Association of ideomotor apraxia with frontal gray matter volume loss in corticobasal syndrome.
OBJECTIVE
To determine the brain areas associated with specific components of ideomotor apraxia (IMA) in corticobasal syndrome (CBS).


METHODS
Case-control and cross-sectional study.


METHODS
Forty-eight patients with CBS and 14 control subjects. Intervention Administration of the Test of Oral and Limb Apraxia.


METHODS
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.
Huey
Edward D
ED
Cognitive Neuroscience Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892-1440, USA.
Pardini
Matteo
M
Cavanagh
Alyson
A
Wassermann
Eric M
EM
Kapogiannis
Dimitrios
D
Spina
Salvatore
S
Ghetti
Bernardino
B
Grafman
Jordan
J
D017668:Age of Onset; D000368:Aged; D020240:Apraxia, Ideomotor / Q000175:diagnosis / Q000473:pathology*; D001479:Basal Ganglia / Q000473:pathology*; D016022:Case-Control Studies; D002421:Caudate Nucleus / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D005868:Gestures; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007100:Imitative Behavior / Q000502:physiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000473:pathology; D017397:Prefrontal Cortex / Q000473:pathology*; D011597:Psychomotor Performance / Q000502:physiology