Graduate Department of Rehabilitation Science, University of Toronto, Canada.
Brain Cogn. 2010 Apr;72(3):483-90. doi: 10.1016/j.bandc.2010.01.004. Epub 2010 Feb 18.
The study investigated performance on pantomime and imitation of transitive and intransitive gestures in 80 stroke patients, 42 with left (LHD) and 38 with right (RHD) hemisphere damage. Patients were also categorized in two groups based on the time that has elapsed between their stroke and the apraxia assessment: acute-subacute (n=42) and chronic (n=38). In addition, patterns of performance in apraxia were examined. We expected that acute-subacute patients would be more impaired than chronic patients and that LHD patients would be more impaired than RHD patients, relative to controls. The hemisphere prediction was confirmed, replicating previous findings. The frequency of apraxia was also higher in all LHD time post-stroke groups. The most common impairment after LHD was impairment in both pantomime and imitation in both transitive and intransitive gestures. Selective deficits in imitation were more frequent after RHD for transitive gestures but for intransitive gestures they were more frequent after LHD. Patients were more impaired on imitation than pantomime, relative to controls. In addition, after looking at both gesture types concurrently, we have described cases of patients who suffered deficits in pantomime of intransitive gestures with preserved performance on transitive gestures. Such cases show that the right hemisphere may be in some cases critical for the successful pantomime of intransitive gestures and the neural networks subserving them may be distinct. Chronic patients were also less impaired than acute-subacute patients, even though the difference did not reach significance. A longitudinal study is needed to examine the recovery patterns in both LHD and RHD patients.
该研究调查了 80 名中风患者（左半球损伤 42 例，右半球损伤 38 例）在模仿和手势模拟任务上的表现。这些患者还根据中风和失用症评估之间的时间间隔分为两组：急性-亚急性（n=42）和慢性（n=38）。此外，还检查了失用症的表现模式。我们预计，急性-亚急性患者的表现会比慢性患者更差，而且左半球损伤患者的表现会比右半球损伤患者更差，与对照组相比。该研究结果与之前的发现一致，验证了大脑半球的预测。所有左半球损伤的中风后时间组的失用症发生率也更高。最常见的损伤是在所有过渡性和非过渡性手势的模仿和模仿中都出现损伤。对于过渡性手势，右半球损伤后更常出现选择性模仿障碍，但对于非过渡性手势，左半球损伤后更常出现这种情况。与对照组相比，患者在模仿上的表现比在模仿上更差。此外，在同时观察两种手势类型后，我们描述了一些患者在过渡性手势的模仿中出现缺陷，但在非过渡性手势的过渡性手势中表现正常。这种情况表明，右半球在某些情况下可能对非过渡性手势的成功模仿至关重要，并且支持它们的神经网络可能是不同的。慢性患者的表现也比急性-亚急性患者差，尽管差异没有达到显著水平。需要进行一项纵向研究，以检查左半球和右半球损伤患者的恢复模式。
