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Behavioural Neurology
Volume 14, Issue 1-2, Pages 1-8

Upper and Lower Face and Ideomotor Apraxia in Patients with Alzheimer’s Disease

Jay Guido Capone,1 Sergio Della Sala,2 Hans Spinnler,1 and Annalena Venneri2

1Third Neurology Ward, San Paolo Hospital, Department of Medicine, Surgery and Dentistry, University of Milan, Milan, Italy
2Neuropsychology Research Group, Department of Psychology, University of Aberdeen, UK

Received 17 December 2002; Accepted 17 December 2002

Copyright © 2003 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction: Apraxia of face movement in Alzheimer's disease (AD) has been rarely investigated. This study aimed at investigating the frequency of lower (mouth, tongue and throat) and upper (eyes and eyebrows) face apraxia, in AD and its relationship with limb apraxia and severity of dementia.

Methods: Fifty seven patients with AD were tested with a new standardised test of face apraxia including upper and lower face movements, which uses an item-difficulty weigthed scoring procedure, the IMA test, a test of ideomotor apraxia and the M.O.D.A., a means to assess dementia severity.

Results: Thirteen (23%) and 19 (33%) participants were below cut-off respectively on the upper and lower face apraxia test. Both sections of the Face Apraxia Test correlated significantly with the Ideomotor Apraxia Test. However, double dissociations between different types of apraxia were observed. Both the upper and lower face apraxia tests correlated significantly with the measure of dementia severity.

Conclusions: The finding show that a proportion of AD patients fails face apraxia tests. Their face apraxia is interlinked with ideomotor limb apraxia, although dissociations are possible. Severity of dementia deterioration accounts for a good proportion of the variability of AD patients’ performance on face apraxia tests.