BACKGROUND & PURPOSE: Ideomotor apraxia is a gestural deficit which is not due to primary sensory or motor deficit, poor auditory comprehension or incooperation. Previous studies on apraxia in AD patients include advanced AD patients who exhibited marked impairment in auditory comprehension, This might have confounded the results of the studies. The purpose of this study is to observe the frequencies and patterns of gestural errors in the early stage of AD. METHOD: Eighteen patients with AD (M : F = 4 : 14, age 62.6 + 7.2) and eighteen age- and sex- matched controls participated in this research. Patients who scored below 80 % of Western Aphasia Battery comprehension subtest and showed marked cognitive impairments were excluded (MMSE; 19.9 + 4.4, CDR 1.1+/- 0.5). Gestures. In response to commands were videotaped and analyzed by 2 neurologists and 1 speech-language pathologist. Test items included 3 types of movements ; 10 limb intrasitive, 15 transitive, and 10 buccofacial. RESULTS: Limb transitive movements were the most affected while buccofacial was the least. The error patterns most frequently observed were body-part-as-objects (BPO, 20%), external configuration orientation (ECO, 16%), and movement error(M, 9%). In comparision, BPO, ECO, M errors in normal control were 2%, 3%, and 4% respectively. In addition, apraxia item, which are to detecting AD were identified. CONCLUSION: It is suggested that the apraxia is commonly associated with AD even in the early stage of the disease and an accurate anaIysis of errors may contribute to establishing an early diagnosis of AD.
Alzheimer Disease* ; Aphasia ; Apraxia, Ideomotor* ; Apraxias ; Comprehension ; Early Diagnosis ; Extremities ; Gestures ; Humans

A woman developed a slowly progressive speech disturbance at age 51. Three years latter she showed difficulty in calculation, reading and writing. At age 57, she complained of right shoulder pain. At age 58, neurological examination revealed rigidity, bradykinesia and ideomotor apraxia in the right upper extremity. This case demonstrats a clinical overlap between progressive nonfluent aphasia and corticobasal degeneration.
Apraxia, Ideomotor ; Female ; Humans ; Hypokinesia ; Neurologic Examination ; Primary Progressive Nonfluent Aphasia ; Shoulder Pain ; Upper Extremity ; Writing

Corticobasal degeneration (CBD) is characterized by asymmetric clinical manifestations including asymmetrical apraxia, alien limb movement and Parkinsonian symptoms. Cognitive function is relatively normal in the early course of illness. We report a 59 years old right-handed male with CBD. He showed asymmetrical ideomotor apraxia, alien limb movement and extrapyramidal symptom, such as cogwheel rigidity and bradykinesia, that were more severe in the right hand. These symptoms have deteriorated progressively for 2 years, but the cognitive function was relatively pre-served. Brain MRI revealed atrophic changes in both parietal lobes. FDG-PET showed an asymmetrical hypometabo-lism in supplementary motor area, parietal lobe, thalamus and basal ganglia, which was more severe in the left than the right hemisphere.
Apraxia, Ideomotor ; Apraxias* ; Basal Ganglia ; Brain ; Emigrants and Immigrants ; Extremities ; Hand ; Humans ; Hypokinesia ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Muscle Rigidity ; Parietal Lobe ; Thalamus

Callosal disconnection results in the functional independence of each hemisphere and usually produces characteristic signs including alien hand, left-sided apraxia, left agraphia and left tactile anomia. Our two patients; a 75-year-old right-handed woman with hypertension and a 71-year-old right-handed woman with diabetes mellitus, showed impairments in the identification of body parts with their left hands in addition to characteristic symptoms such as left ideomotor apraxia, agraphia, tactile anomia, and right alien hand signs with groping and grasping. Brain MRIs of these patients upon admission demonstrated infarcts in the medial portion of the left frontal lobes and in the corpus callosum supplied by the left anterior cerebral artery. The impairment of body parts cognition in our patients can be attributed to the failure of the patient's left hand to communicate with the body schema stored in the left hemisphere.
Aged ; Agraphia ; Anomia ; Anterior Cerebral Artery ; Apraxia, Ideomotor ; Apraxias ; Body Image ; Brain ; Cognition* ; Corpus Callosum ; Diabetes Mellitus ; Emigrants and Immigrants ; Extremities* ; Female ; Frontal Lobe ; Hand ; Hand Strength ; Human Body ; Humans ; Hypertension ; Magnetic Resonance Imaging