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[Graphospasm--clinical presentation, etiology and the course of disease: analysis of 30 cases].

INTRODUCTION: Dystonia, as prolonged, involuntary muscle contraction, causes torsion, repetitive movements and abnormal body position. In so far only a part of body is affected by dystonic movement, it is the question of focal dystonia, which is called writer's cramp if the arm is involved. OBJECTIVE: The objective of the study was to present the specific clinical features of patients with task-specific dystonia, who were diagnosed, treated and followed up at the Institute of Neurology, Clinical Center of Serbia, Belgrade. MATERIAL AND METHODS: In the period 1995-2003, 30 patients with task-specific dystonia were treated at the Institute of Neurology, CCS, who met the adopted criteria for diagnosis. The severity of the diseases was tested by estimating the ability of patient to write the test sentence per time unit, as well as by means of scale for measuring different disabilities, ranging from 0-16 (Marsden-Fahn). Depression, anxiety and obsessiveness were tested by Beck's scale, Hamilton's depression and anxiety scale and Mousdly's obsessiveness scale. Thorough questionnaire focused on clinical details was also used. Besides descriptive statistics, data processing included analysis of variance and Kruskal-Wallis's test. RESULTS: Thirty patients with diagnosis of task-specific dystonia were analyzed. At the onset of the disease, mean-age was 34.1 years (SD=11.4; 13-58), while the duration of disease at the moment of the examination was 10.3 years (SD=10.6; 1-39). There were 20 males and 10 females (sex ratio 2:1). None of the patients reported any history of trauma of subsequently affected region before the development of discomforts. Twelve patients used their hands for a long time during their professions (writing, playing the instrument, type-writing, etc.). Eight patients were typists (26.6%), four were musicians (13.3%), while the rest of cases (18) had some other occupations that did not necessarily imply long-term use of hands (office worker, engineer, physician, mechanical technician, etc.). Twelve patients had simple task-specific dystonia (type I) (40%), ten cases manifested progressive diseases (type II) (33.3%), while the others suffered from dystonia that was present at rest (type III). Two patients had positive family history. DYT 1 mutation was verified in one of them. Depression, anxiety and obsessiveness were not verifed in our patients. Type of writer's cramp was not in correlation with any of the tested parameters except with the age at the onset of the disease, severity of disease according to Marsden's scale and degree of disability.

Adolescent↗
PubMed2002

Manipulo-spatial processing of ideographic characters in left-handers: observation in fMRI.

It has been suggested that left-handers have a cerebral ambilaterality for language representation. Specifically, the use of the right hand for writing may have a specific effect on the cerebral organization in left-handers. In an investigation of the relationship between motor and visual language procedures, functional magnetic resonance imaging at three tesla was conducted during stroke counting of kanji (Japanese ideographic characters) in six left-handers who usually write with their right hand. Two types of stimulus presentation, phonography-displayed and kanji-displayed, were employed to examine the different neural pathways used for processing kanji. Each stimulus presentation involved two motor conditions: one allowed finger movements for tracing the characters, while the other disallowed finger movements. The tasks induced activation in the primary motor area, the premotor area, the supplementary motor area, and the anterior cingulate gyrus as well as the parietal and occipital lobes (Brodmann's area 7/39/19). The activated areas in both the movement-allowed and movement-disallowed conditions were almost identical except for the primary motor area. These results clearly contrasted with those of a previous study of right-handers which showed that right-handed volunteers demonstrated decreased activation in the premotor area and the dorsal pathway during the movement-allowed condition. This discrepancy may be attributable to a difference in cerebral organization for language processing. Specifically, in left-handers, the visuospatial procedure for kanji and the motor procedure for tracing the kanji may be ambilaterally distributed in both hemispheres, whereas in right-handers these procedures may be predominantly lateralized in the left hemisphere.

Acoustic Stimulation↗
PubMed1977

Effects of self-esteem and status on size of signature.

142 second year university students from both Memorial University of Newfoundland (n = 81) and Laurentian University (n = 61) wrote their own signatures as they imagined the following people would do: (a) faculty member (high status) with high self-esteem, (b) faculty member (high status) with low self-esteem, (c) student (low status) with high self-esteem, and (d) student (low status) with low self-esteem. The areas of the signatures were calculated in square centimeters, and there was a significant positive relationship between size of signature and the conditions of high and low self-esteem for both "faculty" and "student" role-playing conditions. There was however no significant relationship between size of signature and status. The results held for both groups of subjects.

Faculty↗
PubMed1978

Right-left orientation and writing hand in children referred for neurodevelopmental assessment.

22 boys and 10 girls with school problems were referred to a pediatrician for medical and neurodevelopmental evaluation--children ranged in ages from 5-4 to 14-7. As part of the pediatric developmental assessment a simple test was used to evaluate each child's ability to identify his own right or left eye, ear, hand and foot. Hand preference for writing was also noted. 32 control children from the same population matched for age and sex with patients were also tested. Patients over 5 yr. old were more likely to have difficulty identifying right and left body parts than control children. All controls over age 7 correctly identified their body parts. 5 patients and 5 controls showed left-hand preference for writing. It is concluded that a more sensitive test for hand preference should be utilized as part of the pediatric neuro-developmental assessment.

Adolescent↗
PubMed1978

"Application for voluntary hospitalization" form: possible aid to diagnosis of mania.

"Application for Voluntary Hospitalization" signed by 13 manics (33 forms) and 13 paranoid schizophrenics (37 forms) at the time of their admissions were examined to test the validity of the hypothesis that one who writes anything more than his first name, middle name, or initial, and last name is likely to be manic. A physician and a nurse who were blind to the diagnosis were able to differentiate, at a significant level, mania from paranoid schizophrenia, using this criterion.

Adult↗
PubMed1979

Bilateral writing ability, cerebral organization, and hand posture.

Among a group of 12 persons selected for the ability to write with ease with either hand, none were found to write using a hooked hand posture with either the right or left hand. Tests of verbal and manipulospatial ability indicated a normal balance of these two types of abilities, usually associated with the left and right hemispheres. Findings are discussed in terms of implications for cerebral organization and hand position in writing.

Dominance, Cerebral↗
PubMed1982

Note on criteria for writing posture used to test Levy and Reid's cerebral organization hypotheses.

Apparent ambiguities in Levy and Reid's writing posture criteria and dissimilar criteria used by other investigators are discussed. Classification of inverted writing postures by a diagram which, as Levy and Reid indicated in 1976, depicts typical writing positions is questioned because their 1978 paper suggests that these diagrammed positions were only an intermediary stage in the classification of some inverters. Results of studies using dissimilar criteria for writing posture appear to be difficult to compare because subjects who may differ in cerebral organization might be placed in the same category. Some of these studies introduced another possible source of confounding because different tasks were used to test lateralization of function. Since different tasks seem to study distinctive facets of language, lateralization of one function in sinistrals, thought to be less lateralized than dextrals, does not predict lateralization of any other function. These considerations suggest that an adequate test of Levy and Reid's ideas concerning the relationship among handedness, hand posture during writing, sex, and cerebral organization requires the development of a standard set of valid criteria for writing posture.

Dominance, Cerebral↗
PubMed1982

Reverse-process sinistral cursive in dextrads: a mirror-writing variant.

A loop executed clockwise in conventional (left to right) cursive writing is performed counterclockwise in classical (right to left) mirror writing. This rotational reversal appears integral to and inseparable from the mirror-writing phenomenon. Yet in Reverse Process Sinistral Cursive, which proceeds left to right, the rotational component escapes its embeddedness in the conventional mirror form and finds individual, overt expression. The product represents a compromise between the competing and often contradictory demands of innate rotational tendencies, legibility, continuity of movement, and conventional writing style. In dextrads, it reflects difficulty in meeting the unaccustomed demands of translating right-sided movement patterns into left-handed writing performance.

Dominance, Cerebral↗