Echopraxia: Difference between revisions
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'''Echopraxia''', a [[tic disorder]] is the involuntary repetition of another person’s movements.<ref name=pmid18612859>{{cite journal | author = Pridmore, S., Brüne, M., Ahmadi, J., Dale, J. | title = Echopraxia in schizophrenia: possible mechanisms | journal = The Royal Australian and New Zealand College of Psychiatrists | pages = 565-71 | year = 2008 | pmid = 18612859}}</ref> Imitation and emulation of physical and verbal actions are critical to early development. However, when these behaviors become reactions rather than a means for learning, they are considered '''echophenomena'''. Echopraxia has been observed in patients with frontal lobe damage, but the exact cause is currently unknown. Patients with Gilles de la Tourette Syndrome, Schizophrenia, and Latah exhibit echopraxia; however, the reason for the link between echopraxia and these disorders is undetermined. Echopraxia is closely related to [[echolalia]], the involuntary repetition of another person’s words or word phrases.<ref name=pmid19175395>{{cite journal | author = Cho, Y., Han, S., Song, S., Lee, B., Heo, K. | title = Palilalia, echolalia, and echopraxia-palipraxia as ictal manifestations in a patient with left frontal lobe epilepsy | journal = Epilepsia | pages = 1616-19 | year = 2009 | pmid = 19175395}}</ref> Although no medical treatments are available, psychological counseling may help patients who exhibit echophenomena in some cases. The effects of therapy vary depending on the initial cause of echopraxia. |
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'''Echopraxia''' is the involuntary repetition or imitation of the observed movements of another. It is closely related to [[echolalia]], the involuntary repetition of another's speech. The [[etymology]] of the term is from Ancient Greek: "[[wikt:ἠχώ|ἠχώ]] (ēkhō) from [[wikt:ἠχή|ἠχή]] (ēkhē “sound”)" and "[[wikt:πρᾶξις|πρᾶξις]] (praksis, “action, activity, practice”)". Echopraxia is also known as echomotism.<ref>{{cite web|title=Medical Dictionary Medilexicon|url=http://www.medilexicon.com/medicaldictionary.php?s=echopraxia}}</ref> |
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==Eponym== |
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Even though it is considered a [[tic]], it is a behavior characteristic of some people with [[autism]],<ref name="pmid1778964">{{Cite journal |author=Realmuto GM, August GJ |title=Catatonia in autistic disorder: a sign of comorbidity or variable expression? |journal=J Autism Dev Disord |volume=21 |issue=4 |pages=517–28 |year=1991 |month=December |pmid=1778964 |doi=10.1007/BF02206874 |url=}}</ref> [[Tourette syndrome]], [[Ganser syndrome]], [[schizophrenia]] (especially [[catatonia|catatonic schizophrenia]]),<ref> {{cite journal |author=Pridmore S, Brüne M, Ahmadi J, Dale J |title=Echopraxia in schizophrenia: possible mechanisms |journal=Aust N Z J Psychiatry |volume=42 |issue=7 |pages=565–71 |year=2008 |month=July |pmid=18612859 |doi=10.1080/00048670802119747 }}</ref> some forms of [[clinical depression]] and some other neurological disorders. |
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Echopraxia is sometimes grouped with echolalia, and referred to as '''echophenomena'''. |
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==Etymology== |
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Different theories have been presented about the [[etiology]] of echopraxia. Symptoms similar to echopraxia are exhibited by children who are still in developmental stages.{{cn|date=April 2012}} |
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Echopraxia, termed in 1904, is derived from Ancient Greek: "ekho" + "praxis", meaning action.<ref>{{cite web|title=Online Etymology Dictionary|url=http://www.etymonline.com/index.php?term=echopraxia}}</ref> |
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== |
==History== |
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Echopraxia was observed in the first case of [[Tourette's Syndrome]]. [[Jean Marc Gaspard Itard]] described the original case of Marquise de Dampierre in 1825.<ref name=pmid22807284>{{cite journal | author = Ganos, C., Ogrzal, T., Schnitzler, A., Münchau, A. | title = The Pathophysiology of Echopraxia/Echolalia: Relevance to Gilles de la Tourette Syndrome | journal = Movement Disorders | year = 2012 | pmid = 22807284}}</ref> |
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* [[Mirror neuron]] |
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==Signs and Symptoms== |
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Echopraxia is typically classified by the uncontrollable mirroring of an observed action. Imitated actions are not limited to a specific type. Imitation can be divided into two types: imitative learning and automatic imitation. Imitative learning occurs when a person consciously mimics an observed action in order to learn the mechanism behind that action and perform it himself or herself. According to [[Jean Piaget]], this is essential to the [[sensorimotor stage]].<ref name=pmid20695703>{{cite journal | author = Cook, R., Press, C., Dickinson, A., Heyes, C. | title = Acquisition of automatic imitation is sensitive to sensorimotor contingency | journal = Journal of Experimental Psychology | pages = 840-52 | year = 2010 | pmid = 20695703}}</ref> Imitative learning continues to develop as a person ages, and is important as new skills are available to learn. For example, a person may learn to hit a nail with a hammer by watching his or her parent hammering nails. Automatic imitation on the other hand, occurs without a person's consent.<ref name=pmid22807284/> Babies begin copying movements soon after birth. It is not possible to diagnose echopraxia at this age, because it is difficult to differentiate between imitative learning and automatic imitation. This normally begins diminishing around the age of 3 years old. If the imitative behavior continues to be present, it is considered echopraxia. Automatic behavior is occasionally present in healthy adults. For instance, when a person observes someone yawning, he or she immediately does the same. These behaviors are not considered echopraxia. |
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==Causes and Pathophysiology== |
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{{Topics related to Tourette syndrome}} |
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When learning a new action, the parietal lobe of the brain is responsible for directly observing the action and its spatial configuration. The premotor cortex of the frontal lobe encodes how that action is being conducted. A healthy brain can differentiate between seeing and doing. Damage to the frontal lobe could be responsible for combining the two and causing echopraxia. |
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Frontal lobe damage may affect the [[mirror neuron system]], a group of neurons in the F5 region of the brain.<ref name=pmid16540574>{{cite journal | author = Aziz-Zadeh, L., Koski, L., Mazziotta, J., Iacoboni, M. | title = Lateralization of the human mirror neuron system | journal = The Journal of Neuroscience | pages = 2964-70 | year = 2006 | pmid = 16540574}}</ref> These neurons fire action potentials when an action is observed, as well as when the action is being performed. They are primarily located in the [[inferior frontal gyrus]] and the inferior lobule of the [[parietal lobe]]. When an action is being observed or executed, the path begins at the occipital cortex, where the brain processes the visual input. The action then progresses to the [[superior temporal sulcus]], which plays an important role in perception of biological movements.<ref name=pmid22727762>{{cite journal | author = Vander Wyk, B. C., Voos, A., Pelphrey, K. A. | title = Action representation in the superior temporal sulcus in children and adults: an fMRI study | journal = Developmental Cognitive Neuroscience | volume = 2 | issue = 4 | pages = 409-16 | year = 2012 | pmid = 22727762}}</ref> The parietal cortex is then able to map the action. Finally, the action passes through the [[inferior frontal gyrus]] and ends at the primary cortex.<ref name=pmid16540574/> Damage to any of these components could cause echopraxia. |
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[[Category:Tourette syndrome]] |
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==Diagnosis== |
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{{abnormal-psych-stub}} |
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Echopraxia not diagnosed by formal testing. It is easier to distinguish in individuals over the age of 5 years old. Because younger children frequently imitate others' actions, it is difficult to define echopraxia in them. Older individuals easily notice echopraxia, because their behaviors in relation to prior behaviors can be differentiated. |
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==Treatment== |
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[[bg:Ехопраксия]] |
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===Medical Treatments=== |
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[[de:Echopraxie]] |
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Medical or chemical treatment is not currently available for tic disorders, including echopraxia. |
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[[es:Ecopraxia]] |
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[[fr:Échopraxie]] |
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===Therapeutic Treatment=== |
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[[it:Ecoprassia]] |
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Therapeutic treatment has an effect on general tic disorders in some cases. If repairable problems contribute to the cause of the tic, such as family, school, or health problems, therapeutic treatment is more likely to be successful. There is evidence which supports a problem being resolved and the tic diminishing.<ref name=pmid18612859>{{cite journal | author = Steeves, T., McKinlay, B. D., Gorman, D., Billinghurst, L., Day, L., Carroll, A., Dion, Y., Doja, A., Luscombe, S., Sandor, P., Pringsheim, T. | title = Canadian guidelines for the evidence-based treatment of tic disorders: behavioural therapy, deep brain stimulation, and transcranial magnetic stimulation | journal = Canadian Journal of Psychiatry | volume = 57 | issue = 3 | pages = 144-51 | year = 2012 | pmid = 18612859}}</ref> |
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[[arz:ايكوبراكسيا]] |
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[[nl:Echopraxie]] |
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===Stress-induced Tic Suppression=== |
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[[pl:Echopraksja]] |
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There have been instances reported where severe stress suppresses the tic. For example, Oliver Sacks has written about a surgeon and amateur pilot with severe Tourette Syndrome who was successful because his tics disappeared in the operating room and on a plane.<ref name=Sacks>{{cite book |last=Sacks |first=Oliver |authorlink=Oliver Sacks |year=1995 |title=An Anthropologist on Mars}}</ref> However, this is not an effective means of treating tics as they re-appear in non-stressful situations. |
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[[pt:Ecopraxia]] |
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[[ro:Ecopraxie]] |
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==Echopraxia in Neurological Disorders== |
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[[ru:Эхопраксия]] |
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The reason for the link between echopraxia and the following neurological disorders is unknown. Possible mechanisms, as follows, have been suggested. |
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===Gilles de la Tourette Syndrome=== |
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Echophenomena is expressed in 21-46% of patients with [[Tourette Syndrome]].<ref name=pmid16540574/> These patients typically experience increased sensitivity to external stimuli, which makes them more susceptible to acquiring tics.<ref name=pmid20535824>{{cite journal | author = Jonas, M., Thomalla, G., Biermann-Ruben, K., Siebner, H. R., Müller-Vahl, K., Baümer, T., Gerloff, C., Schnitzler, A., Orth, M., Münchao, A. | title = Imitation in patients with Gilles de la Tourette syndrome--a behavioral study | journal = Movement Disorders | volume = 25 | issue = 8 | pages = 991-9 | year = 2010 | pmid = 20535824}}</ref> |
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===Schizophrenia=== |
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Some studies have shown that [[Schizophrenia]] is associated with decreased inhibition and increased arousal in the [[nervous system]].<ref name=pmid16540574/> A proposed mechanism for echopraxia in Schizophrenia is related to disinhibition, arousal, and the [[mirror neuron system]]. Dysfunction of the [[anterior cingulate cortex]], where cognitive and motor processes converge, is common in patients with Schizophrenia. This dysfunction could cause movements to pass throughthe inferior frontal gyrus and automatically be repeated.<ref name=pmid16540574/> |
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===Latah=== |
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Echopraxia is a common characteristic in individuals affected with [[Latah]], a condition in South Asia triggered by the [[startle reflex]]. Patients with Latah perform exaggerated actions when startled.<ref name=pmid11391750>{{cite journal | author = Tanner, C. M., Chamberland, J. | title = Latah in Jakarta, Indonesia | journal = Movement Disorders | volume = 16 | issue = 3 | pages = 526-9 | year = 2001 | pmid = 11391750}}</ref> |
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Revision as of 22:57, 19 November 2012
Echopraxia, a tic disorder is the involuntary repetition of another person’s movements.[1] Imitation and emulation of physical and verbal actions are critical to early development. However, when these behaviors become reactions rather than a means for learning, they are considered echophenomena. Echopraxia has been observed in patients with frontal lobe damage, but the exact cause is currently unknown. Patients with Gilles de la Tourette Syndrome, Schizophrenia, and Latah exhibit echopraxia; however, the reason for the link between echopraxia and these disorders is undetermined. Echopraxia is closely related to echolalia, the involuntary repetition of another person’s words or word phrases.[2] Although no medical treatments are available, psychological counseling may help patients who exhibit echophenomena in some cases. The effects of therapy vary depending on the initial cause of echopraxia.
Eponym
Echopraxia is sometimes grouped with echolalia, and referred to as echophenomena.
Etymology
Echopraxia, termed in 1904, is derived from Ancient Greek: "ekho" + "praxis", meaning action.[3]
History
Echopraxia was observed in the first case of Tourette's Syndrome. Jean Marc Gaspard Itard described the original case of Marquise de Dampierre in 1825.[4]
Signs and Symptoms
Echopraxia is typically classified by the uncontrollable mirroring of an observed action. Imitated actions are not limited to a specific type. Imitation can be divided into two types: imitative learning and automatic imitation. Imitative learning occurs when a person consciously mimics an observed action in order to learn the mechanism behind that action and perform it himself or herself. According to Jean Piaget, this is essential to the sensorimotor stage.[5] Imitative learning continues to develop as a person ages, and is important as new skills are available to learn. For example, a person may learn to hit a nail with a hammer by watching his or her parent hammering nails. Automatic imitation on the other hand, occurs without a person's consent.[4] Babies begin copying movements soon after birth. It is not possible to diagnose echopraxia at this age, because it is difficult to differentiate between imitative learning and automatic imitation. This normally begins diminishing around the age of 3 years old. If the imitative behavior continues to be present, it is considered echopraxia. Automatic behavior is occasionally present in healthy adults. For instance, when a person observes someone yawning, he or she immediately does the same. These behaviors are not considered echopraxia.
Causes and Pathophysiology
When learning a new action, the parietal lobe of the brain is responsible for directly observing the action and its spatial configuration. The premotor cortex of the frontal lobe encodes how that action is being conducted. A healthy brain can differentiate between seeing and doing. Damage to the frontal lobe could be responsible for combining the two and causing echopraxia.
Frontal lobe damage may affect the mirror neuron system, a group of neurons in the F5 region of the brain.[6] These neurons fire action potentials when an action is observed, as well as when the action is being performed. They are primarily located in the inferior frontal gyrus and the inferior lobule of the parietal lobe. When an action is being observed or executed, the path begins at the occipital cortex, where the brain processes the visual input. The action then progresses to the superior temporal sulcus, which plays an important role in perception of biological movements.[7] The parietal cortex is then able to map the action. Finally, the action passes through the inferior frontal gyrus and ends at the primary cortex.[6] Damage to any of these components could cause echopraxia.
Diagnosis
Echopraxia not diagnosed by formal testing. It is easier to distinguish in individuals over the age of 5 years old. Because younger children frequently imitate others' actions, it is difficult to define echopraxia in them. Older individuals easily notice echopraxia, because their behaviors in relation to prior behaviors can be differentiated.
Treatment
Medical Treatments
Medical or chemical treatment is not currently available for tic disorders, including echopraxia.
Therapeutic Treatment
Therapeutic treatment has an effect on general tic disorders in some cases. If repairable problems contribute to the cause of the tic, such as family, school, or health problems, therapeutic treatment is more likely to be successful. There is evidence which supports a problem being resolved and the tic diminishing.[1]
Stress-induced Tic Suppression
There have been instances reported where severe stress suppresses the tic. For example, Oliver Sacks has written about a surgeon and amateur pilot with severe Tourette Syndrome who was successful because his tics disappeared in the operating room and on a plane.[8] However, this is not an effective means of treating tics as they re-appear in non-stressful situations.
Echopraxia in Neurological Disorders
The reason for the link between echopraxia and the following neurological disorders is unknown. Possible mechanisms, as follows, have been suggested.
Gilles de la Tourette Syndrome
Echophenomena is expressed in 21-46% of patients with Tourette Syndrome.[6] These patients typically experience increased sensitivity to external stimuli, which makes them more susceptible to acquiring tics.[9]
Schizophrenia
Some studies have shown that Schizophrenia is associated with decreased inhibition and increased arousal in the nervous system.[6] A proposed mechanism for echopraxia in Schizophrenia is related to disinhibition, arousal, and the mirror neuron system. Dysfunction of the anterior cingulate cortex, where cognitive and motor processes converge, is common in patients with Schizophrenia. This dysfunction could cause movements to pass throughthe inferior frontal gyrus and automatically be repeated.[6]
Latah
Echopraxia is a common characteristic in individuals affected with Latah, a condition in South Asia triggered by the startle reflex. Patients with Latah perform exaggerated actions when startled.[10]
References
- ^ a b Pridmore, S., Brüne, M., Ahmadi, J., Dale, J. (2008). "Echopraxia in schizophrenia: possible mechanisms". The Royal Australian and New Zealand College of Psychiatrists: 565–71. PMID 18612859.
{{cite journal}}: CS1 maint: multiple names: authors list (link) Cite error: The named reference "pmid18612859" was defined multiple times with different content (see the help page). - ^ Cho, Y., Han, S., Song, S., Lee, B., Heo, K. (2009). "Palilalia, echolalia, and echopraxia-palipraxia as ictal manifestations in a patient with left frontal lobe epilepsy". Epilepsia: 1616–19. PMID 19175395.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ "Online Etymology Dictionary".
- ^ a b Ganos, C., Ogrzal, T., Schnitzler, A., Münchau, A. (2012). "The Pathophysiology of Echopraxia/Echolalia: Relevance to Gilles de la Tourette Syndrome". Movement Disorders. PMID 22807284.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Cook, R., Press, C., Dickinson, A., Heyes, C. (2010). "Acquisition of automatic imitation is sensitive to sensorimotor contingency". Journal of Experimental Psychology: 840–52. PMID 20695703.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ a b c d e Aziz-Zadeh, L., Koski, L., Mazziotta, J., Iacoboni, M. (2006). "Lateralization of the human mirror neuron system". The Journal of Neuroscience: 2964–70. PMID 16540574.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Vander Wyk, B. C., Voos, A., Pelphrey, K. A. (2012). "Action representation in the superior temporal sulcus in children and adults: an fMRI study". Developmental Cognitive Neuroscience. 2 (4): 409–16. PMID 22727762.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Sacks, Oliver (1995). An Anthropologist on Mars.
- ^ Jonas, M., Thomalla, G., Biermann-Ruben, K., Siebner, H. R., Müller-Vahl, K., Baümer, T., Gerloff, C., Schnitzler, A., Orth, M., Münchao, A. (2010). "Imitation in patients with Gilles de la Tourette syndrome--a behavioral study". Movement Disorders. 25 (8): 991–9. PMID 20535824.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Tanner, C. M., Chamberland, J. (2001). "Latah in Jakarta, Indonesia". Movement Disorders. 16 (3): 526–9. PMID 11391750.
{{cite journal}}: CS1 maint: multiple names: authors list (link)