Mechanisms of dressing apraxia: a case study.

Abstract

OBJECTIVE: To investigate the neural mechanisms that differentiate dressing apraxia from other forms of apraxia such as ideomotor apraxia. Hypotheses examined included (1) that dressing is more sensitive to alternations in body schema, (2) that dressing is a demanding bimanual task, and (3) that clothing represents a particularly complex spatial problem. BACKGROUND: A focal degenerative condition can specifically target a function such as dressing, allowing a unique approach to its study. METHOD: A case study of the cognitive impairments of a 75-year-old man who presented with progressive dressing difficulties in the absence of neglect or motor disturbances. RESULTS: Neuropsychologic testing indicated possible executive function deficits as well as visuospatial and visuocontructional deficits, but intact praxic skills, verbal abilities, and visual recognition skills. In addition, testing revealed no evidence of Balint's or impairments in body schema. CONCLUSION: Overall, the test results suggested that visuospatial dysfunction is the underlying deficit in dressing apraxia. The present case study confirmed the independence of praxic functioning from spatial ability and conversely, the dependence of dressing on spatial ability.