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Medical Graphology: Symptoms in Script

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Some healthy people have small handwriting all their lives—Charlotte and Emily Brontë filled matchbox-size books with miniature script. But if a person’s writing suddenly starts to shrink—letters contracting until they’re cramped and indecipherable, a condition called micrographia—it may be a sign of Parkinson’s, a neuromuscular disease marked by deterioration of dopamine-producing cells in the substantia nigra, the midbrain area that coordinates motor control. Eventually the slowness of movement, rigidity and tremors that cause the small handwriting spread throughout the body.


Martyn Thompson for Proto

Micrographia can appear years before these other symptoms. And because changes in the familiar style of one’s own handwriting are troubling, notes neurologist Charles Adler, professor of neurology at the Mayo Clinic, they can spur patients to see a physician early on.

Handwriting may be important for Parkinson’s patients in another way, says Contreras-Vidal. Using a digital pad to capture such kinematic data as speed and smoothness of motion as a patient writes, physicians can create a personalized neural model of motor control and match it against another model simulating how different drugs enter and affect the brain. “Then,” he says, “we could predict the best type and amount of medication for that person.”

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