Different constraints on grip selection in brain-damaged patients: object use versus object transport

Grip selection without tool knowledge: end-state comfort effect in familiar and novel tool use

A well-known phenomenon for the study of movement planning is the end-state comfort (ESC) effect: When they reach and grasp tools, individuals tend to adopt uncomfortable initial hand postures if that allows a subsequent comfortable final posture. In the context of tool use, this effect is modulated by tool orientation, task goal, and cooperation. However, the cognitive bases of the ESC effect remain unclear. The goal of this study was to determine the contribution of semantic tool knowledge and technical reasoning to movement planning, by testing whether the ESC effect typically observed with familiar tools would also be observed with novel tools. Twenty-six participants were asked to reach and grasp familiar and novel tools under varying conditions (i.e., tool's handle downward vs. upward; tool transport vs. use; solo vs. cooperation). In our findings, the effects of tool orientation, task goal and cooperation were replicated with novel tools. It follows that semantic tool knowledge is not critical for the ESC effect to occur. In fact, we found an "habitual" effect: Participant adopted uncomfortable grips with familiar tools even when it was not necessary (i.e., to transport them), probably because of the interference of habitual movement programming with actual movement programming. A cognitive view of movement planning is proposed, according to which goal comprehension (1) may rely on semantic tool knowledge, technical reasoning, and/or social skills, (2) defines end-state configuration, which in turn (3) calibrates beginning-state comfort and hence the occurrence of the ESC effect.

A Selective Hand Posture Apraxia in an Individual With Posterior Cortical Atrophy and Probable Corticobasal Syndrome

A selective impairment for making hand postures that are required to use specific tools has rarely been reported in individuals with acquired brain injury, and such an impairment has not been documented at all in individuals with degenerative disorders. We describe an individual with posterior cortical atrophy and probable corticobasal syndrome who was unable to use tools because of an inability to make the proper hand posture required for each tool. This individual was, however, able to use the tools properly once her hand postures were corrected, and her ability to manipulate the tools (ie, timing, arm posture, and amplitude) was intact. Also, she had no difficulty with a test of her manipulation knowledge. Areas of hypoperfusion observed by single-photon emission computerized tomography included the anterior intraparietal sulcus in the left parietal lobe, which is an area that has been proposed to control hand postures. This selective impairment might be explained by the reasoning-based hypothesis for apraxia, which attributes hand posture errors in the absence of manipulation errors to dysfunction in one of the three independent pathways that subserve tool use, rather than the manipulation-based hypothesis for apraxia, which attributes hand posture errors to impaired manipulation knowledge. This is the first case with a degenerative disorder that revealed a selective impairment for making hand postures for tool use, which might be explained mainly by apraxia of hand postures along with visuospatial dysfunction (simultanagnosia) and/or sensory disturbance.

The social cognitive dimension of pantomime

Pantomime production is commonly interpreted as reflecting tool-use-related cognitive processes. Yet, in everyday life, pantomime deserves a communication function and the exaggeration of amplitude found during pantomime compared to real tool use may reflect the individual's attempt to communicate the intended gesture. Therefore, the question arises about whether pantomime is a communicative behavior that is nevertheless supported only by non-social cognitive processes. We contribute to answering this question by using kinematic analyses. Participants performed the pantomime of using a saw or a hammer from visual presentation in three conditions: Free (no specific instructions), Self (focus on the real tool-use action), and Others (focus on the communicative dimension). Finally, they used the tool with the corresponding object (Actual condition). Participants' social cognition were assessed using gold standard questionnaires. Our results indicated that the manipulation of instructions had a minor effect on the exaggeration of amplitude during pantomime. We reported a link between the social cognition score and the amplitude in the Others condition for the hammer, which suggests that social cognitive processes could take part in pantomime production in some conditions. Nevertheless, this result does not alter our conclusion that social cognitive processes might be far from necessary for pantomime production.

Physical understanding in neurodegenerative diseases

This quantitative review gives an overview of physical understanding (i.e., the ability to represent and use the laws of physics to interact with the physical world) impairments in Alzheimer's disease (AD), semantic dementia (SD), and corticobasal syndrome (CBS), as assessed mainly with mechanical problem-solving and tool use tests. This review shows that: (1) SD patients have apraxia of tool use because of semantic tool knowledge deficits, but normal performance in tests of physical understanding; (2) AD and CBS patients show impaired performance in mechanical problem-solving tests, probably not because of intrinsic deficits of physical understanding, but rather because of additional cognitive (AD) or motor impairments (CBS); (3) As a result, the performance in mechanical problem-solving tests is not a good predictor of familiar tool use in dementia; (4) Actual deficits of physical understanding are probably observed only in late stages of neurodegenerative diseases, and associated with functional loss.

Pantomime of tool use: looking beyond apraxia

Pantomime has a long tradition in clinical neuropsychology of apraxia. It has been much more used by researchers and clinicians to assess tool-use disorders than real tool use. Nevertheless, it remains incompletely understood and has given rise to controversies, such as the involvement of the left inferior parietal lobe or the nature of the underlying cognitive processes. The present article offers a comprehensive framework, with the aim of specifying the neural and cognitive bases of pantomime. To do so, we conducted a series of meta-analyses of brain-lesion, neuroimaging and behavioural studies about pantomime and other related tasks (i.e. real tool use, imitation of meaningless postures and semantic knowledge). The first key finding is that the area PF (Area PF complex) within the left inferior parietal lobe is crucially involved in both pantomime and real tool use as well as in the kinematics component of pantomime. The second key finding is the absence of a well-defined neural substrate for the posture component of pantomime (both grip errors and body-part-as-tool responses). The third key finding is the role played by the intraparietal sulcus in both pantomime and imitation of meaningless postures. The fourth key finding is that the left angular gyrus seems to be critical in the production of motor actions directed towards the body. The fifth key finding is that performance on pantomime is strongly correlated with the severity of semantic deficits. Taken together, these findings invite us to offer a neurocognitive model of pantomime, which provides an integrated alternative to the two hypotheses that dominate the field: The gesture-engram hypothesis and the communicative hypothesis. More specifically, this model assumes that technical reasoning (notably the left area PF), the motor-control system (notably the intraparietal sulcus), body structural description (notably the left angular gyrus), semantic knowledge (notably the polar temporal lobes) and potentially theory of mind (notably the middle prefrontal cortex) work in concert to produce pantomime. The original features of this model open new avenues for understanding the neurocognitive bases of pantomime, emphasizing that pantomime is a communicative task that nevertheless originates in specific tool-use (not motor-related) cognitive processes.

<Please insert Graphical abstract here>

Bálint syndrome

This chapter starts by reviewing the various interpretations of Bálint syndrome over time. We then develop a novel integrative view in which we propose that the various symptoms, historically reported and labeled by various authors, result from a core mislocalization deficit. This idea is in accordance with our previous proposal that the core deficit of Bálint syndrome is attentional (Pisella et al., 2009, 2013, 2017) since covert attention improves spatial resolution in visual periphery (Yeshurun and Carrasco, 1998); a deficit of covert attention would thus increase spatial uncertainty and thereby impair both visual object identification and visuomotor accuracy. In peripheral vision, we perceive the intrinsic characteristics of the perceptual elements surrounding us, but not their precise localization (Rosenholtz et al., 2012a,b), such that without covert attention we cannot organize them to their respective and recognizable objects; this explains why perceptual symptoms (simultanagnosia, neglect) could result from visual mislocalization. The visuomotor symptoms (optic ataxia) can be accounted for by both visual and proprioceptive mislocalizations in an oculocentric reference frame, leading to field and hand effects, respectively. This new pathophysiological account is presented along with a model of posterior parietal cortex organization in which the superior part is devoted to covert attention, while the right inferior part is involved in visual remapping. When the right inferior parietal cortex is damaged, additional representational mislocalizations across saccades worsen the clinical picture of peripheral mislocalizations due to an impairment of covert attention.

Factors Influencing Manipulation of a Familiar Object in Patients With Limb Apraxia After Stroke

Previous studies have shown that hand actions to visual objects are affected both by perceptual factors and by action goals. Our aim was to study how these processes affected hand actions in chronic stroke patients, based on whether they had limb apraxia. Twenty-two left hemisphere, chronic stroke patients were measured on neuropsychological tasks of limb apraxia, which was identified in a subgroup of 10 patients. All patients underwent testing on a separate task of making simple reach and grasp actions to a cup. Their performance was compared to a group of 18 healthy age-matched volunteers. Participants were instructed to grasp the top or bottom of a cup to either lift or turn it over so as to end with a hand position that was either comfortable or uncomfortable. This task tested the influence of the compatibility of hand–cup orientation, as well as goals driven by the end-state comfort of the hand, on action selection for object manipulation. Participants’ performance was measured in terms of error rates, and speed of initiation and reaching (movement time) to the object. The patients’ performance was significantly delayed, and error rates increased when reaching to grasp a cup under conditions of poor compatibility and end-state comfort. The subgroup of patients with apraxia showed a decreased influence of compatibility of hand interaction with the cup, with increased error rates and delayed response times, compared to patients with no apraxia and healthy volunteers. This is despite the fact they did not display significant deficits on neuropsychological tasks of real object use. The study shows that patients with apraxia have difficulties in selecting elements of object-directed actions, pertaining to both habitual and goal-directed factors.

Effect of object substitution, spontaneous compensation and repetitive training on reaching movements in a patient with optic ataxia

We report the case of M.B. who demonstrated severe optic ataxia with the right hand following stroke in the left hemisphere. The clinical picture may shed light on both the pathological characteristics of reaching and grasping actions, and potential rehabilitation strategies for optic ataxia. First, M.B. demonstrated a dissociation between severely impaired reaching and relatively spared grasping and tool use skills and knowledge, which confirms that grasping may be more intermingled with non-motoric cognitive mechanisms than reaching. Besides, M.B.'s reaching performance was sensitive to movement repetition. We observed a substitution effect: Reaching time decreased if M.B. repeatedly reached toward the same object but increased when object identity changed. This may imply that not only object localization but also object identity, is integrated into movement programming in reach-to-grasp tasks. Second, studying M.B.'s spontaneous compensation strategies ascertained that the mere repetition of reaching movements had a positive effect, to the point M.B. almost recovered to normal level after an intensive one-day repetitive training session. This case study seems to provide one of the first examples of optic ataxia rehabilitation. Reaching skills can be trained by repetitive training even two years post-stroke and despite the presence of visuo-imitative apraxia.

Optic ataxia: beyond the dorsal stream cliché

This chapter reviews clinical and scientific approaches to optic ataxia. This double historic track allows us to address important issues such as the link between Bálint syndrome and optic ataxia, the alleged double dissociation between optic ataxia and visual agnosia, and the use of optic ataxia to argue for a specific vision-for-action occipitoposterior parietal stream. Clinical cases are described and reveal that perceptual deficits have been long shown to accompany ataxia. Importantly, the term ataxia appears to be misleading as patients exhibit a combination of visual and nonvisual perceptual, attentional, and visuomotor guidance deficits, which are confirmed by experimental approaches. Three major features of optic ataxia are described. The first is a spatial feature whereby the deficits exhibited by patients appear to be specific to peripheral vision, akin to the field effect. Visuomotor field examination allows us to quantify this deficit and reveals that it consists of a highly reliable retinocentric hypometria. The third is a temporal feature whereby these deficits are exacerbated under temporal constraints, i.e., when attending to dynamic stimuli. These two aspects combine in a situation where patients have to quickly respond to a target presented in peripheral vision that is experimentally displaced upon movement onset. In addition to the field effect, a hand effect can be described in conditions where the hand is not visible. Spatial and temporal aspects as well as field and hand effects may rely on several posterior parietal modules that remain to be precisely identified both anatomically and functionally. It is concluded that optic ataxia is not a visuomotor deficit and there is no dissociation between perception and action capacities in optic ataxia, hence a fortiori no double dissociation between optic ataxia and visual agnosia. Future directions for understanding the basic pathophysiology of optic ataxia are proposed.

Cognitive Paleoanthropology and Technology: Toward a Parsimonious Theory (PATH)

Tool use in humans and hominins (i.e., extant relatives to humans) is unique in several respects. To date, no attempt has been made to review the main patterns of tool behavior specific to these species as well as to integrate them into a coherent framework. The aim here is to fill this gap by (a) identifying these behavioral specificities and (b) trying to explain the greatest number of these specificities with the lowest number of cognitive mechanisms. Based on this approach, this article provides a potential solution, namely, the PArsimonious THeory of hominin technology (PATH), aiming to account for the cognitive origins of 4 behavioral characteristics: transfer, complex tool use, secondary tool use, and tool saving. A key hypothesis is that the emergence of 2 breaking mechanisms—technical reasoning and semantic reasoning—could have boosted hominin technology. PATH offers an original framework for understanding the most archaic, human cognitive traits, thereby providing a good starting point for future investigation about the cognitive evolution of technology in the genus Homo.

Tool use disorders after left brain damage

In this paper we review studies that investigated tool use disorders in left-brain damaged (LBD) patients over the last 30 years. Four tasks are classically used in the field of apraxia: Pantomime of tool use, single tool use, real tool use and mechanical problem solving. Our aim was to address two issues, namely, (1) the role of mechanical knowledge in real tool use and (2) the cognitive mechanisms underlying pantomime of tool use, a task widely employed by clinicians and researchers. To do so, we extracted data from 36 papers and computed the difference between healthy subjects and LBD patients. On the whole, pantomime of tool use is the most difficult task and real tool use is the easiest one. Moreover, associations seem to appear between pantomime of tool use, real tool use and mechanical problem solving. These results suggest that the loss of mechanical knowledge is critical in LBD patients, even if all of those tasks (and particularly pantomime of tool use) might put differential demands on semantic memory and working memory.

To do it or to let an automatic tool do it? The priority of control over effort

The aim of the present study is to provide experimental data relevant to the issue of what leads humans to use automatic tools. Two answers can be offered. The first is that humans strive to minimize physical and/or cognitive effort (principle of least effort). The second is that humans tend to keep their perceived control over the environment (principle of more control). These two factors certainly play a role, but the question raised here is to what do people give priority in situations wherein both manual and automatic actions take the same time - minimizing effort or keeping perceived control? To answer that question, we built four experiments in which participants were confronted with a recurring choice between performing a task manually (physical effort) or in a semi-automatic way (cognitive effort) versus using an automatic tool that completes the task for them (no effort). In this latter condition, participants were required to follow the progression of the automatic tool step by step. Our results showed that participants favored the manual or semi-automatic condition over the automatic condition. However, when they were offered the opportunity to perform recreational tasks in parallel, the shift toward manual condition disappeared. The findings give support to the idea that people give priority to keeping control over minimizing effort.

Contribution of the posterior parietal cortex in reaching, grasping, and using objects and tools

Neuropsychological and neuroimaging data suggest a differential contribution of posterior parietal regions during the different components of a transitive gesture. Reaching requires the integration of object location and body position coordinates and reaching tasks elicit bilateral activation in different foci along the intraparietal sulcus. Grasping requires a visuomotor match between the object's shape and the hand's posture. Lesion studies and neuroimaging confirm the importance of the anterior part of the intraparietal sulcus for human grasping. Reaching and grasping reveal bilateral activation that is generally more prominent on the side contralateral to the hand used or the hemifield stimulated. Purposeful behavior with objects and tools can be assessed in a variety of ways, including actual use, pantomimed use, and pure imagery of manipulation. All tasks have been shown to elicit robust activation over the left parietal cortex in neuroimaging, but lesion studies have not always confirmed these findings. Compared to pantomimed or imagined gestures, actual object and tool use typically produces activation over the left primary somatosensory region. Neuroimaging studies on pantomiming or imagery of tool use in healthy volunteers revealed neural responses in possibly separate foci in the left supramarginal gyrus. In sum, the parietal contribution of reaching and grasping of objects seems to depend on a bilateral network of intraparietal foci that appear organized along gradients of sensory and effector preferences. Dorsal and medial parietal cortex appears to contribute to the online monitoring/adjusting of the ongoing prehensile action, whereas the functional use of objects and tools seems to involve the inferior lateral parietal cortex. This functional input reveals a clear left lateralized activation pattern that may be tuned to the integration of acquired knowledge in the planning and guidance of the transitive movement.

Cognition, action, and object manipulation

Although psychology is the science of mental life and behavior, little attention has been paid to the means by which mental life is translated into behavior. One domain in which links between cognition and action have been explored is the manipulation of objects. This article reviews psychological research on this topic, with special emphasis on the tendency to grasp objects differently depending on what one plans to do with the objects. Such differential grasping has been demonstrated in a wide range of object manipulation tasks, including grasping an object in a way that reveals anticipation of the object's future orientation, height, and required placement precision. Differential grasping has also been demonstrated in a wide range of behaviors, including 1-hand grasps, 2-hand grasps, walking, and transferring objects from place to place as well as from person to person. The populations in which the tendency has been shown are also diverse, including nonhuman primates as well as human adults, children, and babies. The tendency is compromised in a variety of clinical populations and in children of a surprisingly advanced age. Verbal working memory is compromised as well if words are memorized while object manipulation tasks are performed; the recency portion of the serial position curve is reduced in this circumstance. In general, the research reviewed here points to rich connections between cognition and action as revealed through the study of object manipulation. Other implications concern affordances, Donders' law, naturalistic observation, and the teaching of psychology.

Tool use and perceived distance: when unreachable becomes spontaneously reachable

An interesting issue about human tool use is whether people spontaneously and implicitly intend to use an available tool to perform an action that would be impossible without it. Recent research indicates that targets presented just beyond arm's reach are perceived closer when people intend to reach them with a tool rather than without it. An intriguing issue is whether this effect also occurs when people are not explicitly instructed to use a tool to reach targets. To address this issue, we asked participants to estimate distances that were beyond arm's reach in three conditions. Participants who held passively a long baton underestimated the distances as compared to participants with no baton (Experiment 1). To examine whether this effect resulted from holding the baton, we asked participants to estimate distances while holding passively a shorter baton (Experiment 2). We found that holding this short baton did not influence distance perception. Our findings demonstrate that when people aim at performing a task beyond their action capabilities, they spontaneously and implicitly intend to use a tool if it substantially extends their action capabilities. These findings provide interesting insights into the understanding of the link between the emergence of tool use, intention, and perception.

Tool use and action planning in apraxia

Apraxia after left inferior parietal lesions has been widely interpreted as evidence of damage or impaired access to representations of tool-use, but most research has investigated pantomime of tool actions, not handling of actual tools. An alternative account is that inferior parietal damage does not affect tool-use representations but impairs cognitive processing about postural and hand-tool spatial relationships which is necessary for planning and controlling any complex action. Four apraxic patients and 10 age-matched controls were asked to reach rapidly for tools or abstract objects of similar dimensions. Under conditions of time pressure and divided attention, the patients frequently failed to invert the hand to grasp inverted tools by the handle, whereas ability to invert the hand to avoid a barrier and grasp abstract objects was largely unimpaired. Frequency of errors in tool grasping correlated with severity of apraxia. When inverted tools were correctly grasped, rotation of the wrist occurred later during the reaching movement than when inverting the hand to grasp an abstract object. These data are consistent with the theory of degraded access to tool-use representations in apraxia, but this theory cannot account for co-occurring deficits in imitating or matching meaningless hand or body postures.

Re-examining the gesture engram hypothesis. New perspectives on apraxia of tool use

In everyday life, we are led to reuse the same tools (e.g., fork, hammer, coffee-maker), raising the question as to whether we have to systematically recreate the idea of the manipulation which is associated with these tools. The gesture engram hypothesis offers a straightforward answer to this issue, by suggesting that activation of gesture engrams provides a processing advantage, avoiding portions of the process from being reconstructed de novo with each experience. At first glance, the gesture engram hypothesis appears very plausible. But, behind this beguiling simplicity lies a set of unresolved difficulties: (1) What is the evidence in favour of the idea that the mere observation of a tool is sufficient to activate the corresponding gesture engram? (2) If tool use can be supported by a direct route between a structural description system and gesture engrams, what is the role of knowledge about tool function? (3) And, more importantly, what does it mean to store knowledge about how to manipulate tools? We begin by outlining some of the main formulations of the gesture engram hypothesis. Then, we address each of these issues in more detail. To anticipate our discussion, the gesture engram hypothesis appears to be clearly unsatisfactory, notably because of its incapacity to offer convincing answers to these different issues. We conclude by arguing that neuropsychology may greatly benefit from adopting the hypothesis that the idea of how to manipulate a tool is recreated de novo with each experience, thus opening interesting perspectives for future research on apraxia.