Cite: Dean, D. J., Teulings, H. L., Caligiuri, M., Mittal, V. A. Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis. J. Vis. Exp. (81), e50852, doi:10.3791/50852 (2013).
Subscription Required. Please recommend JoVE to your librarian.
Video and Article:

Name:  jove2.png
Views: 992
Size:  351.2 KB

Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Derek J. Dean(1), Hans-Leo Teulings(2), Michael Caligiuri(3), Vijay A. Mittal(1)
(1) Department of Psychology and Neuroscience, Center for Neuroscience, University of Colorado Boulder,
(2) NeuroScript LLC,
(3) Department of Psychiatry, University of California, San Diego

The authors Derek J. Dean, Michael Caligiuri, and Vijay A. Mittal declare they have no competing financial interests. The author, Hans-Leo Teulings is the owner of NeuroScript who developed and markets the MovAlyzeR software to record and analyze pen movements.

This work was supported by National Institute of Health Grants R01MH094650 to Dr. Mittal.

Fujitsu Lifebook T901 Tablet Computer Fujitsu Ltd.
Neuroscript MovAlyzeR Neuroscript LLC

  1. Cannon, T.D., et al. Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Arch. Gen. Psychiatry. 65, 28-37, doi:10.1001/archgenpsychiatry.2007.3 (2008).
  2. Yung, A.R., Phillips, L.J., Yuen, H.P., & McGorry, P.D. Risk factors for psychosis in an ultra high-risk group: psychopathology and clinical features. Schizophr. Res. 67, 131-142, doi:10.1016/S0920-9964(03)00192-0 (2004).
  3. Miller, T.J., et al. Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability. Schizophr. Bull. 29, 703-715 (2003).
  4. Cornblatt, B.A., et al. The schizophrenia prodrome revisited: a neurodevelopmental perspective. Schizophr. Bull. 29, 633-651 (2003).
  5. Mittal, V.A., Dean, D.J., & Pelletier, A. Dermatoglyphic asymmetries and fronto-striatal dysfunction in young adults reporting non-clinical psychosis. Acta Psychiatr. Scand. 126, 290-297, doi:10.1111/j.1600-0447.2012.01869.x (2012).
  6. Mittal, V.A., Neumann, C., Saczawa, M., & Walker, E.F. Longitudinal progression of movement abnormalities in relation to psychotic symptoms in adolescents at high risk of schizophrenia. Arch. Gen. Psychiatry. 65, 165-171, doi:10.1001/archgenpsychiatry.2007.23 (2008).
  7. Mittal, V.A., et al. Abnormal movements are associated with poor psychosocial functioning in adolescents at high risk for psychosis. Schizophr. Res. 130, 164-169, doi:10.1016/j.schres.2011.05.007 (2011).
  8. Mittal, V.A., et al. Markers of basal ganglia dysfunction and conversion to psychosis: neurocognitive deficits and dyskinesias in the prodromal period. Biol. Psychiatry. 68, 93-99, doi:10.1016/j.biopsych.2010.01.021 (2010).
  9. Walker & Diforio, D. Schizophrenia: a neural diathesis-stress model. Psychol. Rev. 104, 667-685 (1997).
  10. Walker, E.F., Savoie, T., & Davis, D. Neuromotor precursors of schizophrenia. Schizophr. Bull. 20, 441-451 (1994).
  11. Mittal, V.A., et al. Striatal volumes and dyskinetic movements in youth at high-risk for psychosis. Schizophr. Res. 123, 68-70, doi:10.1016/j.schres.2010.08.002 (2010).
  12. Bechdolf, A., et al. Interventions in the initial prodromal states of psychosis in Germany: concept and recruitment. Br. J. Psychiatry Suppl. 48, s45-48, doi:187/48/s45 [pii] 10.1192/bjp.187.48.s45 (2005).
  13. Mittal, V.A., Dean, D.J., Pelletier, A., & Caligiuri, M. Associations between spontaneous movement abnormalities and psychotic-like experiences in the general population. Schizophr. Res. 132, 194-196, doi:10.1016/j.schres.2011.06.028 (2011).
  14. Mittal, V.A., et al. BDNF Val66Met and spontaneous dyskinesias in non-clinical psychosis. Schizophr. Res. 140, 65-70, doi:10.1016/j.schres.2012.06.018 (2012).
  15. Caligiuri, M.P., Teulings, H.L., Dean, C.E., Niculescu, A.B,. & Lohr, J. Handwriting movement analyses for monitoring drug-induced motor side effects in schizophrenia patients treated with risperidone. Hum. Mov. Sci. 28, 633-642, doi:10.1016/j.humov.2009.07.007 (2009).
  16. Caligiuri, M.P., Teulings, H.L., Dean, C.E., Niculescu, A.B., 3rd, & Lohr, J.B. Handwriting movement kinematics for quantifying extrapyramidal side effects in patients treated with atypical antipsychotics. Psychiatry Res. 177, 77-83, doi:10.1016/j.psychres.2009.07.005 (2010).
  17. Caligiuri, M.P., Teulings, H.L., Filoteo, J.V., Song, D., & Lohr, J.B. Quantitative measurement of handwriting in the assessment of drug-induced parkinsonism. Hum. Mov. Sci. 25, 510-522, doi:10.1016/j.humov.2006.02.004 (2006).
  18. Jeste, D.V. & Caligiuri, M.P. Tardive dyskinesia. Schizophr. Bull. 19, 303-315 (1993).
  19. Andersson, K., Fuxe, K., & Agnati, L.F. Effects of single injections of nicotine on the ascending dopamine pathways in the rat. Evidence for increases of dopamine turnover in the mesostriatal and mesolimbic dopamine neurons. Acta Physiol. Scand. 112, 345-347 (1981).
  20. Lane, R.D., Glazer, W.M., Hansen, T.E., Berman, W.H., & Kramer, S.I. Assessment of tardive dyskinesia using the Abnormal Involuntary Movement Scale. J. Nerv. Ment. Dis. 173, 353-357 (1985).
  21. Zhang, X.Y., et al. Smoking and tardive dyskinesia in male patients with chronic schizophrenia. Prog. Neuropsychopharmacol. Biol. Psychiatry. 35, 1765-1769, doi:10.1016/j.pnpbp.2011.06.006 (2011).
  22. Tucha, O. & Lange, K.W. Effects of nicotine chewing gum on a real-life motor task: a kinematic analysis of handwriting movements in smokers and non-smokers. Psychopharmacology. 173, 49-56, doi:10.1007/s00213-003-1690-9 (2004).
  23. Teulings, H.L., Contreras-Vidal, J.L., Stelmach, G.E., & Adler, C.H. Parkinsonism reduces coordination of fingers, wrist, and arm in fine motor control. Exp. Neurol. 146, 159-170, doi:10.1006/exnr.1997.6507 (1997).
  24. Lin, C.Y., Yeh, C.H., Chang, T.T., Kao, C.H., & Tsai, S.Y. Smoking, dopamine transporter, and hand tremor. Clin. Nucl. Med. 37, 35-38, doi:10.1097/RLU.0b013e318238f12d (2012).
  25. Van Gemmert, A.W. & Teulings, H.L. Advances in graphonomics: studies on fine motor control, its development and disorders. Hum. Mov. Sci. 25, 447-453, doi:10.1016/j.humov.2006.07.002 (2006).
  26. Gharabawi, G.M., et al. Abnormal Involuntary Movement Scale (AIMS) and Extrapyramidal Symptom Rating Scale (ESRS): cross-scale comparison in assessing tardive dyskinesia. Schizophr. Res. 77, 119-128, doi:10.1016/j.schres.2005.03.008 (2005).
  27. Cortese, L., et al. Relationship of neuromotor disturbances to psychosis symptoms in first-episode neuroleptic-naive schizophrenia patients. Schizophr. Res. 75, 65-75, doi:10.1016/j.schres.2004.08.003 (2005).
  28. Howes, O.D., et al. Elevated striatal dopamine function linked to prodromal signs of schizophrenia. Arch. Gen. Psychiatry. 66, 13-20, doi:66/1/13 [pii] 10.1001/archgenpsychiatry.2008.514 (2009).
  29. Van Gemmert, A.W., Teulings, H.L., Contreras-Vidal, J.L., & Stelmach, G.E. Parkinson's disease and the control of size and speed in handwriting. Neuropsychologia. 37, 685-694 (1999).