EEG and EMG Analysis of Ideomotor Apraxia
EEG and EMG Analysis of Ideomotor Apraxia
This study will examine how the brain operates during execution and control of voluntary
 movement and what goes wrong with these processes in disease. It will use
 electroencephalography (EEG) and electromyography (EMG) to compare brain function in normal
 subjects and in patients with-a disorder affecting patients with stroke and other brain
 lesions. These patients have problems with timing, sequence and spatial organization of
 certain types of movements.

 EEG measures the electrical activity of the brain. The activity is recorded using wire
 electrodes attached to the scalp or mounted on a Lycra cap placed on the head. EMG measures
 electrical activity from muscles. It uses wire electrodes placed on the skin over the
 muscles.

 Adult healthy normal volunteers and patients with ideomotor apraxia with a single left brain
 lesion may be eligible for this study.

 Study participants will be asked to make certain movements with their arms or hands, such as
 waving and using scissors. Brain and muscle activity will be measured during these tasks with
 EEG and EMG recordings. Patients may be asked to repeat these tests over time as their
 condition changes (such as during recovery from a stroke) to gain information about the
 recovery process.
Ideomotor apraxia is a disorder affecting patients with stroke and a variety of other brain
 lesions. The disorder involves problematic timing, sequence, and spatial organization of
 gestured movements. As a result, patients suffer from incorrect temporal and spatial
 components to movements as evidenced during pantomime of transitive and intransitive
 movements. The errors can be seen in left and right hemisphere damaged patients during
 intransitive movements, but lesions predominate in the left hemisphere for inability to
 pantomime transitive movements. Thus far, damage to parietofrontal circuits has been
 implicated in significantly contributing to this disorder. These circuits, which pave the way
 for sensorimotor processing, are of clear interest in the nature of praxis.

 In the present study, we plan to evaluate further the parietofrontal circuits in these
 patients. Using EEG, we will analyze the movement related cortical potentials (MRCP) in these
 patients compared to controls to evaluate any cortical planning differences. We will analyze
 how the circuits play a role in transitive and intransitive movements in normal subjects and
 patients with Ideomotor apraxia. Each patient will make a series of movement during 64
 channel EEG and EMG recordings. Following recordings, analysis will be made of the event
 related desynchronization (ERD) and the MRCP. Further analysis will look at the activation of
 the parietofrontal circuitry in patients using correlation and coherence methods. For the
 same purposes, MEG studies will be performed to assess similar measures.
We will study normal volunteers and patient groups between the ages of 18-80 years of age
 within the following parameters:

 INCLUSION CRITERIA:

 Normal subjects.

 Patients diagnosed with Ideomotor apraxia with a single left hemisphere lesion.

 Patients with Ideomotor apraxia with corticobasal ganglionic degeneration.

 EXCLUSION CRITERIA

 Normal subjects: abnormal neurologic examination or history of neurologic disorders.

 Ideomotor apraxic patients: a second neurologic disorder including more than one brain
 lesion or the inability to cooperate fully.

 Normal and Ideomotor apraxic patients: cognitively impaired subjects will not be accrued
 (for the purposes of this study, patients that can provide full informed consent for the
 study are not considered cognitively impaired).

 For MRI studies, patients with metallic implants to remove potential risks from this
 procedure.

 For MRI purposes, women who are pregnant are excluded from this part of the protocol.
 Therefore, all women of childbearing potential will have a pregnancy test performed, which
 must be negative, before proceeding.