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Baumard J, Laniepce A, Lesourd M, Guezouli L, Beaucousin V, Gehin M, Osiurak F, Bartolo A. The Neurocognitive Bases of Meaningful Intransitive Gestures: A Systematic Review and Meta-analysis of Neuropsychological Studies. Neuropsychol Rev 2024:10.1007/s11065-024-09634-6. [PMID: 38448754 DOI: 10.1007/s11065-024-09634-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/26/2024] [Indexed: 03/08/2024]
Abstract
Researchers and clinicians have long used meaningful intransitive (i.e., not tool-related; MFI) gestures to assess apraxia-a complex and frequent motor-cognitive disorder. Nevertheless, the neurocognitive bases of these gestures remain incompletely understood. Models of apraxia have assumed that meaningful intransitive gestures depend on either long-term memory (i.e., semantic memory and action lexicons) stored in the left hemisphere, or social cognition and the right hemisphere. This meta-analysis of 42 studies reports the performance of 2659 patients with either left or right hemisphere damage in tests of meaningful intransitive gestures, as compared to other gestures (i.e., MFT or meaningful transitive and MLI or meaningless intransitive) and cognitive tests. The key findings are as follows: (1) deficits of meaningful intransitive gestures are more frequent and severe after left than right hemisphere lesions, but they have been reported in both groups; (2) we found a transitivity effect in patients with lesions of the left hemisphere (i.e., meaningful transitive gestures more difficult than meaningful intransitive gestures) but a "reverse" transitivity effect in patients with lesions of the right hemisphere (i.e., meaningful transitive gestures easier than meaningful intransitive gestures); (3) there is a strong association between meaningful intransitive and transitive (but not meaningless) gestures; (4) isolated deficits of meaningful intransitive gestures are more frequent in cases with right than left hemisphere lesions; (5) these deficits may occur in the absence of language and semantic memory impairments; (6) meaningful intransitive gesture performance seems to vary according to the emotional content of gestures (i.e., body-centered gestures and emotional valence-intensity). These findings are partially consistent with the social cognition hypothesis. Methodological recommendations are given for future studies.
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Affiliation(s)
| | | | - Mathieu Lesourd
- UMR INSERM 1322 LINC, Université Bourgogne Franche-Comté, Besancon, France
| | - Léna Guezouli
- Normandie Univ, UNIROUEN, CRFDP, 76000, Rouen, France
| | | | - Maureen Gehin
- Normandie Univ, UNIROUEN, CRFDP, 76000, Rouen, France
| | - François Osiurak
- Laboratoire d'Étude des Mécanismes Cognitifs (UR 3082), Université Lyon 2, Bron, France
- Institut Universitaire de France (IUF), Paris, France
| | - Angela Bartolo
- Institut Universitaire de France (IUF), Paris, France
- CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Univ. Lille, F-59000, Lille, France
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Takasaki A, Hashimoto M, Fukuhara R, Sakuta S, Koyama A, Ishikawa T, Boku S, Ikeda M, Takebayashi M. Gesture imitation performance in community-dwelling older people: assessment of a gesture imitation task in the screening and diagnosis of mild cognitive impairment and dementia. Psychogeriatrics 2024; 24:404-414. [PMID: 38290836 DOI: 10.1111/psyg.13086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/02/2024] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Gesture imitation, a simple tool for assessing visuospatial/visuoconstructive functions, is reportedly useful for screening and diagnosing dementia. However, gesture imitation performance in healthy older adults is largely unknown, as are the factors associated with lower performance. To address these unknowns, we examined the gesture imitation performance of a large number of community-dwelling older adults aged ≥65 years in Arao City, Kumamoto Prefecture (southern Japan). METHODS The examiner presented the participants with eight gesture patterns and considered it a success if they could imitate them within 10 s. The success rate of each gesture imitation was calculated for three diagnostic groups: cognitively normal (CN) (n = 1184), mild cognitive impairment (MCI) (n = 237), and dementia (n = 47). Next, we reorganised the original gesture imitation battery by combining six selected gestures with the following scoring method: if the participants successfully imitated the gestures, immediately or within 5 s, two points were assigned. If they succeeded within 5-10 s, one point was assigned. The sensitivity and specificity of the battery were investigated to detect the dementia and MCI groups. Factors associated with gesture imitation battery scores were examined. RESULTS Except one complex gesture, the success rate of imitation in the CN group was high, approximately 90%. The sensitivity and specificity of the gesture imitation battery for discriminating between the dementia and CN groups and between the MCI and CN groups were 70%/88%, and 45%/75%, respectively. Ageing, male sex, and a diagnosis of dementia or MCI were associated with lower scores on the gesture imitation battery. CONCLUSION Gesture imitation tasks alone may not be sufficient to detect MCI. However, by combining gestures with set time limits, gesture imitation tasks can be a low-burden and effective method for detecting dementia, even in community medicine, such as during health check-ups.
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Affiliation(s)
- Akihiro Takasaki
- Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Mamoru Hashimoto
- Department of Neuropsychiatry, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Ryuji Fukuhara
- Department of Psychiatry, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shizuka Sakuta
- Department of Neuropsychiatry, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Asuka Koyama
- Faculty of Social Welfare, Kumamoto Gakuen University, Kumamoto, Japan
| | | | - Shuken Boku
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Minoru Takebayashi
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Baumard J, Lesourd M, Remigereau C, Jarry C, Lebaz S, Etcharry-Bouyx F, Chauviré V, Osiurak F, Le Gall D. Sensory Integration Deficits in Neurodegenerative Diseases: Implications for Apraxia. Arch Clin Neuropsychol 2023; 38:1557-1563. [PMID: 36973225 DOI: 10.1093/arclin/acad028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE Apraxia is the inability to perform voluntary, skilled movements following brain lesions, in the absence of sensory integration deficits. Yet, patients with neurodegenerative diseases (ND) may have sensory integration deficits, so we tested the associations and dissociations between apraxia and sensory integration. METHODS A total of 44 patients with ND and 20 healthy controls underwent extensive testing of sensory integration (i.e., localization of tactile, visual, and proprioceptive stimuli; agraphesthesia; astereognosis) and apraxia (i.e., finger dexterity, imitation, tool use). RESULTS The results showed (i) that patients with Alzheimer's disease, corticobasal syndrome, or posterior cortical atrophy were impaired on both dimensions; (ii) An association between both dimensions; (iii) that when sensory integration was controlled for, the frequency of apraxia decreased dramatically in some clinical subgroups. CONCLUSION In a non-negligible portion of patients, the hypothesis of a disruption of sensory integration can be more parsimonious than the hypothesis of apraxia in case of impaired skilled gestures. Clinicians and researchers are advised to integrate sensory integration measures along with their evaluation of apraxia.
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Affiliation(s)
| | - Mathieu Lesourd
- Laboratoire de Psychologie (EA3188), Université Bourgogne Franche Comté, Besançon, France
| | - Chrystelle Remigereau
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), Université d'Angers, Angers, France
| | - Christophe Jarry
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), Université d'Angers, Angers, France
| | - Samuel Lebaz
- Univ Rouen Normandie, CRFDP UR 7475, Rouen F-76000, France
| | - Frédérique Etcharry-Bouyx
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), Université d'Angers, Angers, France
- Département de Neurologie, Centre Hospitalier Universitaire d'Angers, Angers, France
- Unité de Neuropsychologie, Département de Neurologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Valérie Chauviré
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), Université d'Angers, Angers, France
- Département de Neurologie, Centre Hospitalier Universitaire d'Angers, Angers, France
- Unité de Neuropsychologie, Département de Neurologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - François Osiurak
- Laboratoire d'Etude des Mécanismes Cognitifs (EA 3082), Université de Lyon, Lyon, France
- Institut Universitaire de France, Paris, France
| | - Didier Le Gall
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), Université d'Angers, Angers, France
- Département de Neurologie, Centre Hospitalier Universitaire d'Angers, Angers, France
- Unité de Neuropsychologie, Département de Neurologie, Centre Hospitalier Universitaire d'Angers, Angers, France
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Yliranta A, Karjalainen VL, Nuorva J, Ahmasalo R, Jehkonen M. Apraxia testing to distinguish early Alzheimer's disease from psychiatric causes of cognitive impairment. Clin Neuropsychol 2023; 37:1629-1650. [PMID: 36829305 DOI: 10.1080/13854046.2023.2181223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/10/2023] [Indexed: 02/26/2023]
Abstract
Objective: Mood- and stress-related disorders commonly cause attentional and memory impairments in middle-aged individuals. In memory testing, these impairments can be mistakenly interpreted as symptoms of dementia; thus, more reliable diagnostic approaches are needed. The present work defines the discriminant accuracy of the Dementia Apraxia Test (DATE) between psychiatric conditions and early-onset Alzheimer's disease (AD) on its own and in combination with memory tests. Method: The consecutive sample included 50-70-year-old patients referred to dementia investigations for recent cognitive and/or affective symptoms. The DATE was administered and scored as a blinded measurement, and a receiver operating curve analysis was used to define the optimal diagnostic cut-off score. Results: A total of 24 patients were diagnosed with probable AD (mean age 61 ± 4) and 23 with a psychiatric condition (mean age 57 ± 4). The AD patients showed remarkable limb apraxia, but the psychiatric patients mainly performed at a healthy level on the DATE. The test showed a total discriminant accuracy of 87% for a total sum cut-off of 47 (sensitivity 79% and specificity 96%). The limb subscale alone reached an accuracy of 91% for a cut-off of 20 (sensitivity 83% and specificity 100%). All memory tests were diagnostically less accurate, while the combination of the limb praxis subscale and a verbal episodic memory test suggested a correct diagnosis in all but one patient. Conclusions: Apraxia testing may improve the accuracy of differentiation between AD and psychiatric aetiologies. Its potential in severe and chronic psychiatric conditions should be examined in the future.
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Affiliation(s)
- Aino Yliranta
- Faculty of Social Sciences, Tampere University
- Neurology Clinic, Lapland Central Hospital
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Nagahama Y, Okina T, Suzuki N. Neuropsychological basis of impaired gesture imitations in patients with Alzheimer's disease and dementia with Lewy bodies. Int J Geriatr Psychiatry 2022; 37. [PMID: 34505307 DOI: 10.1002/gps.5622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/06/2021] [Indexed: 11/07/2022]
Abstract
INTRODUCTION The aim of this study was to examine the neuropsychological factors that may be related to the impaired gesture imitations in patients with dementia. METHODS The imitation of unilateral finger and bimanual gestures was evaluated in 162 patients with Alzheimer's disease (AD) and 103 patients with dementia with Lewy bodies (DLB). The relationships of gesture imitation performance to global cognition, semantic fluency, phonemic fluency, figure copying, clock drawing, and trail-making test part A (TMT-A) scores were examined. RESULTS Mean scores for unilateral finger imitation were significantly lower in DLB patients than in AD patients, and significantly more DLB patients showed impaired performance in unilateral finger imitation than AD patients. In contrast, the percentage of patients with impaired bimanual gesture imitation was not significantly different between AD and DLB patients. Unilateral finger imitation performance was predicted by pentagon copying in the AD patients, and was predicted by cube copying in the DLB patients. Bimanual gesture imitation performance was predicted by TMT-A scores and phonemic fluency in the AD patients but was predicted by TMT-A scores, cube copying, and parkinsonism severity in the DLB patients. DISCUSSION Our study suggested that bimanual gesture imitation is a complex task that is supported by a wide range of neuropsychological processes, such as visuospatial attention, executive function, and visuomotor control, and therefore, it was easily impaired in early dementia. Unilateral finger imitation was more similar to constructional tasks, such as figure drawing, and was impaired more often in DLB patients than in AD patients.
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Affiliation(s)
- Yasuhiro Nagahama
- Department of Psychiatry and Neurology, Kawasaki Memorial Hospital, Kawasaki, Kanagawa, Japan
| | - Tomoko Okina
- Department of Geriatric Neurology, Shiga General Hospital, Moriyama, Shiga, Japan
| | - Norio Suzuki
- Department of Geriatric Neurology, Shiga General Hospital, Moriyama, Shiga, Japan
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