scholarly journals Network Localization of Alien Limb in Patients with Corticobasal Syndrome

2020 ◽  
Vol 88 (6) ◽  
pp. 1118-1131
Author(s):  
Aaron M. Tetreault ◽  
Tony Phan ◽  
Kalen J. Petersen ◽  
Daniel O. Claassen ◽  
Byran J. Neth ◽  
...  
Keyword(s):  
Corticobasal Syndrome ◽  
Network Localization ◽  
Alien Limb

scholarly journals Alien Limb Syndrome Responsive to Amantadine in a Patient with Corticobasal Syndrome

2015 ◽  
Vol 5 (0) ◽  
pp. 309 ◽  
Author(s):  
Francisco de Assis Aquino Gondim ◽  
José Wagner Leonel Tavares Júnior ◽  
Arlindo A. Morais ◽  
Paulo Marcelo Gondim Sales ◽  
Horta Goes Wagner
Keyword(s):  
Corticobasal Syndrome ◽  
Alien Limb

scholarly journals Corticobasal syndrome: a practical guide

2021 ◽  
Vol 21 (4) ◽  
pp. 276-283
Author(s):  
Duncan Wilson ◽  
Campbell Le Heron ◽  
Tim Anderson
Keyword(s):  
Prognostic Significance ◽  
Corticobasal Degeneration ◽  
Poor Response ◽  
Corticobasal Syndrome ◽  
Language Therapist ◽  
Alien Limb ◽  
Wide Range ◽  
Extrapyramidal Features ◽  
Underlying Pathology ◽  
Insight Into

Corticobasal syndrome is a disorder of movement, cognition and behaviour with several possible underlying pathologies, including corticobasal degeneration. It presents insidiously and is slowly progressive. Clinicians should consider the diagnosis in people presenting with any combination of extrapyramidal features (with poor response to levodopa), apraxia or other parietal signs, aphasia and alien-limb phenomena. Neuroimaging showing asymmetrical perirolandic cortical changes supports the diagnosis, while advanced neuroimaging may give insight into the underlying pathology. Identifying corticobasal syndrome carries some management implications (especially if protein-based treatments arise in the future) and prognostic significance. Its treatment is largely symptomatic and is best undertaken within a multidisciplinary setting, including a neurologist, physiotherapist, occupational therapist, speech language therapist, psychiatrist and, ultimately, a palliative care clinician. Corticobasal syndrome can be a confusing entity for neurologists, not least because it has over time evolved from being considered predominantly as a movement disorder to a condition spanning a wide range of cognitive and motor manifestations. In this practical review, we attempt to disentangle this syndrome and provide clarity around diagnosis, its underlying pathological substrates, key clinical features and potential treatments.

scholarly journals Alien limb in the corticobasal syndrome: phenomenological characteristics and relationship to apraxia

2020 ◽  
Vol 267 (4) ◽  
pp. 1147-1157 ◽  
Author(s):  
David J. Lewis-Smith ◽  
Noham Wolpe ◽  
Boyd C. P. Ghosh ◽  
James B. Rowe
Keyword(s):  
Positive Association ◽  
Theoretical Models ◽  
Corticobasal Syndrome ◽  
Voluntary Action ◽  
Control Group ◽  
Left Hand ◽  
Alien Limb ◽  
Limb Apraxia ◽  
Low Probability ◽  
And Control

AbstractAlien limb refers to movements that seem purposeful but are independent of patients’ reported intentions. Alien limb often co-occurs with apraxia in the corticobasal syndrome, and anatomical and phenomenological comparisons have led to the suggestion that alien limb and apraxia may be causally related as failures of goal-directed movements. Here, we characterised the nature of alien limb symptoms in patients with the corticobasal syndrome (n = 30) and their relationship to limb apraxia. Twenty-five patients with progressive supranuclear palsy Richardson syndrome served as a disease control group. Structured examinations of praxis, motor function, cognition and alien limb were undertaken in patients attending a regional specialist clinic. Twenty-eight patients with corticobasal syndrome (93%) demonstrated significant apraxia and this was often asymmetrical, with the left hand preferentially affected in 23/30 (77%) patients. Moreover, 25/30 (83%) patients reported one or more symptoms consistent with alien limb. The range of these phenomena was broad, including changes in the sense of ownership and control as well as unwanted movements. Regression analyses showed no significant association between the severity of limb apraxia and either the occurrence of an alien limb or the number of alien limb phenomena reported. Bayesian estimation showed a low probability for a positive association between alien limb and apraxia, suggesting that alien limb phenomena are not likely to be related to severity apraxia. Our results shed light on the phenomenology of these disabling and as yet untreatable clinical features, with relevance to theoretical models of voluntary action.

scholarly journals Alien limb in the corticobasal syndrome: phenomenological characteristics and relationship to apraxia

2019 ◽  
Author(s):  
David J. Lewis-Smith ◽  
Noham Wolpe ◽  
Boyd C.P. Ghosh ◽  
James B. Rowe
Keyword(s):  
Positive Association ◽  
Theoretical Models ◽  
Corticobasal Syndrome ◽  
Voluntary Action ◽  
Control Group ◽  
Left Hand ◽  
Alien Limb ◽  
Limb Apraxia ◽  
Low Probability ◽  
And Control

ABSTRACTAlien limb refers to movements that seem purposeful but are independent of patients’ reported intentions. Alien limb often co-occurs with apraxia in the corticobasal syndrome, and anatomical and phenomenological comparisons have led to the suggestion that alien limb and apraxia may be causally related as failures of goal-directed movements. Here, we characterised the nature of alien limb symptoms in patients with the corticobasal syndrome (n=30) and their relationship to limb apraxia. Twenty-five patients with progressive supranuclear palsy Richardson syndrome served as a disease-control group. Structured examinations of praxis, motor function, cognition and alien limb were undertaken in patients attending a regional specialist clinic. Twenty-eight patients with corticobasal syndrome (93%) demonstrated significant apraxia and this was often asymmetrical, with the left hand preferentially affected in 77% of patients. Moreover, 83% reported one or more symptoms consistent with alien limb. The range of these phenomena was broad, including changes in the sense of ownership and control as well as unwanted movements. Regression analyses showed no significant association between the severity of limb apraxia and both the occurrence of an alien limb and the number of alien limb phenomena reported. Bayesian estimation showed a low probability for a positive association between alien limb and apraxia, suggesting that alien limb phenomena are not likely to be related to severe apraxia. Our results shed light on the phenomenology of these disabling and as yet untreatable clinical features, with relevance to theoretical models of voluntary action.

Reply: Sensory alien limb syndrome in stroke and corticobasal syndrome

2011 ◽  
Vol 26 (7) ◽  
pp. 1365-1366
Author(s):  
Julien Delrieu ◽  
Pierre Payoux ◽  
Thierry Voisin
Keyword(s):  
Corticobasal Syndrome ◽  
Alien Limb

scholarly journals Unraveling corticobasal syndrome and alien limb syndrome with structural brain imaging

Cortex ◽  
2019 ◽  
Vol 117 ◽  
pp. 33-40 ◽  
Author(s):  
Franziska Albrecht ◽  
Karsten Mueller ◽  
Tommaso Ballarini ◽  
Leonie Lampe ◽  
Janine Diehl-Schmid ◽  
...  
Keyword(s):  
Brain Imaging ◽  
Corticobasal Syndrome ◽  
Alien Limb ◽  
Structural Brain ◽  
Structural Brain Imaging

scholarly journals Lesion network localization of free will

2018 ◽  
Vol 115 (42) ◽  
pp. 10792-10797 ◽  
Author(s):  
R. Ryan Darby ◽  
Juho Joutsa ◽  
Matthew J. Burke ◽  
Michael D. Fox
Keyword(s):  
Free Will ◽  
Brain Networks ◽  
Brain Lesion ◽  
Brain Lesions ◽  
Anterior Cingulate ◽  
Akinetic Mutism ◽  
Network Localization ◽  
Alien Limb ◽  
Cortex Lesion ◽  
Network Mapping

Our perception of free will is composed of a desire to act (volition) and a sense of responsibility for our actions (agency). Brain damage can disrupt these processes, but which regions are most important for free will perception remains unclear. Here, we study focal brain lesions that disrupt volition, causing akinetic mutism (n = 28), or disrupt agency, causing alien limb syndrome (n = 50), to better localize these processes in the human brain. Lesion locations causing either syndrome were highly heterogeneous, occurring in a variety of different brain locations. We next used a recently validated technique termed lesion network mapping to determine whether these heterogeneous lesion locations localized to specific brain networks. Lesion locations causing akinetic mutism all fell within one network, defined by connectivity to the anterior cingulate cortex. Lesion locations causing alien limb fell within a separate network, defined by connectivity to the precuneus. Both findings were specific for these syndromes compared with brain lesions causing similar physical impairments but without disordered free will. Finally, our lesion-based localization matched network localization for brain stimulation locations that disrupt free will and neuroimaging abnormalities in patients with psychiatric disorders of free will without overt brain lesions. Collectively, our results demonstrate that lesions in different locations causing disordered volition and agency localize to unique brain networks, lending insight into the neuroanatomical substrate of free will perception.

Sensory alien limb syndrome in stroke and corticobasal syndrome

2011 ◽  
Vol 26 (7) ◽  
pp. 1365-1365
Author(s):  
Francisco de Assis Aquino Gondim
Keyword(s):  
Corticobasal Syndrome ◽  
Alien Limb
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