Spatial dysgraphia and cerebellar lesion

Abstract

Spatial dysgraphia is a writing disorder that occurs in patients with right hemisphere lesion. We report a patient with cerebellar atrophy and spatial dysgraphia. To explain this finding, we hypothesize a discoordination between planning of the movement and performance due to a lack of the cerebellar modulation between supratentorial (premotor cortex) and peripheral (proprioceptive) afference during the ongoing handwriting movement.

Cerebellar spatial dysgraphia: further evidence

“…The patient's deficit was similar to that described previously [10] in a patient who had cerebellar atrophy. Despite different cerebellar pathology (atrophic and diffuse versus vascular and focal) the two cases presented very similar writing deficits, confirming the role of the cerebellum in "high-order" writing control.…”

“…Sirs: In a recent report Silveri et al [10] described a patient with cerebellar atrophy who had the typical features of peripheral dysgraphia [3], confirming that the cerebellum is involved in cognition [4,5,7,9,10]. This writing deficit, previously described only in subjects with right supratentorial lesions, is characterized by omission and repetition of strokes and letters and has been related to a deficit in visual and proprioceptive feedback, or in attention to feedback, which allows the updating of graphic motor patterns during sequential hand movement [2,8] The authors explained the patient's deficit by hypothesizing deficient coordination between hand movement planning and performance due to a lack of the cerebellar integration between supratentorial areas and proprioceptive afferent from the skeleton and muscles.…”

Right side neglect in right cerebellar lesion

“…However, the role of the cerebellum in human spatial behaviour is less clear. Although different degrees of impairment have been documented in various spatial tasks in patients with cerebellar lesions,4-6 only occasionally has a spatial deficit reached clinical importance (see, for example, the case of spatial dysgraphia7); this is consistent with the demonstration that the cerebellum participates in the visual and kinaesthetic control of movement 8. Recently, the role of the cerebellum in line bisection judgements has been demonstrated by functional MRI in normal subjects 9.…”

The Cerebellum and Language: The Story So Far

“…With respect to writing deficits, Silveri et al [45,46] described two patients with spatial dysgraphia, characterized by segmented and dysmetric writing movements. The authors hypothesized that a discoordination between the planning of the graphic motor patterns generated by supratentorial structures and peripheral, proprioceptive afferences during ongoing writing movements may cause spatial dysgraphia.…”