Beyond the genome—Towards an epigenetic understanding of handedness ontogenesis

Genetics of human handedness: microtubules and beyond

Handedness (i.e., the preference to use either the left or the right hand for fine motor tasks) is a widely investigated trait. Handedness heritability is consistently estimated to be 25%. After decades of research, recent large-scale genome-wide association and exome sequencing studies have identified multiple genes associated with handedness and highlighted tubulin genes. Tubulin genes play a role in several processes during brain development that may be relevant for handedness ontogenesis, including axon guidance, axon growth, and forming the inner structure of motile cilia. Moreover, tubulin genes are associated with several psychiatric disorders. This finding therefore may offer insights into biological pathways mediating the link between handedness, brain asymmetries, and psychiatric traits.

Perinatal adversities as a common factor underlying the association between atypical laterality and neurodevelopmental disorders: A developmental perspective

Several neurodevelopmental disorders are associated with a higher prevalence of atypical laterality (e.g., left-handedness). Both genetic and non-genetic factors play a role in this association, yet the underlying neurobiological mechanisms are largely unclear. Recent studies have found that stress, mediated by the hypothalamic-pituitary-adrenal (HPA) axis, could be linked to laterality development. These findings provide an opportunity to explore new theoretical perspectives on the association between atypical laterality and neurodevelopmental disorders. This article aims to provide a theoretical framework demonstrating how perinatal adversities could disrupt the typical developmental trajectories of both laterality and neurodevelopment, potentially impacting both the HPA axis and the vestibular system. Additionally, we argue that the relationship between atypical laterality and neurodevelopmental disorders cannot be understood by simply linking genetic and non-genetic factors to a diagnosis, but the developmental trajectories must be considered. Based on these ideas, several perspectives for future research are proposed.

A task-dependent analysis of closed vs. open and fine vs. gross motor skills in handedness

The traditional classifications of motor skills nature (open vs closed; fine vs gross) have not been considered in handedness investigations. Instead, previous research focused on comparing complex vs less complex motor behaviour, leaving a gap in the literature. We compared manual preference between different motor skill characteristics, namely: fine and closed (FC), gross and closed (GC) and gross and open (GO) tasks. The hand preference was assessed with the Global Lateral Preference Inventory in four hundred and forty participants (244 women) aged from 18 to 59 years old. By assessing the degree and direction of handedness in different motor skills, our results showed a stronger lateralization pattern for FC motor skills as compared to GC and GO, with GO also being less lateralized than GC. Our results expand those of previous investigations that used the motor skill complexity definitions by showing how handedness can also be modulated by the interaction between classic motor skills classifications. Future research should consider fine vs. gross and open vs. closed classifications when selecting tasks for analysis of asymmetries of preference.

Handedness in Alzheimer Disease: A Systematic Review

Handedness has been a topic of scientific interest for many years. However, false and misleading ideas have dominated this field with a still limited amount of research into the association with clinical disorders like Alzheimer disease (AD). In accordance with PRISMA guidelines, PubMed, Embase, and Cochrane Library were searched for studies regarding the association of handedness and AD. Twelve articles were included. Case-control studies show that left-handedness is not a risk factor for late-onset AD (LOAD). However, nonright handedness was found to be more prevalent in patients with early-onset AD (EOAD). Moreover, handedness does not seem to affect neuropsychological performance. We also show that collapsing versus separating mixed and left-handedness may yield different results. Future research on the relation between handedness and AD may provide new insight into disease pathogenesis, improve rehabilitation, and help identify patients who will progress, aiding the design of prevention trials.

Fifty Years of Handedness Research: A Neurological and Methodological Update

Handedness, a complex human aspect that reflects the functional lateralization of the hemispheres, also interacts with the immune system. This study aimed to expand the knowledge of the lateralization of hand, foot, and eye activities in patients with immune-mediated (IM) or other (noIM) neurological diseases and to clarify the properties of the Edinburgh Handedness Inventory (EHI) in an Italian population. Three hundred thirty-four patients with IM or noIM diseases affecting the brain or spine and peripheral nervous system were interviewed about stressful events preceding the disease, subjective handedness, and familiarity for left-handedness or ambidexterity. The patients and 40 healthy subjects underwent EHI examination. In the whole group of participants, 24 items of the EHI were classified into five factors (Hand Transitive, Hand Refined, Hand Median, Foot, Eye), demonstrating good reliability and validity. Chronological age had a significant influence on hand and foot EHI factors and the laterality quotient (LQ), particularly on writing and painting. In the patient groups, EHI factors and the LQ were also predicted by age of disease onset, duration of disease, and family history of left-handedness or ambidexterity. No differences were found between patients and healthy subjects, but pencil use scored significantly lower in patients with IM diseases than in those with noIM brain diseases. These results demonstrate that the lateralization of hand and foot activities is not a fixed human aspect, but that it can change throughout life, especially for abstract and symbolic activities. Chronic neurological diseases can cause changes in handedness. This may explain why, unlike systemic immunological diseases, IM neurological diseases are not closely associated with left-handedness. In these patients, the long version of the EHI is appropriate for determining the lateralization of body activities to contextualize the neurological picture; therefore, these findings extend the Italian normative data sets.

Fingerprint patterns in relation to an altered neurodevelopment in patients with autism spectrum disorder

Dermatoglyphic patterns are permanently established and matured before the 24th week of gestation. Their frequencies and localization might be a good indicator of developmental instability in individuals with an altered neurodevelopment and show potential as biomarkers of autism spectrum disorder (ASD). In this study, fingerprint pattern counts and fluctuating asymmetry in the distribution of patterns are compared between 67 boys diagnosed with ASD (aged 5.11 ± 2.51 years) and 83 control boys (aged 8.58 ± 3.14 years). Boys with ASD had a higher rate of discordance in their fingerprint patterns (p = .0026), showing more often bilateral differences in the occurrence of certain patterns. A chi-square test revealed that the difference in pattern frequencies between boys with ASD and the control group is the most significant in frequencies of whorls, tented arches, and ulnar loops. Boys with ASD have significantly fewer ulnar loops, significantly more whorls, and tented arches in the right hand. The achieved results are in favor of the suggestion that prenatal influences, which play a role in the development of bilateral differences in fingerprint patterns up to the 24th week of gestation, may be a potential cause of an altered neurodevelopment in ASD individuals.

A deep phenotyping approach to assess the association of handedness, early life factors and mental health

The development of handedness and other form of functional asymmetries is not yet understood in its critical determinants. Early life factors (e.g., birth weight, birth order) have been discussed to contribute to individual manifestations of functional asymmetries. However, large-scale data such as the UK Biobank suggest that the variance in handedness that is explained by early life factors is minimal. Additionally, atypical handedness has been linked to clinical outcomes such as neurodevelopmental and psychiatric disorders. Against the background of this triad, the current study investigated associations between different forms of functional asymmetries and (a) early life factors as well as (b) clinical outcomes. Functional asymmetries were determined by means of a deep phenotyping approach which notably extends previous work. In our final sample of N = 598 healthy participants, the different variables were tested for associations by means of linear regression models and group comparisons (i.e., ANOVAs and Chi-squared tests). Confirming previous findings from larger cohorts with shallow phenotyping, we found that birth factors do not explain a substantial amount of variance in functional asymmetries. Likewise, functional asymmetries did not seem to have comprehensive predictive power concerning clinical outcomes in our healthy participants. Future studies may further investigate postulated relations in healthy and clinical samples while acknowledging deep phenotyping of laterality.

Stress exposure, hand preference, and hand skill: A deep phenotyping approach

ABSTRACTStress exposure and reactivity may show differential associations with handedness, but shallow phenotyping may influence the current knowledge. Importantly, different handedness measures do not necessarily show high correlations with each other and should not be used interchangeably as they may reflect different dimensions of laterality. Here, data on handedness from 599 participants in the population-based, longitudinal Dortmund Vital Study was used to determine various asymmetry indices. Hand preference was assessed with the Edinburgh Handedness Inventory (EHI) and the lateral preference inventory (LPI) measuring handedness, footedness, earedness, and eyedness. Hand performance was determined using the pegboard test. In addition, data on several dimensions of stress exposure and reactivity, including hair cortisol, and mental well-being was analysed to determine associations with handedness. All handedness measures correlated significantly with each other, with the strongest correlation between the EHI and the LPI handedness score. The EHI and LPI hand measures resulted in the highest effect sizes and most consistent correlations with stress or mental well-being. In contrast, the pegboard test only showed very little association with the stress and mental well-being measures. This highlights the importance of handedness phenotyping. Including preference measures is recommended to disentangle the link between handedness and mental health.

Handedness in post-traumatic stress disorder: A meta-analysis

The main objective of this meta-analysis was to investigate handedness in post-traumatic stress disorder on a meta-analytical level. For this purpose, articles were identified via a search in PubMed, PsychInfo, PubPsych, ResearchGate, and Google Scholar. Studies reporting findings relating to handedness in PTSD patients and healthy controls were considered eligible. In total, k = 14 studies with an overall N of 2939 (747 PTSD patients and 2192 controls) were included in the study. Random-effects meta-analyses, as well as robust Bayes meta-analyses (RoBMA), were conducted for three comparisons: (a) non-right-handedness, (b) left-handedness, and (c) mixed-handedness. Results showed significantly higher frequencies of non-right-handedness (odds ratio = 1.81) and mixed-handedness (odds ratio = 2.42) in PTSD patients compared to controls. No differences were found for left-handedness. This specific effect of mixed-handedness is in line with findings for other disorders, such as schizophrenia. Future studies should investigate common neurodevelopmental origins for the relationship between mixed-handedness and psychopathology and aim at investigating both handedness direction and handedness strength.

Handedness in low-birthweight children: Insights in lateralization

Low-birthweight (LBW) children (n = 96) weighing less than 2.5 kg at birth and normal birthweight (NBW) children (n = 96) from Delhi, India, between the ages of 5 and 12 years were assessed for intelligence with Ravens Colored Progressive Matrices (RCPM), their handedness and hand proficiency for unimanual and bimanual performance. The objective was to know if there is a relation between birthweight and the development of handedness. Compared with NBW children, the LBW group had lower percentile scores for the RCPM. The LBW children were less lateralized than the NBW children in the hand preference test. The LBW children were faster than the NBW for sorting objects with each hand separately, but they were slower in the bimanual envelope task. This indicates a delay in interhemispheric transfer and the development of the corpus callosum that connects the cerebral hemispheres to enable bimanual coordination. In the absence of more direct evidence, hand skill was used as an index of the extent of lateralized control for performance. Findings indicate a relation between birthweight and lateralization in children tested for hand preference.

Taking Sides: Asymmetries in the Evolution of Human Brain Development in Better Understanding Autism Spectrum Disorder

Confirmation from structural, functional, and behavioral studies agree and suggest a configuration of atypical lateralization in individuals with autistic spectrum disorders (ASD). It is suggested that patterns of cortical and behavioral atypicality are evident in individuals with ASDs with atypical lateralization being common in individuals with ASDs. The paper endeavors to better understand the relationship between alterations in typical cortical asymmetries and functional lateralization in ASD in evolutionary terms. We have proposed that both early genetic and/or environmental influences can alter the developmental process of cortical lateralization. There invariably is a “chicken or egg” issue that arises whether atypical cortical anatomy associated with abnormal function, or alternatively whether functional atypicality generates abnormal structure.

The evolution and biological correlates of hand preferences in anthropoid primates

The evolution of human right-handedness has been intensively debated for decades. Manual lateralization patterns in non-human primates have the potential to elucidate evolutionary determinants of human handedness, but restricted species samples and inconsistent methodologies have so far limited comparative phylogenetic studies. By combining original data with published literature reports, we assembled data on hand preferences for standardized object manipulation in 1786 individuals from 38 species of anthropoid primates, including monkeys, apes, and humans. Based on that, we employ quantitative phylogenetic methods to test prevalent hypotheses on the roles of ecology, brain size, and tool use in primate handedness evolution. We confirm that human right-handedness represents an unparalleled extreme among anthropoids and found taxa displaying population-level handedness to be rare. Species-level direction of manual lateralization was largely uniform among non-human primates and did not strongly correlate with any of the selected biological predictors, nor with phylogeny. In contrast, we recovered highly variable patterns of hand preference strength, which show signatures of both ecology and phylogeny. In particular, terrestrial primates tend to display weaker hand preferences than arboreal species. These results challenge popular ideas on primate handedness evolution, including the postural origins hypothesis. Furthermore, they point to a potential adaptive benefit of disparate lateralization strength in primates, a measure of hand preference that has often been overlooked in the past. Finally, our data show that human lateralization patterns do not align with trends found among other anthropoids, suggesting that unique selective pressures gave rise to the unusual hand preferences of our species.

The influence of vestibular system and fetal presentation on handedness, cognitive and motor development: A comparison between cephalic and breech presentation

Genetics are undoubtedly implicated in the ontogenesis of laterality. Nonetheless, environmental factors, such as the intrauterine environment, may also play a role in the development of functional and behavioral lateralization. The aim of this study was to test the Left-Otolithic Dominance Theory (LODT; Previc, 1991) by investigating a hypothetical developmental pattern where it is assumed that a breech presentation, which is putatively associated with a dysfunctional and weakly lateralized vestibular system, can lead to weak handedness and atypical development associated with language and motor difficulties. We used the ALSPAC cohort of children from 7 to 10 years of age to conduct our investigation. Our results failed to show an association between the vestibular system and fetal presentation, nor any influence of the latter on hand preference, hand performance, or language and motor development. Bayesian statistical analyses supported these findings. Contrary to our LODT-derived hypotheses, this study offers evidence that fetal presentation does not influence the vestibular system's lateralization and seems to be a poor indicator for handedness. Nonetheless, we found that another non-genetic factor, prematurity, could lead to atypical development of handedness. This article is protected by copyright. All rights reserved.

Light-induced asymmetries in embryonic retinal gene expression are mediated by the vascular system and extracellular matrix

Left–right asymmetries in the nervous system (lateralisation) influence a broad range of behaviours, from social responses to navigation and language. The role and pathways of endogenous and environmental mechanisms in the ontogeny of lateralisation remains to be established. The domestic chick is a model of both endogenous and experience-induced lateralisation driven by light exposure. Following the endogenous rightward rotation of the embryo, the asymmetrical position in the egg results in a greater exposure of the right eye to environmental light. To identify the genetic pathways activated by asymmetric light stimulation, and their time course, we exposed embryos to different light regimes: darkness, 6 h of light and 24 h of light. We used RNA-seq to compare gene expression in the right and left retinas and telencephalon. We detected differential gene expression in right vs left retina after 6 h of light exposure. This difference was absent in the darkness condition and had already disappeared by 24 h of light exposure, suggesting that light-induced activation is a self-terminating phenomenon. This transient effect of light exposure was associated with a downregulation of the sensitive-period mediator gene DIO2 (iodothyronine deiodinase 2) in the right retina. No differences between genes expressed in the right vs. left telencephalon were detected. Gene networks associated with lateralisation were connected to vascularisation, cell motility, and the extracellular matrix. Interestingly, we know that the extracellular matrix—including the differentially expressed PDGFRB gene—is involved in morphogenesis, sensitive periods, and in the endogenous chiral mechanism of primary cilia, that drives lateralisation. Our data show a similarity between endogenous and experience-driven lateralisation, identifying functional gene networks that affect lateralisation in a specific time window.

Relationships between footedness and aging on postural control: Evidence from the Yakumo study

ABSTRACTThe effects of footedness and aging on postural maintenance function were examined in this study. Using the postural maintenance task, the trajectories of the centre of pressure (COP) were measured with a stabilometer in the lateral and posterior/anterior directions. One hundred and ninety-three right-footers (112 middle-aged: 40-64 years old and 81 old-aged: 65-80 years old) and thirty-two left-footers (14 middle-aged and 18 old-aged) among healthy community members participated in this study. Using the ratio of the COP deviation area sizes for the open- vs. closed-eye conditions as an index, the ratios in the lateral and the posterior/anterior directions were compared in relation to the footedness and the age groups. The results indicated that the left-footers of the older adults group showed a larger COP deviation ratio than that of the middle-aged group, and the left-footers showed a larger deviation ratio in the lateral direction than in the posterior-anterior direction. These findings suggest a weak postural maintenance function of the older adults left footers. As most left-footers are left-handed, health promotion staff should notice that older adults who are left-handers are at a higher risk of falling.

Cultural and environmental aspects influence lateral preferences

Transcultural approaches comparing the distribution of lateral preference between countries focused primarily on handedness. However, other laterality dimensions may also be susceptible to cultural variations. The present study compared lateral preference in five dimensions (hand, foot, trunk, hearing, and visual) of young adults from Brazil and Mozambique. Two hundred and two undergraduate students participated in the study, of which 101 were Brazilian (21.7 ± 1.66 years old) and 101 Mozambican (25.6 ± 6.2 years old). The participants' lateral preference direction and degree were assessed using the global lateral preference inventory. Most Brazilians were classified in the moderate preference category, while Mozambicans had a higher frequency of individuals with strong preferences. Hence, Mozambicans presented a higher lateralization degree for all dimensions. A subsequent analysis considering only preference direction (right, left or indifferent), and not degree, did not show the same outcomes, revealing similarities in preference distribution between the two groups. This finding highlights the necessity to incorporate preference degrees in future analysis to not overlook potential differences. We also conclude lateral preference investigations with transcultural approaches should analyse beyond handedness, as other dimensions can also be modulated by cultural characteristics.

DNA methylation in peripheral tissues and left-handedness

Handedness has low heritability and epigenetic mechanisms have been proposed as an etiological mechanism. To examine this hypothesis, we performed an epigenome-wide association study of left-handedness. In a meta-analysis of 3914 adults of whole-blood DNA methylation, we observed that CpG sites located in proximity of handedness-associated genetic variants were more strongly associated with left-handedness than other CpG sites (P = 0.04), but did not identify any differentially methylated positions. In longitudinal analyses of DNA methylation in peripheral blood and buccal cells from children (N = 1737), we observed moderately stable associations across age (correlation range [0.355-0.578]), but inconsistent across tissues (correlation range [- 0.384 to 0.318]). We conclude that DNA methylation in peripheral tissues captures little of the variance in handedness. Future investigations should consider other more targeted sources of tissue, such as the brain.

Extra food provisioning does not affect behavioural lateralization in nestling lesser kestrels

Costs and benefits of brain lateralization may depend on environmental conditions. Growing evidence indicates that the development of brain functional asymmetries is adaptively shaped by the environmental conditions experienced during early life. Food availability early in life could act as a proxy of the environmental conditions encountered during adulthood, but its potential modulatory effect on lateralization has received little attention. We increased food supply from egg laying to early nestling rearing in a wild population of lesser kestrels Falco naumanni, a sexually dimorphic raptor, and quantified the lateralization of preening behaviour (head turning direction). As more lateralized individuals may perform better in highly competitive contexts, we expected that extra food provisioning, by reducing the level of intra-brood competition for food, would reduce the strength of lateralization. We found that extra food provisioning improved nestling growth, but it did not significantly affect the strength or direction of nestling lateralization. In addition, maternal body condition did not explain variation in nestling lateralization. Independently of extra food provisioning, the direction of lateralization differed between the sexes, with female nestlings turning more often towards their right. Our findings indicate that early food availability does not modulate behavioural lateralization in a motor task, suggesting limited phenotypic plasticity in this trait.

Quantitative multidimensional phenotypes improve genetic analysis of laterality traits

Handedness is the most commonly investigated lateralised phenotype and is usually measured as a binary left/right category. Its links with psychiatric and neurodevelopmental disorders prompted studies aimed at understanding the underlying genetics, while other measures and side preferences have been less studied. We investigated the heritability of hand, as well as foot, and eye preference by assessing parental effects (n ≤ 5028 family trios) and SNP-based heritability (SNP-h2, n ≤ 5931 children) in the Avon Longitudinal Study of Parents and Children (ALSPAC). An independent twin cohort from Hong Kong (n = 358) was used to replicate results from structural equation modelling (SEM). Parental left-side preference increased the chance of an individual to be left-sided for the same trait, with stronger maternal than paternal effects for footedness. By regressing out the effects of sex, age, and ancestry, we transformed laterality categories into quantitative measures. The SNP-h2 for quantitative handedness and footedness was 0.21 and 0.23, respectively, which is higher than the SNP-h2 reported in larger genetic studies using binary handedness measures. The heritability of the quantitative measure of handedness increased (0.45) compared to a binary measure for writing hand (0.27) in the Hong Kong twins. Genomic and behavioural SEM identified a shared genetic factor contributing to handedness, footedness, and eyedness, but no independent effects on individual phenotypes. Our analysis demonstrates how quantitative multidimensional laterality phenotypes are better suited to capture the underlying genetics than binary traits.

Handedness in ADHD: Meta-Analyses

Meta-analyses have shown that several neurodevelopmental and psychiatric disorders, such as autism spectrum disorder and schizophrenia, are associated with a higher prevalence of atypical (left-, non-right-, or mixed-) handedness. One neurodevelopmental disorder for which this association is unclear is attention deficit hyperactivity disorder (ADHD). Here, some empirical studies have found evidence for a higher prevalence of atypical handedness in individuals with ADHD compared to neurotypical individuals. However, other studies failed to establish such an association. Therefore, meta-analytic integration is critical to estimate whether or not there is an association between handedness and ADHD. We report the results of three meta-analyses (left-, mixed-, and non-right-handedness) comparing handedness in individuals with ADHD to controls (typically developing individuals). The results show evidence of a trend towards elevated levels of atypical handedness when it comes to differences in left- and mixed-handedness (p = 0.09 and p = 0.07, respectively), but do show clear evidence of elevated levels of non-right-handedness between individuals with ADHD and controls (p = 0.02). These findings are discussed in the context of the hypothesis that ADHD is a disorder in which mostly right-hemispheric brain networks are affected. Since right-handedness represents a dominance of the left motor cortex for fine motor behavior, such as writing, as well as a left-hemispheric dominance for language functions, and about 90% of individuals are right-handers, this hypothesis might explain why there is not stronger evidence for an association of left-handedness with ADHD. We suggest that the mechanisms involved in the pathogenesis of ADHD might show an overlap with the mechanisms involved in handedness strength, but not handedness direction.

Limb Preference in Animals: New Insights into the Evolution of Manual Laterality in Hominids

Until the 1990s, the notion of brain lateralization—the division of labor between the two hemispheres—and its more visible behavioral manifestation, handedness, remained fiercely defined as a human specific trait. Since then, many studies have evidenced lateralized functions in a wide range of species, including both vertebrates and invertebrates. In this review, we highlight the great contribution of comparative research to the understanding of human handedness’ evolutionary and developmental pathways, by distinguishing animal forelimb asymmetries for functionally different actions—i.e., potentially depending on different hemispheric specializations. Firstly, lateralization for the manipulation of inanimate objects has been associated with genetic and ontogenetic factors, with specific brain regions’ activity, and with morphological limb specializations. These could have emerged under selective pressures notably related to the animal locomotion and social styles. Secondly, lateralization for actions directed to living targets (to self or conspecifics) seems to be in relationship with the brain lateralization for emotion processing. Thirdly, findings on primates’ hand preferences for communicative gestures accounts for a link between gestural laterality and a left-hemispheric specialization for intentional communication and language. Throughout this review, we highlight the value of functional neuroimaging and developmental approaches to shed light on the mechanisms underlying human handedness.

Is Psychopathy a Mental Disorder or an Adaptation? Evidence From a Meta-Analysis of the Association Between Psychopathy and Handedness

Psychopathy has historically been conceptualized as a mental disorder, but there is growing evidence that it may instead be an alternative, adaptive life history strategy designed by natural selection. Although the etiology of mental disorders is not fully understood, one likely contributor is perturbations affecting neurodevelopment. Nonright-handedness is a sign of such perturbations, and therefore can be used to test these competing models. If psychopathy is a mental disorder, psychopaths should show elevated rates of nonright-handedness. However, an adaptive strategy perspective expects psychopaths to be neurologically healthy and therefore predicts typical rates of nonright-handedness. We meta-analyzed 16 studies that investigated the association between psychopathy and handedness in various populations. There was no difference in the rates of nonright-handedness between community participants high and low in psychopathy. Furthermore, there was no difference between psychopathic and nonpsychopathic offenders in rates of nonright-handedness, though there was a tendency for offenders scoring higher on the Interpersonal/Affective dimension of psychopathy to have lower rates of nonright-handedness, and for offenders scoring higher on the Behavioral dimension of psychopathy to have higher rates of nonright-handedness. Lastly, there was no difference in rates of nonright-handedness between psychopathic and nonpsychopathic mental health patients. Thus, our results fail to support the mental disorder model and partly support the adaptive strategy model. We discuss limitations of the meta-analysis and implications for theories of the origins of psychopathy.

It Is Not Just in the Genes

Asymmetries in the functional and structural organization of the nervous system are widespread in the animal kingdom and especially characterize the human brain. Although there is little doubt that asymmetries arise through genetic and nongenetic factors, an overarching model to explain the development of functional lateralization patterns is still lacking. Current genetic psychology collects data on genes relevant to brain lateralizations, while animal research provides information on the cellular mechanisms mediating the effects of not only genetic but also environmental factors. This review combines data from human and animal research (especially on birds) and outlines a multi-level model for asymmetry formation. The relative impact of genetic and nongenetic factors varies between different developmental phases and neuronal structures. The basic lateralized organization of a brain is already established through genetically controlled embryonic events. During ongoing development, hemispheric specialization increases for specific functions and subsystems interact to shape the final functional organization of a brain. In particular, these developmental steps are influenced by environmental experiences, which regulate the fine-tuning of neural networks via processes that are referred to as ontogenetic plasticity. The plastic potential of the nervous system could be decisive for the evolutionary success of lateralized brains.

A Novel Perspective for Examining and Comparing Real and Virtual Test Tasks Performed by the Dominant and Non-Dominant Hand in Healthy Adults

This study presents a novel perspective for the study of functional lateralization in a virtual reality environment. In the model study of handedness, the recognition of the dominant and non-dominant hand in real and virtual conditions was assessed using selected tests, such as a real light exposure test of Piórkowski’s apparatus and classical clinical tests, as well as virtual test tasks, in healthy adults. Statistically significant differences between the dominant and non-dominant hand were observed for tests carried out both in classical conditions and the virtual environment. The results and findings of other studies suggest that the virtual reality approach is a very promising and sensitive tool in the research on functional asymmetries in healthy and disease for motor skills and cognition processes.

The enigma and implications of brain hemispheric asymmetry in neurodegenerative diseases

The lateralization of the human brain may provide clues into the pathogenesis and progression of neurodegenerative diseases. Though differing in their presentation and underlying pathologies, neurodegenerative diseases are all devastating and share an intriguing theme of asymmetrical pathology and clinical symptoms. Parkinson’s disease, with its distinctive onset of motor symptoms on one side of the body, stands out in this regard, but a review of the literature reveals asymmetries in several other neurodegenerative diseases. Here, we review the lateralization of the structure and function of the healthy human brain and the common genetic and epigenetic patterns contributing to the development of asymmetry in health and disease. We specifically examine the role of asymmetry in Parkinson’s disease, Alzheimer’s disease, amyotrophic lateral sclerosis, and multiple sclerosis, and interrogate whether these imbalances may reveal meaningful clues about the origins of these diseases. We also propose several hypotheses for how lateralization may contribute to the distinctive and enigmatic features of asymmetry in neurodegenerative diseases, suggesting a role for asymmetry in the choroid plexus, neurochemistry, protein distribution, brain connectivity and the vagus nerve. Finally, we suggest how future studies may reveal novel insights into these diseases through the lens of asymmetry.

Polygenic scores for handedness and their association with asymmetries in brain structure

Handedness is the most widely investigated motor preference in humans. The genetics of handedness and especially the link between genetic variation, brain structure, and right-left preference have not been investigated in detail. Recently, several well-powered genome-wide association studies (GWAS) on handedness have been published, significantly advancing the understanding of the genetic determinants of left and right-handedness. In the present study, we estimated polygenic scores (PGS) of handedness-based on the GWAS by de Kovel and Francks (Sci Rep 9: 5986, 2019) in an independent validation cohort (n = 296). PGS reflect the sum effect of trait-associated alleles across many genetic loci. For the first time, we could show that these GWAS-based PGS are significantly associated with individual handedness lateralization quotients in an independent validation cohort. Additionally, we investigated whether handedness-derived polygenic scores are associated with asymmetries in gray matter macrostructure across the whole brain determined using magnetic resonance imaging. None of these associations reached significance after correction for multiple comparisons. Our results implicate that PGS obtained from large-scale handedness GWAS are significantly associated with individual handedness in smaller validation samples with more detailed phenotypic assessment.

Handedness Development: A Model for Investigating the Development of Hemispheric Specialization and Interhemispheric Coordination

The author presents his perspective on the character of science, development, and handedness and relates these to his investigations of the early development of handedness. After presenting some ideas on what hemispheric specialization of function might mean for neural processing and how handedness should be assessed, the neuroscience of control of the arms/hands and interhemispheric communication and coordination are examined for how developmental processes can affect these mechanisms. The author’s work on the development of early handedness is reviewed and placed within a context of cascading events in which different forms of handedness emerge from earlier forms but not in a deterministic manner. This approach supports a continuous rather than categorical distribution of handedness and accounts for the predominance of right-handedness while maintaining a minority of left-handedness. Finally, the relation of the development of handedness to the development of several language and cognitive skills is examined.

Paw preferences in mice and rats: Meta-analysis

Mice and rats are among the most common animal model species in both basic and clinical neuroscience. Despite their ubiquity as model species, many clinically relevant brain-behaviour relationships in rodents are not well understood. In particular, data on hemispheric asymmetries, an important organizational principle in the vertebrate brain, are conflicting as existing studies are often statistically underpowered due to small sample sizes. Paw preference is one of the most frequently investigated forms of hemispheric asymmetries on the behavioural level. Here, we used meta-analysis to statistically integrate findings on paw preferences in rats and mice. For both species, results indicate significant hemispheric asymmetries on the individual level. In mice, 81 % of animals showed a preference for either the left or the right paw, while 84 % of rats showed this preference. However, contrary to what has been reported in humans, population level asymmetries were not observed. These results are particularly significant as they point out that paying attention to potential individual hemispheric differences is important in both basic and clinical neuroscience.

Examination and Comparison of Theta Band Connectivity in Left- and Right-Hand Dominant Individuals throughout a Motor Skill Acquisition

The majority of the population identifies as right-hand dominant, with a minority 10.6% identifying as left-hand dominant. Social factors may partially skew the distribution, but it remains that left-hand dominant individuals make up approximately 40 million people in the United States alone and yet, remain underrepresented in the motor control literature. Recent research has revealed behavioral and neurological differences between populations, therein overturning assumptions of a simple hemispheric flip in motor-related activations. The present work showed differentially adaptable motor programs between populations and found fundamental differences in methods of skill acquisition highlighting underlying neural strategies unique to each population. Difference maps and descriptive metrics of coherent activation patterns showed differences in how theta oscillations were utilized. The right-hand group relied on occipital parietal lobe connectivity for visual information integration necessary to inform the motor task, while the left-hand group relied on a more frontal lobe localized cognitive based approach. The findings provide insight into potential alternative methods of information integration and emphasize the importance for inclusion of the left-hand dominant population in the growing conceptualization of the brain promoting the generation of a more complete, stable, and accurate understanding of our complex biology.

Human Lateralization, Maternal Effects and Neurodevelopmental Disorders

In humans, behavioral laterality and hemispheric asymmetries are part of a complex biobehavioral system in which genetic factors have been repeatedly proposed as developmental determinants of both phenomena. However, no model solely based on genetic factors has proven conclusive, pushing towards the inclusion of environmental and epigenetic factors into the system. Moreover, it should be pointed out that epigenetic modulation might also account for why certain genes are expressed differently in parents and offspring. Here, we suggest the existence of a sensitive period in early postnatal development, during which the exposure to postural and motor lateral biases, expressed in interactive sensorimotor coordination with the caregiver, canalizes hemispheric lateralization in the “typical” direction. Despite newborns and infants showing their own inherent asymmetries, the canalizing effect of the interactive context owes most to adult caregivers (usually the mother), whose infant-directed lateralized behavior might have been specifically selected for as a population-level trait, functional to confer fitness to offspring. In particular, the case of the left-cradling bias (LCB; i.e., the population-level predisposition of mothers to hold their infants on the left side) represents an instance of behavioral trait exhibiting heritability along the maternal line, although no genetic investigation has been carried out so far. Recent evidence, moreover, seems to suggest that the reduction of this asymmetry is related to several unfavorable conditions, including neurodevelopmental disorders. Future studies are warranted to understand whether and how genetic and epigenetic factors affect the lateralization of early mother-infant interaction and the proneness of the offspring to neurodevelopmental disorders.

Racemization in Post-Translational Modifications Relevance to Protein Aging, Aggregation and Neurodegeneration: Tip of the Iceberg

Homochirality of DNA and prevalent chirality of free and protein-bound amino acids in a living organism represents the challenge for modern biochemistry and neuroscience. The idea of an association between age-related disease, neurodegeneration, and racemization originated from the studies of fossils and cataract disease. Under the pressure of new results, this concept has a broader significance linking protein folding, aggregation, and disfunction to an organism's cognitive and behavioral functions. The integrity of cognitive function is provided by a delicate balance between the evolutionarily imposed molecular homo-chirality and the epigenetic/developmental impact of spontaneous and enzymatic racemization. The chirality of amino acids is the crucial player in the modulation the structure and function of proteins, lipids, and DNA. The collapse of homochirality by racemization is the result of the conformational phase transition. The racemization of protein-bound amino acids (spontaneous and enzymatic) occurs through thermal activation over the energy barrier or by the tunnel transfer effect under the energy barrier. The phase transition is achieved through the intermediate state, where the chirality of alpha carbon vanished. From a thermodynamic consideration, the system in the homo-chiral (single enantiomeric) state is characterized by a decreased level of entropy. The oscillating protein chirality is suggesting its distinct significance in the neurotransmission and flow of perceptual information, adaptive associative learning, and cognitive laterality. The common pathological hallmarks of neurodegenerative disorders include protein misfolding, aging, and the deposition of protease-resistant protein aggregates. Each of the landmarks is influenced by racemization. The brain region, cell type, and age-dependent racemization critically influence the functions of many intracellular, membrane-bound, and extracellular proteins including amyloid precursor protein (APP), TAU, PrP, Huntingtin, α-synuclein, myelin basic protein (MBP), and collagen. The amyloid cascade hypothesis in Alzheimer's disease (AD) coexists with the failure of amyloid beta (Aβ) targeting drug therapy. According to our view, racemization should be considered as a critical factor of protein conformation with the potential for inducing order, disorder, misfolding, aggregation, toxicity, and malfunctions.

Effects of hand preference on digit lengths and digit ratios among children and adults

BACKGROUND

Prenatal sex hormones may not exclusively determine effects of hand preference on digit ratios. Genetic determination is an alternative possibility.

AIM

To study the likelihood of similar effects of hand preference on digit lengths and digit ratios.

METHODS

We selected similar numbers of left-handers and right-handers in samples of kindergarten children (N = 101, age range: 3.5-7 years) and adults (N = 189, age range: 17-28 years) and measured digit lengths (excluding the thumb) directly on the palmar hand.

RESULTS

Compared to right-handers, left-handers had longer digits and lower third-to-fourth (3D:4D) digit ratios among children, whereas an opposite pattern of handedness differences occurred among adults.

CONCLUSIONS

Effects of hand preference on digit lengths and ratios might be genetically/ontogenetically determined. Also discussed are implications of this set of findings for digit ratio research.

Dichotic listening performance and interhemispheric integration after stress exposure

Functional hemispheric asymmetries (FHAs) have been thought to be relatively stable over time. However, past research has shown that FHAs are more plastic than initially thought. Endocrinological processes have been demonstrated to alter FHAs. As the product of the stress-activated hypothalamus–pituitary–adrenal axis, cortisol influences information processing at every level from stimulus perception to decision making and action. To investigate the influence of acute stress on FHAs, 60 participants performed a Banich–Belger task, as well as a verbal and an emotional dichotic listening task in two sessions. One session included a stress induction via the Trier Social Stress Test, the other session included a control procedure. We calculated across-field advantages (AFAs) in the Banich–Belger task and lateralization quotients for reaction times and responses per side in both dichotic listening tasks. There were no significant differences between the stress and control session in the dichotic listening tasks. In contrast, there was evidence for an influence of cortisol and sympathetic activation indicated by salivary alpha amylase changes on AFAs in the Banich–Belger task. This indicates that acute stress and the related increase in cortisol do not influence dichotic listening performance. However, stress does seem to affect interhemispheric integration of information. Future research using EEG, fMRI and pharmacological interventions is needed to further characterize the relation of hemispheric asymmetries and acute stress.

Four meta-analyses across 164 studies on atypical footedness prevalence and its relation to handedness

Human lateral preferences, such as handedness and footedness, have interested researchers for decades due to their pronounced asymmetries at the population level. While there are good estimates on the prevalence of handedness in the population, there is no large-scale estimation on the prevalence of footedness. Furthermore, the relationship between footedness and handedness still remains elusive. Here, we conducted meta-analyses with four different classification systems for footedness on 145,135 individuals across 164 studies including new data from the ALSPAC cohort. The study aimed to determine a reliable point estimate of footedness, to study the association between footedness and handedness, and to investigate moderating factors influencing footedness. We showed that the prevalence of atypical footedness ranges between 12.10% using the most conservative criterion of left-footedness to 23.7% including all left- and mixed-footers as a single non-right category. As many as 60.1% of left-handers were left-footed whereas only 3.2% of right-handers were left-footed. Males were 4.1% more often non-right-footed compared to females. Individuals with psychiatric and neurodevelopmental disorders exhibited a higher prevalence of non-right-footedness. Furthermore, the presence of mixed-footedness was higher in children compared to adults and left-footedness was increased in athletes compared to the general population. Finally, we showed that footedness is only marginally influenced by cultural and social factors, which play a crucial role in the determination of handedness. Overall, this study provides new and useful reference data for laterality research. Furthermore, the data suggest that footedness is a valuable phenotype for the study of lateral motor biases, its underlying genetics and neurodevelopment.

Brain Lateralization: A Comparative Perspective

Comparative studies on brain asymmetry date back to the 19th century but then largely disappeared due to the assumption that lateralization is uniquely human. Since the reemergence of this field in the 1970s, we learned that left-right differences of brain and behavior exist throughout the animal kingdom and pay off in terms of sensory, cognitive, and motor efficiency. Ontogenetically, lateralization starts in many species with asymmetrical expression patterns of genes within the Nodal cascade that set up the scene for later complex interactions of genetic, environmental, and epigenetic factors. These take effect during different time points of ontogeny and create asymmetries of neural networks in diverse species. As a result, depending on task demands, left- or right-hemispheric loops of feedforward or feedback projections are then activated and can temporarily dominate a neural process. In addition, asymmetries of commissural transfer can shape lateralized processes in each hemisphere. It is still unclear if interhemispheric interactions depend on an inhibition/excitation dichotomy or instead adjust the contralateral temporal neural structure to delay the other hemisphere or synchronize with it during joint action. As outlined in our review, novel animal models and approaches could be established in the last decades, and they already produced a substantial increase of knowledge. Since there is practically no realm of human perception, cognition, emotion, or action that is not affected by our lateralized neural organization, insights from these comparative studies are crucial to understand the functions and pathologies of our asymmetric brain.

Measuring infant handedness reliably from reaching: A systematic review

Researchers have utilized reaching paradigms to measure infant handedness for more than a century. However, methods vary widely. Recent research has identified that the number of trials used in assessment is critical with the recommendation that at least 15 trials are necessary to reliably classify infants into handedness categories via statistical cutoffs. As a first step towards establishing best practices for the field, we identified, categorized, and synthesized findings according to trial number from studies that utilized reaching to index handedness in infants across the first two years of life using PRISMA guidelines. Database searches were conducted in PsycINFO, PubMed, and Ovid MEDLINE®. All articles published through May 2018 were included. Additional records were identified through other sources. After removing duplicates, 1,116 records were screened using the online software program Abstrackr. Of these records, 125 full-text articles were further assessed for eligibility, and 87 articles were included in the qualitative synthesis. Results revealed that the majority of papers published since 1890 (70%) do not meet the 15-trial minimum criterion for statistically reliable measurement of infant handedness. Broad themes from articles meeting the measurement criterion and implications for future research are discussed.

Hemispheric asymmetry in the human brain and in Parkinson's disease is linked to divergent epigenetic patterns in neurons

BACKGROUND

Hemispheric asymmetry in neuronal processes is a fundamental feature of the human brain and drives symptom lateralization in Parkinson's disease (PD), but its molecular determinants are unknown. Here, we identify divergent epigenetic patterns involved in hemispheric asymmetry by profiling DNA methylation in isolated prefrontal cortex neurons from control and PD brain hemispheres. DNA methylation is fine-mapped at enhancers and promoters, genome-wide, by targeted bisulfite sequencing in two independent sample cohorts.

RESULTS

We find that neurons of the human prefrontal cortex exhibit hemispheric differences in DNA methylation. Hemispheric asymmetry in neuronal DNA methylation patterns is largely mediated by differential CpH methylation, and chromatin conformation analysis finds that it targets thousands of genes. With aging, there is a loss of hemispheric asymmetry in neuronal epigenomes, such that hemispheres epigenetically converge in late life. In neurons of PD patients, hemispheric asymmetry in DNA methylation is greater than in controls and involves many PD risk genes. Epigenetic, transcriptomic, and proteomic differences between PD hemispheres correspond to the lateralization of PD symptoms, with abnormalities being most prevalent in the hemisphere matched to side of symptom predominance. Hemispheric asymmetry and symptom lateralization in PD is linked to genes affecting neurodevelopment, immune activation, and synaptic transmission. PD patients with a long disease course have greater hemispheric asymmetry in neuronal epigenomes than those with a short disease course.

CONCLUSIONS

Hemispheric differences in DNA methylation patterns are prevalent in neurons and may affect the progression and symptoms of PD.

Atypical lateralization in neurodevelopmental and psychiatric disorders: What is the role of stress?

Hemispheric asymmetries are a major organizational principle of the human brain. In different neurodevelopmental and psychiatric disorders, like schizophrenia, autism spectrum disorders, depression, dyslexia and posttraumatic stress disorder, functional and/or structural hemispheric asymmetries are altered compared to healthy controls. The question, why these disorders all share the common characteristic of altered hemispheric asymmetries despite vastly different etiologies and symptoms remains one of the unsolved mysteries of laterality research. This review is aimed at reviewing potential reasons for why atypical lateralization is so common in many neurodevelopmental and psychiatric disorders. To this end, we review the evidence for overlaps in the genetic and non-genetic factors involved in the ontogenesis of different disorders and hemispheric asymmetries. While there is evidence for genetic overlap between different disorders, only few asymmetry-related loci have also been linked to disorders and importantly, those effects are mostly specific to single disorders. However, there is evidence for shared non-genetic influences between disorders and hemispheric asymmetries. Most neurodevelopmental and psychiatric disorders show alterations in the hypothalamic-pituitary adrenocortical (HPA) axis and maternal as well as early life stress have been implicated in their etiology. Stress has also been suggested to affect hemispheric asymmetries. We propose a model in which early life stress as well as chronic stress not only increases the risk for psychiatric and neurodevelopmental disorders but also changes structural and functional hemispheric asymmetries leading to the aberrant lateralization patterns seen in these disorders. Thus, pathology-related changes in hemispheric asymmetries are not a factor causing disorders, but rather a different phenotype that is affected by partly overlapping ontogenetic factors, primarily stress.

Schizotypy and altered hemispheric asymmetries: The role of cilia genes

Schizophrenia patients have a higher probability of altered structural and functional differences between the left and right hemisphere. Schizotypy as its nonclinical manifestation has been related to a higher incidence of non-right-handedness and atypical right-hemispheric language dominance. It has been suggested that genes involved in cilia function might link brain asymmetry and neurodevelopmental disorders. We assessed DNA methylation in the promoter regions of seven candidate genes involved in cilia function and psychiatric disorders from buccal cells and investigated their association with schizotypy and language lateralization in 60 healthy adults. Moreover, we determined microstructural properties of the planum temporale in a subsample of 52 subjects using neurite orientation dispersion and density imaging (NODDI). We found a significant association between schizotypy and DNA methylation in the AHI1 promoter region. Moreover, AHI1 DNA methylation significantly predicted language lateralization and asymmetry in estimated planum temporale neurite density. Finally, stronger leftward asymmetry in estimated neurite density was associated with a more pronounced right ear advantage (left hemisphere dominance) in the forced-right condition of the dichotic listening task, measuring attentional modulation of language lateralization. Our results are in line with a shared molecular basis of schizotypy and functional hemispheric asymmetries that is based on cilia function.

Asymmetries in social touch-motor and emotional biases on lateral preferences in embracing, cradling and kissing

In human social interaction, affective touch plays an integral role to communicate intentions and emotions. Three of the most important forms of social touch are embracing, cradling and kissing. These behaviours have been demonstrated to be lateralized, but the underlying mechanisms are still not well understood. Both motor and emotive biases have been suggested to affect laterality of social touch. We aimed to systematically investigate how motor preferences and emotive biases influence the lateralization of embracing, cradling and kissing within the same sample. Participants performed all three forms of social touch in neutral, positive and negative emotional conditions. Like a previous study, we found a rightward bias for embracing that was modulated by both motor preferences and the emotional content of the situation. Kissing and cradling were not influenced by motor preferences. In general, a negative emotional connotation of the situation led to a reduction of lateral biases in social touch, independent of the individual direction.

Contributions of the Left and the Right Hemispheres on Language-Induced Grip Force Modulation of the Left Hand in Unimanual Tasks

Background and Objectives: Language-induced grip force modulation (LGFM) can be used to better understand the link between language and motor functions as an expression of embodied language. However, the contribution of each brain hemisphere to LGFM is still unclear. Using six different action verbs as stimuli, this study evaluated the grip force modulation of the left hand in a unimanual task to characterize the left and right hemispheres' contributions. Materials and Methods: Left-hand LGFM of 20 healthy and consistently right-handed subjects was evaluated using the verbs "to write", "to hold", "to pull" (left-lateralized central processing actions), "to draw", "to tie", and "to drive" (bihemispheric central processing actions) as linguistic stimuli. The time between the word onset and the first interval of statistical significance regarding the baseline (here as reaction time, RT) was also measured. Results: The six verbs produced LGFM. The modulation intensity was similar for the six verbs, but the RT was variable. The verbs "to draw", "to tie", and "to drive", whose central processing of the described action is bihemispheric, showed a longer RT compared to the other verbs. Conclusions: The possibility of a given manual action being performed by the left hand in consistent right-handers does not interfere with the occurrence of LGFM when the descriptor verb of this action is used as a linguistic stimulus, even if the possibility is remote. Therefore, LGFM seems to mainly rely on the left hemisphere, while a greater activation of the right hemisphere in action processing appears to slow the increase in LGFM intensity.

From Science to Practice: A Review of Laterality Research on Ungulate Livestock

In functional laterality research, most ungulate livestock species have until recently been mainly overlooked. However, there are many scientific and practical benefits of studying laterality in ungulate livestock. As social, precocial and domestic species, they may offer insight into the mechanisms involved in the ontogeny and phylogeny of functional laterality and help to better understand the role of laterality in animal welfare. Until now, most studies on ungulate livestock have focused on motor laterality, but interest in other lateralized functions, e.g., cognition and emotions, is growing. Increasingly more studies are also focused on associations with age, sex, personality, health, stress, production and performance. Although the full potential of research on laterality in ungulate livestock is not yet exploited, findings have already shed new light on central issues in cognitive and emotional processing and laid the basis for potentially useful applications in future practice, e.g., stress reduction during human-animal interactions and improved assessments of health, production and welfare. Future research would benefit from further integration of basic laterality methodology (e.g., testing for individual preferences) and applied ethological approaches (e.g., established emotionality tests), which would not only improve our understanding of functional laterality but also benefit the assessment of animal welfare.

Left-handers know what's left is right: Handedness and object affordance

We live in a right-hander's world. Although left-handers become accustomed to using right-handed devices, an underlying preference for objects that afford the dominant hand could remain. We employed eye tracking while left- and right-handed participants viewed advertisements for everyday products. Participants then rated aesthetic appeal, purchase intention, and perceived value. Left-handed participants found advertisements for products that more easily afforded them action to be more aesthetically appealing. They also indicated greater future purchase intention for products that were oriented towards the left hand, and gave these products a higher perceived value. Eye tracking data showed that object handles attracted attention, and were also able to retain participants' attention. Further, across multiple eye movement measures, our data show that participant eye movements were altered by the orientation of the handle, such that this side of the image was examined earlier and for longer, regardless of handedness. Left-handers' preferences might be stronger because they are more aware of object orientation, whereas right-handers do not experience the same difficulties. These findings highlight intrinsic differences in the way in which we perceive objects and our underlying judgments about those products, based on handedness.

Stability and flexibility in cognitive control: Interindividual dynamics and task context processing

Adaptive behaviour requires cognitive control for shielding current goals from distractors (stability) but at the same time for switching between alternative goals (flexibility). In this behavioural study, we examine the stability-flexibility balance in left- and right-handers during two types of decision-making, instructed (sensory cued) and voluntary (own choice), by means of distractor inhibition and hand/task switching. The data revealed that both groups showed opposite tendencies for instructed decision-making. Moreover, right-handers resisted distracting information more efficiently whereas left-handers showed superior switching abilities. When participants were involved in voluntary decision-making, no effects of handedness were noted, which suggests that free-choice processing alters the balance between stability and flexibility. These data illustrate that handedness is an index of individual variation during instructed decision-making, biasing the proficiency of cognitive control towards stability and flexibility of information processing. These biases can however be overruled by top-down strategies that dominate during voluntary decision-making. Overall, the research underlines the antagonistic functions of stability and flexibility in decision-making, and offers an approach for examining cognitive control and the role of internal and external factors in balancing the stability-flexibility trade-off.