Praxis deficits in patients with Parkinson’s disease

Abstract

AbstractBackgroundLimb apraxia has been described in several neurological disorders including Parkinson’s disease (Leiguarda and Marsden, 2000) and may predict progression to Alzheimer’s dementia in patients with mild cognitive impairment. Our aim was to study presence of apraxia and subtypes of deficits in patients with idiopathic Parkinson’s Disease.Method20 patients with idiopathic Parkinson’s disease, recruited from the Oxford Parkinson’s Disease Centre, were tested for presence of limb apraxia, measured on a battery of tasks, comparing their performance to deficits measured using the UPDRS, and independent measures of cognition (MOCA), and dexterity. Results were analysed using Pearson’s correlations, with correction for multiple comparisonsResultDetailed neuropsychological testing revealed significant deficits in praxis with 9 out of 20 patients displaying significant ideomotor deficits on finger and hand imitation, 2 patients showing ideational deficits on pantomime of tool use. Most patients made errors in the praxis tasks even though they did not qualify as apraxic per se, with only one patient performing faultlessly at all the screening tasks.Both ideational and ideomotor deficits correlated with Part 3 of the UPDRS score. Similarly, Part 3 of the UPDRS correlated with cognitive performance on the MOCA. Ideomotor deficits also correlated with deficits in dexterity and response inhibition. Whereas deficits in dexterity correlated with PD severity; praxis and cognitive deficits did not.ConclusionThe study shows different deficits in limb praxis assessed using batteries of tasks in patients with Parkinson’s disease. We identified relationships between praxis deficits and cognitive as well as motor performance in PD patients. Testing for apraxia in PD patients might provide a useful way for stratifying patients’ impairments, progression to PD dementia and response to treatment.