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Arakaki Y, Yoshimoto T, Ishiyama H, Tanaka T, Hattori Y, Ihara M. Preservation of Dopamine Transporters in a Patient With Micrographia Due to Cerebral Infarction: A Case Report. J Mov Disord 2023; 16:221-223. [PMID: 37258282 DOI: 10.14802/jmd.23033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/17/2023] [Indexed: 06/02/2023] Open
Affiliation(s)
- Yoshito Arakaki
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takeshi Yoshimoto
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Hiroyuki Ishiyama
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tomotaka Tanaka
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yorito Hattori
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
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Vertebrobasilar Disease. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00026-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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3
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Persad AR, Mehta V. Permanent isolated micrographia from traumatic basal ganglia injury. Childs Nerv Syst 2019; 35:1415-1418. [PMID: 31127339 DOI: 10.1007/s00381-019-04196-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/06/2019] [Indexed: 10/26/2022]
Abstract
Micrographia is a rare neurological finding in isolation. Most cases of isolated micrographia have been found in association with focal ischemia of the left basal ganglia. Here, we present a case of post-traumatic micrographia stemming from contusion to the left basal ganglia.
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Affiliation(s)
- A R Persad
- Division of Neurosurgery, Department of Surgery, Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - V Mehta
- Division of Neurosurgery, Department of Surgery, Stollery Childrens' Hospital, University of Alberta, 8215 112 Street Northwest, Edmonton, AB, T6G 2B7, Canada.
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Inzelberg R, Plotnik M, Harpaz NK, Flash T. Micrographia, much beyond the writer's hand. Parkinsonism Relat Disord 2016; 26:1-9. [PMID: 26997656 DOI: 10.1016/j.parkreldis.2016.03.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/12/2016] [Accepted: 03/06/2016] [Indexed: 12/17/2022]
Abstract
INTRODUCTION This review on micrographia aims to draw the clinician's attention to non-Parkinsonian etiologies, provide clues to differential diagnosis, and summarize current knowledge on the phenomenology, etiology, and mechanisms underlying micrographia. METHODS A systematic review of the existing literature was performed. RESULTS Micrographia, namely small sized handwriting has long been attributed to Parkinson's disease. However, it has often been observed as part of the clinical picture of additional neurodegenerative disorders, sometimes antedating the motor signs, or following focal basal ganglia lesions without any accompanying parkinsonism, suggesting that bradykinesia and rigidity are not sine-qua-non for the development of this phenomenon. Therefore, micrographia in a patient with no signs of parkinsonism may prompt the clinician to perform imaging in order to exclude a focal basal ganglia lesion. Dopaminergic etiology in this and other cases is doubtful, since levodopa ameliorates letter stroke size only partially, and only in some patients. Parkinsonian handwriting is often characterized by lack of fluency, slowness, and less frequently by micrographia. Deviations from kinematic laws of motion that govern normal movement, including the lack of movement smoothness and inability to scale movement amplitude to the desired size, may reflect impairments in motion planning, possible loss of automaticity and reduced movement vigor. CONCLUSIONS The etiology, neuroanatomy, mechanisms and models of micrographia are discussed. Dysfunction of the basal ganglia circuitry induced by neurodegeneration or disruption by focal damage give rise to micrographia.
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Affiliation(s)
- Rivka Inzelberg
- Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel; Department of Applied Mathematics and Computer Science, The Weizmann Institute of Science, Rehovot, Israel.
| | - Meir Plotnik
- Department of Pharmacology and Physiology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel; Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel; Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel.
| | - Naama Kadmon Harpaz
- Department of Applied Mathematics and Computer Science, The Weizmann Institute of Science, Rehovot, Israel.
| | - Tamar Flash
- Department of Applied Mathematics and Computer Science, The Weizmann Institute of Science, Rehovot, Israel.
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Kim JS, Caplan LR. Vertebrobasilar Disease. Stroke 2016. [DOI: 10.1016/b978-0-323-29544-4.00026-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Wu T, Zhang J, Hallett M, Feng T, Hou Y, Chan P. Neural correlates underlying micrographia in Parkinson's disease. Brain 2015; 139:144-60. [PMID: 26525918 DOI: 10.1093/brain/awv319] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/16/2015] [Indexed: 11/14/2022] Open
Abstract
Micrographia is a common symptom in Parkinson's disease, which manifests as either a consistent or progressive reduction in the size of handwriting or both. Neural correlates underlying micrographia remain unclear. We used functional magnetic resonance imaging to investigate micrographia-related neural activity and connectivity modulations. In addition, the effect of attention and dopaminergic administration on micrographia was examined. We found that consistent micrographia was associated with decreased activity and connectivity in the basal ganglia motor circuit; while progressive micrographia was related to the dysfunction of basal ganglia motor circuit together with disconnections between the rostral supplementary motor area, rostral cingulate motor area and cerebellum. Attention significantly improved both consistent and progressive micrographia, accompanied by recruitment of anterior putamen and dorsolateral prefrontal cortex. Levodopa improved consistent micrographia accompanied by increased activity and connectivity in the basal ganglia motor circuit, but had no effect on progressive micrographia. Our findings suggest that consistent micrographia is related to dysfunction of the basal ganglia motor circuit; while dysfunction of the basal ganglia motor circuit and disconnection between the rostral supplementary motor area, rostral cingulate motor area and cerebellum likely contributes to progressive micrographia. Attention improves both types of micrographia by recruiting additional brain networks. Levodopa improves consistent micrographia by restoring the function of the basal ganglia motor circuit, but does not improve progressive micrographia, probably because of failure to repair the disconnected networks.
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Affiliation(s)
- Tao Wu
- 1 Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China 2 Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Centre of Beijing Institute for Brain Disorders, Beijing, China
| | - Jiarong Zhang
- 1 Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China 2 Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Centre of Beijing Institute for Brain Disorders, Beijing, China
| | - Mark Hallett
- 3 Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Tao Feng
- 2 Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Centre of Beijing Institute for Brain Disorders, Beijing, China 4 China National Clinical Research Centre for Neurological Diseases, Beijing, China 5 Department of Neurology, Centre for Neurodegenerative Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanan Hou
- 1 Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China 2 Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Centre of Beijing Institute for Brain Disorders, Beijing, China
| | - Piu Chan
- 1 Department of Neurobiology, Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China 2 Beijing Key Laboratory on Parkinson's Disease, Parkinson Disease Centre of Beijing Institute for Brain Disorders, Beijing, China
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Major Cognitive Changes and Micrographia following Globus Pallidus Infarct. Case Rep Neurol Med 2014; 2014:252486. [PMID: 25478259 PMCID: PMC4247961 DOI: 10.1155/2014/252486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 10/21/2014] [Accepted: 10/21/2014] [Indexed: 11/24/2022] Open
Abstract
Importance. Globus pallidus (GP) lesions are well known to cause motor deficits but are less commonly—and perhaps not conclusively—associated with cognitive problems. Observations. We present a 45-year-old male with no significant neurological or psychological problems who after suffering a GP infarct was subsequently found to have substantial cognitive problems and micrographia. Formal neuropsychological testing was not possible due to lack of patient follow-up. Conclusions and Relevance. Despite the conflicting literature on the association of GP lesions and cognitive deficits, our patient demonstrated significant neuropsychological changes following his stroke. In addition, evidence of micrographia likely adds to the literature on the localization of this finding. Our case thus suggests that neuropsychological testing may be beneficial after GP strokes.
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Ling H, Massey LA, Lees AJ, Brown P, Day BL. Hypokinesia without decrement distinguishes progressive supranuclear palsy from Parkinson's disease. ACTA ACUST UNITED AC 2012; 135:1141-53. [PMID: 22396397 DOI: 10.1093/brain/aws038] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Repetitive finger tapping is commonly used to assess bradykinesia in Parkinson's disease. The Queen Square Brain Bank diagnostic criterion of Parkinson's disease defines bradykinesia as 'slowness of initiation with progressive reduction in speed and amplitude of repetitive action'. Although progressive supranuclear palsy is considered an atypical parkinsonian syndrome, it is not known whether patients with progressive supranuclear palsy have criteria-defined bradykinesia. This study objectively assessed repetitive finger tap performance and handwriting in patients with Parkinson's disease (n = 15), progressive supranuclear palsy (n = 9) and healthy age- and gender-matched controls (n = 16). The motion of the hand and digits was recorded in 3D during 15-s repetitive index finger-to-thumb tapping trials. The main finding was hypokinesia without decrement in patients with progressive supranuclear palsy, which differed from the finger tap pattern in Parkinson's disease. Average finger separation amplitude in progressive supranuclear palsy was less than half of that in controls and Parkinson's disease (P < 0.001 in both cases). Change in tap amplitude over consecutive taps was computed by linear regression. The average amplitude slope in progressive supranuclear palsy was nearly zero (0.01°/cycle) indicating a lack of decrement, which differed from the negative slope in patients with Parkinson's disease OFF levodopa (-0.20°/cycle, P = 0.002). 'Hypokinesia', defined as <50% of control group's mean amplitude, combined with 'absence of decrement', defined as mean positive amplitude slope, were identified in 87% of finger tap trials in the progressive supranuclear palsy group and only 12% in the Parkinson's disease OFF levodopa group. In progressive supranuclear palsy, the mean amplitude was not correlated with disease duration or other clinimetric scores. In Parkinson's disease, finger tap pattern was compatible with criteria-defined bradykinesia, characterized by slowness with progressive reduction in amplitude and speed and increased variability in speed throughout the tap trial. In Parkinson's disease, smaller amplitude, slower speed and greater speed variability were all associated with a more severe Unified Parkinson's Disease Rating Scale motor score. Analyses of handwriting showed that micrographia, defined as smaller than 50% of the control group's mean script size, was present in 75% of patients with progressive supranuclear palsy and 15% of patients with Parkinson's disease (P = 0.022). Most scripts performed by patients with progressive supranuclear palsy did not exhibit decrements in script size. In conclusion, patients with progressive supranuclear palsy have a specific finger tap pattern of 'hypokinesia without decrement' and they do not have criteria-defined limb bradykinesia. Similarly, 'micrographia' and 'lack of decrement in script size' are also more common in progressive supranuclear palsy than in Parkinson's disease.
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Affiliation(s)
- Helen Ling
- Sara Koe PSP Research Centre, Institute of Neurology, University College London, UK.
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Sakurai Y, Yoshida Y, Sato K, Sugimoto I, Mannen T. Isolated thalamic agraphia with impaired grapheme formation and micrographia. J Neurol 2011; 258:1528-37. [DOI: 10.1007/s00415-011-5981-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 02/23/2011] [Accepted: 02/23/2011] [Indexed: 11/25/2022]
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10
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Blahak C, Capelle HH, Baezner H, Kinfe TM, Hennerici MG, Krauss JK. Micrographia induced by pallidal DBS for segmental dystonia: a subtle sign of hypokinesia? J Neural Transm (Vienna) 2011; 118:549-53. [DOI: 10.1007/s00702-010-0544-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Accepted: 11/29/2010] [Indexed: 10/18/2022]
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Abstract
Micrographia is a condition, in which the sufferers write with small handwriting. Hypophonia is described as low volume speech. Both conditions have been described in neurological conditions, such as lesions in the deep white matter of the brain, Parkinson's disease etc. In this case report, we are presenting a 22-years-old female patient with anorexia nervosa who suffered from both these conditions. The patient also suffered from epilepsy. The onset of these symptoms, progress, and current status provides scope for discussing both the possible biological and psychodynamic etiology for these symptoms in this young woman.
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Affiliation(s)
- Murali Krishnan Sekar
- Eating Disorder Services, Brandon Mental Health Unit, Leicester General Hospital, Leicester, LE5 4PW, United Kingdom.
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Cognitive, affective and behavioural disturbances following vascular thalamic lesions: a review. Cortex 2010; 47:273-319. [PMID: 21111408 DOI: 10.1016/j.cortex.2010.09.002] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 06/21/2010] [Accepted: 09/15/2010] [Indexed: 11/23/2022]
Abstract
During the last decades, many studies have shown that the thalamus is crucially involved in language and cognition. We critically reviewed a study corpus of 465 patients with vascular thalamic lesions published in the literature since 1980. 42 out of 465 (9%) cases with isolated thalamic lesions allowed further neurocognitive analysis. On the neurolinguistic level, fluent output (=31/33; 93.9%), normal to mild impairment of repetition (=33/35; 94.3%), mild dysarthria (=8/9; 88.9%) and normal to mild impairment of auditory comprehension (=27/34; 79.4%) were most commonly found in the group of patients with left and bilateral thalamic lesions. The taxonomic label of thalamic aphasia applied to the majority of the patients with left thalamic damage (=7/11; 63.6%) and to one patient with bithalamic lesions (=1/1). On the neuropsychological level, almost 90% of the left thalamic and bithalamic patient group presented with amnestic problems, executive dysfunctions and behaviour and/or mood alterations. In addition, two thirds (2/3) of the patients with bilateral thalamic damage presented with a typical cluster of neurocognitive disturbances consisting of constructional apraxia, anosognosia, desorientation, global intellectual dysfunctioning, amnesia, and executive dysfunctions associated with behaviour and/or mood alterations. Our study supports the long-standing view of a 'lateralised linguistic thalamus' but restates the issue of a 'lateralised cognitive thalamus'. In addition, critical analysis of the available literature supports the view that aphasia following left or bithalamic damage constitutes a prototypical linguistic syndrome.
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Marinella MA. Subcortical stroke presenting as micrographia. Am J Emerg Med 2007; 25:89-90. [PMID: 17157691 DOI: 10.1016/j.ajem.2006.03.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2006] [Accepted: 03/28/2006] [Indexed: 11/21/2022] Open
Affiliation(s)
- Mark A Marinella
- Wright State University School of Medicine, Dayton, OH 45409, USA.
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Abstract
Micrographia (MG), an acquired impairment of writing characterized by diminution of letter size, coupled with slowing and loss of accuracy, is most frequently observed in the course of degenerative disease of basal ganglia, such as Parkinson's Disease. Only a few cases of MG without concomitant extrapyramidal signs have been described, mostly following vascular lesion of the left basal ganglia. In this article we report an isolated pattern of MG following an extensive traumatic cerebral lesion centered in the left basal ganglia. The nature of this impairment is analyzed according to a cognitive model of writing and interpreted as a specific example of peripheral dysgraphia.
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Affiliation(s)
- Gianfranco Denes
- Department of Neurology, Venice Hospital and Department of Science of Language, Ca' Foscari Venice University, Italy.
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Perrin M, Cordato DJ, Fung VS, Wong D. Acute and reversible micrographia in a patient possibly due to cerebral ischaemia. J Clin Neurosci 2005; 12:329-31. [PMID: 15851098 DOI: 10.1016/j.jocn.2004.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2004] [Accepted: 05/04/2004] [Indexed: 10/26/2022]
Abstract
We report a patient who developed acute and reversible micrographia, presumably due to cerebral ischaemia, on a background of mutism following a pharyngo-laryngectomy 10 years earlier. Magnetic resonance (MR) imaging showed chronic small vessel disease without evidence of an acute ischaemic lesion on diffusion-weighted sequences. Our patient's micrographia improved significantly within 12 days of symptom onset. The MR imaging was performed within 5 days of symptom onset, suggesting that the lesion was either too small for detection or had resolved on diffusion-weighted sequences.
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Affiliation(s)
- M Perrin
- Department of Neurology, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia
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Kim EJ, Lee BH, Park KC, Lee WY, Na DL. Micrographia on free writing versus copying tasks in idiopathic Parkinson's disease. Parkinsonism Relat Disord 2005; 11:57-63. [PMID: 15619464 DOI: 10.1016/j.parkreldis.2004.08.005] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2004] [Revised: 07/22/2004] [Accepted: 08/08/2004] [Indexed: 11/22/2022]
Abstract
BACKGROUND Only a few studies have reported on the frequency of micrographia in idiopathic Parkinson's disease (IPD), and the definition of micrographia in these studies was based simply on the visual inspection of the patients' free writing. OBJECTIVES We investigated the frequency of consistent (CM) and progressive (PM) micrographia by quantifying the patients' copying of a target letter or figure. METHODS Seventy-five IPD patients and 30 sex/age matched healthy controls were assigned the tasks of free writing and letter/figure copying. CM was defined by the average size of the letter or figure written or copied by the patients below the controls' mean-2SD. PM was defined by the slope of reduction in size as a function of the serial positioning of the letters/figures below the mean-2SD of the controls. RESULTS In the free writing, of 75 patients, only one met the criteria for the definition of CM and two met the criteria for the definition of PM definition. In contrast, letter/figure copying tasks identified 33 (44%) patients with CM and 19 (25%) with PM. CONCLUSION Our study suggests that the prior definition of CM or PM by visual inspection in free writing task is less valid, and that the definition of CM and PM, based on the letter/figure copying tasks rather than free writing tests, could be more objective.
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Affiliation(s)
- Eun-Joo Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul 135-710, South Korea
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Nakamura M, Hamamoto M, Uchida S, Nagayama H, Amemiya S, Okubo S, Tanaka K. A case of micrographia after subcortical infarction: possible involvement of frontal lobe function. Eur J Neurol 2003; 10:593-6. [PMID: 12940845 DOI: 10.1046/j.1468-1331.2003.00641.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Most reports of micrographia associated with focal brain lesions have related this finding to damage in the left basal ganglia. Here we describe the case of a 68-year-old man presenting with reversible micrographia accompanied by hypophonia in the absence of extrapyramidal signs after cerebral infarction in the left subcortical region. At the time of the patient's admission, diffusion-weighted magnetic resonance imaging sequence showed the lesion to principally involve the corona radiata, with some involvement of the putamen. Neurologically, mild right-sided brachiofacial hemiparesis and grasp reflexes - a frontal lobe sign - were observed. As his micrographia and hypophonia improved, the patient's grasp reflexes improved in parallel. In addition, recovery of regional cerebral blood flow in the left frontal lobe was confirmed by single photon emission computed tomography (technetium-99 m HMPAO). The present case suggests the possibility that the function of frontal-subcortical circuit might also be involved in the production and improvement of micrographia and that micrographia and hypophonia may share a common pathophysiology.
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Affiliation(s)
- M Nakamura
- Department of Neurology, Tokyo Metropolitan Tama Geriatric Hospital, Tokyo, Japan.
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Derkinderen P, Dupont S, Vidal JS, Chedru F, Vidailhet M. Micrographia secondary to lenticular lesions. Mov Disord 2002; 17:835-7. [PMID: 12210889 DOI: 10.1002/mds.10189] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Four patients with a stroke developed micrographia. In two patients, the condition was pure and in the two other patients it was associated with signs of writer's cramp. We conclude that infarct of the left lenticular nucleus could either mimic pure micrographia similar to that of Parkinson's disease or micrographia associated with dystonia.
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Beversdorf DQ, Anderson JM, Manning SE, Anderson SL, Nordgren RE, Felopulos GJ, Bauman ML. Brief report: macrographia in high-functioning adults with autism spectrum disorder. J Autism Dev Disord 2001; 31:97-101. [PMID: 11439759 DOI: 10.1023/a:1005622031943] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The initial description of Asperger syndrome commented on the poor handwriting and motor coordination difficulties of individuals with this condition. Early descriptions of autism do not remark upon such difficulties. Recent evidence, however, suggests that individuals with both conditions have a similar motor control impairment. Handwriting has not been formally assessed in this context. Our study compared handwriting size between individuals with autism spectrum disorder and age- and IQ-matched control subjects. Macrographia was observed among subjects with autism spectrum disorder which remained statistically significant when covaried with educational level. This finding may correlate with the anatomical abnormalities present in the cerebellum of individuals with autism spectrum disorder.
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Affiliation(s)
- D Q Beversdorf
- Department of Neurology, Ohio State University Medical Center, 1654 Upham Drive, Columbus, Ohio 43210, USA.
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