Hands, Minor Physical Anomalies (MPA’s) & Behavior!

The relationship between hands & behavior had already been notice in the early days of the Greek philosopher Aristotle (384 BC – 322 BC) – who e.g. debated the cause-and-effect relationship in the hand’s development and the emergence of the superior human intellect. Later the Roman physician Galen (129 – 199) became known for advocating the view that physical features could reflect inner characteristics of behavior. And more later the concept of the ‘physiognomy’ suggested that deviant behavior could be predicted from certain physical characteristics of the head and hands.

 

During the 2nd half of the 20th century a new development became manifest. The so-called ‘minor physical anomalies’ (MPA’s) became a study object for medical researchers in order to study the cause of various behavior related disorders – featured with a significant role for the most differentiated extremities of the human body: the hands & face.

 

The current state of research indicates that the etiology of these MPA’s is usually associated with two factors: 1 – genetics (sometimes they are described as congenital physical abnormalities), and 2 – insults to the fetal neural development towards the end of the first trimester (due to: infections, lack of oxygen, diseases in the mother & other prenatal traumas).

 

It became also appearant that MPA’s provide an important clue to specific malformation diagnosis, brain pathology and timing of pathology.

 

Hands, MPA’s & behavior disorders:

In the past few decades MPA’s became associated with etiology studies for a wide range of function & behavior related disorders in newborns & school-age children, such as: autism, Down syndrome, hyperactivity, inhibition, learning disabilities, psychoneurotic behavior, schizophrenia, speach- & language problems.

And especially the ‘Waldrop scale‘ (Waldrop & Halverson, 1971) became a popular tool to study the MPA’s in these populations. And various studies have indicated that the MPA’s included in the ‘Waldrop scale’ are much more often seen in certain groups of youngsters. While the average prevalence of items is usually low in controls (1.10-2,32), studies have reported much higher values in various populations, e.g.: Down syndrome (17.04%), schizophrenia (4.83%), Tourette syndrome (5.45%).

 

And the results typically show a much higher occurence of multiple MPA’s among the patients than in the control populations.

 

 

Hand markers in the Waldrop scale: 

 

Interestingly, various items in the Waldrop scale relate to the hands, including: clinodactyly, nail hypoplasia, simian crease, single flexion crease on the 5th finger, Sydney line & unusual length of the fingers.

 

But the studies so far have also indicated that in the Waldrop scale individual items can not serve for reliable diagnosis. And few details are available regarding the possibility that specified combinations of MPA’s (within one body part or multiple body parts) could serve as a reliable diagnostic marker.

 

Other fascinating related reports have been made where hands become a significant specified marker when combined with other body markers. And these can even play a significant role in the explorations & identification of new syndromes.

 

The illustration below represents an example taken from a study where the missing of fingers (oligodactyly) combined with a disorder on the right eye lid, became a marker for a (new) syndrome that relates to chromosome 21qter (associated e.g. with congenital fibrosis of the extraocular muscles – Tukel CFEOM syndrome). Though there were no behavior problems reported for that syndrome, this example does show hand markers can be recognized as clues that relate to problems in the other extremities (in this example the eyes).

 

Read more about the most well-know MPA hand-marker:

The simian line (a.k.a. single palmar transverse crease)

 

In ‘hand diagnostics’ the role Minor Physical Anomalies significant!