Age of first exposure to American football and long-term neuropsychiatric and cognitive outcomes.

Previous research suggests that age of first exposure (AFE) to football before age 12 may have long-term clinical implications; however, this relationship has only been examined in small samples of former professional football players. We examined the association between AFE to football and behavior, mood and cognition in a large cohort of former amateur and professional football players. The sample included 214 former football players without other contact sport history. Participants completed the Brief Test of Adult Cognition by Telephone (BTACT), and self-reported measures of executive function and behavioral regulation (Behavior Rating Inventory of Executive Function-Adult Version Metacognition Index (MI), Behavioral Regulation Index (BRI)), depression (Center for Epidemiologic Studies Depression Scale (CES-D)) and apathy (Apathy Evaluation Scale (AES)). Outcomes were continuous and dichotomized as clinically impaired. AFE was dichotomized into <12 and ⩾12, and examined continuously. Multivariate mixed-effect regressions controlling for age, education and duration of play showed AFE to football before age 12 corresponded with >2 × increased odds for clinically impaired scores on all measures but BTACT: (odds ratio (OR), 95% confidence interval (CI): BRI, 2.16,1.19-3.91; MI, 2.10,1.17-3.76; CES-D, 3.08,1.65-5.76; AES, 2.39,1.32-4.32). Younger AFE predicted increased odds for clinical impairment on the AES (OR, 95% CI: 0.86, 0.76-0.97) and CES-D (OR, 95% CI: 0.85, 0.74-0.97). There was no interaction between AFE and highest level of play. Younger AFE to football, before age 12 in particular, was associated with increased odds for impairment in self-reported neuropsychiatric and executive function in 214 former American football players. Longitudinal studies will inform youth football policy and safety decisions.

Occupational asphalt is not associated with head and neck cancer.

BACKGROUND: Epidemiologic studies that evaluate the relationship between occupational asphalt exposure and head and neck cancer have had a limited ability to control for known risk factors such as smoking, alcohol and human papillomavirus (HPV). AIMS: To better elucidate this relationship by including known risk factors in a large case-control study of head and neck squamous cell carcinoma (HNSCC) from the greater Boston area. METHODS: We analysed the relationship between occupational asphalt exposure and HNSCC among men in the Greater Boston area of Massachusetts. Analyses were conducted using unconditional multivariable logistic regression, performed with adjustments for age, race, education, smoking, alcohol consumption and HPV serology. RESULTS: There were 753 cases and 913 controls. No associations between HNSCC and occupational asphalt exposure (neither among ever-exposed nor by occupational duration) were observed for exposures in any occupation or those restricted to the construction industry. We also observed no associations in subgroup analyses of never-smokers and ever-smokers. Adjusting for known risk factors further reduced the estimated effect of asphalt exposure on HNSCC risk. CONCLUSIONS: We found no evidence for an association between occupational asphalt exposure and HNSCC. The null findings from this well-controlled analysis could suggest that the risk estimates stemming from occupational cohort studies may be overestimated due to uncontrolled confounding and enhance the literature available for weighing cancer risk from occupational exposure to bitumen.

Urinary naphthalene and phenanthrene as biomarkers of occupational exposure to polycyclic aromatic hydrocarbons.

OBJECTIVES: The study investigated the utility of unmetabolised naphthalene (Nap) and phenanthrene (Phe) in urine as surrogates for exposures to mixtures of polycyclic aromatic hydrocarbons (PAHs). METHODS: The report included workers exposed to diesel exhausts (low PAH exposure level, n = 39) as well as those exposed to emissions from asphalt (medium PAH exposure level, n = 26) and coke ovens (high PAH exposure level, n = 28). Levels of Nap and Phe were measured in urine from each subject using head space-solid phase microextraction and gas chromatography-mass spectrometry. Published levels of airborne Nap, Phe and other PAHs in the coke-producing and aluminium industries were also investigated. RESULTS: In post-shift urine, the highest estimated geometric mean concentrations of Nap and Phe were observed in coke-oven workers (Nap: 2490 ng/l; Phe: 975 ng/l), followed by asphalt workers (Nap: 71.5 ng/l; Phe: 54.3 ng/l), and by diesel-exposed workers (Nap: 17.7 ng/l; Phe: 3.60 ng/l). After subtracting logged background levels of Nap and Phe from the logged post-shift levels of these PAHs in urine, the resulting values (referred to as ln(adjNap) and ln(adjPhe), respectively) were significantly correlated in each group of workers (0.71 < or = Pearson r < or = 0.89), suggesting a common exposure source in each case. Surprisingly, multiple linear regression analysis of ln(adjNap) on ln(adjPhe) showed no significant effect of the source of exposure (coke ovens, asphalt and diesel exhaust) and further suggested that the ratio of urinary Nap/Phe (in natural scale) decreased with increasing exposure levels. These results were corroborated with published data for airborne Nap and Phe in the coke-producing and aluminium industries. The published air measurements also indicated that Nap and Phe levels were proportional to the levels of all combined PAHs in those industries. CONCLUSION: Levels of Nap and Phe in urine reflect airborne exposures to these compounds and are promising surrogates for occupational exposures to PAH mixtures.

Human papillomavirus 6 seropositivity is associated with risk of head and neck squamous cell carcinoma, independent of tobacco and alcohol use.

BACKGROUND: The risk of head and neck squamous cell carcinoma (HNSCC) associated with common human papillomavirus types has not been well defined. METHODS: We conducted a case-control study of 1034 individuals (486 incident cases diagnosed with HNSCC and 548 population-based controls matched to cases by age, gender, and town of residence) in Greater Boston, MA. Sera were tested for antibodies to human papillomavirus (HPV)6, HPV11, HPV16, and HPV18 L1. RESULTS: HPV6 antibodies were associated with an increased risk of pharyngeal cancer [odds ratio (OR)=1.6, 1.0-2.5], controlling for smoking, drinking, and HPV16 seropositivity. In HPV16-seronegative subjects, high HPV6 titer was associated with an increased risk of pharyngeal cancer (OR=2.3, 1.1-4.8) and oral cancer (OR=1.9, 1.0-3.6), suggesting that the cancer risk associated with HPV6 is independent of HPV16. There was no association between smoking and alcohol use and HPV6 serostatus. Further, the risk of pharyngeal cancer associated with heavy smoking was different among HPV6-seronegative (OR 3.1, 2.0-4.8) and HPV6-seropositive subjects (OR=1.6, 0.7-3.5), while heavy drinking also appears to confer differing risk among HPV6-negative (OR 2.3, 1.5-3.7) and -positive subjects (OR=1.3, 0.6-2.9). CONCLUSIONS: There may be interactions between positive serology and drinking and smoking, suggesting that the pathogenesis of human papillomavirus in HNSCC involves complex interactions with tobacco and alcohol exposure.

Dermal exposure and urinary 1-hydroxypyrene among asphalt roofing workers.

The primary objective of this study was to identify significant determinants of dermal exposure to polycyclic aromatic compounds (PACs) among asphalt roofing workers and use urinary 1-hydroxyprene (1-OHP) measurements to evaluate the effect of dermal exposure on total absorbed dose. The study population included 26 asphalt roofing workers who performed three primary tasks: tearing off old roofs (tear-off), putting down new roofs (put-down), and operating the kettle at ground level (kettle). During multiple consecutive work shifts (90 workerdays), dermal patch samples were collected from the underside of each worker's wrists and were analyzed for PACs, pyrene, and benzo(a)pyrene (BAP). During the same work week, urine samples were collected at pre-shift, post-shift, and bedtime each day and were analyzed for 1-OHP (205 urine samples). Linear mixed effects models were used to evaluate the dermal measurements for the purpose of identifying important determinants of exposure, and to evaluate urinary 1-OHP measurements for the purpose of identifying important determinants of total absorbed dose. Dermal exposures to PAC, pyrene, and BAP were found to vary significantly by roofing task (tear-off > put-down > kettle) and by the presence of an old coal tar pitch roof (pitch > no pitch). For each of the three analytes, the adjusted mean dermal exposures associated with tear-off (812 ng PAC/cm2, 14.9 ng pyrene/cm2, 4.5 ng BAP/cm2) were approximately four times higher than exposures associated with operating the kettle (181 ng PAC/cm2, 4.1 ng pyrene/cm2, 1.1 ng BAP/cm2). Exposure to coal tar pitch was associated with a 6-fold increase in PAC exposure (p = 0.0005), an 8-fold increase in pyrene exposure (p < 0.0001), and a 35-fold increase in BAP exposure (p < 0.0001). Similarly, urinary 1-OHP levels were found to be significantly higher on days when an old pitch roof was removed, accounting for a 3.7-fold difference at pre-shift (p = 0.01), a 5.0-fold difference at post-shift (p = 0.004), and a 7.2-fold difference at bedtime (p = 0.002). The pyrene measurements obtained during the work shift were found to be strongly correlated with urinary 1-OHP measurements obtained at the end of that shift (r = 0.8, p < 0.001) as well as at bedtime (r = 0.7, p < 0.001). Ultimately, the results of a distributed lag model indicated that dermal exposure during the preceding 40 hours had a statistically significant effect on urinary 1-OHP. The presence of coal tar pitch was the primary determinant of dermal exposure, particularly for exposure to BAP. However, the task-based differences that were observed while controlling for pitch suggest that exposure to asphalt also contributes to dermal exposures. We found that dermal exposure was a significant determinant of total absorbed dose, suggesting that control strategies aimed at reducing occupational exposure to PACs should include an effort to minimize dermal exposure.

DNA adducts among asphalt paving workers.

OBJECTIVE: Asphalt is used extensively in the highway construction industry and contains a complex mixture of polycyclic aromatic hydrocarbons, some of which are known or suspected to be human carcinogens. Though numerous epidemiologic studies have described an excess cancer risk among asphalt workers, a causal relationship has not been established. Accordingly, the primary objective of this study was to use DNA adducts as a biomarker of biologically effective dose and determine whether DNA damage resulted from occupational exposure to asphalt among paving workers. METHODS: Over a 12 month period, four peripheral blood samples (spring, summer, fall and winter) were obtained from 49 asphalt paving workers (169 samples) and 36 non-paving construction workers (103 samples). The spring, summer and fall samples were collected during the work-season, whereas the winter samples were collected during the off-season (due to the seasonality of paving work). Mononuclear white blood cells were isolated and analyzed for DNA adducts via the (32)P-postlabeling assay and generalized linear models were used to evaluate the DNA adduct data. RESULTS: Among paving workers during the work-season, DNA adducts increased during each day of the workweek such that mean adduct levels were lowest on Mondays (3 adducts per 10(10) nucleotides) and highest on Fridays (46 adducts per 10(10) nucleotides). Additionally, a 3-fold difference in adduct burden was observed by paving task such that mean adduct levels were lowest among roller operators (7 adducts per 10(10) nucleotides) and highest among screedmen (23 adducts per 10(10) nucleotides). Using adducts as a measure of biologically effective dose, these findings (weekday trend and task-based differences) were consistent with a previous evaluation of absorbed dose in the same population. Adduct levels were not, however, higher among paving workers than among non-pavers. Adducts were also highest during the winter months, suggestive of a seasonal effect that has been observed in previous studies. CONCLUSION: These findings indicate that adduct burden increased throughout the workweek among paving workers, suggesting that DNA damage may be associated with occupational exposure to hot-mix asphalt. However, the lack of contrast with non-paving workers, as well as the seasonal variation warrants additional investigation.

Inhalation and dermal exposure among asphalt paving workers.

The primary objective of this study was to identify determinants of inhalation and dermal exposure to polycyclic aromatic compounds (PACs) among asphalt paving workers. The study population included three groups of highway construction workers: 20 asphalt paving workers, as well as 12 millers and 6 roadside construction workers who did not work with hot-mix asphalt. During multiple consecutive work shifts, personal air samples were collected from each worker's breathing zone using a Teflon filter and cassette holder connected in series with an XAD-2 sorbent tube, while dermal patch samples were collected from the underside of each worker's wrist. All exposure samples were analyzed for PACs, pyrene and benzo[a]pyrene. Inhalation and dermal PAC exposures were highest among asphalt paving workers. Among paving workers, inhalation and dermal PAC exposures varied significantly by task, crew, recycled asphalt product (RAP) and work rate (inhalation only). Asphalt mix containing high RAP was associated with a 5-fold increase in inhalation PAC exposures and a 2-fold increase in dermal PAC exposure, compared with low RAP mix. The inhalation PAC exposures were consistent with the workers' proximity to the primary source of asphalt fume (paver operators > screedmen > rakers > roller operators), such that the adjusted mean exposures among paver operators (5.0 microg/m3, low RAP; 24 microg/m3, high RAP) were 12 times higher than among roller operators (0.4 microg/m3, low RAP; 2.0 microg/m3, high RAP). The dermal PAC exposures were consistent with the degree to which the workers have actual contact with asphalt-contaminated surfaces (rakers > screedmen > paver operators > roller operators), such that the adjusted mean exposures among rakers (175 ng/cm2, low RAP; 417 ng/cm2, high RAP) were approximately 6 times higher than among roller operators (27 ng/cm2, low RAP; 65 ng/cm2, high RAP). Paving task, RAP content and crew were also found to be significant determinants of inhalation and dermal exposure to pyrene. The effect of RAP content, as well as the fact that exposures were higher among paving workers than among millers and roadside construction workers, suggests that the PAC and pyrene exposures experienced by these paving workers were asphalt-related.

Urinary 1-hydroxypyrene and polycyclic aromatic hydrocarbon exposure among asphalt paving workers.

OBJECTIVES: Using urinary 1-hydroxypyrene (1-OHP) as a measure of total absorbed dose, the primary objective of this study was to evaluate the total effect of inhalation and dermal PAH exposures while considering other factors such as age, body mass index and smoking that may also have a significant effect on urinary 1-OHP. METHODS: The study population included two groups of highway construction workers: 20 paving workers and 6 milling workers. During multiple consecutive workshifts, personal air and dermal samples were collected from each worker and analyzed for pyrene. During the same work week, urine samples were collected pre-shift, post-shift and at bedtime each day and analyzed for 1-OHP. Distributed lag models were used to evaluate the independent effect of inhalation and dermal exposures that occurred at each of several preceding exposure periods and were used to identify the relevant period of influence for each pathway. RESULTS: The paving workers had inhalation (mean 0.3 micro g/m(3)) and dermal (5.7 ng/cm(2)) exposures to pyrene that were significantly higher than the milling workers. At pre-shift on Monday morning, following a weekend away from work, the pavers and millers had the same mean baseline urinary 1-OHP level of 0.4 micro g/g creatinine. The mean urinary 1-OHP levels among pavers increased significantly from pre-shift to post-shift during each work day, while the mean urinary 1-OHP levels among millers varied little and remained near the baseline level throughout the study period. Among pavers there was a clear increase in the pre-shift data during the work week, such that the average pre-shift level on day 4 (1.4 micro g/g creatinine) was 3.5 times higher than the average pre-shift results on day 1 (0.4 micro g/g creatinine). The results of the distributed lag model indicated that the impact of dermal exposure was approximately eight times the impact of inhalation exposure. Furthermore, dermal exposure that occurred during the preceding 32 h had a statistically significant effect on urinary 1-OHP, while the effect of inhalation exposure was not significant. CONCLUSIONS: We found that distributed lag models are a valuable tool for analyzing longitudinal biomarker data and our results indicate that dermal contact is the primary route of exposure to PAHs among asphalt paving workers. An exposure assessment of PAHs that does not consider dermal exposure may considerably underestimate cumulative exposure and control strategies aimed at reducing occupational exposure to asphalt-related PAHs should include an effort to reduce dermal exposure.

Patterns of orofacial movement velocity across variations in speech rate.

To understand the clinical aspects of speech rate control, a clearer picture is needed of how orofacial structures are coordinated across variations in speech rate. To address this problem, patterns of orofacial tangential velocity or speed were analyzed in a group of 9 normal speakers as they produced the utterance "a bad daba" at fast, normal, and slow speech rates. An electromagnetic system was used to record the movements of the upper lip, lower lip, jaw, and tongue. Measures of the magnitude of peak tangential velocities were obtained across the four structures. Orofacial velocities consistently decreased at slow rates relative to normal rates, whereas at fast rates increased and decreased velocities were observed in an equivalent number of cases. Significant correlations frequently were obtained across speech rate between lip, tongue, and jaw velocities. Upper and lower lip velocities showed consistent positive correlations with one another, whereas marked intersubject differences were observed in the sign of jaw-related correlations. Repeated testing on 3 subjects indicated a high degree of consistency within subjects in the overall patterns of mean velocity for the different structures. Results are discussed in relation to possible motor control differences underlying fast and slow speech, neural coupling of muscle systems, and jaw-related individual differences in speech motor coordination.

Variations in the relative speeds of orofacial structures with stuttering severity.

Stuttering can be characterized in part as a disorder in the coordination of different muscle systems. In light of basic aspects of orofacial physiology and development, the speeds of the lips and tongue relative to the jaw may be an important dimension for evaluating motor coordination among persons who stutter (PWS). To test this idea, an electromagnetic system was used to obtain measures of lip, tongue, and jaw speed in 38 adults (29 PWS and 9 normally fluent speakers, NFS) as they repeated a simple speech utterance at a normal rate. Using categorical ratings of stuttering severity, ratios of tongue speed to jaw speed were significantly greater in PWS rated as severe, compared to NFS and other PWS. Significant increases in lower lip-to-jaw and tongue-to-jaw speed ratios with stuttering severity were also reflected in correlation analyses relating speed ratios to a continuous measure of stuttering severity. These trends in speed ratio were related to increases in lower lip and tongue speed and decreases in jaw speed with stuttering severity. Sources of the speed differences are discussed in relation to underlying muscle activity, motor compensation processes in adults, and the development of orofacial motor control in children who stutter.

The effects of excessive vocalization on acoustic and videostroboscopic measures of vocal fold condition.

Although dysphonia is a recognized consequence of acute vocal abuse, associated changes in vocal fold appearance and function are not well understood. To document these presumed effects of vocal abuse, audio recordings of sustained vowel production were obtained from 42 drill sergeants daily during the first 6 days of a vocally demanding training exercise. Acoustic analysis showed abnormal levels of jitter and shimmer on Day 1 in 16 of the 42 subjects. Considering only the 26 subjects who showed normal voice acoustics on Day 1, the median levels of jitter and shimmer varied little over the course of training, and significant increases in jitter and shimmer were not seen during the study period. However, the distributions for both jitter and shimmer became more positively skewed and showed a greater number of positive outliers over the course of training. This trend was attributed to 11 subjects who showed two or more instances of abnormal voice acoustics over Days 2 through 6. Laryngeal videostroboscopic recordings of sustained vowel production also were obtained prior to and following training. Perceptual ratings of these recordings by 2 observers revealed significant increases in vocal fold edema, erythema, and edge irregularity, and decreases in vocal fold mucosal wave and amplitude of excursion following the 5-day training period. In general, there was considerable intersubject variability in the extent of acoustic and videostroboscopic effects over the course of training. Of the two types of data, videostroboscopy appears to provide a more sensitive indication of the effects of excessive vocalization.

Activation of lip motor units with variations in speech rate and phonetic structure.

The purpose of this study was to describe the activation characteristics of lip-muscle single motor units in relation to speech rate and phonetic structure. Repeated experiments were carried out on three adult subjects from whom recordings of lower lip EMG and two-dimensional displacement were obtained. Single motor unit recordings were obtained from the orbicularis oris inferior (OOI), depressor labii inferior (DLI), and mentalis (MENT) muscles. Subjects' tasks involved repeating CV syllables at 1 to 4 syllables per second (syl/sec). The distribution of interspike intervals and corresponding firing rates were obtained on 11 motor units. The firing rates of OOI and MENT motor units increased as syllable rate changed from 1 to 3 syl/sec, but firing rates tended to be equivalent at 3 and 4 syl/sec. DLI and tonic motor units showed little or no modulation in their firing rates with speech rate. Firing rate data and related observations on lip movement and EMG spike count levels suggest that distinct neuromechanical processes control lip movements at low and high speech rates. Both kinematic and EMG data support the expectation that phonetic structure has its greatest effects on lip opening compared to lip closing movements in CV syllables. OOI and MENT activation levels tended to be highest for /p/ productions compared to /w/ and /f/. This may be related to the requirements for complete lip closure and elevated levels of intraoral pressure for production of /p/.

Intersyllabic movement timing in the fluent speech of stutterers with different disfluency levels.

The goal of this study was to identify possible differences in movement timing in the fluent speech of adult stutterers who show varying levels of speech disfluency. Strain gauge recordings of lip and jaw movements and electroglottographic recordings of laryngeal vibration were obtained in 31 subjects as they repeated simple speech utterances. Measures of the duration and variability of intersyllablic articulatory events were analyzed in relation to speech disfluency level and history of speech treatment. As expected, movement durations were longer in subjects who had been through speech treatment. No significant associations were observed between timing durations and disfluency level. However, more disfluent subjects tended to show reduced variability in timing durations, an effect that was independent of speech treatment. This finding is interpreted in relation to previous observations on control systems that show instability and disfunction in association with reduced output variability. When disfluency level was measured during physiologic testing, duration interacted with speech treatment, with more disfluent subjects in the treatment group showing increased durations in their fluent speech. This effect is attributed to volitional control intended to facilitate speech fluency.

Evidence for suppression of lip muscle reflexes prior to speech.

The early component of the mechanically evoked lip muscle reflexes was studied in order to determine whether a consistent form of modulation occurs in associated neural pathways during the preparation to speak. Electromyograms (EMG) were obtained of upper and lower lip muscle while subjects were presented simultaneously with a visual instruction stimulus and a mechanical reflex stimulus every 4 s. On alternating trials, they were to produce either a single word or maintain their lip posture when they felt the mechanical stimulus. Consistent reductions in reflex amplitude were observed across subjects in lower lip muscle in the speech condition compared with the no-response condition. Statistical analyses suggest that this suppression effect occurred independently of variations in prestimulus EMG. These results are consistent with the idea that trigeminal sensory pathways innervating the perioral region are suppressed in preparation for orofacial movements associated with simple speech utterances.

Lip muscle EMG responses to oral pressure stimulation.

Sinusoidal intraoral pressure changes having peak-to-peak amplitudes of 2-6 cmH2O were applied at frequencies of 2-14 Hz. Reflex responses were observed in the lip muscle EMG of all 6 subjects tested. Across subjects, the phase shift of EMG responses varied in a linear manner with stimulus frequency. This suggests that responses were mediated over a reflex pathway having a relatively fixed response latency. Step-like changes in oral pressure produced a consistent excitatory response having a latency of 30-35 ms. The fact that reflexes may be elicited in lip muscles with oral pressure changes similar to those occurring in speech increases the likelihood that mechanoreceptor responses to intraoral pressure changes are involved in sensorimotor integration for speech production.

Lip muscle reflex and intentional response levels in a simple speech task.

Sensorimotor integration in human lip muscle was studied by recording muscle activity while subjects produced simple speech utterances in response to mechanical stimulation. On each trial subjects were instructed either to produce the syllable "pa" or not respond when they detected movement of a small paddle held between the lips. Mechanical stimuli were adequate to elicit reflexes over poststimulus intervals of 15-30 ms (R1) and 30-50 ms (R2). EMG recordings were obtained from upper and lower lip muscles, and EMG levels were calculated for individual trials over several poststimulus time intervals. The independent effects of stimulus magnitude, prestimulus EMG, and reaction time on poststimulus response levels were assessed using multiple regression analysis. R1 and R2 levels were positively correlated with stimulus magnitude, but stimulus magnitude had little modulating effect on intentional lip muscle responses. Both reflex and intentional response levels showed positive associations with prestimulus EMG level. Instructional set had significant modulating effects on reflex responses in 9 of 10 subjects, but the nature of these effects varied among subjects. These various findings are discussed in relation to similar studies on limb motor systems and lip motor control for speech.

Kinematic analysis of lip closure in stutterers' fluent speech.

An analysis of lip and jaw motion was carried out in order to evaluate previous observations on the fluent speech of stutterers and to describe possible effects of speech therapy. A strain gauge system was used to transduce lip and jaw movements during fluent repetitions of "sapapple" in adult stutterers and nonstutterers. Fifteen movement parameters were measured on lip closure for the initial /p/ sound in a group of 10 normal speakers, 10 stutterers who had no recent speech therapy, and 8 stutterers who had been through an intensive speech therapy program involving modification of speech timing. The no-therapy group and nonstutterers did not differ significantly in terms of any movement parameter. Stutterers who had been through speech therapy showed significant increases in jaw movement duration and time to peak velocity of the upper lip, lower lip, and jaw. The expected timing pattern for lip and jaw velocity peaks on lip closure (UL-LL-J) was the most frequently occurring pattern, but deviations from this pattern were observed in both stutterers and nonstutterers. The occurrence of reversals was most prevalent in the therapy group, and it was associated with increases in jaw movement duration across subjects. It is suggested that for the type of movement studied here, anomalies in stutterers' fluent speech are likely to be the result of acquired adjustments rather than properties of the speech neuromotor system that underly dysfluency.

Somatosensory neurons in human thalamus respond to speech-induced orofacial movements.

As part of stereotactic surgery, microelectrode recordings of somatosensory neurons in thalamus were obtained in 5 patients. Neurons with receptive fields on the lips and tongue were consistently activated when these structures were involved in production of speech sounds. The magnitudes of these responses were similar to those elicited by experimentally applied mechanical stimuli, suggesting that speech-induced somatosensory inputs are not suppressed at the thalamic level.

Gain and spatial characteristics of human lip-muscle reflexes.

Mechanically evoked early and late excitatory reflexes (E1 and E2) and suppression responses (S) were studied in human lip muscle. Acceleration pulses were applied at 30-150 m/s2 independently to the upper and lower lips during lip rounding and lower-lip depression postures, and to both lips during a lip-press posture. E1 responses were prevalent during lip rounding and press gestures and S responses during lip depression. Reflex magnitudes were well correlated with stimulus acceleration for the 3 response components, with E1 responses showing the strongest association. The slopes of linear equations relating reflex and stimulus magnitudes, i.e. reflex gains, for E1 and E2 responses were highly variable across subjects. This variability was partially related to subject gender, females showing larger reflex gains. Two novel findings on the spatial aspects of lip-muscle reflexes are that: (1) S responses in lower-lip muscle are more prevalent to upper-lip versus lower-lip stimulation, and (2) E1 and E2 gains in lower-lip muscle are larger for stimulation of the lower lip compared to stimulation of the upper lip. Further testing suggested that this latter pattern differs with form of stimulation, with a laterally directed sliding stimulus on the upper lip producing predominant effects in both the upper- and lower-lip muscle, and an indenting stimulus producing the largest reflexes in muscle of the stimulated lip.

Speech-muscle visuomotor tracking in dysarthric and nonimpaired speakers.

Assessment of speech-muscle function during nonspeech tasks may provide an important component in the clinical evaluation of speech-motor disorders. Various methodological problems have limited the value of such data in the past. The goal of the present study was to evaluate a set of instrumental, objective procedures for assessment of the nonspeech performance capabilities of different speech-muscle systems. Subjects included 10 nonimpaired adults and a diverse group of 6 adult dysarthric individuals. Each subject performed visuomotor tracking of a 0.6-Hz sinusoidal target with the lower lip, jaw, larynx, and respiratory systems. Cross correlation and phase data were used to describe tracking performance. The nonimpaired subjects showed consistently high cross correlations with little phase shift. The dysarthric subjects showed a wide range of tracking performance which was generally consistent with their overall levels of speech performance and levels of neurological impairment. Differential levels of performance were noted across speech subsystems in some dysarthric subjects. In general, the results suggest that visuomotor-tracking paradigms provide a viable approach to clinical evaluation of speech-muscle function in nonspeech tasks.