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
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
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:
Patients diagnosed with Ideomotor apraxia with a single left hemisphere lesion.
Patients with Ideomotor apraxia with corticobasal ganglionic degeneration.
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
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.