Klinische Neurophysiologie 2012; 43 - P009
DOI: 10.1055/s-0032-1301559

Establishment of a tool use carousel miming real-life actions in the investigation of apraxia

AC Dieler 1, J Randerath 2, Y Li 3, G Goldenberg 4, J Hermsdörfer 5
  • 1Technische Universität München, München
  • 2Department of Psychology, University of Oregon, Eugene, USA
  • 3Neurologische Klinik, Klinikum rechts der Isar, Technische Universität München, München
  • 4Klinik für Neuropsychologie, Städtische Kliniken München GmbH, Klinikum Bogenhausen, München
  • 5Fakultät für Sport- und Gesundheitswissenschaft, Technische Universität München, München

Aim: Tool use is a characteristic ability in humans, which can be disturbed after lesions to fronto-parietal structures, e.g. after stroke of the middle cerebral artery, resulting in apraxia. Tool use performance in apraxic patients is investigated by a variety of paradigms, ranging from the mere observation or pantomime of actions to their actual performance. As a result performance deficits vary depending on the used paradigm, creating an inhomogeneous picture of apraxic behavior. In our current study we establish a tool carousel allowing for the investigation of realistic performance of tool use.

Methods: Patients with left middle cerebral artery stroke, resulting in aphasia and/or apraxia are investigated in their tool use performance on different tools and their respective recipient. During their performance patients are videotaped and motion recording is performed (Liberty, Polhemus) from the patients as well as the investigators movements, allowing for the calculation of time-to-motion-initiation (RT) after presentation of the individual tools as well as assessment of movement kinematics during execution. Comparison with video scores allows correlations between classically defined apraxia errors, RTs and kinematic abnormalities.

Results: In a pre-experiment investigating 33 patients, a hammering task showed longer RTs irrespective of the side of the lesion and kinematic errors in patients with left brain damage only. Application of the tool carousel allows for an improvement of the experimental setting regarding timing and spatial presentation of the tools in question.

Conclusion: Analysis of RTs and kinematics together with controlled presentation of tools provides new insights into apraxia and higher order motor disorders. In ongoing studies the tool carousel allows for the spatially and temporally controlled application of tools providing the possibility of an identical setup in clinical lab studies and fMRI environments.

Literatur: Acknowledgements: This project is supported by a grant from the German Research Foundation (DFG; HE-3592/7-1).