Buxbaum Laurel J, Randerath Jennifer
Moss Rehabilitation Research Institute, Elkins Park, PA, United States.
Motor Cognition Group, Clinical Neuropsychology and Lurija Institute for Rehabilitation and Health Sciences, University of Konstanz, Konstanz; and Schmieder Foundation for Sciences and Research, Allensbach, Germany.
Handb Clin Neurol. 2018;151:349-363. doi: 10.1016/B978-0-444-63622-5.00017-6.
Limb apraxia is a heterogeneous disorder of skilled action and tool use that has long perplexed clinicians and researchers. It occurs after damage to various loci in a densely interconnected network of regions in the left temporal, parietal, and frontal lobes. Historically, a highly classificatory approach to the study of apraxia documented numerous patterns of performance related to two major apraxia subtypes: ideational and ideomotor apraxia. More recently, there have been advances in our understanding of the functional neuroanatomy and connectivity of the left-hemisphere "tool use network," and the patterns of performance that emerge from lesions to different loci within this network. This chapter focuses on the left inferior parietal lobe, and its role in tool and body representation, action prediction, and action selection, and how these functions relate to the deficits seen in patients with apraxia subsequent to parietal lesions. Finally, suggestions are offered for several future directions that will benefit the study of apraxia, including increased attention to research on rehabilitation of this disabling disorder.
肢体失用症是一种关于熟练动作和工具使用的异质性障碍,长期以来一直困扰着临床医生和研究人员。它发生在左颞叶、顶叶和额叶密集互联区域网络中的各个位点受损之后。从历史上看,对失用症研究的高度分类方法记录了与两种主要失用症亚型(观念性失用症和观念运动性失用症)相关的众多表现模式。最近,我们对左半球“工具使用网络”的功能神经解剖学和连通性,以及该网络内不同位点受损后出现的表现模式有了新的认识。本章重点关注左下顶叶及其在工具和身体表征、动作预测和动作选择中的作用,以及这些功能如何与顶叶病变后失用症患者所出现的缺陷相关。最后,针对未来几个有利于失用症研究的方向提出了建议,包括更加关注对这种致残性疾病的康复研究。