Laterality in persons with intellectual disability II. Hand, foot, ear, and eye laterality in persons with Trisomy 21 and Williams-Beuren syndrome

Is the prolongation latency of visual evoked potentials a pathological sign in children with Down’s syndrome without ocular abnormalities? Case–control study of children with Down’s syndrome

Objective

To evaluate retino-cortical function in children with Down’s syndrome (DS) and no evident ocular abnormalities beyond mild refractive error, by recording visual evoked potentials (VEP) in response to pattern-reversal stimuli and comparing to those of age-matched healthy controls.

Methods and analysis

All the children with DS registered at Split-Dalmatia County who met inclusion criteria of no ocular abnormalities and with refraction error between −0.5 and +2.0 D, and their age-matched healthy controls were included in the study (n=36 children, N=72 eyes, for both groups, respectively, with the same age of 9±2 years). Transient VEP was recorded and the waves with a positive peak as a response to a pattern-reversal stimulus, were analysed. The peak P100 latency, defined as the time from the stimulus onset to the main positive peak, and peak to peak amplitudes were measured.

Results

While P100 wave amplitudes were comparable between two groups (p=0.804), P100 latencies were from 4.3 to 28.5 ms longer in children with DS (p<0.001). Interocular latency difference between a VEP dominant and an inferior eye was pronounced in healthy (1.2 ms (0.2–4.0), but was almost diminished in children with DS (0.3 ms (0.1–0.5), p<0.001).

Conclusion

Our study has demonstrated that VEP response is divergent in children with DS compared with their age-matched healthy controls, indicating possible structural or functional abnormalities of the visual cortex. As VEP results are helpful in the diagnosis and treatment planning of vision-related disorders, we should reconsider the use of common VEP diagnostic criteria in subpopulation of children with DS.

A cross-comparison of cognitive ability across 8 genomic disorders

Genomic disorders result from rearrangement of the human genome. Most genomic disorders are caused by copy number variants (CNV), deletions or duplications of several hundred kilobases. Many CNV loci are associated with autism, schizophrenia, and most commonly, intellectual disability (ID). However, there is little comparison of cognitive ability measures across these CNV disorders. This study aims to understand whether existing data can be leveraged for a cross-comparison of cognitive ability among multiple CNV. We found there is a lack of harmonization among assessment instruments and little standardization for reporting summary data across studies. Despite these limitations, we identified a differential impact of CNV loci on cognitive ability. Our data suggest that future cross-comparisons of CNV disorders will reveal meaningful differences across the phenotypic spectrum, especially if standardized phenotypic assessment is achieved.

Paw preferences in mice and rats: Meta-analysis

Mice and rats are among the most common animal model species in both basic and clinical neuroscience. Despite their ubiquity as model species, many clinically relevant brain-behaviour relationships in rodents are not well understood. In particular, data on hemispheric asymmetries, an important organizational principle in the vertebrate brain, are conflicting as existing studies are often statistically underpowered due to small sample sizes. Paw preference is one of the most frequently investigated forms of hemispheric asymmetries on the behavioural level. Here, we used meta-analysis to statistically integrate findings on paw preferences in rats and mice. For both species, results indicate significant hemispheric asymmetries on the individual level. In mice, 81 % of animals showed a preference for either the left or the right paw, while 84 % of rats showed this preference. However, contrary to what has been reported in humans, population level asymmetries were not observed. These results are particularly significant as they point out that paying attention to potential individual hemispheric differences is important in both basic and clinical neuroscience.

Four meta-analyses across 164 studies on atypical footedness prevalence and its relation to handedness

Human lateral preferences, such as handedness and footedness, have interested researchers for decades due to their pronounced asymmetries at the population level. While there are good estimates on the prevalence of handedness in the population, there is no large-scale estimation on the prevalence of footedness. Furthermore, the relationship between footedness and handedness still remains elusive. Here, we conducted meta-analyses with four different classification systems for footedness on 145,135 individuals across 164 studies including new data from the ALSPAC cohort. The study aimed to determine a reliable point estimate of footedness, to study the association between footedness and handedness, and to investigate moderating factors influencing footedness. We showed that the prevalence of atypical footedness ranges between 12.10% using the most conservative criterion of left-footedness to 23.7% including all left- and mixed-footers as a single non-right category. As many as 60.1% of left-handers were left-footed whereas only 3.2% of right-handers were left-footed. Males were 4.1% more often non-right-footed compared to females. Individuals with psychiatric and neurodevelopmental disorders exhibited a higher prevalence of non-right-footedness. Furthermore, the presence of mixed-footedness was higher in children compared to adults and left-footedness was increased in athletes compared to the general population. Finally, we showed that footedness is only marginally influenced by cultural and social factors, which play a crucial role in the determination of handedness. Overall, this study provides new and useful reference data for laterality research. Furthermore, the data suggest that footedness is a valuable phenotype for the study of lateral motor biases, its underlying genetics and neurodevelopment.

Hand selection in a preferential reaching task: The effects of object location, orientation, and task intention in preadolescent children

INTRODUCTION AND METHODS

Hand selection was assessed in preadolescent children (ages 9-11) within a preferential reaching task to delineate the effects of object location, orientation, and task intention on the assessment procedure and compared to data previously acquired from young adults.

RESULTS

The observed differences support the notion that children are still in a process of refining their movements in attempt to discern the most efficient and effective patterns of behavior. Notwithstanding differences in performance, similarities between preadolescents and young adults also emerged. Greater right-hand selection in right space and when the handle was oriented to the right indicate that object proximity and orientation influence efficiency and thus constrain hand selection in unimanual object manipulation and role-differentiated bimanual manipulation.

CONCLUSIONS

Together, findings add to our understanding of hand preference, unimanual and bimanual object manipulation.

Capacity to improve fine motor skills in Williams syndrome

BACKGROUND

Individuals with Williams syndrome (WS) are known to have difficulties in carrying out fine motor movements; however, a detailed behavioural profile of WS in this domain is still missing. It is also unknown how great the capacity to improve these skills with focused and extensive practice is.

METHOD

We studied initial performance and learning capacity in a sequential finger tapping (FT) task in WS and in typical development. Improvement in the FT task has been shown to be sleep dependent. WS subjects participating in the current study have also participated in earlier polysomnography studies, although not directly related to learning.

RESULTS

WS participants presented with great individual variability. In addition to generally poor initial performance, learning capacity was also greatly limited in WS. We found indications that reduced sleep efficiency might contribute to this limitation.

CONCLUSIONS

Estimating motor learning capacity and the depth of sleep disorder in a larger sample of WS individuals might reveal important relationships between sleep and learning, and contribute to efficient intervention methods improving skill acquisition in WS.

Comparative study of laterality in people with fragile X syndrome, people with intellectual disabilities, and people with typical development

Following on from the studies by McManus and Cornish [(1997). Fractionating handedness in mental retardation: What is the role of the cerebellum? Laterality, 2(2), 81-89] and Cornish, Pigram, and Shaw [(1997). Do anomalies of handedness exist in children with fragile-X syndrome? Laterality, 2(2), 91-101], the aim of this paper was to determine laterality in people with fragile X syndrome (FXS). The sample comprised three study groups: the first with 30 people with FXS (mean age 17.9 years), the second 34 people with various intellectual disabilities (ID, mean age 20.9 years), and the third 160 people with typical development (mean age 14.7 years). Laterality was assessed with a test adapted for this study. The results confirm the preponderance of right-handedness (93.3%) in people with FXS and present new data regarding footedness and sensory dominance (eyedness and earedness), indicating inconsistent footedness and ocular cross-dominance. Almost three-quarters (73.5%) of people with other ID were right-handed. The results corroborate those of McManus and Cornish (1997). People with FXS tend to be right-handed but have ocular cross-dominance.

Lateral preference in Williams-Beuren syndrome is associated with cognition and language

Williams-Beuren syndrome (WBS) is a genetically defined neurodevelopmental disorder presenting with intellectual disability associated with a specific neurocognitive profile characterized by anxiety, hypersociability, poor visuospatial skills and relatively preserved language. We have defined the lateral preference in 69 individuals (40 males and 29 females, age range 5-47 years) with WBS confirmed by molecular testing, and explored its correlation with cognition, behavior problems, the main aspects of the behavioral phenotype, and specific molecular variants (parental origin and size of the 7q11.23 deletion). Lateral preference (hand, foot, eye and ear) and neurobehavioral features [intelligence quotient (IQ), sociability, visuospatial construction, narrative skills and behavior] were assessed by a battery of tests and parental interviews. A large proportion of WBS individuals showed either left or mixed handedness (26 and 19%, respectively). Hand, foot and ear lateral preference showed significant association with IQ, with individuals with mixed lateral preference presenting lower general IQ, especially verbal IQ, with respect to subjects with well-defined laterality. Approachability, visuospatial ability, behavior problems or molecular variants were not associated with lateral preference. Our results indicate that, as in other neurodevelopmental disorders, laterality is poorly defined in a significant proportion of WBS individuals, and reinforces the idea that a correct definition of lateral preference is important for cognition and language.

Forelimb preferences in human beings and other species: multiple models for testing hypotheses on lateralization

Functional preferences in the use of right/left forelimbs are not exclusively present in humans but have been widely documented in a variety of vertebrate and invertebrate species. A matter of debate is whether non-human species exhibit a degree and consistency of functional forelimb asymmetries comparable to human handedness. The comparison is made difficult by the variability in hand use in humans and the few comparable studies conducted on other species. In spite of this, interesting continuities appear in functions such as feeding, object manipulation and communicative gestures. Studies on invertebrates show how widespread forelimb preferences are among animals, and the importance of experience for the development of forelimb asymmetries. Vertebrate species have been extensively investigated to clarify the origins of forelimb functional asymmetries: comparative evidence shows that selective pressures for different functions have likely driven the evolution of human handedness. Evidence of a complex genetic architecture of human handedness is in line with the idea of multiple evolutionary origins of this trait.

Hand preference, performance abilities, and hand selection in children

It is widely know that the pattern of human handedness is such that approximately 90% of the population is right handed with the remainder being left handed, at least in the adult population. What is less well understood is how handedness develops and at what age adult-like handedness patterns emerge. Quantified in terms of both preference and performance, a plethora of different behavioral assessments are currently in use with both children and adults. Handedness questionnaires are commonly used; however, these possess inherent limitations, considering their subjective nature. Hand performance measures have also been implemented; however, such tasks appear to measure different components of handedness. In addition to these traditional measures, handedness has been successfully assessed through observation of hand selection in reaching, which has proven to be a unique and effective manner in understanding the development of handedness in children. Research over the past several decades has demonstrated that young children display weak, inconsistent hand preference tendencies and are slower with both hands. Performance differences between the hands are larger for young children, and consistency improves with age. However, there remains some controversy surrounding the age at which hand preference and hand performance abilities can be considered fully developed. The following paper will provide a review of the literature pertaining to hand preference, performance abilities and hand selection in children in an attempt to ascertain the age at which adult-like patterns of hand preference and performance emerge.

Handedness and corpus callosal morphology in Williams syndrome

Williams syndrome is a neurodevelopmental genetic disorder caused by a hemizygous deletion on chromosome 7q11.23, resulting in atypical brain structure and function, including abnormal morphology of the corpus callosum. An influence of handedness on the size of the corpus callosum has been observed in studies of typical individuals, but handedness has not been taken into account in studies of callosal morphology in Williams syndrome. We hypothesized that callosal area is smaller and the size of the splenium and isthmus is reduced in individuals with Williams syndrome compared to healthy controls, and examined age, sex, and handedness effects on corpus callosal area. Structural magnetic resonance imaging scans were obtained on 25 individuals with Williams syndrome (18 right-handed, 7 left-handed) and 25 matched controls. We found that callosal thickness was significantly reduced in the splenium of Williams syndrome individuals compared to controls. We also found novel evidence that the callosal area was smaller in left-handed participants with Williams syndrome than their right-handed counterparts, with opposite findings observed in the control group. This novel finding may be associated with LIM-kinase hemizygosity, a characteristic of Williams syndrome. The findings may have significant clinical implications in future explorations of the Williams syndrome cognitive phenotype.

Preferência podal em lactentes com síndrome de Down: fatores extrínsecos e intrínsecos

Durante o processo de aquisição do chute em lactentes, a preferência podal pode ser influenciada de forma diferente pelos fatores extrínsecos e intrínsecos. O objetivo foi comparar a preferência podal e verificar a influência do peso adicional e do Reflexo Tônico Cervical Assimétrico (RTCA) na preferência podal entre lactentes com síndrome de Down e típicos. Participaram do estudo cinco lactentes com síndrome de Down e cinco típicos aos três e quatro meses de idade. O experimento foi subdividido em quatro condições experimentais: Treinamento, Linha de Base, Peso e Pós-Peso. Os lactentes com síndrome de Down apresentaram preferência à esquerda ou indefinida e os típicos, preferência à direita. O RTCA influenciou na preferência podal em ambos os grupos, indicando que o lado de rotação da cabeça orientou o chute do mesmo lado. Nos lactentes com síndrome de Down a correlação entre RTCA e chutes foi positiva, sendo forte aos três meses e moderada aos quatro meses. Para os lactentes típicos foi observada correlação positiva fraca aos três meses, e aos quatro meses a correlação não foi estatisticamente significativa. Lactentes com síndrome de Down apresentam preferência podal contrária aos lactentes típicos. O RTCA exerce influência na preferência podal por um período mais longo em lactentes com síndrome de Down em comparação aos lactentes típicos.

Unimanual and bimanual continuous movements benefit from visual instructions in persons with Down syndrome

The authors' aim was to understand how persons with Down syndrome (DS) perform different tasks and to assess if there were any differences in performance based on the type of instructions. This is important because of neurological differences in persons with DS and neurological demands for performing different types of tasks. Twenty right-handed participants with DS, 20 chronological age-matched (CA), and 20 mental age-matched (MA) performed unimanual, bimanual, discrete, and continuous drumming following visual, auditory, and verbal instructions. Overall, discrete drumming was performed with shorter movement times than continuous drumming and unimanual drumming was performed with shorter movement amplitude than bimanual drumming. With respect to instructions, persons with DS performed with smaller amplitudes, thus more efficient movements, following the visual instructions than auditory and verbal instructions for all types of tasks, whereas CA performed similarly with all instructions and MA performed with smaller amplitudes with visual instructions than auditory instructions. These results suggest that visual instruction provides the best information for people with DS to aid in performance of many different types of movements.

The Effect of Handedness in Vocational Training among Adults with Intellectual Disability

Aim:

The main aim of this study was to describe the relationship between right-handed, left-handed and mixed-handed adults with intellectual disability and their success in vocational training courses.

Method:

A total of 71 research participants in Iran with moderate and severe intellectual disability were chosen and their hand preferences were determined by means of a hand preference test.

Results:

The results showed that the research participants who were right-handers or left-handers were significantly more successful than those participants who were mixed-handers. There was a significant relationship between left or right handedness and success in job training (chi2= 11.490, df = 2, p = 0.003). Left-handers were statistically more successful in job training programmes than their mixed-hander counterparts (chi2= 9.252, df = 1, p = 0.002).A similar difference was found between right-hander and mixed-hander groups (chi2= 9.047, df = 1, p = 0.003). The difference between left and right handers in job training was not statistically significant (chi2= 0.227, df = 1, p = 0.634).

Conclusion:

Hand preference could be an important consideration in the vocational rehabilitation assessment and evaluation of people with intellectual disabilities. Training programmes may need to be tailored to suit an individual according to handedness, particularly with those who are mixed-handers.

Reversal of handedness effects on bimanual coordination in adults with Down syndrome

BACKGROUND

Research on unimanual tasks suggested that motor asymmetries between hands may be reduced in people with Down syndrome. Our study examined handedness (as assessed by hand performance) and perceptual-motor integration effects on bimanual coordination.

METHODS

Adults with Down syndrome (13 non-right-handed, 22 right-handed), along with comparison groups of adults (16 non-right-handed, 21 right-handed) and children (15 non-right-handed, 22 right-handed) without Down syndrome, drummed with auditory, verbal and visual instructions.

RESULTS

In contrast to handedness effects in the children and adults without Down syndrome, right-handed participants with Down syndrome led more with the left hand, and had lower coordination stability than non-right-handed participants with Down syndrome.

CONCLUSIONS

The reversed handedness effect during bimanual coordination suggests a complex relationship between handedness and task requirements in adults with Down syndrome.

Specific grasp characteristics of children with trisomy 21

Children with trisomy 21 display atypical manual skills that change to some extent during development. We examined grasp characteristics and their development in 35 children with trisomy 21, aged 4-18 years, who performed simple manual tasks (two manual tasks of the Movement Assessment Battery for Children, and grasping of five wooden blocks whose size was determined by their hand size). The age-matched comparison group included 35 typically developing children. Children with trisomy 21 were found to use fewer fingers than children in the comparison group in each task. They also used specific grasps and tended to extend fingers that were not involved in the grip. While some specific grasp characteristics of children with trisomy 21 decreased with age, other did not, and remained present throughout development. The perceptual-motor development of children with trisomy 21 should be analyzed in terms of atypical development rather than developmental delay.

Atypical functional lateralization in children with fetal alcohol syndrome

In order to explore effects of prenatal alcohol exposure on functional lateralization, item tasks measuring preferences of hand, foot, eye, and ear were administered to a sample of 23 children diagnosed with fetal alcohol syndrome (FAS) compared with typically developing (TD) children. In addition, a dichotic listening task was administered to a subsample of 11 children with FAS and a TD group of comparable age, sex and handedness. The children with FAS were characterized by increased nonright-handedness compared with TD children. No differences were evident for preferential use of foot, eye, or ear. Moreover, children with FAS displayed more right ear extinctions during dichotic listening relative to TD children, indicating a lack of right ear advantage. The results add to findings of decreased manual asymmetry and less left-lateralized speech perception in children with developmental disorders, and are further discussed in relation to the high incidence of callosal abnormalities in alcohol-exposed children.

The development of hand preference in children: the effect of task demands and links with manual dexterity

Lateralisation of hand preference and manual dexterity are known to develop over childhood, while in adulthood strength of hand preference has been shown to interact with extrinsic task demands. Some evidence exists to suggest that strength of hand preference and motor skill may be related. In the current study a handedness inventory, midline crossing (QHP) and peg-moving tasks were used to investigate: (1) the development of hand preference between 4 and 11 years; (2) whether extrinsic task demands affect strength of hand preference, and (3) whether strength of hand preference was associated with manual dexterity. Younger children (4-5 years) showed weak hand preference in comparison to older children (8-11 years), and extrinsic task demands influenced willingness to cross the body's midline with the preferred hand. Age and peg-moving speed were associated with midline crossing in certain task conditions. Overall, results suggest a coupling between manual dexterity and brain maturation in typical development.

Impairments in motor coordination without major changes in cerebellar plasticity in the Tc1 mouse model of Down syndrome

Down syndrome (DS) is a genetic disorder arising from the presence of a third copy of human chromosome 21 (Hsa21). Recently, O'Doherty et al. [An aneuploid mouse strain carrying human chromosome 21 with Down syndrome phenotypes. Science 309 (2005) 2033–2037] generated a trans-species aneuploid mouse line (Tc1) that carries an almost complete Hsa21. The Tc1 mouse is the most complete animal model for DS currently available. Tc1 mice show many features that relate to human DS, including alterations in memory, synaptic plasticity, cerebellar neuronal number, heart development and mandible size. Because motor deficits are one of the most frequently occurring features of DS, we have undertaken a detailed analysis of motor behaviour in cerebellum-dependent learning tasks that require high motor coordination and balance. In addition, basic electrophysiological properties of cerebellar circuitry and synaptic plasticity have been investigated. Our results reveal that, compared with controls, Tc1 mice exhibit a higher spontaneous locomotor activity, a reduced ability to habituate to their environments, a different gait and major deficits on several measures of motor coordination and balance in the rota rod and static rod tests. Moreover, cerebellar long-term depression is essentially normal in Tc1 mice, with only a slight difference in time course. Our observations provide further evidence that support the validity of the Tc1 mouse as a model for DS, which will help us to provide insights into the causal factors responsible for motor deficits observed in persons with DS.

Hand preference and hand performance: cross-sectional developmental trends and family resemblance in degree of laterality

The first aim of the study was to compare developmental trends in the degree of laterality (independent of direction) observed in two handedness tasks. The second aim was to assess family resemblance in the degree of laterality using the same two tasks. The sample was comprised of 186 left-handers and 302 right-handers aged from 6 to 66. Some of the sample were members of the same families. Bishop's card-reaching task was used to assess hand preference, and Annett's peg-moving task to assess manual performance. For the card-reaching task, children aged 7 to 10/11 recorded more midline crossings than the other age groups (both younger and older). No general age-related trend was observed for the Annett pegboard. For the card-reaching task, family resemblance was very low and not significant. The degree of laterality, assessed with the peg-moving task, showed a small but significant resemblance in father-offspring pairs (sons and daughters). Putative involvement of a maternally suppressed gene on chromosome 2p12 and of the androgen receptor was discussed.

Lateral preferences in children with intellectual deficiency of idiopathic origin

The goal of this study was to evaluate lateral preferences in a population of children with intellectual deficiency of idiopathic origin, compared with those of typically developing (TD) children. Two groups of children with mild or moderate intellectual deficiency were observed. Handedness (using a 10-item test and Bishop's card-reaching task), eyedness and footedness were studied. The younger group consisted of sixteen 10- to 11-year olds; the older group comprised fourteen 12- to 14-year olds. A control group of fifteen TD children was matched for age with the younger group of intellectually deficient (ID) children. The results show that the occurrence of left-handedness is not higher in children with ID of unknown origin than in age-matched TD children. However, we observed a marginally reduced tendency toward right-handedness in ID than in TD children: more mixed-handers among ID than TD children; test-retest consistency of hand preference significantly lower in the 10- to 11-year-old ID children than in the age-matched TD children; greater tendency of ID children to use their nonpreferred left hand when the card was presented to the left, as compared with TD children. Left-eyedness and crossed hand-eye preference were also more frequent in ID than in age-matched TD children. No age-related difference in laterality was found in ID children. These results partially support other studies indicating that less rightward asymmetry is associated with intellectual deficiency in children.