Tool use disorders in neurodegenerative diseases: roles of semantic memory and technical reasoning

Troubles d'utilisation des objets dans les pathologies neurodégénératives : Rôles de la mémoire sémantique et du raisonnement technique

Josselin Baumard (1) , Mathieu Lesourd (2, 3) , Christophe Jarry (1) , Catherine Merck (4) , Frédérique Etcharry-Bouyx (1, 5) , Valérie Chauviré (1, 5) , Serge Belliard (4, 6) , Olivier Moreaud (7, 8) , Bernard Croisile (3) , François Osiurak (9, 2) , Didier Le Gall (1, 10)

1 LPPL - Laboratoire de Psychologie des Pays de la Loire
2 EMC - Laboratoire d'Etude des Mécanismes Cognitifs
3 Hôpital Neurologique Pierre Wertheimer, Service de Neurologie
4 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
5 Département de Neurologie, CHU Angers, France
6 Neuropsychologie cognitive et neuroanatomie fonctionnelles de la mémoire humaine
7 CMRR - Centre Mémoire de Ressources et de Recherche [Grenoble]
8 LPNC - Laboratoire de Psychologie et NeuroCognition
9 IUF - Institut universitaire de France
10 CHU Angers - Centre Hospitalier Universitaire d'Angers

In the field of apraxia, it has been suggested that the ability to use tools and objects in daily life depends not only on semantic knowledge about tool function and context of use but also on technical reasoning about mechanical properties of tools and objects. The aim of the present work was to assess tool use abilities regarding these hypotheses in patients with neurodegenerative diseases and reduced autonomy. Performance of patients with Alzheimer’s disease (n = 31), semantic dementia (n = 16) and corticobasal syndrome (n = 7) was compared to that of healthy control participants (n = 31) in familiar tool use tasks, functional/contextual associations and mechanical problem solving. A conversion method was applied to data in order to avoid ceiling effects. Tool use disorders were found in all patient groups but the underlying reasons were different. Patients with semantic dementia had difficulties in imagining and selecting familiar tools due to the semantic loss but they performed in normal range in mechanical problem solving tasks. Interestingly, they performed better with only one tool and its corresponding object, which is interpreted as a partial compensation of semantic loss by spared technical reasoning. Patients with corticobasal syndrome exhibited the reverse pattern, that is, mechanical problem solving deficits without semantic loss. However, additional qualitative research is needed to disentangle the relative contributions of motor and technical reasoning deficits to this pattern. Both of these profiles were found in patients with Alzheimer’s disease. For all that, these patients did not commit the same errors as stroke patients with left brain-damage documented in previous works. Several hypotheses are proposed to account for the specificity of tool use disorders in neurodegenerative diseases, and recommendations are provided to caregivers.

Mots clés: apraxia; semantic dementia; corticobasal degeneration; mechanical problem-solving; Alzheimer's disease

Domaines: Psychologie; Neurosciences; Anthropologie biologique

Josselin Baumard, Mathieu Lesourd, Christophe Jarry, Catherine Merck, Frédérique Etcharry-Bouyx, et al.. Tool use disorders in neurodegenerative diseases: roles of semantic memory and technical reasoning. Cortex, 2016, 82, pp.119-132. ⟨10.1016/j.cortex.2016.06.007⟩. ⟨hal-01337538⟩