Mixed lateral preference in posttraumatic stress disorder

Fifty Years of Handedness Research: A Neurological and Methodological Update

Handedness, a complex human aspect that reflects the functional lateralization of the hemispheres, also interacts with the immune system. This study aimed to expand the knowledge of the lateralization of hand, foot, and eye activities in patients with immune-mediated (IM) or other (noIM) neurological diseases and to clarify the properties of the Edinburgh Handedness Inventory (EHI) in an Italian population. Three hundred thirty-four patients with IM or noIM diseases affecting the brain or spine and peripheral nervous system were interviewed about stressful events preceding the disease, subjective handedness, and familiarity for left-handedness or ambidexterity. The patients and 40 healthy subjects underwent EHI examination. In the whole group of participants, 24 items of the EHI were classified into five factors (Hand Transitive, Hand Refined, Hand Median, Foot, Eye), demonstrating good reliability and validity. Chronological age had a significant influence on hand and foot EHI factors and the laterality quotient (LQ), particularly on writing and painting. In the patient groups, EHI factors and the LQ were also predicted by age of disease onset, duration of disease, and family history of left-handedness or ambidexterity. No differences were found between patients and healthy subjects, but pencil use scored significantly lower in patients with IM diseases than in those with noIM brain diseases. These results demonstrate that the lateralization of hand and foot activities is not a fixed human aspect, but that it can change throughout life, especially for abstract and symbolic activities. Chronic neurological diseases can cause changes in handedness. This may explain why, unlike systemic immunological diseases, IM neurological diseases are not closely associated with left-handedness. In these patients, the long version of the EHI is appropriate for determining the lateralization of body activities to contextualize the neurological picture; therefore, these findings extend the Italian normative data sets.

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.

Acute and chronic stress alter behavioral laterality in dogs

Dogs are one of the key animal species in investigating the biological mechanisms of behavioral laterality. Cerebral asymmetries are assumed to be influenced by stress, but this subject has not yet been studied in dogs. This study aims to investigate the effect of stress on laterality in dogs by using two different motor laterality tests: the Kong™ Test and a Food-Reaching Test (FRT). Motor laterality of chronically stressed (n = 28) and emotionally/physically healthy dogs (n = 32) were determined in two different environments, i.e., a home environment and a stressful open field test (OFT) environment. Physiological parameters including salivary cortisol, respiratory rate, and heart rate were measured for each dog, under both conditions. Cortisol results showed that acute stress induction by OFT was successful. A shift towards ambilaterality was detected in dogs after acute stress. Results also showed a significantly lower absolute laterality index in the chronically stressed dogs. Moreover, the direction of the first paw used in FRT was a good predictor of the general paw preference of an animal. Overall, these results provide evidence that both acute and chronic stress exposure can change behavioral asymmetries in dogs.

Handedness in post-traumatic stress disorder: A meta-analysis

The main objective of this meta-analysis was to investigate handedness in post-traumatic stress disorder on a meta-analytical level. For this purpose, articles were identified via a search in PubMed, PsychInfo, PubPsych, ResearchGate, and Google Scholar. Studies reporting findings relating to handedness in PTSD patients and healthy controls were considered eligible. In total, k = 14 studies with an overall N of 2939 (747 PTSD patients and 2192 controls) were included in the study. Random-effects meta-analyses, as well as robust Bayes meta-analyses (RoBMA), were conducted for three comparisons: (a) non-right-handedness, (b) left-handedness, and (c) mixed-handedness. Results showed significantly higher frequencies of non-right-handedness (odds ratio = 1.81) and mixed-handedness (odds ratio = 2.42) in PTSD patients compared to controls. No differences were found for left-handedness. This specific effect of mixed-handedness is in line with findings for other disorders, such as schizophrenia. Future studies should investigate common neurodevelopmental origins for the relationship between mixed-handedness and psychopathology and aim at investigating both handedness direction and handedness strength.

Is There an Association between Paw Preference and Emotionality in Pet Dogs?

Research with humans and other animals has suggested that preferential limb use is linked to emotionality. A better understanding of this still under-explored area has the potential to establish limb preference as a marker of emotional vulnerability and risk for affective disorders. This study explored the potential relationship between paw preference and emotionality in pet dogs. We examined which paw the dogs preferentially used to hold a Kong™ and to perform two different locomotion tests. Dogs' emotionality was assessed using a validated psychometric test (the Positive and Negative Activation Scale-PANAS). Significant positive correlations were found for dogs' paw use between the different locomotion tasks, suggesting that dogs may show a more general paw preference that is stable across different types of locomotion. In comparison, the correlations between the Kong™ Test and locomotion tests were only partially significant, likely due to potential limitations of the Kong™ Test and/or test-specific biomechanical requirements. No significant correlations were identified between paw preference tests and PANAS scores. These results are in contrast to previous reports of an association between dog paw preference and emotionality; animal limb preference might be task-specific and have variable task-consistency, which raises methodological questions about the use of paw preference as a marker for emotional functioning.

Does Functional Lateralization in Birds Have any Implications for Their Welfare?

We know a good deal about brain lateralization in birds and a good deal about animal welfare, but relatively little about whether there is a noteworthy relationship between avian welfare and brain lateralization. In birds, the left hemisphere is specialised to categorise stimuli and to discriminate preferred categories from distracting stimuli (e.g., food from an array of inedible objects), whereas the right hemisphere responds to small differences between stimuli, controls social behaviour, detects predators and controls attack, fear and escape responses. In this paper, we concentrate on visual lateralization and the effect of light exposure of the avian embryo on the development of lateralization, and we consider its role in the welfare of birds after hatching. Findings suggest that light-exposure during incubation has a general positive effect on post-hatching behaviour, likely because it facilitates control of behaviour by the left hemisphere, which can suppress fear and other distress behaviour controlled by the right hemisphere. In this context, particular attention needs to be paid to the influence of corticosterone, a stress hormone, on lateralization. Welfare of animals in captivity, as is well known, has two cornerstones: enrichment and reduction of stress. What is less well-known is the link between the influence of experience on brain lateralization and its consequent positive or negative outcomes on behaviour. We conclude that the welfare of birds may be diminished by failure to expose the developing embryos to light but we also recognise that more research on the association between lateralization and welfare is needed.

Functional cerebral asymmetry in dogs living under different environmental conditions

Investigating the link between stress and functional cerebral asymmetry (FCA) has been a subject of interest in recent years. The demonstration of this link in the field of veterinary medicine is particularly important as measuring FCA has the potential to be an alternative and non-invasive behavioral method to assess stress in dogs. The present study aimed to investigate whether FCA is affected by different environmental conditions in dogs. The main aim of this study was to investigate the changes in FCA in dogs living under different conditions. To this aim, strength and direction of FCA in 40 urban free-ranging dogs were measured by a Kong test. Dogs were divided into four groups considering their environmental conditions: The dogs in Group 1 (n = 8) were rehabilitated urban free ranging dogs, which were kept in enriched shelter conditions. The dogs in Group 2 (n = 9) were adopted free ranging dogs, which lived in home environment for more than 1 year. The dogs in Group 3 (n = 11) were urban free ranging dogs, which stayed in individual cages in a dog shelter for more than 6 months. The dogs in Group 4 (n = 12) were adopted urban free ranging dogs, which stayed in a dog pension for more than 30 days. Considering the length of their stay in a kennel environment, quality of living condition and emotional states, the dogs in Group 3 and 4 were classified as chronically stressed dogs. Statistically significant differences existed between groups considering strength and direction of lateralization. Most of the dogs in Group 1 (87.5 %) and Group 2 (77.8 %) showed significant paw preferences, whereas most of the dogs in the Group 3 (72.7 %) and Group 4 (75 %) were categorized as ambilateral. Considering the individual level asymmetry in dogs and environmental conditions of dogs in Group 3 and 4, one may suggest that high ambilaterality levels is related with chronic stress. Thus, reduced FCA may not be the reason for stress sensibility, rather it can be an outcome of stressful situations. These results are the first to demonstrate the possible link between chronic stress and ambilaterality in dogs.

Translation, cultural adaption, and test-retest reliability of Chinese versions of the Edinburgh Handedness Inventory and Waterloo Footedness Questionnaire

Quantitative assessments of handedness and footedness are often required in studies of human cognition and behaviour, yet no reliable Chinese versions of commonly used handedness and footedness questionnaires are available. Accordingly, the objective of the present study was to translate the Edinburgh Handedness Inventory (EHI) and the Waterloo Footedness Questionnaire-Revised (WFQ-R) into Mandarin Chinese and to evaluate the reliability and validity of these translated versions in healthy Chinese people. In the first stage of the study, Chinese versions of the EHI and WFQ-R were produced from a process of translation, back translation and examination, with necessary cultural adaptations. The second stage involved determining the reliability and validity of the translated EHI and WFQ-R for the Chinese population. One hundred and ten Chinese participants were tested online, and the results showed that the Cronbach's alpha coefficient of internal consistency was 0.877 for the translated EHI and 0.855 for the translated WFQ-R. Another 170 Chinese participants were tested and re-tested after a 30-day interval. The intra-class correlation coefficients showed high reliability, 0.898 for the translated EHI and 0.869 for the translated WFQ-R. This preliminary validation study found the translated versions to be reliable and valid tools for assessing handedness and footedness in this population.

The interrelationships between moral attitudes, posttraumatic stress disorder symptoms and mixed lateral preference in Israeli reserve combat troops

BACKGROUND

Combat soldiers often encounter moral dilemmas during operational deployment, especially when an armed engagement is situated within a civilian setting. The study of moral dilemmas and posttraumatic stress disorder (PTSD) has mostly focused on the impact of war atrocities and moral injury. However, the relationship between moral attitudes and different combat-related pathologies has not been thoroughly addressed by quantitative studies.

AIMS

We aimed to assess the relationship between combatant's moral attitudes, severity of PTSD symptoms and mixed lateral preference.

METHODS

Data on moral objection, PTSD severity and lateral preference were collected in a right-handed non-pathologic sample (n = 147) of reserve combat troops in the Israel Defense Forces (IDF).

RESULTS

Nearly one-fifth (19.7%) of the reserve personnel who served in the occupied territories have reported high moral objection to the commands they were expected to act upon. This group of participants exhibited more PTSD symptoms and higher levels of mixed lateral preference. Multiple linear regression analyses revealed a mediating role of moral objection in the relationship between PTSD symptoms severity and lateral preference.

CONCLUSIONS

Our findings suggest that moral objection has significant implications on combatant's psychological and organic well-being. The findings highlight the need to include moral attitudes in research and clinical practice among combat personnel and veterans.

Eye Movement Desensitization and Reprocessing in a Patient With Asperger’s Disorder: Case Report

Eye movement desensitization and reprocessing (EMDR) has demonstrated efficacy in the treatment of posttraumatic stress disorder (PTSD). This case demonstrates the successful use of EMDR for the treatment of PTSD in a patient with Asperger’s disorder and examines potential pitfalls both in detecting and treating PTSD in patients with autism spectrum disorders. Our patient was a 21–year-old female with a diagnosis of Asperger’s disorder and multiple traumas stemming primarily from physical abuse at the hands of her peers in school. Treatment was provided in an accelerated format, being provided 3 days a week for approximately 3 weeks leaving at least 1 day in between sessions. After receiving 8 EMDR sessions, her scores improved on the Posttraumatic Checklist with effects maintained at 8-month follow-up.

Caudate gray matter volume in obsessive-compulsive disorder is influenced by adverse childhood experiences and ongoing drug treatment

BACKGROUND

Exposure to adverse childhood experiences (ACE) increases the risk of adult physical and mental health disorders, including obsessive-compulsive disorder (OCD), and influences adult cortical neural responses and gray matter (GM) volumes. Robust neuroimaging findings associated OCD with corticostriatal dysfunction and with abnormal morphology and metabolism of cortical areas and basal ganglia.

METHODS

We explored the GM correlates of ACE in 40 patients with OCD (15 drug-naive and 25 drug-treated patients) with magnetic resonance imaging voxel-based morphometry at 3.0 T. Regional GM volumes were the dependent variable, and drug treatment (naive vs treated) and breadth of exposure to ACE (high vs low) were the factors of interest. Sex, duration of illness, and handedness were considered as nuisance covariates. Whole brain statistical threshold was P < 0.05 familywise error corrected for multiple comparisons.

RESULTS

Patients with higher levels of exposure to ACE showed increased GM volume in the head of the left caudate nucleus. Ongoing drug treatment was associated with reduced GM volume in the same area. Earlier age at onset of OCD, need for medication treatment, and mixed handedness were correlated with higher levels of ACE.

CONCLUSIONS

Exposure to ACE increased, and ongoing drug treatment decreased, caudate GM in OCD. Increased volume and metabolism of the caudate nucleus have been consistently associated with OCD. Our findings suggest a detrimental effect of ACE on the brain underpinnings of OCD, with an opposite effect of medications.

Neuropsychological Effects of Posttraumatic Stress Disorder in Children and Adolescents

Posttraumatic Stress Disorder (PTSD) can affect people of all ages but the literature is lacking on children and adolescents who experience PTSD. The consequences of this disorder extend beyond the basic symptoms by which it is defined. Neuroanatomically, the brains of children with PTSD have been found to be abnormally symmetrical in several structures, resulting in abnormal functioning. Neuropsychological assessment reveals that children and adolescents with the PTSD syndrome have significant deficits in memory, attention, executive functioning, and in overall verbal intelligence that needs to be discriminated from other syndromes with similar deficits, for example, Attention Deficit Hyperactivity Disorder (ADHD). This review presents the research findings with regard to these deficits in learning and behaviour that school psychologists encounter with students who experience PTSD. Implications for the practice of school psychology and suggestions for future research are discussed.

Lateralized abnormalities in auditory M50 sensory gating and cortical thickness of the superior temporal gyrus in post-traumatic stress disorder: preliminary results

Auditory sensory gating deficits have been reported in subjects with post-traumatic stress disorder (PTSD), but the hemispheric and neuronal origins of this deficit are not well understood. The objectives of this study were to: (1) investigate auditory sensory gating of the 50-ms response (M50) in patients diagnosed with PTSD by utilizing magnetoencephalography (MEG); (2) explore the relationship between M50 sensory gating and cortical thickness of the superior temporal gyrus (STG) measured with structural magnetic resonance imaging (MRI); and (3) examine the association between PTSD symptomatology and bilateral sensory gating. Seven participants with combat-related PTSD and eleven controls underwent the paired-click sensory gating paradigm. MEG localized M50 neuronal generators to the STG in both groups. The PTSD group displayed impaired M50 gating in the right hemisphere. Thinner right STG cortical thickness was associated with worse right sensory gating in the PTSD group. The right S1 M50 source strength and gating ratio were correlated with PTSD symptomatology. These findings suggest that the structural integrity of right hemisphere STG cortices play an important role in auditory sensory gating deficits in PTSD.

Converging evidence for abnormalities of the prefrontal cortex and evaluation of midsagittal structures in pediatric posttraumatic stress disorder: an MRI study

Volumetric imaging research has shown abnormal brain morphology in posttraumatic stress disorder (PTSD) when compared with control subjects. We present results on a study of brain morphology in the prefrontal cortex (PFC) and midline structures, via indices of gray matter volume and density, in pediatric PTSD. We hypothesized that both methods would demonstrate aberrant morphology in the PFC. Further, we hypothesized aberrant brainstem anatomy and reduced corpus callosum volume in children with PTSD. Twenty-four children (aged 7-14) with history of interpersonal trauma and 24 age- and gender-matched controls underwent structural magnetic resonance imaging (sMRI). Images of the PFC and midline brain structures were first analyzed using volumetric image analysis. The PFC data were then compared with whole brain voxel-based techniques using statistical parametric mapping (SPM). The PTSD group showed significantly increased gray matter volume in the right and left inferior and superior quadrants of the PFC and smaller gray matter volume in the pons and posterior vermis areas by volumetric image analysis. The voxel-by-voxel group comparisons demonstrated increased gray matter density mostly localized to ventral PFC as compared with the control group. Abnormal frontal lobe morphology, as revealed by separate-complementary image analysis methods, and reduced pons and posterior vermis areas are associated with pediatric PTSD. Voxel-based morphometry may help to corroborate and further localize data obtained by volume of interest methods in PTSD.

Left hand preference is related to posttraumatic stress disorder

Previous studies have found an increased prevalence of mixed/left handedness in male combat veterans and children with posttraumatic stress disorder (PTSD). This study examined lateral preference and screened for possible PTSD using a self-completion instrument in a general population sample (N = 596). Fifty-one individuals met all criteria for possible diagnosis of PTSD and, significantly, this group contained relatively more left handers; this effect was associated with strong left-handedness, rather than weak or mixed handedness. Left handers were found to have significantly higher scores in arousal symptoms of PTSD. This study extends previous findings to a civilian population and to women and suggests the association with left handedness may be a robust finding in people with PTSD.

Consistent association between mixed lateral preference and PTSD: confirmation among a national study of 2490 US Army Vietnam veterans

OBJECTIVE

To evaluate the research-based association between mixed lateral preference for handedness and risk for posttraumatic stress disorder (PTSD) in a large-scale sample of US Army Vietnam veterans exposed to war zone stressors.

METHOD

We used a national sample of 2490 male US Army veterans, who completed the Edinburgh Handedness Inventory (EHI), a measure ranging from -100 (pure left-handedness) to +100 (pure right-handedness). We developed several classifications representing levels of mixed laterality: a) an EHI -70 to +70 (EHI 70, moderate mixed); b) an EHI -50 to +50 (EHI 50, consistent mixed); and c) an EHI 0, plus reports of using either hand on > or =50% of the tasks assessed (EHI 0+, extreme mixed). We controlled for intelligence, race, Army entry age, and Army volunteer status, and we assessed the impact of combat exposure.

RESULTS

Although all three handedness measures were associated with current PTSD in bivariate analyses, only Edinburgh 0+ was associated with PTSD in the multivariate model (odds ratio (OR) = 2.1; p = .021). However, when we classified handedness by high combat exposure, all three measures were associated with PTSD, with ORs = 2.5, 2.8, and 4.7 for EHI 70, EHI 50, and EHI 0+, respectively (all p < .001). Veterans with mixed laterality and high combat exposure also had significantly increased PTSD symptoms (all p < .001).

CONCLUSION

Our study confirmed findings reported among mostly smaller clinical samples and suggested that mixed lateral preference was associated with PTSD, especially among those individuals exposed to more severe psychological trauma.