Is Shadowing Behavior Caused by Body Representation Disorders and Apraxia?

Shadowing is a person-following behavior, commonly observed in dementia (e.g., Alzheimer’s disease). It may be caused by neuropsychological impairments associated with posterior brain lesions, as Kudo et al. described it in a patient with posterior cortical atrophy and no frontal signs. These authors have suggested that shadowing may arise from the combination of visuospatial impairments, aphasia, apraxia, and prosopagnosia. However, how these symptoms may contribute to shadowing remains unclear. It is suggested that the combination of visuospatial impairments, body representation disorders, and apraxia, may result in complete loss of spatial representations and hence, shadowing behavior

The body and the tool : A neuropsychological study of apraxia and body schema in neurodegenerative diseases.

Les troubles praxiques font partie des critères d’inclusion decertaines pathologies neurodégénératives et sont de nature à réduirel'autonomie de ces patients. Pourtant, les rares travaux dans cedomaine prennent rarement en compte les spécificités liées auxpathologies dégénératives (e.g., évolution, lésions diffuses,phénotypes différents), sans compter qu’il n’existe pas de consensusthéorique sur l’apraxie. Les troubles d'utilisation des outils ontlongtemps été expliqués par la perte de représentations stockées (e.g.,connaissances sur les objets ou les gestes) mais des modèles récentssuggèrent de distinguer l’utilisation proprement dite de l’usagecommunément admis. De même, l’apraxie est fréquemment mise enrapport avec la perte d’une représentation du corps mais une mise enperspective historique de la littérature permet de constater qu'il s'agitd'un postulat tout à fait récent. La présente thèse émet une propositionalternative en opposant à la notion de représentation corporelle desprocessus plus dynamiques et neurologiquement ancrés tels quel’intégration sensorielle. Au plan théorique, la présente thèse proposeainsi une mise en perspective historique et une revue critique de lalittérature, ainsi qu’une réflexion épistémologique opposant savoir etraisonnement, permettant de distinguer des troubles spécifiques dugeste et des répercussions "dans le geste" d'autres niveaux deperturbations. Au plan clinique, ce travail de neuropsychologieclinique et expérimentale examine ces différents niveaux dans uneperspective différentielle et montre que les dissociations envisagéessont cliniquement opérantes.Apraxia is a diagnostic criterion for neurodegenerativediseases and can reduce autonomy in these patients. Yet, the fewstudies that have been done in this domain rarely take into accountspecificities of dementia (e.g., evolution, diffuse lesions, differentphenotypes) and there is no theoretical consensus on apraxia. Tooluse disorders are mainly explained by the loss of stored knowledge(e.g., about tools or gestures) but recent models suggest to distinguishthe actual use of tools from common usage. Likewise, apraxiai sfrequently linked with the loss of body representations but a historicalperspective of the literature demonstrates that it is a relatively recentassumption. The present doctoral thesis submits an alternativeproposal by opposing body representation and more dynamic andneurological processes, that is, sensory integration. Thus, at thetheoretical level this work proposes a historical perspective and acritical review of existing literature, as well as an epistemologicalreflection that contrasts knowledge and reasoning, and that makes adistinction between specific gesture disorders and consequences ofother cognitive impairments on gesture production. At a clinical level,this neuropsychological research examines these different levels ofimpairments in patients through a differential approach. Results showthat the aforementioned theoretical considerations are clinicallyvalidated

De l’outil et du corps : Etude neuropsychologique des troubles praxiques et du schéma corporel dans les pathologies neurodégénératives

Apraxia is a diagnostic criterion for neurodegenerativediseases and can reduce autonomy in these patients. Yet, the fewstudies that have been done in this domain rarely take into accountspecificities of dementia (e.g., evolution, diffuse lesions, differentphenotypes) and there is no theoretical consensus on apraxia. Tooluse disorders are mainly explained by the loss of stored knowledge(e.g., about tools or gestures) but recent models suggest to distinguishthe actual use of tools from common usage. Likewise, apraxiai sfrequently linked with the loss of body representations but a historicalperspective of the literature demonstrates that it is a relatively recentassumption. The present doctoral thesis submits an alternativeproposal by opposing body representation and more dynamic andneurological processes, that is, sensory integration. Thus, at thetheoretical level this work proposes a historical perspective and acritical review of existing literature, as well as an epistemologicalreflection that contrasts knowledge and reasoning, and that makes adistinction between specific gesture disorders and consequences ofother cognitive impairments on gesture production. At a clinical level,this neuropsychological research examines these different levels ofimpairments in patients through a differential approach. Results showthat the aforementioned theoretical considerations are clinicallyvalidated.Les troubles praxiques font partie des critères d’inclusion decertaines pathologies neurodégénératives et sont de nature à réduirel'autonomie de ces patients. Pourtant, les rares travaux dans cedomaine prennent rarement en compte les spécificités liées auxpathologies dégénératives (e.g., évolution, lésions diffuses,phénotypes différents), sans compter qu’il n’existe pas de consensusthéorique sur l’apraxie. Les troubles d'utilisation des outils ontlongtemps été expliqués par la perte de représentations stockées (e.g.,connaissances sur les objets ou les gestes) mais des modèles récentssuggèrent de distinguer l’utilisation proprement dite de l’usagecommunément admis. De même, l’apraxie est fréquemment mise enrapport avec la perte d’une représentation du corps mais une mise enperspective historique de la littérature permet de constater qu'il s'agitd'un postulat tout à fait récent. La présente thèse émet une propositionalternative en opposant à la notion de représentation corporelle desprocessus plus dynamiques et neurologiquement ancrés tels quel’intégration sensorielle. Au plan théorique, la présente thèse proposeainsi une mise en perspective historique et une revue critique de lalittérature, ainsi qu’une réflexion épistémologique opposant savoir etraisonnement, permettant de distinguer des troubles spécifiques dugeste et des répercussions "dans le geste" d'autres niveaux deperturbations. Au plan clinique, ce travail de neuropsychologieclinique et expérimentale examine ces différents niveaux dans uneperspective différentielle et montre que les dissociations envisagéessont cliniquement opérantes

Is Bodily Experience an Epiphenomenon of Multisensory Integration and Cognition?

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De la psychométrie à la psychologie, la norme existe-t-elle ?

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The challenge of apraxia: Toward an operational definition?

International audienceThe diagnosis of limb apraxia relies mainly on exclusion criteria (e.g., elementary motor or sensory deficits, aphasia). Due to the diversity of apraxia definitions and assessment methods, patients may or may not show apraxia depending on the chosen assessment method or theory, making the definition of apraxia somewhat arbitrary. As a result, "apraxia" may be diagnosed in patients with different cognitive impairments. Based on a quantitative and critical review of the literature, it is argued that this situation has its roots in the evolution from a task-based approach (i.e., the use of gold standard tests to detect apraxia) toward a process-based approach, namely, the deconstruction of the conceptual or production systems of action into multiple cognitive processes: language, executive functions, working memory, semantic memory, body schema, body image, visual-spatial skills, social cognition, visual-kinesthetic engrams, manipulation knowledge, technical reasoning, structural inference, and categorical apprehension. The coexistence of both approaches in the current literature is a major challenge that stands in the way of a scientific definition of apraxia. As a step toward a solution, we suggest to focus on symptoms, and on two complementary definition criteria (in addition with traditional exclusion criteria): Specificity (i.e., is apraxia explained by the alteration of cognitive processes specifically dedicated to gesture production?), and consistency (i.e., is the gesture production impairment consistent across tasks?). Two categories of limb apraxia are proposed: symptomatic apraxia (i.e., gesture production deficits that are secondary to more general cognitive impairments) and idiopathic apraxia (i.e., gesture production deficits that can be observed in isolation). It turns out that the only apraxia subtype that fulfills exclusion, specificity, and consistency criteria is limb-kinetic apraxia. A century after Liepmann’s demonstration of the autonomy of apraxia toward language, the autonomy of this syndrome toward the rest of cognition remains an open question, while it poses new challenges to apraxia studies

Cerebral correlates of Imitation of Intransitive Gestures: An Integrative Review of Neuroimaging Data and Brain Lesion Studies

The aim of the present review is to investigate the cerebral correlates, more particularly the role of the parietal lobe, when imitating intransitive gestures, a task highly sensitive to apraxic errors. By providing an integrative review of functional imaging and brain lesion studies, we focused our attention on the meaning of gestures (meaningful and meaningless) and the body parts (finger and hand). We found that imitation of intransitive gestures is relying upon a bilateral brain network including fronto-parietal areas irrespective of meaning or body parts. Moreover, we observed that while imitation of meaningful and meaningless gestures is predominantly impacted following left parietal lesions, more brain areas are engaged during meaningless gesture imitation. Concerning body parts, whereas imitation of hand postures is relying upon the left parietal lobe (angular gyrus), imitation of finger postures is more likely to be impaired following lesions in the frontal lobe, insula and basal ganglia. These results question neuropsychological theories on apraxia and open promising avenues for a better understanding of apraxia

Physical understanding in neurodegenerative diseases

International audienceThis 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

Is There Really a Loss of Agency in Patients With Apraxia of Tool Use?

International audienceThe sense of agency refers to the experience of controlling one’s own motor actions and, as a result, external events (Pacherie, 2008; Haggard and Chambon, 2012). Surprisingly, this aspect has been largely overlooked in the literature on apraxia, a disorder affecting skilled and volitional movements (De Renzi, 1989). In this context, an outstanding issue is whether loss of agency is an ignored dimension of apraxia—and particularly of apraxia of tool use (see below)—or whether loss of agency and apraxia of tool use are two independent syndromes based on distinct neurocognitive mechanisms. The goal of this Opinion article is to tackle this issue. Note that we will mainly focus here on apraxia of tool use, namely, difficulties in selecting appropriate everyday tools and/or in performing the mechanical action needed to complete a task. This is only one of the manifestations of apraxia, which may also concern the production of symbolic, meaningful, or meaningless gestures (Osiurak and Rossetti, 2017)