The work will be a reanalysis and reconceptualization of the concept of apraxia. Apraxia is currently understood as a motor speech disorder but an analysis of the neural network properties of apraxia indicate a more complex and far reaching disorder with implications for intentionality, motor coordination and motor control of response inhibition in a variety of human behavioral and emotional reactions. A thorough redefinition of apraxia will be provided along with suggestions for diagnoses and treatment. The primary audience will be diagnostic and treating professionals in a variety of disciplines (outlined above). Secondarily, the book will provide an argument and justification for considering developmental apraxia pf speech to be a separate and discrete white matter based disorder. Finally, this work will serve as a driver of future research in the area.
Author(s): Theodore Wasserman, Lori Drucker Wasserman
Series: Neural Network Model: Applications and Implications
Publisher: Springer
Year: 2023
Language: English
Pages: 227
City: Cham
Introduction: Why Apraxia
Contents
Chapter 1: Apraxia, Dyspraxia, and Motor Coordination Disorders: Definitions and Confounds
History and Current State of the Study of Apraxia
Current Definitions
Definitional Definitions and Confounds in Apraxia Research
Hypothetical Neural Mechanisms of Apraxia
Double-Duty Neurons and Apraxia
Recognized Apraxia Conditions
Limb-Kinetic Apraxia
Ideomotor Apraxia
Conceptual Apraxia
Ideational Apraxia
Buccofacial Apraxia
Constructional Apraxia
Oculomotor Apraxia
Type 1
Ataxia-Oculomotor Apraxia Type 2 (AOA2)
Orofacial Apraxia
Verbal Apraxia
Other Apraxia Conditions
Verbal–Motor Dissociation Apraxia
Tactile Apraxia
Acquired Apraxia of Speech (AOS)
Newer Models of Speech Production
Childhood Apraxia of Speech
Neuropsychological Models of Apraxia
Dual-Stream Models and Types of Apraxia
References
Chapter 2: The Etiology of Apraxia
Genetically Based Apraxia
Non-stroke-Related Progressive Apraxia of Speech
Apraxia Associated with Neurodevelopmental Disorders
Childhood Apraxia of Speech (CAS)
FOXP2/7q31.1 Deletion
GRIN2A
SETBP1
Microdeletions of BCL11A
KANSL1 or 17q21.31 Microdeletion Koolen-De Vries Syndrome (KdVS)
ELKS/ERC1 and 12p13.33 Deletion
16p11.2 Deletion
Corticobasal Degeneration (CBD)
References
Chapter 3: The Human Connectome: An Overview
The Connectome and Neural Networks
The Importance of Understanding the Connectome
Hubs
Networks and Connectomics
Scaling
Degeneracy
Structural Plasticity
Challenges to Understanding the Connectome
The Relationship of Connectome to Clinical Diagnosis
Neural Response to the Disruption of Pathway Function
Diaschisis
Transneuronal Degeneration
Dedifferentiation
The Neural Networks of Apraxia
References
Chapter 4: Neuronal Populations, Neural Nodes, and Apraxia
Apraxia and Neural Pathways
What Is the Neural Population Level?
Integrating Neural Populations into a Coherent Neural Network
Glossary
How the Neural Substrate Enables Integration of Distributed Neural Information and Thus the Emergence of Coherent Mental and Cognitive States
What Is the Interface of Network Structure and Praxis?
Neural Pathways and Structures Implicated in Apraxia Conditions
Limb-Kinetic Apraxia
Ideomotor Apraxia
Conceptual Apraxia
Ideational Apraxia
Buccofacial Apraxia
Oral Motor and Verbal Apraxia
Constructional Apraxia
Childhood Apraxia of Speech
References
Chapter 5: It Is Not Only Apraxia
The Structural Beginnings of Brain-Based Behavioral and Cognitive Connections: A Theoretical Basis
The Development of Networks
Feedforward Impact
The Cerebral Cortex and Basal Ganglia
Neural Pathways Are Recruited for Multiple Functional Outcomes
Disruption of Early Domains Are Not Just Domain Specific
Limb-Kinetic Apraxia and Associated Conditions
Ideomotor Apraxia and Associated Conditions
Conceptual Apraxia and Associated Conditions
Ideational Apraxia and Related Conditions
Oral Motor and Verbal Apraxia and Related Conditions
Apraxic Conditions Rarely Occur in Isolation
White Matter Degeneration Following Injury
Neural Network Damage Models
References
Chapter 6: Developmental Coordination Disorder
Developmental Coordination Disorder (DCD)
The History of Developmental Coordination Disorder
DCD Early Signs and Phenotypical Presentations
Genetics Play a Role in Developmental Coordination Disorder
Neuroimaging and Brain Studies
DCD and the Impact on Other Neural Substrates
How Embedded in Other Systems Is the Motor System?
Motor Networks in the Newborn and Their Involvement with Later Skills Development
Functional Expression in Later Development
Child Development: The Result of the Integration of Movement, Language, and Cognitive Processes
When Does the Development of the Motor System Begin?
References
Chapter 7: Childhood Apraxia of Speech
What Is Childhood Apraxia of Speech?
Is There a Difference Between CAS and Verbal Dyspraxia?
So, What Can We Definitively Say About the Definition of CAS?
The Idea of CAS Has Historically Been Controversial
What Are Some Comorbidity Associations?
Is CAS Underdiagnosed?
The Results of Definitional Confusion
Identifying the Speech Errors that Characterize CAS
Speech: Structure Versus Function
Genetics, Language Disorders, and CAS
References
Chapter 8: Neural Network Components of Childhood Apraxia of Speech and Associated Comorbidities
Hemispheres and History
Arcuate Fasciculus
Interconnections of the Arcuate Fasciculus
Hemispheres Do Not Operate in Isolation
Hemispheres and the Three Rs
The Connectome, Development, and CAS
CAS Is Multifactorial from a Network Perspective
The Dual Pathway Model
The Critical Contribution of the Dorsal Pathway
Cortical and Subcortical Involvement in Motor Speech
Prediction Errors and Motor Speech
Cerebellum and CAS
Cerebellar Dysfunction and CAS
Basal Ganglia and Procedural Memory
Broca’s Area, Basal Ganglia Loops, and the Supplementary Motor Area (SMA)
Language and Motor Cortex in the Interpretation of Speech
In Summary
The Implications of Bottom-Up Development for the Functional Implications of CAS
Treatment of CAS
References
Chapter 9: Neuropsychological Assessment of Apraxia: Where Network Reality and Domain Assessment Collide
How Many Domains Are There?
Domains Are Complex and Subsume Multiple Functions
Questionable Assumptions Concerning Ability of Neuropsychological Tests
Assumption: Most Disorders Are Produced by Discrete and Dissociable Neuropsychological Deficits
Assumption: We Can Assess Components of a Neural Network Independently of Its Other Components
Assumption: Neuropsychological Tests Were Designed to Assess Brain Function
Assumption: Neuropsychological Tests Can Identify Specific, Discrete, and Dissociable Brain-Based Deficits
Pathognomonic Signs in the Assessment of Apraxia
Clinical Presentation
Developmental Apraxia of Speech and Pathognomonic Sign
What to Do, What to Do?
References
Chapter 10: Treatment for Apraxia: Plasticity and Regeneration
Lack of Consensus for the Selection of Treatments for Apraxia
Classes of Treatment for Apraxia
Restorative (Restitutive) Treatments
Compensatory (Substitutive) Treatments
Assistive Technology
Treatment Examples
Neural Plasticity
Mechanisms of Neural Plasticity
Treatment That Supports Neural Plasticity
Brain Injury, Plasticity, and Functional Recovery
What Enhances Neural Plasticity?
Environmental Enrichment and Neural Plasticity
Regeneration
Limitations of Plasticity
Treatment Going Forward: Neurorehabilitation
References
Chapter 11: Understanding Apraxia Going Forward
The Problem of Diagnosis
Problems for Neuropsychologists
Staying in Our Lane
Understanding Disorders from a Neural Network Perspective
Network Theory and Complex Networks
Research Domain Criteria (RDoC) (Insel, 2014)
Diagnosing Apraxia: Why Make It Complicated?
Assess It All: Downstream and Upstream Impact of Network Disruption
The Case for a Separate Diagnosis for Childhood Apraxia of Speech
Genetics
The Problem of Treatment
“Testing” for Apraxia
References
Appendix I: Network Properties Breakdown of Ideational Apraxia
Research Domain Criteria
Ideational Apraxia
Circuits Involved
Inferior Parietal Cortex
Posterior Parietal Cortex: Goal Selection
Premotor Cortex
Superior Temporal Sulcus
Supplementary Motor Area
Construct: Initiation
Circuits Involved
Dorsal Cingulate
Construct: Execution
Circuits Involved
Efferent and Afferent Spinal and Peripheral Pathways
Motor Cortex
Construct: Inhibition and Execution
Circuits Involved
Basal Ganglia
Supplementary Motor Area
Posterior Cingulate Gyrus
Inferior Frontal Gyrus
Dorsolateral Prefrontal Cortex
Inferior Parietal Cortex
Lateral Premotor Cortex
Medial Prefrontal Cortex
Index
