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Query: UMLS:C0003635 (apraxia)
 2,817 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We present preliminary data on the utility of functional brain imaging with [99mTc]-d,l-HM-PAO and single photon emission computed tomography (SPECT) in the study of patients with dementia of the Alzheimer type (DAT), HIV-related dementia syndrome, and the "on-off" syndrome of Parkinson's disease. In comparison with a group of age-matched controls, the DAT patients revealed distinctive bilateral temporal and posterior parietal deficits, which correlate with detailed psychometric evaluation. Patients with amnesia as the main symptom (group A) showed bilateral mesial temporal lobe perfusion deficits (p less than 0.02). More severely affected patients (group B) with significant apraxia, aphasia, or agnosia exhibited patterns compatible with bilateral reduced perfusion in the posterior parietal cortex, as well as reduced perfusion to both temporal lobes, different from the patients of the control group (p less than 0.05). SPECT studies of HIV patients with no evidence of intracraneal space occupying pathology showed marked perfusion deficits. Patients with Parkinson's disease and the "on-off" syndrome studied during an "on" phase (under levodopa therapy) and on another occasion after withdrawal of levodopa ("off") demonstrated a significant change in the uptake of [99mTc]-d,l-HM-PAO in the caudate nucleus (lower on "off") and thalamus (higher on "off"). These findings justify the present interest in the functional evaluation of the brain of patients with dementia. [99mTc]-d,l-HM-PAO and regional cerebral blood flow (rCBF)/SPECT appear useful and highlight individual disorders of flow in a variety of neuropsychiatric conditions.
J Cereb Blood Flow Metab 1988 Dec
PMID:CBF tomograms with [99mTc-HM-PAO in patients with dementia (Alzheimer type and HIV) and Parkinson's disease--initial results. 326 77

Awareness of self-generated movements arises from comparing motor plans, and the accompanying (hypothetical) efference copy, with the visual and proprioceptive consequences of movement. Here we used repetitive transcranial magnetic stimulation (rTMS) to investigate the role of a posterior region in the superior parietal lobule (SPL) in this process. Nine healthy volunteers performed a finger extension actively and passively while wearing a CyberGlove; the glove recorded these (actual) finger movements and used this information in real time to move a virtual hand displayed on a computer screen. To assess the participant's awareness of movement onset, we introduced a delay between the onset of the actual and virtual movement (60-270 ms, 30 ms increments); the task was to judge whether the virtual hand movements were delayed relative to the actual hand movements. Low-frequency rTMS (15 min, 0.6 Hz) was applied either over the left SPL or the left temporal cortex (control site) to decrease excitability of these regions and, in turn, test their role in the awareness of self-generated movement. Following the SPL stimulation, participants' assessments of asynchrony were impaired for active but not passive movements. No significant changes were observed after rTMS applied over the control site. We suggest that these findings are consistent with the role of the SPL in evaluating the temporal congruency of peripheral (visual) and central (efference copy) signals associated with self-generated movements. As such, this region may contribute to the sense of 'agency' and its disturbances in disorders such as apraxia and schizophrenia.
Cereb Cortex 2003 Sep
PMID:The role of parietal cortex in awareness of self-generated movements: a transcranial magnetic stimulation study. 1290 95

Successful behavior depends on effective communication between distant brain regions. Moreover, disturbance of effective communication can cause neurological symptoms like apraxia, dyslexia or object agnosia. Interregional communication can be assessed by coherence analysis of synchronized neuronal oscillations, and has been referred to as synchrony or "binding". The concept of synchrony as a means of information coding is attractive, but its functional relevance has been challenged. We hypothesized that if synchrony is functionally relevant in humans, then more synchrony should determine better behavioral performance. Here, we show in a visuotactile integration task that the amount of low-frequency (7-13Hz), long-range electroencephalographic coherence between visual and sensorimotor cortex is significantly correlated with the level of performance. Trials with highest coherences were the most successful ones and vice versa in the absence of differences in regional activation measured as task-related spectral power. In summary, quantitatively linking the amount of long-range synchrony with the degree of behavioral success in humans, the present data suggest that the ability to generate topographically specific synchrony of high amplitude is functionally relevant for behavioral success. They also raise the possibility that the magnitude of regional activation is less representative of the efficacy of brain functioning than interregional synchrony.
Cereb Cortex 2005 May
PMID:Larger interregional synchrony is associated with greater behavioral success in a complex sensory integration task in humans. 1534 29

Pantomime of tool use is a frequently used test for apraxia. For basic cognitive neuroscience, pantomime of tool use is of interest because it constitutes a link between instrumental and communicative manual actions. We used lesion subtraction analysis to determine the locations specifically associated with defective pantomime of tool use in patients with left-brain damage and aphasia. Subtraction of lesions of patients with normal pantomime from those with defective pantomime yielded a maximum difference in the inferior frontal gyrus and adjacent portions of the insula and precentral gyrus. This result remained essentially the same when possible confounding influences of impaired language comprehension and of lesion size were controlled by selecting patients equated on these measures and when only patients with preserved imitation of gestures were considered. By contrast, parietal lesions did not have a specific impact on pantomime. We speculate that the vulnerability of pantomime to lesions of left inferior frontal cortex is due to the high demands on selection of a very restrained range of features out of the many features that may come to mind when imagining the actual use of the tool.
Cereb Cortex 2007 Dec
PMID:Pantomime of tool use depends on integrity of left inferior frontal cortex. 1733 7

The brain computes spatial relationships as necessary to achieve behavioral goals. Loss of this spatial cognitive ability after damage to posterior parietal cortex may contribute to constructional apraxia, a syndrome in which a patient's ability to reproduce spatial relationships between the parts of an object is disrupted. To explore neural correlates of object-relative spatial representation, we recorded neural activity in parietal area 7a of monkeys performing an object construction task. We found that neurons were activated as a function of the spatial relationship between a task-critical coordinate and a reference object. Individual neurons exhibited an object-relative spatial preference, such that different neural populations were activated when the spatial coordinate was located to the left or right of the reference object. In each case, the representation was robust to translation of the reference object, and neurons maintained their object-relative preference when the position of the object varied relative to the angle of gaze and viewer-centered frames of reference. This provides evidence that the activity of a subpopulation of parietal neurons active in the construction task represented relative position as referenced to an object and not absolute position with respect to the viewer.
Cereb Cortex 2007 Dec
PMID:Representing spatial relationships in posterior parietal cortex: single neurons code object-referenced position. 1738 30

Recent functional neuroimaging and brain lesion studies have implicated a network of left hemisphere regions in human tool use: 1) posterior middle temporal cortex involved in conceptual knowledge of tools, 2) posterior inferior parietal cortex for representations of learned tool use gestures, and 3) anterior inferior parietal cortex, along with posterior inferior frontal and ventral premotor cortices, involved in grasping and manipulating objects. Here, we use diffusion tensor imaging (DTI) to investigate the anatomical connections that support this putative network. DTI scans were acquired from nineteen right-handed males and a deterministic tractography algorithm was used to identify connections between these regions implicated in tool use. Three of the resulting pathways were larger in the left than the right hemisphere. One connected posterior middle temporal cortex and the anterior inferior parietal cortex, a second connected posterior middle temporal cortex and the posterior inferior parietal cortex, and a third connected anterior inferior parietal cortex and the frontal lobe. In contrast, the connection between the posterior inferior parietal cortex and the frontal lobe was highly rightwardly asymmetric. Although further study is necessary to establish the functions of these pathways, we integrate our findings with previous evidence from functional neuroimaging and apraxia studies to suggest some possible functions.
Cereb Cortex 2010 Mar
PMID:A DTI investigation of neural substrates supporting tool use. 1960 79

Impaired tool use despite preserved basic motor functions occurs after stroke in the context of apraxia, a cognitive motor disorder. To elucidate the neuroanatomical underpinnings of different tool use deficits, prospective behavioral assessments of 136 acute left-hemisphere stroke patients were combined with lesion delineation on magnetic resonance imaging (MRI) images for voxel-based lesion-symptom mapping. Deficits affecting both the selection of the appropriate recipient for a given tool (ToolSelect, e.g., choosing the nail for the hammer), and the performance of the typical tool-associated action (ToolUse, e.g., hammering in the nail) were associated with ventro-dorsal stream lesions, particularly within inferior parietal lobule. However, ToolSelect compared with ToolUse deficits were specifically related to damage within ventral stream regions including anterior temporal lobe. Additional retrospective error dichotomization based on the videotaped performances of ToolUse revealed that spatio-temporal errors (movement errors) were mainly caused by inferior parietal damage adjacent to the intraparietal sulcus while content errors, that is, perplexity, unrecognizable, or semantically incorrect movements, resulted from lesions within supramarginal gyrus and superior temporal lobe. In summary, our results suggest that in the use of tools, conceptual and production-related aspects can be differentiated and are implemented in anatomically distinct streams.
Cereb Cortex 2016 09
PMID:Differential Roles of Ventral and Dorsal Streams for Conceptual and Production-Related Components of Tool Use in Acute Stroke Patients. 2627 Nov 12

Encoding hand position by the cerebral cortex is essential not only for the neural representation of the body image but also for different actions based on eye-hand coordination. These include reaching for visual objects as well as complex movement sequences, such as tea-making, tool use, and object construction, among many others. All these functions depend on a continuous refreshing of the hand position representation, relying on both predictive signaling and afferent information. The hand position influence on neural activity in the parietofrontal system, together with eye position signals, are the basic elements of an eye-hand matrix from which all the above functions can emerge and could be regarded as key features of a network with several entry points, command nodes and outflow pathways, as confirmed by the discovery of a direct parietospinal projection for the control of hand action. The integrity of this system is crucial for daily life, as testified by the consequences of cortical lesions, spanning from severe paralysis to complex forms of apraxia. In this review, I will sketch my personal understanding of the scientific and conceptual trajectory of a line of investigation with many unexpected influences on cortical function and disease, from motor behavior to cognition.
Cereb Cortex 2019 02 01
PMID:A Brief History of the Encoding of Hand Position by the Cerebral Cortex: Implications for Motor Control and Cognition. 2937 34

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.
Cereb Cortex Commun 2020
PMID:Structural Disconnection of the Tool Use Network after Left Hemisphere Stroke Predicts Limb Apraxia Severity. 3313 27