Kinematic analysis of movement imitation in apraxia.

Accuracy of the final position and kinematics of movement were analysed during the imitation of meaningless gestures in patients with unilateral brain lesions who performed with the hand ipsilateral to the lesion and in control subjects. Controls imitated the gestures virtually without spatial errors. The kinematics of their movements was characterized by single-peaked and approximately bell-shaped velocity profiles of the transport phase combined with no or only minor corrective movements in the final phase. Patients with right brain damage (RBD) performed as well as control subjects with respect to both spatial accuracy of final hand-positions and kinematic parameters of the movement trajectories. Patients with left brain damage (LBD) committed spatial parapraxias and had a much higher frequency of kinematic abnormalities. However, there was no correlation between kinematic abnormalities and apraxic errors. There were kinematically abnormal movements which reached a correct final position as well as kinematically normal movements leading to apraxic errors. One possible explanation for the combined occurrence of kinematic abnormalities and parapraxias in LBD patients would be that they are independent sequels of left hemisphere lesions. An alternative account is that the associations and dissociations result from an interaction between one common basic deficit and strategies to cope with this deficit. The basic deficit may concern the mental representation of the target position. The LBD patients may react to the absence of an appropriate representation of the target by one of two alternative strategies; they may switch to a strategy of slowed, on-line controlled movements to find the required final position, or they may move their hand smoothly at normal speed to a roughly specified location without taking note of their deficiency. Depending on whether these strategies are successful or not they would lead to the observed associations and dissociations between kinematic abnormalities and spatial parapraxias.