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Cited by 26Motor Control and AdaptationNeurobiology of Language and BilingualismNeural and Behavioral Psychology Studies

Functional MRI of Handwriting Tasks: A Study of Healthy Young Adults Interacting with a Novel Touch-Sensitive Tablet

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Karimpoor, Mahta, Churchill, Nathan W., Tam, Fred, Fischer, Corinne E., Schweizer, Tom A., Graham, Simon J.·2018·Frontiers in Human Neuroscience
DOI 10.3389/fnhum.2018.00030PMC PMC5816817
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Abstract

Handwriting is a complex human activity that engages a blend of cognitive and visual motor skills. Current understanding of the neural correlates of handwriting has largely come from lesion studies of patients with impaired handwriting. Task-based fMRI studies would be useful to supplement this work. To address concerns over ecological validity, previously we developed a fMRI-compatible, computerized tablet system for writing and drawing including visual feedback of hand position and an augmented reality display. The purpose of the present work is to use the tablet system in proof-of-concept to characterize brain activity associated with clinically relevant handwriting tasks, originally developed to characterize handwriting impairments in Alzheimer's disease patients. As a prelude to undertaking fMRI studies of patients, imaging was performed of twelve young healthy subjects who copied sentences, phone numbers, and grocery lists using the fMRI-compatible tablet. Activation maps for all handwriting tasks consisted of a distributed network of regions in reasonable agreement with previous studies of handwriting performance. In addition, differences in brain activity were observed between the test subcomponents consistent with different demands of neural processing for successful task performance, as identified by investigating three quantitative behavioral metrics (writing speed, stylus contact force and stylus in air time). This study provides baseline behavioral and brain activity results for fMRI studies that adopt this handwriting test to characterize patients with brain impairments.

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  • Karimpour et al. used a tablet with real-time visual feedback and found that cortical activation during handwriting was more widespread compared with studies using traditional pen-and-paper writing.

    “Karimpour et al. [26] used a tablet with real-time visual feedback to monitor handwriting, revealing that cortical activation during handwriting was more widespread compared with studies using traditional pen-and-paper writing.”

    From The Neuroscience Behind Writing: Handwriting vs. Typing—Who Wins the Battle? (2025) · cites this paper as [26]

    The Introduction describes a touch-sensitive tablet with visual feedback, and the Discussion reports brain activity during handwriting with that device. The Discussion compares its findings with earlier studies but does not say activation was more widespread than in pen-and-paper studies; it calls the comparison an initial assessment of consistency. Page numbers are unavailable in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • The use of a digital interface reduced involvement of the somatosensory cortex, suggesting that physical contact with paper might be a key factor in the cognitive processing of handwriting.

    “Specifically, the use of a digital interface reduced involvement of the somatosensory cortex, suggesting that physical contact with paper might be a key factor in the cognitive processing of handwriting.”

    From The Neuroscience Behind Writing: Handwriting vs. Typing—Who Wins the Battle? (2025) · cites this paper as [26]

    The Discussion (‘Brain Activity: All Handwriting Tasks’; page unavailable) reports somatosensory activation during tablet handwriting, but does not compare it with writing on paper. The Methods describe stylus contact with the tablet. Our copy therefore does not establish reduced somatosensory involvement with a digital interface or the proposed importance of physical contact with paper. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • Because the same key can be activated by various finger movements, typing often disrupts the precise correspondence between a single gesture and the final product.

    “However, since the same key can be activated by various finger movements, this mechanical process often disrupts the precise correspondence between a single gesture and the final product [26].”

    From The Neuroscience Behind Writing: Handwriting vs. Typing—Who Wins the Battle? (2025) · cites this paper as [26]

    The Introduction and Discussion describe handwriting with a stylus, including coordinated finger movements, but do not address typing. Searches for typing, keys, and keyboards found no passage about whether different finger movements can activate the same key or disrupt a gesture-to-product correspondence. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

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Cited by

Sorted by citations

Authors
Karimpoor, M., Churchill, N. W., Tam, F., Fischer, C. E., Schweizer, T. A., & Graham, S. J.
Affiliations
  • University of Toronto (CA)
  • St. Michael's Hospital (CA)
Corresponding author
Karimpoor, Mahta
ORCID
Venue
Frontiers in Human Neuroscience
Publisher
Frontiers Media SA
Published
2018-02-13
Volume
12
Pages
30-30
ISSN
1662-5161 (ISSN-L)
DOI
10.3389/fnhum.2018.00030
PMC
PMC5816817
OpenAlex
W2789328590
Cited by
26
References
4
Citations by year
2026: 4 · 2025: 4 · 2022: 5 · 2021: 6 · 2020: 2 · 2019: 5
FWCI
1.90
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Human Neuroscience (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Heart and Stroke Foundation of Canada (G-13-00002824)
  • Canadian Institutes of Health Research (114813)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Motor Control and Adaptation
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords
handwriting, augmented reality displays, visual feedback, brain activation maps, writing speed, handwriting impairment, Alzheimer's disease, ecological validity, healthy young adults

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