Brain, Vol. 124, No. 12, 2513-2527,
December 2001
© 2001 Oxford University Press
Cortical and subcortical contributions to ideomotor apraxia
Analysis of task demands and error types
1 Department of Neurology, University of Florida, Gainesville, Florida, 2 Department of Psychology, Louisiana State University, Baton Rouge 3 Deparment of Psychiatry and Neurology, Tulane University School of Medicine, and Neurology Service, Veterans Affairs Medical Center, New Orleans, Louisiana, USA
Correspondence to:
Brenda Hanna-Pladdy, Department of Neurology, University of Florida Health Science Center, 100 South Newell Drive, Room L3-100, Box 100236 UFBI, Gainesville, Florida, 32610-0236, USA pladdybh{at}neurology.ufl.edu
Ideomotor apraxia (IMA) is often associated with damage of the dominant parietal cortex, but many other lesion sites have been implicated suggesting that the praxis system is mediated by a distributed modular network. Although IMA has been reported with subcortical lesions, the role of subcortical structures in the praxis neural network has not been fully addressed. To ascertain the role of subcortical structures in praxis, we compared praxis performance on a variety of tasks in patients with left hemisphere cortical and subcortical lesions. The cortical patients presented with deficits in the production of transitive and intransitive gestures-to-verbal command and imitation, as well as impaired gesture discrimination. In contrast, the subcortical group demonstrated mild production-execution deficits for transitive pantomimes, but normal imitation and discrimination. Qualitative error analysis of production deficits, revealed that both patient groups produced timing errors and the full range of spatial errors. Whereas the subcortical group made more postural errors than the cortical group, sequencing, unrecognizable and no-response errors were only produced by the cortical group. The different profiles of praxis deficits associated with cortical and subcortical lesions, suggests that these structures may have different roles in praxis.
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