title: Writing error may be a predictive sign for impending brain atrophy progression in amyotrophic lateral sclerosis: a preliminary study using X-ray computed tomography.
abstract: OBJECTIVE
  To investigate whether writing errors are predictive of longitudinal brain atrophy progression in patients with amyotrophic lateral sclerosis (ALS).
  
  
  METHODS
  The frequency of writing errors in 6 ALS patients without dementia was compared with longitudinal changes in lateral ventricular areas of the bilateral anterior and inferior horns on X-ray computed tomography scans. The increase in area per month for the anterior and inferior horns was used as a measure of longitudinal brain atrophy progression, and was calculated as: (area on the initial scan - area on the follow-up scan)/scan interval (month).
  
  
  RESULTS
  The longitudinal rate of increase in the area of the anterior horns showed significant associations with the rates of total writing errors (r = 0.886, p = 0.0152), kana errors (r = 0.887, p = 0.0148) and kana omission (r = 0.856, p = 0.0268), whereas that for the inferior horns size showed no significant association with any writing errors.
  
  
  CONCLUSIONS
  The increased area of the anterior horns indicates frontal-lobar atrophy, and writing errors may be a predictive sign for impending brain atrophy progression in the frontal lobes, which reflects the development of anterior-type dementia.
authors: Department of Neurology, Brain Nerve Center, Showa University Fujigaoka Hospital, Aoba-ku, Yokohama, Japan. h_ichikawa0527@yahoo.co.jp
authors: Hiroo
authors: H
authors: Ichikawa
authors: Hideki
authors: H
authors: Ohno
authors: Hidetomo
authors: H
authors: Murakami
authors: Yohei
authors: Y
authors: Ohnaka
authors: Mitsuru
authors: M
authors: Kawamura