Pantomime comprehension and ideomotor apraxia

Neuropsychologia, 2001

We compared gesture comprehension and imitation in patients with lesions in the left parietal lobe (LPAR, n= 5) and premotor cortex/supplementary motor area (LPMA, n =8) in patients with damage to the right parietal lobe (RPAR, n= 6) and right premotor/supplementary motor area (RPMA, n= 6) and in 16 non-brain damaged control subjects. Three patients with left parietal lobe damage had aphasia. Subjects were shown 136 meaningful pantomimed motor acts on a videoscreen and were asked to identify the movements and to imitate the motor acts from memory with their ipsilesional and contralesional hand or with both hands simultaneously. Motor tasks included gestures without object use (e.g. to salute, to wave) pantomimed imitation of gestures on one's own body (e.g. to comb one's hair) and pantomimed imitation of motor acts which imply tool use to an object in extrapersonal space (e.g. to hammer a nail). Videotaped test performance was analysed by two independent raters; errors were classified as spatial errors, body part as object, parapraxic performance and non-identifiable movements. In addition, action discrimination was tested by evaluating whether a complex motor sequence was correctly performed. Results indicate that LPAR patients were most severely disturbed when imitation performance was assessed. Interestingly, LPAR patients were worse when imitating gestures on their own bodies than imitating movements with reference to an external object use with most pronounced deficits in the spatial domain. In contrast to imitation, comprehension was not or only slightly disturbed and no clear correlation was found between the severity of imitation deficits and gesture comprehension. Moreover, although the three patients with aphasia imitated the movements more poorly than non-aphasic LPAR patients, the severity of comprehension errors did not differ. Whereas unimanual imitating performance and gesture comprehension of PMA patients did not differ significantly from control subjects, bimanual tasks were severely disturbed, in particular when executing different movements simultaneously with the right and left hands.

The South African journal of communication disorders. Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings, 1978

Journal of The International Neuropsychological Society, 2002

Patients with apraxia are more impaired when performing transitive pantomimes than intransitive gestures. This dissociation might be related to the differences in movement complexity. Alternatively, the programs for intransitive gestures might be better defined, more widely distributed, or easier to activate than are those for transitive pantomimes. The purpose of this study was to test the complexity versus representational hypotheses. Twenty right-handed normal subjects both performed and discriminated correct from incorrect transitive pantomimes and intransitive gestures. The discrimination was performed by having subjects point at illustrations of hand postures. The subjects performed better when discriminating postures than when performing gestures or pantomimes. On both the production and discrimination tests, subjects performed better with intransitive gestures than transitive pantomimes. Although the finding that even normal subjects had more difficulty performing transitive pantomimes than intransitive gestures might appear to support the complexity hypothesis, that subjects also had more difficulty discriminating transitive than intransitive postures supports the representational activation hypothesis.

Contemporary Issues in Communication Science and Disorders

This study examined the effects of aphasia and ideomotor apraxia on conversational gesture. Participants included 8 neurologically normal control participants and 12 participants having aphasia from a single left-hemisphere stroke. Testing included the Western Aphasia Battery (Kertesz, 1982), the Florida Apraxia Battery (Rothi et al., 1992), and scoring of conversational gesture. Statistical findings using a between-group analysis of variance revealed a statistically significant difference in quantity and type of gestures used between experimental and control participants. Within the experimental participants, there was a clear relationship between severity of aphasia and conversational gesture, but not between severity of ideomotor apraxia and conversational gesture. Therefore, severity of aphasia appears to be a better predictor than severity of ideomotor apraxia for the production of spontaneous gesture.

Brain and Language, 1976

Neuropsychologia, 1995

Imitation of meaningless gestures was examined in patients with left brain damage (LBD), right brain damage (RBD) and controls. In addition to imitation on the own body, patients were asked to replicate the gestures on a life-sized mannikin. Manual dexterity was assessed by manipulation of beads, and general visuospatial abilities by block-design. LBD patients who displayed apraxia when imitating gestures on their own bodies scored dramatically worse than any other group when imitation was assessed on the mannikin. By contrast, on block-design and manipulation of beads patients with RBD were inferior not only to LBD patients without apraxia but also to apractic patients. Analysis of CT scans revealed that apraxia occurred with frontal, parietal and deep lesions, and that the impairment on the manipulation of the mannikin was present regardless of lesion site. The results support the contention that the basic deficit underlying impaired imitation of meaningless gestures in apraxia is to be sought at a conceptual level. Possibly, patients with apraxia are not able to evoke and represent conceptual knowledge about the human body which is necessary for performing the apparently simple task of imitating gestures.

International journal of language & communication disorders, 2017

Human communication occurs through both verbal and visual/motoric modalities. Simultaneous conversational speech and gesture occurs across all cultures and age groups. When verbal communication is compromised, more of the communicative load can be transferred to the gesture modality. Although people with aphasia produce meaning-laden gestures, the communicative value of these has not been adequately investigated. To investigate the communicative effectiveness of pantomime gesture produced spontaneously by individuals with aphasia during conversational discourse. Sixty-seven undergraduate students wrote down the messages conveyed by 11 people with aphasia that produced pantomime while engaged in conversational discourse. Students were presented with a speech-only, a gesture-only and a combined speech and gesture condition and guessed messages in both a free description and a multiple-choice task. As hypothesized, listener comprehension was more accurate in the combined pantomime gest...

2014

Background: Human communication occurs through both verbal and visual/motoric modalities. Simultaneous conversational speech and gesture occurs across all cultures and age groups. When verbal communication is compromised, more of the communicative load can be transferred to the gesture modality. Although people with aphasia produce meaning-laden gestures, the communicative value of these has not been adequately investigated. Aims: To investigate the communicative effectiveness of pantomime gesture produced spontaneously by individuals with aphasia during conversational discourse. Methods & Procedures: Sixty-seven undergraduate students wrote down the messages conveyed by 11 people with aphasia that produced pantomime while engaged in conversational discourse. Students were presented with a speech-only, a gesture-only and a combined speech and gesture condition and guessed messages in both a free description and a multiple-choice task. Outcomes & Results: As hypothesized, listener comprehension was more accurate in the combined pantomime gesture and speech condition as compared with the gesture-or speech-only conditions. Participants achieved greater accuracy in the multiple-choice task as compared with the free-description task, but only in the gestureonly condition. The communicative effectiveness of the pantomime gestures increased as the fluency of the participants with aphasia decreased. Conclusions & Implications: These results indicate that when pantomime gesture was presented with aphasic speech, the combination had strong communicative effectiveness. Future studies could investigate how pantomimes can be integrated into interventions for people with aphasia, particularly emphasizing elicitation of pantomimes in as natural a context as possible and highlighting the opportunity for efficient message repair.

Neuropsychologia, 1997

In two patients with damage to the inferior portion of the left angular gyrus severely defective imitation of meaningless gestures contrasted with preserved performance of meaningful gestures to verbal command and with preserved imitation of meaningful gestures[ In one patient the imitation de_cit was restricted to the imitation of hand positions while imitation of _nger con_gurations was normal[ In both patients replication of the hand positions on a mannikin was as defective as imitation on themselves[ This pattern of preserved and impaired performances is incompatible with two!stage models of apraxia which posit that defective imitation stems from damage to an executional stage of gesture production[ Interruption of a direct route from perception to execution of action could account for the dissociation between defective imitation of meaningless and preserved performance of meaningful gestures [ We propose that functioning of this route requires the integrity of general knowledge about the structure of the human body[ Þ 0886 Elsevier Science Ltd[ All rights reserved[ Key Words] apraxia^motor control^parietal lobe^imitation[ * ÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐÐ than the pantomime of object use even in controls[ Neuropsychologische Abteilung Krankenhaus Mu à nchenÐ They concluded that only the reverse dissociation was Bogenhausen Englschalkingerstrasse 66 D 70814 Mu à nchen\ FRG^tel[] ¦38!78!8169 1095^fax] ¦38!78!8169 1978[ speci_c for left!brain damage ð3Ł[ Single case studies cast

Cortex, 2014

Anosognosia is a multifaceted, neuro-psychiatric syndrome characterized by defective awareness of a variety of perceptuo-motor, cognitive or emotional deficits. The syndrome is also characterized by modularity, i.e., deficits of awareness in one domain (e.g., spatial perception) co-existing with spared functions in another domain (e.g., memory). Anosognosia has mainly been reported after right hemisphere lesions. It is however somewhat surprising that no studies have thus far specifically explored the possibility that lack of awareness involves apraxia, i.e., a deficit in the ability to perform gestures caused by an impaired higher-order motor control and not by low-level motor deficits, sensory loss, or failure to comprehend simple commands. We explored this issue by testing fifteen patients with vascular lesions who were assigned to one of three groups depending on their neuropsychological profile and brain lesion. The patients were asked to execute various actions involving the upper limb or bucco-facial body parts. In addition they were also asked to judge the accuracy of these actions, either performed by them or by other individuals. The judgment of the patients was compared to that of two external observers. Results show that our bucco-facial apraxic patients manifest a specific deficit in detecting their own gestural errors. Moreover they were less aware of their defective performance in bucco-facial as compared to limb actions. Our results hint at the existence of a new form of anosognosia specifically involving apraxic deficits.