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观念运动性失用症:综述

Ideomotor apraxia: a review.

作者信息

Wheaton Lewis A, Hallett Mark

机构信息

Human Motor Control Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1428, United States.

出版信息

J Neurol Sci. 2007 Sep 15;260(1-2):1-10. doi: 10.1016/j.jns.2007.04.014. Epub 2007 May 16.

Abstract

Ideomotor apraxia (IMA) is a disorder traditionally characterized by deficits in properly performing tool-use pantomimes (e.g., pretending to use a hammer) and communicative gestures (e.g., waving goodbye). These deficits are typically identified with movements made to verbal command or imitation. Questions about this disorder relate to its diagnosis, anatomical correlates, physiological mechanisms involved, and the patients in whom IMA is best characterized. In this review, utilizing information presented at an international workshop, we summarize the present state of knowledge about IMA. We include insights on how to distinguish IMA from the other motor apraxias and confounding disorders. We discuss testing for IMA and the need for more rigorous tests that examine more elements, such as imitation, actual use, task selection, and recognizing proper use. From neurophysiological insights, we propose hypotheses of the necessity of networks in praxis performance. We also point out that more neurophysiological knowledge in humans might lead to a better understanding of how different brain structures may aid in the rehabilitation of praxis. While little is known about exactly how rehabilitation may be pursued, biological evidence warrants the further exploration of this issue.

摘要

观念运动性失用症(IMA)是一种传统上以正确执行工具使用模仿动作(例如假装使用锤子)和交流手势(例如挥手告别)存在缺陷为特征的疾病。这些缺陷通常通过对言语指令或模仿做出的动作来识别。关于这种疾病的问题涉及其诊断、解剖学关联、所涉及的生理机制以及最能体现IMA特征的患者。在本综述中,我们利用在一次国际研讨会上展示的信息,总结了关于IMA的当前知识状态。我们纳入了有关如何将IMA与其他运动性失用症和混淆性疾病区分开来的见解。我们讨论了IMA的测试以及对更严格测试的需求,这些测试要检查更多要素,如模仿、实际使用、任务选择以及识别正确使用。从神经生理学见解出发,我们提出了实践表现中网络必要性的假设。我们还指出,更多关于人类的神经生理学知识可能有助于更好地理解不同脑结构如何辅助实践康复。虽然对于如何进行康复的确切情况知之甚少,但生物学证据保证了对这个问题进行进一步探索的合理性。

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