The key facts
- Doctors consider handwriting changes a possible symptom of CNS pathologies, since writing involves the motor cortex, cerebellum, basal ganglia, and areas of memory and speech.
- In Parkinson's disease, micrographia develops — letters shrink toward the end of a line; this can be one of the first symptoms of the disease.
- A sudden worsening of handwriting without an apparent cause may indicate acute cerebrovascular accident, traumatic brain injury, or the onset of multiple sclerosis — a reason to urgently see a neurologist.
Handwriting as a Possible Symptom
Handwriting changes are usually attributed to haste or carelessness, but doctors consider writing style one of the possible symptoms of central nervous system pathology. Neurologist Ekaterina Demyanovskaya, an expert at the Gemotest Laboratory, told Gazeta.Ru about this. According to her, writing by hand engages several areas of the brain at once: the motor cortex, cerebellum, basal ganglia, as well as structures related to memory and speech. A failure in any of these links is reflected in how a person holds a pen and forms letters, and the nature of the changes depends on which part of the nervous system is affected.
Parkinson's and Alzheimer's Disease
In Parkinson's disease, micrographia develops: letters gradually shrink, become angular and almost illegible. At the beginning of a line the size may remain acceptable, but by the end of the sentence the characters shrink to a minimum — this is associated with impaired automaticity of fine movements and dysfunction of the basal ganglia. Micrographia often appears among the first symptoms, even before obvious motor disturbances, and therefore can serve as a guide for early diagnosis. In Alzheimer's disease the picture is less uniform: in some patients handwriting becomes disorganized, the evenness of lines is disrupted, pen pressure weakens, and the spatial arrangement of letters deteriorates.
When to See a Doctor Urgently
“Sudden changes deserve special attention. If handwriting has sharply deteriorated without an apparent cause, this may indicate acute cerebrovascular accident, traumatic brain injury, or the onset or exacerbation of a demyelinating disease, such as multiple sclerosis. The above symptoms, as well as the appearance of pronounced hand tremor, uncontrolled jerks, or sudden illegibility, are a reason to immediately see a neurologist,” said Demyanovskaya.
Less Acute Causes
There are also less acute but significant causes of handwriting changes. With chronic stress, pen pressure increases and handwriting becomes tense; with deep emotional exhaustion or depression, lines lose stability and letters lose clarity. Age-related changes associated with arthrosis of the small joints of the hand or deteriorating vision also affect writing, but occur gradually and without other warning signs such as tremor or memory decline. In distal polyneuropathy involving the upper limbs, for example in diabetes mellitus, handwriting may deteriorate due to reduced finger sensitivity. Normally, the main characteristics of handwriting remain stable throughout life. Earlier, Russians were warned about the early signs of dementia.
