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Functional brain imaging in apraxia

D A Kareken1, F Unverzagt, K Caldemeyer

  • 1Department of Neurology, Indiana University School of Medicine, and the Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis 46202, USA. dkareken@.iupui.edu

Archives of Neurology
|January 27, 1998
PubMed
Summary

Functional neuroimaging reveals that apraxia involves widespread brain dysfunction, particularly in parietal and frontal regions. This challenges the theory of localized knowledge storage for skilled movements.

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Area of Science:

  • Neuroscience
  • Neurology

Background:

  • Limited functional neuroimaging studies exist for apraxia, despite known structural lesions.
  • This study utilized positron emission tomography (PET) to investigate cerebral glucose metabolism in a patient with apraxia.

Observation:

  • A 65-year-old woman presented with progressive difficulties in object manipulation, writing, and speech.
  • Neurological and neuropsychological assessments revealed ideomotor and buccofacial apraxia.
  • Magnetic resonance imaging (MRI) showed generalized atrophy and mild ischemic changes.

Findings:

  • Positron emission tomography (PET) revealed hypometabolism in posterior frontal, supplementary motor, and parietal regions, with greater involvement on the left.
  • A focal metabolic deficit was identified in the angular gyrus.

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  • Despite apraxia, the patient demonstrated preserved gesture recognition.

    • Implications:

    • The findings suggest that knowledge of limb praxis is not solely stored in the dominant parietal cortex.
    • Gesture comprehension may be more diffusely represented in the brain.
    • This challenges existing theories on the neural basis of apraxia and skilled motor control.