Introduction
Limb apraxia refers to a variety of deficits in expert motion that aren’t penalties of motor weak point, sensory impairment, or lack of comprehension or coordination (Heilman and Rothi, 2003). Sufferers with the dysfunction have difficulties performing expert actions, akin to shaving or making a cup of tea. In stroke sufferers, limb apraxia could be demonstrated by impairments each after they use the affected and the unaffected hand. The syndrome is more and more acknowledged as a predictor of poor purposeful restoration after a stroke that impacts sufferers’ actions of day by day residing, with better charges of sufferers with this dysfunction being dependent or ending up in nursing properties (Donkervoort et al., 2006; Bickerton et al., 2012). Along with the motor impairments brought on by this dysfunction, apraxia might worsen different cognitive impairments, akin to aphasia, by compromising sufferers’ skill to speak by means of gestures.
Conventional theories of the dysfunction have categorized praxis deficits in line with errors made by sufferers in duties involving (1) Imitation of each meaningless and significant gestures (e.g., asking a affected person to repeat meaningless hand or finger gestures or else to repeat a well-recognized gesture, akin to saluting), (2) Pantomiming of significant gestures or software use (both intransitive, e.g., “present me the way you cease site visitors” or transitive gestures, e.g., “present me how you’d brush your tooth, utilizing a toothbrush in your hand”), and (3) Precise software use (e.g., asking the affected person to reveal the usage of a torch) or within the efficiency of advanced sequences of actions (e.g., asking the affected person to make tea) (Leiguarda and Marsden, 2000; Donkervoort et al., 2006; Dovern et al., 2011). Whereas pantomime and object-use duties pertain to deficits implicating conceptual (semantic) planning for significant gestures, imitation of meaningless gestures checks the implementation or manufacturing methods (Cubelli et al., 2000; Leiguarda and Marsden, 2000; Heilman and Rothi, 2003).
Most screening batteries for apraxia contain the usage of pantomiming and imitation of meaningless hand gestures, as a result of these duties are significantly delicate for detecting praxis deficits (Niessen et al., 2014; Buchmann and Randerath, 2017). This has shaped the idea for his or her inclusion for testing praxis within the Birmingham Cognitive Display (BCoS) (Bickerton et al., 2012; Humphreys et al., 2012).
Lesion-mapping research investigating limb apraxia agree that left hemisphere harm performs a task on this dysfunction, implicating the fronto-temporo-parietal community (Mengotti et al., 2013; Buxbaum et al., 2014; Hoeren et al., 2014; Goldenberg and Randerath, 2015). They report a big function for the inferior parietal lobe in tool-use pantomime and in imitation of meaningless gestures (Buxbaum et al., 2014; Hoeren et al., 2014; Dressing et al., 2018). Nevertheless, there isn’t any clear dichotomy between the 2, because the neural correlates of pantomime are widespread (Daprati and Sirigu, 2006; Goldenberg et al., 2007; Worth et al., 2010; Manuel et al., 2013; Goldenberg and Randerath, 2015).
A number of components might account for these findings. Lesion-mapping research of apraxia have been restricted by methodological points, notably within the evaluation strategies used, and variability within the duties used to review the dysfunction. There have been inconsistencies within the screening instruments used to evaluate numerous subtypes of the dysfunction (Goldenberg, 2017). The lesion-symptom mapping strategies employed have included the usage of handbook delineation of irregular mind tissue, which may produce inconsistencies throughout operators (Gillebert et al., 2014). The usage of dichotomized knowledge, categorizing apraxia as being current or absent as a substitute of together with steady scores, had meant that preliminary research included small numbers of sufferers.
The usage of voxel-based lesion-symptom mapping (VLSM) has enabled the inclusion of a lot bigger and unselected cohorts of sufferers in more moderen research (akin to in Manuel et al., 2013; Buxbaum et al., 2014; Hoeren et al., 2014). The usage of steady, somewhat than dichotomized, apraxia scores has additionally allowed for a extra fine-grained description of the neural correlates of praxis deficits by enhancing energy in these analyses (Cohen, 1983). The variability brought on by the inclusion of sufferers at numerous levels of restoration after stroke – from early subacute to persistent levels – is being mitigated by finding out extra homogenous cohorts of sufferers (Hoeren et al., 2014; Weiss et al., 2016).
An essential issue that has been ignored in a number of lesion-mapping research of the dysfunction previously has been the connection of apraxia with different cognitive issues, particularly, aphasia (Goldenberg and Randerath, 2015). A number of research report the co-occurrence of the 2 issues, with little proof of the presence of apraxia with no aphasia in right-handed sufferers (Selnes et al., 1991; Papagno et al., 1993; Weiss et al., 2016). This has change into more and more related in mild of current research that point out that pantomime of software use, which is broadly utilized in diagnosing this dysfunction (Buchmann and Randerath, 2017), might need a communicative function (Dressing et al., 2018; Finkel et al., 2018). A lesion-mapping examine investigating apraxia and aphasia in left-hemisphere stroke sufferers distinguished between a community involving frontal, insular, inferior parietal, and superior temporal areas supporting language features and lesions involving the sensorimotor, premotor, and parietal cortices related to praxis duties, with the inferior premotor space (BA44) co-localizing for each (Weiss et al., 2016). One other lesion-mapping examine by Finkel et al. (2018) recognized two putative networks sub-serving communication and motor features when stroke sufferers pantomimed tool-use actions.
On this examine, we make use of a giant database of stroke sufferers that included each neuropsychological measures of praxis and imaging knowledge, out there from the sufferers’ scientific CT scans on admission. Earlier lesion-symptom mapping research of the dysfunction have used MR imaging due to the large availability of analytic strategies for lesion delineation on this imaging modality (Seghier et al., 2008), which may then be used to establish correlations between lesion and behavioral deficits (VLSM – Sperber and Karnath, 2018). Most of those research investigated the dysfunction on the persistent stage (Manuel et al., 2013; Buxbaum et al., 2014), and a few within the earlier levels after stroke (Hoeren et al., 2014). The benefit of investigating sufferers within the acute and subacute levels is that lesions straight referring to the stroke could be recognized earlier than modifications akin to atrophy (brought on by post-stroke degeneration) happen (Lindberg et al., 2007). That is essential when utilizing automated lesion delineation strategies, as atrophy might have an effect on the delineation of lesions.
Our purpose was to analyze the neural correlates of deficits in praxis in a big cohort of subacute stroke sufferers who took half within the BCoS (Humphreys et al., 2012). The validity of the screening duties for apraxia administered within the BCoS has been confirmed beforehand (Bickerton et al., 2012).
We used an automatic CT processing toolbox, developed in our laboratory (totally described in Gillebert et al., 2014), which enabled lesion delineation for voxel-based lesion-mapping analyses to be carried out. We performed large-scale retrospective VLSM analyses (Bates et al., 2003) on a gaggle of subacute unselected brain-damaged sufferers utilizing steady somewhat than descriptive cognitive scores of praxis from the BCoS (Humphreys et al., 2012).
Supplies and Strategies
Sufferers
The sufferers have been recruited into the Birmingham Cognitive Display challenge (BCoS), a multi-center scientific examine investigating cognitive impairments after subacute stroke (sufferers have been recruited from a number of stroke models throughout the West Midlands space of the UK). This examine was accepted by the Nationwide Analysis Ethics Service (NRES): Essex 1 Analysis Ethics Committee (REC) and native NHS trusts. Sufferers have been included within the examine if: (1) they have been inside 3 months of a confirmed first stroke and medically steady; (2) they have been judged by the scientific workforce to have the ability to focus for no less than 30 min to allow cognitive testing; (3) they’d ample command of English to observe directions; and (4) they have been in a position to present written knowledgeable consent to take part within the examine (Bickerton et al., 2012). Therefore, all of the sufferers on this examine had supplied knowledgeable consent for the usage of their neuropsychological and imaging knowledge within the analysis.
The BCoS includes the assessments of apraxia detailed under. Moreover, we included assessments of different cognitive domains, specifically: consideration, reminiscence, language, and quantity processing. These knowledge have been supplemented by a CT head scan and demographic data, which was obtained from the sufferers’ scientific recordsdata.
Sufferers have been excluded if they’d no lesion seen on CT scan or had scans that weren’t ample for additional analyses (e.g., these not fulfilling the imaging standards set out under). They have been additionally excluded if they’d ventricular enlargement documented within the report.
From an preliminary cohort of 484 sufferers who had taken half within the BCoS screening and had imaging out there, a last pattern of 387 sub-acute stroke sufferers who had each ample imaging and a full set of praxis testing was included on this examine. Sufferers with a primary stroke in both their left, proper, or each hemispheres have been included to kind an unselected, unbiased group of sufferers on the acute and subacute levels after stroke. Desk 1 gives full demographic data on the affected person cohort. The group included 353 right-handed sufferers and 34 left-handed sufferers. Of the sufferers who have been left-handed, 4 sufferers had right-hemisphere lesions, two sufferers had bilateral lesions, and 28 sufferers had left-hemisphere lesions. A complete of 349 sufferers from the cohort had had an ischemic stroke, and 38 sufferers had had a hemorrhagic stroke.
Desk 1. Affected person demographics and imaging particulars (SD = customary deviation).
Neuropsychological Assessments – Praxis Duties
The cognitive evaluation of the sufferers befell in hospital settings within the acute and sub-acute stage (≤3 months) post-stroke. The typical time between stroke onset and take a look at administration was 24.3 days (minimal = 1 day, most = 93 days), with 264 sufferers examined inside 1 month after stroke. Neuropsychological testing was performed utilizing the BCoS (Humphreys et al., 2012).
The praxis duties within the BCoS are aimed toward assessing the cognitive processes subserving praxis, specifically: (1) the enter of visually conveyed gestures; (2) the coding of physique half and place; (3) entry to saved information in regards to the that means of gestures; and (4) entry to motor output remodeling spatiotemporal ideas of gestures into motor instructions (see Determine 1 in Bickerton et al., 2012; Humphreys et al., 2012).
Determine 1. Map depicting the lesion overlap of 387 members. The colour bar signifies the variety of sufferers that had lesion at every voxel. The quantity over every mind slice signifies the Z coordinate in MNI area.
Within the present examine, we used three of the BCoS praxis checks to evaluate the presence of apraxia: Gesture Manufacturing, Gesture Recognition, and Meaningless Gesture Imitation. The BCoS additionally contains an evaluation of orientation in time and area, offering a short measure of orientation in time, particular person, and place and of total comprehension, which was utilized in our imaging analyses as a covariate of no curiosity to take away deficits in primary cognitive skill (which could possibly be brought on by different scientific situations at early levels after stroke, akin to delirium) as potential confounds.
A earlier examine examined the validity and reliability of the praxis duties within the BCoS towards present screens and included the affected person cohort reported right here (Bickerton et al., 2012). The inter-rater reliability for praxis on this explicit cohort of sufferers has been reported and printed earlier than, in Chapters 6 and seven of the BCoS handbook (Zwinkels et al., 2004; Humphreys et al., 2012).
In line with standards printed beforehand (Humphreys et al., 2012), sufferers have been thought-about apraxic in the event that they scored under the beforehand printed set cut-off rating in no less than considered one of these three praxis duties. Desk 2 lists the cut-off scores. Nevertheless, for the needs of the present examine, the sufferers’ praxis scores have been entered as a steady variable for the imaging analyses. Every of the three praxis duties is detailed under. Two of the duties (Gesture Manufacturing and Gesture Imitation) required empty-handed execution of gestures to check conceptual and manufacturing deficits, respectively, in line with conventional fashions of the dysfunction, with out the confound of getting the object-at-hand (Goldenberg, 2013a). Sufferers used their dominant hand or, if they’d hemiparesis, their unaffected hand. A complete of 266 sufferers used their left hand, and 121 sufferers used their proper hand for the efficiency of all praxis duties reported on this examine.
Desk 2. Age adjusted cut-off scores for praxis duties used on this examine.
Gesture Manufacturing
The Gesture Manufacturing job concerned pantomiming a complete of six gestures (three transitive, three intransitive) upon verbal command. The take a look at included body-centered (salute, utilizing a glass), non-body-centered (cease, utilizing a salt cellar), repetitive (hitch-hiking, utilizing a hammer), and non-repetitive (cease, utilizing a glass) actions. All actions could be carried out as a single-step sequence. Sufferers have been allowed a most of 15 s per merchandise to reply and have been requested to execute the motion as soon as. Two factors got for an accurate and correct gesture; 1 level for a recognizable however inaccurate gesture (e.g., together with spatial and/or motion errors); 0 factors got for both no response after 15 s, an unrecognizable response or perseveration from earlier gestures. The ultimate sum rating (most = 12) was used within the analyses.
Gesture Recognition
Within the Gesture Recognition Activity, the examiner produced six actions, which sufferers needed to acknowledge: three transitive (utilizing a cup, utilizing a key, utilizing a lighter) and three intransitive (come over, good, goodbye) actions. Because the examiner confirmed every gesture, the sufferers needed to choose the motion being carried out from a multiple-choice record, which included 4 various responses for every motion, in writing. The 4 alternate options for every motion corresponded to: (1) the right motion (e.g., utilizing a lighter); (2) a semantically associated motion (utilizing a match); (3) a visually associated motion (utilizing a gun); and (4) an unrelated motion (utilizing a torch). The sufferers have been allowed a most of 15 s per merchandise to reply by pointing to their chosen assertion, and so they got one level for every appropriate response. The ultimate sum rating (most = 6) was used within the analyses.
The information from each transitive and intransitive gestures in these duties have been entered collectively as a composite measure. Therefore this examine doesn’t report variations between the 2.
Meaningless Gesture Imitation
The sufferers have been requested to repeat 4 meaningless gestures introduced by the examiner. Two of those gestures concerned a sequence of two hand positions in relation to the pinnacle, and the opposite two concerned a single finger place. This job contrasted the oblique path to motion manufacturing (i.e., imitating meaningless gestures) with “lexical” motion recognition and manufacturing to call (see Bickerton et al., 2012). Three factors got for a gesture that was accurately and exactly imitated after the first presentation; two factors if the gesture was appropriate and exact after the 2nd presentation; 1 level if sufferers made just one error after the 2nd presentation (e.g., incomplete motion sequence, incorrect spatial relationship between hand and head, or incorrect finger/hand place); 0 factors if sufferers made multiple error, gave no response or confirmed perseveration from earlier merchandise(s) after the 2nd presentation. The ultimate sum rating (most = 12) was used within the analyses.
Desk 2 offers the praxis duties cut-off scores based mostly on the fifth percentile throughout age teams (from Humphreys et al., 2012). We report the charges of praxis deficits in line with these cut-off scores within the part “Outcomes.”
Image Naming
The Image-Naming job was used to regulate for language deficits in our examine. The duty entails asking sufferers to call objects that the examiner exhibits them an image of. There have been 14 objects that sufferers needed to acknowledge and identify. These have been: bell, peas, grape, umbrella, raspberry, colander, leak, stopwatch, bat, pineapple, chisel, tiger, hook, and spanner. Sufferers scored one level for every appropriate naming, with a possible whole rating of 14.
Imaging and Lesion Evaluation
CT Information Acquisition
CT scans have been acquired as a part of the sufferers’ scientific evaluation throughout their hospital admission. For the 387 sufferers included on this examine, the common time between the stroke and CT scan acquisition was 4.4 days (Minimal = 0 days, Most = 64 days; Commonplace Deviation of 11 days, with greater than 80% of circumstances scanned inside 1 week).
The examine used standardized CT imaging protocols, as follows. The scanners used have been a Siemens Sensation 16 and a GE Medical System LightSpeed 16 and LightSpeed Plus. The photographs lined the entire mind, with slices aligned alongside the AC-PC aircraft and an in-plane decision of 0.5 × 0.5 mm and a slice thickness various between 4 and 5 mm. A CT database of greater than 500 sufferers with acute/subacute stroke was out there, along with their scientific and demographic knowledge, in addition to a accomplished battery of neuropsychological checks from the BCoS (Humphreys et al., 2012). Sufferers with inappropriate CT scans have been excluded from the examine: these have been sufferers with a CT scan through which a shunt was seen or sufferers in whom the sector of view didn’t embody the pinnacle (n = 127) (Gillebert et al., 2014).
Automated Lesion Delineation Methodology
We applied an automatic toolbox for pre-processing and lesion mapping of CT mind scans (Gillebert et al., 2014). This process, totally described in Gillebert et al. (2014), concerned the normalization of CT photos from stroke sufferers to template area (Rorden et al., 2012a). Areas of hypo- or hyper-intensity, akin to ischemic or hemorrhagic stroke, respectively, have been outlined by voxel-wise comparisons with a gaggle of management CT photos. The validation and effectiveness of this strategy have been demonstrated each by visible inspection utilizing CT photos in sub-samples of stroke sufferers from the identical dataset as on this examine (CT picture database collected for the Birmingham College Cognitive Display, see textual content footnote 1) and by utilizing simulated lesions. Each checks are reported in a earlier examine (Gillebert et al., 2014).
In line with this technique, CT scans have been pre-processed utilizing SPM8 (The Wellcome Belief Centre for Neuroimaging, London, United Kingdom), and lesion delineation was carried out utilizing in-house software program written in Matlab (The MathWorks, Natick, MA, United States). Firstly, threshold-based clustering at 0.1% most depth was applied to take away irrelevant indicators (Batenburg and Sijbers, 2009). The ensuing CT photos have been spatially aligned to a template utilizing the co-registration software in SPM8. CT picture depth was then reworked utilizing an invertible formulation to emphasise the distinction between cerebrospinal fluid and parenchyma (Rorden et al., 2012a).
The transformed CT photos have been then warped to MNI area utilizing a CT template (Rorden et al., 2012b). Firstly, a normalization perform was used to calculate and apply a 12-parameter affine transformation that maximized the alignment to the template. The distribution of all picture intensities was then calculated to create masks of the mind and the ventricles that have been utilized to generate skull-stripped photos. These have been then normalized and resliced at a 1-mm isotropic decision utilizing a big bounding field that included each the cortex and the cerebellum. The normalized CT photos have been smoothed with a 4-mm FWHM Gaussian filter (Salmond et al., 2002; Stamatakis and Tyler, 2005) in line with the belief of random area idea used within the statistical evaluation (Worsley, 2003).
The lesion of every stroke affected person was routinely recognized utilizing a voxel-based outlier detection process based mostly on the Crawford-Howell parametric t-test for case-control comparisons (Crawford and Howell, 1998; Crawford et al., 2009). An outlier t-score map was generated utilizing this take a look at that coded the diploma of abnormality of every voxel depth based mostly on a comparability to the traditional vary from management CT scans. These t-score maps have been thresholded to generate binary lesion maps in MNI area (Gillebert et al., 2014) that have been used to carry out VLSM analyses.
Voxel-Primarily based Lesion-Symptom Mapping
The lesion maps obtained from the aforementioned process underwent VLSM analyses to establish the neural underpinnings of praxis deficits after stroke, based mostly on the evaluation toolbox supplied by Bates et al. (2003)4. The behavioral outcomes for every of the praxis duties out there from 387 sufferers have been entered into separate VLSM analyses because the variable of curiosity, with further covariates of age, handedness, whole lesion quantity, and evaluation of orientation in time and area to regulate for these confounding components (Gillebert et al., 2014; Chechlacz et al., 2015). We added an evaluation of orientation in time and area based mostly on correlations of deficits on this generic cognitive area with praxis.
A linear mannequin was fitted at every voxel, relating the distinctive rating for every praxis job to lesion depth (0 for no lesion; 1 for lesion). Checks have been confined to these voxels through which no less than 10 sufferers had a lesion. Solely voxels that reached the false discovery charge (FDR) threshold of p < 0.05 have been thought-about important.
The usage of CT imaging didn’t permit a transparent segmentation of grey and white matter as is often carried out in VLSM analyses of MRI knowledge. Nevertheless, this has been utilized in CT in earlier publications on neglect and a spotlight (Gillebert et al., 2014; Chechlacz et al., 2015).
The anatomical localization for important areas (FDR-corrected at p < 0.05) was recognized based mostly on the multi-modal parcellation of human cerebral cortex supplied by the Human Connectome Venture (HCP) (Andreas, 2016; Glasser et al., 2016). The anatomical localization of areas positioned inside white matter tracts was based mostly on the Catani Atlas of Human Mind Connections (Thiebaut de Schotten et al., 2011). The interpretation of our outcomes was supported by the experience of an anatomist (Prof. R. E. Passingham). Figures 1, 2 have been created utilizing the template at MRICroGL.
Determine 2. VLSM map of lesions related to praxis deficits in every of the three duties, FDR-corrected at p < 0.05, displayed on a T1 anatomical template in MNI area.
Outcomes
Behavioral Outcomes
The behavioral outcomes from particular person praxis duties and comparisons with different cognitive features have been used to establish the prevalence of deficits in every subtask on this cohort of sufferers. Word that this evaluation was not used to tell the lesion-mapping analyses reported under. As an alternative, the behavioral knowledge for every job have been entered as a steady variable. The rationale for reporting the behavioral outcomes under was to supply a sign of the variety of sufferers who have been deemed to be performing under the cut-off for praxis on these screening duties. This was not used to tell our imaging analyses.
Within the behavioral analyses, cut-off scores for regular efficiency (two customary deviations under the imply of age-matched wholesome controls) have been 11.5 on Gesture Manufacturing, 5.8 Gesture Recognition, and 11.5 in Imitation, based mostly on normative knowledge printed beforehand (see Desk 2 and Chapter 6 and seven of Humphreys et al., 2012). Primarily based on these standards, 204 out of 387 sufferers carried out abnormally on Gesture Manufacturing, 248 out of 387 on Gesture Recognition, and 252 out of 387 Imitation (on common, 235 sufferers out of 387 scored under vary for apraxia). Of the left-handed sufferers, 12 out of 28 sufferers with left-hemisphere harm had no praxis deficits, whereas 16 sufferers with left-hemisphere harm scored under the cut-off in no less than two of the praxis duties, indicating they have been most certainly left-hemisphere dominant (Goldenberg, 2013b).
The typical affected person outcomes on the three praxis duties are outlined in Desk 3.
Desk 3. Sufferers’ common leads to the three praxis duties.
Along with praxis scores, we computed sufferers’ basic orientation in time and area and aphasia (utilizing a picture-naming job from the BCoS). A complete of 63 out of 387 (16%) of sufferers carried out under the cut-off rating for the orientation job, and 212 sufferers out of 387 (55%) carried out under the cut-off rating for image naming, indicating language deficits adjusted for age.
We ran correlation analyses to establish whether or not our covariates of no curiosity have been considerably correlated with a composite measure of apraxia, incorporating the scores of every of the three praxis duties. Orientation in time and area correlated considerably with the composite Apraxia rating (r387 = 0.396, p < 0.0001), as did lesion measurement (r387 = −0.120, p = 0.018) and age (r387 = −0.200, p < 0.0001).
Imaging Outcomes
Lesion overlap is proven in Determine 1. Determine 2 exhibits the lesion-symptom maps for every of the three duties, FDR-corrected at p < 0.05, in axial and rendered views; Desk 4 gives the coordinates for every space and every job.
Deficits within the Gesture Manufacturing job have been related to lesions in a community of areas involving the left superior temporal sulcus (x = −50, y = −36, z = −12; t = 3.99), the left uncinate fasciculus (x = −28, y = −4, z = −16; t = 4.41) (which connects the temporal lobe with the inferior frontal cortex together with Broca’s space), and the white matter beneath the left major motor cortex, inside the superior longitudinal fasciculus (x = −34, y = −25, z = 31; t = 4.05). The lesions recognized disconnections between the temporal and parietal lobes with the frontal lobe, resulting in impairment in changing gestures into motor instructions.
Deficits within the Gesture Recognition job revealed important associations with lesions within the left superior temporal sulcus (x = −54, y = −44, z = −6; t = 4.24).
Lastly, areas considerably related to the meaningless gesture imitation job comprised the left visible striate and pre-striate cortices (x = −29, y = −88, z = −8; t = 5.74), PGi parietal space (x = −42, y = −56, z = 13; t = 4.97), and parahippocampal space (x = −32, y = −39, z = −15; t = 5.13). We report the outcomes for all sufferers mixed in Desk 4.
Subgroup analyses have been carried out to establish lesions pertaining to right- versus left-handed sufferers with right- versus left-hemisphere lesions, individually. Solely the analyses pertaining to right-handed sufferers with each left- and right-hemisphere lesions mixed revealed important outcomes (FDR-corrected at p < 0.05). No important outcomes have been recognized within the different subgroups. However, we recognized the lesion areas at p < 0.005 uncorrected for left-, adopted by right-hemisphere lesions in right-handed sufferers, that are reported in part “Subgroup VLSM Analyses” of the Supplementary Materials. Of word, not like different stories (Goldenberg, 2013b), in our knowledge, there have been no important variations in efficiency of the BCOS praxis duties between subgroups of sufferers, as reported on this dataset beforehand (Bickerton et al., 2012; Humphreys et al., 2012).
A follow-up evaluation was carried out to establish lesion-symptom mapping that remoted praxis deficits from screened within the BCoS from language (image naming). This was performed by re-running the VLSM analyses outlined above with scores from the Image Naming job within the BCOS (Humphreys et al., 2012) as a further covariate. No important outcomes have been discovered on this evaluation.
We explored this outcome additional by correlating the separate praxis with the picture-naming job. Image Naming considerably correlated with Gesture Manufacturing (r387 = 0.501, p < 0.0001), Gesture Recognition (r387 = 0.368, p < 0.0001), and Meaningless Gesture Imitation (r387 = 0.407, p < 0.0001). Furthermore, we applied VLSM analyses for Image Naming. The outcomes recognized the superior temporal gyrus and are supplied within the Supplementary Materials (part “VLSM Outcomes of Image Naming Activity”).
Dialogue
We performed VLSM analyses for apraxia based mostly on a big cohort of acute and subacute stroke sufferers. A validated battery of cognitive duties for praxis (BCoS) was used (Bickerton et al., 2012) and analyzed alongside scientific CT photos through which stroke lesions have been routinely delineated. Our findings relate particularly to the early levels after stroke. Left, proper, and bilateral hemisphere lesions have been included in a VLSM evaluation, through which the sufferers’ scores in three praxis duties from the BCoS have been entered as steady variables, creating an unbiased knowledge pattern.
Our outcomes confirmed that deficits resulting in apraxia outcome from left-hemisphere lesions (Goldenberg, 2013a). The lesion areas recognized concerned a community of areas comprising extrastriate visible areas, superior and medial temporal gyri, inferior parietal and inferior frontal areas, and white matter connections between the latter. As in current VLSM research of apraxia, our findings problem conventional theories, which describe a distinguished function of the parietal lobe within the dysfunction (Goldenberg, 2014). We recognized as a substitute ventral stream areas that pertain to the action-observation community. We talk about our leads to relation to earlier research of apraxia, drawing parallels with the literature on language issues after stroke. The final part highlights the implications of utilizing scientific CT imaging in lesion-symptom mapping of apraxia.
Neural Correlates of Apraxia Recognized in Our Examine
Our outcomes recognized an affiliation of left-hemisphere lesions affecting the superior and medial temporal areas with all praxis duties, specifically gesture manufacturing, recognition, and meaningless gesture imitation. As well as, harm to the underlying white matter connections between the temporal cortex and the inferior frontal gyrus (the uncinate fascicle), in addition to the superior longitudinal fasciculus underlying the first motor cortex (Pandya et al., 2015), have been related to deficits in gesture manufacturing. Harm within the inferior parietal area PGi (Andreas, 2016; Glasser et al., 2016), prestriate, and parahippocampal space 2 (as recognized within the HCP atlas; fusiform space, in different atlases) have been related to deficits in meaningless gesture imitation.
Voxel-based lesion-symptom mapping research of apraxia report large networks of mind areas within the dysfunction, parallelling ours. These embody inferior frontal (Pazzaglia et al., 2008), parietal, and temporal (Buxbaum et al., 2014; Hoeren et al., 2014) and in addition subcortical areas (Pramstaller and Marsden, 1996; Haaland et al., 2000; Leiguarda and Marsden, 2000). An essential issue figuring out the end result of affected person research pertains to the duties used to elicit conceptual and manufacturing deficits in apraxia, in addition to the imaging modalities used to review these mind features. We talk about the influence of those within the sections under.
Conventional Mind Networks Recognized in Apraxia and the Position of Duties Utilized in Understanding the Neural Correlates of the Dysfunction
Lesions of the parietal lobe, significantly affecting the dominant hemisphere, have historically dominated neuropsychological fashions of apraxia (Liepmann, 1908, 1920). A lot of our understanding of the function of parietal areas in motion has come from anatomical and physiological research of non-human primates. A dorsal visible stream has been subdivided into dorso-dorsal and ventro-dorsal streams, subserving motor representations permitting the implementation of attain and grasp actions, respectively (Rizzolatti and Matelli, 2003; Daprati and Sirigu, 2006). The ventral stream, which was initially proposed to mediate perceptual data (Goodale and Milner, 1992), has additionally been proven to play a task within the choice of actions (Milner and Goodale, 2008; Weiller et al., 2009; Rijntjes et al., 2012). Latest literature suggests there are connections between the 2, supporting a task for ventral stream buildings in each motion commentary and object use (Borra et al., 2010; Ramayya et al., 2010; Passingham et al., 2014; van Polanen and Davare, 2015).
Parietal Cortex Contribution to Apraxia
The function of the inferior parietal cortex in limb apraxia has been reported in research that used each actual object-use duties (Goldenberg and Hagmann, 1998; Osiurak et al., 2008; Goldenberg and Spatt, 2009) and pantomime of object use (Buxbaum et al., 2014; Hoeren et al., 2014). Useful neuroimaging research report a distinguished function for the left inferior parietal cortex within the precise use of objects (Lewis, 2006; Osiurak and Badets, 2016; Reynaud et al., 2016). Our examine didn’t contain the usage of purposeful neuroimaging, and the duties used for screening for apraxia concerned pantomime of each transitive (with objects) and intransitive (with no objects) gestures. Specifically, it didn’t embody the usage of actual objects.
The shortage of serious lesions in inferior parietal areas in our pantomime duties could possibly be on account of task-related components (reported under) and the imaging modality used (specifically lesion-symptom mapping somewhat than fMRI, reported in better element in sections “Supplies and Strategies,” “Settings Used for Our Voxel Primarily based Lesion Symptom Mapping” of the Supplementary Materials, and “Interpretation of Our Imaging Outcomes Primarily based on CT Imaging”).
In relation to the previous, it’s noteworthy that there are anatomical connections between the superior temporal areas recognized in our examine and the inferior parietal areas reported in non-human primates (Rozzi et al., 2006). One chance is that an impact of a lesion within the superior temporal sulcus could possibly be to disconnect move of data referring to organic movement (see under) from the inferior parietal cortex. This might elicit behavioral deficits in software use. Lesion-mapping research are descriptive. In contrast to purposeful neuroimaging research, they don’t give an appreciation of how lesions in a single space would possibly influence activation or perform in one other space related to it.
Position of the Temporal Cortex in Apraxia
There’s an rising quantity of proof for a communicative element to pantomiming gestures, even those who pertain to object-use. A lesion-symptom mapping examine involving pantomiming of object-use recognized two networks implicated within the job: a “posterior” community of mind areas, comprising inferior parietal and dorsal stream areas, representing the motor features of object use and an “anterior” community of mind areas, comprising inferior frontal and temporal areas, referring to the communicative parts of the duty (Finkel et al., 2018). The Gesture Recognition job within the BCOS requires comprehension of gestures and what they symbolize when selecting amongst a multiple-choice set of choices in writing. What’s extra, the scores we obtained from Gesture Recognition and Gesture Manufacturing duties mixed each transitive and intransitive gestures, probably emphasizing a task for communication as in Finkel et al.’s (2018) examine. The lesions recognized in our duties have been positioned predominantly in superior temporal somewhat than parietal areas, akin to the “anterior” community, which was attributed to communication in Finkel et al’s., 2018 examine.
However, our outcomes on the Meaningless Gesture Imitation job, which didn’t require any verbal comprehension, additionally implicated each the superior and infero-temporal cortex, in addition to inferior parietal space PGi. The examine by Buxbaum et al. (2014) additionally recognized lesions within the posterior temporal lobe and temporo-occipital areas as important each in gesture representations of instruments and in summary motion representations when examined with meaningless gesture imitation. Each our outcomes and theirs problem the standard mannequin of apraxia through which the parietal lobe performs a central function, revealing the involvement of a wider community that includes the left temporal lobe within the dysfunction (Goldenberg, 2009).
Within the sub-sections under, we argue for a potential function of the temporal cortex in understanding motion intentions, both by means of comprehension or by means of motion commentary.
A task for the temporal cortex in praxis and comprehension
In our examine, we discovered no voxels pertaining to apraxia alone when covarying for language deficits measured utilizing a Image Naming job. Furthermore, the 2 deficits co-existed in roughly 50% of our affected person cohort. Lesions involving superior temporal areas, recognized in Gesture Manufacturing, have been additionally current in Image Naming. Taken collectively our findings counsel that the 2 deficits would possibly overlap (Goldenberg and Randerath, 2015; Finkel et al., 2018). In one other examine by Weiss et al. (2016), praxis and language have been differentiable.
One purpose for the discrepancy between our and Weiss et al.’s (2016) outcomes might relate to the behavioral duties used on this examine. The duties utilized in our examine have been a part of a cognitive screening program developed to check stroke sufferers (BCOS, Humphreys et al., 2012) through which language is examined utilizing Image Naming. This job entails the naming of a lot of graspable objects (Bub et al., 2018). Earlier research utilizing fMRI have recognized a task for dorsal stream buildings in figuring out manipulable objects (Chao and Martin, 2000; Creem and Proffitt, 2001). There’s proof that naming manipulable objects influences actions (Bub et al., 2018; Masson, 2018). One potential clarification of our incapacity to distinguish between these two issues in our knowledge would possibly relate to the truth that ventral stream networks to “identify” and “use” objects might overlap (Mahon et al., 2007). One other chance pertains to the truth that each Gesture Recognition and Manufacturing duties within the BCOS contain comprehension and that this may increasingly overlap with language features (Goldenberg and Randerath, 2015). Our measure of those praxis duties mixed transitive and intransitive gestures, which have been proven to check for communication (Johnen et al., 2016; Dressing et al., 2018; Finkel et al., 2018).
However, these components nonetheless fail to elucidate the very fact we recognized the superior temporal gyrus in a meaningless gesture imitation job that concerned no communication. We define under a potential clarification for this latter outcome.
Areas recognized in our job that kind a part of the motion commentary community
The involvement of the superior temporal space within the gesture imitation job in our examine, which didn’t contain any verbal or semantic interpretations, parallels the roles described for these areas in motion commentary, which have been recognized in non-human primates.
Research have demonstrated the presence of cells within the superior temporal sulcus that code for motion commentary and are delicate to organic movement stimuli (Jellema and Perrett, 2003; Barraclough et al., 2009). This area is anatomically related to inferior parietal areas, which in flip hook up with central premotor areas (Rozzi et al., 2006; Borra et al., 2008). The latter community of areas has been described because the “mirror neuron” community (Bonini et al., 2011), which is concerned in understanding actions. Related areas have been described in human fMRI research, with proof that the inferior parietal area is activated when wholesome topics are required to grasp the that means of gestures (Passingham et al., 2014) or when specialists are requested to look at skillful actions which can be acquainted (Calvo-Merino et al., 2005). In our examine, each the prestriate and inferior temporal cortices have been concerned within the imitation of meaningless gestures. This might relate to the function of the inferior temporal cortex within the discrimination between shapes (Huxlin et al., 2000). It might be that sufferers have to grasp the form of the hand that must be copied.
A affected person examine by Achilles et al. (2016) gives some help for the above. Left-hemisphere stroke sufferers with and with out apraxia have been requested to charge the familiarity of meaningless gestures, which they imitated. Sufferers with apraxia have been discovered to have higher efficiency when copying meaningless gestures that have been judged as being acquainted by the entire affected person cohort, suggesting that they have been in a position to acknowledge familiarity in meaningless gestures.
Our outcomes help a task for temporal lobe and prestriate areas in understanding the that means of actions in meaningless gesture imitation duties, even when language features will not be implicated (Buxbaum et al., 2014; Passingham et al., 2014). This would possibly present a non-verbal community sub-serving each the understanding of motion intentions and communication.
“Area-general” and “domain-specific” deficits after stroke and interpretation of our lesion-mapping outcomes
The presence of comparable areas sub-serving features akin to praxis and language expertise would possibly point out that their involvement in these could possibly be generic to each duties (Geranmayeh et al., 2014). This has been demonstrated within the case of parietal lobe involvement, which is implicated in a wide variety of cognitive features (Humphreys and Lambon Ralph, 2015). Within the language literature, the parietal cortex has been proven to affect each “domain-general” and “domain-specific” deficits. An instance of the previous is the “A number of Demand” system, which exerts top-down management on a variety of duties and entails processes akin to cognitive flexibility, behavioral inhibition, and attentional management (Duncan, 2010; Hampshire et al., 2012).
The identical is more likely to be true for the function of the temporal lobe in praxis. Primarily based on the literature, the function of the temporal cortex in praxis could also be “area particular”, in offering information of software perform (Campanella et al., 2010; Buxbaum et al., 2014; Hoeren et al., 2014), or “area basic”, in understanding motion that means and “idea of thoughts” (Allison et al., 2000; Saygin, 2007). The previous system could also be used for naming and utilizing instruments (Mahon et al., 2007), while the latter system can be used for understanding others’ intentions by means of actions and non-verbal communication cues (Allison et al., 2000; Finkel et al., 2018).
Our examine, like others, highlights a relationship between language and apraxia (Goldenberg and Randerath, 2015). Nevertheless, we can not draw conclusive proof of the affect of 1 on the opposite. Some authors have tried to realize such a differentiation with novel imaging analyses in lesion-symptom mapping, permitting the subtraction of 1 impact from the opposite (Dressing et al., 2018). Nevertheless, to formally differentiate the relative contribution of the temporal lobe between the 2 cognitive domains, a scientific comparability between language and praxis expertise would require extra devoted duties, which would come with duties for organic movement focused at differentiating between speech and hand gestures. This could must be supplemented with converging proof from fMRI and lesion-mapping strategies (Mahon et al., 2007).
Interpretation of Our Imaging Outcomes Primarily based on Medical CT Imaging
This examine is one of some to have applied lesion-symptom mapping strategies on the scientific CT scans of a retrospective cohort of stroke sufferers (Rorden et al., 2012b; Gillebert et al., 2014; de Haan and Karnath, 2018). Medical CT is the imaging technique of alternative in sufferers admitted to hyperacute stroke models in the UK.
Latest advances (Ripolles et al., 2012; Rorden et al., 2012b) have made the identification of each ischemic and hemorrhagic lesions potential on the identical CT scan (Chawla et al., 2009; Gillebert et al., 2014). The lesion delineation approach we used compares CT picture depth from a single affected person with a gaggle of photos from management members to establish outlier voxels (Crawford et al., 2009; Gillebert et al., 2014). In impact, this strategy resembles the evaluation of MR photos (Stamatakis and Tyler, 2005). The usage of standardized preprocessing strategies for CT (Rorden et al., 2012a) allowed us to acquire comparable outcomes, when it comes to lesion localization, to these reported in MRI research (Buxbaum et al., 2014; Hoeren et al., 2014). However, our lesion sizes and the variety of sufferers required to acquire these outcomes did differ considerably from lesion-mapping strategies which have used MRI (Manuel et al., 2013; Buxbaum et al., 2014; Weiss et al., 2016). This will have occurred because of the following methodological caveats. (1) The usage of automated lesion delineation in our examine might have underestimated lesion sizes, significantly for ischemic strokes, which are sometimes troublesome to detect on CT. The approach would possibly profit from extra refined data that could possibly be supplied with complementary perfusion CT (Wing and Markus, 2019), which was not out there on the time of information assortment. (2) A examine investigating the influence of pattern measurement on the reproducibility of lesion-symptom mapping outcomes (Lorca-Puls et al., 2018) reported hanging variations when it comes to both under- or over-estimated impact sizes. An extra shortcoming of lesion-symptom mapping strategies known as “the partial harm downside” (Rorden et al., 2009) is that they might fail to think about the contribution of anatomically distributed areas in producing a behavioral deficit. It’s because sufferers might current with totally different lesions in a distributed community, for which mass univariate analyses might miss the essential areas concerned, due as soon as once more, to low statistical energy (Herbet et al., 2015; Gajardo-Vidal et al., 2018). Some authors have proposed methods of mitigating the organic constraints of lesion distributions with the usage of multivariate sample evaluation strategies (Smith et al., 2013; Mah et al., 2014). (3) Affected person choice: though we tried to acquire an unbiased data-sample, nearly all of our sufferers had strokes affecting the center cerebral artery, with lesions positioned within the convexity of the hemisphere. This led to low numbers of sufferers with extra superior lesions, in all probability decreasing the statistical energy to detect results in these cortical areas (Kroliczak and Frey, 2009; Agnew et al., 2012; Buxbaum et al., 2014). (4) Lesion localization: the usage of CT imaging had the caveat of requiring totally different anatomical atlases for grey and white matter localization. The overview by de Haan and Karnath (2018) outlines important variations within the interpretation of lesion mapping outcomes based mostly on which atlas is used for anatomical localization. Atlases such because the AAL (Tzourio-Mazoyer et al., 2002) and Harvard-Oxford atlases (Desikan et al., 2006), that are broadly out there in statistical evaluation packages, under-represent the variety of cortical areas (Van Essen et al., 2012). To keep away from the mislabeling of areas (Passingham and Rowe, 2015), the anatomical localization of serious areas on this examine have been recognized utilizing separate atlases for white and grey matter areas (see part “Supplies and Strategies” and Desk 4, above). For localization of grey matter areas, we chosen to make use of a extra detailed atlas, specifically the HCP atlas (Andreas, 2016; Glasser et al., 2016).
Conclusion
We’ve got performed a lesion mapping examine on praxis deficits with the most important cohort studied to this point. The sufferers have been within the early levels after a stroke (Bernhardt et al., 2017). Our outcomes counsel an essential function for temporal lobe buildings within the dysfunction. This space was not solely implicated within the information of software features when testing sufferers on pantomime duties however was additionally current within the imitation of meaningless gestures. This discovering concurs with different VLSM research of the dysfunction in stroke (Buxbaum et al., 2014; Hoeren et al., 2014) in addition to with earlier literature involving praxis deficits in neurodegenerative issues (Crutch et al., 2007; Johnen et al., 2016).
The implication of ventral stream areas in praxis, even when no object recognition is required, akin to within the meaningless gesture imitation job, has been largely ignored (Goldenberg, 2014). It’s seemingly that the community implicated in apraxia developed to sub-serve parallel features for praxis and language in people (Badets and Osiurak, 2017). New duties are being developed that present proof that skillful software use might help linguistic skills (Brozzoli et al., 2019). Our outcomes help current research designed to make use of motion commentary duties for the rehabilitation of this devastating dysfunction (Pazzaglia and Galli, 2019). Additional work is required to establish the granularity of the contributions of the temporal lobe and its connections in praxis and language deficits in sufferers with stroke and neurodegenerative situations.
The adoption of research strategies borrowed from MRI (Seghier et al., 2008) that assist the automated normalization into customary area and, subsequently, inter-individual comparisons of CT photos gives a window of alternative for lesion-symptom mapping in bigger affected person cohorts (Gillebert et al., 2014). This can pave the way in which for a greater understanding of cognitive deficits after stroke, akin to apraxia.
Information Availability Assertion
The datasets generated for this examine can be found on request to the corresponding writer and contingent on the approval of sharing this dataset by the BCOS workforce and native ethics committee.
Ethics Assertion
The research involving human members have been reviewed and accepted by the Nationwide Analysis Ethics Service (NRES): Essex 1 Analysis Ethics Committee (REC). The sufferers/members supplied their written knowledgeable consent to take part on this examine.
Writer Contributions
ER conceptualized the examine with DM. DM supplied the info evaluation strategies, which GP and ZZ applied. JR was a part of the unique BCOS workforce who collected the info and along with the late Professor Humphreys supplied entry to it to finish this examine. ZZ re-analyzed knowledge with covariates of no curiosity (of aphasia and neglect) and created the Determine 1. JK and ZZ created the supplementary figures. JK and RP supplied the anatomy and atlas help. ER and RP wrote up the manuscript. All authors reviewed and edited the manuscript.
Funding
This work was supported by the Stroke Affiliation UK (grant to Prof. G. W. Humphreys), and an Oxfordshire Well being Companies Analysis Committee analysis grant to ER (Ref. 1227). JK holds a Wellcome Belief Sir Henry Wellcome Postdoctoral Fellowship (204696/Z/16/Z).
Battle of Curiosity
The authors declare that the analysis was performed within the absence of any business or monetary relationships that could possibly be construed as a possible battle of curiosity.
Acknowledgments
We want to thank Prof. Glyn Humphreys’ workforce and the scientific groups in Birmingham, who have been concerned within the knowledge assortment for the Birmingham Cognitive Screening Program.
Supplementary Materials
The Supplementary Materials for this text could be discovered on-line at: https://www.frontiersin.org/articles/10.3389/fnhum.2019.00422/full#supplementary-material
Footnotes
References
Achilles, E. I. S., Fink, G. R., Fischer, M. H., Dovern, A., Held, A., Timpert, D. C., et al. (2016). Impact of that means on apraxic finger imitation deficits. Neuropsychologia 82, 74–83. doi: 10.1016/j.neuropsychologia.2015.12.022
PubMed Summary | CrossRef Full Textual content | Google Scholar
Agnew, Z. Okay., Clever, R. J., and Leech, R. (2012). Dissociating object directed and non-object directed motion within the human mirror system; implications for theories of motor simulation. PLoS One 7:e32517. doi: 10.1371/journal.pone.0032517
PubMed Summary | CrossRef Full Textual content | Google Scholar
Allison, T., Puce, A., and McCarthy, G. (2000). Social notion from visible cues: function of the STS area. Tendencies Cogn. Sci. 4, 267–278.
PubMed Summary | Google Scholar
Barraclough, N. E., Keith, R. H., Xiao, D., Oram, M. W., and Perrett, D. I. (2009). Visible adaptation to goal-directed hand actions. J. Cogn. Neurosci. 21, 1806–1820. doi: 10.1162/jocn.2008.21145
PubMed Summary | CrossRef Full Textual content | Google Scholar
Batenburg, Okay. J., and Sijbers, J. (2009). Optimum threshold choice for tomogram segmentation by projection distance minimization. IEEE Trans. Med. Imag. 28, 676–686. doi: 10.1109/TMI.2008.2010437
PubMed Summary | CrossRef Full Textual content | Google Scholar
Bates, E., Wilson, S. M., Saygin, A. P., Dick, F., Sereno, M. I., Knight, R. T., et al. (2003). Voxel-based lesion–symptom mapping. Nat. Neurosci. 6:448.
Google Scholar
Bernhardt, J., Hayward, Okay. S., Kwakkel, G., Ward, N. S., Wolf, S. L., Borschmann, Okay., et al. (2017). Agreed definitions and a shared imaginative and prescient for brand new requirements in stroke restoration analysis: the stroke restoration and rehabilitation roundtable taskforce. Neurorehabil. Neural. Restore. 31, 793–799. doi: 10.1177/1545968317732668
PubMed Summary | CrossRef Full Textual content | Google Scholar
Bickerton, W. L., Riddoch, M. J., Samson, D., Balani, A. B., Mistry, B., and Humphreys, G. W. (2012). Systematic evaluation of apraxia and purposeful predictions from the birmingham cognitive display. J. Neurol. Neurosurg. Psychiatry 83, 513–521. doi: 10.1136/jnnp-2011-300968
PubMed Summary | CrossRef Full Textual content | Google Scholar
Bonini, L., Serventi, F. U., Simone, L., Rozzi, S., Ferrari, P. F., and Fogassi, L. (2011). Greedy neurons of monkey parietal and premotor cortices encode motion targets at distinct ranges of abstraction throughout advanced motion sequences. J. Neurosci. 31, 5876–5886. doi: 10.1523/JNEUROSCI.5186-10.2011
PubMed Summary | CrossRef Full Textual content | Google Scholar
Borra, E., Belmalih, A., Calzavara, R., Gerbella, M., Murata, A., Rozzi, S., et al. (2008). Cortical connections of the macaque anterior intraparietal (AIP) space. Cereb. Cortex 18, 1094–1111. doi: 10.1093/cercor/bhm146
PubMed Summary | CrossRef Full Textual content | Google Scholar
Borra, E., Ichinohe, N., Sato, T., Tanifuji, M., and Rockland, Okay. S. (2010). Cortical connections to space TE in monkey: hybrid modular and distributed group. Cereb. Cortex 20, 257–270. doi: 10.1093/cercor/bhp096
PubMed Summary | CrossRef Full Textual content | Google Scholar
Brozzoli, C., Roy, A. C., Lidborg, L. H., and Lovden, M. (2019). Language as a software: motor proficiency utilizing a software predicts particular person linguistic skills. Entrance. Psychol. 10:1639. doi: 10.3389/fpsyg.2019.01639
PubMed Summary | CrossRef Full Textual content | Google Scholar
Bub, D. N., Masson, M. E. J., and Kumar, R. (2018). Time course of motor affordances evoked by pictured objects and phrases. J. Exp. Psychol. Hum. Percept. Carry out. 44, 53–68. doi: 10.1037/xhp0000431
PubMed Summary | CrossRef Full Textual content | Google Scholar
Buchmann, I., and Randerath, J. (2017). Choice and utility of acquainted and novel instruments in sufferers with left and proper hemispheric stroke: psychometrics and normative knowledge. Cortex 94, 49–62. doi: 10.1016/j.cortex.2017.06.001
PubMed Summary | CrossRef Full Textual content | Google Scholar
Buxbaum, L. J., Shapiro, A. D., and Coslett, H. B. (2014). Vital mind areas for tool-related and imitative actions: a componential evaluation. Mind 137, 1971–1985. doi: 10.1093/mind/awu111
PubMed Summary | CrossRef Full Textual content | Google Scholar
Calvo-Merino, B., Glaser, D. E., Grezes, J., Passingham, R. E., and Haggard, P. (2005). Motion commentary and bought motor expertise: an FMRI examine with skilled dancers. Cereb. Cortex 15, 1243–1249. doi: 10.1093/cercor/bhi007
PubMed Summary | CrossRef Full Textual content | Google Scholar
Campanella, F., D’Agostini, S., Skrap, M., and Shallice, T. (2010). Naming manipulable objects: anatomy of a class particular impact in left temporal tumours. Neuropsychologia 48, 1583–1597. doi: 10.1016/j.neuropsychologia.2010.02.002
PubMed Summary | CrossRef Full Textual content | Google Scholar
Chawla, M., Sharma, S., Sivaswamy, J., and Kishore, L. T. (2009). “A way for computerized detection and classification of stroke from mind CT photos,” in Proceedings of the Annual Worldwide Convention of the IEEE Engineering in Medication and Biology Society, Minneapolis, MN.
Google Scholar
Chechlacz, M., Mantini, D., Gillebert, C. R., and Humphreys, G. W. (2015). Asymmetrical white matter networks for attending to international versus native options. Cortex 72, 54–64. doi: 10.1016/j.cortex.2015.01.022
PubMed Summary | CrossRef Full Textual content | Google Scholar
Crawford, J. R., Garthwaite, P. H., and Howell, D. C. (2009). On evaluating a single case with a management pattern: another perspective. Neuropsychologia 47, 2690–2695. doi: 10.1016/j.neuropsychologia.2009.04.011
PubMed Summary | CrossRef Full Textual content | Google Scholar
Crawford, J. R., and Howell, D. C. (1998). Regression equations in scientific neuropsychology: an analysis of statistical strategies for evaluating predicted and obtained scores. J. Clin. Exp. Neuropsychol. 20, 755–762. doi: 10.1076/jcen.20.5.755.1132
PubMed Summary | CrossRef Full Textual content | Google Scholar
Creem, S. H., and Proffitt, D. R. (2001). Greedy objects by their handles: a needed interplay between cognition and motion. J. Exp. Psychol. Hum. Percept. Carry out. 27, 218–228. doi: 10.1037/0096-1523.27.1.218
CrossRef Full Textual content | Google Scholar
Crutch, S. J., Rossor, M. N., and Warrington, E. Okay. (2007). A novel approach for the quantitative evaluation of apraxic deficits: utility to people with delicate cognitive impairment. J. Neuropsychol. 1(Pt 2), 237–257. doi: 10.1348/174866407×209943
PubMed Summary | CrossRef Full Textual content | Google Scholar
Desikan, R. S., Segonne, F., Fischl, B., Quinn, B. T., Dickerson, B. C., Blacker, D., et al. (2006). An automatic labeling system for subdividing the human cerebral cortex on MRI scans into gyral based mostly areas of curiosity. Neuroimage 31, 968–980. doi: 10.1016/j.neuroimage.2006.01.021
PubMed Summary | CrossRef Full Textual content | Google Scholar
Donkervoort, M., Dekker, J., and Deelman, B. (2006). The course of apraxia and ADL functioning in left hemisphere stroke sufferers handled in rehabilitation centres and nursing properties. Clin. Rehabil. 20, 1085–1093. doi: 10.1177/0269215506071257
PubMed Summary | CrossRef Full Textual content | Google Scholar
Dovern, A., Fink, G. R., Saliger, J., Karbe, H., Koch, I., and Weiss, P. H. (2011). Apraxia impairs intentional retrieval of by the way acquired motor information. J. Neurosci. 31, 8102–8108. doi: 10.1523/JNEUROSCI.6585-10.2011
PubMed Summary | CrossRef Full Textual content | Google Scholar
Dressing, A., Nitschke, Okay., Kummerer, D., Bormann, T., Beume, L., Schmidt, C. S. M., et al. (2018). Distinct contributions of dorsal and ventral streams to imitation of tool-use and communicative gestures. Cereb. Cortex 28, 474–492. doi: 10.1093/cercor/bhw383
PubMed Summary | CrossRef Full Textual content | Google Scholar
Finkel, L., Hogrefe, Okay., Frey, S. H., Goldenberg, G., and Randerath, J. (2018). It takes two to pantomime: communication meets motor cognition. Neuroimage. Clin. 19, 1008–1017. doi: 10.1016/j.nicl.2018.06.019
PubMed Summary | CrossRef Full Textual content | Google Scholar
Gajardo-Vidal, A., Lorca-Puls, D. L., Crinion, J. T., White, J., Seghier, M. L., Leff, A. P., et al. (2018). How distributed processing produces false negatives in voxel-based lesion-deficit analyses. Neuropsychologia 115, 124–133. doi: 10.1016/j.neuropsychologia.2018.02.025
PubMed Summary | CrossRef Full Textual content | Google Scholar
Geranmayeh, F., Brownsett, S. L., and Clever, R. J. (2014). Activity-induced mind exercise in aphasic stroke sufferers: what’s driving restoration? Mind 137(Pt 10), 2632–2648. doi: 10.1093/mind/awu163
PubMed Summary | CrossRef Full Textual content | Google Scholar
Gillebert, C. R., Humphreys, G. W., and Mantini, D. (2014). Automated delineation of stroke lesions utilizing mind CT photos. Neuroimage. Clin. 4, 540–548. doi: 10.1016/j.nicl.2014.03.009
PubMed Summary | CrossRef Full Textual content | Google Scholar
Glasser, M. F., Coalson, T. S., Robinson, E. C., Hacker, C. D., Harwell, J., Yacoub, E., et al. (2016). A multi-modal parcellation of human cerebral cortex. Nature 536, 171–178. doi: 10.1038/nature18933
PubMed Summary | CrossRef Full Textual content | Google Scholar
Goldenberg, G., Hermsdorfer, J., Glindemann, R., Rorden, C., and Karnath, H. O. (2007). Pantomime of software use is determined by integrity of left inferior frontal cortex. Cereb. Cortex 17, 2769–2776. doi: 10.1093/cercor/bhm004
PubMed Summary | CrossRef Full Textual content | Google Scholar
Heilman, Okay. M., and Rothi, L. J. (2003). “Apraxia,” in Medical Neuropsychology, ed. Okay. M. Heilman (New York, NY: Oxford College Press), 141–163.
Google Scholar
Herbet, G., Lafargue, G., and Duffau, H. (2015). Rethinking voxel-wise lesion-deficit evaluation: a brand new problem for computational neuropsychology. Cortex 64, 413–416. doi: 10.1016/j.cortex.2014.10.021
PubMed Summary | CrossRef Full Textual content | Google Scholar
Hoeren, M., Kummerer, D., Bormann, T., Beume, L., Ludwig, V. M., Vry, M. S., et al. (2014). Neural bases of imitation and pantomime in acute stroke sufferers: distinct streams for praxis. Mind 137, 2796–2810. doi: 10.1093/mind/awu203
PubMed Summary | CrossRef Full Textual content | Google Scholar
Humphreys, G. W., Bickerton, W. L., Samson, D., and Riddoch, M. J. (2012). BCoS Cognitive Display. Psychology Press.
Google Scholar
Huxlin, Okay. R., Saunders, R. C., Marchionini, D., Pham, H. A., and Merigan, W. H. (2000). Perceptual deficits after lesions of inferotemporal cortex in macaques. Cereb. Cortex 10, 671–683. doi: 10.1093/cercor/10.7.671
CrossRef Full Textual content | Google Scholar
Jellema, T., and Perrett, D. I. (2003). Cells in monkey STS conscious of articulated physique motions and consequent static posture: a case of implied movement? Neuropsychologia 41, 1728–1737. doi: 10.1016/S0028-3932(03)00175-171
PubMed Summary | CrossRef Full Textual content | Google Scholar
Johnen, A., Brandstetter, L., Kargel, C., Wiendl, H., Lohmann, H., and Duning, T. (2016). Shared neural correlates of limb apraxia in early levels of Alzheimer’s dementia and behavioural variant frontotemporal dementia. Cortex 84, 1–14. doi: 10.1016/j.cortex.2016.08.009
PubMed Summary | CrossRef Full Textual content | Google Scholar
Kroliczak, G., and Frey, S. H. (2009). A standard community within the left cerebral hemisphere represents planning of software use pantomimes and acquainted intransitive gestures on the hand-independent degree. Cereb. Cortex 19, 2396–2410. doi: 10.1093/cercor/bhn261
PubMed Summary | CrossRef Full Textual content | Google Scholar
Liepmann, H. (1908). Drei Aufsatze aus dem Apraxiegebiet. Berlin: Karger.
Google Scholar
Liepmann, H. (1920). Apraxie. Ergebn Ges Med. 1, 516–543.
Google Scholar
Lindberg, P. G., Skejo, P. H., Rounis, E., Nagy, Z., Schmitz, C., Wernegren, H., et al. (2007). Wallerian degeneration of the corticofugal tracts in persistent stroke: a pilot examine relating diffusion tensor imaging, transcranial magnetic stimulation, and hand perform. Neurorehabil. Neural. Restore. 21, 551–560. doi: 10.1177/1545968307301886
PubMed Summary | CrossRef Full Textual content | Google Scholar
Lorca-Puls, D. L., Gajardo-Vidal, A., White, J., Seghier, M. L., Leff, A. P., Inexperienced, D. W., et al. (2018). The influence of pattern measurement on the reproducibility of voxel-based lesion-deficit mappings. Neuropsychologia 115, 101–111. doi: 10.1016/j.neuropsychologia.2018.03.014
PubMed Summary | CrossRef Full Textual content | Google Scholar
Mahon, B. Z., Milleville, S. C., Negri, G. A. L., Rumiati, R. I., Caramazza, C., and Martin, A. (2007). Motion-related properties form object representations within the ventral stream. Neuron 55, 507–520. doi: 10.1016/j.neuron.2007.07.011
PubMed Summary | CrossRef Full Textual content | Google Scholar
Manuel, A. L., Radman, N., Mesot, D., Chouiter, L., Clarke, S., Annoni, J. M., et al. (2013). Inter- and intrahemispheric dissociations in ideomotor apraxia: a large-scale lesion-symptom mapping examine in subacute brain-damaged sufferers. Cereb. Cortex 23, 2781–2789. doi: 10.1093/cercor/bhs280
PubMed Summary | CrossRef Full Textual content | Google Scholar
Mengotti, P., Corradi-Dell’Acqua, C., Negri, G. A., Ukmar, M., Pesavento, V., and Rumiati, R. I. (2013). Selective imitation impairments differentially work together with language processing. Mind 136(Pt 8), 2602–2018. doi: 10.1093/mind/awt194
PubMed Summary | CrossRef Full Textual content | Google Scholar
Osiurak, F., Aubin, G., Allain, P., Jarry, C., Richard, I., and Le Gall, D. (2008). Object utilization and object utilization: a single-case examine. Neurocase 14, 169–183. doi: 10.1080/13554790802108372
PubMed Summary | CrossRef Full Textual content | Google Scholar
Pandya, D., Petrides, M., Seltzer, B., and Cipollon, P. (2015). Cerebral Cortex:Structure, Connections and the Twin Origin Idea. Oxford: Oxford College Press.
Google Scholar
Papagno, C., Della Sala, S., and Basso, A. (1993). Ideomotor apraxia with out aphasia and aphasia with out apraxia: the anatomical help for a double dissociation. J. Neurol. Neurosurg. Psychiatry 56, 286–289. doi: 10.1136/jnnp.56.3.286
PubMed Summary | CrossRef Full Textual content | Google Scholar
Passingham, R. E., Chung, A., Goparaju, B., Cowey, A., and Vaina, L. M. (2014). Utilizing motion understanding to grasp the left inferior parietal cortex within the human mind. Mind Res. 1582, 64–76. doi: 10.1016/j.brainres.2014.07.035
PubMed Summary | CrossRef Full Textual content | Google Scholar
Passingham, R. E., and Rowe, J. B. (2015). A Brief Information to Mind Imaging: The Neuroscience of Human Cognition. Oxford: Oxford College Press.
Google Scholar
Pazzaglia, M., Smania, N., Corato, E., and Aglioti, S. M. (2008). Neural underpinnings of gesture discrimination in sufferers with limb apraxia. J. Neurosci. 28, 3030–3041. doi: 10.1523/JNEUROSCI.5748-07.2008
PubMed Summary | CrossRef Full Textual content | Google Scholar
Worth, C. J., Crinion, J. T., Leff, A. P., Richardson, F. M., Schofield, T. M., Prejawa, S., et al. (2010). Lesion websites that predict the power to gesture how an object is used. Arch. Ital Biol. 148, 243–258.
PubMed Summary | Google Scholar
Reynaud, E., Lesourd, M., Navarro, J., and Osiurak, F. (2016). On the neurocognitive origins of human software use : a essential overview of neuroimaging knowledge. Neurosci. Biobehav. Rev. 64, 421–437. doi: 10.1016/j.neubiorev.2016.03.009
PubMed Summary | CrossRef Full Textual content | Google Scholar
Rijntjes, M., Weiller, C., Bormann, T., and Musso, M. (2012). The twin loop mannequin: its relation to language and different modalities. Entrance. Evol. Neurosci. 4:9. doi: 10.3389/fnevo.2012.00009
PubMed Summary | CrossRef Full Textual content | Google Scholar
Ripolles, P., Marco-Pallares, J., de Diego-Balaguer, R., Miro, J., Falip, M., Juncadella, M., et al. (2012). Evaluation of automated strategies for spatial normalization of lesioned brains. Neuroimage 60, 1296–1306. doi: 10.1016/j.neuroimage.2012.01.094
PubMed Summary | CrossRef Full Textual content | Google Scholar
Rorden, C., Bonilha, L., Fridriksson, J., Bender, B., and Karnath, H. O. (2012a). Age-specific CT and MRI templates for spatial normalization. Neuroimage 61, 957–965. doi: 10.1016/j.neuroimage.2012.03.020
PubMed Summary | CrossRef Full Textual content | Google Scholar
Rorden, C., Hjaltason, H., Fillmore, P., Fridriksson, J., Kjartansson, O., Magnusdottir, S., et al. (2012b). Allocentric neglect strongly related to selfish neglect. Neuropsychologia 50, 1151–1157. doi: 10.1016/j.neuropsychologia.2012.03.031
PubMed Summary | CrossRef Full Textual content | Google Scholar
Rorden, C., Fridriksson, J., and Karnath, H. O. (2009). An analysis of conventional and novel instruments for lesion habits mapping. Neuroimage 44, 1355–1362. doi: 10.1016/j.neuroimage.2008.09.031
PubMed Summary | CrossRef Full Textual content | Google Scholar
Rozzi, S., Calzavara, R., Belmalih, A., Borra, E., Gregoriou, G. G., Matelli, M., et al. (2006). Cortical connections of the inferior parietal cortical convexity of the macaque monkey. Cereb. Cortex 16, 1389–1417. doi: 10.1093/cercor/bhj076
PubMed Summary | CrossRef Full Textual content | Google Scholar
Salmond, C. H., Ashburner, J., Vargha-Khadem, F., Connelly, A., Gadian, D. G., and Friston, Okay. J. (2002). The precision of anatomical normalization within the medial temporal lobe utilizing spatial foundation features. Neuroimage 17, 507–512. doi: 10.1006/nimg.2002.1191
PubMed Summary | CrossRef Full Textual content | Google Scholar
Seghier, M. L., Ramlackhansingh, A., Crinion, J., Leff, A. P., and Worth, C. J. (2008). Lesion identification utilizing unified segmentation-normalisation fashions and fuzzy clustering. Neuroimage 41, 1253–1266. doi: 10.1016/j.neuroimage.2008.03.028
PubMed Summary | CrossRef Full Textual content | Google Scholar
Selnes, O. A., Pestronk, A., Hart, J., and Gordon, B. (1991). Limb apraxia with out aphasia from a left sided lesion in a proper handed affected person. J. Neurol. Neurosurg. Psychiatry 54, 734–737. doi: 10.1136/jnnp.54.8.734
PubMed Summary | CrossRef Full Textual content | Google Scholar
Smith, D. V., Clithero, J. A., Rorden, C., and Karnath, H. O. (2013). Decoding the anatomical community of spatial consideration. Proc. Natl. Acad. Sci. U.S.A. 110, 1518–1523. doi: 10.1073/pnas.1210126110
PubMed Summary | CrossRef Full Textual content | Google Scholar
Stamatakis, E. A., and Tyler, L. Okay. (2005). Figuring out lesions on structural mind images-validation of the strategy and utility to neuropsychological sufferers. Mind Lang. 94, 167–177. doi: 10.1016/j.bandl.2004.12.010
PubMed Summary | CrossRef Full Textual content | Google Scholar
Thiebaut de Schotten, M., Ffytche, D. H., Bizzi, A., Dell’Acqua, F., Allin, M., Walshe, M., et al. (2011). Atlasing location, asymmetry and inter-subject variability of white matter tracts within the human mind with MR diffusion tractography. Neuroimage 54, 49–59. doi: 10.1016/j.neuroimage.2010.07.055
PubMed Summary | CrossRef Full Textual content | Google Scholar
Tzourio-Mazoyer, N., Landeau, B., Papathanassiou, D., Crivello, F., Etard, O., Delcroix, N., et al. (2002). Automated anatomical labeling of activations in SPM utilizing a macroscopic anatomical parcellation of the MNI MRI single-subject mind. Neuroimage 15, 273–289. doi: 10.1006/nimg.2001.0978
PubMed Summary | CrossRef Full Textual content | Google Scholar
Van Essen, D. C., Glasser, M. F., Dierker, D. L., Harwell, J., and Coalson, T. (2012). Parcellations and hemispheric asymmetries of human cerebral cortex analyzed on surface-based atlases. Cereb. Cortex 22, 2241–2262. doi: 10.1093/cercor/bhr291
PubMed Summary | CrossRef Full Textual content | Google Scholar
van Polanen, V., and Davare, M. (2015). Interactions between dorsal and ventral streams for controlling expert grasp. Neuropsychologia 79(Pt B), 186–191. doi: 10.1016/j.neuropsychologia.2015.07.010
PubMed Summary | CrossRef Full Textual content | Google Scholar
Weiller, C., Musso, M., Rijntjes, M., and Saur, D. (2009). Please don’t underestimate the ventral pathway in language. Tendencies Cogn. Sci. 13, 369–370. doi: 10.1016/j.tics.2009.06.007
PubMed Summary | CrossRef Full Textual content | Google Scholar
Weiss, P. H., Ubben, S. D., Kaesberg, S., Kalbe, E., Kessler, J., Liebig, T., et al. (2016). The place language meets significant motion: a mixed habits and lesion evaluation of aphasia and apraxia. Mind Struct. Funct. 221, 563–576. doi: 10.1007/s00429-014-0925-3
PubMed Summary | CrossRef Full Textual content | Google Scholar
Zwinkels, A., Geusgens, C., van de Sande, P., and Van Heugten, C. (2004). Evaluation of apraxia: inter-rater reliability of a brand new apraxia take a look at, affiliation between apraxia and different cognitive deficits and prevalence of apraxia in a rehabilitation setting. Clin. Rehabil. 18, 819–827. doi: 10.1191/0269215504cr816oa
PubMed Summary | CrossRef Full Textual content | Google Scholar
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