Ideomotor apraxia: A review

Abstract

Ideomotor apraxia (IMA) is a disorder traditionally characterized by deficits in properly performing tool-use pantomimes (e.g., pretending to use a hammer) and communicative gestures (e.g., waving goodbye). These deficits are typically identified with movements made to verbal command or imitation. Questions about this disorder relate to its diagnosis, anatomical correlates, physiological mechanisms involved, and the patients in whom IMA is best characterized. In this review, utilizing information presented at an international workshop, we summarize the present state of knowledge about IMA. We include insights on how to distinguish IMA from the other motor apraxias and confounding disorders. We discuss testing for IMA and the need for more rigorous tests that examine more elements, such as imitation, actual use, task selection, and recognizing proper use. From neurophysiological insights, we propose hypotheses of the necessity of networks in praxis performance. We also point out that more neurophysiological knowledge in humans might lead to a better understanding of how different brain structures may aid in the rehabilitation of praxis. While little is known about exactly how rehabilitation may be pursued, biological evidence warrants the further exploration of this issue.

Associative sequence learning: the role of experience in the development of imitation and the mirror system

“…The ASL theory, in contrast, predicts that imitation is likely to occur in a variety of species, to the extent that the sensorimotor experience of the imitated actions was available during development. While early studies of imitation in non-human animals were beset with methodological problems (see Tomasello et al 1987;Whiten & Ham 1992), recent data (see also Huber et al 2009) provide compelling evidence for imitation of simple movements across a range of species, including chimpanzees (Custance et al 1995;Whiten et al 1996Whiten et al , 2004, marmosets (Bugnyar & Huber 1997;Voelkl & Huber 2007), dogs (Slabbert & Rasa 1997;Range et al 2007) and several bird species (Lefebvre et al 1997;Campbell et al 1999;Mui et al 2008). For example, dogs will perform a paw-press action to obtain a food reward, rather than the usually preferred mouth action, after observing a demonstrator dog using this action (Range et al 2007).…”

“…Lesions to the inferior parietal lobe, particularly in the left hemisphere, often result in apraxia-a deficit in miming gestures and in imitation (Wheaton & Hallett 2007). Lesions to the inferior frontal cortex in apraxia are not as widely reported as are parietal lesions, and may not always result in imitation deficits: Goldenberg et al (2007) found impairment in miming gestures following lesions to the left inferior frontal gyrus (IFG), but imitation was preserved in some of these patients.…”

A topographic study on the evaluation of speech and language in the acute phase of a first stroke

“…The left inferior parietal component of these lesions is the main responsible for these types of apraxia, though they can also be found in premotor and callosal lesions 21 .…”

Correlation between Assessments of Arm and Leg Ideomotor Apraxia in Hemiplegic Stroke Patients

“…In addition, IMA persists to some extent in 45% of patients of all severities 1 year after stroke onset 8) . Many previous studies have shown that IMA typically affects both the ipsilesional and contralesional limbs and results in disorders of gesture orientation, joint coordination, motor velocity, and spatial distortion in execution of a motor program, in spite of a global preservation of action-planning ability [9][10][11] .…”

“…These assessments generally include the face, or the upper or lower limbs 12,13) . The assessment of IMA involves specific patterns of apraxic behavior, including the ability to mimic the use of a gesture and imitate it concurrently with a demonstration provided by the examiner 11,12) . The assessment of the gesture imitation is a significant predictor of questionnaire ratings of dependency given by health care-givers 2,14) .…”