Orofacial apraxia in corticobasal degeneration, progressive supranuclear palsy, multiple system atrophy and Parkinson's disease.
OBJECTIVE
To determine whether the assessment of orofacial praxis is useful for the differential diagnosis of parkinsonian syndromes and to understand the neural mechanisms underlying OFA, searching for the respective roles of cortical and subcortical structures.


METHODS
Forty-four patients were assessed: 12 with idiopathic Parkinson's disease (IPD), 8 with multiple system atrophy (MSA), 12 with progressive supranuclear palsy (PSP) and 12 with corticobasal degeneration (CBD). An easy bedside scale was used, exploring single gestures, gestures with noise production and multiple sequential gestures. We searched for group and task effects.


RESULTS
Patients with CBD were significantly more impaired than those with IPD, MSA or PSP (p<0.001). Our assessment was unable to distinguish between the IPD, MSA and PSP groups. There was a clear task effect in CBD with a major impairment in multiple sequential gestures (p<0.0001).


CONCLUSIONS
Assessment of orofacial praxis helps in the clinical diagnosis of CBD. Patients with IPD, MSA and PSP did not present with OFA. We suggest that the deficit in multiple sequential gestures in CBD is related to simultaneous lesions of the parietal lobule and the supplementary motor area.
Ozsancak
Canan
C
Service de Neurologie et Pathologie du Mouvement, EA 2683 Clinique Neurologique, CHU de Lille, 59037, Lille Cedex, France. c_ozsancak@yahoo.fr
Auzou
Pascal
P
Dujardin
Kathy
K
Quinn
Niall
N
Destée
Alain
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001072:Apraxias / Q000209:etiology*; D001480:Basal Ganglia Diseases / Q000175:diagnosis / Q000503:physiopathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D019578:Multiple System Atrophy / Q000503:physiopathology*; D015999:Multivariate Analysis; D019636:Neurodegenerative Diseases / Q000503:physiopathology; D009460:Neurologic Examination / Q000379:methods; D009483:Neuropsychological Tests; D000857:Olfaction Disorders / Q000209:etiology; D010300:Parkinson Disease / Q000175:diagnosis / Q000503:physiopathology*; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis / Q000503:physiopathology*