Hand-preference and population schizotypy: a meta-analysis

Roles of Handedness and Hemispheric Lateralization: Implications for Rehabilitation of the Central and Peripheral Nervous Systems: A Rapid Review

IMPORTANCE

Handedness and motor asymmetry are important features of occupational performance. With an increased understanding of the basic neural mechanisms surrounding handedness, clinicians will be better able to implement targeted, evidence-based neurorehabilitation interventions to promote functional independence.

OBJECTIVE

To review the basic neural mechanisms behind handedness and their implications for central and peripheral nervous system injury.

DATA SOURCES

Relevant published literature obtained via MEDLINE.

FINDINGS

Handedness, along with performance asymmetries observed between the dominant and nondominant hands, may be due to hemispheric specializations for motor control. These specializations contribute to predictable motor control deficits that are dependent on which hemisphere or limb has been affected. Clinical practice recommendations for occupational therapists and other rehabilitation specialists are presented.

CONCLUSIONS AND RELEVANCE

It is vital that occupational therapists and other rehabilitation specialists consider handedness and hemispheric lateralization during evaluation and treatment. With an increased understanding of the basic neural mechanisms surrounding handedness, clinicians will be better able to implement targeted, evidence-based neurorehabilitation interventions to promote functional independence. Plain-Language Summary: The goal of this narrative review is to increase clinicians' understanding of the basic neural mechanisms related to handedness (the tendency to select one hand over the other for specific tasks) and their implications for central and peripheral nervous system injury and rehabilitation. An enhanced understanding of these mechanisms may allow clinicians to better tailor neurorehabilitation interventions to address motor deficits and promote functional independence.

Stress exposure, hand preference, and hand skill: A deep phenotyping approach

ABSTRACTStress exposure and reactivity may show differential associations with handedness, but shallow phenotyping may influence the current knowledge. Importantly, different handedness measures do not necessarily show high correlations with each other and should not be used interchangeably as they may reflect different dimensions of laterality. Here, data on handedness from 599 participants in the population-based, longitudinal Dortmund Vital Study was used to determine various asymmetry indices. Hand preference was assessed with the Edinburgh Handedness Inventory (EHI) and the lateral preference inventory (LPI) measuring handedness, footedness, earedness, and eyedness. Hand performance was determined using the pegboard test. In addition, data on several dimensions of stress exposure and reactivity, including hair cortisol, and mental well-being was analysed to determine associations with handedness. All handedness measures correlated significantly with each other, with the strongest correlation between the EHI and the LPI handedness score. The EHI and LPI hand measures resulted in the highest effect sizes and most consistent correlations with stress or mental well-being. In contrast, the pegboard test only showed very little association with the stress and mental well-being measures. This highlights the importance of handedness phenotyping. Including preference measures is recommended to disentangle the link between handedness and mental health.

The sexual selection of creativity: A nomological approach

Cultural innovations, such as tools and other technical articles useful for survival, imply that creativity is an outcome of evolution. However, the existence of purely ornamental items obfuscates the functional value of creativity. What is the functional or adaptive value of aesthetic and intellectual ornaments? Recent evidence shows a connection between ornamental creativity, an individual's attractiveness, and their reproductive success. However, this association is not sufficient for establishing that creativity in humans evolved by sexual selection. In this critical review, we synthesize findings from many disciplines about the mechanisms, ontogeny, phylogeny, and the function of creativity in sexual selection. Existing research indicates that creativity has the characteristics expected of a trait evolved by sexual selection: genetic basis, sexual dimorphism, wider variety in males, influence of sex hormones, dysfunctional expressions, an advantage in mating in humans and other animals, and psychological modules adapted to mating contexts. Future studies should investigate mixed findings in the existing literature, such as creativity not being found particularly attractive in a non-WEIRD society. Moreover, we identified remaining knowledge gaps and recommend that further research should be undertaken in the following areas: sexual and reproductive correlates of creativity in non-WEIRD societies, relationship between androgens, development, and creative expression, as well as the impact of ornamental, technical and everyday creativity on attractiveness. Evolutionary research should analyze whether being an evolved signal of genetic quality is the only way in which creativity becomes sexually selected and therefore passed on from generation to generation. This review has gone a long way toward integrating and enhancing our understanding of ornamental creativity as a possible sexual selected psychological trait.

Ambiguous handedness and visuospatial pseudoneglect in schizotypy in physical and computer-generated virtual environments

Virtual reality (VR) technology has increased clinical attention in the health care of schizophrenia spectrum disorders in both diagnoses of the symptoms and assessment of schizotypal traits. However, the exact nature of VR-induced positive treatment effect in schizotypy is still unknown. In this study, VR technology was used as a non-invasive neurocognitive trigger to test the asymmetric visuospatial representational instability found in individuals with high schizotypy. The study aimed to reveal the brain functional hemispheric laterality in physical and virtual realities in individuals with schizotypal traits. Fifty-one healthy, right-handed participants (24 males and 27 females) were enrolled through public advertisements. Hemispheric functional asymmetry was measured by the Line Bisection Task (LBT). The results revealed that (a) LBT bias in the physical reality showed a handedness-related leftward pseudoneglect, however, similar handedness-related pseudoneglect in VR has not been found. (b) Comparing LBT bias in physically real and VR environments showed rightward drift in VR environments independently to the degree of handedness. (c) The schizotypy has no association with handedness, however, the cognitive schizotypy is related to the LBT bias. Higher cognitive schizotypy in VR associated with left hemispatial pseudoneglect. In conclusion, schizotypy is associated with ambiguous behavioral and cognitive functional laterality. In individuals with high cognitive schizotypy, the VR environment enhanced the representational articulation of the left hemispace. This effect may be originated from the enhancement of the right hemisphere overactivation and is followed by a lower mental control of the overt behavior.

Sex-Related Differences in White Matter Asymmetry and Its Implications for Verbal Working Memory in Psychosis High-Risk State

Objective: Sexual dimorphism has been investigated in schizophrenia, although sex-specific differences among individuals who are at clinical high-risk (CHR) for developing psychosis have been inconclusive. This study aims to characterize sexual dimorphism of language areas in the brain by investigating the asymmetry of four white matter tracts relevant to verbal working memory in CHR patients compared to healthy controls (HC). HC typically show a leftward asymmetry of these tracts. Moreover, structural abnormalities in asymmetry and verbal working memory dysfunctions have been associated with neurodevelopmental abnormalities and are considered core features of schizophrenia. Methods: Twenty-nine subjects with CHR (17 female/12 male) for developing psychosis and twenty-one HC (11 female/10 male) matched for age, sex, and education were included in the study. Two-tensor unscented Kalman filter tractography, followed by an automated, atlas-guided fiber clustering approach, were used to identify four fiber tracts related to verbal working memory: the superior longitudinal fasciculi (SLF) I, II and III, and the superior occipitofrontal fasciculus (SOFF). Using fractional anisotropy (FA) of tissue as the primary measure, we calculated the laterality index for each tract. Results: There was a significantly greater right>left asymmetry of the SLF-III in CHR females compared to HC females, but no hemispheric difference between CHR vs. HC males. Moreover, the laterality index of SLF-III for CHR females correlated negatively with Backward Digit Span performance, suggesting a greater rightward asymmetry was associated with poorer working memory functioning. Conclusion: This study suggests increased rightward asymmetry of the SLF-III in CHR females. This finding of sexual dimorphism in white matter asymmetry in a language-related area of the brain in CHR highlights the need for a deeper understanding of the role of sex in the high-risk state. Future work investigating early sex-specific pathophysiological mechanisms, may lead to the development of novel personalized treatment strategies aimed at preventing transition to a more chronic and difficult-to-treat disorder.

Schizotypy and altered hemispheric asymmetries: The role of cilia genes

Schizophrenia patients have a higher probability of altered structural and functional differences between the left and right hemisphere. Schizotypy as its nonclinical manifestation has been related to a higher incidence of non-right-handedness and atypical right-hemispheric language dominance. It has been suggested that genes involved in cilia function might link brain asymmetry and neurodevelopmental disorders. We assessed DNA methylation in the promoter regions of seven candidate genes involved in cilia function and psychiatric disorders from buccal cells and investigated their association with schizotypy and language lateralization in 60 healthy adults. Moreover, we determined microstructural properties of the planum temporale in a subsample of 52 subjects using neurite orientation dispersion and density imaging (NODDI). We found a significant association between schizotypy and DNA methylation in the AHI1 promoter region. Moreover, AHI1 DNA methylation significantly predicted language lateralization and asymmetry in estimated planum temporale neurite density. Finally, stronger leftward asymmetry in estimated neurite density was associated with a more pronounced right ear advantage (left hemisphere dominance) in the forced-right condition of the dichotic listening task, measuring attentional modulation of language lateralization. Our results are in line with a shared molecular basis of schizotypy and functional hemispheric asymmetries that is based on cilia function.

Evolution of cerebral asymmetry

The human brain is often characterized in terms of a duality, with the left and right brains serving complementary functions, and even individuals are sometimes classified as either "left-brained" or "right-brained." Recent evidence from brain imaging shows that hemispheric asymmetry is multidimensional, comprised of independent lateralized circuits. Cerebral asymmetries, which include handedness, probably arise in phylogenesis through the fissioning of ancestral systems that divided and lateralized with increasing demand for specialization. They also vary between individuals, with some showing absent or reversed asymmetries. It is unlikely that this variation is controlled by a single gene, as sometimes assumed, but depends rather on complex interplay among several, perhaps many, genes. Hemispheric asymmetry has often been regarded as a unique mark of being human, but it has also become evident that behavioral and cerebral asymmetries are not confined to humans, and are widespread among animal species. They nevertheless exist against a fundamental background of bilateral symmetry, suggesting a tradeoff between the two. Individual differences in asymmetry, moreover, are themselves adaptive, contributing to the cognitive and behavioral specializations necessary for societies to operate efficiently.

Neuroticism, schizotypy, and scale anchors influence eye movement behaviour in the visual exploration of abstract art: An exploratory study

The same piece of artwork can attract both admiration and rejection from different people. One potential explanation for this effect is individual differences in perceptual biases, which influence the way in which we see different aspects of the same image. We explored the relationship between individual differences (i.e., personality) and eye movements for examinations of abstract art. Images were presented for 5000ms, after which participants judged aesthetic appeal and perceived value using visual analogue scales. Scale anchor labels (Looks Good/Looks Bad; $0/$5000) were counterbalanced between participants such that positive labels were on the left half of the time and on the right half of the time. Overall, more fixations occurred to the right and upper visual fields. Neuroticism significantly predicted the proportion of fixations to the left, whereas cognitive disorganisation negatively predicted the proportion of fixations to upper space. Participants found images more aesthetically pleasing and more valuable when positive anchors were on the left. Findings demonstrate that personality traits influence fixation patterns. Further, the positioning of positive anchor labels on the left leads to higher ratings of visual stimuli.

Segregating polymorphisms of FOXP2 are associated with measures of inner speech, speech fluency and strength of handedness in a healthy population

We genotyped a healthy population for three haplotype-tagging FOXP2 SNPs, and tested for associations of these SNPs with strength of handedness and questionnaire-based metrics of inner speech characteristics (ISP) and speech fluency (FLU), as derived from the Schizotypal Personality Questionnaire-BR. Levels of mixed-handedness were positively correlated with ISP and FLU, supporting prior work on these two domains. Genotype for rs7799109, a SNP previously linked with lateralization of left frontal regions underlying language, was associated with degree of mixed handedness and with scores for ISP and FLU phenotypes. Genotype of rs1456031, which has previously been linked with auditory hallucinations, was also associated with ISP phenotypes. These results provide evidence that FOXP2 SNPs influence aspects of human inner speech and fluency that are related to lateralized phenotypes, and suggest that the evolution of human language, as mediated by the adaptive evolution of FOXP2, involved features of inner speech.

The Many Sides of Hemispheric Asymmetry: A Selective Review and Outlook

Hemispheric asymmetry is commonly viewed as a dual system, unique to humans, with the two sides of the human brain in complementary roles. To the contrary, modern research shows that cerebral and behavioral asymmetries are widespread in the animal kingdom, and that the concept of duality is an oversimplification. The brain has many networks serving different functions; these are differentially lateralized, and involve many genes. Unlike the asymmetries of the internal organs, brain asymmetry is variable, with a significant minority of the population showing reversed asymmetries or the absence of asymmetry. This variability may underlie the divisions of labor and the specializations that sustain social life. (JINS, 2017, 23, 710-718).

Allusive thinking (remote associations) and auditory top-down inhibition skills differentially predict creativity and positive schizotypy

INTRODUCTION

Positive schizotypy and creativity seem to be linked. However, the question still remains why they are related, and what may make the difference? As creative ideation is hypothesised as a dual process (association and inhibition), the propensity for remote associations might be a shared mechanism. However, positive schizotypy and creative thinking might be differentially linked to inhibition. Therefore, this study investigated a potentially overlapping feature of positive schizotypy and creativity (remote associations) as well as a potential dissociative factor (auditory inhibition).

METHODS

From a large screening sample, 46 participants covering a broad range of positive schizotypy were selected. Association proneness was assessed via two association tasks, auditory inhibition skill with the forced-left condition of the Dichotic Listening Test, and creative thinking by means of two creative ideation tests.

RESULTS

Positive schizotypy and creative thinking were positively associated. Both traits were linked to lower rates of common associations. However, creative thinking was associated with higher and positive schizotypy with lower inhibitory control in the auditory domain.

CONCLUSIONS

While creativity and positive schizotypy shared some variance (related to remote associations), profound inhibition skills may be vital for creative performance and may coincide with lower levels of positive schizotypy.

Neurological soft signs: Effects of trait schizotypy, psychological distress and auditory hallucination predisposition

Schizotypy is regarded as a trait vulnerability for psychotic disorders, yet alone is insufficient for development of a diagnosable disorder. Additional symptoms and psychological distress are necessary for help seeking and transition from an at risk mental state to a clinical diagnosis. The present study investigated the interaction between trait schizotypy, state auditory verbal hallucination (AVH) predisposition, distress and handedness for the expression of neurological soft signs (NSS), a neurodevelopmental vulnerability factor for psychosis. Cluster analysis formed schizotypy groups statistically across the dimensions captured by the SPQ. It was hypothesized that schizotypy and AVH predisposition would interact, resulting in significantly greater NSS. Psychological distress and handedness were hypothesized to be significant covariates, accounting for some variance in the expression of NSS between the groups. A sample of University students (n = 327) completed the Schizotypal Personality Questionnaire, Launay-Slade Hallucination Scale, General Health Questionnaire and the Neurological Evaluation Scale (NES). Cluster Analysis revealed four schizotypy groups. Distress was not a significant covariate in any analysis. As expected, those with high overall schizotypy and high AVH predisposition expressed significantly greater Motor-Coordination NSS compared to those with high schizotypy and low AVH predisposition. Within the Mixed Interpersonal and Cognitive-Perceptual Schizotypy cluster, those with low AVH predisposition expressed significantly more Motor-Coordination NSS than those with high AVH predisposition. These findings suggest motor coordination NSS are detectable in schizotypy, and AVH predisposition appears to interact with these traits. This study highlights the importance of considering both trait and subclinical state risk factors when investigating risk for psychosis.

Handedness and schizotypy: The potential effect of changing the writing-hand

Mixed-handedness, which has been associated with schizotypy in recent studies, might exist for at least two different reasons: it is innate or it has been forced. We examined whether the association between mixed-handedness and schizotypy differs depending on its source. We enrolled 3485 college students in Taiwan. We used both the Perceptual Aberration Scale and Schizotypal Personality Questionnaire to assess schizotypy, and the Annett Hand Preference Questionnaire to assess handedness. Two ways of classifying handedness were examined: the three-way classification based on Annett's categories and mixed- vs. non-mixed-handedness based on Degree of Handedness. Both mixed-handedness groups showed higher positive schizotypy scores. Among mixed handers, those who had been required to change their writing hand from left to right had higher positive schizotypy scores. Being forced to change writing hand seemed to be related to a higher level of schizotypy. The potential effect of the social pressure against using the left hand for writing is discussed.

Associations between schizotypy and cerebral laterality

Atypical lateralization for language has been found in schizophrenia, suggesting that language and thought disorders on the schizophrenia spectrum may be due to left hemispheric dysfunction. However, research with those with non-clinical schizotypy has been inconsistent, with some studies finding reduced or reversed language laterality (particularly with positive schizotypal traits), and others finding typical left hemispheric specialization. The aim of the current study was to use both a behavioural (dual reading-finger tapping) task and an functional magnetic resonance imaging lexical decision task to investigate language laterality in a university sample of high- and low-schizotypal adults. Findings revealed no evidence for atypical lateralization in our sample for both overall schizotypy (measured by the Oxford-Liverpool Inventory of Feelings and Experiences) and positive schizotypy (measured by the Unusual Experiences subscale) groups. Our findings provide further evidence that non-clinical schizotypy is not associated with atypical language laterality.

The PCSK6 gene is associated with handedness, the autism spectrum, and magical ideation in a non-clinical population

Common polymorphisms in the gene PCSK6, whose protein product mediates the development of brain and body asymmetry through the NODAL pathway, have recently been associated with handedness in three studies, making it a key candidate gene for understanding the developmental and expression of human lateralization. We tested the hypothesis that the PCSK6 VNTR polymorphism rs1053972 influences the expression of handedness and aspects of dimensional schizotypy and autism. For a sample of 709 healthy individuals, rs1053972 genotype was significantly associated with categorical measures of handedness, and with dimensional handedness in subsets of the population with high schizotypy and magical ideation or a lack of strong right-handedness. Both findings showed evidence of stronger or exclusive effects among females, compared to males. Genotypes of PCSK6 also showed significant sex-limited associations with magical ideation, a component of positive schizotypal cognition measured using the Schizotypal Personality Questionnaire, and total autism score, measured using the Autism Spectrum Quotient. These results partially replicate previous studies on effects of PCSK6 rs1053972 genetic variation on handedness phenotypes, link the PCSK6 gene with the dimensional expression of neurodevelopmental conditions in healthy individuals, and show that associations of this gene with handedness and psychological phenotypes exhibit evidence of sex-limited effects.

Deeper into schizotypy and motor performance: Investigating the nature of motor control in a non-psychiatric sample

Numerous studies have demonstrated that motor control deficits are characteristic of patients diagnosed with schizophrenia and those at-risk for the development of the disorder. Recent advances in the quantification of motor dysfunction have confirmed this, but these methods fail to consider an important aspect of subject performance: the qualitative nature of their psychomotor dyscontrol. We report on a novel technique used to quantify the qualitative nature of psychomotor performance and its relation to schizotypy. Control (n = 35) and schizotypic subjects (n = 47) completed a line-drawing task that yields metrics for psychomotor control and predominant frequency. Schizotypes evidenced greater psychomotor dyscontrol and lower predominant frequencies than controls. These results are interpreted as evidence of reduced visual-motor integration, self-monitoring capacity, or adherence to basic motor principles in schizotypes. The potential use of these metrics as putative endophenotypes for the liability for schizophrenia and the implications of these findings for the relationship between schizophrenia and schizotypy are discussed.

Evidence of Sex-Linked Familial Transmission of Lateral Preferences for Hand, Foot, Eye, Ear, and Overall Sidedness in a Latent Variable Analysis

This study investigated the familial transmission of handedness, footedness, eyedness, earedness, and of underlying sidedness in a sample of adults (n = 592 families; 1528 individuals in total), using multi-item inventories and probabilistic methods for preference classification. Our results corroborate three classes of lateral preferences and of sidedness each, right, mixed, and left. Consistent with genetic studies, we obtained evidence of parent-of-origin and sex-of-children effects, suggesting important roles of maternal mixed preferences and of paternal left preferences. Further, parental age at conception predicted mixed preferences in the child. We recommend a trichotomous classification of lateral preferences also in future studies, and to intensify research into the genetic bases of footedness, eyedness and earedness.

Mixed-footedness is a more relevant predictor of schizotypy than mixed-handedness

Mixed-handedness was reported indicative of schizotypy, relevant to psychosis and schizophrenia. However, studies suffered from validity threats and did not systematically investigate associations with footedness. Moreover, there is a dearth of studies in the general population and it is currently untested whether widely used self-report scales measure schizotypy in a comparable way in student and community samples. The present study used two large and independent community and student samples (total N>2800) and utilized latent class analysis (LCA) for the classification of handedness and footedness. Psychometric properties and measurement equivalence of the Schizotypal Personality Questionnaire-Brief form (SPQ-B) in the two samples were also examined. We found that mixed-handedness (<6% prevalence), but also much more common mixed-footedness (25% prevalence), was specifically and similarly associated with higher schizotypy in both samples, Cohen d=0.15-0.18. Findings indicate that schizotypal traits in conjunction with mixed lateral preferences are thus more prevalent in the overall population than previously assumed, and that footedness may be the more relevant predictor of schizotypy than handedness. Findings are further consistent with evidence on neurodevelopmental instability, but also epigenetic mechanisms involving the sex chromosomes, regarding possible common causes of both mixed-handedness and psychosis-relevant traits.

Estimation of heritability for varied indexes of handedness

Inconsistent results of the molecular studies for handedness have been reported. One of the key issues involved could be ways of assessing handedness. The current study aimed to identify the index of handedness better reveal the genetic component, which showed higher heritability. We measured handedness using the Annett's handedness questionnaire. The college students participating in this study filled the questionnaire in the class while their first-degree relatives returned questionnaires one to two weeks later. A total of 1,968 subjects returned their questionnaires, including 640 college students and 1,328 first-degree relatives. Among the 449 college students returning at least one handedness questionnaire for their parents, a total of 449 fathers, 440 mothers, and 425 siblings participated in the study. The index of mixed-handedness (e.g., Degree of Handedness) showed highest heritability (0.67), followed by the Hand Preference Index (0.52), and then the Direction of Handedness (0.39). Using an index of mixed-handedness for future molecular studies was suggested.

Evidence for general right-, mixed-, and left-sidedness in self-reported handedness, footedness, eyedness, and earedness, and a primacy of footedness in a large-sample latent variable analysis

Lateral preferences are important for the study of cerebral lateralization and may be indicative of neurobehavioral disorders, neurodevelopmental instability, and deficits in lateralization. Previous studies showed that self-reported preferences are also concordantly interrelated, suggesting a common genetic or biological origin, sidedness. However, with regard to the assessment and classification of lateral preferences, there is a dearth of psychometric studies, but a need for psychometrically validated instruments that can be reliably used in applied research. Based on three independent large samples (total N>15,100), this study investigated the psychometric properties of widely-used lateral preference scales of handedness, footedness, eyedness, and earedness. Preferences were consistently and replicably categorical, consisting of right, mixed, and left preferences each, underlining that primarily qualitative, rather than quantitative, differences differentiate lateral preferences. Right-, mixed-, and left-sidedness underlay the individual preferences, but sidedness alone could not fully explain the observed inter-relations. Footedness was the single most important indicator of sidedness. Our data were further consistent with predictions of right shift theory and corroborated a 'pull-to-concordance' in hand-foot preferences. We recommend the use of psychometrically validated scales and of a trichotomous classification of lateral preferences in future research, but conclude that handedness may be a biased indicator of underlying sidedness. Footedness needs to be examined more closely with regard to cerebral lateralization, neurodevelopmental disorders, and neurodevelopmental instability.

The imprinted gene LRRTM1 mediates schizotypy and handedness in a nonclinical population

Imprinted genes have been posited to have important roles in human brain development and cognition, but their effects in nonclinical populations have yet to be investigated. Single-nucleotide polymorphisms (SNPs) of the imprinted gene LRRTM1 have previously been associated with schizophrenia risk and with handedness in individuals with dyslexia. We tested the hypothesis that genetic variation (SNPs) and epigenetic variation (methylation) in this gene are associated with schizotypy and handedness in a nonclinical population. Risk alleles of the three schizophrenia-linked SNPs were associated with significantly and substantially higher levels of total schizotypy. Variation in SNP genotypes was not associated with handedness, but levels of methylation in a block of CpG sites in the putative LRRTM1 promoter region were associated with more-mixed handedness. These findings provide evidence of continuity between schizophrenia and schizotypy with regard to the psychological effects of allelic variation in this imprinted gene, and show that epigenetic variation in an imprinted gene mediates the development and expression of human handedness.

Left brain, right brain: facts and fantasies

Handedness and brain asymmetry are widely regarded as unique to humans, and associated with complementary functions such as a left-brain specialization for language and logic and a right-brain specialization for creativity and intuition. In fact, asymmetries are widespread among animals, and support the gradual evolution of asymmetrical functions such as language and tool use. Handedness and brain asymmetry are inborn and under partial genetic control, although the gene or genes responsible are not well established. Cognitive and emotional difficulties are sometimes associated with departures from the "norm" of right-handedness and left-brain language dominance, more often with the absence of these asymmetries than their reversal.

Season of birth, mixed-handedness, and psychometric schizotypy: preliminary results from a prospective study

Season of birth and hand preference were examined in a sample of 42 (7 males, 35 females) individuals who were identified as schizotypic based on their scores on selected scales of the Chapman Psychosis Proneness Scales (CPPS) and a matched comparison sample of 42 individuals with non-deviant CPPS scores. Presence or absence of schizotypy was analyzed using chi square tests of independence with the presence or absence of each risk factor serving as the independent variable. Further analyses incorporated independent means t tests to examine mean scores on the CPPS with the presence or absence of each risk factor again serving as the independent variable. Results supported the hypothesis that winter/early-spring birth would be associated with psychometric schizotypy, although the results for mixed-handedness fell just short of statistical significance. However, mixed hand preference was associated with higher scores on MagId and PerAb scales of the CPPS, but not the RSA scale, which suggests that mixed laterality is associated with the more cognitive-perceptual aspects of schizotypy. Results are discussed in relation to previous literature and their relevance to the prediction of schizophrenia-related psychosis.

Laterality of handgrip strength: age- and physical training-related changes in Lithuanian schoolchildren and conscripts

Laterality in handgrip strength was assessed by analyzing dynamometric data of the right and left hand in three samples of Lithuanian boys and girls aged 7-20 years. In addition, the influence of general physical training on the laterality of handgrip strength was explored in a sample of conscripts. A negative secular trend in handgrip strength of schoolchildren has been detected since 1965, and with increasing age, right-handedness has become more pronounced. Children that were ambidextrous (by grip strength) showed negative deviations in physical status more often than their right- or left-handed peers. During one year of physical training, the conscripts had a larger increase in grip strength of the left than in the right hand, and a marked shift in handgrip laterality toward left-handed and ambidextrous individuals was observed. The different impact of schooling and physical training on handgrip strength laterality might partly explain variations in the prevalence of handedness in different societies with divergent cultures and lifestyles (e.g., more or less sedentary).

How are autism and schizotypy related? Evidence from a non-clinical population

Both autism spectrum conditions (ASCs) and schizophrenia spectrum conditions (SSCs) involve altered or impaired social and communicative functioning, but whether these shared features indicate overlapping or different etiological factors is unknown. We outline three hypotheses (overlapping, independent, and diametric) for the possible relationship between ASCs and SSCs, and compare their predictions for the expected relationships between autistic and schizotypal phenotypes using the Autism Spectrum Quotient and the Schizotypal Personality Questionnaire-Brief Revised from a large non-clinical sample of undergraduate students. Consistent with previous research, autistic features were positively associated with several schizotypal features, with the most overlap occurring between interpersonal schizotypy and autistic social and communication phenotypes. The first component of a principal components analysis (PCA) of subscale scores reflected these positive correlations, and suggested the presence of an axis (PC1) representing general social interest and aptitude. By contrast, the second principal component (PC2) exhibited a pattern of positive and negative loadings indicative of an axis from autism to positive schizotypy, such that positive schizotypal features loaded in the opposite direction to core autistic features. These overall PCA patterns were replicated in a second data set from a Japanese population. To evaluate the validity of our interpretation of the PCA results, we measured handedness and mental rotation ability, as these are established correlates of SSCs and ASCs, respectively. PC2 scores were significantly associated with hand preference, such that increasingly 'schizotypal' scores predicted reduced strength of handedness, which is consistent with previous research. PC1 scores were positively related to performance on the mental rotation task, suggesting trade-offs between social skills and visual-spatial ability. These results provide novel evidence for an autism-positive schizotypy axis, and highlight the importance of recognizing that psychological variation involving reduced social interest and functioning may have diverse causes.

Psychotic-like symptoms and positive schizotypy are associated with mixed and ambiguous handedness in an adolescent community sample

The objective of this study was to replicate the association between atypical handedness and psychosis-proneness in a representative sample of adolescents from the general population. It expands previous studies by (1) analyzing a variety of atypical handedness indexes (left, mixed, ambiguous, and inconsistent), (2) measuring comprehensively the multidimensionality of psychosis-proneness, and (3) analyzing the association of different patterns of atypical handedness with nonclinical dimensions of both trait (schizotypy) and sub-clinical symptom (psychotic-like experiences) levels. Seven hundred and twenty-eight adolescents were assessed for handedness by the 12-item self-report Annett Hand Preference Questionnaire and for psychosis-proneness by the Oxford-Liverpool Inventory of Feelings and Experiences and the Community Assessment of Psychic Experiences scales. Writing-hand alone did not detect associations between laterality and psychosis-proneness. Mixed- rather than left-handedness was related to psychosis-proneness, and this was more evident when analyzing subjects with ambiguous handedness exclusively. When analysis was restricted to subjects with non-ambiguous handedness, strong left-handedness was related to psychosis-proneness. The positive dimension showed a stronger association than the negative one with atypical handedness. Results partially support mixed-handedness as a marker of developmental disorders underlying both atypical lateralization and psychosis-proneness. Among various possible mixed-handedness patterns, inconsistent hand use across primary actions, and for the same action across time, seems particularly related to psychosis-proneness and thus requires further exploration.

Schizotypal trait in healthy women is associated with a shift away from dextrality on a spatial motor control task, but not on a force control task

It is generally acknowledged that schizophrenia and schizotypy lie on the same continuum, while there is an ongoing debate as to whether schizotypy represents true dimension or quasi-dimension. Evidence suggests that reduced hemispheric lateralization and mixed handedness are associated with both schizophrenia and schizotypy. However, the possible relationship of schizotypy with laterality as assessed with motor function tasks has not been well documented. A few studies using fine motor control tasks have demonstrated the relationship between schizotypy and reduced laterality among student populations, yet little has been done in community samples. Here we employed 249 healthy women and examined the association between schizotypal traits assessed with the Schizotypal Personality Questionnaire and motor functions assessed with the Purdue Pegboard test (as a measure of spatial motor control) and a handgrip force test. Correlational and categorical analyses both showed that schizotypal traits were significantly associated with leftward and bilateral bias in the fine motor control task, but not in the handgrip force test. Schizotypy did not significantly affect the performance level on either of these tasks. These results indicate that schizotypal traits in healthy women are associated with a shift away from dextrality, supporting the fully dimensional model of schizotypy.

The cross-cultural nature of the relationship between schizotypy and mixed-handedness

Positive schizotypy is associated with non-right-handedness, which includes left- and mixed-handedness. However, because the underlying mechanisms might be different, it is important to examine whether both left- and mixed-handedness are associated with a high incidence of schizotypy. During 2009-2010, we used both the Perceptual Aberration Scale and Schizotypal Personality Questionnaire to assess 1315 undergraduate students in Taiwan for schizotypy and the Annett handedness questionnaire to assess handedness. Among the three-way classifications based on Annett's grouping, the fully left-handed group appeared to have the lowest score of positive schizotypy; next was the fully right-handed group and then the mixed-handed. Among the three-way classifications driven from cluster analysis, mixed-handers showed highest score of positive schizotypy. When handedness was treated continuously, both direction (e.g., Hand Preference Index) and consistency (e.g., Either hand use score) indicators were significantly correlated with schizotypy. The results of regression analyses showed that the quadratic handedness measure were negatively associated with schizotypy. The results remained similar after correcting for social pressure on left-handedness. In conclusion, the relationship between schizotypy and mixed-handedness appears to be cross-cultural. The dichotomous classification of handedness, right- vs. non-right-handedness, appears to be insufficient. Additional studies on the distinct mechanisms of mixed- and left-handedness are warranted.

Schizotypy trait and striatal dopamine receptors in healthy volunteers

Individuals with schizotypal features exhibit cognitive, perceptual and social deficits that are similar to but less prominent than those seen in patients with schizophrenia. Dopaminergic hyperactivity in the striatum has been related to the positive symptoms of schizophrenia, and brain-imaging studies of dopamine uptake in the striatum are thought to be linked to the pathophysiological mechanisms underlying schizophrenia. The aim of this study was to investigate whether the increased availability of striatal dopamine (DA) D(2/3) receptors is related to elevated levels of schizotypal features in healthy individuals. The Schizotypal Personality Questionnaire (SPQ) was administered to 55 healthy volunteers. The availability of their striatal DA D(2/3) receptors was analysed using [(123)I] iodobenzamide single photon emission computed tomography (SPECT). Although the SPQ total scores showed no correlation with the availability of total (left and right) striatal DA D(2) receptors, the SPQ disorganised subscale scores were positively correlated with the availability of right striatal DA D(2/3) receptors. Our findings demonstrated that the availability of striatal DA D(2/3) receptors may be associated with schizotypal features in healthy volunteers.

Stressing schizotypy: the modulating role of stress-relieving behaviours and intellectual capacity on functional hemispheric asymmetry

Relative cognitive impairments are common along the schizophrenia spectrum reflecting potential psychopathological markers. Yet stress, a vulnerability marker in schizophrenia (including its spectrum), is likewise related to cognitive impairments. We investigated whether one such cognitive marker (attenuated functional hemispheric asymmetry) during stressful life periods might be linked to individuals' schizotypal features or rather to individuals' stress-related experiences and behaviours. A total of 58 students performed a left hemisphere dominant (lateralised lexical decisions) and right hemisphere dominant (sex decisions on composite faces) task. In order to account for individual differences in stress sensitivity we separated participants into groups of high or low cognitive reserve according to their average current marks. In addition, participants filled in questionnaires on schizotypy (short O-LIFE), perceived stress, stress response, and a newly adapted questionnaire that enquired about potential stress compensation behaviour (elevated substance use). The most important finding was that enhanced substance use and cognitive disorganisation contributed to a right and left hemisphere shift in language dominance, respectively. We discuss that (i) former reports on right hemisphere shifts in language dominance with positive schizotypy might be explained by an associated higher substance use and (ii) cognitive disorganisation relates to unstable cognitive functioning that depend on individuals' life circumstances, contributing to published reports on inconsistent laterality-schizotypy relationships.

Mixed handedness is associated with greater age-related decline in volumes of the hippocampus and amygdala: the PATH through life study

Handedness has been found to be associated with structural and functional cerebral differences. Left handedness and mixed handedness also appear to be associated with an elevated risk of some developmental and immunological disorders that may contribute to pathological processes developing in ageing. Inconsistent reports show that left handedness may be more prevalent in early-onset as well as late-onset Alzheimer's disease, but might also be associated with slower decline. Such inconsistencies may be due to handedness being usually modeled as a binary construct while substantial evidence suggests it to be a continuous trait. The aim of this study was to investigate the relationship between brain structures known to be implicated in pathological ageing and strength and direction of handedness. The association between handedness and hippocampal and amygdalar atrophy was investigated in 327 cognitively healthy older individuals. Handedness was measured with the Edinburgh Inventory. Two measures were computed from this index, one reflecting the direction (left = 0/right = 1) and the other the degree of handedness (ranging from 0 to 1). Hippocampal and amygdalar volumes were manually traced on scans acquired 4 years apart. Regression analyses were used to assess the relationship between strength and direction of handedness and incident hippocampal and amygdalar atrophy. Analyses showed that strength but not direction of handedness was a significant predictor of hippocampal (Left: beta = 0.118, P = 0.013; Right: beta = 0.116, P = 0.010) and amygdalar (Right: beta = 0.105, P = 0.040) atrophy. The present findings suggest that mixed but not left handedness is associated with greater hippocampal and amygdalar atrophy. This effect may be due to genetic, environmental, or behavioural differences that will need further investigation in future studies.

A psychometric approach to the relationship between hand-foot preference and auditory hallucinations in the general population: atypical cerebral lateralization may cause an abnormal sense of agency

The present study examined the relationship between the atypical cerebral lateralization pattern represented in hand and foot preferences and schizotypal personality traits, especially proneness to auditory hallucinations as related to a sense of agency. A sense of agency, measured with questionnaires in the present study, is the sense that "I am the one who causes the actions." Although atypical lateralization and an abnormal sense of agency may be related to schizophrenia or schizotypal personality, the connection between them has remained unclear. The present study used cluster analysis to categorize the handedness-footedness combinations. The results indicated that people with right-handedness and left-footedness may have more schizotypal traits and that their abnormal sense of agency may cause schizotypal personality traits. Although the reasons for crossed lateral preference remain unclear, we discuss this in terms of early switching in handedness, which may underlie atypical lateralization and lead to the experience of auditory hallucinations deriving from an abnormal sense of agency.

Going beyond students: an association between mixed-hand preference and schizotypy subscales in a general population

Research on the sub-clinical condition of schizotypy suggests that it is associated with mixed handedness. To date, however, this research has focussed on undergraduate populations. If the association between schizotypy and mixed-handedness is the result of an underlying neurological trait, it is important to demonstrate that the effect extends to the general population. With this in mind, 699 participants were drawn from a wide community sample. Schizotypy was measured using the Psychosis Proneness Questionnaire and handedness was assessed using the Annett inventory. To avoid the sometimes arbitrary definitions of left-, right- and mixed-handed, regression analyses were used to explore the data. There was no evidence of a difference in schizotypy between individuals with a left- or right-hand preference. People with a mixed-hand preference, however, had higher scores on PER-MAG (Perceptual Aberration and Magical Ideation) and HYP-IMP (Hypomania and Impulsive Non-Conformity) scales (positive traits). No effect was observed for the SAN (Social Anhedonia) and PAN (Physical Anhedonia) scales (negative traits). The nature of the association between schizotypy and handedness observed in the current study is similar to that reported for student populations. The possibility that the association is related to response biases or a biological mechanism is discussed.

Handedness and schizotypy in non-psychotic relatives of patients with schizophrenia

Existing studies have found the relationship between handedness and schizotypy to be inconsistent, and had limited generalisability since only highly homogeneous groups have been investigated. This study aimed to examine the relation between handedness and the four schizotypal factors identified from a previous confirmatory factor analysis in a population of high familial loading for schizophrenia. Study participants consisted of non-psychotic first-degree relatives (850 parents and 334 siblings) of sib-pairs who were co-affected with schizophrenia. All participants were interviewed with the Diagnostic Interview for Genetic Studies, which contains a section of the modified Structured Interview for Schizotypy, and the Annett handedness questionnaire. Both categorical and continuous indicators for handedness were examined. Non-right-handed siblings of schizophrenia patients displayed more positive schizotypal features than their right-handed counterparts when the two-way Annett's handedness classification was adopted. No association was found when handedness was treated as continuous. The relationship between handedness and schizotypy was insignificant for parents probably due to the strong social pressure against left-handedness. We concluded that categorical non-right-handedness was associated with positive schizotypy in non-psychotic siblings of schizophrenia patients. The results indicate that an atypical cerebral lateralisation underlying non-right-handedness may be also a contributing factor to positive schizotypy.

The influence of tobacco consumption on the relationship between schizotypy and hemispheric asymmetry

Tobacco use is positively associated with severity of symptoms along the schizophrenia spectrum. Accordingly it could be argued that neuropsychological performance, formerly thought to be modulated by schizotypy, is actually modulated by drug use or an interaction of drug use and schizotypy. We tested whether habitual cigarette smokers as compared to non-smokers would show a neuropsychological profile similar to that observed along the schizophrenia spectrum and, if so, whether smoking status or nicotine dependence would be more significant modulators of behavior than schizotypy. Because hemispheric dominance has been found to be attenuated along the schizophrenia spectrum, 40 right-handed male students (20 non-smokers) performed lateralized left- (lexical decisions) and right- (facial decision task) hemisphere dominant tasks. All individuals completed self-report measures of schizotypy and nicotine dependence. Schizotypy predicted laterality in addition to smoking status: While positive schizotypy (Unusual Experiences) was unrelated to hemispheric performance, Cognitive Disorganization predicted reduced left hemisphere dominant language functions. These latter findings suggest that Cognitive Disorganization should be regarded separately as a potentially important mediator of thought disorganization and language processing. Additionally, increasing nicotine dependence among smokers predicted a right hemisphere shift of function in both tasks that supports the role of the right hemisphere in compulsive/impulsive behavior.

Neural correlates of irony comprehension: the role of schizotypal personality traits

To detect that a conversational turn is intended to be ironic is a difficult challenge in everyday language comprehension. Most authors suggested a theory of mind deficit is crucial for irony comprehension deficits in psychiatric disorders like schizophrenia; however, the underlying pathophysiology and neurobiology are unknown and recent research highlights the possible role of language comprehension abnormalities. Fifteen female right-handed subjects completed personality testing as well as functional magnetic resonance imaging (fMRI) and neuropsychology. Subjects were recruited from the general population. No subject had a lifetime history of relevant psychiatric disorder; however, subjects differed in their score on the German version of the schizotypal personality questionnaire (SPQ). During fMRI scans, the subjects silently read 44 short text vignettes that ended in either an ironic or a literal statement. Imaging was performed using a 3 T Siemens scanner. The influence of schizotypy on brain activation was investigated by using an SPM5 regression analysis with the SPQ total score and the SPQ cognitive-perceptual score as regressors. Reading ironic in contrast to literal sentences activated a bilateral network including left medial prefrontal and left inferior parietal gyri. During reading of ironic sentences, brain activation in the middle temporal gyrus of both hemispheres showed a significant negative association with the SPQ total score and the SPQ cognitive-perceptual score. Significant positive correlation with the SPQ total score was present in the left inferior frontal gyrus. We conclude schizotypal personality traits are associated with a dysfunctional lateral temporal language rather than a theory of mind network.

Mixed-handedness is linked to mental health problems in children and adolescents

OBJECTIVE

Problems with language and symptoms of attention-deficit/hyperactivity disorder (ADHD) in childhood and adolescence are often strongly linked to low scholastic performance. Early recognition of children who are at increased risk is necessary. Our objective was to determine whether mixed-handedness, which is associated with atypical cerebral laterality, is associated with language, scholastic, and ADHD symptoms in childhood and adolescence.

METHODS

Prospective data come from the Northern Finland Birth Cohort 1986, a longitudinal, population-based birth cohort with assessments when children were 7 to 8 and 16 years of age (N = 7871). Teacher, parent, and/or adolescent reports were used to assess language difficulties, scholastic performance, and mental health, including ADHD symptoms.

RESULTS

Mixed-handed children, relative to right-handed, had approximately a twofold increase in odds of having difficulties with language and scholastic performance at the age of 8 years. Eight years later, as 16-year-olds, adolescents had twofold increase in odds concerning difficulties in school with language and with ADHD symptoms. Mixed-handed children were more likely to have scores indicating probable psychiatric disturbance, including ADHD symptoms. As adolescents, mixed-handed children with previous behavioral problems were at considerably higher risk for scoring within the range of probable ADHD-inattention or ADHD-combined case. Mixed-handedness was associated with greater symptom severity in children and adolescents (P = .01) concerning psychiatric disturbance and ADHD inattention but not ADHD hyperactivity.

CONCLUSIONS

The results indicate that mixed-handed children have a greater likelihood of having language, scholastic, and mental health problems in childhood and that these persist into adolescence. Thus, these results suggest that mixed-handedness, particularly in the presence of difficulties, could aid in the recognition of children who are at risk for stable problems. Additional research is needed to understand the connections between neural substrates related to atypical cerebral asymmetry, mixed-handedness, and mental health problems including ADHD symptoms.