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不同临床样本中的肢体失用症特征。

[Formula: see text] Limb apraxia profiles in different clinical samples.

机构信息

University of Konstanz, Konstanz, Germany.

Lurija Institute for Rehabilitation Sciences and Health Research at the University of Konstanz, Konstanz, Germany.

出版信息

Clin Neuropsychol. 2020 Jan;34(1):217-242. doi: 10.1080/13854046.2019.1585575. Epub 2019 Apr 19.

Abstract

: Limb apraxia is a motor cognitive disorder that has been mainly studied in patients with dementia or left hemisphere stroke (LHS). However, limb apraxia has also been reported in patients with right hemisphere stroke (RHS), multiple sclerosis (MS) or traumatic brain injury (TBI). This study's aim was to report detailed praxis performance profiles in samples suffering from these different neurological disorders by use of the Diagnostic Instrument for Limb Apraxia (DILA-S).: 44 LHS patients, 36 RHS patients, 27 patients with dementia, 26 MS and 44 TBI patients participated. The diagnostics included the imitation of meaningless and meaningful hand gestures, pantomime of tool-use, single real tool-use as well as a multistep naturalistic action task (preparing breakfast).: Apraxia occurred in all tested samples but to a varying degree and with dissimilar profiles. LHS patients demonstrated most severe deficits in pantomime, but they were also vulnerable to deficits in real tool-use. Dementia patients showed high incidence rates of apraxia in almost all subscales of the DILA-S. RHS patients demonstrated difficulties in imitation and pantomime of tool-use, but they did not show severe difficulties with real tool-use. TBI patients appeared challenged by multistep naturalistic actions. The tested MS sample did not show clinically relevant symptoms in the DILA-S.: Different types of patients display varying limb apraxic symptoms detectable by the DILA-S. In these limb apraxia susceptible populations, testing should be warranted as standard. Prospectively, individual error profiles may be helpful for shaping motor cognitive training.

摘要

肢体失用症是一种运动认知障碍,主要在痴呆症或左半球中风(LHS)患者中进行研究。然而,肢体失用症也在右半球中风(RHS)、多发性硬化症(MS)或创伤性脑损伤(TBI)患者中报告过。本研究的目的是通过使用肢体失用症诊断工具(DILA-S)报告患有这些不同神经障碍的患者的详细动作表现。

共有 44 名 LHS 患者、36 名 RHS 患者、27 名痴呆症患者、26 名 MS 患者和 44 名 TBI 患者参与了研究。诊断包括无意义和有意义的手部手势模仿、工具使用的模仿、单一真实工具使用以及多步骤自然动作任务(准备早餐)。

失用症发生在所有测试的样本中,但程度和表现形式不同。LHS 患者在模仿和工具使用的模仿方面表现出最严重的缺陷,但他们也容易出现真实工具使用方面的缺陷。痴呆症患者在 DILA-S 的几乎所有子量表中都表现出高的失用症发生率。RHS 患者在模仿和工具使用的模仿方面表现出困难,但他们在真实工具使用方面没有严重的困难。TBI 患者在多步骤自然动作方面表现出挑战。测试的 MS 样本在 DILA-S 中没有表现出临床相关的症状。

不同类型的患者表现出不同的肢体失用症状,可通过 DILA-S 检测到。在这些易患肢体失用症的人群中,应进行标准的测试。从前景来看,个体的错误谱可能有助于塑造运动认知训练。

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