Objective: We aim to study apraxia in Parkinson’s disease.

Background: Limb apraxia is a cognitive motor disorder of skilled, purposive movements not caused by elementary motor and sensory deficits, abnormalities of tone or posture, akinesia, tremor or chorea. Accordingly to Leiguarda and Marsden (2000), there is a parietofrontal system that encodes reaching and grasping mechanisms and a frontostriatal system that encodes sequential motor events.

Methods: 32 consecutive outpatients (22 with left-side predominant disease) with Parkinson’s disease in ON state were evaluated with Apraxia Screen of TULIA (AST), Movement Disorders Society-Unified Parkinson’s disease Rating Scale (UPDRS) part I-III and Montreal Cognitive Assessment (MoCA). Demographic data was collected.

Results: AST scores are correlated with MoCA (r=0.633, p<0.001) and visuospatial/executive (r=0.363, p=0.041), naming (r=0.594, p<0.001), attention (0.613, p<0.001), language (r=0.698, p<0.001) and orientation (r=0.532, p=0,002). AST scores are correlated with UPDRS 1.1 (Cognitive Impairment; r=-0.663, p<0.001), 1.2 (Hallucinations and Psychosis; r=-0.425, p=0.005), 1.5 (Apathy; r=-0.489, p=0.004), 3.3a (Rigidity – neck; r=-0.452, p=0.009), 3.3e (Rigidity – Left Lower Extremity; r=-0.444, p=0.011), 3.4b (Finger Tapping – Left Hand; r=-0.355, p=0.046) and 3.15b (Postural tremor – left hand; r=-0-357, p=0.045).

Conclusions: Apraxia is related with cognitive decline namely in domains related with frontal and parietal lobes and language. In terms of motor function, apraxia is correlated with left limb bradikynesia, rigidity and tremor. This was unexpected, considering most of the patients are right-handed and apraxia is considered to have a left-hemisphere dominance. This supports the importance of basal ganglia’s role in praxis, namely on left limbs control. We are collecting more data in order to further explore this issue.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/apraxia-in-parkinsons-disease/