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Continuum (Minneapolis, Minn.) Dec 2021Limb apraxia is one of the most common and most disabling disorders caused by brain damage. However, apraxia is one of the least recognized disorders associated with... (Review)
Review
PURPOSE OF REVIEW
Limb apraxia is one of the most common and most disabling disorders caused by brain damage. However, apraxia is one of the least recognized disorders associated with cerebral disease. This article discusses the signs and symptoms of, means of testing for, the pathophysiology of, and possible management of upper limb apraxia.
RECENT FINDINGS
Upper limb apraxia has four major forms: ideomotor, limb-kinetic, conceptual, and ideational. Although recent findings are included in this article, a full understanding of these disorders, including the means of testing, their possible pathophysiology, and the diseases that may cause these disorders, requires that some older literature is also discussed.
SUMMARY
This article guides clinicians in testing for and diagnosing the different forms of upper limb apraxia, identifying the underlying diseases that may cause apraxia, managing the different forms of the disorder, and possible forms of rehabilitation.
Topics: Apraxias; Humans; Upper Extremity
PubMed: 34881728
DOI: 10.1212/CON.0000000000001014 -
Current Neurology and Neuroscience... Nov 2004In this review, we present a summary of some of the most pertinent new research on aspects of apraxia. Rather than attempt a review of all neurologic syndromes that have... (Review)
Review
In this review, we present a summary of some of the most pertinent new research on aspects of apraxia. Rather than attempt a review of all neurologic syndromes that have been identified as forms of apraxia, such as buccofacial, truncal, apraxia of eye opening, and apraxia of speech, we focus on current literature and trends in the study of limb apraxia. Although the classic empirical approach to the study of apraxia has been through systematic neuropsychologic assessment of various aspects of the syndrome, questions remain regarding the exact neural substrate that forms the foundation of the praxis system. More recent work using sophisticated neuroimaging methods has yielded a wealth of new data that contributes significantly to our understanding of the neuroanatomic correlates of this complex disorder. In addition, the results of recent sophisticated neuropsychologic studies have suggested modifications to classic cognitive models of apraxia. A discussion of current work and directions for future research are also provided.
Topics: Apraxias; Brain; Cognition; Diagnostic Imaging; Humans; Models, Neurological; Neuropsychological Tests
PubMed: 15509449
DOI: 10.1007/s11910-004-0071-z -
Seminars in Speech and Language Feb 2018Apraxia of speech (AOS) is a motor speech disorder that disrupts the planning and programming of speech motor movements. In the acute stage of stroke recovery, AOS... (Review)
Review
Apraxia of speech (AOS) is a motor speech disorder that disrupts the planning and programming of speech motor movements. In the acute stage of stroke recovery, AOS following unilateral (typically) left hemisphere stroke can occur alongside dysarthria, an impairment in speech execution and control, and/or aphasia, a higher-level impairment in language function. At this time, perceptual evaluation (the systematic, although subjective, description of speech and voice characteristics) is perhaps the only "gold standard" for differential diagnosis when it comes to motor speech disorders. This poses a challenge for speech-language pathologists charged with the evaluation of poststroke communication abilities, as distinguishing production impairments associated with AOS from those that can occur in aphasia and/or dysarthria can be difficult, especially when more than one deficit is present. Given the need for more objective, reliable methods to identify and diagnose AOS, several studies have turned to acoustic evaluation and neuroimaging to supplement clinical assessment. This article focuses on these recent advances. Studies investigating acoustic evaluation of AOS will be reviewed, as well as those that have considered the extent that neuroimaging can guide clinical decision making. Developments in the treatment of AOS will also be discussed. Although more research is needed regarding the use of these methods in everyday clinical practice, the studies reviewed here show promise as emerging tools for the management of AOS.
Topics: Apraxias; Diagnosis, Differential; Humans; Neuroimaging; Speech; Speech Acoustics; Speech Disorders; Speech Production Measurement; Stroke
PubMed: 29359303
DOI: 10.1055/s-0037-1608853 -
Journal of Clinical and Experimental... Feb 2023To investigate the role and influence of apraxia regarding dementia severity in Alzheimer's disease (AD). In addition, to examine whether apraxia or its association to... (Review)
Review
INTRODUCTION
To investigate the role and influence of apraxia regarding dementia severity in Alzheimer's disease (AD). In addition, to examine whether apraxia or its association to dementia severity show distinct characteristics between typical and atypical variants of AD, that commonly include frontal, logopenic, posterior, and Down's syndrome variant.
METHOD
The search conducted on 4 December 2020 in the Cinahl, Ovid Medline, PsycArticles, PsycInfo, Scopus and Web of Science databases yielded 251 non-duplicate records published since 2000. Ten records examining the association between Clinical Dementia Rating (CDR) scores and apraxia in AD were included in the review.
RESULTS
Dementia severity was related to apraxia in AD, and the prevalence and severity of apraxia increased as dementia progressed. Constructional, ideomotor (imitation of meaningless gestures), orofacial, speech, gait, and total praxis, including constructional, ideomotor, and ideational praxis, tasks differentiated dementia severity in AD. In the atypical variants of AD apraxia occurred frequently but because of the small number of participants, no statistical analyses were available.
CONCLUSIONS
The results highlight the need for extensive assessment of AD severity, and praxis assessment throughout the disease course. Apraxia affects the independent functioning and communication of the patient, tool use, and the ability to perform activities of daily living. Apraxia occurs frequently in AD and other neurodegenerative diseases, and apraxia assessment has shown to differentiate AD from other neurodegenerative diseases, particularly frontotemporal dementia. Thus, apraxia assessment serves in recognizing the atypical variants of AD as well.
Topics: Humans; Alzheimer Disease; Activities of Daily Living; Neuropsychological Tests; Apraxias; Frontotemporal Dementia
PubMed: 37039061
DOI: 10.1080/13803395.2023.2199971 -
Revue Neurologique 2017Gestural apraxia was first described in 1905 by Hugo Karl Liepmann. While his description is still used, the actual terms are often confusing. The cognitive approach... (Review)
Review
Gestural apraxia was first described in 1905 by Hugo Karl Liepmann. While his description is still used, the actual terms are often confusing. The cognitive approach using models proposes thinking of the condition in terms of production and conceptual knowledge. The underlying cognitive processes are still being debated, as are also the optimal ways to assess them. Several neuroimaging studies have revealed the involvement of a left-lateralized frontoparietal network, with preferential activation of the superior parietal lobe, intraparietal sulcus and inferior parietal cortex. The presence of apraxia after a stroke is prevalent, and the incidence is sufficient to propose rehabilitation.
Topics: Apraxias; Brain; History, 20th Century; History, 21st Century; Humans; Neuroimaging; Neuropsychological Tests; Psychomotor Performance; Stroke
PubMed: 28844701
DOI: 10.1016/j.neurol.2017.07.005 -
Current Neurology and Neuroscience... Nov 2019This chapter focuses on limb apraxia, a cognitive-motor disorder of learned skilled movement, and the nature of the spatiotemporal errors that disrupt movement sequences. (Review)
Review
PURPOSE OF REVIEW
This chapter focuses on limb apraxia, a cognitive-motor disorder of learned skilled movement, and the nature of the spatiotemporal errors that disrupt movement sequences.
RECENT FINDINGS
A cognitive model that attempts to reconcile conceptual and preparatory aspects of the motor program with perceptual and kinematic features will be discussed. An update on the localization of the praxis network will be provided. In addition, a long-held view that limb apraxia does not have ecological relevance will be disputed in the context of studies that have shown that limb apraxia (i) is one of the most important predictors of increased caregiver burden and (ii) is associated with impaired activities of daily living in post-stroke patients. This review summarizes current screening tools and the few randomized clinical controlled treatment studies to date. Limb apraxia is underdiagnosed and very few therapeutic options are available. Cognitive process models should be used to inform future controlled multi-modal treatment strategies.
Topics: Activities of Daily Living; Apraxias; Humans; Models, Neurological
PubMed: 31713690
DOI: 10.1007/s11910-019-0989-9 -
Rhode Island Medical Journal (2013) Mar 2022
Topics: Apraxias; Humans
PubMed: 35211706
DOI: No ID Found -
American Journal of Speech-language... Aug 2014To present a systematic review of single-case experimental treatment studies for childhood apraxia of speech (CAS). (Review)
Review
PURPOSE
To present a systematic review of single-case experimental treatment studies for childhood apraxia of speech (CAS).
METHOD
A search of 9 databases was used to find peer-reviewed treatment articles from 1970 to 2012 of all levels of evidence with published communication outcomes for children with CAS. Improvement rate differences (IRDs) were calculated for articles with replicated (n > 1), statistically compared treatment and generalization evidence.
RESULTS
Forty-two articles representing Phase I and II single-case experimental designs (SCEDs; n = 23) or case series or description studies ( n = 19) were analyzed. Six articles showed high CAS diagnosis confidence. Of the 13 approaches within the 23 SCED articles, treatments were primarily for speech motor skills ( n = 6), linguistic skills ( n = 5), or augmentative and alternative communication ( n = 2). Most participants responded positively to treatment, but only 7 of 13 approaches in SCED studies reported maintenance and/or generalization of treatment effects. Three approaches had preponderant evidence (Smith, 1981). IRD effect sizes were calculated for Integral Stimulation/Dynamic Temporal and Tactile Cueing, Rapid Syllable Transition Treatment, and Integrated Phonological Awareness Intervention.
CONCLUSIONS
At least 3 treatments have sufficient evidence for Phase III trials and interim clinical practice. In the future, efficacy needs to be established via maintenance and generalization measures.
Topics: Apraxias; Awareness; Child; Combined Modality Therapy; Generalization, Psychological; Humans; Longitudinal Studies; Phonetics; Speech Production Measurement; Speech Therapy; Treatment Outcome; Vocabulary
PubMed: 24686844
DOI: 10.1044/2014_AJSLP-13-0035 -
American Journal of Speech-language... Feb 2020Purpose The purpose of this article is to describe a treatment approach, Dynamic Temporal and Tactile Cueing (DTTC), and to provide clinicians and clinical researchers a... (Review)
Review
Purpose The purpose of this article is to describe a treatment approach, Dynamic Temporal and Tactile Cueing (DTTC), and to provide clinicians and clinical researchers a clear understanding of the theory and principles that contributed to the design of the treatment as well as the clinical decisions that must be made when implementing it. While brief descriptions of DTTC have been provided in textbooks, a complete summary of the rationale, essential elements, method, and procedures has not yet been published. Such a summary is important so that clinicians can gain a better understanding of and more confidence in using the method for appropriate children. Furthermore, this article provides clinicians and clinical researchers essential information for measurement of fidelity. Method The important elements of the DTTC method with rationale for their inclusion are described. The temporal hierarchy of DTTC is depicted, and the dynamic procedure is described in detail, with suggestions for fidelity measurement. Finally, a discussion of important decisions clinicians must make when implementing DTTC is presented. Conclusions The goal of DTTC is to improve the efficiency of neural processing for the development and refinement of sensorimotor planning and programming. The rationale for DTTC in general, as well as the key elements important to its administration, are supported by models of speech production and theories of motor learning. Important clinical decisions regarding stimuli, organization of practice, and feedback are based on principles of motor learning in order to facilitate acquisition, retention, and continued improvement of motor speech skills.
Topics: Apraxias; Child; Cues; Humans; Motor Skills; Speech Disorders; Speech-Language Pathology
PubMed: 31846588
DOI: 10.1044/2019_AJSLP-19-0005 -
Current Neurology and Neuroscience... Nov 2008Apraxia is classically defined as difficulty performing learned, skilled gestures. In this review, we describe the range of motor impairments classified as apraxia,... (Review)
Review
Apraxia is classically defined as difficulty performing learned, skilled gestures. In this review, we describe the range of motor impairments classified as apraxia, focusing on ideomotor limb apraxia. We present several prominent models of praxis to explain the variety of difficulties seen in patients with apraxia. We also discuss the large-scale frontal-parietal-basal ganglia network thought to underlie praxis. In this context, we highlight the common occurrence of limb apraxia in corticobasal degeneration, a neurodegenerative condition characterized by frontal, parietal, and basal ganglia disease.
Topics: Apraxia, Ideomotor; Apraxias; Behavior; Extremities; Humans; Models, Biological; Motor Activity; Neuropsychological Tests; Psychomotor Performance
PubMed: 18957186
DOI: 10.1007/s11910-008-0078-y