Association of Ideomotor Apraxia With Frontal Gray Matter Volume Loss in Corticobasal Syndrome
Association of Ideomotor Apraxia With Frontal Gray Matter Volume Loss in Corticobasal Syndrome
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DOI：
10.1001/archneurol.2009.218
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发表时间：
2009-10-01
影响因子：
--
通讯作者：
Grafman, Jordan
中科院分区：
文献类型：
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作者：
Huey, Edward D.;Pardini, Matteo;Grafman, Jordan
目标：确定皮质基底神经综合征（CBS）中与认知失用症（IMA）特定成分相关的脑区。设计：病例对照和横断面研究。参与者：48名CBS患者和14名对照受试者。干预：口腔和肢体失用症测试管理。主要结果测量：CBS患者和健康对照之间的差异以及CBS患者中通过基于体素的形态测定法确定的灰质体积和IMA面积之间的相关性。总体而言，IMA与CBS患者左侧补充运动区、运动前皮质和尾状核的灰质体积减少相关。失用症的总体程度与运动障碍的一侧无关。实践模仿（与命令）在CBS患者中尤其受损。患者表现出平等的损害，在传递性和不传递性praxis.Conclusions：在CBS患者，IMA与左后额叶皮质和皮质下容量的损失。尽管显示出与IMA相关的左额叶体积损失，CBS患者对手势的模仿尤其受损。这些发现表明，要么是CBS的IMA影响了绕过运动记忆痕迹的实践路线，要么是运动记忆痕迹受到影响，但它们存在于下顶叶皮层以外的区域。
Objective: To determine the brain areas associated with specific components of ideomotor apraxia (IMA) in corticobasal syndrome (CBS).Design: Case-control and cross-sectional study.Participants: Forty-eight patients with CBS and 14 control subjects.Intervention: Administration of the Test of Oral and Limb Apraxia.Main Outcome Measures: Differences between patients with CBS and healthy controls and associations between areas of gray matter volume and IMA determined by voxel-based morphometry in patients with CBS.Results: Overall, IMA was associated with decreased gray matter volume in the left supplemental motor area, premotor cortex, and caudate nucleus of patients with CBS. The overall degree of apraxia was independent of the side of motor impairment. Praxis to imitation (vs command) was particularly impaired in the patients with CBS. Patients demonstrated equal impairment in transitive and intransitive praxis.Conclusions: In patients with CBS, IMA is associated with left posterior frontal cortical and subcortical volume loss. Despite showing left frontal volume loss associated with IMA, patients with CBS have particularly impaired imitation of gestures. These findings suggest either that the IMA of CBS affects a route of praxis that bypasses motor engrams or that motor engrams are affected but that they exist in areas other than the inferior parietal cortex.