Mechanisms underlying limb apraxia
Research type
Research Study
Full title
Understanding motor processing pathways to guide therapy for limb apraxia
IRAS ID
119720
Contact name
Matthew A Lambon Ralph
Contact email
Sponsor organisation
Cambridge University Hospitals NHS Foundation Trust & The University of Cambridge
Clinicaltrials.gov Identifier
14/SC/0074, NRES REC Reference No
Duration of Study in the UK
9 years, 3 months, 8 days
Research summary
Limb apraxia is a disorder in performing skilled/learnt movements often observed in patients after a stroke, but also in neurodegenerative diseases and movement disorders such as Parkinson's disease. Patients typically have problems with using everyday objects or sequencing actions as simple as making a cup of tea. Studies have shown that this condition is associated with worse functional recovery after a stroke. Despite implications on recovery - this condition is still poorly understood.
We have obtained a BMA award which aims to understand the mechanisms underlying this disorder so as to target more appropriate therapies.
We hypothesize that an important reason patients with apraxia have higher order motor deficits relates to an inability to select among competing actions.
In an initial behavioural study, participants will be tested in conditions where they have to perform movements towards handheld objects. We will vary the familiarity of the action they have to perform by changing object characteristics (such as its position) and task instruction. We will measure their responses with quantitative methods (speed and accuracy of movement, as well as movement kinematics). We will compare any deficits obtained in patients with limb apraxia secondary to stroke versus those with Parkinson's disease. We hypothesise that deficits in action selection in those two groups would differ in this task.
In the second phase of the study, we will use well established brain imaging techniques to identify the motor pathways which may be implicated in this disorder by comparing brain activations during such task performance, together with functional and structural connectivity measures of brain pathways in stroke patients with limb apraxia versus stroke patients without apraxia and healthy volunteers.
Patient groups will be recruited from specialist clinics (PD patients from Professor Brown's movement disorder clinic; stroke patients from Professor Kischka's follow-up stroke clinic) in Oxford University Hospitals.
REC name
South Central - Berkshire Research Ethics Committee
REC reference
14/SC/0074
Date of REC Opinion
26 Feb 2014
REC opinion
Favourable Opinion