Foundas A L, Macauley B L, Raymer A M, Maher L M, Rothi L J, Heilman K M
Department of Psychiatry and Neurology, Tulane University School of Medicine and Veterans Affairs Medical Center, New Orleans 70112-2632, USA.
Neuropsychiatry Neuropsychol Behav Neurol. 1999 Jul;12(3):161-6.
Ideomotor apraxia was studied in patients with Alzheimer disease (AD) and unilateral left hemispheric damaged (LHD) stroke to determine whether these groups differed.
Given that the neuropathology of AD is bilateral and more diffuse than the localized involvement in patients after an LHD stroke, and given that the cognitive deficits in AD are more widespread than in LHD stroke, the authors predicted that patients with these disorders would differ in response to an auditory command task administered to evaluate ideomotor apraxia, and that the two patient groups would be significantly more impaired than healthy matched control subjects.
Twenty-one persons were studied, including equal numbers of patients with AD, patients with unilateral LHD stroke, and control subjects. An auditory command test of limb apraxia was administered and videotaped to score performance and to code spatial-temporal or content errors.
The patients with AD and LHD stroke were significantly more impaired than healthy control subjects. Whereas the patients with AD and LHD stroke were equally apraxic and did not differ in their performance of transitive limb movements, the patients with AD were significantly more impaired than the patients with stroke when performing intransitive limb movements. A positive correlation was found between severity of dementia and severity of apraxia in the patients with AD. The patients with LHD stroke were as likely to make spatial-temporal as content errors when performing intransitive limb movements, whereas the patients with AD made content errors only. Error types produced with transitive limb movements did not differ between groups; spatial-temporal errors were the most common errors made both by patients with AD and patients with LHD stroke.
As predicted, patients with AD and with LHD stroke were impaired when producing limb movements after auditory command, and both patient groups were significantly more impaired than the healthy adults. Patients with AD were significantly more impaired than patients with stroke when performing intransitive limb movements, and error types differed by group. Patients with AD and patients with stroke were equally impaired when performing transitive movements, and error types did not differ by group. Patients with ideomotor apraxia are often degraded in their production of transitive and intransitive movements, and the observation that performance may differ depending on the type of limb movement suggests that movement representations for transitive and intransitive movements may be at least partially independent.
对阿尔茨海默病（AD）患者和左侧半球单侧受损（LHD）的中风患者进行观念运动性失用症研究，以确定这两组患者是否存在差异。
鉴于AD的神经病理学是双侧性的，且比LHD中风患者的局限性病变更为弥漫，同时鉴于AD患者的认知缺陷比LHD中风患者更为广泛，作者预测，这两种疾病的患者在接受用于评估观念运动性失用症的听觉指令任务时会有不同表现，且这两组患者的受损程度会明显高于健康对照受试者。
对21人进行了研究，其中AD患者、单侧LHD中风患者和对照受试者人数相等。进行了一项肢体失用症的听觉指令测试，并进行录像，以对表现进行评分，并对空间 - 时间或内容错误进行编码。
AD患者和LHD中风患者的受损程度明显高于健康对照受试者。虽然AD患者和LHD中风患者的失用症程度相同，且在执行传递性肢体运动时表现无差异，但在执行非传递性肢体运动时，AD患者的受损程度明显高于中风患者。在AD患者中，痴呆严重程度与失用症严重程度之间存在正相关。LHD中风患者在执行非传递性肢体运动时出现空间 - 时间错误和内容错误的可能性相同，而AD患者仅出现内容错误。传递性肢体运动产生的错误类型在两组之间没有差异；空间 - 时间错误是AD患者和LHD中风患者最常见的错误。
正如预测的那样，AD患者和LHD中风患者在接受听觉指令后产生肢体运动时存在受损情况，且两组患者的受损程度均明显高于健康成年人。在执行非传递性肢体运动时，AD患者的受损程度明显高于中风患者，且错误类型因组而异。在执行传递性运动时，AD患者和中风患者的受损程度相同，且错误类型不因组而异。观念运动性失用症患者在产生传递性和非传递性运动时往往表现下降，并且观察到表现可能因肢体运动类型而异，这表明传递性和非传递性运动的运动表征可能至少部分独立。
