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Biomedical subjects

C Ochipa

Publications and source records attributed to C Ochipa.

6 recordsLinked to original sources

Selective deficit of praxis imagery in ideomotor apraxia.

We studied imagery for learned, skilled movements (praxis imagery) in a patient with severe ideomotor apraxia and intact language abilities. This patient, who made predominantly spatial and movement errors when performing transitive movements demonstrating the use of tools (transitive gestures), was also impaired in her ability to answer imagery questions about joint movement or the spatial position of the hands during action. However, visual object imagery was spared. The finding of parallel praxis production and praxis imagery deficits in this patient suggests that the same representations used for gesture production are also activated during imagery of motor acts. Our findings also suggest that certain aspects of motor imagery may be dissociable from general object imagery.

Apraxias↗

Progressive ideomotor apraxia: evidence for a selective impairment of the action production system.

We report a patient with slowly progressive bilateral limb apraxia associated with an asymmetrical focal degenerative process of the parietal lobes. Clinical assessment of praxis production suggested a striking deficit in controlling the spatiotemporal attributes of purposeful skilled limb movements, consistent with ideomotor apraxia. The precise nature of the action production impairment was further defined by objective three-dimensional computergraphic analysis of transitive movements which demonstrated significant kinematic deficits in spatial accuracy, timing, spatiotemporal coupling, and joint coordination. Gesture comprehension and discrimination were spared. Furthermore, detailed evaluation of the conceptual praxis system revealed that despite an almost complete inability to perform transitive movements accurately, abstract knowledge of tool function and action was remarkably well preserved. The critical dissociation between intact conceptual knowledge of action and impaired movement execution documented in this case points to a fundamental competence/performance dichotomy in apraxia and provides empirical support for cognitive models of praxis that divide the action system into distinct conceptual and production subcomponents. Within this theoretical framework, our patient's severe ideomotor apraxia is interpreted to represent a selective disruption of the action production system.

Apraxias↗

Conduction apraxia.

A left hemisphere damaged patient with ideomotor apraxia is described, whose performance on pantomime to verbal command was superior to pantomime imitation. His reception of these same gestures (gesture naming) was spared. This syndrome has been named conduction apraxia. To account for this selective impaired performance on gesture imitation, a separation of the representations for gesture production and reception is proposed and a non-lexical gesture processing route for gesture imitation is suggested.

Aged↗

Praxis and the right hemisphere.

We report our observations on praxis in a strongly right-handed man following a massive stroke that resulted in virtually complete destruction of the left cerebral hemisphere. Our patient was severely impaired in pantomiming transitive gestures with the left hand and in reproducing novel non-symbolic hand and arm movement sequences. However, overlearned habitual actions like actual object use and intransitive gestures were relatively spared. Performance of axial commands was intact. Gesture recognition and discrimination were also preserved. Based on these findings, we propose that the praxis system of the right hemisphere is strongly biased toward "concrete" or context-dependent execution of familiar, well-established action routines. The right hemisphere is critically dependent on transcallosal contribution from the left hemisphere for control of the left hand in "abstract" or context-independent performance of transitive movements and in learning novel movement sequences. At least in some individuals, the right hemisphere can recognize and discriminate gestures. Possible implications of our findings for the cerebral control of praxis and for recovery from apraxia are discussed.

Aphasia, Broca↗

Conceptual apraxia in Alzheimer's disease.

Theoretical models of praxis have two major components, a praxis conceptual system that includes knowledge of tool use and mechanical knowledge and a praxis production system that includes the information needed to program skilled motor acts. Because patients with Alzheimer's disease may have an impairment of the central conceptual system, we wanted to learn if they had a conceptual apraxia by testing their knowledge of the type of actions associated with tool use, their ability to associate tools with objects that receive their action, their ability to understand the mechanical nature of problems and the mechanical advantages tools may afford. We studied 32 subjects with probable Alzheimer's disease and 32 controls by examining tool-action relationships and tool-object associations. We tested mechanical knowledge by having subjects select alternative tools and solve mechanical puzzles by developing new tools. The Alzheimer's group was subdivided into four groups based on the presence or absence of ideomotor apraxia and a lexical-semantic deficit. Results indicated that each of the four Alzheimer's groups differed from normal controls on at least some measures of conceptual apraxia, suggesting that Alzheimer's patients do have a disturbance of the praxis conceptual system and that impairment of this system is not directly related to language impairment or ideomotor apraxia.

Aged↗

Ideational apraxia: a deficit in tool selection and use.

We report a 67-year-old left-handed man who exhibited an ideational apraxia in both clinical and nonclinical natural settings following a right hemisphere infarction. His inability to use tools could not be explained by a motor production deficit (ideomotor apraxia), because he made content errors and could not match tools with objects. His deficit could not be attributed to an agnosia or language comprehension deficit, because he could name tools and point to tools on command. Based on our testing, it appeared that this patient had a loss of knowledge related to tool use.

Aged↗