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Letters   |    
Numbers Written Counterclockwise in the Clock Drawing Test
Hui-Ju Kao, M.D.; Tung-Hua Chiang, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E48-E49. doi:10.1176/appi.neuropsych.13030052
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Dept. of Neurology, Taichung Wizcare Hospital, Taichung City 404, Taiwan

Dept. of Neurology, Cheng-Ching Hospital, Taichung City 400, Taiwan

Correspondence: Hui-Ju Kao, M.D.; e-mail: kaohj.np99@gmail.com

Copyright © 2014 by the American Psychiatric Association

Extract

To the Editor: A recent review (Windows to the Brain: The Clock Drawing Task: Common Errors and Functional Neuroanatomy)1 described Rouleau’s qualitative system and the relationship between clock-drawing errors and brain networks. Frontoparietal and frontostriatal circuits are important for visuospatial and executive functions necessary for accurate clock-drawing. We highlight the error of counterclockwise numbers as spatial and/or planning deficits according to Rouleau’s system and argue that most of correctly sequenced numbers 1–12 written counterclockwise may suggest memory-system involvement.

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FIGURE 1. Relationships Among Number-Order Errors in the Clock Drawing Test
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References

Eknoyan  D;  Hurley  RA;  Taber  KH:  The clock drawing task: common errors and functional neuroanatomy.  J Neuropsychiatry Clin Neurosci 2012; 24:260–265
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Mendez  MF;  Ala  T;  Underwood  KL:  Development of scoring criteria for the clock drawing task in Alzheimer’s disease.  J Am Geriatr Soc 1992; 40:1095–1099
[PubMed]
 
Brugnolo  A;  Morbelli  S;  Dessi  B  et al:  The reversed clock drawing test phenomenon in Alzheimer’s disease: a perfusion SPECT study.  Dement Geriatr Cogn Disord 2010; 29:1–10
[CrossRef] | [PubMed]
 
Lepore  M;  Conson  M;  Grossi  D  et al:  On the different mechanisms of spatial transpositions: a case of representational allochiria in clock drawing.  Neuropsychologia 2003; 41:1290–1295
[CrossRef] | [PubMed]
 
Lepore  M;  Conson  M;  Ferrigno  A  et al:  Spatial transpositions across tasks and response modalities: exploring representational allochiria.  Neurocase 2004; 10:386–392
[CrossRef] | [PubMed]
 
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