marsden who had explained that "writer's cramp" should be seen as a "focal dystonia". This article discusses the statements of Sheehy and Marsden in comparison with other scientific findings regarding the occupational cramps--above all "writer's cramp". It is concluded that there are different therapeutic approaches derived from the respective theory and which are considered to lessen the movement disorder. Scientific literature suggests that psychotherapy or some therapeutic approaches of behaviour therapy are more effectful in mastering this "mysterious" disorder than any pharmacological substance tested upto now.

Dystonia↗
PubMed1988

[The difference in writing disorders in primary agraphia and congenital dyslexia and their clinical relevance].

If after a brain injury reading and writing disturbances persist, the question is: primary agraphia or writing disorders due to dyslexia? If the anamnesis cannot answer this question, a decision is possible by means of four essential differences between writing disorders on the background of primary agraphia and those associated with dyslexia: 1. Agraphic persons correct their mistakes, dyslectics do not. 2. The word formations (paragraphias) due to primary agraphia do not bear close phonetical resemblances, whereas word formations by dyslectic persons are plainly phonetical. 3. Agraphics persevere, dyslectics do not. 4. In primary agraphia, the patient will also show difficulties in writing numbers; in a dyslectic disorder, he/she will not.

Adolescent↗
PubMed1994

[Physiology, psychology and pathology of writing and spelling--an overview].

Writing and spelling are conceived as concerted actions comprising cognitive planning, motor action and an expressive content. In literate societies the individual use of alphabetic systems is acquired immediately after speech as a "cultural technique". As such these systems demand specific cognitive and motor skills which have been analysed primarily on the basis of neurological and psychiatric syndromes. We distinguish primary developmental disturbances and secondarily acquired disturbances of writing and spelling, categorizing the latter into four essential disturbance areas: linguistic command, motor execution, automatism control and dynamic tonus regulation. The clinical significance of writing and spelling is not confined to its possible disturbances. In pathologically induced restrictions of cognitive functions or of social skills the fact is rather that the written language frequently contributes to the development of individual coping strategies. From the psychodynamic aspect, written communication is characterized principally by its proximity-regulating function.

Handwriting↗
PubMedDate not supplied

[Congenital subluxation of the metacarpophalangeal joint of the thumb as the cause of writer's syndrome].

A 26-year-old male patient developed a writer's cramp syndrome, the underlying cause of which was shown to be a congenital subluxation of the first metacarpophalangeal joint. The clinical symptoms are presented, the indications for surgery reviewed and the operative technique in accordance with A.N. Witt described. Post-operatively, the pathological hypermobility of the first metacarpophalangeal joint has been eliminated, and global function of the hand has normalized.

Adult↗