THE EXECUTIVE AND IDEATIONAL COMPONENTS OF APRAXIA
THE EXECUTIVE AND IDEATIONAL COMPONENTS OF APRAXIA
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DOI：
10.1016/s0010-9452(88)80047-9
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发表时间：
1988-12-01
期刊：
影响因子：
3.6
通讯作者：
DERENZI, E
中科院分区：
文献类型：
--
作者：
BARBIERI, C;DERENZI, E
56例左脑损伤(LBD)患者和38例右脑损伤(RBD)患者分别用患侧同侧手进行两次练习。其中一项任务需要准确地模仿考官的动作，并评估其执行能力；另一项任务要求患者模仿所展示但没有手拿的物体的使用，而且还涉及一个概念成分，即手势的唤起。区分正常和病理表现的分界点被设定在60名对照患者中发现的最差评分水平。在这两项测试中，失用症被发现主要与左脑损伤有关。然而，虽然在使用对象测试时，实际上只有LBD患者不合格，但在模仿测试中，也有相当大比例的RBD患者表现出轻度失用。当两种测试的表现进行对比时，LBD患者和RBD患者在动作模仿方面的得分明显低于在模仿物体使用方面的得分，而相反的分离几乎只在LBD患者中发现。从这些数据我们推断，左脑对练习的支配在概念阶段更明显，右脑也有少量参与手势执行阶段的控制。
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.