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Tool use and action planning in apraxia.

Alan Sunderland¹, Leigh Wilkins¹, Rob Dineen²

¹School of Psychology, University of Nottingham, Nottingham NG7 2RD, United Kingdom.

Neuropsychologia

|January 19, 2011

Summary

Patients with apraxia (a motor disorder) struggle with tool use, particularly when grasping inverted objects. This suggests difficulties with spatial relationships rather than just tool knowledge.

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Area of Science:

Neuroscience
Cognitive Psychology
Rehabilitation Medicine

Background:

Apraxia is often linked to left inferior parietal lesions, traditionally interpreted as damage to tool-use representations.
Most research focuses on pantomime, not actual tool handling, leaving alternative explanations unexplored.

Purpose of the Study:

To investigate whether apraxia impairs tool-use representations or the cognitive processing of spatial relationships necessary for complex actions.
To differentiate between theories of apraxia by examining tool grasping in real-world scenarios.

Main Methods:

Four patients with apraxia and 10 controls performed rapid reaching tasks involving tools and abstract objects.
Tasks included conditions of time pressure and divided attention to assess hand-tool spatial relationship processing.

Main Results:

Apraxic patients frequently failed to orient their hands correctly for inverted tools, unlike grasping abstract objects or avoiding barriers.
Grasping errors correlated with apraxia severity, and wrist rotation timing differed for tools versus abstract objects.
These findings challenge purely representational theories of apraxia.

Conclusions:

Data support the theory that apraxia involves impaired cognitive processing of spatial relationships for tool use, not just degraded tool-use representations.
The findings highlight the importance of spatial processing in apraxia and suggest limitations of current theories in explaining all observed deficits.