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Silveri MC, Lo Monaco MR, Tondinelli A, Leggio M, Olivito G. Clinical and MRI characterization of apraxic syndrome in corticobasal degeneration: A single-case study. Clin Neuropsychol 2024; 38:508-528. [PMID: 37674289 DOI: 10.1080/13854046.2023.2219469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/24/2023] [Indexed: 09/08/2023]
Abstract
Objective: To identify the cortical and subcortical distribution of atrophy and the disorganization of white matter bundles underlying the apraxic disorders in a patient with corticobasal degeneration (CBD). Method: Patient underwent appropriate neuropsychological tasks aimed at identifying the nature of the apraxic disorder and morphometric structural MRI with whole-brain voxel-wise analysis. Results: Progressive limbkinetic apraxia (LKA) with onset in the right upper limb with subsequent extension to the limbs, trunk, orofacial district, and eye movements was documented, associated with element of ideomotor apraxia (IMA). The MRI study showed grey matter atrophy extending to much of the frontal cortex bilaterally, including the precentral cortex, and into the inferior parietal regions. Caudate and putamen were involved on the left. Significant clusters of white matter atrophy were found in the bilateral superior longitudinal fasciculus (SLF), inferior longitudinal fasciculus (ILF) and corpus callosum (CC). Sensory evoked potentials (SEPs) and motor evoked potentials (MEPs) were normal. Conclusion: Previous observations in CBD indicate lack of inhibitory control from the sensory to the primary motor cortex with dysfunctional frontoparietal and cortico-motoneuron projections. Our neuroimaging data are partially consistent with these observations suggesting that the apraxic disorder in our patient might be produced by the disconnection of the primary motor cortex from the parietal areas that prevents selection and control of muscle movements, in the presence of preserved cortico-motoneuron as demonstrated by normal PEM. Apraxic disorders in CBD are high-level deficits of movement control that spare the motoneuron.
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Affiliation(s)
- Maria Caterina Silveri
- Fondazione Policlinico Universitario 'Agostino Gemelli' IRCSS, Rome, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Maria Rita Lo Monaco
- Fondazione Policlinico Universitario 'Agostino Gemelli' IRCSS, Rome, Italy
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alice Tondinelli
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Maria Leggio
- Department of Psychology, Sapienza Università di Roma, Rome, Italy
- Ataxia Research Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Giusy Olivito
- Department of Psychology, Sapienza Università di Roma, Rome, Italy
- Ataxia Research Laboratory, IRCCS Fondazione Santa Lucia, Rome, Italy
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Souza-Couto D, Bretas R, Aversi-Ferreira TA. Neuropsychology of the parietal lobe: Luria's and contemporary conceptions. Front Neurosci 2023; 17:1226226. [PMID: 37928730 PMCID: PMC10623013 DOI: 10.3389/fnins.2023.1226226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
The parietal lobe, constituting approximately 20% of the human brain, comprises two main regions: the somatosensory cortex and the posterior parietal cortex. The former is responsible for receiving and processing information from the organism itself or its external environment, while the latter performs concurrent summaries and higher cognitive functions. The present study seeks to integrate modern research findings with Luria's previous discoveries in order to gain a nuanced understanding of the roles assigned to the parietal lobe as well as its lateralization differences.
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Affiliation(s)
- Dyecika Souza-Couto
- Laboratory of Biomathematics and Physical Anthropology, Federal University of Alfenas, Alfenas, Brazil
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Abbate C, Trimarchi PD, Manzoni L, Quarenghi AM, Salvi GP, Inglese S, Giunco F, Bagarolo R, Mari D, Arosio B. A posterior variant of corticobasal syndrome: Evidence from a longitudinal study of cognitive and functional status in a single case. COGENT PSYCHOLOGY 2018. [DOI: 10.1080/23311908.2018.1452868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- Carlo Abbate
- Geriatric Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via Pace 9, 20122 Milan, Italy
| | - Pietro Davide Trimarchi
- Alzheimer’s Assessment Unit, S. Maria Nascente, Fondazione IRCCS Don Carlo Gnocchi, via Alfonso Capecelatro 66, 20148 Milan, Italy
| | - Laura Manzoni
- Istituto Clinico Quarenghi, via San Carlo 70, 24016 San Pellegrino Terme, Italy
| | | | - Gian Pietro Salvi
- Istituto Clinico Quarenghi, via San Carlo 70, 24016 San Pellegrino Terme, Italy
| | - Silvia Inglese
- Geriatric Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via Pace 9, 20122 Milan, Italy
| | - Fabrizio Giunco
- Alzheimer’s Assessment Unit, S. Maria Nascente, Fondazione IRCCS Don Carlo Gnocchi, via Alfonso Capecelatro 66, 20148 Milan, Italy
| | - Renzo Bagarolo
- Alzheimer’s Assessment Unit, S. Maria Nascente, Fondazione IRCCS Don Carlo Gnocchi, via Alfonso Capecelatro 66, 20148 Milan, Italy
| | - Daniela Mari
- Department of Medical Sciences and Community Health, University of Milan, via Francesco Sforza 35, 20122 Milan, Italy
| | - Beatrice Arosio
- Geriatric Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, via Pace 9, 20122 Milan, Italy
- Department of Medical Sciences and Community Health, University of Milan, via Francesco Sforza 35, 20122 Milan, Italy
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Stamenova V, Roy EA, Szilagyi G, Honjo K, Black SE, Masellis M. Progression of limb apraxia in corticobasal syndrome: neuropychological and functional neuroimaging report of a case series. Neurocase 2015; 21:642-59. [PMID: 25325827 DOI: 10.1080/13554794.2014.964730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The current study described the progression of limb apraxia in seven corticobasal syndrome patients through a comprehensive battery, including both gesture production tasks and conceptual tool/action knowledge tasks. The examination of the behavioral and neuroimaging (SPECT) data revealed two patient subgroups. One group consisted of patients with preserved conceptual tool/action knowledge, relatively mild gesture production and neuropsychological deficits with few significantly hypoperfused regions of interest. The other group consisted of those whose conceptual tool/action knowledge and general cognition eventually deteriorated and who were quite severely affected in their gesture production performance. These patients were characterized by bilateral hypoperfusion in parietal regions and in one case bilateral anterior cingulate regions.
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Affiliation(s)
- Vessela Stamenova
- a Rotman Research Institute , Baycrest/University of Toronto , Toronto , ON , Canada
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5
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There is more than imitation. Cortex 2014; 57:275-6; discussion 306-8. [DOI: 10.1016/j.cortex.2014.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 01/29/2014] [Indexed: 11/21/2022]
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Abstract
SUMMARY Apraxia is a cognitive-motor disorder affecting gestural communication and tool use, and is seen in various neurodegenerative disorders. Apraxia is a major feature of the corticobasal syndrome associated with nonlevodopa-responsive, typically asymmetric parkinsonism. Mild apraxia may also be seen in Parkinson’s disease, at least in later stages of the disease. Furthermore, patients with Alzheimer’s disease or posterior cortical atrophy are prone to develop apraxia during their disease course. However, apraxia may be difficult to dissect from other motor (e.g., dystonia and bradykinesia in corticobasal syndrome) or cognitive (e.g., dysexecutive or semantic memory deficits in Alzheimer’s disease) dysfunction. Therefore, the ecological significance of apraxia in neurodegenerative disorders may not always be obvious. Although treatment protocols for apraxia have been developed in stroke, there is little information on the management of apraxia in neurodegenerative disorders. Owing to their progressive nature, benefits from therapeutic interventions are certainly limited, although some capacity of motor learning may be preserved, at least in earlier disease stages. In advanced cases, management of apraxia should focus on compensatory measures, for instance, on adapting the patient’s environment to their needs, particularly when related to safety and comfort.
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Affiliation(s)
- Stephan Bohlhalter
- Neurology & Neurorehabilitation Center, Department of Internal Medicine, Luzerner Kantonsspital & Department of Clinical Research, University of Bern, 6000 Luzern 16, Switzerland
| | - Francois Osiurak
- Laboratoire d’Etude des Mécanismes Cognitifs (EA 3082), Université Lyon 2, Lyon, France
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7
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Stamenova V, Roy EA, Black SE. Limb apraxia in corticobasal syndrome. Cortex 2011; 47:460-72. [DOI: 10.1016/j.cortex.2010.04.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Revised: 03/31/2010] [Accepted: 04/29/2010] [Indexed: 11/26/2022]
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Kertesz A, McMonagle P. Behavior and cognition in corticobasal degeneration and progressive supranuclear palsy. J Neurol Sci 2010; 289:138-43. [DOI: 10.1016/j.jns.2009.08.036] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
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.
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Affiliation(s)
- Rachel Goldmann Gross
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA
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Stamenova V, Roy EA, Black SE. A Model-Based Approach to Understanding Apraxia in Corticobasal Syndrome. Neuropsychol Rev 2008; 19:47-63. [DOI: 10.1007/s11065-008-9079-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Accepted: 11/20/2008] [Indexed: 10/21/2022]
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11
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Petreska B, Adriani M, Blanke O, Billard AG. Apraxia: a review. PROGRESS IN BRAIN RESEARCH 2007; 164:61-83. [PMID: 17920426 DOI: 10.1016/s0079-6123(07)64004-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Praxic functions are frequently altered following brain lesion, giving rise to apraxia - a complex pattern of impairments that is difficult to assess or interpret. In this chapter, we review the current taxonomies of apraxia and related cognitive and neuropsychological models. We also address the questions of the neuroanatomical correlates of apraxia, the relation between apraxia and aphasia and the analysis of apraxic errors. We provide a possible explanation for the difficulties encountered in investigating apraxia and also several approaches to overcome them, such as systematic investigation and modeling studies. Finally, we argue for a multidisciplinary approach. For example, apraxia should be studied in consideration with and could contribute to other fields such as normal motor control, neuroimaging and neurophysiology.
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Affiliation(s)
- Biljana Petreska
- Learning Algorithms and Systems Laboratory (LASA), Ecole Polytechnique Fédérale de Lausanne (EPFL), EPFL-STI-I2S-LASA, Station 9, CH 1015 Lausanne, Switzerland.
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Buxbaum LJ, Kyle K, Grossman M, Coslett HB. Left Inferior Parietal Representations for Skilled Hand-Object Interactions: Evidence from Stroke and Corticobasal Degeneration. Cortex 2007; 43:411-23. [PMID: 17533764 DOI: 10.1016/s0010-9452(08)70466-0] [Citation(s) in RCA: 180] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patients with ideomotor apraxia (IM) are frequently more impaired in the production and imitation of object-related (transitive) than non-object-related, symbolic (intransitive) gestures, but reasons for this dissociation, and its anatomical underpinnings, remain unclear. Our theoretical model of praxis (Buxbaum, 2001) postulates that left inferior parietal lobe (IPL) gesture representations store information about postures and movements of the body and hand for skillful manipulation of familiar objects; in contrast, bilateral fronto-parietal dynamic calculations provide constantly-updated information about the current position and movement of the body and hand for both familiar and novel, transitive and intransitive movements. This account predicts distinct patterns of IM in patients with left IPL damage versus bilateral fronto-parietal involvement. Consistent with predictions, 16 stroke patients with left IPL damage were more impaired with transitive than intransitive gestures, whereas 4 patients with bilateral fronto-parietal damage due to corticobasal degeneration (CBD) were not [F (1, 18) = 8.5 p < .01]. Additionally, the hand posture component of transitive gestures was the most impaired aspect of gesture in CVA, but tended to be the least impaired aspect of gesture in CBD [F (3, 54) = 5.1, p < .005]. Finally, CVA patients were more impaired with transitive hand postures than meaningless or intransitive hand postures, whereas CBD patients showed the opposite pattern. These data indicate that the left IPL mediates representations of skilled hand-object interactions, as distinct from dynamic coding of the body in space, and suggest that the IPL maps between representations of object identity in the ventral stream and spatial body representations mediated by the dorsal system.
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Affiliation(s)
- Laurel J Buxbaum
- Moss Rehabilitation Research Institute, Philadelphia, PA 19141, USA.
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Mostofsky SH, Dubey P, Jerath VK, Jansiewicz EM, Goldberg MC, Denckla MB. Developmental dyspraxia is not limited to imitation in children with autism spectrum disorders. J Int Neuropsychol Soc 2006; 12:314-26. [PMID: 16903124 DOI: 10.1017/s1355617706060437] [Citation(s) in RCA: 223] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Impaired imitation of skilled gestures is commonly reported in autism. Questions, however, remain as to whether impaired imitation is associated with a more generalized deficit in performance of gestures consistent with a dyspraxia and whether the pattern of errors differs from that observed in typically developing children. To address these questions, praxis in 21 high-functioning children with autism spectrum disorders (ASD) was compared with 24 typically developing controls using a traditional approach in which performance was evaluated through detailed examination of error types. Children with ASD produced significantly fewer correct responses not only during Gesture to Imitation, but also during Gesture to Command and with Tool Use. The pattern of errors in ASD was similar to that of controls with spatial errors being most common in both groups; however, body-part-for-tool errors were more common in children with ASD, suggesting dyspraxia is not entirely attributable to motor deficits. The findings suggest that autism is associated with a generalized praxis deficit, rather than a deficit specific to imitation. In a developmental disorder such as autism, the findings may reflect abnormalities in frontal/parietal-subcortical circuits important for acquisition (i.e., learning) of sensory representations of movement and/or the motor sequence programs necessary to execute them.
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Affiliation(s)
- Stewart H Mostofsky
- Department of Developmental Cognitive Neurology, Kennedy Krieger Institute, Johns Hopkins University School of Medicine, 707 N. Broadway, Baltimore, MD 21205, USA.
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Corticobasal degeneration. NEURODEGENER DIS 2005. [DOI: 10.1017/cbo9780511544873.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ozsancak C, Auzou P, Dujardin K, Quinn N, Destée A. Orofacial apraxia in corticobasal degeneration, progressive supranuclear palsy, multiple system atrophy and Parkinson's disease. J Neurol 2005; 251:1317-23. [PMID: 15592726 DOI: 10.1007/s00415-004-0530-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2003] [Revised: 05/03/2004] [Accepted: 05/06/2004] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine whether the assessment of orofacial praxis is useful for the differential diagnosis of parkinsonian syndromes and to understand the neural mechanisms underlying OFA, searching for the respective roles of cortical and subcortical structures. METHODS Forty-four patients were assessed: 12 with idiopathic Parkinson's disease (IPD), 8 with multiple system atrophy (MSA), 12 with progressive supranuclear palsy (PSP) and 12 with corticobasal degeneration (CBD). An easy bedside scale was used, exploring single gestures, gestures with noise production and multiple sequential gestures. We searched for group and task effects. RESULTS Patients with CBD were significantly more impaired than those with IPD, MSA or PSP (p<0.001). Our assessment was unable to distinguish between the IPD, MSA and PSP groups. There was a clear task effect in CBD with a major impairment in multiple sequential gestures (p<0.0001). CONCLUSION Assessment of orofacial praxis helps in the clinical diagnosis of CBD. Patients with IPD, MSA and PSP did not present with OFA. We suggest that the deficit in multiple sequential gestures in CBD is related to simultaneous lesions of the parietal lobule and the supplementary motor area.
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Affiliation(s)
- Canan Ozsancak
- Service de Neurologie et Pathologie du Mouvement, EA 2683 Clinique Neurologique, CHU de Lille, 59037, Lille Cedex, France.
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Abstract
The presence of cognitive impairment in corticobasal degeneration (CBD) is now widely recognised. Our review of the literature reveals that, although the pattern and severity of neuropsychological impairments can be highly variable across patients, several general trends can be identified. The most characteristic impairments are limb apraxia (usually ideomotor), constructional and visuospatial difficulties, acalculia, frontal dysfunction, and nonfluent aphasia. The limb apraxia is associated with deficits in drawing, copying, and handwriting, but there is emerging evidence that the problems with handwriting are not due exclusively to the apraxia. The findings with respect to episodic memory are more variable, but when there is impairment in this area, it tends to be milder than that seen in Alzheimer's disease. Semantic memory functioning appears relatively preserved but has been poorly studied. Problems with speech are common, and may be due to dysarthria or buccofacial apraxia. Aphasia, although initially considered rare, is in fact a common accompaniment of CBD, may be the presenting feature, and is typically nonfluent in type. More systematic investigation of the clinical and neuropathological overlap between progressive nonfluent aphasia (generally considered to be a form of frontotemporal dementia) and CBD is needed.
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Affiliation(s)
- Naida L Graham
- University Neurology Unit, University of Cambridge, Cambridge, United Kingdom
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Jacobs DH, Adair JC, Macauley B, Gold M, Gonzalez Rothi LJ, Heilman KM. Apraxia in corticobasal degeneration. Brain Cogn 1999; 40:336-54. [PMID: 10413565 DOI: 10.1006/brcg.1999.1085] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Corticobasal degeneration (CBD) is a degenerative disease that often presents with an asymmetric progressive ideomotor limb apraxia. Some apraxic subjects may fail to perform skilled purposive movements on command because they have lost the memories or representations that specify how these movements should be performed (representational deficit). In contrast, other apraxic subjects may have the movement representations but are unable to utilize the information contained in them to execute skilled purposive movements (production-execution deficit). To learn if the apraxic deficit in CBD is induced by a representational or a production-execution deficit, we tested three nondemented subjects with CBD on tasks requiring production of meaningful or meaningless gestures to command, gesture imitation, gesture discrimination, and novel gesture learning. A fourth subject with incomplete data also is presented. The results suggest that the apraxia associated with CBD is initially induced by a production-execution defect with relative sparing of the movement representations.
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Affiliation(s)
- D H Jacobs
- Memory Disorders Clinic, Orlando Regional Healthcare System, Orlando, Florida 32608, USA
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