Neuroimaging correlates of handwriting quality as children learn to read and write

Paul Gimenez, Nicolle Bugescu, Jessica M. Black, Roeland Hancock, Kenneth Pugh, Masanori Nagamine, Emily Kutner, Paul Mazaika, Robert Hendren, Bruce D. McCandliss, Fumiko Hoeft

Reading and writing are related but separable processes that are crucial skills to possess in modern society. The neurobiological basis of reading acquisition and development, which critically depends on phonological processing, and to a lesser degree, beginning writing as it relates to letter perception, are increasingly being understood. Yet direct relationships between writing and reading development, in particular, with phonological processing is not well understood. The main goal of the current preliminary study was to examine individual differences in neurofunctional and neuroanatomical patterns associated with handwriting in beginning writers/readers. In 46 5-6 year-old beginning readers/writers, ratings of handwriting quality, were rank-ordered from best to worst and correlated with brain activation patterns during a phonological task using functional MRI, and with regional gray matter volume from structural T1 MRI. Results showed that better handwriting was associated negatively with activation and positively with gray matter volume in an overlapping region of the pars triangularis of right inferior frontal gyrus. This region, in particular in the left hemisphere in adults and more bilaterally in young children, is known to be important for decoding, phonological processing, and subvocal rehearsal. We interpret the dissociation in the directionality of the association in functional activation and morphometric properties in the right inferior frontal gyrus in terms of neural efficiency, and suggest future studies that interrogate the relationship between the neural mechanisms underlying reading and writing development.