Ideational and conceptual apraxia by cerebral infarction in the left basal ganglia and right pons: a case report.
Yuka Nakaya, Koji Hayashi, Asuka Suzuki and 6 others
PMID 41613154WHAT IT FOUND
A patient with no limb paralysis or aphasia lost the ability to operate complex machinery and ATMs after strokes in the left basal ganglia and right pons.
Standard apraxia tests missed this deficit, which appeared only when assessing abstract, multi-step tasks.
Key findings
01The patient could not operate a car gear shift, ATM, or smartphone despite preserved limb strength and no aphasia.
02Standard apraxia testing (SPTA) returned normal results because it focuses on simple, automated routines rather than complex conceptual planning.
03The patient's errors, such as using a keyboard instead of a mouse to open a file, indicated a failure in selecting the correct tool for the task rather than a motor execution problem.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a single case report, so the findings cannot be generalized to other patients with similar lesions. The specific nuclei within the basal ganglia and white matter pathways involved could not be definitively identified using conventional MRI. The patient's prior proficiency with ATMs and banking systems was based on family report, not pre-stroke testing.
Declared interests
The authors declared that no financial support was received for this work.
The easy way to misread this
Do not assume that normal results on standard apraxia tests (like the SPTA) rule out ideational or conceptual apraxia. These tests may only assess simple, automated routines and can miss deficits in complex, abstract tool use.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →