Writing and drawing tilts after right hemisphere stroke are signs of a wrong verticality representation - Laboratoire de Psychologie et Neurocognition
Pré-Publication, Document De Travail Année : 2024

Writing and drawing tilts after right hemisphere stroke are signs of a wrong verticality representation

Rémi Lafitte
  • Fonction : Auteur
  • PersonId : 1444613
Flora Diaine
  • Fonction : Auteur
  • PersonId : 1074103
Olivier Carré
  • Fonction : Auteur
Céline Piscicelli
  • Fonction : Auteur
  • PersonId : 1444614

Résumé

BACKGROUND Many signs of spatial dysgraphia and drawing errors after right hemispheric stroke (RHS) have been attributed to spatial neglect or impaired sensory feedback. Counterclockwise (contralesional) tilts of graphomotor productions remained to be explained. OBJECTIVE To test whether graphomotor tilts stem from a tilted representation of verticality transposed to the top/bottom axis of the sheet of paper, from data of the DOBRAS cohort. METHODS Handwriting and drawing orientations were measured from the writing of three lines and the drawing of the Gainotti Figure (house roof lines). Verticality perception was measured with the visual (VV) and postural (PV) verticals. Severity of extra-body (EBN) and body (BN) neglect were each quantified with composite scores (battery of 8 tests). RESULTS We analyzed data of 133 individuals: 64 healthy individuals (median age 63 years) and 69 with a subacute RHS (median age 68 years). With respect to normal cut-offs (writing -5.4°; drawing - 8.1°), 26/69 (38%) individuals with RHS showed at least one graphomotor tilt (median[IQR] of writing tilt: -6.8°[-9.7;-1.7]; drawing tilt: -10.9°[-17.6;-6.4]). Compared to individuals without graphomotor tilts, those having both writing and drawing tilts showed greater contralesional tilts in verticality perception (VV: -1.4°[-4;0.6] vs -7.9°[-11.5;-7.5]; PV: -1°[-2.4;0.2] vs -8°[-9;-5.4], Ps ≤.001) and more severe spatial neglect (EBN: 4.2[1.8;9.3] vs 16.6[10.2;20.4]; BN: 22.7[17;28.2] vs 37.8[35.9;39.7], Ps ≤.01). Composite graphomotor z-scores on writing and drawing correlated both with verticality estimates (VV+PV, rs=.46, p <10-4 23 ) and spatial neglect scores (EBN+BN, rs=-.36, p <.01). CONCLUSION Contralesional tilts of writing and drawing after RHS are primary related to a tilted representation of verticality, and secondary related to spatial neglect. They are easy to detect and could be considered as a first step to perform early, before conventional tests of verticality perception.
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Dates et versions

hal-04793426 , version 1 (20-11-2024)

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  • HAL Id : hal-04793426 , version 1

Citer

Rémi Lafitte, Flora Diaine, Shenhao Dai, Olivier Carré, Eve Dupierrix, et al.. Writing and drawing tilts after right hemisphere stroke are signs of a wrong verticality representation. 2024. ⟨hal-04793426⟩
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