[Normal writing, mirror writing and profile representation. Comparison of 2 groups of 7 to 18 year old students (righthanded and lefthanded subjects)].
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After removal of a left parietal meningioma a 74-year-old right-handed woman developed temporary mirror writing and mirror reading. Further analysis of the mirror phenomena came from tachistoscopic hemifield stimulation showing a right hemisphere superiority for the recognition of words presented in mirror fashion. These neuropsychological results are discussed in the context of common concepts. Finally the hypothesis of bihemispheral mirror-image engrams according to Orton will be suggested as a comprehensive explanation and supported by evidence from the literature.
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Mirror-writing is script that runs in the direction opposite to normal, with the individual letters also reversed. Although mirror-writing is well recognized as occurring in the presence of central nervous system damage, and is especially seen in association with hemiplegia, its mechanism has not yet been elucidated. The purpose of the present study is to document a high incidence of mirror-writing among patients aged 65 years or more, and to investigate the relationship of mirror-writing with brain damage and the degree of cognitive dysfunction. The subjects analyzed in this study were 112 patients (44 males and 68 females) and their average age was 73.8 years. Hasegawa's Dementia Scale (HDS) was used to evaluate their cognitive function. We could find no cases of mirror-writing with the right hand. A high incidence of mirror-writing was found in patients who could use their left hand. Mirror-writing was seen in 67% of patients with cerebral lesions on CT scan. However, we could not observe any relationship between the incidence of mirror-writing and damage to a given circumscribed area of the brain. More than 90% of demented patients, whose HDS scores were less than 20, showed mirror-writing with their left hand. The mean score on the HDS for those with a high incidence of mirror-writing was significantly lower than the score for those without mirror-writing. These results indicate that a high incidence of mirror-writing among aged patients is related to cerebral damage and cognitive dysfunction.
It has been reported that left-handed subjects are better able to write in mirror-reversed script than right-handers (Tankle & Heilman, 1983). Vaid and Stiles Davis (1989) conducted studies which led them to contradict the supposed superiority of left-handers in this area. In these studies, left as well as right-handed subjects were examined under normal- and mirror-writing conditions. Both examinations included the analysis of writing time and the accuracy of mirror writing (error rates). Using a digitizing tablet, we examined normal- and mirror-writing performance of left-handers, right-handers, and left-handed subjects who habitually write with their right hand. Our results support the finding of Tankle and Heilman (1983) that left-handers perform better in mirror-writing tasks.
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This minireview concerns a new observation on mirror writing. An uncommon form of writing, mirror writing is seen among healthy individuals, but it can also follow a variety of neurological diseases; it is nearly always carried out with the left hand and is more easily undertaken by left-handers. We have found that a particularly high prevalence of left-handed mirror writing has been reported among those whose native languages are traditionally written in a leftward direction, including Chinese, Japanese, and Hebrew. Innate left-handers and those whose languages are written leftward thus share an unusual facility for left-handed mirror writing, an observation that may have implications for understanding hemisphere specialization in relation to handedness.
It has been claimed that left-handed individuals are better than right-handers at writing in a mirror script (R. Tankle & K. Heilman, 1983, Brain and Language, 19, 115-123). We tested this claim by comparing the mirror writing ability of normal right- and left-handed adults as a function of hand used and hand use order. Our results do not support the notion of a left-hander superiority in mirror writing since, in two different experiments, right-handed individuals were found to be as good as left-handers. Instead, we obtained evidence for an order effect such that in both experiments, mirror writing was faster in those who started the task with their right hand.
The mechanism of mirror writing was investigated using legal Chinese characters and illegal pseudocharacters. It was found from the results of right-handers in experiment 1 that the performance of normal writing and mirror writing for legal characters was better than that of normal writing and mirror writing for pseudocharacters. A reasonable explanation for this character-superiority effect is that normal engrams and mirror engrams exist only for legal characters but not for pseudocharacters. Further analysis revealed that the character-superiority effect took place in normal writing only when the right hand was used and the same effect was observed in mirror writing only when the left hand was used. It seemed that the normal engrams used in normal writing were stored in the left hemisphere while the mirror engrams used in mirror writing were stored in the right hemisphere. The results in experiment 2 from the left-handers showed the similar pattern as that of the right-handers. The mirror-engram hypothesis seems to be the best mechanism to account for the performance difference of right hand and left hand in mirror writing.
Mirror writing was done in 72 preschool children, 40 school children, 60 mentally retarded school children, 40 normal adults, 37 patients suffering from cerebrovascular diseases with or without aphasia and 13 patients with Parkinson's disease. The results showed that total mirror writing was demonstrated in only 2 cases and partial mirror writing with the left hand in 72 cases and with the right hand in 16 cases. The incidence of mirror writing in writing with left hand was higher (45.8%) in preschool children. It gradually decreased to 43.3% in mentally retarded school children, 24.3% in cerebrovascular disease (CVD) patients, 10.0% in school children, 7.7% in Parkinson's disease (PD) patients and 2.5% in normal adults. The relationships between mirror writing and left/right disorientation, between mirror writing and development of Chinese writing language and between mirror writing and higher cerebral function were observed.
OBJECTIVE: To determine if examination of mirror writing in the elderly could be used to assess the degradation of the brain function. METHODS: The occurrence of mirror writing in 146 subjects was examined. Among them, 104 were males and 42 females. All subjects were university graduates. Age ranged from 40 to 85 years with an average of 62.7 +/- 13.4. These subjects were divided into two groups, a non-elderly group consisting of 60 subjects (41.1%) and an elderly group 86 subjects (58.9%). All 146 subjects were examined with 10 items for determination of handedness, mini-mental state examination and the written language of Chinese Aphasia Examination Scale (Draft) including spontaneous writing, writing from dictation and copying. The above mentioned performances of written language were done by left and right hand. RESULTS: The results of examination revealed that in 146 subjects there were 7 subjects with mirror writing, which occurred only in the elderly group, accounting for 8.1%. In the elderly group, mirror writing was found in one subject of 70-79 years group and 6 subjects of age over 80 years. Mirror writing appeared in the elderly was of mild degree with an average percentage of 1.9 +/- 0.4. CONCLUSION: It is suggested that examination of mirror writing in the elderly may be used to assess the degradation of the brain function in senile subjects.
INTRODUCTION: Mirror writing is a rare disorder in which the patient's handwriting is done backwards and a mirror is needed to be able to read it. Although mirror writing presents both spontaneously and pathologically, it is mainly due to cerebrovascular lesions in the dominant hemisphere. CASE REPORT: A right-handed 62-year-old female who, following a left parietal-occipital infarction, evidenced by computerized tomography scanning, developed mirror writing with the left hand associated with mnemonic, gnosic and praxic disorders. The symptoms continued for a year after the episode. CONCLUSIONS: Mirror writing and other associated disorders are a consequence of a dysfunction of the left parietal-occipital lobe and the optic thalamus on the same side.
Mirror writing occurs when individual letters and whole word strings are produced in reverse direction. By analogy, mirror reading refers to the preference to read mirror reversed over normally written words. These phenomena appear rarely after brain damage and offer insight into the nervous system's organization of visual-spatial and visual-motor representations. We present the case of a 51-year-old patient with persistent mirror writing and reading following traumatic brain injury. She preferred to write in the mirror direction with either hand. She drew asymmetric pictures with the same directional bias as normal right-handed subjects, and she did not exhibit left-right confusion regarding other pictures. By contrast, on picture-word matching and lexical decision tasks, she was faster and more accurate with mirrored than normally written words. This pattern of performance suggests that her behavior was not accounted for by reflected motor programs, or by the mirroring of visual-spatial representations in general. Rather, we suggest that her behavior was produced by privileged access to mirrored graphemes. Furthermore, because she seemed better able to read irregular words in mirrored than in normal formats, we suggest that mirrored representations may exist at the whole word level and not simply at the letter level.
Mirror writing is the ability to write from right to left, reversing each letter so that when held to a mirror the script appears normal. There is no information on the prevalence of this trait but a suggestion was received that it may be hereditary. A newspaper survey was carried out to discover the approximate prevalence and whether a hereditary factor is involved. The results indicated a prevalence of 1 in 6500. There is strong evidence that the trait is hereditary and is associated with non-right-handedness'. It is hypothesised that mirror writers may comprise a very small group of people who not only have bilateral language centres but also have an interconnecting pathway between these centres via the corpus callosum. The surprising genetic nature of a trait with no obvious evolutionary consequences is discussed. The data can best be explained on the basis of the trait being the phenotypic expression of an X-linked dominant gene, which does have evolutionary consequences. Similarities are noted between the proposed genetics of mirror writing and those of synaesthesia and of a few pathological X-linked dominant syndromes such as Rett syndrome. Other similarities and contrasts between mirror writing and synaesthesia are noted.
A 20-year-old female experienced temporary unintentional mirror writing associated with low perfusion of the bilateral anterior cerebral arteries. When she was 17 years old, she had developed multiple idiopathic intracerebral hemorrhages and right hemiparesis. At the age of 20, she had a generalized convulsion for which she was transferred to our department. Computed tomography (CT) and magnetic resonance images of the brain were obtained, but no fresh abnormal lesion could be detected. The following day, after she had recovered from postictal symptoms, she wrote mirror image words, and her mirror writing then gradually improved within one week. Single photon emission CT showed low perfusion of both anterior cerebral arteries. We concluded that bilateral vascular insufficiency to the supplementary motor areas and corpus callosum caused mirror writing in this case.
A loop executed clockwise in conventional (left to right) cursive writing is performed counterclockwise in classical (right to left) mirror writing. This rotational reversal appears integral to and inseparable from the mirror-writing phenomenon. Yet in Reverse Process Sinistral Cursive, which proceeds left to right, the rotational component escapes its embeddedness in the conventional mirror form and finds individual, overt expression. The product represents a compromise between the competing and often contradictory demands of innate rotational tendencies, legibility, continuity of movement, and conventional writing style. In dextrads, it reflects difficulty in meeting the unaccustomed demands of translating right-sided movement patterns into left-handed writing performance.
We experienced a 4-year-11-month old girl with right side dominant spastic diplegia caused by preterm birth and neonatal asphyxia. She tended to use the left hand but showed mirror writing on both hands, which was aggravated by correction of handedness to the right. Magnetic resonance T2-weighted imaging revealed a localized high intensity lesion in the white matter of her left parietal lobe, caused by hypoxic insult and suggested a damage of spatial orientation center. Wechsler Preschool and Primary Scale of Intelligence showed a total IQ of 76, VIQ of 86 and PIQ of 74, revealing borderline intelligence with insufficient visual perception. Frostig visual perception test revealed lower scores of position in space. Spatial confusion caused by a lesion in the left parietal lobe might have induced the mirror writing of this case. Forced correction to use the right hand with damaged left parietal lobe may aggravate spatial confusion and consequently worsen mirror writing.
The effect of the hemispace in which writing was performed was assessed in two left hemisphere stroke patients who demonstrated left-handed mirror writing. Both patients produced significantly more mirrored words when writing in right, as compared to left (body) hemispace. We suggest that writing in the right hemispace activates the left hemisphere. Further, we propose that mirror writing in the right hemispace is attributable to activation of the damaged left hemisphere spatial system, which fails to assist in the translation of right hand motor programs into those appropriate to the left hand. Writing in left hemispace, in contrast, activates the intact right hemisphere based spatial system which guides the execution or monitoring of motor productions in left hemispace. The result is writing which remains directionally correct when the left hand is used in left hemispace.