Long-Term Experience of Chinese Calligraphic Handwriting Is Associated with Better Executive Functions and Stronger Resting-State Functional Connectivity in Related Brain Regions

Chen, Wen; He, Yong; Gao, Yang; Zhang, Cuiping; Chen, Chuansheng; Bi, Suyu; Yang, Pin; Wang, Yiwen; Wang, Wenjing

doi:10.1371/journal.pone.0170660

Cited by 21 publications

(20 citation statements)

References 77 publications

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“…The significant results of this finger writing therapy for brain stroke rehabilitation are interpreted from the framework of sensorimotor feedback theory. 8 , 10 , 33 , 34 This is learned and practiced by the finger tracing on the groove of the carved Chinese character plates, using the tactile, 27 , 28 feeling, and the task tracking 29 , 30 of feedback control of the sensorimotor movement of the writing finger in order to stimulate brain responses and activation 14 to elicit neuroplasticity. 22 , 33 – 36 This dynamic practice contributes to the effectiveness of the stroke rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

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Chinese calligraphy handwriting (CCH): a case of rehabilitative awakening of a coma patient after stroke

Kao

Lam²,

Kao³

2018

NDT

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IntroductionThis study investigated the efficacy of Chinese calligraphy handwriting (CCH) for the awakening of patients under a vegetative state after stroke. The theories, the instrument, and the treatment protocols were reported. A single case of a severe stroke patient who was in a coma state for 2 years is presented in this study. The objectives were to apply finger writing as a new method to awaken a stroke patient in a coma state and to test the effect of this method in improving the patient’s vegetative states over time.Case presentationA 55-year-old man suffered a severe stroke in 2004 which left him in a coma for 2 years without any systematic rehabilitation. A culture-based finger-writing method of visual-spatial intervention was then applied to improve his condition. The writing tasks involved aided viewing and finger tracing of sets of innovative characters with enriched visual-spatial and movement characteristics. Following regular treatment protocols involving diverse movement and sensory feedback, the patient was awakened after 12 months. As a consequence, the patient showed significant behavioral changes favoring enhanced focusing, alertness, visual scan, visual span, and quickened visual and motor responses. The treatment continued for another 12 months. As the treatment progressed, we gradually observed improvements in his attention span and mental concentration. His eye ball movements – the left eye in particular – were quickened and showed wider visual angularity in his focal vision. Currently, the patient can now watch television, engage in improved visual sighting, and focus on visual-spatial and cognitive-linguistic materials.ConclusionThis CCH method of training by finger tracking has shown its effectiveness in awakening the patient from his coma state and in producing long-term, clinical outcomes that were similar from those that took place 10 years ago. This finding supports the efficacy of the system for clinical improvement of the patient’s conditions.

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Section: Discussionmentioning

confidence: 99%

“…Recent neuroimaging research has focused on CCH and brain activation studies. 14 Valid resting-state fMRI data were collected from the CCH and control participants. The CCH individuals showed better neural functions of updating and inhibition, but the two groups did not differ in shifting.…”

Section: Introductionmentioning

confidence: 99%

Chinese calligraphy handwriting (CCH): a case of rehabilitative awakening of a coma patient after stroke

Kao

Lam²,

Kao³

2018

NDT

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“…Following previous research that found both structural and functional brain plasticity in response to many types of intensive training such as musical training [3, 4], driving [5], and juggling [6, 7], we have examined brain plasticity related to CCH training. Our previous two studies found that CCH training strengthened the RSFC of brain areas involved in updating and inhibition [8] and decreased the volume of the posterior cingulate cortex (PCC) [9].…”

Section: Introductionmentioning

confidence: 99%

“…Given our previous findings of CCH training’s effects on the RSFC of certain brain areas [8], we hypothesized long-term CCH practicing would have an effect on the topological parameters of the resting-state brain network, including the frontal and parietal cortices, basal ganglia, and PCC. We explored the long-term CCH training’s effect on the topological characteristics of the whole brain and four specific modules.…”

Section: Introductionmentioning

confidence: 99%

Long-term Chinese calligraphic handwriting training has a positive effect on brain network efficiency

Chen

et al. 2019

PLoS ONE

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As a visual art form, Chinese calligraphic handwriting (CCH) has been found to correlate with certain brain activity and to induce functional connectivity reorganization of the brain. This study investigated the effect of long-term CCH training on brain functional plasticity as assessed with network measures. With the resting-state fMRI data from 31 participants with at least five years of CCH training and 40 controls, we constructed brain functional networks, examined group differences at both the whole brain and modular levels, and correlated the topological characteristics with calligraphy skills. We found that, compared to the control group, the CCH group showed shorter characteristic path lengths and higher local efficiency in certain brain areas in the frontal and parietal cortices, limbic system, basal ganglia, and thalamus. Moreover, these network measures in the cingulate cortex, caudate nucleus, and thalamus were associated with CCH performance (i.e., copying and creating skills). These results suggest that long-term CCH training has a positive effect on the topological characteristics of brain networks.

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“…The CCH group also shows stronger resting-state functional connectivity than the control group in the brain areas involved in updating and inhibition. These outcomes suggest that long-term CCH training may be associated with improvements in specific aspects of the executive functions and the strengthened neural networks in related brain regions (Chen et al, 2017). At a deeper level of analysis, when processing the visual-spatial configurations of Chinese characters at the cortical level, the act of writing can initiate and facilitate cognitive activities and functions of related cortical substrates (Kao et al, 2018;Xu, Kao, Zhang, Lam, & Wang, 2013).…”

Section: Introductionmentioning

confidence: 99%

HRV Regulation by Calligraphic Finger-writing and Guqin Music: A Pilot Case Study

Lam

Kao

et al. 2019

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Introduction. Previous research shows that brush Chinese calligraphy handwriting (CCH) improves one's cognitive functions as well as emotional and mental health. Similarly, Guqin, the popular Chinese musical instrument, induces positive emotions and emotional stability. The present study tested the efficacy of using the index finger to achieve similar mind-body changes. Methods. We employed a heart rate variability (HRV) Calligraphy-Guqin biofeedback intervention that was implemented with a Zephyr HxM Bluetooth chest heart rate monitoring device and an Android smartphone. A web-based HRV big database app stored the data from three consecutive sessions: (1) 5 min of Guqin music listening; (2) 5 min of CCH finger writing of calligraphy; and (3) again 5 min of Guqin music listening. The second session was designed to explore additive effects of the fingerwriting task. One subject participated with the index finger employed for the writing task. Results. The results showed that the first and third Guqin sessions elicited 55% and 68% HRV coherences, respectively, while the CCH finger writing in the second session elicited 31% of high HRV coherence. The increase in HRV coherence between the two Guqin sessions was attributed to the calligraphy finger writing training effect. The practice of finger writing contributed to increased HRV regulation through heightened attention and concentration.

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Long-Term Experience of Chinese Calligraphic Handwriting Is Associated with Better Executive Functions and Stronger Resting-State Functional Connectivity in Related Brain Regions

Cited by 21 publications

References 77 publications

Chinese calligraphy handwriting (CCH): a case of rehabilitative awakening of a coma patient after stroke

Chinese calligraphy handwriting (CCH): a case of rehabilitative awakening of a coma patient after stroke

Long-term Chinese calligraphic handwriting training has a positive effect on brain network efficiency

HRV Regulation by Calligraphic Finger-writing and Guqin Music: A Pilot Case Study

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