EFFECTS OF BRAIN DAMAGE ON SWALLOWING AND SPEECH

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Speech and swallowing disorders frequently co-exist in neurologically impaired patients. However, a neuromotor relationship between the function of speech and swallowing is not well-defined. The interaction between speech and swallowing is investigated in the present project by testing the hypothesis that disordered structural movement during swallowing may be predicted from the acoustic correlates of speech movement by the same structures. Deglutition and speech are studied in 3 groups of subjects who have sustained cerebro-vascular accidents at different levels of the neuraxis (cortical, internal capsule-basal ganglia, brainstem) and a group of neurologically normal subjects. Lesion localization is determined with nuclear magnetic resonance (NMR) imaging, and movement patterns will be imaged with videofluoroscopy. Range and duration of lingua-velar, velopharyngeal, and laryngeal movements during speech and swallowing will be quantified and examined in relation to site of neurologic damage and movement patterns. Acoustic properties of speech productions, including duration and amplitude of frication at the release of a lingua-velar consonant, an index of oral nasal coupling, a measure of maximum phonation time (s/z ratio), and pitch range will be examined with digital signal processing techniques. The set of acoustic parameters will be used to predict selected range and duration measures of swallowing. Prediction of lingua-velar, velopharyngeal and laryngeal swallowing movements from the acoustic correlates of speech, should provide practicing speech pathologists or swallowing therapists with better tools to assess speech and swallowing and could lead to new treatment. The findings will add to current knowledge concerning neural organization of head and neck structures to accomplish swallowing and speech production.