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Vol. 58, No. 3, 2007
Issue release date: October 2007
Eur Neurol 2007;58:142–145
(DOI:10.1159/000104714)

Gait Apraxia: Further Clues to Localization

Nadeau S.E.
Geriatric Research, Education and Clinical Center and the Brain Rehabilitation Research Center, Malcom Randall Veterans Administration Medical Center, and the Department of Neurology, University of Florida College of Medicine, Gainesville, Fla., USA

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Abstract

Background/Aims: Gait apraxia characterized primarily by gait ignition failure has been linked to lesions involving the dorsomedial frontal lobes, but the precise locus within this general region has not been determined. It has previously been hypothesized by Thompson and Marsden that disease, disconnection, or dysfunction of supplementary motor area (SMA) may account for the similarities in the gait disorders observed in Binswanger’s disease, hydrocephalus, frontal lobe lesions, and Parkinson’s disease. We reevaluate this hypothesis. Methods: Clinical description and MRI of 2 subjects with gait apraxia characterized primarily by gait ignition failure. Results: Both subjects had incapacitating gait disorders characterized by particular difficulty with initiating gait and making turns. Both had MRI-demonstrated lesions of the SMA region, parasagittal convexity premotor cortex, or subjacent white matter bilaterally, one due to primary CNS lymphoma, one due to a lobar atrophy. Conclusions: In both these cases, the lesions were substantially more limited and focal than any reported heretofore in the literature on gait apraxia or freezing of gait. The clinicopathologic correlation in these cases provides partial support for the Thompson and Marsden hypothesis, but also may implicate parasagittal convexity premotor cortex in the genesis of gait apraxia.



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References

  1. Della Sala S, Francescani A, Spinnler H: Gait apraxia after bilateral supplementary motor area lesion. J Neurol Neurosurg Psychiatry 2002;72:77–85.
  2. Meyer JS, Barron DW: Apraxia of gait: a clinico-physiological study. Brain 1960;83:261–284.

    External Resources

  3. Denny-Brown D: The nature of apraxia. J Nerv Ment Dis 1958;126:9–31.
  4. Rossor MN, Tyrrell PJ, Warrington EK, Thompson PD, Marsden CD, Lantos P: Progressive frontal gait disturbance with atypical Alzheimer’s disease and corticobasal degeneration. J Neurol Neurosurg Psychiatry 1999;67:345–352.
  5. Miyai I, Tanabe HC, Sase I, Eda H, Oda I, Konishi I, et al: Cortical mapping of gait in humans: a near-infrared spectroscopic topography study. Neuroimage 2001;14:1186–1192.
  6. Nadeau SE, McCoy KJM, Crucian GP, Greer RA, Rossi F, Bowers D, et al: Cerebral blood flow changes in depressed patients after treatment with repetitive transcranial magnetic stimulation: evidence of individual variability. Neuropsychiatry Neuropsychol Behav Neurol 2002;15:159–175.
  7. Alexander MP, Stuss DT, Picton T, Shallice T, Gillingham S: Regional frontal injuries cause distinct impairments in cognitive control. Neurology, in press.
  8. Hodges JR, Davies RR, Xuereb JH, Casey B, Broe M, Bak TH, et al: Clinicopathological correlates in frontotemporal dementia. Ann Neurol 2004;56:399–406.
  9. Kertesz A, McMonagle P, Blair M, Davidson W, Munoz DG: The evolution and pathology of frontotemporal dementia. Brain 2005;128:1996–2005.
  10. Stark M, Coslett HB, Saffran EM: Impairment of an egocentric map of locations: implications for perception and action. Cogn Neuropsychol 1996;13:481–523.
  11. Factor SA, Higgins DS, Qian : Primary progressive freezing gait: a syndrome with many causes. Neurology 2006;66:411–414.
  12. Factor SA, Jennings DL, Molho ES, Marek KL: The natural history of the syndrome of primary progressive freezing gait. Arch Neurol 2002;59:1778–1783.
  13. Fabre N, Brefel C, Sabatini U, Celsis P, Montastruc JL, Chollet F, et al: Normal frontal perfusion in patients with frozen gait. Mov Disord 1998;13:677–683.
  14. Thompson PD, Marsden CD: Gait disorder of subcortical arteriosclerotic encephalopathy: Binswanger’s disease. Movement Disorders 1987;2:1–8.


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