Long-term Chinese calligraphic handwriting training has a positive effect on brain network efficiency.
ABSTRACT: As a visual art form, Chinese calligraphic handwriting (CCH) has been found to correlate with certain brain activity and to induce functional connectivity reorganization of the brain. This study investigated the effect of long-term CCH training on brain functional plasticity as assessed with network measures. With the resting-state fMRI data from 31 participants with at least five years of CCH training and 40 controls, we constructed brain functional networks, examined group differences at both the whole brain and modular levels, and correlated the topological characteristics with calligraphy skills. We found that, compared to the control group, the CCH group showed shorter characteristic path lengths and higher local efficiency in certain brain areas in the frontal and parietal cortices, limbic system, basal ganglia, and thalamus. Moreover, these network measures in the cingulate cortex, caudate nucleus, and thalamus were associated with CCH performance (i.e., copying and creating skills). These results suggest that long-term CCH training has a positive effect on the topological characteristics of brain networks.
Project description:As a special kind of handwriting with a brush, Chinese calligraphic handwriting (CCH) requires a large amount of practice with high levels of concentration and emotion regulation. Previous studies have showed that long-term CCH training has positive effects physically (induced by handwriting activities) and psychologically (induced by the state of relaxation and concentration), the latter of which is similar to the effects of meditation. The aim of this study was to investigate the long-term CCH training effect on anxiety and attention, as well as brain structure. Participants were 32 individuals who had at least five years of CCH experience and 44 controls. Results showed that CCH training benefited individuals' selective and divided attention but did not decrease their anxiety level. Moreover, the VBM analysis showed that long-term CCH training was mainly associated with smaller grey matter volumes (GMV) in the right precuneus/posterior cingulate cortex (PCC). No brain areas showed larger GMV in the CCH group than the control group. Using two sets of regions of interest (ROIs), one related to meditation and the other to handwriting, ROI analysis showed significant differences between the CCH and the control group only at the meditation-related ROIs, not at the handwriting-related ROIs. Finally, for the whole sample, the GMV of both the whole brain and the PCC were negatively correlated with selective attention and divided attention. The present study was cross-sectional and had a relatively small sample size, but its results suggested that CCH training might benefit attention and influence particular brain structure through mental processes such as meditation.
Project description:Chinese calligraphic handwriting (CCH) is a traditional art form that requires high levels of concentration and motor control. Previous research has linked short-term training in CCH to improvements in attention and memory. Little is known about the potential impacts of long-term CCH practice on a broader array of executive functions and their potential neural substrates. In this cross-sectional study, we recruited 36 practitioners with at least 5 years of CCH experience and 50 control subjects with no more than one month of CCH practice and investigated their differences in the three components of executive functions (i.e., shifting, updating, and inhibition). Valid resting-state fMRI data were collected from 31 CCH and 40 control participants. Compared with the controls, CCH individuals showed better updating (as measured by the Corsi Block Test) and inhibition (as measured by the Stroop Word-Color Test), but the two groups did not differ in shifting (as measured by a cue-target task). The CCH group showed stronger resting-state functional connectivity (RSFC) than the control group in brain areas involved in updating and inhibition. These results suggested that long-term CCH training may be associated with improvements in specific aspects of executive functions and strengthened neural networks in related brain regions.
Project description:In previous work, we found that intensive amplitude training successfully improved micrographia in Parkinson's disease (PD). Handwriting abnormalities in PD also express themselves in stroke duration and writing fluency. It is currently unknown whether training changes these dysgraphic features.To determine the differential effects of amplitude training on various hallmarks of handwriting abnormalities in PD.We randomized 38 right-handed subjects in early to mid-stage of PD into an experimental group (n = 18), receiving training focused at improving writing size during 30 minutes/day, five days/week for six weeks, and a placebo group (n = 20), receiving stretch and relaxation exercises at equal intensity. Writing skills were assessed using a touch-sensitive tablet pre- and post-training, and after a six-week retention period. Tests encompassed a transfer task, evaluating trained and untrained sequences, and an automatization task, comparing single- and dual-task handwriting. Outcome parameters were stroke duration (s), writing velocity (cm/s) and normalized jerk (i.e. fluency).In contrast to the reported positive effects of training on writing size, the current results showed increases in stroke duration and normalized jerk after amplitude training, which were absent in the placebo group. These increases remained after the six-week retention period. In contrast, velocity remained unchanged throughout the study.While intensive amplitude training is beneficial to improve writing size in PD, it comes at a cost as fluency and stroke duration deteriorated after training. The findings imply that PD patients can redistribute movement priorities after training within a compromised motor system.
Project description:Do handwriting skills transfer when a child writes in two different scripts, such as the Latin and Cyrillic alphabets? Are our measures of handwriting skills intrinsically bound to one alphabet or will a child who faces handwriting difficulties in one script experience similar difficulties in the other script? To answer these questions, 190 children from grades 1-4 were asked to copy a short text using both the Cyrillic and Latin alphabets on a digital tablet. A recent change of policy in Kazakhstan gave us an opportunity to measure transfer, as the Latin-based Kazakh alphabet has not yet been introduced. Therefore, pupils in grade 1 had a 6-months experience in Cyrillic, and pupils in grades 2, 3, and 4 had 1.5, 2.5, and 3.5 years of experience in Cyrillic, respectively. This unique situation created a quasi-experimental situation that allowed us to measure the influence of the number of years spent practicing Cyrillic on the quality of handwriting in the Latin alphabet. The results showed that some of the differences between the two scripts were constant across all grades. These differences thus reflect the intrinsic differences in the handwriting dynamics between the two alphabets. For instance, several features related to the pen pressure on the tablet are quite different. Other features, however, revealed decreasing differences between the two scripts across grades. While we found that the quality of Cyrillic writing increased from grades 1-4, due to increased practice, we also found that the quality of the Latin writing increased as well, despite the fact that all of the pupils had the same absence of experience in writing in Latin. We can therefore interpret this improvement in Latin script as an indicator of the transfer of fine motor control skills from Cyrillic to Latin. This result is especially surprising given that one could instead hypothesize a negative transfer, i.e., that the finger controls automated for one alphabet would interfere with those required by the other alphabet. One interesting side-effect of these findings is that the algorithms that we developed for the diagnosis of handwriting difficulties among French-speaking children could be relevant for other alphabets, paving the way for the creation of a cross-lingual model for the detection of handwriting difficulties.
Project description:Mastering transcription skills is an important goal in the development of children's written language abilities, and handwriting fluency and spelling accuracy are crucial indicators of transcription ability. The current study was a two-year longitudinal study to investigate the reciprocal relationship of handwriting fluency and spelling accuracy. Participants included 123 students living in mainland China, who were tracked from third to fifth grade, and were administered a comprehensive battery of tests including assessments for non-verbal intelligence, phonological awareness, rapid automatized naming, and copying and dictation of Chinese characters. The results showed that: (1) previous handwriting fluency predicted subsequent spelling accuracy; and (2) previous spelling accuracy predicted subsequent handwriting fluency. These findings indicated there is a bidirectional relationship between handwriting fluency and spelling accuracy in Chinese. This implies spelling accuracy should not be unilaterally emphasized when teaching children new vocabulary, but attention should also be given to the cultivation of handwriting fluency in daily pedagogical practice.
Project description:BACKGROUND:First graders born prematurely perform poorly on handwriting speed and legibility. However, whether there are specific legibility factors in which preterm children demonstrate difficulty remains unknown. In addition, handwriting performance beyond the first grade and the influence of sex on handwriting performance in preterm children are still unclear. We aimed to investigate the influence of prematurity and sex on multiple dimensions of handwriting in grade two and to identify the contributors to performance. METHODS:Sixty-three preterm (34 boys and 29 girls) and 67 full-term (27 boys and 40 girls) peers in grade two were included. Class teachers were asked to complete the Chinese Handwriting Evaluation Form. A subgroup of 39 preterm children received assessments on intelligence, visual perception, tactile and kinesthetic sensation, and fine motor skills. Their inattention behavior was rated using a maternal self-report with a behavioral scale. RESULTS:Boys born prematurely exhibited poorer performance in the speed dimension than full-term boys (p = 0.008), whereas there was comparable performance in the two groups of girls (p = 0.221). In the dimensions related to legibility, preterm boys (32.4%) had a higher percentage of children with difficulty in the construction dimension than the other groups (preterm girls: 6.9%, full-term boys: 7.4%, full-term girls: 5.0%). However, no group difference was found in the dimensions of accuracy and directionality. Of the sensory-perceptual-motor factors, attention was the most significant predictor of accuracy in performance (p = 0.046) and speed dimensions (p = 0.001) in preterm children. CONCLUSIONS:Boys appear to be vulnerable to the adverse impacts of preterm birth in terms of performance in the dimensions of speed and construction in grade two. Based on the significant contribution of attention to handwriting performance in preterm children, assessment and intervention in the area of attention is strongly suggested for preterm children with handwriting problems.
Project description:BACKGROUND:Handwriting ability is related to many neuronal functions, such as visual-perceptual skills, orthographic coding, motor planning and execution, kinesthetic feedback and visual-motor coordination. To date, there is no specific assessment tool for to assess preschool children's handwriting ability in Mainland China. Our study aimed to develop a tool to assess the handwriting ability of children aged 5-6 years old in Mainland China and to analyze its reliability and validity. METHODS:The investigation comprised three phases: 1) original tool generation, 2) tool revision, 3) reliability analysis (i.e., interrater, test-retest) and validity analysis (i.e., content, criterion). RESULTS:The sample included a total of 482 children. The internal consistency (Cronbach alpha) was 0.74. The test-retest correlation coefficients ranged from 0.38 to 0.80. As expected, our data showed an improving trend in handwriting, and differences in respect to age and gender. When compared with the 'handwriting difficulty' group, each subtest score of children in the 'normal' group showed significant differences (p < 0.05). The correlation validity, compared with the visual-motor integration development test (VMI), was 0.17-0.52. CONCLUSION:The Handwriting Test for Preschool Children (HT-PRE), which is a newly developed handwriting screening tool for preschool children aged 5-6 years old in Mainland China, has displayed a very good internal consistency, acceptable test-retest reproducibility, and good criterion-based validity, and has also shown good application prospects for handwriting difficulty screening in a clinical setting.
Project description:Handwriting is a complex skill to acquire and it requires years of training to be mastered. Children presenting dysgraphia exhibit difficulties automatizing their handwriting. This can bring anxiety and can negatively impact education. 280 children were recruited in schools and specialized clinics to perform the Concise Evaluation Scale for Children's Handwriting (BHK) on digital tablets. Within this dataset, we identified children with dysgraphia. Twelve digital features describing handwriting through different aspects (static, kinematic, pressure and tilt) were extracted and used to create linear models to investigate handwriting acquisition throughout education. K-means clustering was performed to define a new classification of dysgraphia. Linear models show that three features only (two kinematic and one static) showed a significant association to predict change of handwriting quality in control children. Most kinematic and statics features interacted with age. Results suggest that children with dysgraphia do not simply differ from ones without dysgraphia by quantitative differences on the BHK scale but present a different development in terms of static, kinematic, pressure and tilt features. The K-means clustering yielded 3 clusters (Ci). Children in C1 presented mild dysgraphia usually not detected in schools whereas children in C2 and C3 exhibited severe dysgraphia. Notably, C2 contained individuals displaying abnormalities in term of kinematics and pressure whilst C3 regrouped children showing mainly tilt problems. The current results open new opportunities for automatic detection of children with dysgraphia in classroom. We also believe that the training of pressure and tilt may open new therapeutic opportunities through serious games.
Project description:There are currently no systematic reviews or meta-analyses of Chinese calligraphy therapy (CCT) to reduce neuropsychiatric symptoms. The aim of this systematic review and meta-analysis was to explore the efficacy of CCT for people with neuropsychiatric symptoms.We searched Chinese and English databases, including the Cochrane Central Register of Controlled Trials and Wanfang Data for relevant articles published between the earliest year available and December 2016. The search was limited to randomized controlled trials and controlled clinical studies and the associated keywords were "handwriting," "Chinese calligraphy," "Chinese calligraphy therapy," "Calligraphy exercise," and "Calligraphy training." The 21 articles that met these criteria were used in the analysis. The Joanna Briggs Institute critical appraisal checklist was used to assess methodological quality.CCT significantly reduced psychosis (10 studies, 965 subjects, standardized mean difference [SMD]?=?-?0.17, 95% confidence intervals [CI] [-?0.30, -?0.40], Z?=?2.60, p?<?0.01), anxiety symptoms (9 studies, 579 subjects, SMD?=?-?0.78, 95% CI [-?0.95, -?0.61], Z?=?8.98, p?<?0.001), and depressive symptoms (7 studies, 456 subjects, SMD?=?-?0.69, 95% CI [-?0.88, -?0.50], Z?=?7.11, p?<?0.001). CCT also significantly improved cognitive function (2 studies, 55 subjects, MD?=?2.17, 95% CI [-?0.03, 4.38], Z?=?1.93, p?=?0.05) and neurofeedback (3 studies, 148 subjects, SMD?=?-?1.09, 95% CI [-?1.44, -?0.73], Z?=?6.01, p?<?0.001). The therapy also significantly reduced the positive psychopathological expression of schizophrenia symptoms (4 studies, 287 subjects, SMD?=?-?0.35, 95% CI [-?0.59, -?0.12], Z?=?2.96, p?=?0.003) and reduced the negative symptoms of schizophrenia (4 studies, 276 subjects, SMD?=?-?1.39, 95% CI [-?1.65, -?1.12], Z?=?10.23, p?<?0.001).CCT exerts a curative effect on neuropsychiatric symptoms, but the evidence remains insufficient. A large number of RCTs are needed to facilitate additional systematic reviews of evidence for CCT.