Barbieri C, De Renzi E
Clinica Neurologica dell'Università di Modena.
Cortex. 1988 Dec;24(4):535-43. doi: 10.1016/s0010-9452(88)80047-9.
Fifty six left brain-damaged (LBD) patients and 38 right brain-damaged (RBD) patients were requested to perform two measures of praxis using the hand ipsilateral to the side of lesion. One task required the accurate imitation of actions made by the examiner and taxed executive abilities; the other task required the patient to pantomime the use of objects that were shown, but not handed, and it also involved an ideational component, i.e., the evocation of gestures. The cut-off point discriminating a normal from a pathological performance was set at the level of the poorest score found in 60 control patients. On both tests apraxia was found to be associated primarily with left brain-damage. However, while on the use of objects test practically only LBD patients failed, on the imitation test there was also a sizeable proportion of RBD patients who showed a mild apraxia. When the performance on the two tests was contrasted, there were as many LBD patients as RBD patients who scored remarkably lower on movement imitation than on pantomiming the use of objects, whereas the opposite dissociation was found almost exclusively in LBD patients. We infer from these data that the left hemisphere dominance for praxis is more marked at the ideational stage and that there is also a minor right hemisphere participation in the control of the executive stage of gesture.
56名左侧脑损伤（LBD）患者和38名右侧脑损伤（RBD）患者被要求使用损伤侧同侧的手进行两项实践能力测试。一项任务要求准确模仿检查者做出的动作，这考验执行能力；另一项任务要求患者对展示但未递交给他们的物体进行动作模仿，这还涉及概念成分，即唤起手势。区分正常表现与病理表现的临界值设定为60名对照患者中发现的最低分数水平。在两项测试中，失用症主要与左侧脑损伤有关。然而，在物体使用测试中，几乎只有左侧脑损伤患者失败，而在模仿测试中，也有相当比例的右侧脑损伤患者表现出轻度失用症。当对比两项测试的表现时，在动作模仿测试中得分明显低于物体使用模仿测试的左侧脑损伤患者和右侧脑损伤患者数量相同，而几乎仅在左侧脑损伤患者中发现了相反的分离现象。我们从这些数据中推断，左半球在实践能力方面的优势在概念阶段更为明显，并且右半球在手势执行阶段的控制中也有较小程度的参与。
