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Limb apraxia in neurodegenerative disorders

机译:神经退行性疾病中的肢体失用

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Apraxia is a cognitive-motor disorder affecting gestural communication and tool use, and is seen in various neurodegenerative disorders. Apraxia is a major feature of the corticobasal syndrome associated with nonlevodopa-responsive, typically asymmetric parkinsonism. Mild apraxia may also be seen in Parkinson's disease, at least in later stages of the disease. Furthermore, patients with Alzheimer's disease or posterior cortical atrophy are prone to develop apraxia during their disease course. However, apraxia may be difficult to dissect from other motor (e.g., dystonia and bradykinesia in corticobasal syndrome) or cognitive (e.g., dysexecutive or semantic memory deficits in Alzheimer's disease) dysfunction. Therefore, the ecological significance of apraxia in neurodegenerative disorders may not always be obvious. Although treatment protocols for apraxia have been developed in stroke, there is little information on the management of apraxia in neurodegenerative disorders. Owing to their progressive nature, benefits from therapeutic interventions are certainly limited, although some capacity of motor learning may be preserved, at least in earlier disease stages. In advanced cases, management of apraxia should focus on compensatory measures, for instance, on adapting the patient's environment to their needs, particularly when related to safety and comfort.
机译:失用症是影响手势沟通和工具使用的认知运动障碍,常见于各种神经退行性疾病。失用症是与非左旋多巴反应性(通常为非对称性帕金森病)相关的皮质基底肌综合征的主要特征。帕金森氏病至少在疾病晚期也可能出现轻度失用。此外,患有阿尔茨海默氏病或​​后皮质萎缩的患者在其病程中易于发生失用症。然而,失用症可能难以与其他运动功能障碍(例如,皮质基底肌综合征的肌张力障碍和运动迟缓)或认知功能障碍(例如,阿尔茨海默氏病的执行力或语义记忆功能障碍)分离。因此,神经退行性疾病失用症的生态学意义可能并不总是很明显。尽管已经在中风中开发了用于失用症的治疗方案,但是关于神经退行性疾病中失用症的处理的信息很少。由于其进步的性质,尽管至少在疾病的早期阶段,可以保留一定的运动学习能力,但是治疗干预的益处当然是有限的。在晚期病例中,失用症的治疗应侧重于补偿性措施,例如,使患者的环境适应他们的需求,特别是在与安全性和舒适性有关的情况下。

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