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Apraxia and aphasia

The functional-anatomical basis for their dissociation

From the Department of Clinical Neurological Sciences (Dr. Kertesz), St. Joseph's Hospital, London, Ontario, Canada; Language Research Laboratory (Dr. Ferro), Centro de Estudos Egas Moniz, Department of Neurology, Hospital de St. Maria, Lisbon, Portugal; and Program in Communicative Disorders (Dr. Shewan), The University of Western Ontario, London, Ontario.

We studied the functional and anatomical relationship between aphasia and apraxia in 177 patients with CT evidence of left hemisphere stroke. In six severe aphasics, praxis was spared; these cases were analyzed in detail. One patient had a small temporal lesion with severe Wernicke's aphasia. Large frontoparietal lesions were found in the others. The sparing of praxis suggested bilateral representation of visuokinesthetic motor patterns, and functionally active right parietofrontal connections. Some of these patients had uncommon patterns of skull asymmetries that may have been related to bilateral distribution of function.

Address correspondence and reprint requests to Dr. Kertesz, Department of Clinical Neurological Sciences, St. Joseph's Hospital, London, Ontario, Canada, N6A 4V2.

This study was partly supported by an Ontario Ministry of Health Grant PR 696 to Dr. Kertesz, and by a fellowship from the Portuguese National Research Institute (INIC) for Dr. Ferro. Some of the data collected in this research was supported by a grant from the Ministry of Health of Ontario, project number DM 324, to C.M. Shewan and A. Kertesz for a study of language therapy and recovery from aphasia.

Accepted for publication April 13, 1983.

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