Motor Aspects of Lateralization: Evidence for Evaluation of the Hypotheses of Chapter 8
Robert Miller in Axonal Conduction Time and Human Cerebral Laterality, 2019
Apraxia has been defined as the inability to perform complex purposeful movements in the absence of primary motor or sensory deficits. Geschwind (1975) defines apraxia as a “disorder of learned movement.” These definitions can accommodate the fact that there are disorders of learned movements produced by either left or right hemisphere damage. However, they hide the fact that there are disorders of learned movement specific to left hemisphere damage, categorically different from those resulting from right hemisphere damage, and probably confined to humans. From the above brief survey, it is clear that the central concept of apraxia which needs explaining applies to those forms of apraxia (ideomotor and ideational apraxia), which occur after left dominant lesions; and of these, the ideomotor apraxia is by far the most important. The remainder of this subsection is mainly about this form of apraxia.
Neurological issues
Andrea Utley in Motor Control, Learning and Development, 2018
The motor cortex can be regarded as a keyboard where each key represents a different area of the body. The keyboard is played by adjacent parts of the frontal lobe, particularly the supplementary motor area and the premotor cortex. Each of these structures is intimately involved in the production and control of skilled movement. The planning of complex behavior probably occurs in the prefrontal cortex; then the premotor cortex, along with the supplementary motor area, receive sensory information from the parietal and temporal lobes. So, at the simplest level, the parietal and temporal lobes analyze sensory information, the prefrontal cortex and supplementary area decide what action (behavior) is to be taken, and then the motor cortex executes the instructions. Damage to the cerebral cortex can result in apraxia. Apraxia is characterized by inability to perform a skilled or learned act that cannot be explained by an elementary motor or sensory deficit or language-comprehension disorder, despite having the desire and the physical ability to perform the act (Zadikoff and Lang 2005). Other research has shown that damage to the left or right hemispheres results in differing motor impairment. Steenbergen et al. (2004) found that subjects with left brain damage have difficulties with planning a task. Similarly, Haaland (2006) demonstrated that left frontoparietal circuits control limb praxis and motor sequencing.
Rehabilitation of Apraxia in Adults and Children
Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth in Neuropsychological Rehabilitation, 2017
Although no single taxonomy or classification of different forms of apraxia exists, two forms are usually reported as the most typical and most studied forms of apraxia: ideational and ideomotor apraxia (van Heugten, 2002). A patient with ideational apraxia does not know what to do because the idea or concept of the motor act is lacking. The sorts of errors observed in ideational apraxia are behavioural omissions, mislocation or misuse of objects or sequence mistakes. In ideomotor apraxia the idea or plan of action is not impaired (i.e. the patient knows what to do) but the implementation into a proper action is disturbed (i.e. the patient does not know how to do it). The patient may use body parts as objects, show spatial orientation problems, use inappropriate hand postures, or show perseverative and content errors. The most striking error is making mistakes when performing an action on command but performing the same action correctly in a natural setting.
Posterior cortical atrophy: clinical, neuroimaging, and neuropathological features
Published in Expert Review of Neurotherapeutics, 2023
John Best, Marianne Chapleau, Gil D. Rabinovici
A directed history is very important as patients frequently experience misdiagnosis or late diagnosis. Many of the symptoms are perceptual in nature, and therefore may not have been noted by loved ones or coworkers. This is in contrast to disorders with deficits of memory, expressive language or organization and planning. There is emerging evidence of the language deficits in PCA given the proximity to a number of language network hubs and connections, though language symptoms are not presently a part of the core criteria in PCA. While constructional deficits such as impaired drawing or building of 3-dimensional objects are frequently noted during evaluation, this is a less common complaint in individuals with PCA. A number of apraxias (inability to perform particular purposive actions) can develop in PCA. A commonly described symptom is dressing apraxia, which can include putting clothes on backwards or inside out, difficulty finding the holes for arms or legs, and more fine motor tasks such as tying laces, buttoning, or zipping. Use of technology such as computers is frequently impaired. Patients can also develop difficulty with simple calculations and may make frequent errors in managing finances. Patients may describe a nonspecific progressive anxiety, which is frequently an early symptom of Alzheimer’s disease [30].
A combined therapy for limb apraxia and related anosognosia
Published in Neuropsychological Rehabilitation, 2020
Ilka Buchmann, Lisa Finkel, Mareike Dangel, Dorothee Erz, Kathi Maren Harscher, Moritz Kaupp-Merkle, Joachim Liepert, Brigitte Rockstroh, Jennifer Randerath
Limb apraxia is commonly defined as a motor-cognitive disorder leading to difficulties in imitating gestures, pantomiming tool-use and actually using real tools (Goldenberg, 2013). Despite its negative impact on independence in daily life activities (Goldenberg & Hagmann, 1998b; Goldenberg, Daumüller, & Hagmann, 2001; Unsal-Delialioglu, Kurt, Kaya, Culha, & Ozel, 2008) and rehabilitation success (Dovern, Fink, & Weiss, 2012; Hanna-Pladdy, Heilman, & Foundas, 2003; Wu, Burgard, & Radel, 2014), studies on the effectiveness of apraxia rehabilitation are scarce (Buxbaum et al., 2008; Buxbaum & Randerath, 2018; Cantagallo, Maini, & Rumiati, 2012; Dovern et al., 2012; van Heugten & Geusgens, 2017; Worthington, 2016). Further, to the best of our knowledge, there were only two new rehabilitation approaches published since the review by Buxbaum and colleagues in 2008 (see also Worthington, 2016). This apparent lack in novel training approaches may be explained by the persisting misbelief, that apraxia only occurs in lab settings but not in real life and further, that it recovers spontaneously (van Heugten & Geusgens, 2017). However, studies have shown that 88% of patients diagnosed with apraxia were still apraxic after 20 weeks of standard neurorehabilitation (Donkervoort, Dekker, & Deelman, 2006).
Effect of object substitution, spontaneous compensation and repetitive training on reaching movements in a patient with optic ataxia
Published in Neuropsychological Rehabilitation, 2020
Josselin Baumard, Frédérique Etcharry-Bouyx, Valérie Chauviré, Delphine Boussard, Mathieu Lesourd, Chrystelle Remigereau, Yves Rossetti, François Osiurak, Didier Le Gall
The differential diagnosis between optic ataxia and apraxia (i.e., the inability to perform voluntary gestures in the absence of sensory or motor deficits; Rothi et al., 1991) is sometimes difficult. Optic ataxia can be unilateral – following left brain damage (Perenin & Vighetto, 1988; Revol et al., 2003) – and affects the spatial accuracy of reaching and grasping movements performed under visual control, following contralateral lesions in the superior parietal lobule and precuneus (area 7). In contrast, apraxia is generally a bilateral symptom that impairs either tool use or gestures performed without visual control (e.g., imitation of reflexive configurations), and results from lesions in the left inferior parietal lobe and parieto-occipital junction (areas 39 and 40; Goldenberg, 2009).
Related Knowledge Centers
- Motor Skill
- Posterior Parietal Cortex
- Corpus Callosum
- Motor Planning
- Traumatic Brain Injury
- Stroke
- Dementia
- Alzheimer's Disease
- Brain Tumor
- Neurodegenerative Disease