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At least 19 recordsLinked to original sources
PubMed2003

Cognitive representations of hand posture in ideomotor apraxia.

Ideomotor apraxia (IM) is a disorder of skilled action characterized by spatiotemporal errors in pantomiming object use and in using objects. Recent evidence suggests that at least some patients with IM may exhibit particular deficits in forming hand configurations appropriate for object use. Sirigu et al. [Cortex 31 (1995) 41] reported an apraxic who positioned her hand inappropriately when attempting to use objects in accordance with stored knowledge of object-specific manipulation, but in reaching tasks could grasp the same objects appropriately in response to their structure. To this point, however, apraxics' ability to respond to functional and structural attributes of objects has not been empirically assessed. We investigated the hypothesis that patients with IM (n=9) due to left inferior parietal damage would be impaired in producing and recognizing hand postures associated with familiar objects, indicating deficient memorial representations for object-specific hand postures. In contrast, we predicted relatively unimpaired ability to produce and recognize appropriate hand postures with novel objects, indicating integrity of "on line" spatiomotor procedures coding hand position in response to object structure. Apraxics' performance was contrasted with 10 healthy controls and 8 brain-lesioned non-apraxics. Consistent with our predictions, the apraxics responded abnormally with familiar objects but normally in recognizing hand postures appropriate for novel objects. In addition, performance with objects calling for a prehensile response (pinch or clench) was superior to that with objects evoking a non-prehensile response (palm or poke). These data suggest degradation of inferior parietally-mediated representations of the precise hand postures associated with familiar objects. Furthermore, they are consistent with possible over-reliance upon dorsal system procedures for calculating precision and power grip in response to object structure.

Aged↗
PubMed1995

Sensorimotor learning in ideomotor apraxia.

Sensorimotor learning ability in patients with ideomotor apraxia was investigated, using as subjects, eight patients with ideomotor apraxia, 8 with aphasia without ideomotor apraxia, and 8 normal controls. The aphasia, apraxia, and normal control groups were matched for age, sex, and education. The aphasia and apraxia groups were chosen to control for lesion size and scores on Kimura's recurring figure test, the Token test, and intelligence. The mirror-aiming test was performed and the learning effect in terms of decreases in total time, the number of errors, and the times for errors were examined. There was no statistically significant difference between the learning effect of the apraxic group and that of the aphasic group for total time, the number of errors, and the times for errors; however, there were group differences on each trial for number of errors and the times for errors. These results suggest that patients with ideomotor apraxia have some difficulties in motor performance rather than disturbance of learning.

Aphasia↗
PubMed1993

Ideomotor apraxia in Alzheimer's disease.

Ideomotor apraxia, tested on verbal command and by imitation, was checked in 23 patients suffering from dementia of Alzheimer's type of different severity and in 17 age-matched controls. A significant deterioration of ideomotor praxis could be shown even in mild dementia. Correlations of ideomotor apraxia and aphasia, tested by the Token test were found to be significant.

Aged↗
PubMed1998

Ideomotor apraxia test: a new test of imitation of gestures for elderly people.

Ideomotor apraxia is one of the earliest disturbances in Alzheimer's disease (AD); no test of this disturbance has yet been validated for elderly people. We propose a test of meaningless gesture imitation and its relevance in elderly people is studied. The Ideomotor Apraxia Test (IAT) consists of showing 10 gestures. Each item is graded from 0 to 3. IAT was carried out on 55 patients with AD (mean age: 86.8 +/- 6.8 (71-100); mean MMS score: 14.6 +/- 6.3) and 26 elderly patients without cognitive impairment (mean age: 84.1 +/- 7.5 (70-100); mean MMS score: 27.5 +/- 1.9). The inter-rater reliability, a threshold, the apparent sensitivity and specificity and the relationship between the MMS score and the ideomotor apraxia score were determined. The mean apraxia score was 14.9 +/- 7.3 in the AD group and 28 +/- 1.6 in the normal group (P < 0.0001). Inter-rater agreement is excellent (P = 0.995). The threshold is 27. The apparent sensitivity and specificity are very good (95% and 88%, respectively). The correlation between the MMS score and ideomotor apraxia score is excellent (r = 0.83 (95% CI; 0.72-0.91). Age and educational level do not influence ideomotor apraxia score. IAT is the first test that evaluates meaningless gesture imitating capacity in an elderly population. It is an easy and quick-to-perform test, useful routinely for diagnosis of AD. It could contribute to the early diagnosis of AD and is correlated with the severity of cognitive impairment. Copyright 1998 Lippincott Williams & Wilkins

Journal Article↗
PubMed1987

Ideomotor apraxia in patients with dementia of Alzheimer type.

Ideomotor apraxia was checked in a carefully selected group of patients with Alzheimer's dementia, all in the mild stage of the disease. It was shown that ideomotor apraxia is not an early neuropsychological feature. When compared with other cognitive measures, the speed of deterioration of ideomotor apraxia appears to be particularly slow.

Aged↗
PubMed1991

Ideomotor apraxia in Huntington's disease.

The pattern of movement errors in ideomotor apraxia suggests an abnormality in selection and sequencing of component movements. Individuals with Huntington's disease were evaluated prospectively for the presence of apraxia, and aspects of motor and cognitive function were correlated with apraxic errors. Based on a conservative apraxia rating, ideomotor apraxia occurred in three (33%) of nine patients with a mean duration of disease of 10.4 years. Only two (22%) individuals made no apraxic errors, however, and the group as a whole made apraxic errors in 26% of movements. Apraxia was associated with errors in imitation of nonsymbolic movements but not with errors in recognition of gestures. It correlated significantly with duration of disease and with progressive abnormalities of posture but not with other individual aspects of elementary motor or cognitive function. These associations indicate that apraxia in Huntington's disease may be due primarily to involvement of subcortical motor structures rather than cerebral cortex.

Adult↗
PubMed2001

Ideomotor apraxia: a call to action.

Although ideomotor apraxia (IM) has been a topic of investigation since the early 20th century, progress in studying the disorder has been hindered by important (and sometimes unarticulated) differences in the underlying theoretical models of various investigative groups. As a result, it is difficult to draw conclusions about the expected performance of IM patients on various tests of praxis (e.g. pantomime, single object use, gesture imitation, and naturalistic action); the relationship of IM to ideational apraxia (IA); the degree to which specific error types are diagnostic of one or the other disorder; the relationship of semantic knowledge to gesture representations; and the role of spatiomotor systems external to the stored gesture representation system. Here an updated model of IM is presented, informed by recent physiological and functional neuroimaging literature, as a step towards resolving some of these concerns. The model is intended to lay the groundwork for future investigations of specific performance patterns in different subtypes of IM.

Apraxia, Ideomotor↗
PubMed2006

Evaluation of ideomotor apraxia in patients with stroke: a study of reliability and validity.

OBJECTIVE: This aim of this study was to determine the reliability and validity of an established ideomotor apraxia test when applied to a Turkish stroke patient population and to healthy controls. SUBJECTS: The study group comprised 50 patients with right hemiplegia and 36 with left hemiplegia, who had developed the condition as a result of a cerebrovascular accident, and 33 age-matched healthy subjects. METHODS: The subjects were evaluated for apraxia using an established ideomotor apraxia test. The cut-off value of the test and the reliability coefficient between observers were determined. RESULTS: Apraxia was found in 54% patients with right hemiplegia (most being severe) and in 25% of left hemiplegic patients (most being mild). The apraxia scores for patients with right hemiplegia were found to be significantly lower than for those with left hemiplegia and for healthy subjects. There was no statistically significant difference between patients with left hemiplegia and healthy subjects. CONCLUSION: It was shown that the ideomotor apraxia test could distinguish apraxic from non-apraxic subjects. The reliability coefficient among observers in the study was high and a reliability study of the ideomotor apraxia test was therefore performed.

Adult↗
PubMed1997

Ideomotor apraxia: behavioral dimensions and neuroanatomical basis.

Ideomotor apraxia, disordered movement execution to command, commonly follows left-hemisphere damage, implying left-hemisphere dominance for certain kinds of movements. To delineate this dominance we used different command modalities to elicit meaningful movements and tested imitation of nonsense movements. Twenty-seven patients with unilateral hemispheric stroke and 10 age-matched controls were evaluated. Patients with left-hemisphere damage performed both meaningful and nonsense movements poorer than the other study groups; thus, the meaningfulness of the movements is irrelevant for the left-hemisphere motor dominance. The performance varied, however, with the command modality and movement type. Based on this and earlier studies we posit that the left-hemisphere motor dominance is determined by the artificiality of the test situation (it concerns movements performed to command and out of the natural context) and increased spatial and temporal complexity of the demanded movements. No association between the lesion locus within the left hemisphere and the severity of the ideomotor apraxia was found.

Aged↗
PubMed1996

Ideomotor apraxia and cerebral dominance for motor control.

Ideomotor apraxia is a symptom of left hemisphere damage. Patients with ideomotor apraxia commit errors when imitating movements with their left, non-paralyzed hand. This has been taken as evidence for a motor dominance of the left hemisphere. It has been hypothesized that the left hemisphere is dominant for internal preprogramming of skilled movements of either hand. We investigated the kinematics of movement trajectories of imitation of meaningless gestures. Group analysis confirmed that hesitant, feedback-controlled movement prevail in patients with apraxia, but analysis of single cases revealed the existence of kinematically normal movements leading to apractic errors. Enhanced reliance on feedback-control appears to be a compensatory strategy rather than the source of apractic errors. In a second study we explored the alternative hypothesis that patients with apraxia lack a general concept of the human body which is necessary to mediate the translation of a target position seen on the model into a target position on the patient's body. Imitation of movements was examined on oneself and on a mannikin. Patients with apraxia who made errors when imitating on themselves committed errors also when imitating on the mannikin. Taken together, both studies support the view that the source of errors in the imitation of gestures is to be sought at a conceptual level. This casts doubts on the alleged dominance of the left hemisphere for motor control.

Apraxias↗
PubMed1992

Neuropsychological and neuroanatomical dimensions of ideomotor apraxia.

Fifty-five right-handed men with left hemisphere stroke were systematically investigated for ideomotor apraxia of various body parts. Standardized aphasia and apraxia examinations in all cases, and appropriately timed CT in 28 cases, were used for analysis of psychological and anatomical properties of ideomotor apraxia. It is not possible to ignore the modality of eliciting the movement (command or imitation) and the body part being moved (buccofacial, limb or whole body) from any comprehensive theory about ideomotor apraxia. Different levels of performance are seen with different body parts to different modalities in different aphasic groups. Some subtypes of ideomotor apraxia (buccofacial) have highly specified anatomical basis. Some (limb) have apparently distributed anatomies, and others (whole body) have as yet unknown bases.

Adult↗
PubMed2001

Cortical and subcortical contributions to ideomotor apraxia: analysis of task demands and error types.

Ideomotor apraxia (IMA) is often associated with damage of the dominant parietal cortex, but many other lesion sites have been implicated suggesting that the praxis system is mediated by a distributed modular network. Although IMA has been reported with subcortical lesions, the role of subcortical structures in the praxis neural network has not been fully addressed. To ascertain the role of subcortical structures in praxis, we compared praxis performance on a variety of tasks in patients with left hemisphere cortical and subcortical lesions. The cortical patients presented with deficits in the production of transitive and intransitive gestures-to-verbal command and imitation, as well as impaired gesture discrimination. In contrast, the subcortical group demonstrated mild production-execution deficits for transitive pantomimes, but normal imitation and discrimination. Qualitative error analysis of production deficits, revealed that both patient groups produced timing errors and the full range of spatial errors. Whereas the subcortical group made more postural errors than the cortical group, sequencing, unrecognizable and no-response errors were only produced by the cortical group. The different profiles of praxis deficits associated with cortical and subcortical lesions, suggests that these structures may have different roles in praxis.

Aphasia↗
PubMed2003

Upper and lower face and ideomotor apraxia in patients with Alzheimer's disease.

INTRODUCTION: Apraxia of face movement in Alzheimer's disease (AD) has been rarely investigated. This study aimed at investigating the frequency of lower (mouth, tongue and throat) and upper (eyes and eyebrows) face apraxia, in AD and its relationship with limb apraxia and severity of dementia. METHODS: Fifty seven patients with AD were tested with a new standardised test of face apraxia including upper and lower face movements, which uses an item-difficulty weighted scoring procedure, the IMA test, a test of ideomotor apraxia and the M.O.D.A., a means to assess dementia severity. RESULTS: Thirteen (23%) and 19 (33%) participants were below cut-off respectively on the upper and lower face apraxia test. Both sections of the Face Apraxia Test correlated significantly with the Ideomotor Apraxia Test. However, double dissociations between different types of apraxia were observed. Both the upper and lower face apraxia tests correlated significantly with the measure of dementia severity. CONCLUSIONS: The finding show that a proportion of AD patients fails face apraxia tests. Their face apraxia is interlinked with ideomotor limb apraxia, although dissociations are possible. Severity of dementia deterioration accounts for a good proportion of the variability of AD patients' performance on face apraxia tests.

Aged↗
PubMed1999

Ideomotor apraxia in Alzheimer disease and left hemisphere stroke: limb transitive and intransitive movements.

OBJECTIVE: Ideomotor apraxia was studied in patients with Alzheimer disease (AD) and unilateral left hemispheric damaged (LHD) stroke to determine whether these groups differed. BACKGROUND: Given that the neuropathology of AD is bilateral and more diffuse than the localized involvement in patients after an LHD stroke, and given that the cognitive deficits in AD are more widespread than in LHD stroke, the authors predicted that patients with these disorders would differ in response to an auditory command task administered to evaluate ideomotor apraxia, and that the two patient groups would be significantly more impaired than healthy matched control subjects. METHODS: Twenty-one persons were studied, including equal numbers of patients with AD, patients with unilateral LHD stroke, and control subjects. An auditory command test of limb apraxia was administered and videotaped to score performance and to code spatial-temporal or content errors. RESULTS: The patients with AD and LHD stroke were significantly more impaired than healthy control subjects. Whereas the patients with AD and LHD stroke were equally apraxic and did not differ in their performance of transitive limb movements, the patients with AD were significantly more impaired than the patients with stroke when performing intransitive limb movements. A positive correlation was found between severity of dementia and severity of apraxia in the patients with AD. The patients with LHD stroke were as likely to make spatial-temporal as content errors when performing intransitive limb movements, whereas the patients with AD made content errors only. Error types produced with transitive limb movements did not differ between groups; spatial-temporal errors were the most common errors made both by patients with AD and patients with LHD stroke. CONCLUSIONS: As predicted, patients with AD and with LHD stroke were impaired when producing limb movements after auditory command, and both patient groups were significantly more impaired than the healthy adults. Patients with AD were significantly more impaired than patients with stroke when performing intransitive limb movements, and error types differed by group. Patients with AD and patients with stroke were equally impaired when performing transitive movements, and error types did not differ by group. Patients with ideomotor apraxia are often degraded in their production of transitive and intransitive movements, and the observation that performance may differ depending on the type of limb movement suggests that movement representations for transitive and intransitive movements may be at least partially independent.

Aged↗
PubMed2000

Ideomotor apraxia, visuomotor control and the explicit representation of posture.

Ideomotor apraxia is normally viewed as a disorder of the representation or execution of action. However, the evidence from gesture imitation is that apraxic patients are unable to reproduce the final posture of a gesture but may not show abnormality in movement kinematics. This supports a hypothesis that impaired gesture imitation is due to a deficit in a conceptual representation of body posture rather than indicating a disorder specific to action control. The present study evaluated whether other aspects of apraxic behaviour might also be most consistent with a deficit in the representation of posture. Patients with left hemisphere damage and apraxia on gesture imitation had difficulty in reproducing a series of actions due to failure to adopt the required configuration of the hand whereas there was no consistent reduction in speed of response once the actions had been learned. They also tended to use an abnormal, clumsy grasp when using a spoon but this dissociated from accurate performance on other tests of manual dexterity where there was less scope for variation in configuration of the hand. These data suggest that the most common deficit in ideomotor apraxia is impaired ability to perform tasks where the goal is to reproduce or adopt complex hand configurations and that impaired execution of some types of action is secondary to this problem. This is consistent with a role for the human left parietal lobe in providing an explicit representation of posture which is used to guide some actions and to supplement a more primitive system of direct visuomotor control.

Adult↗
PubMed1999

Role of somatosensory feedback from tools in realizing movements by patients with ideomotor apraxia.

In order to investigate the underlying mechanism of ideomotor apraxia, we studied 9 patients who could not mime using tools despite the ability to manipulate actual tools normally. In all the mime tasks, visually presented tools or model gestures by examiners were fundamentally ineffectual in improving the patients' performances. Even the remarkable improvement demonstrated when using actual tools disappeared immediately after the subjects took their hands off them. In a further experiment, 4 of the 9 patients were required to pretend to use tools while holding a stick, resulting in significant improvements or normal miming. These findings suggest that the somatosensory feedback continuously supplied from a handheld tool is a crucial component in enabling patients with ideomotor apraxia to actually use tools.

Acoustic Stimulation↗