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Recovery from apraxic deficits and its neural correlate.

M Kusch1,2, C C Schmidt2, L Göden1

  • 1Department of Neurology, University Hospital Cologne, Cologne, Germany.

Restorative Neurology and Neuroscience
|October 5, 2018
PubMed
Summary

Recovery from apraxia after stroke is possible, with limb apraxia showing better improvement than bucco-facial apraxia. Lesions in the left insula correlate with recovery, while parietal lobe and SLF damage predict persistent apraxia.

Keywords:
StrokeVLSMaphasiainsular cortexneurorehabilitation

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Area of Science:

  • Neuroscience
  • Neurology
  • Cognitive Science

Background:

  • Apraxia is a motor cognition deficit impacting tool use and gesture imitation.
  • Limited data exist on stroke-related apraxia recovery and its neural correlates.
  • No prior lesion mapping studies have investigated apraxia recovery mechanisms.

Purpose of the Study:

  • To examine recovery from apraxic deficits post-stroke.
  • To investigate differential recovery patterns between imitation and pantomime tasks.
  • To identify neural correlates of apraxia recovery using lesion mapping.

Main Methods:

  • 39 left hemisphere stroke patients were assessed for apraxia at admission and ~11 days later.
  • Voxel-based lesion-symptom mapping (VLSM) was employed to correlate lesion location with recovery.
  • Clinical imaging data were collected for all participants.

Main Results:

  • Significant recovery from apraxia was observed between assessments.
  • Limb apraxia showed a tendency towards better recovery than bucco-facial apraxia.
  • Left insula lesions correlated with apraxia remission; parietal lobe (IPL) and SLF lesions correlated with persistent deficits.

Conclusions:

  • Lesions in core fronto-parietal praxis network regions (IPL, SLF) lead to more persistent apraxia.
  • Lesions in the left insula, while contributing to apraxia, may allow for better recovery.
  • These findings elucidate the neural basis of apraxia recovery and highlight the role of specific brain regions.