The Experts below are selected from a list of 1035 Experts worldwide ranked by ideXlab platform
Jordan Grafman - One of the best experts on this subject based on the ideXlab platform.
-
association of ideomotor Apraxia with frontal gray matter volume loss in corticobasal syndrome
JAMA Neurology, 2009Co-Authors: Edward D Huey, Matteo Pardini, Alyson L Cavanagh, Dimitrios Kapogiannis, Salvatore Spina, Bernardino Ghetti, Eric M Wassermann, Jordan GrafmanAbstract:Objective To determine the brain areas associated with specific components of ideomotor Apraxia (IMA) in corticobasal syndrome (CBS). Design Case-control and cross-sectional study. Participants Forty-eight patients with CBS and 14 control subjects. Intervention Administration of the Test of Oral and Limb Apraxia. Main Outcome Measures Differences between patients with CBS and healthy controls and associations between areas of gray matter volume and IMA determined by voxel-based morphometry in patients with CBS. Results Overall, IMA was associated with decreased gray matter volume in the left supplemental motor area, premotor cortex, and caudate nucleus of patients with CBS. The overall degree of Apraxia was independent of the side of motor impairment. Praxis to imitation (vs command) was particularly impaired in the patients with CBS. Patients demonstrated equal impairment in transitive and intransitive praxis. Conclusions In patients with CBS, IMA is associated with left posterior frontal cortical and subcortical volume loss. Despite showing left frontal volume loss associated with IMA, patients with CBS have particularly impaired imitation of gestures. These findings suggest either that the IMA of CBS affects a route of praxis that bypasses motor engrams or that motor engrams are affected but that they exist in areas other than the inferior parietal cortex.
-
comparison of Apraxia in corticobasal degeneration and progressive supranuclear palsy
Neurology, 2001Co-Authors: V Pharr, B Fantie, M Stark, Irene Litvan, Bob Uttl, Jordan GrafmanAbstract:Objective: To describe ideomotor Apraxia in patients with corticobasal degeneration and those with progressive supranuclear palsy, two parkinsonian disorders that are often misdiagnosed due to the overlap in their clinical features, and to determine whether systematic Apraxia testing is useful for differential diagnosis. Methods: Fourteen patients fulfilling National Institute of Neurological Disorders and Stroke–Society for Progressive Supranuclear Palsy clinical criteria for progressive supranuclear palsy, 13 patients fulfilling modified Lang criteria for corticobasal degeneration, and 12 normal healthy control subjects were given the Test of Oral and Limb Apraxia, which was scored according to the Florida Apraxia Battery for occurrence of various types of apraxic errors. Results: Both patients with progressive supranuclear palsy and corticobasal degeneration committed a greater number of apraxic errors than normal healthy control subjects on both transitive and intransitive tasks (p Conclusions: Patients with corticobasal degeneration show more severe ideomotor Apraxia than patients with progressive supranuclear palsy, and systematic assessment of ideomotor Apraxia facilitates the differential diagnosis between patients with progressive supranuclear palsy and those with corticobasal degeneration.
Kathleen Y Haaland - One of the best experts on this subject based on the ideXlab platform.
-
coordination deficits in ideomotor Apraxia during visually targeted reaching reflect impaired visuomotor transformations
Neuropsychologia, 2010Co-Authors: Pratik K Mutha, Robert L Sainburg, Kathleen Y HaalandAbstract:Ideomotor Limb Apraxia, commonly defined as a disorder of skilled, purposeful movement, is characterized by spatiotemporal deficits during a variety of actions. These deficits have been attributed to damage to, or impaired retrieval of, stored representations of learned actions, especially object-related movements. However, such deficits might also arise from impaired visuomotor transformation mechanisms that operate in parallel to or downstream from mechanisms for storage of action representations. These transformation processes convert extrinsic visual information into intrinsic neural commands appropriate for the desired motion. These processes are a key part of the movement planning process and performance errors due to inadequate transformations have been shown to increase with the dynamic complexity of the movement. This hypothesis predicts that apraxic patients should show planning deficits when reaching to visual targets, especially when the coordination and/or dynamic requirements of the task increase. Three groups (18 healthy controls, 9 non-apraxic and 9 apraxic left hemisphere damaged patients) performed reaching movements to visual targets that varied in the degree of interjoint coordination required. Relative to the other two groups, apraxic patients made larger initial direction errors and showed higher variability during their movements, especially when reaching to the target with the highest intersegmental coordination requirement. These problems were associated with poor coordination of shoulder and elbow torques early in the movement, consistent with poor movement planning. These findings suggest that the requirement to transform extrinsic visual information into intrinsic motor commands impedes the ability to accurately plan a visually targeted movement in ideomotor Limb Apraxia.
-
ipsilateral deficits in 1 handed shoe tying after left or right hemisphere stroke
Archives of Physical Medicine and Rehabilitation, 2009Co-Authors: Janet L Poole, Joseph Sadek, Kathleen Y HaalandAbstract:Abstract Poole JL, Sadek J, Haaland KY. Ipsilateral deficits in 1-handed shoe tying after left or right hemisphere stroke. Objective To examine 1-handed shoe tying performance and whether cognitive deficits more associated with left or right hemisphere damage differentially affect it after unilateral stroke. Design Observational cohort comparing ipsilesional shoe tying, spatial and language skills, and Limb praxis. Setting Primary care Veterans Affairs and private medical center. Interventions Not applicable. Participants Volunteer right-handed sample of adults with left or right hemisphere damage and healthy demographically matched adults. Main Outcome Measure The number of correct trials and the total time to complete 10 trials tying a shoe using the 1-handed method. Results Both stroke groups had fewer correct trials and were significantly slower tying the shoe than the control group. Spatial skills predicted accuracy and speed after right hemisphere damage. After left hemisphere damage, accuracy was predicted by spatial skills and Limb praxis, while speed was predicted by Limb praxis only. Conclusions Ipsilesional shoe tying is similarly impaired after left or right hemisphere damage, but for different reasons. Spatial deficits had a greater influence after right hemisphere damage, and Limb Apraxia had a greater influence after left hemisphere damage. Language deficits did not affect performance, indicating that aphasia does not preclude using this therapy approach. These results suggest that rehabilitation professionals should consider assessment of Limb Apraxia and ipsilesional skill training in the performance of everyday tasks.
-
treatment of Limb Apraxia moving forward to improved action
American Journal of Physical Medicine & Rehabilitation, 2008Co-Authors: Laurel J Buxbaum, Mark Hallett, Kathleen Y Haaland, Lewis A Wheaton, Kenneth M Heilman, Amy D Rodriguez, Leslie Gonzalez J RothiAbstract:Limb Apraxia is a common disorder of skilled, purposive movement that is frequently associated with stroke and degenerative diseases such as Alzheimer disease. Despite evidence that several types of Limb Apraxia significantly impact functional abilities, surprisingly few studies have focused on development of treatment paradigms. Additionally, although the most disabling types of Apraxia reflect damage to gesture and/or object memory systems, existing treatments have not fully taken advantage of principles of experience known to affect learning and neural plasticity. We review the current state of the art in the rehabilitation of Limb Apraxia, indicate possible points of contact with the learning literature, and generate suggestions for how translational principles might be applied to the development of future research on treatment of this disabling disorder.
-
left hemisphere dominance for movement
Clinical Neuropsychologist, 2006Co-Authors: Kathleen Y HaalandAbstract:Clinical neuropsychology's dependence upon a core scientific background in clinical neuropsychology, and clinical psychology, neurology, and neuroanatomy, as well as biopsychology, cognitive neuroscience, and cognitive science is the basis of its designation as an APA-approved clinical specialty. This dependence highlights the importance of these scientific underpinnings and the scientist-practitioner model of training, detailed in the Houston Guidelines. This presentation is meant to demonstrate that cognitive neuroscience research should influence our conception of brain behavior relationships, which, in turn, should influence our clinical work. In addition, I want to illustrate how the utilization of converging methods, which is an increasingly popular approach to research, can ensure more valid conclusions about the neuroanatomical substrates for complex skills. Limb Apraxia will be used as an example of a deficit that has functional implications and whose cognitive mechanisms and neuroanatomical correlates are better understood as a result of research that combines neuroanatomical imaging of brain damaged patients, functional imaging, and cognitive paradigms. This work demonstrates that left frontoparietal circuits control Limb praxis and motor sequencing, suggesting that these complex motor skills should be examined in patients with such damage.
-
ideomotor Limb Apraxia in huntington s disease implications for corticostriate involvement
Neuropsychologia, 2003Co-Authors: Joanne M Hamilton, Kathleen Y Haaland, John C Adair, Jason BrandtAbstract:Abstract Ideomotor Limb Apraxia, a disorder of goal-directed movement, has been attributed to lesions in the frontal and parietal lobes, but the role of subcortical structures is less certain. In order to determine its prevalence in a disorder affecting the basal ganglia and corticostriatal connections, we examined imitation of hand gestures in Huntington’s disease (HD) patients. We also assessed the relationship between Apraxia and cognitive and motor dysfunction in an effort to better understand the neural underpinnings of Apraxia in HD. If damage restricted to the basal ganglia produces ideomotor Limb Apraxia, then we would expect to find evidence of Apraxia in patients who were early in the disease course when selective striatal damage is most common. Such a pattern, however, was not found in our sample. Instead, patients with greater neurological impairment and with a longer duration of disease were more likely than less affected patients to demonstrate Apraxia. Apraxia was not related to severity of chorea, but was associated with greater impairment in eye movements, voluntary movements, and verbal fluency. These findings suggest that Apraxia in HD results from damage to the corticostriate pathways and the basal ganglia rather than from damage restricted to the basal ganglia.
Barbara Borroni - One of the best experts on this subject based on the ideXlab platform.
-
Left parietal cortex transcranial direct current stimulation enhances gesture processing in corticobasal syndrome
European Journal of Neurology, 2015Co-Authors: Marta Bianchi, Maura Cosseddu, Michela Brambilla, Maria Cristina Rizzetti, Alessandro Padovani, Rosa Manenti, Maria Cotelli, Barbara BorroniAbstract:Background and purpose Corticobasal syndrome (CBS) is a clinical entity characterized by higher cortical dysfunctions associated with asymmetric onset of levodopa-resistant parkinsonism, dystonia and myoclonus. One of the most typical and distressful features of CBS is Limb Apraxia, which affects patients in their everyday life. Transcranial direct current stimulation (tDCS) is a non-invasive procedure of cortical stimulation, which represents a promising tool for cognitive enhancement and neurorehabilitation. The present study investigated whether anodal tDCS over the parietal cortex (PARC), would improve ideomotor upper Limb Apraxia in CBS patients. Methods Fourteen patients with possible CBS and upper Limb Apraxia were enrolled. Each patient underwent two sessions of anodal tDCS (left and right PARC) and one session of placebo tDCS. Ideomotor upper Limb Apraxia was assessed using the De Renzi ideomotor Apraxia test that is performed only on imitation. Results A significant improvement of the De Renzi ideomotor Apraxia test scores (post-stimulation versus pre-stimulation) after active anodal stimulation over the left PARC was observed (χ2 = 17.6, P = 0.0005), whilst no significant effect was noticed after active anodal stimulation over the right PARC (χ2 = 7.2, P = 0.07). A post hoc analysis revealed a selective improvement in the De Renzi ideomotor Apraxia score after active anodal stimulation over the left PARC compared with placebo stimulation considering both right (P = 0.03) and left upper Limbs (P = 0.01). Conclusions These findings indicate that tDCS to the PARC improves the performance of an ideomotor Apraxia test in CBS patients and might represent a promising tool for future rehabilitation approaches.
-
white matter changes in corticobasal degeneration syndrome and correlation with Limb Apraxia
JAMA Neurology, 2008Co-Authors: Barbara Borroni, Alessandro Padovani, Valentina Garibotto, Chiara Agosti, Simona Maria Brambati, Giuseppe Bellelli, Roberto Gasparotti, Daniela PeraniAbstract:Background Data on white matter changes in corticobasal degeneration syndrome (CBDS) are not yet available, whereas cortical gray matter loss is a feature of this condition. The structural abnormalities related to a key feature of CBDS (Limb Apraxia) are unknown. Objectives To measure selective structural changes in early CBDS using diffusion tensor imaging and voxel-based morphometry and to evaluate the structural correlates of Limb Apraxia. Design Patient and control group comparison. Setting Referral center for dementia and movement disorders. Participants Twenty patients with CBDS and 21 matched control subjects. Interventions Clinical and standardized neuropsychological evaluations, including assessment of Limb Apraxia. Main Outcome Measures Gray and white matter changes in early CBDS. Results Diffusion tensor imaging revealed decreases in fractional anisotropy in the long frontoparietal connecting tracts, the intraparietal associative fibers, and the corpus callosum. Fractional anisotropy was also reduced in the sensorimotor projections of the cortical hand areas. Voxel-based morphometry showed a prevalent gray matter reduction in the left hemisphere (in the inferior frontal and premotor cortices, parietal operculum, superotemporal gyrus, and hippocampus). The pulvinar, bilaterally, and the right cerebellar cortex also showed atrophy. Limb Apraxia correlated with parietal atrophy and with fractional anisotropy reductions in the parietofrontal associative fibers ( P Conclusions The present integrative approach to in vivo structural anatomy combines hodologic imaging, describing patterns of white matter connections between cortical areas, with neuropsychological data. This provides new evidence of gray matter and fiber tract abnormalities in early-phase disease and contributes to clarifying the neural basis of Apraxia in CBDS.
Laurel J Buxbaum - One of the best experts on this subject based on the ideXlab platform.
-
structural disconnection of the tool use network after left hemisphere stroke predicts Limb Apraxia severity
Cerebral cortex communications, 2020Co-Authors: Frank E Garcea, Clint Greene, Scott T Grafton, Laurel J BuxbaumAbstract:Producing a tool use gesture is a complex process drawing upon the integration of stored knowledge of tools and their associated actions with sensory-motor mechanisms supporting the planning and control of hand and arm actions. Understanding how sensory-motor systems in parietal cortex interface with semantic representations of actions and objects in the temporal lobe remains a critical issue and is hypothesized to be a key determinant of the severity of Limb Apraxia, a deficit in producing skilled action after left hemisphere stroke. We used voxel-based and connectome-based lesion-symptom mapping with data from 57 left hemisphere stroke participants to assess the lesion sites and structural disconnection patterns associated with poor tool use gesturing. We found that structural disconnection among the left inferior parietal lobule, lateral and ventral temporal cortices, and middle and superior frontal gyri predicted the severity of tool use gesturing performance. Control analyses demonstrated that reductions in right-hand grip strength were associated with motor system disconnection, largely bypassing regions supporting tool use gesturing. Our findings provide evidence that Limb Apraxia may arise, in part, from a disconnection between conceptual representations in the temporal lobe and mechanisms enabling skilled action production in the inferior parietal lobule.
-
structural disconnection of the tool use network after left hemisphere stroke predicts Limb Apraxia severity
bioRxiv, 2020Co-Authors: Frank E Garcea, Clint Greene, Scott T Grafton, Laurel J BuxbaumAbstract:Abstract Producing a tool use gesture is a complex process drawing upon the integration of stored knowledge of tools and their associated actions with sensory-motor mechanisms supporting the planning and control of hand and arm actions. Understanding how sensory-motor systems in parietal cortex interface with semantic representations of actions and objects in the temporal lobe remains a critical issue, and is hypothesized to be a key determinant of the severity of Limb Apraxia, a deficit in producing skilled action after left hemisphere stroke. We used voxel-based and connectome-based lesion symptom mapping with data from 57 left hemisphere stroke participants to assess the lesion sites and structural disconnection patterns associated with poor tool use gesturing. We found that structural disconnection between the left inferior parietal lobule, lateral temporal lobe (left middle temporal gyrus) and ventral temporal cortex (left medial fusiform gyrus) predicted the severity of tool use gesturing performance. Control analyses demonstrated that reductions in right-hand grip strength were associated with motor system disconnection, bypassing regions supporting tool use gesturing. Our findings provide causal evidence that Limb Apraxia may arise, in part, from disconnection of conceptual representations in the temporal lobe from mechanisms enabling skilled action production in the inferior parietal lobule.
-
treatment of Limb Apraxia moving forward to improved action
American Journal of Physical Medicine & Rehabilitation, 2008Co-Authors: Laurel J Buxbaum, Mark Hallett, Kathleen Y Haaland, Lewis A Wheaton, Kenneth M Heilman, Amy D Rodriguez, Leslie Gonzalez J RothiAbstract:Limb Apraxia is a common disorder of skilled, purposive movement that is frequently associated with stroke and degenerative diseases such as Alzheimer disease. Despite evidence that several types of Limb Apraxia significantly impact functional abilities, surprisingly few studies have focused on development of treatment paradigms. Additionally, although the most disabling types of Apraxia reflect damage to gesture and/or object memory systems, existing treatments have not fully taken advantage of principles of experience known to affect learning and neural plasticity. We review the current state of the art in the rehabilitation of Limb Apraxia, indicate possible points of contact with the learning literature, and generate suggestions for how translational principles might be applied to the development of future research on treatment of this disabling disorder.
-
the role of the dynamic body schema in praxis evidence from primary progressive Apraxia
Brain and Cognition, 2000Co-Authors: Laurel J Buxbaum, Tania Giovannetti, David J. LibonAbstract:Abstract On an influential model of Limb praxis, ideomotor Apraxia results from damage to stored gesture representations or disconnection of representations from sensory input or motor output (Heilman & Gonzalez Rothi, 1993; Gonzalez Rothi et al., 1991). We report data from a patient with progressive ideomotor Limb Apraxia which cannot be readily accommodated by this model. The patient, BG, is profoundly impaired in gesturing to command, to sight of object, and to imitation, but gestures nearly normally with tool in hand and recognizes gestures relatively well. In addition, performance is profoundly impaired on imitation of meaningless gestures and on tasks requiring spatiomotor transformations of body-position information. We provide evidence that BG's Apraxia is largely attributable to impairments external to the stored gesture system in procedures coding the dynamic positions of the body parts of self and others; that is, the body schema. We propose a model of a dynamic, interactive praxis system subserved by posterior parietal cortex in which stored representational elements, when present, provide “top-down” support to spatiomotor procedures computed on-line. In addition to accounting for BG's performance, this model accommodates a common pattern of ideomotor Apraxia more readily than competing accounts.
Tim Vanbellingen - One of the best experts on this subject based on the ideXlab platform.
-
Different visual exploration of tool-related gestures in left hemisphere brain damaged patients is associated with poor gestural imitation
Neuropsychologia, 2015Co-Authors: Tim Vanbellingen, Rahel Schumacher, Noëmi Eggenberger, Simone Hopfner, Dario Cazzoli, Basil Preisig, Manuel Bertschi, Thomas Nyffeler, Klemens Gutbrod, Claudio L. BassettiAbstract:According to the direct matching hypothesis, perceived movements automatically activate existing motor components through matching of the perceived gesture and its execution. The aim of the present study was to test the direct matching hypothesis by assessing whether visual exploration behavior correlate with deficits in gestural imitation in left hemisphere damaged (LHD) patients. Eighteen LHD patients and twenty healthy control subjects took part in the study. Gesture imitation performance was measured by the test for upper Limb Apraxia (TULIA). Visual exploration behavior was measured by an infrared eye-tracking system. Short videos including forty gestures (20 meaningless and 20 communicative gestures) were presented. Cumulative fixation duration was measured in different regions of interest (ROIs), namely the face, the gesturing hand, the body, and the surrounding environment. Compared to healthy subjects, patients fixated significantly less the ROIs comprising the face and the gesturing hand during the exploration of emblematic and tool-related gestures. Moreover, visual exploration of tool-related gestures significantly correlated with tool-related imitation as measured by TULIA in LHD patients. Patients and controls did not differ in the visual exploration of meaningless gestures, and no significant relationships were found between visual exploration behavior and the imitation of emblematic and meaningless gestures in TULIA. The present study thus suggests that altered visual exploration may lead to disturbed imitation of tool related gestures, however not of emblematic and meaningless gestures. Consequently, our findings partially support the direct matching hypothesis.
-
a new bedside test of gestures in stroke the Apraxia screen of tulia ast
Journal of Neurology Neurosurgery and Psychiatry, 2011Co-Authors: Tim Vanbellingen, Bernd Kersten, A Van De Winckel, Rene M Muri, M Bellion, F Baronti, Stephan BohlhalterAbstract:Background Apraxia in patients with stroke may be overlooked, as clumsiness and deficient gestural communication are often attributed to frequently coexisting sensorimotor deficits and aphasia. Early and reliable detection of Apraxia by a bedside test is relevant for functional outcome in patients with stroke. The present study was aimed at constructing a new bedside screening test for Apraxia, called the Apraxia Screen of TULIA (AST), based on the comprehensive standardised Test for Upper-Limb Apraxia (TULIA). Methods First, an item-reduction analysis of the TULIA (48 gestures) was performed, based on the methods of classical test theory and on a larger sample of patients with stroke (n¼133) and matched healthy controls (n¼50). Stepwise elimination of items resulted in a set of 12 items, demonstrating high internal consistency (Cronbach alpha¼0.92). The six-point scoring method of the TULIA was dichotomised to the score levels pass and fail. In the second part of this study the validity of the AST was assessed prospectively in a new cohort of patients with stroke (n¼31) by using the Pearson correlation analysis and binary classification display with the TULIA. Results and discussion Validation of the 12-item AST with the TULIA showed a remarkable diagnostic reliability with high specificity, sensitivity and positive predictive value, for the presence and severity of Apraxia. The AST is shown to be a reliable and valid bedside test in patients with stroke, allowing a straightforward assessment of Apraxia within a few minutes.
-
comprehensive assessment of gesture production a new test of upper Limb Apraxia tulia
European Journal of Neurology, 2010Co-Authors: Tim Vanbellingen, Manuel Bertschi, Bernd Kersten, B Van Hemelrijk, A Van De Winckel, Rene M Muri, W De Weerdt, Stephan BohlhalterAbstract:Background: Only few standardized Apraxia scales are available and they do not cover all domains and semantic features of gesture production. Therefore, the objective of the present study was to evaluate the reliability and validity of a newly developed test of upper Limb Apraxia (TULIA), which is comprehensive and still short to administer. Methods: The TULIA consists of 48 items including imitation and pantomime domain of non-symbolic (meaningless), intransitive (communicative) and transitive (tool related) gestures corresponding to 6 subtests. A 6-point scoring method (0–5) was used (score range 0–240). Performance was assessed by blinded raters based on videos in 133 stroke patients, 84 with left hemisphere damage (LHD) and 49 with right hemisphere damage (RHD), as well as 50 healthy subjects (HS). Results: The clinimetric findings demonstrated mostly good to excellent internal consistency, inter- and intra-rater (test–retest) reliability, both at the level of the six subtests and at individual item level. Criterion validity was evaluated by confirming hypotheses based on the literature. Construct validity was demonstrated by a high correlation (r = 0.82) with the De Renzi-test. Conclusion: These results show that the TULIA is both a reliable and valid test to systematically assess gesture production. The test can be easily applied and is therefore useful for both research purposes and clinical practice.