Drawing and writing: An ALE meta-analysis of sensorimotor activations

Regional brain activity and neural network changes in cognitive-motor dual-task interference: A functional near-infrared spectroscopy study

Previous neuroimaging studies have reported dual-task interference (DTi) and deterioration of task performance in a cognitive-motor dual task (DT) compared to that in a single task (ST). Greater frontoparietal activity is a neural signature of DTi; nonetheless, the underlying mechanism of cortical network in DTi still remains unclear. This study aimed to investigate the regional brain activity and neural network changes during DTi induced by highly demanding cognitive-motor DT. Thirty-four right-handed healthy young adults performed the spiral-drawing task. They underwent a paced auditory serial addition test (PASAT) simultaneously or independently while their cortical activity was measured using functional near-infrared spectroscopy. Motor performance was determined using the balanced integration score (BIS), a balanced index of drawing speed and precision. The cognitive task of the PASAT was administered with two difficulty levels defined by 1 s (PASAT-1 s) and 2 s (PASAT-2 s) intervals, allowing for the serial addition of numbers. Cognitive performance was determined using the percentage of correct responses. These motor and cognitive performances were significantly reduced during DT, which combined a drawing and a cognitive task at either difficulty level, compared to those in the corresponding ST conditions. The DT conditions were also characterized by significantly increased activity in the right dorsolateral prefrontal cortex (DLPFC) compared to that in the ST conditions. Multivariate Granger causality (GC) analysis of cortical activity in the selected frontoparietal regions of interest further revealed selective top-down causal connectivity from the right DLPFC to the right inferior parietal cortex during DTs. Furthermore, changes in the frontoparietal GC connectivity strength between the PASAT-2 s DT and ST conditions significantly correlated negatively with changes in the percentage of correct responses. Therefore, DTi can occur even in cognitively proficient young adults, and the right DLPFC and frontoparietal network being crucial neural mechanisms underlying DTi. These findings provide new insights into DTi and its underlying neural mechanisms and have implications for the clinical utility of cognitive-motor DTs applied to clinical populations with cognitive decline, such as those with psychiatric and brain disorders.

Associative white matter tracts selectively predict sensorimotor learning

Human learning varies greatly among individuals and is related to the microstructure of major white matter tracts in several learning domains, yet the impact of the existing microstructure of white matter tracts on future learning outcomes remains unclear. We employed a machine-learning model selection framework to evaluate whether existing microstructure might predict individual differences in learning a sensorimotor task, and further, if the mapping between tract microstructure and learning was selective for learning outcomes. We used diffusion tractography to measure the mean fractional anisotropy (FA) of white matter tracts in 60 adult participants who then practiced drawing a set of 40 unfamiliar symbols repeatedly using a digital writing tablet. We measured drawing learning as the slope of draw duration over the practice session and measured visual recognition learning for the symbols using an old/new 2-AFC task. Results demonstrated that tract microstructure selectively predicted learning outcomes, with left hemisphere pArc and SLF3 tracts predicting drawing learning and the left hemisphere MDLFspl predicting visual recognition learning. These results were replicated using repeat, held-out data and supported with complementary analyses. Results suggest that individual differences in the microstructure of human white matter tracts may be selectively related to future learning outcomes.

Electroencephalographic slowing during REM sleep in older adults with subjective cognitive impairment and mild cognitive impairment

STUDY OBJECTIVES

In older adults with Alzheimer's disease, slowing of electroencephalographic (EEG) activity during REM sleep has been observed. Few studies have examined EEG slowing during REM in those with mild cognitive impairment (MCI) and none have examined its relationship with cognition in this at-risk population.

METHODS

Two hundred and ten older adults (mean age = 67.0, SD = 8.2 years) underwent comprehensive neuropsychological, medical, and psychiatric assessment and overnight polysomnography. Participants were classified as subjective cognitive impairment (SCI; n = 75), non-amnestic MCI (naMCI, n = 85), and amnestic MCI (aMCI, n = 50). REM EEG slowing was defined as (δ + θ)/(α + σ + β) power and calculated for frontal, central, parietal, and occipital regions. Analysis of variance compared REM EEG slowing between groups. Correlations between REM EEG slowing and cognition, including learning and memory, visuospatial and executive functions, were examined within each subgroup.

RESULTS

The aMCI group had significantly greater REM EEG slowing in the parietal and occipital regions compared to the naMCI and SCI groups (partial η2 = 0.06, p < 0.05 and 0.06, p < 0.05, respectively), and greater EEG slowing in the central region compared to SCI group (partial η2 = 0.03, p < 0.05). Greater REM EEG slowing in parietal (r = -0.49) and occipital regions (r = -0.38 [O1/M2] and -0.33 [O2/M1]) were associated with poorer visuospatial performance in naMCI.

CONCLUSIONS

REM EEG slowing may differentiate older adults with memory impairment from those without. Longitudinal studies are now warranted to examine the prognostic utility of REM EEG slowing for cognitive and dementia trajectories.

Selective cortical adaptations associated with neural efficiency in visuospatial tasks - the comparison of electroencephalographic profiles of expert and novice artists

Visuospatial cognition encapsulates an individual's ability to efficiently navigate and make sense of the multimodal cues from their surroundings, and therefore has been linked to expert performance across multiple domains, including sports, performing arts, and highly skilled tasks, such as drawing (Morrone and Minini, 2023). As neural efficiency posits a task-specific functional reorganization facilitated by long-term training, the present study employs a visuospatial construction task as a means of investigating the neurophysiological adaptations associated with expert visuospatial cognitive performance. Electroencephalogram (EEG) data acquisitions were used to evaluate the event-related changes (ER%) and statistical topographic maps of nine expert versus nine novice artists. The expert artists displayed overall higher global ER% compared to the novices within task-active intervals. Significant increases in relative ER% were found in the theta (t (10) = 3.528, p = 0.003, CI = [27.3,120.9]), lower-alpha (t (10) = 3.751, p = 0.002, CI = [28.2,110.5]), upper-alpha (t (10) = 3.829, p = 0.002, CI = [50.2,189.8]), and low beta (t (10) = 4.342, p < 0.001, CI = [37.0,114.9]) frequency bands, when comparing the experts to the novice participants. These results were particularly found in the frontal (t (14) = 2.014, p = 0.032, CI = [7.7,245.4]) and occipital (t (14) = 2.647, p = 0.010, CI = [45.0,429.7]) regions. Further, a significant decrease in alpha ER% from lower to upper activity (t (8) = 4.475, p = 0.001, CI = [21.0, 65.8]) was found across cortical regions in the novice group. Notably, greater deviation between lower and upper-alpha activity was found across scalp locations in the novice group, compared to the experts. Overall, the findings demonstrate potential local and global EEG-based indices of selective cortical adaptations within a task requiring a high degree of visuospatial cognition, although further work is needed to replicate these findings across other domains.

Lateralized Functional Connectivity of the Sensorimotor Cortex and its Variations During Complex Visuomotor Tasks

Previous studies have shown that the left hemisphere dominates motor function, often observed through homotopic activation measurements. Using a functional connectivity approach, this study investigated the lateralization of the sensorimotor cortex during handwriting and drawing, two complex visuomotor tasks with varying contextual demands. We found that both left- and right-lateralized connectivity in the primary motor cortex (M1), dorsal premotor cortex (PMd), somatosensory cortex, and visual regions were evident in adults (males and females), primarily in an interhemispheric integrative fashion. Critically, these lateralization tendencies remained highly invariant across task contexts, representing a task-invariant neural architecture for encoding fundamental motor programs consistently implemented in different task contexts. Additionally, the PMd exhibited a slight variation in lateralization degree between task contexts, reflecting the ability of the high-order motor system to adapt to varying task demands. However, connectivity-based lateralization of the sensorimotor cortex was not detected in 10-year-old children (males and females), suggesting that the maturation of connectivity-based lateralization requires prolonged development. In summary, this study demonstrates both task-invariant and task-sensitive connectivity lateralization in sensorimotor cortices that support the resilience and adaptability of skilled visuomotor performance. These findings align with the hierarchical organization of the motor system and underscore the significance of the functional connectivity-based approach in studying functional lateralization.

Cortico-spinal modularity in the parieto-frontal system: A new perspective on action control

Classical neurophysiology suggests that the motor cortex (MI) has a unique role in action control. In contrast, this review presents evidence for multiple parieto-frontal spinal command modules that can bypass MI. Five observations support this modular perspective: (i) the statistics of cortical connectivity demonstrate functionally-related clusters of cortical areas, defining functional modules in the premotor, cingulate, and parietal cortices; (ii) different corticospinal pathways originate from the above areas, each with a distinct range of conduction velocities; (iii) the activation time of each module varies depending on task, and different modules can be activated simultaneously; (iv) a modular architecture with direct motor output is faster and less metabolically expensive than an architecture that relies on MI, given the slow connections between MI and other cortical areas; (v) lesions of the areas composing parieto-frontal modules have different effects from lesions of MI. Here we provide examples of six cortico-spinal modules and functions they subserve: module 1) arm reaching, tool use and object construction; module 2) spatial navigation and locomotion; module 3) grasping and observation of hand and mouth actions; module 4) action initiation, motor sequences, time encoding; module 5) conditional motor association and learning, action plan switching and action inhibition; module 6) planning defensive actions. These modules can serve as a library of tools to be recombined when faced with novel tasks, and MI might serve as a recombinatory hub. In conclusion, the availability of locally-stored information and multiple outflow paths supports the physiological plausibility of the proposed modular perspective.

Writing letters in two graphic systems: Behavioral and neural correlates in Latin-Arabic biscripters

Biscriptuality is the ability to read and write using two scripts. Despite the increasing number of biscripters, this phenomenon remains poorly understood. Here, we focused on investigating graphomotor processing in French-Arabic biscripters. We chose the French and Arabic alphabets because they have comparable visuospatial complexity and linguistic features, but differ dramatically in their graphomotor characteristics. In a first experiment we describe the graphomotor features of the two alphabets and showed that while Arabic and Latin letters are produced with the same velocity and fluency, Arabic letters require more pen lifts, contain more right-to-left strokes and clockwise curves, and take longer to write than Latin letters. These results suggest that Arabic and Latin letters are produced via different motor patterns. In a second experiment we used functional magnetic resonance imaging to ask whether writing the two scripts relies upon partially distinct or fully overlapping neural networks, and whether the elements of the previously described handwriting network are recruited to the same extent by the two scripts. We found that both scripts engaged the so-called "writing network", but that within the network, Arabic letters recruited the left superior parietal lobule (SPL) and the left primary motor cortex (M1) more strongly than Latin letters. Both regions have previously been identified as holding scale-invariant representations of letter trajectories. Arabic and Latin letters also activated distinct regions that do not belong to the writing network. Complementary analyses indicate that the differences observed between scripts at the neural level could be driven by the specific graphomotor features of each script. Overall, our results indicate that particular features of the practiced scripts can lead to different motor organization at both the behavioral and brain levels in biscripters.

Associative white matter tracts selectively predict sensorimotor learning

Human learning is a complex phenomenon that varies greatly among individuals and is related to the microstructure of major white matter tracts in several learning domains, yet the impact of the existing myelination of white matter tracts on future learning outcomes remains unclear. We employed a machine-learning model selection framework to evaluate whether existing microstructure might predict individual differences in the potential for learning a sensorimotor task, and further, if the mapping between the microstructure of major white matter tracts and learning was selective for learning outcomes. We used diffusion tractography to measure the mean fractional anisotropy (FA) of white matter tracts in 60 adult participants who then underwent training and subsequent testing to evaluate learning. During training, participants practiced drawing a set of 40 novel symbols repeatedly using a digital writing tablet. We measured drawing learning as the slope of draw duration over the practice session and visual recognition learning as the performance accuracy in an old/new 2-AFC recognition task. Results demonstrated that the microstructure of major white matter tracts selectively predicted learning outcomes, with left hemisphere pArc and SLF 3 tracts predicting drawing learning and the left hemisphere MDLFspl predicting visual recognition learning. These results were replicated in a repeat, held-out data set and supported with complementary analyses. Overall, results suggest that individual differences in the microstructure of human white matter tracts may be selectively related to future learning outcomes and open avenues of inquiry concerning the impact of existing tract myelination in the potential for learning.

Significance statement

A selective mapping between tract microstructure and future learning has been demonstrated in the murine model and, to our knowledge, has not yet been demonstrated in humans. We employed a data-driven approach that identified only two tracts, the two most posterior segments of the arcuate fasciculus in the left hemisphere, to predict learning a sensorimotor task (drawing symbols) and this prediction model did not transfer to other learning outcomes (visual symbol recognition). Results suggest that individual differences in learning may be selectively related to the tissue properties of major white matter tracts in the human brain.

Brain Correlates of Chinese Handwriting and Their Relation to Reading Development in Children: An fMRI Study

Handwriting plays an important role in written communication, reading, and academic success. However, little is known about the neural correlates of handwriting in children. Using functional magnetic resonance imaging (fMRI) and a copying task, we investigated regional brain activation and functional lateralization associated with Chinese handwriting in children (N = 36, 9-11 years old), as well as their relations to reading skills. We found significant activation of the bilateral frontal motor cortices, somatosensory cortex, intraparietal sulcus (IPS), fusiform gyrus (FuG), and cerebellum during handwriting, suggesting that an adult-like brain activation pattern emerges by middle childhood. Moreover, children showed left-lateralized and bilateral activation of motor regions and right-lateralized activation of the FuG and cerebellum during handwriting, suggesting that functional lateralization of handwriting is not fully established by this age. Finally, the activation of Exner's area and the lateralization of the IPS and cerebellum during handwriting were correlated with reading skills, possibly representing a neural link between handwriting and reading in children. Collectively, this study reveals the brain correlates of handwriting and their relation to reading development in Chinese children, offering new insight into the development of handwriting and reading skills.

Disruption of Functional Brain Networks Underlies the Handwriting Deficit in Children With Developmental Dyslexia

Developmental dyslexia (DD) is a neurological-based learning disorder that affects 5-17.5% of children. Handwriting difficulty is a prevailing symptom of dyslexia, but its neural mechanisms remain elusive. Using functional magnetic resonance imaging (fMRI), this study examined functional brain networks associated with handwriting in a copying task in Chinese children with DD (n = 17) and age-matched children (n = 36). We found that dyslexics showed reduced network connectivity between the sensory-motor network (SMN) and the visual network (VN), and between the default mode network (DMN) and the ventral attention network (VAN) during handwriting, but not during drawing geometric figures. Moreover, the connectivity strength of the networks showing group differences was correlated with handwriting speed, reading and working memory, suggesting that the handwriting deficit in DD is linked with disruption of a large-scale brain network supporting motoric, linguistic and executive control processes. Taken together, this study demonstrates the alternations of functional brain networks that underly the handwriting deficit in Chinese dyslexia, providing a new clue for the neural basis of DD.

Fine motor skills and motor control networking in developmental age

Objectives

We investigated the relationships between fine motor skills, fitness, anthropometrics, gender and perceived motor performance in school beginners. The aim of our study was to delineate whether and to what extent fine motor control would show meaningful synchrony with other motor variables in the age of onset of handwriting in school.

Methods

A sample of N = 239 of 6‐to‐8‐year‐old children were tested with an array of tasks measuring fine motor (i.e., dexterity and speed) and grapho‐motor performance (tracing on a tablet screen), anthropometric indexes, and fitness (shuttle run) measures. A subset of 95 children was also tested for perceived motor competence.

Results

In spite of an overall poor anthropometric condition, our participants were relatively fit. As expected, older children performed better in both, fine motor tasks and the shuttle test. The girls were better in fine motor skills, and an original speed‐quality trade‐off in the drawing was found. However, the magnitude of difference by grade was greater for boys' fine motor skills than those of girls'. A network analysis revealed three specific clusters, (1) perceived competencies, (2) fitness, and (3) fine motor skills.

Conclusions

Given the relative independence of these areas of physical performance, we suggest focusing on these three clusters as distinct areas of physical education. Fine motor skills deserve further consideration, especially at an early school age. We have demonstrated that network analysis and technology devices used to evaluate motor development are useful and meaningful tools.

Neural Correlates of Executed Compared to Imagined Writing and Drawing Movements: A Functional Magnetic Resonance Imaging Study

Objective

In this study we used functional magnetic resonance imaging (fMRI) to investigate whether motor imagery (MI) of handwriting and circle drawing activates a similar handwriting network as writing and drawing itself.

Methods

Eighteen healthy right-handed participants wrote the German word “Wellen” and drew continuously circles in a sitting (vertical position) and lying position (horizontal position) to capture kinematic handwriting parameters such as velocity, pressure and regularity of hand movements. Afterward, they performed the same tasks during fMRI in a MI and an executed condition.

Results

The kinematic analysis revealed a general correlation of handwriting parameters during sitting and lying except of pen pressure during drawing. Writing compared to imagined writing was accompanied by an increased activity of the ipsilateral cerebellum and the contralateral sensorimotor cortex. Executed compared to imagined drawing revealed elevated activity of a fronto–parieto-temporal network. By contrasting writing and drawing directly, executed writing induced an enhanced activation of the left somatosensory and premotor area. The comparison of the MI of these tasks revealed a higher involvement of occipital activation during imagined writing.

Conclusion

The kinematic results pointed to a high comparability of writing in a vertical and horizontal position. Overall, we observed highly overlapping cortical activity except of a higher involvement of motor control areas during motor execution. The sparse difference between writing and drawing can be explained by highly automatized writing in healthy individuals.

Protracted Neural Development of Dorsal Motor Systems During Handwriting and the Relation to Early Literacy Skills

Handwriting is a complex visual-motor skill that affects early reading development. A large body of work has demonstrated that handwriting is supported by a widespread neural system comprising ventral-temporal, parietal, and frontal motor regions in adults. Recent work has demonstrated that this neural system is largely established by 8 years of age, suggesting that the development of this system occurs in young children who are still learning to read and write. We made use of a novel MRI-compatible writing tablet that allowed us to measure brain activation in 5-8-year-old children during handwriting. We compared activation during handwriting in children and adults to provide information concerning the developmental trajectory of the neural system that supports handwriting. We found that parietal and frontal motor involvement during handwriting in children is different from adults, suggesting that the neural system that supports handwriting changes over the course of development. Furthermore, we found that parietal and frontal motor activation correlated with a literacy composite score in our child sample, suggesting that the individual differences in the dorsal response during handwriting are related to individual differences in emerging literacy skills. Our results suggest that components of the widespread neural system supporting handwriting develop at different rates and provide insight into the mechanisms underlying the contributions of handwriting to early literacy development.

The Visuospatial and Sensorimotor Functions of Posterior Parietal Cortex in Drawing Tasks: A Review

Drawing is a comprehensive skill that primarily involves visuospatial processing, eye-hand coordination, and other higher-order cognitive functions. Various drawing tasks are widely used to assess brain function. The neuropsychological basis of drawing is extremely sophisticated. Previous work has addressed the critical role of the posterior parietal cortex (PPC) in drawing, but the specific functions of the PPC in drawing remain unclear. Functional magnetic resonance imaging and electrophysiological studies found that drawing activates the PPC. Lesion-symptom mapping studies have shown an association between PPC injury and drawing deficits in patients with global and focal cerebral pathology. These findings depicted a core framework of the fronto-parietal network in drawing tasks. Here, we review neuroimaging and electrophysiological studies applying drawing paradigms and discuss the specific functions of the PPC in visuospatial and sensorimotor aspects. Ultimately, we proposed a hypothetical model based on the dorsal stream. It demonstrates the organization of a PPC-centered network for drawing and provides systematic insights into drawing for future neuropsychological research.

Functional brain networks underlying automatic and controlled handwriting in Chinese

This study aimed to identify the functional brain networks underlying the distinctions between automatic and controlled handwriting in Chinese. Network-based analysis was applied to functional magnetic resonance imaging data collected while adult participants performed a copying task under automatic and speed-controlled conditions. We found significant differences between automatic and speed-controlled handwriting in functional connectivity within and between the frontoparietal network, default mode network, dorsal attention network, somatomotor network and visual network; these differences reflect the variations in general attentional control and task-relevant visuomotor operations. However, no differences in brain activation were detected between the two handwriting conditions, suggesting that the reorganization of functional networks, rather than the modulation of local brain activation, underlies the dissociations between automatic and controlled handwriting in Chinese. Our findings illustrate the brain basis of handwriting automaticity, shedding new light on how handwriting automaticity may be disrupted in individuals with neurological disorders.

Right Inferior Parietal Lobule Activity Is Associated With Handwriting Spontaneous Tempo

Handwriting is a complex activity including motor planning and visuomotor integration and referring to some brain areas identified as "writing centers." Although temporal features of handwriting are as important as spatial ones, to our knowledge, there is no evidence of the description of specific brain areas associated with handwriting tempo. People with multiple sclerosis (PwMS) show handwriting impairments that are mainly referred to as the temporal features of the task. The aim of this work was to assess differences in the brain activation pattern elicited by handwriting between PwMS and healthy controls (HC), with the final goal of identifying possible areas specific for handwriting tempo. Subjects were asked to write a sentence at their spontaneous speed. PwMS differed only in temporal handwriting features from HC and showed reduced activation with a subset of the clusters observed in HC. Spearman's correlation analysis was performed between handwriting temporal parameters and the activity in the brain areas resulting from the contrast analysis, HC > PwMS. We found that the right inferior parietal lobule (IPL) negatively correlated with the duration of the sentence, indicating that the higher the right IPL activity, the faster the handwriting performance. We propose that the right IPL might be considered a "writing tempo center."

Course induced dexterity development and cerebellar grey matter growth of dentistry students: a randomised trial

This study primarily focuses on the assessment of dentistry students’ improvement of manual skills resulting from their participation in courses. We aimed to prove that systematic manual skills development significantly improves dexterity. We hypothesized that the dexterity training regimen improves manual dexterity demonstrated by the HAM-Man (Hamburg Assessment Test for Medicine-Manual Dexterity) test scores and CGM (cerebellar grey matter) growth. Thirty volunteers were randomly divided into two equal groups (study and control). Firstly, volunteers were examined by the HAM-Man test and baseline MRI scans. Afterwards, a manual skills development course was launched for the “study group”. Secondly, all the manual skills of the students were evaluated longitudinally, by the HAM-Man test. Simultaneously, the follow-up MRI scans were taken to observe morphologic changes in the cerebellum. The Wilcoxon signed-rank test and Student Paired t-test were used for statistical analyses. Value p < 0.05 was considered significant. After the training, significant growth of CGM as well as improvement on manual skill assessment tests, were found in the study group. Training courses are suitable for preparing students with low levels of dexterity for performing demanding tasks. The improvement is demonstrable by a wire bending test and by bilateral CGM enlargement as well.

The Neural Bases of Drawing. A Meta-analysis and a Systematic Literature Review of Neurofunctional Studies in Healthy Individuals

Drawing is a multi-component process requiring a wide range of cognitive abilities. Several studies on patients with focal brain lesions and functional neuroimaging studies on healthy individuals demonstrated that drawing is associated with a wide brain network. However, the neural structures specifically related to drawing remain to be better comprehended. We conducted a systematic review complemented by a meta-analytic approach to identify the core neural underpinnings related to drawing in healthy individuals. In analysing the selected studies, we took into account the type of the control task employed (i.e. motor or non-motor) and the type of drawn stimulus (i.e. geometric, figurative, or nonsense). The results showed that a fronto-parietal network, particularly on the left side of the brain, was involved in drawing when compared with other motor activities. Drawing figurative images additionally activated the inferior frontal gyrus and the inferior temporal cortex, brain areas involved in selection of semantic features of objects and in visual semantic processing. Moreover, copying more than drawing from memory was associated with the activation of extrastriate cortex (BA 18, 19). The activation likelihood estimation coordinate-based meta-analysis revealed a core neural network specifically associated with drawing which included the premotor area (BA 6) and the inferior parietal lobe (BA 40) bilaterally, and the left precuneus (BA 7).

These results showed that a fronto-parietal network is specifically involved in drawing and suggested that a crucial role is played by the (left) inferior parietal lobe, consistent with classical literature on constructional apraxia.

Functional parcellation of the right cerebellar lobule VI in children with normal or impaired reading

Neuroimaging studies have reported that the right cerebellar lobule VI is engaged in reading, but its role is unclear. The goal of our study was to identify functionally-dissociable subregions in the right lobule VI and how these subregions contribute to reading in children with normal or impaired reading. In Experiment I, typically developing children performed an orthographic task and a phonological task during functional magnetic resonance imaging (fMRI). We classified the voxels in the right lobule VI into seven zones based on the patterns of functional connectivity with the cerebrum across both tasks. In Experiment II, we compared the brain activation and cerebro-cerebellar connectivities of each subregion between children readers with different reading levels. We did not find significant group differences in cerebellar activation. However, we found that impaired readers had considerably higher functional connectivity between R1 and the right angular gyrus and the right precuneus compared to the control group in the phonological task. These findings show that the right cerebellar lobule VI is functionally parceled and its subregions might be differentially connected with the cerebrum between children with normal reading abilities and those with impaired reading.

The Importance of Cursive Handwriting Over Typewriting for Learning in the Classroom: A High-Density EEG Study of 12-Year-Old Children and Young Adults

To write by hand, to type, or to draw – which of these strategies is the most efficient for optimal learning in the classroom? As digital devices are increasingly replacing traditional writing by hand, it is crucial to examine the long-term implications of this practice. High-density electroencephalogram (HD EEG) was used in 12 young adults and 12, 12-year-old children to study brain electrical activity as they were writing in cursive by hand, typewriting, or drawing visually presented words that were varying in difficulty. Analyses of temporal spectral evolution (TSE, i.e., time-dependent amplitude changes) were performed on EEG data recorded with a 256-channel sensor array. For young adults, we found that when writing by hand using a digital pen on a touchscreen, brain areas in the parietal and central regions showed event-related synchronized activity in the theta range. Existing literature suggests that such oscillatory neuronal activity in these particular brain areas is important for memory and for the encoding of new information and, therefore, provides the brain with optimal conditions for learning. When drawing, we found similar activation patterns in the parietal areas, in addition to event-related desynchronization in the alpha/beta range, suggesting both similarities but also slight differences in activation patterns when drawing and writing by hand. When typewriting on a keyboard, we found event-related desynchronized activity in the theta range and, to a lesser extent, in the alpha range in parietal and central brain regions. However, as this activity was desynchronized and differed from when writing by hand and drawing, its relation to learning remains unclear. For 12-year-old children, the same activation patterns were found, but to a lesser extent. We suggest that children, from an early age, must be exposed to handwriting and drawing activities in school to establish the neuronal oscillation patterns that are beneficial for learning. We conclude that because of the benefits of sensory-motor integration due to the larger involvement of the senses as well as fine and precisely controlled hand movements when writing by hand and when drawing, it is vital to maintain both activities in a learning environment to facilitate and optimize learning.

Ecological validity of experimental set-up affects parietal involvement during letter production

Studies of symbol production using fMRI often use techniques that introduce an artificial pairing between motor production and visual perception. These techniques allow participants to see their own output by recording their pen trajectories using a touchscreen-only tablet and displaying these productions on a mirror placed above their head. We recently developed an MR-safe writing tablet with video display that allows participants to see their own hand and their own productions while producing symbols in real time on the surface where they are producing them-allowing for more ecologically valid fMRI studies of production. We conducted a study to determine whether the participation of posterior parietal cortex during symbol production was affected by the pairing of motor production and visual feedback associated with the two types of tablets. We performed ROI analyses in intraparietal sulcus while adult participants produced letters to dictation using either a touchscreen-only tablet (no visual guidance of the hand) (n = 14) or using a touchscreen-and-video-display tablet (visual guidance of the hand) (n = 14). We found that left posterior intraparietal sulcus was more active during production with the touchscreen-only tablet than during production with the touchscreen-and-video-display tablet. These results suggest that posterior parietal involvement during production tasks is associated with the somewhat artificial visual-motor pairing that is introduced by the techniques used in some studies of symbol production.

Task-Modulated Corticocortical Synchrony in the Cognitive-Motor Network Supporting Handwriting

Both motor and cognitive aspects of behavior depend on dynamic, accurately timed neural processes in large-scale brain networks. Here, we studied synchronous interplay between cortical regions during production of cognitive-motor sequences in humans. Specifically, variants of handwriting that differed in motor variability, linguistic content, and memorization of movement cues were contrasted to unveil functional sensitivity of corticocortical connections. Data-driven magnetoencephalography mapping (n = 10) uncovered modulation of mostly left-hemispheric corticocortical interactions, as quantified by relative changes in phase synchronization. At low frequencies (~2–13 Hz), enhanced frontoparietal synchrony was related to regular handwriting, whereas premotor cortical regions synchronized for simple loop production and temporo-occipital areas for a writing task substituting normal script with loop patterns. At the beta-to-gamma band (~13–45 Hz), enhanced synchrony was observed for regular handwriting in the central and frontoparietal regions, including connections between the sensorimotor and supplementary motor cortices and between the parietal and dorsal premotor/precentral cortices. Interpreted within a modular framework, these modulations of synchrony mainly highlighted interactions of the putative pericentral subsystem of hand coordination and the frontoparietal subsystem mediating working memory operations. As part of cortical dynamics, interregional phase synchrony varies depending on task demands in production of cognitive-motor sequences.

New Insight on Motor Behavior: The Link Between the Hopping Task and the Tracing Performance as Hint of Gross and Fine Motor Functions

The gross motor coordination tasks are thought to be likely not linked to the fine motor coordination tasks. The authors aimed to investigate this matter through a network analysis linking graphomotor (by tablet PC tracing), gross coordination (by Körperkoordinationstest für Kinder items), and strength (by handgrip) parameters in school children. Interestingly, the authors found that "Hopping" was the strongest central node, with linkages to "Quality" and "Speed" on tracing test. Handgrip strength did not link to gross coordination and graphomotor parameters, except with "Pressure." Graphomotor performances suggested substantial peculiarities in developmental trajectories. Sport participation did not influence gross coordination nor graphomotor performances. The authors suggest considering the functional link between hopping and graphomotricity both in planning physical education and in understanding coordination impairments, through the developmental trajectories.

Contributions of the Left and the Right Hemispheres on Language-Induced Grip Force Modulation of the Left Hand in Unimanual Tasks

Background and Objectives: Language-induced grip force modulation (LGFM) can be used to better understand the link between language and motor functions as an expression of embodied language. However, the contribution of each brain hemisphere to LGFM is still unclear. Using six different action verbs as stimuli, this study evaluated the grip force modulation of the left hand in a unimanual task to characterize the left and right hemispheres' contributions. Materials and Methods: Left-hand LGFM of 20 healthy and consistently right-handed subjects was evaluated using the verbs "to write", "to hold", "to pull" (left-lateralized central processing actions), "to draw", "to tie", and "to drive" (bihemispheric central processing actions) as linguistic stimuli. The time between the word onset and the first interval of statistical significance regarding the baseline (here as reaction time, RT) was also measured. Results: The six verbs produced LGFM. The modulation intensity was similar for the six verbs, but the RT was variable. The verbs "to draw", "to tie", and "to drive", whose central processing of the described action is bihemispheric, showed a longer RT compared to the other verbs. Conclusions: The possibility of a given manual action being performed by the left hand in consistent right-handers does not interfere with the occurrence of LGFM when the descriptor verb of this action is used as a linguistic stimulus, even if the possibility is remote. Therefore, LGFM seems to mainly rely on the left hemisphere, while a greater activation of the right hemisphere in action processing appears to slow the increase in LGFM intensity.

Broca's area is jointly activated during speech and gesture production

Despite the frequent suggestion in the literature that Broca's area is a common link between vocal and gestural models of the origins of language, this has never been established within a single motor-production study. In the present functional MRI experiment, participants were asked to describe the spatial properties of objects (e.g. a motorcycle) using speech, pantomime, and drawing. Pairwise conjunction analyses revealed that the left inferior gyrus - in combination with the left basal ganglia and ventral anterior thalamus - was jointly activated for the production of speech and pantomime but not for the conjunctions with drawing. Drawing and pantomime instead showed strong overlap in the intraparietal sulcus and superior parietal region bilaterally. These results provide the first demonstration in a production study that Broca's area is jointly activated by speech and gesture when depicting the same semantic content.

An Analysis of the Brain Systems Involved with Producing Letters by Hand

Complex visual-motor behaviors dominate human-environment interactions. Letter production, writing individual letters by hand, is an example of a complex visual-motor behavior composed of numerous behavioral components, including the required motor movements and the percepts that those motor movements create. By manipulating and isolating components of letter production, we provide experimental evidence that this complex visual-motor behavior is supported by a widespread neural system that is composed of smaller subsystems related to different sensorimotor components. Adult participants hand-printed letters with and without "ink" on an MR-safe digital writing tablet, perceived static and dynamic representations of their own handwritten letters, and perceived typeface letters during fMRI scanning. Our results can be summarized by three main findings: (1) Frontoparietal systems were associated with the motor component of letter production, whereas temporo-parietal systems were more associated with the visual component. (2) The more anterior regions of the left intraparietal sulcus were more associated with the motor component, whereas the more posterior regions were more associated with the visual component, with an area of visual-motor overlap in the posterior intraparietal sulcus. (3) The left posterior intraparietal sulcus and right fusiform gyrus responded similarly to both visual and motor components, and both regions also responded more during the perception of one's own handwritten letters compared with perceiving typed letters. These findings suggest that the neural systems recruited during complex visual-motor behaviors are composed of a set of interrelated sensorimotor subsystems that support the full behavior in different ways and, furthermore, that some of these subsystems can be rerecruited during passive perception in the absence of the full visual-motor behavior.

Storytelling Is Intrinsically Mentalistic: A Functional Magnetic Resonance Imaging Study of Narrative Production across Modalities

People utilize multiple expressive modalities for communicating narrative ideas about past events. The three major ones are speech, pantomime, and drawing. The current study used functional magnetic resonance imaging to identify common brain areas that mediate narrative communication across these three sensorimotor mechanisms. In the scanner, participants were presented with short narrative prompts akin to newspaper headlines (e.g., "Surgeon finds scissors inside of patient"). The task was to generate a representation of the event, either by describing it verbally through speech, by pantomiming it gesturally, or by drawing it on a tablet. In a control condition designed to remove sensorimotor activations, participants described the spatial properties of individual objects (e.g., "binoculars"). Each of the three modality-specific subtractions produced similar results, with activations in key components of the mentalizing network, including the TPJ, posterior STS, and posterior cingulate cortex. Conjunction analysis revealed that these areas constitute a cross-modal "narrative hub" that transcends the three modalities of communication. The involvement of these areas in narrative production suggests that people adopt an intrinsically mentalistic and character-oriented perspective when engaging in storytelling, whether using speech, pantomime, or drawing.

Voxel-based morphometry in creative writers: Grey matter increase in a prefronto-thalamic-cerebellar network

Continuous practice modulates those features of brain anatomy specifically associated with requirements of the respective training task. This study aimed to highlight brain structural changes going along with long-term experience in creative writing. To this end, we investigated the grey matter volume of 23 expert writers with voxel-based morphometry and compared it to 28 matched nonexpert controls. Expert writers had higher grey matter volume in the right superior frontal and middle frontal gyri (BA 9,10) as well as left middle frontal gyrus (BA 9, 10, 46), the bilateral medial dorsal nuclei of the thalamus and left posterior cerebellum. A regression analysis confirmed the association of enhanced grey matter volume in the right superior frontal gyrus (BA 10) with practice index of writing. In region-of-interest based regression analyses, we found associations of grey matter volume in the right Broca's analogue (BA 44) and right primary visual cortex (BA 17) with creativity ratings of the texts written during scanning, but not with a standardised verbal creativity test. Creative writing thus seems to be strongly connected to a prefronto-thalamic-cerebellar network that supports the continuous generation, organisation and revision of ideas that is necessary to write literary texts.

Voxel-based lesion analysis of brain regions underlying reading and writing

The neural basis of reading and writing has been a source of inquiry as well as controversy in the neuroscience literature. Reading has been associated with both left posterior ventral temporal zones (termed the "visual word form area") as well as more dorsal zones, primarily in left parietal cortex. Writing has also been associated with left parietal cortex, as well as left sensorimotor cortex and prefrontal regions. Typically, the neural basis of reading and writing are examined in separate studies and/or rely on single case studies exhibiting specific deficits. Functional neuroimaging studies of reading and writing typically identify a large number of activated regions but do not necessarily identify the core, critical hubs. Last, due to constraints on the functional imaging environment, many previous studies have been limited to measuring the brain activity associated with single-word reading and writing, rather than sentence-level processing. In the current study, the brain correlates of reading and writing at both the single- and sentence-level were studied in a large sample of 111 individuals with a history of chronic stroke using voxel-based lesion symptom mapping (VLSM). VLSM provides a whole-brain, voxel-by-voxel statistical analysis of the role of distinct regions in a particular behavior by comparing performance of individuals with and without a lesion at every voxel. Rather than comparing individual cases or small groups with particular behavioral dissociations in reading and writing, VLSM allowed us to analyze data from a large, well-characterized sample of stroke patients exhibiting a wide range of reading and writing impairments. The VLSM analyses revealed that reading was associated with a critical left inferior temporo-occipital focus, while writing was primarily associated with the left supramarginal gyrus. Separate VLSM analyses of single-word versus sentence-level reading showed that sentence-level reading was uniquely associated with anterior to mid-portions of the middle and superior temporal gyri. Both single-word and sentence-level writing overlapped to a great extent in the left supramarginal gyrus, but sentence-level writing was associated with additional underlying white matter pathways such as the internal capsule. These findings suggest that critical aspects of reading and writing processes diverge, with reading relying critically on the ventral visual recognition stream and writing relying on a dorsal visuo-spatial-motor stream.

Chinese calligraphy handwriting (CCH): a case of rehabilitative awakening of a coma patient after stroke

INTRODUCTION

This study investigated the efficacy of Chinese calligraphy handwriting (CCH) for the awakening of patients under a vegetative state after stroke. The theories, the instrument, and the treatment protocols were reported. A single case of a severe stroke patient who was in a coma state for 2 years is presented in this study. The objectives were to apply finger writing as a new method to awaken a stroke patient in a coma state and to test the effect of this method in improving the patient's vegetative states over time.

CASE PRESENTATION

A 55-year-old man suffered a severe stroke in 2004 which left him in a coma for 2 years without any systematic rehabilitation. A culture-based finger-writing method of visual-spatial intervention was then applied to improve his condition. The writing tasks involved aided viewing and finger tracing of sets of innovative characters with enriched visual-spatial and movement characteristics. Following regular treatment protocols involving diverse movement and sensory feedback, the patient was awakened after 12 months. As a consequence, the patient showed significant behavioral changes favoring enhanced focusing, alertness, visual scan, visual span, and quickened visual and motor responses. The treatment continued for another 12 months. As the treatment progressed, we gradually observed improvements in his attention span and mental concentration. His eye ball movements - the left eye in particular - were quickened and showed wider visual angularity in his focal vision. Currently, the patient can now watch television, engage in improved visual sighting, and focus on visual-spatial and cognitive-linguistic materials.

CONCLUSION

This CCH method of training by finger tracking has shown its effectiveness in awakening the patient from his coma state and in producing long-term, clinical outcomes that were similar from those that took place 10 years ago. This finding supports the efficacy of the system for clinical improvement of the patient's conditions.

Being on Target: Visual Information during Writing Affects Effective Connectivity in Parkinson's Disease

A common motor symptom of Parkinson's disease (PD) is micrographia, characterized by a decrease in writing amplitude. Despite the relevance of this impairment for activities of daily living, the underlying neural network abnormalities and the impact of cueing strategies on brain connectivity are unknown. Therefore, we investigated the effects of visual cues on visuomotor network interactions during handwriting in PD and healthy controls (HCs). Twenty-eight patients with early disease, ON dopaminergic medication, and 14 age-matched controls performed a pre-writing task with and without visual cues in the scanner. Patients displayed weaker right visuo-parietal coupling than controls, suggesting impaired visuomotor integration during writing. Surprisingly, cueing did not have the expected positive effects on writing performance. Patients and controls, however, did activate similar networks during cued and uncued writing. During cued writing, the stronger influence of both visual and motor areas on the left superior parietal lobe suggested that visual cueing induced greater visual steering. In the absence of cues, there was enhanced coupling between parietal and supplementary motor areas (SMA) in line with previous findings in HCs during uncued motor tasks. In conclusion, the present study showed that patients with PD, despite their compromised brain function, were able to shift neural networks similar to controls. However, it seemed that visual cues provided a greater accuracy constraint on handwriting rather than offering unequivocal beneficial effects. Altogether, the results suggest that the effectiveness of using compensatory neural networks through applying external stimuli is task dependent and may compromise motor control during writing.

Motor control of handwriting in the developing brain: A review

This review focuses on the acquisition of writing motor aspects in adults, and in 5-to 12-year-old children without learning disabilities. We first describe the behavioural aspects of adult writing and dominant models based on the notion of motor programs. We show that handwriting acquisition is characterized by the transition from reactive movements programmed stroke-by-stroke in younger children, to an automatic control of the whole trajectory when the motor programs are memorized at about 10 years old. Then, we describe the neural correlates of adult writing, and the changes that could occur with learning during childhood. The acquisition of a new skill is characterized by the involvement of a network more restricted in space and where neural specificity is increased in key regions. The cerebellum and the left dorsal premotor cortex are of fundamental importance in motor learning, and could be at the core of the acquisition of handwriting.

Behavior, sensitivity, and power of activation likelihood estimation characterized by massive empirical simulation

Given the increasing number of neuroimaging publications, the automated knowledge extraction on brain-behavior associations by quantitative meta-analyses has become a highly important and rapidly growing field of research. Among several methods to perform coordinate-based neuroimaging meta-analyses, Activation Likelihood Estimation (ALE) has been widely adopted. In this paper, we addressed two pressing questions related to ALE meta-analysis: i) Which thresholding method is most appropriate to perform statistical inference? ii) Which sample size, i.e., number of experiments, is needed to perform robust meta-analyses? We provided quantitative answers to these questions by simulating more than 120,000 meta-analysis datasets using empirical parameters (i.e., number of subjects, number of reported foci, distribution of activation foci) derived from the BrainMap database. This allowed to characterize the behavior of ALE analyses, to derive first power estimates for neuroimaging meta-analyses, and to thus formulate recommendations for future ALE studies. We could show as a first consequence that cluster-level family-wise error (FWE) correction represents the most appropriate method for statistical inference, while voxel-level FWE correction is valid but more conservative. In contrast, uncorrected inference and false-discovery rate correction should be avoided. As a second consequence, researchers should aim to include at least 20 experiments into an ALE meta-analysis to achieve sufficient power for moderate effects. We would like to note, though, that these calculations and recommendations are specific to ALE and may not be extrapolated to other approaches for (neuroimaging) meta-analysis.