Sunday 8 September 2013

Gesture and apraxia

Mengotti, P et al (2003) Selective imitation impairments differentially interact with language processing, Brain, 136, 2602-2618.

Introduction

  • Ideational apraxia - patient struggles to come up with a plan/ idea for how to use objects (sequencing may be incorrect..)
  • Ideational apraxia - difficulties translating an idea into movement e.g. with imitation.



Methods

  • 57 patients with damage to their dominant left-hemisphere were tested on: 1) ability to process language, 2) Use objects functionally, 3) imitate meaningful gestures, and 4) imitate meaningless gestures.

Results

  • The patients' ability to imitate meaningful gestures and their performance on naming/ repetition tasks appeared to be related. Whereas their imitation of meaningless gestures was correlated to the patients' comprehension.

Conclusion
  • Imitation of familiar gestures relies on the language system because these gestures are linked to the corresponding lexical semantic representations.
  • The angular gyrus is important for gesturing.

How does this relate to practice?
  • Meaningless gestures - if a patient is unable to imitate meaningful gestures perhaps you could try new gestures which you then develop new representations for e.g. fidt/palm for yes/no.
  • Increase in the use of meaningful gestures may be a positive diagnostic sign for naming/ language.
  • There are two separate pathways for gesture imitation (one via semantics and one not).
  • Working on gesture/ total communication may positively impact language/ naming.

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