Praxis Network Research Articles

Action goals and the praxis network: an fMRI study

The praxis representation network (PRN) of the left cerebral hemisphere is typically linked to the control of functional interactions with familiar tools. Surprisingly, little is known about the PRN engagement in planning and execution of tool-directed actions motivated by non-functional but purposeful action goals. Here we used functional neuroimaging to perform both univariate and multi-voxel pattern analyses (MVPA) in 20 right-handed participants who planned and later executed, with their dominant and non-dominant hands, disparate grasps of tools for different goals, including: (1) planning simple vs. demanding functional grasps of conveniently vs. inconveniently oriented tools with an intention to immediately use them, (2) planning simple—but non-functional—grasps of inconveniently oriented tools with a goal to pass them to a different person, (3) planning reaching movements directed at such tools with an intention to move/push them with the back of the hand, and (4) pantomimed execution of the earlier planned tasks. While PRN contributed to the studied interactions with tools, the engagement of its critical nodes, and/or complementary right hemisphere processing, was differently modulated by task type. E.g., planning non-functional/structural grasp-to-pass movements of inconveniently oriented tools, regardless of the hand, invoked the left parietal and prefrontal nodes significantly more than simple, non-demanding functional grasps. MVPA corroborated decoding capabilities of critical PRN areas and some of their right hemisphere counterparts. Our findings shed new lights on how performance of disparate action goals influences the extraction of object affordances, and how or to what extent it modulates the neural activity within the parieto-frontal brain networks.

Mapping the human praxis network: an investigation of white matter disconnection in limb apraxia of gesture production.

Left hemispheric cerebral stroke can cause apraxia, a motor cognitive disorder characterized by deficits of higher-order motor skills such as the failure to accurately produce meaningful gestures. This disorder provides unique insights into the anatomical and cognitive architecture of the human praxis system. The present study aimed to map the structural brain network that is damaged in apraxia. We assessed the ability to perform meaningful gestures with the hand in 101 patients with chronic left hemisphere stroke. Structural white matter fibre damage was directly assessed by diffusion tensor imaging and fractional anisotropy mapping. We used multivariate topographical inference on tract-based fractional anisotropy topographies to identify white matter disconnection associated with apraxia. We found relevant pathological white matter alterations in a densely connected fronto-temporo-parietal network of short and long association fibres. Hence, the findings suggest that heterogeneous topographical results in previous lesion mapping studies might not only result from differences in study design, but also from the general methodological limitations of univariate topographical mapping in uncovering the structural praxis network. A striking role of middle and superior temporal lobe disconnection, including temporo-temporal short association fibres, was found, suggesting strong involvement of the temporal lobe in the praxis network. Further, the results stressed the importance of subcortical disconnections for the emergence of apractic symptoms. Our study provides a fine-grain view into the structural connectivity of the human praxis network and suggests a potential value of disconnection measures in the clinical prediction of behavioural post-stroke outcome.

Structural organization of the praxis network predicts gesture production: Evidence from healthy subjects and patients with schizophrenia

Hand gestures are an integral part of social interactions and communication. Several imaging studies in healthy subjects and lesion studies in patients with apraxia suggest the praxis network for gesture production, involving mainly left inferior frontal, posterior parietal and temporal regions. However, little is known about the structural connectivity underlying gesture production. We recruited 41 healthy participants and 39 patients with schizophrenia. All participants performed a gesture production test, the Test of Upper Limb Apraxia, and underwent diffusion tensor imaging. We hypothesized that gesture production is associated with structural network connectivity as well as with tract integrity. We defined the praxis network as an undirected graph comprised of 13 bilateral regions of interest and derived measures of local and global structural connectivity and tract integrity from Finsler geometry. We found an association of gesture deficit with reduced global and local efficiency of the praxis network. Furthermore, reduced tract integrity, for example in the superior longitudinal fascicle, arcuate fascicle or corpus callosum were related to gesture deficits. Our findings contribute to the understanding of structural correlates of gesture production as they first present diffusion tensor imaging data in a combined sample of healthy subjects and a patient cohort with gestural deficits.

Dysbalanced Resting-State Functional Connectivity Within the Praxis Network Is Linked to Gesture Deficits in Schizophrenia.

Patients with schizophrenia frequently present deficits in gesture production and interpretation, greatly affecting their communication skills. As these gesture deficits can be found early in the course of illness and as they can predict later outcomes, exploring their neural basis may lead to a better understanding of schizophrenia. While gesturing has been reported to rely on a left lateralized network of brain regions, termed praxis network, in healthy subjects and lesioned patients, studies in patients with schizophrenia are sparse. It is currently unclear whether within-network connectivity at rest is linked to gesture deficit. Here, we compared the functional connectivity between regions of the praxis network at rest between 46 patients and 44 healthy controls. All participants completed a validated test of hand gesture performance before resting-state functional magnetic resonance imaging (fMRI) was acquired. Patients performed gestures poorer than controls in all categories and domains. In patients, we also found significantly higher resting-state functional connectivity between left precentral gyrus and bilateral superior and inferior parietal lobule. Likewise, patients had higher connectivity from right precentral gyrus to left inferior and bilateral superior parietal lobule (SPL). In contrast, they exhibited lower connectivity between bilateral superior temporal gyrus (STG). Connectivity between right precentral gyrus and left SPL, as well as connectivity between bilateral STG, correlated with gesture performance in healthy controls. We failed to detect similar correlations in patients. We suggest that altered resting-state functional connectivity within the praxis network perturbs correct gesture planning in patients, reflecting the gesture deficit often seen in schizophrenia.

Limb Apraxia: a Disorder of Learned Skilled Movement.

This chapter focuses on limb apraxia, a cognitive-motor disorder of learned skilled movement, and the nature of the spatiotemporal errors that disrupt movement sequences. A cognitive model that attempts to reconcile conceptual and preparatory aspects of the motor program with perceptual and kinematic features will be discussed. An update on the localization of the praxis network will be provided. In addition, a long-held view that limb apraxia does not have ecological relevance will be disputed in the context of studies that have shown that limb apraxia (i) is one of the most important predictors of increased caregiver burden and (ii) is associated with impaired activities of daily living in post-stroke patients. This review summarizes current screening tools and the few randomized clinical controlled treatment studies to date. Limb apraxia is underdiagnosed and very few therapeutic options are available. Cognitive process models should be used to inform future controlled multi-modal treatment strategies.

Dopaminergic modulation of the praxis network in Parkinson's disease.

Apraxia is a deficit in central motor planning impairing praxis functions such as gesture production or tool use that affects a substantial number of patients with advanced Parkinson's disease. We investigated the functional connectivity of the praxis network in patients in early stages of Parkinson's disease having an increased risk for apraxia and evaluated the influence of dopaminergic therapy on praxis abilities and related networks.13 patients with mild to moderate Parkinson's disease (ON and OFF dopaminergic therapy) and 13 healthy controls completed a praxis sensitive functional MRI task and apraxia assessments. Functional connectivity analyses included a graph theoretical approach analyzing the global efficiency within the praxis network followed by a seed-to-voxel functional connectivity analysis.Patients in the OFF but not in the ON state showed significantly lower praxis scores than controls. Patients in both states displayed higher global efficiency within the praxis network than controls revealing the bilateral supramarginal gyri as hubs. Seed-to-voxel functional connectivity analyses showed aberrations of right-hemispheric praxis areas in the OFF but not in the ON state. Patients in the ON state exhibited a significantly higher functional connectivity between the supramarginal gyrus and the primary motor cortex, basal ganglia, and frontal areas than in the OFF state.Dopaminergic therapy seems to normalize praxis abilities and related praxis networks in early stages of Parkinson's disease potentially by facilitating the propagation of long-term representations of object-related actions to motor execution areas.

Recovery from apraxic deficits and its neural correlate.

Apraxia is a deficit of motor cognition leading to difficulties in actual tool use, imitation of gestures, and pantomiming object use. To date, little data exist regarding the recovery from apraxic deficits after stroke, and no statistical lesion mapping study investigated the neural correlate of recovery from apraxia. Accordingly, we here examined recovery from apraxic deficits, differential associations of apraxia task (imitation vs. pantomime) and effector (bucco-facial vs. limb apraxia) with recovery, and the underlying neural correlates. We assessed apraxia in 39 patients with left hemisphere (LH) stroke both at admission and approximately 11 days later. Furthermore, we collected clinical imaging data to identify brain regions associated with recovery from apraxic deficits using voxel-based lesion-symptom mapping (VLSM). Between the two assessments, a significant recovery from apraxic deficits was observed with a tendency of enhanced recovery of limb compared to bucco-facial apraxia. VLSM analyses revealed that within the lesion pattern initially associated with apraxia, lesions of the left insula were associated with remission of apraxic deficits, whereas lesions to the (inferior) parietal lobe (IPL; supramarginal and angular gyrus) and the superior longitudinal fasciculus (SLF) were associated with persistent apraxic deficits. Data suggest that lesions affecting the core regions (and white matter) of the fronto-parietal praxis network cause more persistent apraxic deficits than lesions affecting other regions (here: the left insula) that also contribute to motor cognition and apraxic deficits.

Deficient supplementary motor area at rest: Neural basis of limb kinetic deficits in Parkinson's disease.

Parkinson's disease (PD) patients frequently suffer from limb kinetic apraxia (LKA) affecting quality of life. LKA denotes an impairment of precise and independent finger movements beyond bradykinesia, which is reliably assessed by coin rotation (CR) task. BOLD fMRI detected activation of a left inferior parietal-premotor praxis network in PD during CR. Here, we explored which network site is most critical for LKA using arterial spin labeling (ASL). Based on a hierarchical model, we hypothesized that LKA would predominantly affect the functional integrity of premotor areas including supplementary motor areas (SMA). Furthermore, we suspected that for praxis function with higher demand on temporal-spatial processing such as gesturing, inferior parietal lobule (IPL) upstream to premotor areas would be essential. A total of 21 PD patients and 20 healthy controls underwent ASL acquisition during rest. Behavioral assessment outside the scanner involved the CR, finger tapping task, and the test of upper limb apraxia (TULIA). Whole-brain analysis of activity at rest showed a significant reduction of CR-related perfusion in the left SMA of PD. Furthermore, the positive correlation between SMA perfusion and CR, seen in controls, was lost in patients. By contrast, TULIA was significantly associated with the perfusion of left IPL in both patients and controls. In conclusion, the findings suggest that LKA in PD are linked to an intrinsic disruption of the left SMA function, which may only be overcome by compensatory network activation. In addition, gestural performance relies on IPL which remains available for functional recruitment in early PD.

T177. STRUCTURAL ORGANIZATION OF THE PRAXIS NETWORK PREDICTS GESTURE PRODUCTION: EVIDENCE FROM HEALTHY SUBJECTS AND PATIENTS WITH SCHIZOPHRENIA

BackgroundHand gestures are an integral part of social interactions and are involved in nonverbal and verbal communication. The convey language that is expressed by motor actions, and thus depend on the interplay of various brain regions. Several functional magnetic resonance imaging studies in healthy subjects suggest the praxis network for gesture production, involving distinct frontal, parietal and temporal regions. Lesions studies in subjects with apraxia, following left brain damage corroborate these findings. However, little is known about the structural connectivity underlying gesture production. We aimed to provide novel insights into the structural connectivity of the praxis network and how it is related to gesture production.MethodsOur sample consisted of 41 healthy subjects and of 40 patients with schizophrenia, demonstrating gesture impairments and structural network abnormalities. All participants performed a gesture production test, the test of upper limb apraxia and underwent diffusion weighted magnetic resonance imaging. Finsler geometry was used to investigate structural connectivity and graph theory to estimate global and local efficiency of the praxis network, which consists of 13 bilateral regions of interest.ResultsOur findings showed an association of gesture production with network attributes and specific connections within the praxis network. Thus, global and local efficiency and most of the intra- and interhemispheric connections within the gesture network predicted gesture production across groups. Global efficiency of the praxis network further predicted gesture production only in the patient group. Local efficiency of many ROIs and connections of interest predicted production in patients at trend-level. In contrast, there were no significant or trend-level associations of gesture production with network attributes in controls.DiscussionThe results revealed an association of impaired gesture performance with structural alterations of the praxis network, including global and local efficiency and many connections of interest. Our findings are of great importance in the understanding of the structural correlates of gesture production and shed further light on the neural underpinnings of gesture deficits in a patient group with severe social deficits.

Limbic Interference During Social Action Planning in Schizophrenia.

Schizophrenia is characterized by social interaction deficits contributing to poor functional outcome. Hand gesture use is particularly impaired, linked to frontal lobe dysfunction and frontal grey matter deficits. The functional neural correlates of impaired gesturing are currently unclear. We therefore investigated aberrant brain activity during impaired gesturing in schizophrenia. We included 22 patients with schizophrenia and 25 healthy control participants matched for age, gender, and education level. We obtained functional magnetic resonance imaging data using an event-related paradigm to assess brain activation during gesture planning and execution. Group differences in whole brain effects were calculated using factorial designs. Gesture ratings were performed by a single rater, blind to diagnoses and clinical presentation. During gesture planning and execution both groups activated brain areas of the praxis network. However, patients had reduced dorsolateral prefrontal cortex (DLPFC) and increased inferior parietal lobe (IPL) activity. Performance accuracy was associated with IPL activity in patients. Furthermore, patients activated temporal poles, amygdala and hippocampus during gesture planning, which was associated with delusion severity. Finally, patients demonstrated increased dorsomedial prefrontal cortex activity during planning of novel gestures. We demonstrate less prefrontal, but more IPL and limbic activity during gesturing in schizophrenia. IPL activity was associated with performance accuracy, whereas limbic activity was linked to delusion severity. These findings may reflect impaired social action planning and a limbic interference with gestures in schizophrenia contributing to poor gesture performance and consequently poor social functioning in schizophrenia.

Altered praxis network underlying limb kinetic apraxia in Parkinson's disease - an fMRI study.

Parkinson's disease (PD) patients frequently suffer from dexterous deficits impeding activities of daily living. There is controversy whether impaired fine motor skill may stem from limb kinetic apraxia (LKA) rather than bradykinesia. Based on classical models of limb praxis LKA is thought to result when premotor transmission of time-space information of skilled movements to primary motor representations is interrupted. Therefore, using functional magnetic resonance imaging (fMRI) we tested the hypothesis that dexterous deficits in PD are associated with altered activity and connectivity in left parieto-premotor praxis network. Whole-brain analysis of fMRI activity during a task for LKA (coin rotation) showed increased activation of superior and inferior parietal lobule (SPL, IPL) and ventral premotor cortex (vPM) in PD patients compared to controls. For bradykinesia (assessed by finger tapping) a decreased fMRI activity could be detected in patients. Additionally, psychophysical interaction analysis showed increased functional connectivity between IPL and the posterior hippocampi in patients with PD. By contrast, functional connectivity to the right dorsolateral prefrontal cortex was decreased in patients with PD compared to controls.In conclusion, our data demonstrates that dexterous deficits in PD were associated with enhanced fMRI activation of the left praxis network upstream to primary motor areas, mirroring a neural correlate for the behavioral dissociation of LKA and bradykinesia. Furthermore, the findings suggest that patients recruit temporal areas of motor memory as an attempt to compensate for impaired motor skills. Finally, dysexecutive function may contribute to the deficit.

EP 1. Brain activity after acute left hemispheric stroke in imitation and tool associated actions

Background Apraxia, a disorder of higher motor control, frequently leads to impaired tool use or imitation capacities due to left hemispheric lesions. However, despite similar lesion size or location, patients present with different apraxic deficits thus different early reorganization mechanism may be assumed. To understand the impaired praxis network after stroke on a functional level, we correlated behavioral performance in imitation and tool use tasks with activation patterns in fMRI of 47 acute left-hemispheric stroke patients. Methods A cohort of 47 acute stroke patients (mean age 63.5 years ± SD 13.6; 13 female) with first ever embolic stroke in the left arteria cerebri media territory were tested for deficits in imitation of meaningless hand and finger postures and tool associated actions (pantomime of tool use, imitation of tool use, actual tool use). Testing was performed mean 4.8 days ± SD 2.9 post stroke. FMRI was acquired during presentation of video sequences of tool-associated actions viewed from a first-person perspective. Voxel wise linear regression analyses for task scores only and with lesion volume as covariate as well as group differences for categorized behavioral performance (deficit vs. no deficit) were calculated to analyze activity associated with behavioral performance in tool use and meaningless imitation. Analyses were performed using GLMflex. Results are presented on a p Results Intact imitation of meaningless postures was associated with activation in the left middle occipital gyrus as well as in the left superior temporal lobe in linear regression analyses and categorical group differences (deficit vs. no deficit). Tool associated tasks correlated with activation in the left supramarginal gyrus and superior temporal lobe without occipital activation. For group differences in pantomime of tool use (deficit vs. no deficit) an additional activation for patients with low behavioral performance could be found in the posterior middle temporal gyrus. Conclusion For intact imitation of meaningless postures and tool associated actions, specific left hemispheric activation patterns in the acute phase after stroke could be determined. These areas are commonly associated to the left hemispheric praxis network. While intact imitation of meaningless gestures seems to rely on intact left middle occipital gyrus for visual analysis of the presented movement tool associated actions rather seem to rely on integrity of the supramarginal gyrus, known to store movement engrams. Patients with deficits in pantomime of tool use additionally show activation of posterior middle temporal gyrus for semantic movement information. These mechanisms possibly can be interpreted as early compensatory effort.

Increased functional connectivity between cortical hand areas and praxis network associated with training-related improvements in non-dominant hand precision drawing

Chronic forced use of the non-dominant left hand yields substantial improvements in the precision and quality of writing and drawing. These changes may arise from increased access by the non-dominant (right) hemisphere to dominant (left) hemisphere mechanisms specialized for end-point precision control. To evaluate this prediction, 22 healthy right-handed adults underwent resting state functional connectivity (FC) MRI scans before and after 10 days of training on a left hand precision drawing task. 89% of participants significantly improved left hand speed, accuracy, and smoothness. Smoothness gains were specific to the trained left hand and persistent: 6 months after training, 71% of participants exhibited above-baseline movement smoothness. Contrary to expectations, we found no evidence of increased FC between right and left hemisphere hand areas. Instead, training-related improvements in left hand movement smoothness were associated with increased FC between both sensorimotor hand areas and a left-lateralized parieto-prefrontal network implicated in manual praxis. By contrast, skill retention at 6 months was predicted by changes including decreased FC between the representation of the trained left hand and bilateral sensorimotor, parietal, and premotor cortices, possibly reflecting consolidation and a disengagement of early learning processes. These data indicate that modest amounts of training (<200min total) can induce substantial, persistent improvements the precision and quality of non-dominant hand control in healthy adults, supported by strengthened connectivity between bilateral sensorimotor hand areas and a left-lateralized parieto-prefrontal praxis network.

Structural brain correlates of defective gesture performance in schizophrenia

IntroductionThe neural correlates of impaired performance of gestures are currently unclear. Lesion studies showed variable involvement of the ventro-dorsal stream particularly left inferior frontal gyrus (IFG) in gesture performance on command. However, findings cannot be easily generalized as lesions may be biased by the architecture of vascular supply and involve brain areas beyond the critical region. The neuropsychiatric syndrome of schizophrenia shares apraxic-like errors and altered brain structure without macroanatomic lesions. Schizophrenia may therefore qualify as a model disorder to test neural correlates of gesture impairments. MethodsWe included 45 schizophrenia patients and 44 healthy controls in the study to investigate the structural brain correlates of defective gesturing in schizophrenia using voxel based morphometry. Gestures were tested in two domains: meaningful gestures (transitive and intransitive) on verbal command and imitation of meaningless gestures. Cut-off scores were used to separate patients with deficits, patients without deficits and controls. Group differences in gray matter (GM) volume were explored in an ANCOVA. ResultsPatients performed poorer than controls in each gesture category (p < .001). Patients with deficits in producing meaningful gestures on command had reduced GM predominantly in left IFG, with additional involvement of right insula and anterior cingulate cortex. Patients with deficits differed from patients without deficits in right insula, inferior parietal lobe (IPL) and superior temporal gyrus. ConclusionsImpaired performance of meaningful gestures on command was linked to volume loss predominantly in the praxis network in schizophrenia. Thus, the behavioral similarities between apraxia and schizophrenia are paralleled by structural alterations. However, few associations between behavioral impairment and structural brain alterations appear specific to schizophrenia.

Early dysfunctions of fronto-parietal praxis networks in Parkinson\u2019s disease

In Parkinson’s disease (PD) the prevalence of apraxia increases with disease severity implying that patients in early stages may already have subclinical deficits. The aim of this exploratory fMRI study was to investigate if subclinical aberrations of the praxis network are already present in patients with early PD. In previous functional imaging literature only data on basal motor functions in PD exists. Thirteen patients with mild parkinsonian symptoms and without clinically diagnosed apraxia and 14 healthy controls entered this study. During fMRI participants performed a pantomime task in which they imitated the use of visually presented objects. Patients were measured ON and OFF dopaminergic therapy to evaluate a potential medication effect on praxis abilities and related brain functions. Although none of the patients was apraxic according to De Renzi ideomotor scores (range 62–72), patients OFF showed significantly lower praxis scores than controls. Patients exhibited significant hyperactivation in left fronto-parietal core areas of the praxis network. Frontal activations were clearly dominant in patients and were correlated with lower individual praxis scores. We conclude that early PD patients already show characteristic signs of praxis network dysfunctions and rely on specific hyperactivations to avoid clinically evident apraxic symptoms. Subclinical apraxic deficits were shown to correlate with an activation shift from left parietal to left frontal areas implying a prospective individual imaging marker for incipient apraxia.

Pedagogy, Education and Praxis: understanding new forms of intersubjectivity through action research and practice theory

The Pedagogy, Education and Praxis (PEP) network is a cross-institutional, collaborative research programme which brings together researchers from Australia, Columbia, Finland, Norway, Sweden, the Caribbean, the Netherlands and the United Kingdom. These researchers are investigating the nature, traditions and conditions of pedagogy, education and praxis and how they are understood, developed and sustained in different national contexts and various educational settings. The PEP international network emerged in 2005 out of a series of discussions about the ways in which the bureaucratization and de-professionalization of education were eroding the moral, social and political commitments that informed pedagogical practice until the recent past, and a shared conviction of the need for a form of educational research committed to reviving and restoring these commitments. This article outlines the PEP’s research programme, ‘Action Research and Site Based Education Development’, through the lens of the theory of practice architectures. This theory offers insights into the cultural-discursive, material-economic and social-political conditions that shape practices, throwing light on contemporary educational issues and suggesting ways forward for site based education development.

V8. Structural alteration of the praxis network were associated with poor gesture performance in schizophrenia patients

Background Schizophrenia is associated with poor nonverbal communication. Impairments in the performance of hand gestures have been shown in 67% of patients with schizophrenia. These deficits are similar to those seen in Apraxia, which is often due to lesions in the inferior parietal (IPL) lobe, insula and inferior frontal gyrus (IFG). In Schizophrenia however, the neural correlates are unknown. Therefore, we investigated structural correlates of impaired gesture performance in schizophrenia. Methods In 43 patients with schizophrenia spectrum disorders, gesture performance was assessed by the comprehensive Test of Upper Limb Apraxia (TULIA). Performance was video recorded and blindly rated for accuracy. Structural brain imaging was measured in all patients using a 3-T MR Scanner. Grey matter density was correlated with TULIA scores using Whole-Brain Voxel-Based Morphometry (VBM) and total intracranial volume as covariate. White matter integrity was correlated with TULIA scores using Tract-Based Spatial Statistics (TBSS) and age as covariate. Results The TULIA total score correlated with grey matter density in several clusters of the praxis network at p p Conclusions Aberrant brain structure is associated with poor gesture performance in schizophrenia. Particularly in key regions of the praxis network, i.e. insula, parietal cortex, we detected correlations of gesture performance and grey and white matter markers. In addition, the anterior cingulate cortex grey matter was correlated to gesture performance, a region implicated in action planning and control. Therefore, specific brain structural alterations may contribute to deficits in nonverbal communication in schizophrenia ( Fig. 1 ).

V7. Impaired postural knowledge in schizophrenia is associated with structural gray and white matter alterations in the praxis network.

Background Higher order processes such as recognition of gestures rely on a network of distinct and distant brain areas. Particularly the role of key regions such as the left inferior frontal gyrus (IFG) and the inferior parietal lobe is subject to ongoing debate. Schizophrenia patients suffer from impaired gesture performance and recognition. However, neural correlates of impaired gesture recognition have not yet been investigated. We therefore aim to test associations between structural brain imaging and postural knowledge in schizophrenia using voxel based morphometry (VBM) and tract based spatial statistics (TBSS). Methods In total, 44 patients with schizophrenia (DSM-5 criteria; 59% men, mean age 38) underwent structural MR imaging and performed the comprehensive postural knowledge task (PKT) for hand gestures. All patients except four were treated with antipsychotics. T1-weighted images were processed using SPM8 and DTI-data using FSL TBSS routines. We explored correlations of PKT scores and gray matter (GM) volume in VBM data and correlations of PKT scores and white matter (WM) integrity in TBSS data. Results were corrected for multiple comparisons using family wise error correction. Results Impaired postural knowledge was related to reduced GM volume and WM integrity. Whole brain analyses revealed effects of postural knowledge on gray matter volume within the bilateral insula extending to the IFG, the left primary motor cortex, the left superior parietal lobe and the bilateral hippocampi. Furthermore, significant correlations within fiber tracts connecting these regions – particularly alterations within the bilateral cingulum bundle and cingulum, the right superior longitudinal fasciculus, the right anterior limb of internal capsule, and the left uncinated fasciculus – were associated with PKT performance. Conclusions Poor postural knowledge in schizophrenia was associated with GM volume reductions in the praxis network. Our results are in line with the literature as particularly lesions in the left IFG were found to predict poor gesture recognition in brain damaged patients. In addition an effect of postural knowledge on WM integrity was shown within fiber tracts connecting key regions of gesture processing. Furthermore, the hippocampus is engaged in spatial memory and navigation. The results suggest that structural brain alterations in the common gesture network contribute to impaired postural knowledge in schizophrenia ( Fig. 1 ).

P20. Deficit actual tool use in schizophrenia is linked to structural alterations in key regions of planning and executing of tool use and connecting fibers

Introduction Schizophrenia patients frequently suffer from complex motor abnormalities including fine and gross motor disturbances, abnormal involuntary movements, neurological soft signs and parkinsonism. These symptoms occur early in the course of the disease, continue in chronic patients and may deteriorate with antipsychotic medication ( Walther and Strik, 2012 ). Furthermore gesture performance is impaired in patients, including the pantomime of tool use. Whether schizophrenia patients would show difficulties of actual tool use has not yet been investigated. Human tool use is complex and relies on a network of distinct and distant brain areas. We therefore aim to test if schizophrenia patients had difficulties in tool use and to assess associations with structural brain imaging using voxel based morphometry (VBM) and tract based spatial statistics (TBSS). Methods In total, 44 patients with schizophrenia (DSM-5 criteria; 59% men, mean age 38) underwent structural MR imaging and performed the Tool-Use test ( Randerath et al., 2011 ). The test examines the use of a scoop and a hammer in three conditions: pantomime (without the tool), demonstration (with the tool) and actual use (with a recipient object). T1-weighted images were processed using SPM8 and DTI-data using FSL TBSS routines. To assess structural alterations of impaired tool use we first compared gray matter (GM) volume in VBM and white matter (WM) integrity in TBSS data of patients with and without difficulties of actual tool use. Next we explored correlations of Tool use scores and VBM and TBSS data. Group comparisons were family wise error corrected for multiple tests. Correlations were uncorrected (p Results Tool use was impaired in schizophrenia (43.2% pantomime, 11.6% demonstration, 11.6% use). Impairment was related to reduced GM volume and WM integrity. Whole brain analyses detected an effect in the SMA in group analysis. Correlations of tool use scores and brain structure revealed alterations in brain areas of the dorso-dorsal pathway (superior occipital gyrus, superior parietal lobule, and dorsal premotor area) and the ventro-dorsal pathways (middle occipital gyrus, inferior parietal lobule) the action network, as well as the insula and the left hippocampus. Furthermore, significant correlations within connecting fiber tracts - particularly alterations within the bilateral corona radiata superior and anterior as well as the corpus callosum - were associated with Tool use performance. Conclusions Tool use performance was impaired in schizophrenia, which was associated with reduced GM volume in the action network. Our results are in line with reports of impaired tool use in patients with brain lesions particularly of the dorso-dorsal and ventro-dorsal stream of the action network. In addition an effect of tool use on WM integrity was shown within fiber tracts connecting regions important for planning and executing tool use. Furthermore, hippocampus is part of a brain system responsible for spatial memory and navigation.The results suggest that structural brain alterations in the common praxis network contribute to impaired tool use in schizophrenia ( Fig. 1 ).

Dynamics of functional and effective connectivity within human cortical motor control networks

ObjectivePraxis, the performance of complex motor gestures, is crucial to the development of motor and social/communicative capacities. Praxis relies on a network consisting of inferior parietal and premotor regions, particularly on the left, and is thought to require transformation of spatio-temporal representations (parietal) into movement sequences (premotor). MethodWe examined praxis network dynamics by measuring EEG effective connectivity while healthy subjects performed a praxis task. ResultsPropagation from parietal to frontal regions was not statistically greater on the left than the right. However, propagation from left parietal regions to all other regions was significantly greater during gesture preparation than execution. Moreover, during gesture preparation only, propagation from the left parietal region to bilateral frontal regions was greater than reciprocal propagations to the left parietal region. This directional specificity was not observed for the right parietal region. ConclusionsThese findings represent direct electrophysiological evidence for directionally predominant propagation in left frontal–parietal networks during praxis behavior, which may reflect neural mechanisms by which representations in the human brain select appropriate motor sequences for subsequent execution. SignificanceIn addition to bolstering the classic view of praxis network function, these results also demonstrate the relevance of additional information provided by directed connectivity measures.