Imitation of gestures by disconnected hemispheres

PU's corpus callosum was severed as a sequel of bleeding from an arteriovenous malformation. The lesion affects the truncus and the splenium and caused somatosensory and visual disconnection of the hemispheres. On clinical testing PU's left hand was apraxic for pantomime of object use but not for imitation. By contrast, when stimuli for imitation of meaningless hand and finger postures were presented tachistocopically to either the left or the right visual field, both hemispheres turned out to be apraxic in different ways. Imitation of hand postures was perfect for right-handed imitation of stimuli presented to the left hemisphere but defective in all other conditions. Imitation of finger postures was below the normal range in all conditions initially, but improved to normality for right-hand imitation of stimuli presented to the left hemsiphere after repeated testing. After successful imitation of gestures presented to the left hemisphere PU commented that he imitated without really seeing the stimulus by 'formulating the unseen', whereas after presentation to the right hemisphere he felt that he saw the stimulus but could not imitate. We propose that imitation of meaningless gestures affords a coding of gestures with reference to knowledge about body parts which can be applied only by the left hemisphere. Imitation of finger postures puts additional demands on fine grained visuospatial discrimination which necessitates a contribution by the right hemisphere.