Midline Hand Drift as a Possible Sign of Neurologic Disorder
Bibliographic record
Abstract
Movement and maintenance of posture involve many interacting factors that rely on a broad neural network. These factors include proprioception, body schema, and peripersonal and extrapersonal space, all of which may be affected in individuals with neurocognitive disorders. Frontal release signs are a common clinical finding in such individuals, resulting from the disruption of the related neural networks. In this case series, we discuss the potential clinical relevance of midline hand drift (MHD). MHD is a rarely documented physical exam finding in which one or both hands move toward the midline when the individual is seated upright with their eyes open, arms outstretched, and palms facing upwards. Upon examination, 24 individuals with a chief complaint of worsening memory were found to have MHD. All 24 individuals with MHD had at least mild cognitive impairment, and 22 were also diagnosed with a neurodegenerative disorder. The most common diagnoses among these individuals were Parkinson disease dementia, Lewy body dementia, and vascular dementia. Nine of the 24 patients demonstrated no frontal release signs upon examination. MHD may be a useful clinical finding that aids in the diagnosis of an underlying neurocognitive disorder. Assessing for MHD may be most beneficial for individuals who are in the earlier stages of neurocognitive decline. They may show mild impairment on the Mini-Mental State Examination or the Montreal Cognitive Assessment, but no other characteristic findings (eg, frontal release signs).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".