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Seminars in Speech and Language Nov 2002Prosody is a complex process that involves modulation of pitch, loudness, duration, and linearity in the acoustic stream to serve linguistic and affective communication... (Review)
Review
Prosody is a complex process that involves modulation of pitch, loudness, duration, and linearity in the acoustic stream to serve linguistic and affective communication goals. It arises from the interaction of distributed neural networks that may be anatomically and functionally lateralized. Intrinsic prosody is mediated largely through left hemisphere mechanisms and encompasses those elements of linguistic microstructure (e.g., syllabic magnitudes and durations, basic consonantal and vocalic gesture specifications, and so) that yield the segmental aspects of speech. Extrinsic prosody is processed primarily by right hemisphere (RH) mechanisms and involves manipulation of intonation across longer perceptual groupings. Intrinsic prosody deficits can lead to several core symptoms of speech apraxia such as difficulty with utterance initiation and syllable transitionalization and may lead to the establishment of inappropriate syllable boundaries. The intrinsic prosody profiles associated with acquired apraxia of speech, developmental speech apraxia, and ataxic dysarthria may aid in the clinical differentiation of these disorders.
Topics: Apraxias; Cerebellum; Humans; Phonetics; Severity of Illness Index; Speech Acoustics; Speech Production Measurement
PubMed: 12461724
DOI: 10.1055/s-2002-35799 -
Fortschritte Der Neurologie-Psychiatrie Jul 2008Apraxias are disorders of motor cognition that cannot be explained by basic sensorimotor deficits or aphasia. The relatively high frequency of apraxia (approximately... (Review)
Review
Apraxias are disorders of motor cognition that cannot be explained by basic sensorimotor deficits or aphasia. The relatively high frequency of apraxia (approximately half of all patients with left-hemispheric stroke suffer from apraxia during the acute phase) as well as its prognostic value for determining the outcome of rehabilitative therapy clearly convey the necessity of more comprehensive research into the pathophysiology of apraxia in order to develop new therapeutic strategies. In recent years, functional imaging (PET and fMRI) has helped to provide important new insights into the pathophysiology of ideomotor apraxia (defective movement plan) and ideational apraxia (defective action concept). In this review, the neural bases for the clinically observed dissociations between the imitation of abstract and symbolic movements (as in ideomotor apraxia) and for the object-trigger system (which is disturbed in ideational apraxia) will be exemplified. Furthermore, we will recapitulate recent studies that provide evidence for the complementary functions of the right and left parietal cortices in the spatial and temporal organization of complex, object-related actions. The particular importance of the left parietal cortex for motor cognition is further supported by studies examining the integration of spatial and temporal movement information during the generation of a movement plan as well as by the generation of such movement plans in the left parietal cortex independent from the hand that executes the movement.
Topics: Apraxias; Brain; Humans; Magnetic Resonance Imaging; Parietal Lobe; Positron-Emission Tomography
PubMed: 18604774
DOI: 10.1055/s-2008-1038206 -
International Journal of Psychiatry in... 1992A case is described in which a patient had pseudoneurological symptoms that were present only upon direct observation or when the patient was in clinical test...
A case is described in which a patient had pseudoneurological symptoms that were present only upon direct observation or when the patient was in clinical test situations. The differential diagnosis of apraxia is discussed as well as clinical suggestions for evaluating patients with suspected factitious apraxia.
Topics: Adult; Amnesia; Apraxias; Comorbidity; Craniocerebral Trauma; Factitious Disorders; Female; Humans; MMPI; Malingering; Movement Disorders; Neuropsychological Tests; Somatoform Disorders; Videotape Recording
PubMed: 1487391
DOI: 10.2190/9HK8-C888-5A6N-QUFK -
Neuroscience and Biobehavioral Reviews Jul 2024Limb apraxia is a motor disorder frequently observed following a stroke. Apraxic deficits are classically assessed with four tasks: tool use, pantomime of tool use,... (Meta-Analysis)
Meta-Analysis Review
Limb apraxia is a motor disorder frequently observed following a stroke. Apraxic deficits are classically assessed with four tasks: tool use, pantomime of tool use, imitation, and gesture understanding. These tasks are supported by several cognitive processes represented in a left-lateralized brain network including inferior frontal gyrus, inferior parietal lobe (IPL), and lateral occipito-temporal cortex (LOTC). For the past twenty years, voxel-wise lesion symptom mapping (VLSM) studies have been used to unravel the neural correlates associated with apraxia, but none of them has proposed a comprehensive view of the topic. In the present work, we proposed to fill this gap by performing a systematic Anatomic Likelihood Estimation meta-analysis of VLSM studies which included tasks traditionally used to assess apraxia. We found that the IPL was crucial for all the tasks. Moreover, lesions within the LOTC were more associated with imitation deficits than tool use or pantomime, confirming its important role in higher visual processing. Our results questioned traditional neurocognitive models on apraxia and may have important clinical implications.
Topics: Humans; Apraxias; Brain Mapping; Brain; Likelihood Functions; Brain Injuries; Stroke
PubMed: 38754714
DOI: 10.1016/j.neubiorev.2024.105720 -
Sleep Dec 2019Early in life impairment of orofacial growth leads to sleep-disordered breathing (SDB). Normal lingual gnosis and praxis are part of this early development related to...
STUDY OBJECTIVES
Early in life impairment of orofacial growth leads to sleep-disordered breathing (SDB). Normal lingual gnosis and praxis are part of this early development related to the normal sensorimotor development of the tongue and surrounding oral musculature. The aim of this retrospective study was to explore if lingual praxia is impaired in both SDB children and adults and if there is an association to craniofacial morphology.
METHODS
The ability to perform simple tongue maneuvers was investigated in 100 prepubertal SDB children and 150 SDB adults (shown with polysomnography). All individuals had a clinical investigation by specialists to assess any orofacial growth impairment and the elements potentially behind this impairment. In a subgroup of individuals both able and unable to perform the maneuvers, we also performed a blind recognition of forms placed in the mouth.
RESULTS
A subgroup of pediatric and adult SDB patients presented evidence not only of orofacial growth impairment, but also apraxia independent of age and severity of OSA.
CONCLUSIONS
By 3 years of age, children should be able to perform requested tongue maneuvers and have oral form recognition. Abnormal gnosis-praxis was noted, independent of age in SDB children and adults, demonstrating that an abnormal functioning of the tongue in the oral cavity during early development can be detected. Both children and adults with SDB may present similar absences of normal oral development very early in life and a similar presentation of apraxia, suggesting that the distinction of SDB in children versus adults may not be relevant.
Topics: Adult; Apraxias; Child; Child, Preschool; Cognition; Female; Humans; Male; Middle Aged; Polysomnography; Retrospective Studies; Sleep Apnea, Obstructive; Tongue
PubMed: 31581285
DOI: 10.1093/sleep/zsz168 -
Journal of Neurology Apr 2010The clinical and neuroanatomical correlates of specific apraxias in neurodegenerative disease are not well understood. Here we addressed this issue in progressive...
The clinical and neuroanatomical correlates of specific apraxias in neurodegenerative disease are not well understood. Here we addressed this issue in progressive nonfluent aphasia (PNFA), a canonical subtype of frontotemporal lobar degeneration that has been consistently associated with apraxia of speech (AOS) and in some cases orofacial apraxia, limb apraxia and/or parkinsonism. Sixteen patients with PNFA according to current consensus criteria were studied. Three patients had a corticobasal syndrome (CBS) and two a progressive supranuclear palsy (PSP) syndrome. Speech, orofacial and limb praxis functions were assessed using the Apraxia Battery for Adults-2 and a voxel-based morphometry (VBM) analysis was conducted on brain MRI scans from the patient cohort in order to identify neuroanatomical correlates. All patients had AOS based on reduced diadochokinetic rate, 69% of cases had an abnormal orofacial apraxia score and 44% of cases (including the three CBS cases and one case with PSP) had an abnormal limb apraxia score. Severity of orofacial apraxia (but not AOS or limb apraxia) correlated with estimated clinical disease duration. The VBM analysis identified distinct neuroanatomical bases for each form of apraxia: the severity of AOS correlated with left posterior inferior frontal lobe atrophy; orofacial apraxia with left middle frontal, premotor and supplementary motor cortical atrophy; and limb apraxia with left inferior parietal lobe atrophy. Our findings show that apraxia of various kinds can be a clinical issue in PNFA and demonstrate that specific apraxias are clinically and anatomically dissociable within this population of patients.
Topics: Aged; Aphasia; Apraxias; Brain; Brain Mapping; Female; Humans; Magnetic Resonance Imaging; Male; Neurologic Examination; Neuropsychological Tests
PubMed: 19908082
DOI: 10.1007/s00415-009-5371-4 -
Cerebral Cortex (New York, N.Y. : 1991) Apr 2024Apraxia localization has relied on voxel-based, lesion-symptom mapping studies in left hemisphere stroke patients. Studies on the neural substrates of different...
Apraxia localization has relied on voxel-based, lesion-symptom mapping studies in left hemisphere stroke patients. Studies on the neural substrates of different manifestations of apraxia in neurodegenerative disorders are scarce. The primary aim of this study was to look into the neural substrates of different manifestations of apraxia in a cohort of corticobasal syndrome patients (CBS) by use of cortical thickness. Twenty-six CBS patients were included in this cross-sectional study. The Goldenberg apraxia test (GAT) was applied. 3D-T1-weighted images were analyzed via the automated recon-all Freesurfer version 6.0 pipeline. Vertex-based multivariate General Linear Model analysis was applied to correlate GAT scores with cortical thickness. Deficits in imitation of meaningless gestures correlated with bilateral superior parietal atrophy, extending to the angular and supramarginal gyri, particularly on the left. Finger imitation relied predominantly on superior parietal lobes, whereas the left angular and supramarginal gyri, in addition to superior parietal lobes, were critical for hand imitation. The widespread bilateral clusters of atrophy in CBS related to apraxia indicate different pathophysiological mechanisms mediating praxis in neurodegenerative disorders compared to vascular lesions, with implications both for our understanding of praxis and for the rehabilitation approaches of patients with apraxia.
Topics: Humans; Corticobasal Degeneration; Cross-Sectional Studies; Apraxias; Magnetic Resonance Imaging; Neurodegenerative Diseases; Atrophy; Imitative Behavior
PubMed: 38629797
DOI: 10.1093/cercor/bhae154 -
Der Nervenarzt Oct 2022
Topics: Apraxias; Humans; Magnetic Phenomena; Speech; Transcranial Magnetic Stimulation; Treatment Outcome
PubMed: 35274149
DOI: 10.1007/s00115-022-01261-x -
Clinical Linguistics & Phonetics 2008The role of embodiment in communication is attracting an increased interest. This interest is to some extent caused by hypotheses and findings concerning mirror neurons... (Review)
Review
The role of embodiment in communication is attracting an increased interest. This interest is to some extent caused by hypotheses and findings concerning mirror neurons in macaques, that is, neurons that are activated by production as well as perception of, for example, a certain movement of action. Mirror neurons seem to provide a fairly simple mechanism for acting, perceiving, imitating and pantomime, which could be crucial to the development of human communication and language. A number of theories try to extend similar ideas in describing human embodied communication. Some of the consequences of these theories are: (1) the close relation between speech and gestures; (2) the close relation between speech/language and praxis; and (3) the reconsideration of the importance for communication of more automatized versus more controlled processing. The purpose here is to point to possible consequences for clinical research and therapy concerning language disorders.
Topics: Animals; Aphasia; Apraxias; Biological Evolution; Communication; Gestures; Humans; Imitative Behavior; Macaca; Motor Cortex; Neurons; Nonverbal Communication; Psychomotor Performance; Speech; Visual Perception
PubMed: 18415730
DOI: 10.1080/02699200801918879 -
Neurology Aug 2016
Topics: Apraxias; Humans; Neurology
PubMed: 27502963
DOI: 10.1212/WNL.0000000000002954