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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Limb apraxia in a patient with cerebral infarct: diffusion tensor tractography study
Ji Heon Hong1, Jun Lee, Yoon Woo Cho
1Department of Physical Therapy, Sun Moon University, Asan-Si, Republic of Korea.
Neurorehabilitation
|June 8, 2012
Summary
This study details a patient with ideomotor apraxia (IMA) and limb-kinetic apraxia (LKA) after a cerebral infarct. Diffusion tensor tractography revealed neural tract injuries linked to these motor control deficits.
Area of Science:
- Neuroscience
- Neurology
- Radiology
Background:
- Cerebral infarcts can lead to complex motor deficits, including apraxias.
- Ideomotor apraxia (IMA) and limb-kinetic apraxia (LKA) represent distinct impairments in motor planning and execution.
Observation:
- A 67-year-old male presented with right upper extremity paralysis and weakness following a left frontal lobe cerebral infarct.
- Post-infarct, the patient exhibited impaired fine motor control, characterized by slow, clumsy grasp-release movements, despite intact motor planning.
- Diffusion tensor tractography (DTT) revealed partial injuries in specific neural tracts of the left hemisphere.
Findings:
- The patient was diagnosed with IMA and LKA, scoring 20 on the IMA test.
- DTT identified injuries in the premotor cortex fibers, supplementary motor area fibers, and superior longitudinal fasciculus.
- These observed tract injuries correlated with the patient's specific apraxia symptoms.
Implications:
- DTT is a valuable tool for visualizing neural tract damage underlying apraxias after stroke.
- Understanding the specific tract injuries can inform rehabilitation strategies for patients with post-stroke motor deficits.
- This case highlights the intricate relationship between specific white matter pathways and complex motor functions.
