Goldenberg G, Hagmann S
Neuropsychological Department, Hospital München-Bogenhausen, Germany.
Neuropsychologia. 1997 Mar;35(3):333-41. doi: 10.1016/s0028-3932(96)00085-1.
In two patients with damage to the inferior portion of the left angular gyrus severely defective imitation of meaningless gestures contrasted with preserved performance of meaningful gestures to verbal command and with preserved imitation of meaningful gestures. In one patient the imitation deficit was restricted to the imitation of hand positions while imitation of finger configurations was normal. In both patients replication of the hand positions on a mannikin was as defective as imitation on themselves. This pattern of preserved and impaired performances is incompatible with two-stage models of apraxia which posit that defective imitation stems from damage to an executional stage of gesture production. Interruption of a direct route from perception to execution of action could account for the dissociation between defective imitation of meaningless and preserved performance of meaningful gestures. We propose that functioning of this route requires the integrity of general knowledge about the structure of the human body.
在两名左侧角回下部受损的患者中，对无意义手势的模仿严重缺陷，与之形成对比的是，对言语指令的有意义手势表现保留，对有意义手势的模仿也保留。在一名患者中，模仿缺陷仅限于手部姿势的模仿，而手指构型的模仿则正常。在两名患者中，在人体模型上复制手部姿势与对自身的模仿一样存在缺陷。这种保留和受损表现的模式与失用症的两阶段模型不相符，该模型认为模仿缺陷源于手势产生执行阶段的损伤。从感知到动作执行的直接通路中断可以解释无意义模仿缺陷与有意义手势表现保留之间的分离。我们提出，这条通路的运作需要关于人体结构的一般知识的完整性。
