Functional brain imaging in apraxia

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: An extensive literature describes structural lesions in apraxia, but few studies have used functional neuroimaging. We used positron emission tomography (PET) to characterize relative cerebral glucose metabolism in a 65-year-old, right-handed woman with progressive decline in ability to manipulate objects, write, and articulate speech. Objection: To characterize functional brain organization in apraxia. Design and Methods: The patient underwent a neurological examination, neuropsychological testing, magnetic resonance imaging, and fludeoxyglucose F 18 PET. The patient's magnetic resonance image was coregistered to her PET image, which was compared with the PET images of 7 right-handed, healthy controls. Hemispheric regions of interest were normalized by calcrine cortex. Results: Except for apraxia and mild grip weakness, results of the neurological examination were normal. There was ideomotor apraxia of both hands (command, imitation, and object) and buccofacial apraxia. The patient could recognize meaningful gestures performed by the examiner and discriminate between his accurate and awkward pantomime. The magnetic resonance image showed moderate generalized atrophy and mild ischemic changes. Positron emission tomographic scans showed abnormal fludeoxyglucose F 18 uptake in the posterior frontal, supplementary motor, and parietal regions, the left affected more than the right. Focal metabolic deficit was present in the angular gyms, an area hypothesized to store conceptual knowledge of skilled movement. Conclusions: Greater parietal than frontal physiological dysfunction and preserved gesture recognition are not consistent with the theory that knowledge of limb praxis is stored in the dominant parietal cortex. Gesture comprehension may be more diffusely distributed.

Original languageEnglish
Pages (from-to)107-113
Number of pages7
JournalArchives of Neurology
Volume55
Issue number1
DOIs
StatePublished - 1998

Fingerprint

Apraxias
Functional Neuroimaging
Positron-Emission Tomography
Gestures
Parietal Lobe
Fluorodeoxyglucose F18
Neurologic Examination
Ideomotor Apraxia
Magnetic Resonance Spectroscopy
Women's Rights
Aptitude
Hand Strength
Atrophy
Extremities
Hand
Magnetic Resonance Imaging
Organizations
Electrons
Glucose
Brain Imaging

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Functional brain imaging in apraxia. / Kareken, David; Unverzagt, Frederick; Caldemeyer, Karen; Farlow, Martin; Hutchins, Gary.

In: Archives of Neurology, Vol. 55, No. 1, 1998, p. 107-113.

Research output: Contribution to journalArticle

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