A selective impairment of hand posture for object utilization in apraxia

This study reports the case of an apraxic patient who was impaired in all aspects of gestural behavior following bilateral posterior parietal cortex lesions. The main impairment concerned manual prehension of objects during their utilization. The deficit contrasted with both normal movement trajectories of the arm during execution of such gestures, and with accurate manual prehension in the context of simple reaching movements. Although recognition of gestures and pantomimes made by the examiner was preserved, the patient showed a striking inability to visually discriminate or describe manual prehension associated with object utilization. We thus propose the existence of specialized cortical mechanisms for the representation and activation of the postural schemata of the hand required for complex actions.