Pantomime, praxis, and aphasia

Abstract

The production and comprehension of pantomimed movements by aphasic subjects were studied with respect to their relationship to the aphasic deficit on one hand and apraxia on the other. At issue was whether impaired use of pantomime is a manifestation of reduced symbolic capacity or purely a manifestation of an apraxic impairment of purposeful movement or both. Tests of pantomime included a Pantomime Recognition Test, a nonverbal Transitive Pantomime Production Test, and an Intransitive Pantomime Production Test (to oral command). Imitation of Nonmeaningful Movements served as a measure of apraxia, uncontaminated by symbolic or linguistic factors. Imitation of Meaningful Movements taken from the pantomime tasks was also tested. Independent measures of auditory comprehension, picture naming, and reading comprehension were used as indices of language impairment. Intellectual function was measured by the Performance scale of the WAIS. Thirty aphasic subjects were examined. Twenty healthy age-matched normals served to establish scoring standards for the pantomime tests. Multiple regression analysis revealed significant, independent contributions from both auditory comprehension and imitation of Nonmeaningful Movements to all of the tests of pantomime production and pantomime recognition. All measures of pantomime production and pantomime recognition were strongly intercorrelated. While the three language measures were strongly correlated with each other, auditory comprehension was the only one of them that was significantly and consistently related to the pantomime tests. None was related to the imitation of nonmeaningful movement. The results are taken as indicating (1) that pantomime production and imitation share common factors with both praxis and auditory comprehension; (2) apraxia entails impairment of both production and interpretation of purposeful movements. Possible theoretical accounts for these results are offered.