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Dermatoglyphics of hyperactive males.

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AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 59243-249(19821
Dermatoglyphics of Hyperactive Males
LESLIE Y. MORGAN, RICHARD C. JUBERG, DALAND R. JUBERG, A N D
ROBERT P. HARDMAN
Department of Medical Genetics and Birth Defects, Children’sMedical Center
(L.EM.. R . C J , D.R.J.IandDepartment ofPediatrics (R.C.J,R.P.H.), Wright
State University School o f Medicine, Dayton, Ohio 45404
K E Y WORDS
Hyperactivity
Behavior, Dermatoglyphics, Flexion creases, Genetics,
ABSTRACT
In investigating the dermatoglyphics of hyperactive subjects, it
was proposed that if similar hyperactives were sampled and significant differences were found from suitable controls, a genetic effect could be responsible.
From two clinical populations, we ascertained 26 subjects in 24 sibships comprising the hyperactive study group. The control subjects came from an earlier study.
Tables 2-9 contain summaries of the dermatoglyphic analyses of both subjects
and controls. Data were grouped following a dermatoglyphic principle of complexity of pattern, specifically, and the number of triradii present. The scheme for reporting the results is: selection of the characteristic (pattern, ridge count); determination of the areas (digit, palm, sole); and comparison of the frequencies or
counts in the two populations (hyperactives, controls). Among the 45 statistical
tests, four achieved a 5% level of significance. Thus, with a seemingly homogeneous sample of hyperactive males and with criteria for comparisons, no characteristic dermatoglyphic features emerged. Considering the highly characteristic effects of chromosomal abnormality on dermatoglyphics as well as the features
associated with an early intrauterine developmental disturbance, the lack of dermatoglyphic similarities in these hyperactive males reduces the likelihood of such
a profound factor as a causal mechanism.
Hyperactivity in childhood has escaped
causal understanding at least partly because
of difficulty distinguishing between hyperactive and normal behavior. Hyperactivity commonly disturbs someone-a parent, a teacher,
or any person in frequent communication with
the accused- but tolerance of irritating behavior differs among persons. Other reasons exist for the lack of understanding: the frequent
assumption that hyperactivity may be transient; the hope that amelioration may be
achieved by behavior modification or medication; and the belief that the behavior will not
interfere with progress to a normal adult life.
Such reasoning suggests that hyperactivity
deserves no effort in etiologic research. How.
ever, hyperactivity frequently interferes with
educating the affected and usually disturbs
any others sharing the same environment.
Views differ concerning the origin, manifestations, and even the existence of the hyperac-
0002-9483/82/5903-0243$02.500 1982 ALAN R. LISS, INC.
tive syndrome. Some observers point to possible disturbances in the neurochemistry or
neurophysiology of the central nervous system. One extreme of the etiological spectrum
hypothesizes complete genetic determination,
while the other extreme claims total environmental determination. Between these extremes, interactive contributions of genetic
and environmental factors could be implicated,
although not necessarily in the same proportions in all cases.
A genetic component could result from a
major gene effect. Such a gene produces a pronounced phenotypic effect. A major gene controls the production of a discontinuous or qualitative character in contrast to a minor gene,
which, along with similar genes, has an individually small effect. These polygenes control
Received January 4, 1982; accepted April 18, 1982.
244
L.Y. MORGAN, R.C. JUBERG, D.R. JUBERG, AND R.P. HARDMAN
common polygenic effects. A major gene
might be X linked and recessive considering
the male predominance and occasional sibships with similarly affected brothers. The occurrence of an affected female is compatible
with X linkage if her father were affected and
her mother a carrier. Furthermore, the prevalence attributed to hyperactivity suggests a
high gene frequency resulting in a high frequency of carrier females. This would explain
apparent male-to-male transmission, the classic evidence against X linkage.
A genetic component also could be ascribed
to minor gene effects. These, as well as a major
gene, could affect behavior in concert with environmental factors. Minor gene effects constitute the mechanism of polygenic inheritance.
Several common congenital malformations are
ascribed to multifactorial determination, of
which the genetic component comes from the
polygenic effect of minor genes, and aberrant
sex ratios in them can be explained by differential male or female susceptibility. Indeed, in a
study of adopted hyperactive children, the
data were consistent with genetic determination, and a polygenic model was postulated
(Morrison and Stewart, 1973).
Dermatoglyphic characteristics are mainly
heritable. However, the precise mechanisms
are not understood, and early in utero infections, such as rubella, can affect the developmental patterns. Though many of the quantitative aspects of dermatoglyphic characters
appear to be determined polygenically, evidence supports single gene determination of
certain specific combinations of patterns or sequences (Juberg et al., 1980; Morgan et al.,
1978).
Hyperactivity may be clinically heterogeneous. Likewise, it may be etiologically heterogeneous. Quite possibly many causes might
produce this outward sign of underlying dysfunction. One twin study, however, offered evidence of a considerable heritable component to
activity level (Willerman, 1973). Unfortunately, no clear objective identification of the hyperactive subject exists. Consequently, an investigation regarding genetic etiology, which
may as well be heterogeneous, must strive to
select a homogeneous clinical sample.
In investigating their dermatoglyphics, we
proposed that if we sampled similar hyperactives and found significant differences from
suitable controls, a genetic effect could be responsible. This would imply an association,
possibly developmental or genetic linkage, be-
tween common factors determining the dermatoglyphics and hyperactivity.
MATERIALS
From two clinical populations, we selected
26 subjects in 24 sibships to comprise the hyperactive study group. All subjects were referred from sources familiar with evaluating
hyperactive behavior: 1)the 4 sibships with 5
white subjects came from a specialty clinic at a
nearby military hospital; and 2) the 20 sibships
with 21 white subjects came from the private
pediatric neurologic practice of one of the coauthors (R.P.H.), a practice recognized to be
particularly experienced in diagnosing and assessing the causes of hyperactive behavior. All
referrals during a restricted period of time
were accepted, and although two females were
referred, they were not included because of
male-female differences in dermatoglyphics.
The two referring physicians, familiar with
each other and their clinical practices, collaborated in selecting the patients to form a homogeneous sample.
In the opinion of the referring clinicians, one
of whom in 20 years has evaluated over 20,000
referrals for hyperactivity, the subjects represented the extreme end of the spectrum of hyperactive syndrome most suggestive of underlying organic origin. Their selection followed
an extensive family history, assessment of
school reports and the results of psychoeducational testing, observation of familial interactions, and intensive physical examination,
including detailed neurologic evaluation. Conventional procedure calls for the physician to
obtain descriptions of behavior in order to diagnose the hyperactive syndrome (Forman,
Hetznecker, and Dunn, 1979). The same
authors stress that classroom observations
and psychoeducational tests are most useful
diagnostically. The study group presented a
contrast to subjects at the opposite end of the
spectrum, those with highly suspicious psychological origins.
The subjects frequently demonstrated purposeless movements and were often restless.
Parents and teachers alike noted their short attention spans, distractibility, and impulsiveness. They were described as easily frustrated
and rather excitable. All had experienced emotional and behavioral difficulties.
Three families contained two males similarly
affected by hyperactive behavior: 1) two brothers; 2) dizygotic twin brothers; and 3) father
and son. The mean age of the subjects was 12
DERMATOGLYPHICS OF HYPERACTIVE MALES
TABLE 1. Birth order of 26' hyperactive subjects
Sibship
size
~~.
1
1
2
3
3
8
2
0
1
4
5
Birth order
~-
2
3
4
5
-
-
0
-
-
1
1
1
-
0
0
8
1
0
0
years. Excluding the probands, the sex ratio in
their siblings was 1.0. Table 1 shows their birth
order. At birth of the probands, mean maternal
age was 25% years and mean paternal age was
28?h years. None of the parents was known to
be consanguineous. All families resided in
southwestern Ohio and were representative of
the clinical population and private practice
from which they were drawn.
The control subjects came from an earlier
study of laterality (Morgan et al., 1976). They
were the 25 male, white probands in 54 families
randomly ascertained in the summer session of
Louisiana State University at Eunice in 1974.
Two groups of students were enrolled at the
time of that study: one consisted of the undergraduates attending the summer session, and
the other comprised a group between their
third and fourth high school years who were
enrolled in a special program for students of
high academic standing.
Though not of concern at the time of the
study, hyperactive behavior was not evident in
any of the subjects, and we obtained no history
of it. Through a later survey we were able to
contact 19 families, and by specific inquiry we
confirmed that none considered their sons to
be hyperactive and neither had their teachers
nor anyone else. All subjects were progressing
normally or superiorly in school. We have previously shown their dermatoglyphic characteristics to be comparable with those of other populations (Morgan et al., 1978; Juberg et al.,
1980).
METHODS
The dermatoglyphic prints of all subjects
were obtained by inking the skin from either a
prepared glass plate or a roller and then applying the inked surface to a glossy paper.' The
prints were analyzed with a Wild M-8 Stereomicroscope following established guidelines
W e obtained written intormed consent from 20 families and implied
informed consent from 5 families in the hyperactive group and from all
families of the control group
245
(Cummins and Midlo, 1961). The classification
used was of Dar et al. (1977) for the flexion
creases. One investigator (L.Y.M.) performed
all analyses of prints from subjects and controls except for the classification of the flexion
creases (D.R.J.).
RESULTS
Tables 2-9 contain summaries of the dermatoglyphic analyses of both subjects and controls. The qualitative data could not be analyzed by simple comparisons of pattern
frequencies for all separate areas, because of
the large numbers of classifiable variables and
the small number of subjects. Thus, the
grouped data followed a dermatoglyphic principle of complexity of pattern, specifically, the
number of triradii present. Two triradii determine a whorl, whereas one triradius or none result in a loop or an arch, respectively.
The scheme for reporting the results is: selection of the characteristic (pattern,ridge count);
determination of the areas (digit, palm, sole):
and comparison of the frequencies or counts in
the two populations (hyperactives, controls).
Statistical analyses employed x2,not requiring
either correction for continuity (Yates)or testing for exact probability (Fisher), and
Student's t.
Pattern (whorl, nonwhorl) by digit x group
(hyperactiue/control)
There was no trend across the digits, and the
presence or absence of a whorl did not differen
tiate the two groups (Table 2). Analysis by x 2
for 10 digits with one degree of freedom (d.f.)
showed a significant difference only for L, on
which more whorls occurred in hyperactives
(0.05 > p > 0.01).
Pattern (whorl, nonwhorl) by hand x group
lhyperactiue/control)
The number of whorls on the left hand (0.05
> p > 0.01) as well as across both hands (0.05
> p > 0.01) did differentiate the two groups by
more whorls present in the hyperactives (Table
2). Analysis was by x2 with 1 d.f. for the hands
considered separately and together.
Ridge counts b y individual digits and total
digital ridge count x group
lhyperactive/control)
No difference existed between the two
groups (Table3). Analysis for 10 digits individually and the total for all 10 digits was by Student's t with 49 d.f.
246
L.Y. MORGAN, R.C. JUBERG, D.R. JUBERG, AND R.P. HARDMAN
TABLE 3. Individual and total digital ridge counts in 26
hyperactive and 25 control subjects
Digit
L,
L
2
L3
L4
w a
m o
vcr
mu,
N N
L5
R,
R>
R3
0 0
c)
'6i
6
m m
0 0
0 0
0 0
0 -
0 0
d h
NN
- 3
mm
m a
m N
1 3
0 0
NQ,
0 0
0 0
,-I
R4
R5
Total
Mean and standard deviation
Subject
Hyperactive
Control
18.3 + 5.0
11.7 f 7 . 3
13.3k7.1
16.5 f6.3
14.4 + 4.8
20.1 k 6 .1
11.5 + 7 .2
13.8 f 7.4
17.3 +5.2
16.0 f 4.6
17.3 f 6.5
11.5 k 8 .3
13.0 k 6 . 8
16.6 f 6.4
14.3 + 5.7
21.4 f 5.5
13.0 8.1
13.4 f6.3
16.9 f 7.5
15.1 f 5.5
153.3 k 48.9
152.4 f 55.2
Palmar pattern (third interdigital, fourth
interdigital, hypothenar) distribution by hand
(unilateral and bilateral) x group
(hyperactive/control)
The distribution of a true palmar pattern on
either side, the left or the right side, or on both
sides, or on neither, thus making four classes,
in the third interdigital, fourth interdigital, or
hypothenar region did not differentiate the
two groups (Table 4). The three areas
considered were those in which patterns,
usually loops but occasionally whorls, most
commonly occur. Three remaining areas,
second interdigital, first interdigital, and
thenar, less commonly have patterns. Analysis
was by x 2 with 3 d.f.
Palmar pattern (third interdigital, fourth
interdigital, hypothenar) occurrence by hand
(unilateral by side or either side) x group
(hyperactive/control)
With one exception, no significant differences existed between the two groups where a
true pattern occurred (Table 4).The exception
was the left hypothenar area in which the occurrence in hyperactives exceeded that in controls (0.05 > p > 0.01). Analysis was done by xz
with 1d.f. for unilateral left, unilateral right, or
either side for the three areas taken separately.
Size o f atd angle by hand x group
(hyperactive/control)
No significant differences emerged from
comparison of size of the atd angles (Table 5).
The atd angle is largely a function of the site of
the axial triradius, t, but it is also determined
247
DERMATOGLYPHICS OF HYPERACTIVE MALES
T A B m 4. Frequency of unilateral and bilateral true patterns in the third interdigital, fourth interdigital, and hypothenar
patmar areas in 26 hyperactive and 25 control subjects
Palmar area
Side
Unilateral
left
Unilateral
right
Bilateral
Either unilateral or bilateral
Subject
Third
interdigital
Fourth
interdigital
Hyperactive
Control
Hyperactive
Control
Hyperactive
Control
Hyperactive
Control
14
15
by the sites of the a and d triradii. Analysis of
each side was by Student’s t with 49 d.f.
A-B ridge count by hand x group
(hyperactiue/control)
Side
Left
Right
Both
Angle (degrees)
Mean and standard deviation
Hyperactive
Control
48.6 f 13.1
47.4* 8.8
96.1 f 20.5
4 5 . 6 i 7.7
4 5 . 1 i 6.7
90.3 & 11.8
TABLE 6. A-B ridge count of each palm in 26 hyperactive
and 25 control subjects
Side
Left
Right
Both
Ridge count
Mean and standard deviation
Hyperactive
Control
*
44.4 4.9
43.7 i4.7
88.1 f8.0
43.4 f 4.6
43.5 6.0
86.9 +9.6
*
9
tance between these palmar triradii, situated
at the bases of the second and third digits.
Analysis was by Student’s t with 49 d.f. separately by hand and for the sum of both hands.
Frequency of palmar main line sequence by
side (unilateral and bilateral) x group
(hyperactivekontrol)
No significant differences came from comparing the ridge counts between the a and b triradii (Table 6). This is one measure of the disTABLE 5. A T D angle of each palm in 26 hyperactive
and 25 control subjects
Hypothenar
Main line sequences are not susceptible to
grouping, and the number of unique sequences
prohibited the accumulation of large enough
totals for testing (Table 7). The three most
common sequences occurred in approximately
equal numbers in the two groups.
The main line sequence was determined by
constructing a line from the midpoint of the
third digit to the midpoint of the wrist and listing the lines in their order of crossing from distal to proximal. Appropriate designations for
parallel lines, for lines emanating from accessory triradii, and for main lines that did not
cross the constructed line were used.
Hallucalpattern by type and side (unilateral or
either) x group (hyperactive/control)
Hallucal patterns as distal loop, tibial loop,
whorl, or fibular arch were classified and their
occurrence on individual side or on either foot
TABLE 7. Frequency of palmar main line sequences in 26 hyperactive and 25 control subjects
Frequency
Main line
sequence
___CBDAT
CDBAT
DCBAT
17 others
summed
Left
Hyperactive
Control
7
7
5
2
12
4
5
9
Right
Hyperactive
10
8
3
5
Control
12
6
2
5
Both
Hyperactive
11
13
5
17
Control
19
10
7
14
248
L.Y. MORGAN, R.C. JUBERG, D.R. JUBERG, AND R.P. HARDMAN
TABLE 8. Frequency o f hallucal patterns on each foot in 26 hyperactive and 25 control subjects
Frequency
Hallucal
pattern
Left
Hyperactive
Loop, distal
Loop, tibia1
Whorl
Arch, fibular
Control
12
14
5
7
2
2
9
0
TABLE 9. Frequency
Right
Hyperactive
14
3
8
1
Typical, type A, ,
Typical, type A2.t
Typical, type
Simian, type Bo.,
Simian, type B2.1
Simian, type B3.3
Unusual, type D, I
Both
Hyperactive
26
8
15
3
13
3
9
0
Control
27
5
18
0
of palmar flexion crease patterns in 26 hyperactive and 25 control subjects
____._________.
Palmar flexion
crease pattern
Control
Left
Hyperactive
19
4
0
0
1
2
0
Control
11
2
4
0
0
1
1
were tested (Table8).There were no significant
differences among the three x2 tables with 3
d.f. Other plantar areas were not studied.
Palmar flexion crease type by hands together
x group (hyperactiue/control)
Table 9 shows the classification of palmar
flexion creases as typical, simian, and unusual,
and the subclassification. For purposes of testing by x2 with 1 d.f., all typical were gathered
and compared with all simian plus unusual
creases. There was no significant difference.
DISCUSSION
Among the preceding 45 statistical tests,
four achieved a 5% level of significance. In that
many comparisons, by chance alone between
two and three would be expected to be significant at the 5% level. Thus, with a seemingly
homogeneous sample of hyperactive males
with our criteria for comparisons, no characteristic dermatoglyphic features emerged. Nevertheless, the four significant differences can be
summarized as showing: 1) the hyperactives
had a more complex pattern than the,controls;
2) the more complex pattern was the whorl;
and 3) the left hand, specifically the third digit
and the hypothenar area, showed more complex patterns and more patterns, respectively.
Only two prior studies bear similarity to this
investigation. Lerer (1977)reported more simian creases and Sydney lines by direct observa-
Frequency
Right
Hyperactive
20
3
2
0
0
1
0
Control
15
2
6
1
0
0
1
Both
Hyperactive
39
I
2
0
1
3
0
Control
32
4
10
1
0
1
2
tion in hyperactive boys and girls than in the
controls. Though included in our study, the
flexion creases are not considered as dermatoglyphics, as originally defined by Cummins
and Midlo (1961).The findings by detailed classification of the flexion creases, nevertheless,
did not support the contention of abnormal
palmar flexion creases in hyperactive children.
In another study, dermatoglyphic abnormalities were not found in dyslexic children (Cummings et al., 1978). However, aside from an assumed common origin in the central nervous
system, dyslexia and hyperactivity are not
alike.
Recently, the frequencies of fingerprint patterns in children with early-onset autism, a severe behavioral and communicative disorder,
were compared with populations of childhood
schizophrenics, adult schizophrenics, and normals (Sank and Firschein, 1979).There were no
differences between autistics and childhood
schizophrenics, but there were differences between autistics and adult schizophrenics and
the controls. However, these are all much more
severe behavioral disturbances than the hyperactive syndrome, suggesting genetic and thus
earlier etiological determination.
Characteristic dermatoglyphics commonly
occur among certain kinds of clinical abnormalities, especially among subjects with various malformations of the hands and feet
(Schaumann and Alter, 1976). Dermatoglyph-
DERMATOGLYPHICS OF HYPERACTIVE MALES
ics may be diagnostically abnormal in aneuploidy, more often when an additional chromosome is an autosome than when it is a sex
chromosome. They may also be deviant to a
lesser extent in structural chromosomal abnormalities, for instance, the deletion syndromes.
Dermatoglyphics have not often been found to
characterize disorders due to single gene inheritance or congenital malformation syndromes
of unknown etiology.
Considering the highly characteristic effects
of chromosomal abnormality on dermatoglyphics as well as the features associated with
an intrauterine developmental disturbance, it
was believed that the lack of dermatoglyphic
similarities in hyperactive males observed in
the present study reduces the likelihood of
such a profound factor as a causal mechanism.
However, finding no characteristic dermatoglyphics in hyperactive males does not negate
the possibility that some subjects with hyperactivity may be genetically determined. The
possibility of genetic determination offers
highly useful clinical applicability, including
management of the affected and genetic
counseling.
ACKNOWLEDGMENTS
The authors wish to thank Charles C. Faust,
Ph.D., Louisiana State University in Eunice,
for providing information.
249
LITERATURE CITED
Cummings, C, Flynn, D. and Preuss. M (1978) Dermatoglyphic traits and minor anomalies in “dyslexic” children.
Am. J. Hum. Genet., 30:lOlA.
Cummins. H. and Midlo. C 119611 Finger Prints. Palms and
Soles: An Introduction to Dermatoglyphics. New York:
Dover Publications.
Dar. H. Schmidt, R. and Nitowsky, HM (1977) Palmar
crease variants and their clinical significance: a study of
newborns a t risk. Ped. Res. I1:103-108.
Juberg. RC, Morgan, LY, and Faust, CC (19801 The inheritance of digital dermatoglyphic patterns in 54 American
Caucasian families. Am. J . Phys. Anthropol. 52:7-12.
Lerer. RJ (1977)Do hyperactive children tend to have abnormal palmar creases? Clin. Ped. I6:645-647.
Morgan, LY. Juberg, RC. and Faust. CC (1976) Digital dermatoglyphics correlated with laterality. Excerpta Medica. V International Congress of Human Genetics, Mexico
City, 1976. no. 542, p. 205.
Morgan, LY. Juberg, RC. and Faust CC 11978) The inheritance of palmar and hallucal dermatoglyphic patterns in
fifty-four American Caucasian families. Am. J. Phys. Anthropol. 49:44 1-447.
Morrison, JR. and Stewart, MA 119731The psychiatric stat u s of the legal families of adopted hyperactive children.
Arch. Gen. Psychiatry 2.9888-891.
Sank, D. and Firschein. BDS (19781 Fingerprints and lateral
preferences of early-onset autism. In W. Wertelecki and
C.C. Plato (edsl: Dermatoglyphics - Fifty Years LaLer.
New York: Alan R. Liss. Inc.. pp. 679-695.
Schaumann. B. and Alter. M (1976) Dermatoglyphics in
Medical Disorders. New York: Springer-Verlag.
Willerman. L 119731 Activity level and hyperactivity in
twins. Child Dev. 4 4 2 2 8 - 2 9 3 .
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