Progressive micrographia shown in horizontal, but not vertical, writing in Parkinson's disease

Hui Ing Ma, Wen Juh Hwang, Shao Hsia Chang, Tsui Ying Wang

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

All published studies on micrographia, a diminution of letter size, examine handwriting in the horizontal direction. Writing horizontally typically requires increased wrist extension as handwriting progresses from left to right. Chinese characters, however, can be written not only horizontally from left to right, but also vertically from top to bottom. We examined the effect of handwriting direction on character size and stroke length. Fifteen participants with Parkinson's disease (PD) and 15 age-matched controls wrote the same Chinese characters both horizontally and vertically. Handwriting performance was recorded with a digitizing tablet, and a custom-written computer program was used to provide objective data about character size and stroke length. The PD group had a linear decrease in overall character size and horizontal strokes along the writing sequence in the horizontal direction, but not in the vertical direction. The controls had shorter horizontal strokes in the horizontal than the vertical direction, but there was no progressive shortening of stroke length along the writing sequence. The results suggest that traditionally reported progressive micrographia in horizontal writing may not be generalizable to vertical writing. The observed decrease of handwriting size in the horizontal direction suggests that micrographia in PD may be associated with wrist extension. For clinical implications, patients may mitigate their micrographia by changing handwriting direction.

Original languageEnglish
Pages (from-to)169-174
Number of pages6
JournalBehavioural Neurology
Volume27
Issue number2
DOIs
Publication statusPublished - 2013

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All Science Journal Classification (ASJC) codes

  • Neuropsychology and Physiological Psychology
  • Neurology
  • Clinical Neurology

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