Dysarthria - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

DYSARTHRIA A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Dysarthria: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-497-00385-6 1. Dysarthria-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International, Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on dysarthria. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON DYSARTHRIA ............................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Dysarthria..................................................................................... 5 The National Library of Medicine: PubMed ................................................................................ 18 CHAPTER 2. NUTRITION AND DYSARTHRIA ................................................................................... 53 Overview...................................................................................................................................... 53 Finding Nutrition Studies on Dysarthria.................................................................................... 53 Federal Resources on Nutrition ................................................................................................... 54 Additional Web Resources ........................................................................................................... 54 CHAPTER 3. ALTERNATIVE MEDICINE AND DYSARTHRIA ............................................................. 57 Overview...................................................................................................................................... 57 National Center for Complementary and Alternative Medicine.................................................. 57 Additional Web Resources ........................................................................................................... 62 General References ....................................................................................................................... 63 CHAPTER 4. DISSERTATIONS ON DYSARTHRIA ............................................................................... 65 Overview...................................................................................................................................... 65 Dissertations on Dysarthria......................................................................................................... 65 Keeping Current .......................................................................................................................... 65 CHAPTER 5. PATENTS ON DYSARTHRIA ......................................................................................... 67 Overview...................................................................................................................................... 67 Patent Applications on Dysarthria .............................................................................................. 67 Keeping Current .......................................................................................................................... 68 CHAPTER 6. BOOKS ON DYSARTHRIA ............................................................................................. 69 Overview...................................................................................................................................... 69 Book Summaries: Federal Agencies.............................................................................................. 69 Book Summaries: Online Booksellers........................................................................................... 74 Chapters on Dysarthria................................................................................................................ 75 CHAPTER 7. MULTIMEDIA ON DYSARTHRIA .................................................................................. 77 Overview...................................................................................................................................... 77 Video Recordings ......................................................................................................................... 77 Audio Recordings......................................................................................................................... 78 CHAPTER 8. PERIODICALS AND NEWS ON DYSARTHRIA ............................................................... 81 Overview...................................................................................................................................... 81 News Services and Press Releases................................................................................................ 81 Newsletter Articles ...................................................................................................................... 82 Academic Periodicals covering Dysarthria .................................................................................. 83 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 87 Overview...................................................................................................................................... 87 NIH Guidelines............................................................................................................................ 87 NIH Databases............................................................................................................................. 89 Other Commercial Databases....................................................................................................... 91 APPENDIX B. PATIENT RESOURCES ................................................................................................. 93 Overview...................................................................................................................................... 93 Patient Guideline Sources............................................................................................................ 93 Finding Associations.................................................................................................................... 95 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 97 Overview...................................................................................................................................... 97 Preparation................................................................................................................................... 97 Finding a Local Medical Library.................................................................................................. 97

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Medical Libraries in the U.S. and Canada ................................................................................... 97 ONLINE GLOSSARIES................................................................................................................ 103 Online Dictionary Directories ................................................................................................... 103 DYSARTHRIA DICTIONARY.................................................................................................... 105 INDEX .............................................................................................................................................. 137

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with dysarthria is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about dysarthria, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to dysarthria, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on dysarthria. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to dysarthria, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on dysarthria. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON DYSARTHRIA Overview In this chapter, we will show you how to locate peer-reviewed references and studies on dysarthria.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and dysarthria, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “dysarthria” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Motor Speech Problems Associated with Stroke: The Dysarthrias Source: Topics in Stroke Rehabilitation. 1(2): 65-75. Summer 1994. Contact: Available from Aspen Publishers, Inc. 200 Orchard Drive, Gaithersburg, MD 20878. (800) 638-8437; Fax (301) 417-7650. Summary: Dysarthria is one of a number of communication problems that may occur following a stroke. The presence of dysarthria can affect both rehabilitation efforts as well as social and vocational adjustment. In this article, the author reviews methods of classifying the dysarthrias and presents the types of dysarthrias most often encountered post-stroke. The characteristics of these dysarthria types are then related to the underlying neuropathology. Finally, a model of intervention that addresses the impairment, disability, and handicap of the dysarthria is presented. The author also

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provides specific examples of the role of the rehabilitation team in the management of dysarthria. 6 tables. 32 references. (AA-M). •

Dysarthria: Tools for Clinical Decision-Making Source: in The ASHA Leader. (9)9:5 May, 2004. Contact: Available from American Speech-Language-Hearing Association. 10801 Rockville Pike, Rockville, MD 20852. Web site: http://www.professional.asha.org. Summary: This article describes two tools designed to assist speech-language professionals in making clinical decisions for patients diagnosed with the speech condition dysarthria. The first tool is a model of disablement that provides a framework for understanding a broad range of consequences of dysarthria and the second is evidence-based practice (EBP) guidelines that provide up-to-date and systematic reviews of intervention-related issues.

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Treatment Efficacy: Dysarthria Source: Journal of Speech and Hearing Research (JSHR). 39(5): S46-S57. October 1996. Summary: This article discusses treatment efficacy issues in speech language therapy for dysarthria. The author first defines dysarthria and then reviews the disorders of Parkinson's disease, stroke, traumatic brain injury, amyotrophic lateral sclerosis, and cerebral palsy. These disorders represent important clinical diagnoses in which dysarthria is a frequent and debilitating symptom. The roles played by speech-language pathologists include participation in differential diagnosis, provision of speech treatment, staging of treatment, and timely education so that clients and families can make informed decisions about communication alternatives. The author presents both scientific and clinical evidence that suggests that individuals with dysarthria benefit from the services of speech language pathologists. Group-treatment studies, singlesubject studies, and case reports illustrate the effectiveness of various types of speech treatment. Research into the effectiveness of augmentative and alternative communication systems for individuals with cerebral palsy is also presented. 2 tables. 116 references. (AA-M).

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Intensive Voice Treatment and Respiration Treatment for Hypokinetic-Spastic Dysarthria After Traumatic Brain Injury Source: American Journal of Speech-Language Pathology. 10(1): 51-64. February 2001. Contact: Available from American Speech-Language-Hearing Association (ASHA). Subscription Sales Coordinator, 10801 Rockville Pike, Rockville, MD 20852-3279. (888) 498-6699. Fax (301) 897-7358. Website: www.asha.org. Summary: This article reports on a study in which the short term efficacy of the Lee Silverman Voice Treatment (LSVT) and the short and long term efficacy of LSVT exercises combined with respiration treatment and physical therapy (Combination Treatment) were examined in a young man. The patient was diagnosed with mixed hypokinetic spastic dysarthria (a motor speech impairment) 20 months after sustaining a traumatic brain injury (TBI). The efficacy of the LSVT, an intensive 4 week program that focuses on increased vocal effort, is well documented for idiopathic Parkinson's disease. The authors note that their account is the first known published use of LSVT with TBI. Breathing and speech function were assessed by spirometry, respiratory kinematics, intelligibility, and other selected acoustic and auditory perceptual measures. Improvements generally were minor and inconsistent after LSVT, although sound

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pressure level (SPL) and loudness increased notably. After an additional 6 weeks of intensive Combination Treatment, the patient demonstrated gains for resting and speech breathing. In addition, SPL increased further and sentence intelligibility improved substantially. The gains were maintained to varying degrees after 10 weekly sessions of Combination Treatment. Although several measures returned to baseline 3 months after treatment ceased, some improvements in resting and speech breathing remained. Most importantly, improvements in vocal SPL and sentence intelligibility persisted in this patient. On the basis of these results, Combination Treatment, including LSVT, respiration treatment, and physical therapy, is recommended for individuals with mixed hypokinetic spastic dysarthria and upper body hypertonicity regardless of etiology (cause). 3 figures. 4 tables. 26 references.

Federally Funded Research on Dysarthria The U.S. Government supports a variety of research studies relating to dysarthria. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to dysarthria. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore dysarthria. The following is typical of the type of information found when searching the CRISP database for dysarthria: •

Project Title: DISORDERS

ARTICULATORY

KINEMATICS

IN

NEUROGENIC

SPEECH

Principal Investigator & Institution: Weismer, Gary G.; Professor; Waisman Ctr/Mr & Human Devlmt; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2004; Project Start 01-DEC-1998; Project End 31-MAR-2009 Summary: (provided by applicant): This is a proposal to study the articulatory underpinnings of speech intelligibility deficits in the neurogenic speech disorders associated with Parkinson disease (PD) and amyotrophic lateral sclerosis (ALS). The proposed work uses x-ray microbeam (articulatory kinematic), speech acoustic, and speech intelligibility measures to address a major descriptive need, as well as a clinically- and theoretically-relevant hypothesis. Very little is known about lingual behavior in dysarthrias, and what is known about labial and mandibular behavior in dysarthria is confined to a limited type of speech material and measurement strategy. The present proposal includes a variety of speech materials to allow a broad characterization of articulatory kinematics (and the speech acoustic and intelligibility 2

Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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results of those motions) for speech production behavior. One way in which the articulatory kinematics will be characterized is by means of a measure of articulatory working space (i.e., parameterization of ranges). A central hypothesis is that there is a relationship between the size of these articulatory working spaces defined kinematically on the one hand, and the size of the acoustic working spaces and speech intelligibility on the other hand. Specifically, we test the idea, in several ways, that articulatory reduction is the primary segmental reason for reduced intelligibility in persons with ALS and PD. The hypothesis has been shown in the first funding period to hold across speakers within each of the two disorder groups, and will now be studied within neurologicallyimpaired speakers who are asked to control speech variables such as rate, loudness, and clarity so as to create variation in the magnitude of articulatory movements. Another major area of study is to identify the nature and possible disorder of articulatory coordination in dysarthria. Dysarthria is often described as having a prominent component of articulatory dyscoordination, but the small amount of relevant data that exist have not revealed the kind of frank coordination disorder that might be expected from typical textbook descriptions. A finding from the first funding cycle of small abnormalities in the degree of coordination, but an essentially-normal 'form' of coordination for a particular phonetic sequence will be followed up with analyses of additional sequences, as well as with the inclusion of analyses of articulatory scale in these patients and in neurologically-healthy controls. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: ASSESSMENT AND VALIDATION OF TONGUE FATIGUE FOR SPEECH Principal Investigator & Institution: Solomon, Nancy P.; Assistant Professor; Henry M. Jackson Fdn for the Adv Mil/Med Rockville, Md 20852 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2005 Summary: (provided by applicant): Fatigue is a common clinical symptom in persons with neuromotor disorders, many of whom have a concomitant dysarthria. To track fatigue-related changes with treatment or disease progression, an objective measure is needed to quantify fatigue. The long-term objectives of this research are to validate a clinical assessment of tongue fatigue and to examine the role of tongue fatigue in disordered speech. A noninvasive, nonaversive physiologic assessment technique has been designed and preliminarily tested to reflect the sense of effort associated with fatigue. The first specific aim is to use this technique to test individuals with Parkinson?s disease (PD), amyotrophic lateral sclerosis (ALS), and a group of sex- and age-matched, neurologically normal, control subjects. The benefit of this line of research is to provide a simple objective assessment of fatigue. According to the clinical literature, fatigue can exacerbate dysarthria; however, data are not available to substantiate this claim. The second specific aim of this research, therefore, tests the assumption that speech is more susceptible to fatigue in persons with dysarthria than in normal speakers. The study attempts to induce acute tongue fatigue with speech-like tongue exercises in the same groups of subjects (ALS, PD, neurologically normal) and to demonstrate effects on tongue function. The exercise consists of fast syllable repetitions involving lingual targets and movements. Tongue fatigue, indicated by the fatigue measure tested under Aim 1, is expected after the tongue exercises in the disordered groups. As a control for the potential effects of overall lassitude and reduced motivation, the subjects will perform the task with the hand before and after the speech-like exercises as well; no difference is anticipated. Furthermore, functional effects will be examined by comparing speech produced before and after the tongue exercises. This aim will provide evidence

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to support the clinical relevance of the exacerbation of dysarthria by fatigue and further validate the constant-effort technique as an indicator of fatigue. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: AUTOSOMAL DOMINANT ATAXIA Principal Investigator & Institution: Gomez, Christopher M.; Professor; Neurology; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2001; Project Start 01-AUG-1998; Project End 31-JUL-2004 Summary: (from applicant's abstract) The autosomal dominant spinocerebellar ataxias (SCAS) and episodic ataxias (EAs) are a group of adult- and juvenile-onset neurodegenerative diseases characterized by progressive or intermittent dysarthria and incoordination due to degeneration of the cerebellum and brainstem. Advances in the genetic understanding of these diseases have established that, despite similar clinical presentations, there are at least 9 genetically distinct subtypes, SCAI-SCA7, EA-1 and EA-2. Clinical observations suggest that eye movements and postural stability are universally but differentially impaired in the SCAs, presumably due to regional differences in brainstem and cerebellar involvement in the disease. The voluntary and reflexive control of oculomotor and vestibular function rely heavily on the normal function of the cerebellum and its interaction with brainstem neurons. A precise understanding of extraocular movements and vestibular dependent reflexes in SCA may identify both common abnormalities useful for comparative scoring among kindreds, and abnormalities that are unique to a given SCA subtype. In this project the applicants propose to take advantage of a large database of SCA patients, and recent developments in both the genetics of autosomal dominant ataxia, and in the technology for recording and analyzing eye movements and the dynamic control of posture to address the question of whether specific patterns of eye movement abnormalities and postural instability characterize genetically-defined SCAs. These studies will allow them to assess the functional integrity of widespread areas of the brainstem and cerebellum. These measurements are non-invasive, more sensitive than static magnetic resonance imaging, and can be applied to a larger number of genetically defined ataxia patients than could be possible using pathological studies. They propose to: 1) Determine the genetic status of all SCA and EA (episodic ataxia) patients in the University of Minnesota Ataxia Database. 2) Determine whether genetically homogeneous forms of SCA manifest unique patterns of oculomotor and vestibular abnomalities. 3) Determine whether the length of CAG repeat expansions in SCA 1, 2, 3 and 6 correlate with the profile of oculomotor and vestibular abnormalities. 4) Define the progression of oculomotor, vestibular and postural abnormalities as a function of disease duration for SCA 1-7. These studies may identify diagnostic features for some SCA types and provide valuable information about selective vulnerability of CNS neurons and the pathogenesis of CAG repeat diseases. They also may identify traits common to all patients with ataxia that will be useful quantitative measures for therapeutic trials. These studies will test the hypothesis that sensitive measures of eye movements and balance can be used to detect and quantify ataxia from its earliest stages. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: CLINICAL STUDIES OF MITOCHONDRIAL DISEASE Principal Investigator & Institution: Johns, Donald R.; Professor; Beth Israel Deaconess Medical Center St 1005 Boston, Ma 02215 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 31-AUG-2005

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Summary: (Adapted from The Applicant's Abstract): Mitochondrial diseases have protean clinical manifestations, including the nervous system and eye. We identified a novel mitochondrial disease, Sensory Ataxic Neuropathy, Dysarthria, and Ophthalmoplegia (SANDO), which is associated with multiple mitochondrial DNA (mtDNA) deletions. Sensory ataxia is prominent in two other neurologic diseases, Friedreich's ataxia and ataxia with vitamin E deficiency, caused by neuronal oxidative stress. Leber's hereditary optic neuropathy (LHON) was the first disease to be associated with mtDNA point mutations. There have been tremendous diagnostic advances in LHON, but little therapeutic progress. Three primary LHON-associated mtDNA mutations account for the majority of LHON cases. Tobacco and alcohol act as interacting epigenetic factors in LHON. Cybrids are cytoplasmic hybrid cell lines, formed by the fusion of the same recipient nucleus with different donor mutant mitochondria, that are cellular models of mtDNA-mediated disease. Oxidative stress is a critical cellular imbalance between prooxidant species and antioxidant defenses. The hypothesis to be tested is that disruption of mitochondrial energy production (via mtDNA point mutations or multiple deletions) renders neurons more sensitive to oxidative stress and is a unifying feature of LHON and SANDO. We propose studies with the following specific aims: 1. To develop an in vitro cybrid cellular therapeutic model of LHON to facilitate the testing of novel therapeutic hypotheses and guide future rational therapy; 2. To define the epigenetic risk factors that interact with LHONassociated mtDNA mutations. Clinical epidemiology (retrospective & prospective) studies of our extensive population of molecularly-confirmed LHON patients will be performed; 3.To perform preventive and therapeutic clinical trials in molecularlyconfirmed LHON patients and their at-risk maternal relatives; 4. To refine and expand the molecularly-proven SANDO clinical phenotype. The ultimate goal of this patientoriented research, is to advance the prevention and treatment of LHON, SANDO, and other mitochondrial diseases. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: COARTICULATION IN DYSARTHRIA Principal Investigator & Institution: Tjaden, Kris K.; Associate Professor; Communicative Disorders & Scis; State University of New York at Buffalo Suite 211 Ub Commons Buffalo, Ny 14228 Timing: Fiscal Year 2002; Project Start 15-JAN-2001; Project End 31-DEC-2005 Summary: Coarticulation has been studied extensively in neurologically normal speakers and figures prominently in theories of normal speech production. In so far as coarticulation presumably would have a similar status in a speech production theory of dysarthria, and a basic understanding of coarticulation is essential for elaborating such a theory, research investigating coarticulation in dysarthria appears warranted. The idea that coarticulation influences perceptual impressions of precision further indicates that studies investigating coarticulatory patterns in dysarthria may suggest articulatory characteristics that could be targeted in therapy to improve precision. The current project aims to study anticipatory coarticulation for speakers with Amyotrophic Lateral Sclerosis (ALS), Parkinson disease (PD), and Multiple Sclerosis (MS), as inferred from the acoustic signal. Neurologically healthy speakers will be studied for comparison purposes. The Perceptual-Acoustic Theory (PAT), a theory of normal speech production theory, will be used as a starting point for studying anticipatory coarticulation in PD, ALS, and MS. Specific predictions that the PAT suggests concerning anticipatory coarticulation for neurologic speakers will be tested. One goal of the project is to characterize anticipatory coarticulation for the typical or habitual speech of individuals

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with ALS, MS, and PD. A second goal is to determine the effects of two treatment techniques - slowed articulatory rate and increased vocal intensity- on anticipatory coarticulation in ALS, MS, and PD. A third goal is to document the relationship between perceptual impressions of precision and coarticulation. Second formant (F2) frequency values, first moment coefficients, and consonant F2 measures will be used to infer coarticulation. Scaled estimates of precision also will be related to select acoustic measures of coarticulation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: EFFECTS OF AAC STRATEGIES ON DYSARTHRIC SPEECH Principal Investigator & Institution: Hustad, Katherine C.; Communication Sciences & Disorders; Pennsylvania State University-Univ Park 110 Technology Center University Park, Pa 16802 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 30-JUN-2003 Summary: (provided by applicant): Intelligibility is a multifaceted construct that is influenced by a myriad of variables such as linguistic-contextual knowledge of the listener, as well as the acoustic signal produced by the speaker. However, there has been little systematic investigation of the differential effects of listener-related and speakerrelated variables on intelligibility or the extent to which these variables can be exploited to enhance intelligibility for speakers with chronic dysarthria. The long-term goal of this research is to understand the independent and interactive contributions of speakerrelated and listener-related variables to speech intelligibility in individuals with chronic dysarthria of varying severity. The intervention strategy, alphabet supplementation (AS), in which speakers with dysarthria point to the first letter of each word while simultaneously speaking, is of particular interest in the present research. Preliminary studies suggest that AS has the potential to significantly enhance intelligibility of dysarthric speech; however; the reasons why intelligibility is improved are unknown. It is hypothesized that both speaker-related production changes and linguistic knowledge provided to listeners play a role. Two related studies will investigate the effects of these variables. Study 1 will examine the effects of intrinsic and extrinsic listener knowledge on intelligibility of habitual dysarthric speech through manipulation of semantic predictability and experimentally imposed alphabet cues. Study 2 will examine the effects of speaker-related production changes associated with implementation of AS through analysis of spectral and temporal acoustic differences between habitual speech and speech produced while implementing AS. Across both studies, 16 individuals with dysarthria secondary to cerebral palsy will serve as speakers and 256 non-disabled individuals will serve as listeners. Listeners will orthographically transcribe videotapes of speakers using habitual speech and using alphabet supplementation. Intelligibility data and acoustic data will be subjected to analysis of variance to answer research questions. The proposed studies will gather clinically-relevant efficacy data regarding AS as an intervention strategy within a theoretical framework. Outcomes of these studies will provide critical clinical information as well as important theoretical information that will begin to quantify contributors to speech intelligibility in dysarthria. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: FRIEDREICH ATAXIA HIGH THROUGHPUT DRUG SCREENING ASSAYS Principal Investigator & Institution: Wilson, Robert B.; Associate Professor; Pathology and Lab Medicine; University of Pennsylvania 3451 Walnut Street Philadelphia, Pa 19104 Timing: Fiscal Year 2003; Project Start 01-FEB-2003; Project End 31-JAN-2005 Summary: (provided by applicant): Friedreich's ataxia (FRDA) is an autosomal recessive, inherited neurodegenerative disorder. The signs and symptoms of FRDA are reminiscent of the mitochondrial encephalomyopathies and include progressive ataxia of all four limbs, dysarthria, areflexia, sensory loss, and muscle weakness. Skeletal deformities and cardiomyopathy are found in most patients, impaired glucose tolerance and diabetes mellitus are found in -30% of patients, and reduced visual acuity and hearing loss are occasionally seen. Onset of symptoms usually occurs around puberty and most patients are confined to a wheelchair by their late 20s. Myocardial failure is the most common cause of premature death. FRDA is the most common hereditary ataxia, with a prevalence of approximately 1 in 40,000 in European populations, and there is currently no proven effective treatment. FRDA is caused by mutations in the FRDA gene, which encodes the protein frataxin. Although encoded in the nucleus, frataxin is imported into the mitochondrial matrix. Studies of yeast and murine frataxin homologues, and of patient material, indicate that mitochondrial dysfunction, caused by oxidative damage and concomitant mitochondrial iron accumulation, underlies the signs and symptoms of FRDA. Preliminary studies using simple measures of mitochondrial function in the yeast model system, and in primary FRDA cells, support the feasibility of using a cell-based approach to high-throughput drug screening for FRDA. Hit compounds from such a screen could then be tested in the recently developed mouse models of the disease. The protein targets of hit compounds could be identified using a chemical genetic approach in yeast, allowing further drug development. The overall goal of the proposed research is to identify potential treatments for FRDA. The Specific Aims are: 1) To develop high-throughput, cell-based drug screening assays for FRDA. Because mitochondrial dysfunction underlies the signs and symptoms of FRDA, our assays will be designed to screen for compounds that improve mitochondrial function. We will use measures of mitochondrial function suitable for a 96-well format, in the yeast model system, and in primary FRDA cells. 2) To develop a chemical genetic screening assay for the identification of drug targets. We will use a colony-color screening technique in the yeast model system to identify the target proteins of hit compounds from our high-throughput drug screening assays for FRDA. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: IDENTIFYING COMMUNICATIVE SIGNALS IN DYSARTHRIC SPEECH Principal Investigator & Institution: Patel, Rupal; Speech-Lang Path and Audiology; Northeastern University 360 Huntington Ave Boston, Ma 02115 Timing: Fiscal Year 2004; Project Start 01-MAY-2004; Project End 30-APR-2006 Summary: (provided by applicant): Dysarthria, a speech disorder resulting from damage to the brain or peripheral nerves leads to slow, imprecise, and poorly coordinated speech movements. For many individuals, speech is not a viable communication option. This has devastating consequences on quality of life. Despite severe dysarthria, many individuals continue to use vocalizations when interacting with

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familiar communication partners suggesting that reliable information is embedded in the dysarthric speech signal. Identifying these consistent vocal signals has the potential to afford many individuals with an alternative channel of communication. Previous work has assumed that salient information is primarily encoded in speech sound segments. Our recent investigations have shown that prosodic features such as fundamental frequency (perceived as pitch), intensity (perceived as loudness), and syllable duration also carry significant communicative information. We hypothesize that speakers with severe dysarthria have sufficient control of prosody, given that these features vary over slower time scales than segmental units such as phonemes and thus may be easier to produce. We have demonstrated control of prosody in isolated vowels and in phrases to mark question-statement contrasts. To extend beyond previous work we will study a more complex task of local syllable-level control of prosody that better approximates natural speech. Fifteen speakers with severe dysarthria and fifteen nonimpaired controls will produce four-syllable phrases with stress placed on specified syllables to modulate the meaning of the phrase. To determine whether speakers with severe dysarthria can accurately signal stress, a group of 60 listeners will judge which syllable was stressed in each recording (Specific Aim 1). Statistical analyses will be performed to examine listener accuracy for each speaker and to compare results across speaker groups. To understand how speakers with dysarthria mark contrastive stress, we will extract and analyze several acoustic features including fundamental frequency, intensity, duration, pause and spectral tilt (Specific Aim 2). Separate analyses of variance will performed on each feature to quantify its importance in signaling stress and to determine feature-wise differences between speakers. Last, we will compare stress patterning in speakers with severe dysarthria and non-impaired speakers to gain a better understanding of acoustic correlates and compensatory mechanisms associated with signaling stress in dysarthria (Specific Aim 3). If speakers with dysarthria can reliably exploit prosodic cues, our findings will guide the development of intervention strategies that focus on the role of prosody for improving the effectiveness of natural communication, and the design of novel communication devices that leverage prosody as a communicative signal. Our ultimate goal is to understand the factors that lead to improved speaker expressiveness, and to leverage this knowledge to help individuals communicate more naturally and effectively, enabling them to engage more fully in educational, vocational, and social activities. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INTELLIGIBILITY ASSESSMENT IN DYSARTHRIA Principal Investigator & Institution: Kent, Ray D.; Professor; Waisman Ctr/Mr & Human Devlmt; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2002; Project Start 01-JUL-1985; Project End 31-DEC-2005 Summary: Dysarthria is a frequent result of several neurological disorders, including Parkinson disease, stroke, cerebellar pathologies, multiple sclerosis, and traumatic brain injury. Dysarthrias often lead to decreased speech intelligibility, but they also affect other dimensions of spoken language, including voice quality, prosody, and paralinguistic features. These have not been studied collectively in large numbers of individuals with dysarthria. This project uses a multiple-task protocol with both perceptual and acoustic measures to examine intelligibility, voice quality, prosody, and paralinguistic aspects in children and adults with acquired dysarthria. Several newly developed analyses will be used to provide quantitative data toward the construction of profiles of speech impairment and neurologic lesion. Included will be the first

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systematic replication of the original work that led to the contemporary classification of the dysarthrias. The data on dysarthria will be integrated with data on speech development and normal adult speech in a neural network model of speech production that is based on internal models of auditory and articulatory representations of speech. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: INVESTIGATING ALGORITHMS

SPEECH

DISORDERS

WITH

EMERGING

Principal Investigator & Institution: Salvatore, Anthony P.; University of Texas El Paso El Paso, Tx 79968 Timing: Fiscal Year 2003; Project Start 01-JUN-2003; Project End 31-MAY-2007 Summary: (provided by applicant): This project proposes to investigate various speech disorders with emerging computational algorithms. Specifically, it is in our plan to develop an expert system based upon the use of recent advances in neural networks, fuzzy logic and other computational algorithms. Although several researchers in communication disorders have already claimed some initial success with these recently emerging tools, a thorough investigation is warranted to tap the full potential of these algorithms. It is anticipated that the proposed system will be capable of objectively analyzing communication disorders based on multi-dimensional measures of speech fluency, acoustic variables, and some selected physiologic assessments. Specifically, the proposed system will be applied to differentiate between the set of data from normal and speech-language disordered individuals so that the burden of perceptual judgment by the clinician is objectively resolved by the expert system. There is significant evidence from clinical experience that this corpus of measures contain the information necessary to make the differential diagnosis. However, this information has not been mined successfully through objective means because of the multitude of simultaneous variables present in these tasks, and lack of sufficient technical thrust in this province. It is expected that this project will include a wide variety of communication disorders such as: stuttering, spasmodic dysphonia, aphasia, apraxia and dysarthria. This technology is expected to benefit clinicians in objective decision-making. Currently individual clinicians perform this task. It is subjective and time consuming. The clinical decisions on treatment methods depend upon the nature and extent of the training and any biases inherent in that training of individual clinicians. This limitation may be overcome by the unlimited learning potential of the computer. Another aim of this project is to develop a model of communication disorders based upon the underlying mechanisms of the expert system. It is anticipated that such a model will provide helpful insights into the pathophysiology of communication disorders. Furthermore, the results of this research is expected to improve the current knowledge of the comparative strengths and weaknesses of existing algorithms and develop means to combine the advantages of several computational methods within one operating system. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MINORITY PREDOCTORAL FELLOWSHIP PROGRAM Principal Investigator & Institution: Fossett, Tepanta R.; Communication Sci & Disorders; University of Pittsburgh at Pittsburgh 350 Thackeray Hall Pittsburgh, Pa 15260 Timing: Fiscal Year 2002; Project Start 01-SEP-2002; Project End 31-AUG-2003 Summary: (provided by applicant): The overall objective of this research is to advance understanding of the cognitive, linguistic and motoric mechanisms involved in normal

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and pathologic speech production systems. The specific aim of this proposal is to examine the effects of speaking rate manipulations on phonologic encoding in normal and aphasic persons without dysarthria or apraxia of speech (AOS). Changes in speaking rate may affect phonologic encoding and/or motor level processes. Sound production errors frequently occur in aphasia and are often used as evidence to establish differential diagnosis among types of aphasia and other neurogenic communication disorders (e.g., AOS). The frequent co-occurrence of language and motor level deficits following stroke has caused confusion regarding what types of errors can serve as evidence for disruption of specific levels of the production system. Serial order errors, however, are generally assumed to result from disruption of phonologic encoding processes in some individuals with aphasia who are without concomitant deficits in the speech motor system. Based on a spreading-activation model, it is hypothesized that manipulating speaking rate will affect serial order errors in predictable patterns in individuals with aphasia and in unimpaired speakers. In this repeated measures design, subjects will produce sentences at three speaking rates, in response to auditorily presented tongue-twister stimuli. Phonological-level serial order error (anticipation, perseverative and exchange) ratios will serve as the primary dependent variable. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: MOLECULAR GENETICS OF THE SCA1 LOCUS Principal Investigator & Institution: Orr, Harry T.; Professor; Lab Medicine and Pathology; University of Minnesota Twin Cities 200 Oak Street Se Minneapolis, Mn 554552070 Timing: Fiscal Year 2002; Project Start 01-AUG-1986; Project End 29-FEB-2004 Summary: Spinocerebellar ataxia type 1 (SCA1) is one of a series of autosomal dominant cerebellar ataxia. SCA1 patients develop gait ataxia, dysarthria and nystagmus. As the disease progresses other signs of cerebellar and brainstem dysfunction become apparent with death resulting from loss of bulbar function. Neuropathology in SCA1 includes severe loss of cerebellar Purkinje cells. SCA1 is among a group of neurodegenerative disorders caused by an expansion of a CAG triplet repeat encoding a polyglutamine tract within each respective disease protein. Substantial progress has been made towards understanding the molecular basis of SCA1 pathogenesis. However, several critical questions remain for SCA1 and for polyglutamine disorders in general. These, for the most part, relate to the relative importance of the polyglutamine tract vs. its protein context for driving disease. We propose a model of SCA1 pathogenesis in which disease ensues due to a disruption of nuclear architecture and/or function in specific neurons by mutant ataxin-1 (the SCA1 gene product). In this model, there are predicted to be several points at which residues in ataxin-1 that, along with the polyglutamine tract, would have a critical role in driving the development and progression of disease. The aims of this proposal use a genetic approach to testing several important aspects of this model in transgenic mice: 1) Whether disease progression requires the transport of mutant ataxin-1 to the nucleus, 2) Whether disease progression is dependent on the ability of mutant ataxin-1 once in the nucleus to induce alterations in nuclear structure/function, 3) To examine the role of the nuclear proteins that interact with ataxin-1 in SCA1 pathogenesis, and 4) Examine the importance of the timing of mutant ataxin-1 expression on disease progression. Understanding the importance of these factors for SCA1 pathogenesis should provide insights for polyglutamine diseases in general. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Dysarthria

Project Title: NEURAL MODELING AND IMAGING OF SPEECH Principal Investigator & Institution: Guenther, Frank H.; Associate Professor; Cognitive and Neural Systems; Boston University Charles River Campus 881 Commonwealth Avenue Boston, Ma 02215 Timing: Fiscal Year 2002; Project Start 01-FEB-1996; Project End 31-JAN-2006 Summary: The primary goal of this research project is the continued development, testing, and refinement of a comprehensive computational modeling framework addressing the neural processes underlying speech perception and production. This framework is defined using adaptive neural networks, allowing comparisons with data from imaging studies of brain function. The proposed research includes five modeling studies and nine closely related functional magnetic resonance imaging (fMRI) experiments to test model predictions. These studies constitute five subprojects to flesh out different aspects of the investigators' modeling framework. The first subproject, modeling and imaging studies of neural map formation in the auditory cortical areas, will extend their earlier studies into the nature of sound categories in the auditory system (e.g., phonemic categories) and the warping of auditory perceptual space evident from phenomena such as categorical perception and the perceptual magnet effect. The second subproject, modeling and imaging studies of visual influences on speech perception, will extend the investigators' earlier work studying the nature of visual influences on speech perception as evidenced by the McGurk effect, and will address learning processes hypothesized to underlie visual-auditory associations. The third subproject, modeling and imaging studies of central aspects of the DIVA model, will address the neural processes underlying the control of speech articulations, including the involvement of the cerebellum in normal subjects and subjects with cerebellar damage, and the effects of auditory and somatosensory feedback perturbations to activations in different brain areas. The fourth subproject, modeling and imaging studies of movement selection, initiation, and sequencing, will address the involvement of the supplementary motor area, anterior cingulate area, and basal ganglia in speech production. In the fifth subproject, a distributed model of cortical and subcortical interactions in speech, the results of earlier projects will be combined into a comprehensive model of the neural processes underlying speech perception and production. The modeling hypotheses have been specifically designed to be testable with existing or easily attainable fMRI techniques. Several new imaging and data analysis techniques will also be investigated to stay abreast of the most effective methods for testing the hypotheses. When appropriate, these techniques will be utilized to improve the experiments. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: NEURO-INFLAMMATION GANGLIOSIDOSIS

AND

TREATMENT

IN

GM2

Principal Investigator & Institution: Kyrkanides, Stephanos; Assistant Professor in Orthodontics; Eastman Dentistry; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2004; Project Start 01-MAR-2004; Project End 28-FEB-2008 Summary: (provided by applicant): Tay-Sachs and Sandhoff disease are inherited lysosomal storage disorders resulting from beta-hexosaminidase deficiency. Affected patients present with neurodegeneration, mental and motor deterioration, muscular flaccidity, blindness, dysarthria, impaired thermal sensitivity, increasing dementia and cherry-red spots in the macula of the eye. Depending on the clinical severity patients

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may reach a vegetative state followed by death as early as 2-4 years of life. The neurons of the brain, cerebellum, brain stem, spinal cord, trigeminal and spinal root ganglia display swollen vacuolated perikarya stored with excessive amounts of GM2 ganglioside, leading to aberrant neuronal function, microglia activation and brain inflammation. Based on these observations, we hypothesize that microglia activation and neuro-inflammation secondary to GM2 neuronal gangliosidosis contributes to neurodegeneration and disease development. To test this hypothesis, we propose to investigate neuronal storage and its effects on the microglia/monocyte/macrophage system in a mouse model of GM2 gangliosidosis (hexB-/-knockout). First, we will determine the role of GM2 gangliosidosis in brain inflammation by selectively rescuing neurons from beta-hexosaminidase deficiency. Second, we will investigate the role of peripheral blood mononuclear cells in GM2 gangliosidosis by inhibiting monocyte/macrophage infiltration into the brain. Subsequently, we will transduce bone marrow derived-cells with the therapeutic gene betaHex, capable of expressing both subunits of the human beta-hexosaminidase, and evaluate their efficacy in attenuating disease development in a fashion similar to that described after bone marrow transplantation. In the last specific aim, we will determine whether beta-hexosaminidase gene therapy administered intraperitoneally to hexB-/- P2 neonates can effectively transduce neurons, glia and peripheral blood mononuclear cells with the therapeutic gene betaHex. With this more of therapy we anticipate a resolution of GM2 storage and neuro-inflammation ultimately leading to amelioration of the clinical phenotype of the disease. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PERCEPTION OF DYSARTHRIC SPEECH Principal Investigator & Institution: Liss, Julie M.; Associate Professor; Speech and Hearing Science; Arizona State University P.O. Box 873503 Tempe, Az 852873503 Timing: Fiscal Year 2004; Project Start 01-JUL-2004; Project End 30-JUN-2009 Summary: (provided by applicant): There currently exists no functional model of speech perception in dysarthria that captures the critical interface between speech signal characteristics and the cognitive-perceptual processes brought to bear on that signal by the listener. Yet such a model is necessary, not only to explain intelligibility deficits, but also to guide and justify treatment decisions in clinical practice. Two series of experiments will be undertaken, which focus on the signal-listener interface for lexical segmentation, or the perceptual task of parsing the continuous acoustic stream into discrete words. The first set will focus on the nature of the intelligibility deficit by examining speech perception errors among different forms and severity levels of dysarthria. This will define and establish the relationships among segmental and suprasegmental deficit patterns, dysarthria severity levels, and the perceptual consequences of each. The second set of experiments will focus on the sources of intelligibility gains, by directly manipulating listener constraints in a training paradigm. In both series of experiments, predictions proposed by two accounts of lexical segmentation will be tested. These include the Metrical Segmentation Strategy Hypothesis (MSS; Cutler & Norris, 1988; Cutler & Butterfield, 1992), and the Hierarchical Model of Speech Segmentation (HMSS; Mattys, S.L. The hierarchical model of speech segmentation. BBSRC, 2003-2006). Lexical boundary error and segmental analyses will be conducted on listeners' transcription of phrases produced by speakers with different forms and severities of dysarthria. It is predicted that, for a given pattern of dysarthria (form), there will be evidence of differences in the effectiveness of listeners' cognitive-perceptual strategies, directly traceable to severity of speech deficit.

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For a given level of speech deficit severity, there will be evidence of differences in the effectiveness of listeners' cognitive-perceptual strategies, directly traceable to dysarthria form. By examining perceptual error patterns elicited in a training paradigm, it will be possible to identify which aspects of the acoustic signal are of perceptual salience in a default mode, and which features can be elevated in perceptual salience via training. Information learned about differences in the perceptual processing of different forms and severities of dysarthria will be used to develop a model of speech intelligibility deficits in dysarthria, and will have applicability to management programs in speech rehabilitation. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: PROSODIC IMPAIRMENT AND SPEECH INTELLIGIBILITY IN PERSO* Principal Investigator & Institution: Bunton, Kate E.; Ctr/ Neurogenic Communication Disorders; University of Arizona P O Box 3308 Tucson, Az 857223308 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 31-JUL-2006 Summary: (provided by applicant): The proposed study investigates the role of sentence level fundamental frequency (F0) variation in speech intelligibility for persons with dysarthria associated with idiopathic Parkinson's disease (PD). It is of interest to know how prosody contributes to speech intelligibility deficits in developing an acousticphonetic model of speech intelligibility in dysarthria. The effects of segmental and suprasegmental variables on speech intelligibility have been addressed independently; however, few studies have been directed toward studying the interaction of segmental and suprasegmental variables and their effects on speech perception. Prosodic impairment, such as difficulty producing F0 variability across an utterance, may reduce the salience of acoustic cues to segment identity and have a detrimental effect on speech intelligibility. The primary aim of the proposed study is to look at changes in segment perception as a result of modification of the F0 contour. The study uses a speech resynthesis program that allows the investigator to modify F0 contours at the sentence level without affecting the timing and formant characteristics of the utterance. It is hypothesized that flattening of the F0 contour will increase segmental error rates, particularly for vowels. Enhancing the F0 contour to include the peaks and valleys typical in normal speakers will decrease segment error rates. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SPEECH SUPPLEMENTED WORD PREDICTION PROGRAM Principal Investigator & Institution: Jakobs, Thomas; President; Invotek, Inc. 1026 Riverview Dr Alma, Ar 72921 Timing: Fiscal Year 2004; Project Start 14-JUN-2004; Project End 31-MAR-2005 Summary: (provided by applicant): Commercial speech recognition software offers many people with physical limitations an important computer access method. While this access method is reasonably reliable for people with typical speech, people with motor speech disorders (dysarthria) are presently not able to reliably use this technology for writing and assistive technology control. The purpose of this research is to provide these people with a unique assistive-device access method that utilizes their speech. This will be accomplished by developing a Speech Supplemented Word Prediction Program that enables people with dysarthria to use their speech capabilities to interact with personal computers and augmentative and alternative communication software. The central element of the program will be speech-recognition software that

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can be trained to exploit the user's speech capabilities for use in conjunction with a custom word prediction program. The combination of the word prediction software and the speech recognition engine may provide the speaker with an effective new communication method. It may be exceptionally efficient, potentially reducing the number of keystrokes required to produce text by 75%. It also promotes the effective use of dysarthric speech for communication. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE ANATOMICAL BASIS OF HUMAN TONGUE BIOMECHANICS Principal Investigator & Institution: Sanders, Ira; Associate Professor; Otolaryngology; Mount Sinai School of Medicine of Nyu of New York University New York, Ny 10029 Timing: Fiscal Year 2002; Project Start 01-FEB-2001; Project End 31-JUL-2004 Summary: (provided by applicant): What is special about the human tongue that allows it to perform the movements that are unique to human speech and swallowing? The biomechanics of the tongue are dependent on its anatomy, and some of the most basic facts of human tongue anatomy are unknown. It is hypothesized that the human tongue contains specialized anatomy related to the movements of human speech and swallowing. Studying this anatomy will increase our understanding of tongue movements; provide a normative baseline from which to compare pathological conditions, and provide the detail required for progress in surgical procedures on the tongue, including transplantation. The human tongue presents formidable challenges for the anatomist: the small muscle groups that interweave in complex ways are technically difficult to trace; it is often difficult to identify specific muscles in histological sections; and many techniques routinely used in animal studies cannot be used on human post mortem tissue. However, based on experience studying the human larynx, a systematic approach is proposed with a variety of techniques that have all been successfully tested in the preliminary work. Tongue anatomy will simultaneously be studied on the gross anatomical, microscopic and molecular level using the following methods: 1) high-resolution magnetic resonance microscopy of tongue tissue to study 3D structural detail; 2) Sihler's stain, a process that renders whole tongue specimens translucent while counterstalning the nerve supply and outlines of muscle groups; 3) serial sectioning of whole tongues followed by staining to show details of muscle structure and insertion into connective tissue; 4) micro dissection of muscle fibers followed by silver and acetylcholinesterase staining to study details of muscle fiber size and shape, motor endplate types, and terminal axon branching; 5) myofibrillar ATPase, to type the muscle fibers of each muscle; 6) immunohistochemistry, to identify the myosin heavy chain (MHC) within tongue muscles; and 7) immunoelectrophoresis and immunoblotting, to confirm the immunohistochemistry. Preliminary work has supported the presence of specialized anatomy in the human tongue. Certaln muscles are significantly different in size and position when compared to other mammalian tongues. The genioglossus muscle, for example, is greatly enlarged while the inferior longitudinal is comparatively smaller. In addition, human tongue muscles have unusual internal structure: some appear to be compartmentalized into smaller groups of muscle fibers arranged in series. In the superior longitudinal muscle preliminary work suggests that these muscle compartments are surprisingly short and that the muscle fibers are interconnected in complex webs. Overall, the human tongue has the highest proportion of slow twitch muscle fibers yet reported in any mammalian tongue, and these are arranged in a gradient with the higher proportions found medially and in the tongue base. Among these slow muscle fibers are large numbers of slow tonic muscle fibers, an extremely rare type of muscle fiber with unique contractile properties. In summary, the

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dearth of information about the human tongue appears to offer an opportunity to increase our understanding of the special nature of speech and swallowing as well as the pathophysiology of dysphagia and dysarthria. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with dysarthria, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “dysarthria” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for dysarthria (hyperlinks lead to article summaries): •

A 15-year-old boy with central nervous system vasculopathy presenting with dysarthria-clumsy hand syndrome. Author(s): Golomb MR, Weiss SK, Ibrahim SH, deVeber GA. Source: Journal of Child Neurology. 2002 March; 17(3): 241-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12026247

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A 34-year-old man with facial droop and dysarthria. Author(s): Latif AA, Jneid H, Isada CM, Francis GS. Source: Cleve Clin J Med. 2003 July; 70(7): 602, 604, 607-10 Passim. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12882382

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A 56-year-old man with progressive dysphagia, dysarthria and ataxia. Author(s): Wolfsthal SD, Benitez RM. Source: Md Med J. 1996 November; 45(11): 933-7. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8942170

3

PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A comparison of speech and language therapy techniques for dysarthria in Parkinson's disease. Author(s): Deane KH, Whurr R, Playford ED, Ben-Shlomo Y, Clarke CE. Source: Cochrane Database Syst Rev. 2001; (2): Cd002814. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11406045

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A double-blind trial of clonazepam in the treatment of parkinsonian dysarthria. Author(s): Biary N, Pimental PA, Langenberg PW. Source: Neurology. 1988 February; 38(2): 255-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3277083

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A hereditary disorder with dementia, spastic dysarthria, vertical eye movement paresis, gait disturbance, splenomegaly, and abnormal copper metabolism. Author(s): Willvonseder R, Goldstein NP, McCall JT, Yoss RE, Tauxe WN. Source: Neurology. 1973 October; 23(10): 1039-49. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4795418

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A lacunar stroke. The dysarthria-clumsy hand syndrome. Author(s): Fisher CM. Source: Neurology. 1967 June; 17(6): 614-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6067394

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A new neurological entity manifesting as involuntary movements and dysarthria with possible abnormal copper metabolism. Author(s): Tagawa A, Ono S, Shibata M, Imai T, Suzuki M, Shimizu N. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2001 December; 71(6): 7803. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11723201

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A patient selection profile for the use of speech prostheses in adult dysarthria. Author(s): Bedwinek AP, O'Brien RL. Source: Journal of Communication Disorders. 1985 June; 18(3): 169-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3891798

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A speaking task analysis of the dysarthria in cerebellar disease. Author(s): Kent RD, Kent JF, Rosenbek JC, Vorperian HK, Weismer G. Source: Folia Phoniatrica Et Logopaedica : Official Organ of the International Association of Logopedics and Phoniatrics (Ialp). 1997; 49(2): 63-82. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9197089

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A syndrome of paralysis of downward gaze, dysarthria, pseubulbar palsy, axial rigidity of neck and trunk and dementia. Author(s): Messert B, Van Nuis C. Source: The Journal of Nervous and Mental Disease. 1966 July; 143(1): 47-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5957583

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A syndrome with painful lipomas, familial dysarthria, abnormal eye-movements and clumsiness. Author(s): Juhlin L, Strand A, Johnsen B. Source: Acta Med Scand. 1987; 221(2): 215-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3591458

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Accelerated speech in dysarthria after acquired brain injury: acoustic correlates. Author(s): Ziegler W, Hoole P, Hartmann E, von Cramon D. Source: Br J Disord Commun. 1988 December; 23(3): 215-28. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3267417

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Acceleration and weakness in parkinsonian dysarthria. Author(s): Netsell R, Daniel B, Celesia GG. Source: J Speech Hear Disord. 1975 May; 40(2): 170-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=189132

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Acoustic analysis of dysarthria profile in ALS patients. Author(s): Tomik B, Krupinski J, Glodzik-Sobanska L, Bala-Slodowska M, Wszolek W, Kusiak M, Lechwacka A. Source: Journal of the Neurological Sciences. 1999 October 31; 169(1-2): 35-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10540005

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Acoustic characteristics of dysarthria associated with cerebellar disease. Author(s): Kent RD, Netsell R, Abbs JH. Source: Journal of Speech and Hearing Research. 1979 September; 22(3): 627-48. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=502519

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Acoustic characteristics of the question-statement contrast in severe dysarthria due to cerebral palsy. Author(s): Patel R. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2003 December; 46(6): 1401-15. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14700364

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Acoustic reflex measurement in adults with cerebral palsy and dysarthria. Author(s): Schliesser HF, Deshayes IL. Source: Folia Phoniatr (Basel). 1982; 34(5): 242-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7173758

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Acoustic-phonetic contrasts and intelligibility in the dysarthria associated with mixed cerebral palsy. Author(s): Ansel BM, Kent RD. Source: Journal of Speech and Hearing Research. 1992 April; 35(2): 296-308. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1573870

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Acquired childhood dysarthria: review of its clinical presentation. Author(s): van Mourik M, Catsman-Berrevoets CE, Paquier PF, Yousef-Bak E, van Dongen HR. Source: Pediatric Neurology. 1997 November; 17(4): 299-307. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9436793

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Acquired dysarthria in childhood: an analysis of dysarthric features in relation to neurologic deficits. Author(s): van Dongen HR, Arts WF, Yousef-Bak E. Source: Neurology. 1987 February; 37(2): 296-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3808312

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Acute dysarthria induced by low dose methotrexate therapy in a patient with erythrodermic cutaneous T-cell lymphoma: an unusual manifestation of neurotoxicity. Author(s): Aplin CG, Russell-Jones R. Source: Clinical and Experimental Dermatology. 1999 January; 24(1): 23-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10233644

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Alterations in communication. Biopsychosocial aspects of aphasia, dysarthria, and right hemisphere syndromes in the stroke patient. Author(s): Pimental PA. Source: Nurs Clin North Am. 1986 June; 21(2): 321-37. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3517820

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An acoustical study of the fricative /s/ in the speech of individuals with dysarthria. Author(s): Chen H, Stevens KN. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2001 December; 44(6): 1300-14. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11776366

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An unusual but easily treatable cause of dysphagia and dysarthria complicating stroke. Author(s): Wright AJ. Source: British Medical Journal (Clinical Research Ed.). 1985 November 16; 291(6506): 1412-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3933689

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Apraxia dysarthria. Author(s): Reef H. Source: J S Afr Speech Hear Assoc. 1967 September; 14(1): 37-44. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5634157

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Articulatory deficits in parkinsonian dysarthria: an acoustic analysis. Author(s): Ackermann H, Ziegler W. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1991 December; 54(12): 1093-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1783924

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Ataxic dysarthria. Author(s): Kent RD, Kent JF, Duffy JR, Thomas JE, Weismer G, Stuntebeck S. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2000 October; 43(5): 1275-89. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11063247

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Ataxic dysarthria: treatment sequences based on intelligibility and prosodic considerations. Author(s): Yorkston KM, Beukelman DR. Source: J Speech Hear Disord. 1981 November; 46(4): 398-404. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7300267

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Atypical dysarthria in Munchausen syndrome. Author(s): Kallen D, Marshall RC, Casey DE. Source: Br J Disord Commun. 1986 December; 21(3): 377-80. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3651321

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Brainstem anesthesia presenting as dysarthria. Author(s): Rosen WJ. Source: Journal of Cataract and Refractive Surgery. 1999 August; 25(8): 1170-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10445209

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Cerebellar mutism with subsequent dysarthria in an adult: case report. Author(s): Dunwoody GW, Alsagoff ZS, Yuan SY. Source: British Journal of Neurosurgery. 1997 April; 11(2): 161-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9156007

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Cerebellar speech representation: lesion topography in dysarthria as derived from cerebellar ischemia and functional magnetic resonance imaging. Author(s): Urban PP, Marx J, Hunsche S, Gawehn J, Vucurevic G, Wicht S, Massinger C, Stoeter P, Hopf HC. Source: Archives of Neurology. 2003 July; 60(7): 965-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12873853

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Cerebral blood flow in pure dysarthria: role of frontal cortical hypoperfusion. Author(s): Okuda B, Kawabata K, Tachibana H, Sugita M. Source: Stroke; a Journal of Cerebral Circulation. 1999 January; 30(1): 109-13. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9880397

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Characteristics of speaking rate in the dysarthria associated with amyotrophic lateral sclerosis. Author(s): Turner GS, Weismer G. Source: Journal of Speech and Hearing Research. 1993 December; 36(6): 1134-44. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8114480

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Characteristics of the dysarthria of multiple system atrophy. Author(s): Kluin KJ, Gilman S, Lohman M, Junck L. Source: Archives of Neurology. 1996 June; 53(6): 545-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8660157

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Chronic dysarthria and metoclopramide. Author(s): Walsh TD. Source: Annals of Neurology. 1982 May; 11(5): 545. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7103433

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Clinical anatomic study of pure dysarthria. Author(s): Ichikawa K, Kageyama Y. Source: Stroke; a Journal of Cerebral Circulation. 1991 June; 22(6): 809-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2057982

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Clinical and acoustical variability in hypokinetic dysarthria. Author(s): Metter EJ, Hanson WR. Source: Journal of Communication Disorders. 1986 October; 19(5): 347-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3490498

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Clinical correlates of quantitative acoustic analysis in ataxic dysarthria. Author(s): Chiu MJ, Chen RC, Tseng CY. Source: European Neurology. 1996; 36(5): 310-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8864714

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Clinical study of 35 patients with dysarthria-clumsy hand syndrome. Author(s): Arboix A, Bell Y, Garcia-Eroles L, Massons J, Comes E, Balcells M, Targa C. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2004 February; 75(2): 2314. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14742595

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Clinicoanatomic studies in dysarthria: review, critique, and directions for research. Author(s): Cochrane Database Syst Rev. 2002;(4):CD002088 Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2001 June; 44(3): 53551. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12519567

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Creutzfeldt-Jakob disease presenting as isolated dysarthria and dysphagia due to pseudobulbar palsy. Author(s): Frank HG, Schnorf H, Genoud D, Pizzolato P, Glatzel M, Landis T. Source: European Neurology. 2000; 44(2): 126-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10965170

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DAF as instrumental treatment for dysarthria in progressive supranuclear palsy: a case report. Author(s): Hanson WR, Metter EJ. Source: J Speech Hear Disord. 1980 May; 45(2): 268-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6449631

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Differential diagnostic patterns of dysarthria. Author(s): Darley FL, Aronson AE, Brown JR. Source: Journal of Speech and Hearing Research. 1969 June; 12(2): 246-69. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5808852

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Differential subsystem impairment, differential motor system impairment, and decomposition of respiratory movement in ataxic dysarthria: a spurious trilogy. Author(s): Hixon TJ, Hoit J. Source: J Speech Hear Disord. 1984 November; 49(4): 435-41. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6503251

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Direct magnitude estimates of speech intelligibility in dysarthria: effects of a chosen standard. Author(s): Weismer G, Laures JS. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2002 June; 45(3): 42133. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12068996

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Disorders of nasality in subjects with upper motor neuron type dysarthria following cerebrovascular accident. Author(s): Thompson EC, Murdoch BE. Source: Journal of Communication Disorders. 1995 September; 28(3): 261-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8530721

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Distinguishing and improving dysarthria due to facial weakness. Author(s): Starr A. Source: Archives of Neurology. 1989 February; 46(2): 125. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2916949

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Distinguishing and improving dysarthria due to facial weakness. Author(s): Starr A. Source: Archives of Neurology. 1988 October; 45(10): 1061. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3178525

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Dysarthria after large doses of intravenous diazepam. Author(s): Ishikawa T, Hato M, Tauchi A, Wada Y. Source: Jpn J Psychiatry Neurol. 1988 December; 42(4): 759-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3249473

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Dysarthria and a numb hand in an elderly woman. Author(s): McDonald CL, Mahmood NF, Grant KF. Source: Hosp Pract (Off Ed). 1992 January 15; 27(1): 71-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1730798

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Dysarthria and aphagia: a case study of neuromuscular treatment. Author(s): Harris B, Murry T. Source: Archives of Physical Medicine and Rehabilitation. 1984 July; 65(7): 408-12. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6743001

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Dysarthria and apraxia of speech associated with FK-506 (tacrolimus). Author(s): Boeve BF, Kimmel DW, Aronson AE, de Groen PC. Source: Mayo Clinic Proceedings. 1996 October; 71(10): 969-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8820772

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Dysarthria and cerebellar ataxia: late occurrence of severe neurotoxicity in a liver transplant recipient. Author(s): Belli LS, De Carlis L, Romani F, Rondinara GF, Rimoldi P, Alberti A, Bettale G, Dughetti L, Ideo G, Sberna M, et al. Source: Transplant International : Official Journal of the European Society for Organ Transplantation. 1993 May; 6(3): 176-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8499072

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Dysarthria and dysphagia as long-term sequelae in a child treated for posterior fossa tumour. Author(s): Cornwell PL, Murdoch BE, Ward EC, Morgan A. Source: Pediatric Rehabilitation. 2003 April-June; 6(2): 67-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14534043

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Dysarthria and lacunar stroke: pathophysiologic aspects. Author(s): Urban PP, Hopf HC, Zorowka PG, Fleischer S, Andreas J. Source: Neurology. 1996 November; 47(5): 1135-41. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8909418

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Dysarthria and orofacial apraxia in corticobasal degeneration. Author(s): Ozsancak C, Auzou P, Hannequin D. Source: Movement Disorders : Official Journal of the Movement Disorder Society. 2000 September; 15(5): 905-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11009198

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Dysarthria and pathological laughter/crying as presenting symptoms of corticobasalganglionic degeneration syndrome. Author(s): Thumler BH, Urban PP, Davids E, Siessmeier M, Schreckenberger T, Benz P, Stoeter P, Bartenstein P, Hopf HC. Source: Journal of Neurology. 2003 September; 250(9): 1107-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14504974

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Dysarthria and visual hallucinations due to flecainide toxicity. Author(s): Ramhamadany E, Mackenzie S, Ramsdale DR. Source: Postgraduate Medical Journal. 1986 January; 62(723): 61-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3099275

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Dysarthria as the isolated clinical symptom of borreliosis--a case report. Author(s): Gustaw K, Mirecka U. Source: Annals of Agricultural and Environmental Medicine : Aaem. 2001; 8(1): 95-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11426931

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Dysarthria as the leading symptom of hypothyroidism. Author(s): Stollberger C, Finsterer J, Brand E, Tschabitscher D. Source: American Journal of Otolaryngology. 2001 January-February; 22(1): 70-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11172218

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Dysarthria associated with focal unilateral upper motor neuron lesion. Author(s): Hartman DE, Abbs JH. Source: Eur J Disord Commun. 1992; 27(3): 187-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1306385

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Dysarthria associated with giant cell arteritis. Author(s): Lee CC, Su WW, Hunder GG. Source: The Journal of Rheumatology. 1999 April; 26(4): 931-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10229420

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Dysarthria due to loss of voluntary respiration. Author(s): Noda S, Umezaki H. Source: Archives of Neurology. 1982 February; 39(2): 132. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7059301

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Dysarthria during basilar artery balloon occlusion. Author(s): Hartmann A, Conolly ES, Duong DH, Prestigiacomo CJ, Joshi S, Mohr JP, Mast H. Source: Neurology. 1999 July 22; 53(2): 421-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10430442

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Dysarthria in a patient with probable acquired chloridorrhea. Author(s): Marx M, Marx C, Luft FC. Source: American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation. 2003 December; 42(6): 1283-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14655202

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Dysarthria in acute ischemic stroke: lesion topography, clinicoradiologic correlation, and etiology. Author(s): Urban PP, Wicht S, Vukurevic G, Fitzek C, Fitzek S, Stoeter P, Massinger C, Hopf HC. Source: Neurology. 2001 April 24; 56(8): 1021-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11320172

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Dysarthria in bilateral thalamic infarction. A case study. Author(s): Ackermann H, Ziegler W, Petersen D. Source: Journal of Neurology. 1993 June; 240(6): 357-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8336176

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Dysarthria in children with cerebellar or brainstem tumors. Author(s): van Mourik M, Catsman-Berrevoets CE, Yousef-Bak E, Paquier PF, van Dongen HR. Source: Pediatric Neurology. 1998 May; 18(5): 411-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9650681

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Dysarthria in Friedreich disease. Author(s): Gentil M. Source: Brain and Language. 1990 April; 38(3): 438-48. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2346881

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Dysarthria in multiple sclerosis. Author(s): Darley FL, Brown JR, Goldstein NP. Source: Journal of Speech and Hearing Research. 1972 June; 15(2): 229-45. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5047862

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Dysarthria in Wilson's disease. Author(s): Berry WR, Darley FL, Aronson AE. Source: Journal of Speech and Hearing Research. 1974 June; 17(2): 169-83. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4836038

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Dysarthria of adult cerebral palsy: I. Intelligibility and articulatory impairment. Author(s): Platt LJ, Andrews G, Young M, Quinn PT. Source: Journal of Speech and Hearing Research. 1980 March; 23(1): 28-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7442182

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Dysarthria of adult cerebral palsy: II. Phonemic analysis of articulation errors. Author(s): Platt LJ, Andrews G, Howie PM. Source: Journal of Speech and Hearing Research. 1980 March; 23(1): 41-55. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7442183

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Dysarthria of motor neuron disease: clinician judgments of severity. Author(s): Seikel JA, Wilcox KA, Davis J. Source: Journal of Communication Disorders. 1990 December; 23(6): 417-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2286723

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Dysarthria of motor neuron disease: longitudinal measures of segmental durations. Author(s): Seikel JA, Wilcox KA, Davis J. Source: Journal of Communication Disorders. 1991 October-December; 24(5-6): 393-409. Erratum In: J Commun Disord 1992 April-June; 25(2-3): 201-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1809779

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Dysarthria resulting from lithium carbonate. A case report. Author(s): Solomon K, Vickers R. Source: Jama : the Journal of the American Medical Association. 1975 January 20; 231(3): 280. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1172735

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Dysarthria, progressive parkinsonian features and symmetric necrosis of putamen in a family with painful lipomas (Dercum disease variant). Author(s): Kyllerman M, Brandberg G, Wiklund LM, Mansson JE. Source: Neuropediatrics. 2002 April; 33(2): 69-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12075486

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Dysarthria. Author(s): Espir ML, Rose FC. Source: Br J Hosp Med. 1982 March; 27(3): 269, 273-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7074263

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Dysarthria: an unusual side effect of tricyclic antidepressants. Author(s): Quader SE. Source: British Medical Journal. 1977 July 9; 2(6079): 97. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=871810

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Dysarthria: lonely symptom of tardive dystonia. Author(s): Ananth J, Swartz R, Chung C, Gadasally R. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 1997 May; 42(4): 428-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9161771

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Dysarthria--clumsy hand syndrome and cerebellar hemorrhage. Author(s): Roy EP 3rd, Keefover RW, Riggs JE, Marano GD. Source: Annals of Neurology. 1987 April; 21(4): 415-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3579229

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Dysarthria-clumsy hand syndrome due to infarction of the cerebral peduncle. Author(s): Urban PP, Hopf HC, Visbeck A, Fleischer S, Andreas J. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1996 February; 60(2): 2312. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8708665

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Dysarthria--clumsy hand syndrome or homolateral ataxia and crural paresis? Author(s): De Smet Y. Source: Annals of Neurology. 1991 May; 29(5): 574-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1859189

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Dysarthria--clumsy hand syndrome produced by capsular infarct. Author(s): Spertell RB, Ransom BR. Source: Annals of Neurology. 1979 September; 6(3): 263-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=534426

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Dysphagia and dysarthria as a result of cocaine abuse. Author(s): DeVore RA, Tucker HM. Source: Otolaryngology and Head and Neck Surgery. 1988 February; 98(2): 174-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3128761

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Dysphagia, dysarthria and falls in an elderly man. Author(s): McGleenon B, Steele IC, Passmore AP. Source: Postgraduate Medical Journal. 1997 June; 73(860): 321-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9246324

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Dysphasia, dyspraxia, and dysarthria: distinguishing features, Part I. Author(s): Boss BJ. Source: J Neurosurg Nurs. 1984 June; 16(3): 151-60. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6564142

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Dysphasia, dyspraxia, and dysarthria: distinguishing features, Part II. Author(s): Boss BJ. Source: J Neurosurg Nurs. 1984 August; 16(4): 211-6. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6565751

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Effect of bilateral stimulation of the subthalamic nucleus on parkinsonian dysarthria. Author(s): Gentil M, Pinto S, Pollak P, Benabid AL. Source: Brain and Language. 2003 May; 85(2): 190-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12735936

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Effect of speaking rate manipulations on acoustic and perceptual aspects of the dysarthria in amyotrophic lateral sclerosis. Author(s): Weismer G, Laures JS, Jeng JY, Kent RD, Kent JF. Source: Folia Phoniatrica Et Logopaedica : Official Organ of the International Association of Logopedics and Phoniatrics (Ialp). 2000 September-October; 52(5): 201-19. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10965174

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Effect of speech task on intelligibility in dysarthria: a case study of Parkinson's disease. Author(s): Kempler D, Van Lancker D. Source: Brain and Language. 2002 March; 80(3): 449-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11896652

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Effects of cerebellar lesions on monkey jaw-force control: implications for understanding ataxic dysarthria. Author(s): Larson CR, Sutton D. Source: Journal of Speech and Hearing Research. 1978 June; 21(2): 309-23. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=100657

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Effects of penicillamine therapy and low-copper diet on dysarthria in Wilson's disease (hepatolenticular degeneration). Author(s): Berry WR, Aronson AE, Darley FL, Goldstein NP. Source: Mayo Clinic Proceedings. 1974 June; 49(6): 405-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4835812

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Effects of subthalamic nucleus stimulation on parkinsonian dysarthria and speech intelligibility. Author(s): Rousseaux M, Krystkowiak P, Kozlowski O, Ozsancak C, Blond S, Destee A. Source: Journal of Neurology. 2004 March; 251(3): 327-34. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=15015014

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Effects of temporal alterations on speech intelligibility in parkinsonian dysarthria. Author(s): Hammen VL, Yorkston KM, Minifie FD. Source: Journal of Speech and Hearing Research. 1994 April; 37(2): 244-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8028306

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Electromyographic studies of the function of the facial muscles in dysarthria. Author(s): Leanderson R, Persson A, Ohman S. Source: Acta Otolaryngol Suppl. 1969; 263: 89-94. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5269066

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EMA analysis of tongue function in children with dysarthria following traumatic brain injury. Author(s): Murdoch BE, Goozee JV. Source: Brain Injury : [bi]. 2003 January; 17(1): 79-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12519650

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Evaluation of velopharyngeal function in dysarthria. Author(s): Netsell R. Source: J Speech Hear Disord. 1969 May; 34(2): 113-22. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5782399

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Extensive brain calcification and progressive dysarthria and dysphagia associated with chronic hypoparathyroidism. Author(s): Cheek JC, Riggs JE, Lilly RL. Source: Archives of Neurology. 1990 September; 47(9): 1038-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2396932

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Functional outcome assessment in dysarthria. Author(s): Hustad KC, Beukelman DR, Yorkston KM. Source: Seminars in Speech and Language. 1998; 19(3): 291-302. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9720133

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Heredofamilial syndrome of spastic paraplegia, dysarthria and cutaneous lesions in ive siblings. Author(s): Bahemuka M, Brown JD. Source: Developmental Medicine and Child Neurology. 1982 August; 24(4): 519-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7117711

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Hyperkinetic dysarthria as an early indicator of impending tardive dyskinesia. Author(s): Portnoy RA. Source: J Speech Hear Disord. 1979 May; 44(2): 214-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=502488

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Hypothalamic mass in a 28-year-old man with diabetes insipidus ataxia, nystagmus and dysarthria. Author(s): Iwaki T. Source: Neuropathology : Official Journal of the Japanese Society of Neuropathology. 2001 March; 21(1): 99-100. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11304050

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Identical twins with mental retardation, dysarthria, progressive spastic paraplegia, and brachydactyly type E: a new syndrome or variant of Fitzsimmons-Guilbert syndrome? Author(s): Lacassie Y, Arriaza MI, Duncan MC, Dijamco C, McElveen C, Stahls PF 3rd. Source: American Journal of Medical Genetics. 1999 May 21; 84(2): 90-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10323731

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Identification of dysarthria types based on perceptual analysis. Author(s): Zyski BJ, Weisiger BE. Source: Journal of Communication Disorders. 1987 October; 20(5): 367-78. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3655012

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Image on progressive dysarthria. Author(s): O'Shanick GJ. Source: The American Journal of Psychiatry. 1997 April; 154(4): 584-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9090361

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Images in neuroscience. Progressive dysarthria: structural and brain correlations. Author(s): Selnes OA, Holcomb HH, Gordon B. Source: The American Journal of Psychiatry. 1996 March; 153(3): 309-10. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8610816

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Impaired cortico-bulbar tract function in dysarthria due to hemispheric stroke. Functional testing using transcranial magnetic stimulation. Author(s): Urban PP, Hopf HC, Fleischer S, Zorowka PG, Muller-Forell W. Source: Brain; a Journal of Neurology. 1997 June; 120 ( Pt 6): 1077-84. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9217690

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Implementing speech supplementation strategies: effects on intelligibility and speech rate of individuals with chronic severe dysarthria. Author(s): Hustad KC, Jones T, Dailey S. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2003 April; 46(2): 462-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14700386

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Influence of verbal and nonverbal contexts on the sentence intelligibility of a speaker with dysarthria. Author(s): Garcia JM, Cannito MP. Source: Journal of Speech and Hearing Research. 1996 August; 39(4): 750-60. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8844555

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In-hospital patients with aphasia, dysarthria deserve our attention. Author(s): Del Torro JF. Source: Asha. 1996 Spring; 38(2): 4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8857459

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Intelligibility in acquired dysarthria--a neuro-phonetic approach: three case studies. Author(s): Grunwell P, Huskins S. Source: Journal of Communication Disorders. 1979 February; 12(1): 9-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=422750

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Interarticulator coordination in dysarthria: an X-ray microbeam study. Author(s): Weismer G, Yunusova Y, Westbury JR. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2003 October; 46(5): 1247-61. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14575356

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Interlabial contact pressures exhibited in dysarthria following traumatic brain injury during speech and nonspeech tasks. Author(s): Goozee JV, Murdoch BE, Theodoros DG. Source: Folia Phoniatrica Et Logopaedica : Official Organ of the International Association of Logopedics and Phoniatrics (Ialp). 2002 July-August; 54(4): 177-89. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12169804

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Is 20 years too long?: improving intelligibility in long-standing dysarthria--a single case treatment study. Author(s): Keatley A, Wirz S. Source: Eur J Disord Commun. 1994; 29(2): 183-201. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7865922

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Isolated cerebellar dysarthria associated with a heat stroke. Author(s): Manto MU. Source: Clinical Neurology and Neurosurgery. 1996 February; 98(1): 55-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8681482

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Isolated dysarthria caused by a right paravermal infarction. Author(s): Gironell A, Arboix A, Marti-Vilalta JL. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1996 August; 61(2): 205-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8708696

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Isolated dysarthria due to extracerebellar lacunar stroke: a central monoparesis of the tongue. Author(s): Urban PP, Wicht S, Hopf HC, Fleischer S, Nickel O. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1999 April; 66(4): 495-501. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10201423

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Isolated dysarthria. Author(s): Okuda B, Tachibana H. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 2000 January; 68(1): 11920. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10671133

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Isolated dysarthria. Author(s): Arboix A, Massons J, Oliveres M, Titus F. Source: Stroke; a Journal of Cerebral Circulation. 1991 April; 22(4): 531. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2024284

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Kinematic analysis of lower lip movements in ataxic dysarthria. Author(s): Ackermann H, Hertrich I, Scharf G. Source: Journal of Speech and Hearing Research. 1995 December; 38(6): 1252-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8747818

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Kinematic analysis of tongue movements in dysarthria following traumatic brain injury using electromagnetic articulography. Author(s): Goozee JV, Murdoch BE, Theodoros DG, Stokes PD. Source: Brain Injury : [bi]. 2000 February; 14(2): 153-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10695571

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Lacunar infarctions and dysarthria. Author(s): Arboix A, Marti-Vilalta JL. Source: Archives of Neurology. 1990 February; 47(2): 127. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2302081

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Lexical boundary error analysis in hypokinetic and ataxic dysarthria. Author(s): Liss JM, Spitzer SM, Caviness JN, Adler C, Edwards BW. Source: The Journal of the Acoustical Society of America. 2000 June; 107(6): 3415-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10875386

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Lip function in subjects with upper motor neuron type dysarthria following cerebrovascular accidents. Author(s): Thompson EC, Murdoch BE, Stokes PD. Source: Eur J Disord Commun. 1995; 30(4): 451-66. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8634499

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Lip muscle function in Parkinsonian Dysarthria. Author(s): Leanderson R, Meyerson BA, Persson A. Source: Acta Oto-Laryngologica. 1972 November; 74(5): 350-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4565338

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Lognormal distribution of pause length in ataxic dysarthria. Author(s): Rosen KM, Kent RD, Duffy JR. Source: Clinical Linguistics & Phonetics. 2003 September; 17(6): 469-86. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14564832

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Long-term recovery patterns of severe dysarthria following head injury. Author(s): Enderby P, Crow E. Source: Br J Disord Commun. 1990 December; 25(3): 341-54. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2151367

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Management of velopharyngeal incompetence in dysarthria: a historical review. Author(s): Dworkin JP, Johns DF. Source: Clinical Otolaryngology and Allied Sciences. 1980 February; 5(1): 61-74. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7363492

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Maximum performance tests in children with developmental spastic dysarthria. Author(s): Wit J, Maassen B, Gabreels FJ, Thoonen G. Source: Journal of Speech and Hearing Research. 1993 June; 36(3): 452-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8331902

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Metoclopramide-induced dysarthria. Author(s): Sandyk R. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1983 October 29; 64(19): 732. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6623283

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Micrographia due to focal cerebral lesions as seen in the dysarthria-clumsy hand syndrome. Author(s): Noda S, Itoh H, Goda S. Source: Neurology. 1994 January; 44(1): 150-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8290051

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Modification of articulation in dysarthria. Author(s): Ince LP, Rosenberg DN. Source: Archives of Physical Medicine and Rehabilitation. 1973 May; 54(5): 233-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4701406

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Modification of lip hypertonia in dysarthria using EMG feedback. Author(s): Netsell R, Cleeland CS. Source: J Speech Hear Disord. 1973 February; 38(1): 131-40. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4698381

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Mutism and cerebellar dysarthria after brain stem surgery: case report. Author(s): Frim DM, Ogilvy CS. Source: Neurosurgery. 1995 April; 36(4): 854-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7596521

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Mutism, oropharyngeal apraxia and dysarthria after posterior fossa tumour excision. Author(s): Bhatoe HS. Source: British Journal of Neurosurgery. 1997 August; 11(4): 341-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9337934

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Nerve deafness, dysarthria and ataxia in chronic granulocytic leukaemia--a case report. Author(s): Kanyike FB, Kigonya RM. Source: East Afr Med J. 1982 June; 59(6): 420-4. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6959801

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Neuropathologic correlates of dysarthria in progressive supranuclear palsy. Author(s): Jellinger K. Source: Archives of Neurology. 2001 September; 58(9): 1499-500. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11559331

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Neuropathological correlates of dysarthria in progressive supranuclear palsy. Author(s): Kluin K, Gilman S, Foster N, Sima A, D'Amato C, Bruch L, Bluemlein L, Little R, Johanns J. Source: Archives of Neurology. 2001 February; 58(2): 265-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11176965

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Nonsurgical treatment of drooling in a patient with closed head injury and severe dysarthria. Author(s): Dworkin JP, Nadal JC. Source: Dysphagia. 1991; 6(1): 40-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1884637

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Palato-pharyngo-laryngeal myoclonus: an unusual cause of dysphagia and dysarthria. Author(s): Drysdale AJ, Ansell J, Adeley J. Source: The Journal of Laryngology and Otology. 1993 August; 107(8): 746-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8409734

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Paravermal infarct and isolated cerebellar dysarthria. Author(s): Amarenco P, Chevrie-Muller C, Roullet E, Bousser MG. Source: Annals of Neurology. 1991 August; 30(2): 211-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1897913

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Parkinsonian dysarthria: an aerodynamic and perceptual description of velopharyngeal closure for speech. Author(s): Hoodin RB, Gilbert HR. Source: Folia Phoniatr (Basel). 1989; 41(6): 249-58. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2599488

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Paroxysmal ataxic dysarthria. Author(s): Netsell R, Kent RD. Source: J Speech Hear Disord. 1976 February; 41(1): 93-109. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1256044

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Paroxysmal dysarthria and ataxia in a patient with Behcet's disease. Author(s): Akman-Demir FG, Eraksoy M, Gurvit IH, Saruhan-Direskeneli G, Aral O. Source: Journal of Neurology. 1995 May; 242(5): 344-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7643145

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Paroxysmal dysarthria and ataxia: associated MRI abnormality. Author(s): Gorard DA, Gibberd FB. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1989 December; 52(12): 1444-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2614451

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Paroxysmal dysarthria and other transient neurological disturbances in disseminated sclerosis. Author(s): Espir ML, Watkins SM, Smith HV. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1966 August; 29(4): 323-30. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5969089

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Paroxysmal dysarthria and Raynaud's phenomenon in the tongue. Author(s): Nielsen HV, Kristensen JK, Klemp P, Staberg B, Thomsen K. Source: Acta Med Scand. 1984; 216(4): 431-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6516913

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Pathophysiology of dysarthria in cerebral palsy. Author(s): Neilson PD, O'Dwyer NJ. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1981 November; 44(11): 1013-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7334387

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Pathophysiology of motor speech disorders (dysarthria). Author(s): Hirose H. Source: Folia Phoniatr (Basel). 1986; 38(2-4): 61-88. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3527898

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Perceptual characteristics of Cantonese hypokinetic dysarthria. Author(s): Whitehill TL, Ma JK, Lee AS. Source: Clinical Linguistics & Phonetics. 2003 June-August; 17(4-5): 265-71. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12945601

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Perceptual-phonetic predictors of single-word intelligibility: a study of Cantonese dysarthria. Author(s): Whitehill TL, Ciocca V. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2000 December; 43(6): 1451-65. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11193965

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Persistent dysarthria with apraxia associated with a combination of lithium carbonate and haloperidol. Author(s): Bond WS, Carvalho M, Foulks EF. Source: The Journal of Clinical Psychiatry. 1982 June; 43(6): 256-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6806252

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Phonemic behavior of aphasic subjects without dysarthria or apraxia of speech. Author(s): Halpern H, Keith RL, Darley FL. Source: Cortex. 1976 December; 12(4): 365-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1009773

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Physiologic deficits in the orofacial system underlying dysarthria in amyotrophic lateral sclerosis. Author(s): Langmore SE, Lehman ME. Source: Journal of Speech and Hearing Research. 1994 February; 37(1): 28-37. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8170127

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Physiological and perceptual features of dysarthria in Moebius syndrome: directions for treatment. Author(s): Murdoch BE, Johnson SM, Theodoros DG. Source: Pediatric Rehabilitation. 1997 April-June; 1(2): 83-97. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9689243

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Physiological assessment of tongue function in dysarthria following traumatic brain injury. Author(s): Goozee JV, Murdoch BE, Theodoros DG. Source: Logopedics, Phoniatrics, Vocology. 2001; 26(2): 51-65. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11769343

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Pontine infarction producing dysarthria-clumsy hand syndrome and ataxic hemiparesis. Author(s): Koppel BS, Weinberger G. Source: European Neurology. 1987; 26(4): 211-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3595659

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Prevalence and characteristics of dysarthria in a multiple-sclerosis incidence cohort: relation to neurological data. Author(s): Hartelius L, Runmarker B, Andersen O. Source: Folia Phoniatrica Et Logopaedica : Official Organ of the International Association of Logopedics and Phoniatrics (Ialp). 2000 July-August; 52(4): 160-77. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10782009

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Primary pontine hemorrhage and the dysarthria-clumsy hand syndrome. Author(s): Tuhrim S, Yang WC, Rubinowitz H, Weinberger J. Source: Neurology. 1982 September; 32(9): 1027-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7202151

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Progression of dysarthria and dysphagia in postmortem-confirmed parkinsonian disorders. Author(s): Muller J, Wenning GK, Verny M, McKee A, Chaudhuri KR, Jellinger K, Poewe W, Litvan I. Source: Archives of Neurology. 2001 February; 58(2): 259-64. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11176964

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Progressive dysarthria. Case reports and a review of the literature. Author(s): Santens P, Van Borsel J, Foncke E, Meire V, Merkx H, De Bleecker J, De Reuck J. Source: Dementia and Geriatric Cognitive Disorders. 1999 May-June; 10(3): 231-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10325452

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Progressive dysarthria: definition and clinical follow-up. Author(s): Soliveri P, Piacentini S, Carella F, Testa D, Ciano C, Girotti F. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2003 October; 24(3): 211-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14598092

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Prosodic control in severe dysarthria: preserved ability to mark the questionstatement contrast. Author(s): Patel R. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2002 October; 45(5): 858-70. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12381044

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Prosodic deviation in dysarthria: a case study. Author(s): Vance JE. Source: Eur J Disord Commun. 1994; 29(1): 61-76. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8032107

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Prosthetic management and speech improvement in individuals with dysarthria of the palate. Author(s): Schweiger JW, Netsell R, Sommerfeld RM. Source: The Journal of the American Dental Association. 1970 June; 80(6): 1348-53. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=4909459

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Pure dysarthria due to anterior internal capsule and/or corona radiata infarction: a report of five cases. Author(s): Ozaki I, Baba M, Narita S, Matsunaga M, Takebe K. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1986 December; 49(12): 1435-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3806121

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Pure dysarthria due to small cortical stroke. Author(s): Kim JS, Kwon SU, Lee TG. Source: Neurology. 2003 April 8; 60(7): 1178-80. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12682329

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Pure dysarthria, isolated facial paresis, or dysarthria-facial paresis syndrome. Author(s): Kim JS. Source: Stroke; a Journal of Cerebral Circulation. 1994 October; 25(10): 1994-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8091443

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Putaminal hemorrhage presenting as dysarthria-clumsy hand syndrome. Author(s): Fisher M. Source: Bull Clin Neurosci. 1984; 49: 1-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6546036

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Quantitative description of the dysarthria in women with amyotrophic lateral sclerosis. Author(s): Kent JF, Kent RD, Rosenbek JC, Weismer G, Martin R, Sufit R, Brooks BR. Source: Journal of Speech and Hearing Research. 1992 August; 35(4): 723-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1405527

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Reproducibility and variability of speech muscle activity in athetoid dysarthria of cerebral palsy. Author(s): Neilson PD, O'Dwyer NJ. Source: Journal of Speech and Hearing Research. 1984 December; 27(4): 502-17. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6521456

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Resolution of dysarthria in multiple sclerosis by treatment with weak electromagnetic fields. Author(s): Sandyk R. Source: The International Journal of Neuroscience. 1995 November; 83(1-2): 81-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8746751

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Respiratory dyskinesia and dysarthria from prolonged neuroleptic use: tardive dyskinesia? Author(s): Faheem AD, Brightwell DR, Burton GC, Struss A. Source: The American Journal of Psychiatry. 1982 April; 139(4): 517-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6121492

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Severe dysarthria with right hemisphere stroke. Author(s): Ropper AH. Source: Neurology. 1987 June; 37(6): 1061-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3587630

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Slowly progressive isolated dysarthria: longitudinal course, speech features, and neuropsychological deficits. Author(s): de Koning I, van Doorn PA, van Dongen HR. Source: Journal of Neurology. 1997 October; 244(10): 664-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9402545

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Sonagraphic and auditory analysis of dysarthria in a case of Steele-OlzewskiRichardson syndrome. Author(s): Arnott G, Lhote-Munier E, Vanecloo F, Milbled G. Source: Folia Phoniatr (Basel). 1975; 27(06): 443-56. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1232049

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Spastic dysarthria after acquired brain injury: an acoustic study. Author(s): Ziegler W, von Cramon D. Source: Br J Disord Commun. 1986 August; 21(2): 173-87. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3828204

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Spastic paraplegia, dysarthria, brachydactyly, and cone shaped epiphyses: confirmation of the Fitzsimmons syndrome. Author(s): Hennekam RC. Source: Journal of Medical Genetics. 1994 March; 31(3): 251-2. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8014978

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Spastic quadriparesis, dysarthria, and dysphagia following cervical hyperextension: a traumatic pontomedullary syndrome. Author(s): Riggs JE, Schochet SS Jr. Source: Military Medicine. 1995 February; 160(2): 94-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7783927

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Speech and language therapy for dysarthria due to non-progressive brain damage. Author(s): Sellars C, Hughes T, Langhorne P. Source: Cochrane Database Syst Rev. 2002; (4): Cd002088. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12519567

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Speech and language therapy for dysarthria due to non-progressive brain damage. Author(s): Sellars C, Hughes T, Langhorne P. Source: Cochrane Database Syst Rev. 2001; (2): Cd002088. Review. Update In: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11406032

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Speech and language therapy for dysarthria due to nonprogressive brain damage: a systematic Cochrane review. Author(s): Sellars C, Hughes T, Langhorne P. Source: Clinical Rehabilitation. 2002 February; 16(1): 61-8. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11837527

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Speech and language therapy for dysarthria in Parkinson's disease. Author(s): Deane KH, Whurr R, Playford ED, Ben-Shlomo Y, Clarke CE. Source: Cochrane Database Syst Rev. 2001; (2): Cd002812. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11406044

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Speech and pause characteristics following speech rate reduction in hypokinetic dysarthria. Author(s): Hammen VL, Yorkston KM. Source: Journal of Communication Disorders. 1996 November-December; 29(6): 429-44; Quiz 444-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8956101

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Speech prosthesis retention problems in dysarthria: case report. Author(s): Brand HA, Matsko TA, Avart HN. Source: Archives of Physical Medicine and Rehabilitation. 1988 March; 69(3 Pt 1): 213-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3348723

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Speech rate and rhythm in cerebellar dysarthria: an acoustic analysis of syllabic timing. Author(s): Ackermann H, Hertrich I. Source: Folia Phoniatrica Et Logopaedica : Official Organ of the International Association of Logopedics and Phoniatrics (Ialp). 1994; 46(2): 70-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8173615

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Speech recognition and dysarthria: a single subject study of two individuals with profound impairment of speech and motor control. Author(s): Havstam C, Buchholz M, Hartelius L. Source: Logopedics, Phoniatrics, Vocology. 2003; 28(2): 81-90. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14582831

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Stroke with dysarthria: evaluate and treat; garden variety or down the garden path? Author(s): Duffy JR. Source: Seminars in Speech and Language. 1998; 19(1): 93-8; Quiz 99. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9519396

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Subthalamic nucleus stimulation and dysarthria in Parkinson's disease: a PET study. Author(s): Pinto S, Thobois S, Costes N, Le Bars D, Benabid AL, Broussolle E, Pollak P, Gentil M. Source: Brain; a Journal of Neurology. 2004 March; 127(Pt 3): 602-15. Epub 2004 January 21. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14736753

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Syllabic timing in dysarthria. Author(s): Ziegler W, Hartmann E, Hoole P. Source: Journal of Speech and Hearing Research. 1993 August; 36(4): 683-93. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8377481

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Symptomatic differences in decreased alternating motion rates between individuals with spastic and with ataxic dysarthria: an acoustic analysis. Author(s): Ozawa Y, Shiromoto O, Ishizaki F, Watamori T. Source: Folia Phoniatrica Et Logopaedica : Official Organ of the International Association of Logopedics and Phoniatrics (Ialp). 2001 March-April; 53(2): 67-72. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11244280

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Task-related factors in oral motor control: speech and oral diadochokinesis in dysarthria and apraxia of speech. Author(s): Ziegler W. Source: Brain and Language. 2002 March; 80(3): 556-75. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11896657

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Temporal acoustic measures of dysarthria associated with amyotrophic lateral sclerosis. Author(s): Caruso AJ, Burton EK. Source: Journal of Speech and Hearing Research. 1987 March; 30(1): 80-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3560901

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Temporal and spectral aspects of coarticulation in ataxic dysarthria: an acoustic analysis. Author(s): Hertrich I, Ackermann H. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 1999 April; 42(2): 367-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10229453

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Temporal speech characteristics of individuals with multiple sclerosis and ataxic dysarthria: 'scanning speech' revisited. Author(s): Hartelius L, Runmarker B, Andersen O, Nord L. Source: Folia Phoniatrica Et Logopaedica : Official Organ of the International Association of Logopedics and Phoniatrics (Ialp). 2000 September-October; 52(5): 228-38. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10965176

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The analysis of acquired dysarthria in childhood. Author(s): Bak E, van Dongen HR, Arts WF. Source: Developmental Medicine and Child Neurology. 1983 February; 25(1): 81-87. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6832501

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The behavioral consequences of a communication intervention on institutionalized residents with aphasia and dysarthria. Author(s): Buckwalter KC, Cusack D, Beaver M, Sidles E, Wadle K. Source: Archives of Psychiatric Nursing. 1988 October; 2(5): 289-95. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2465742

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The dysarthria-clumsy hand syndrome: a distinct clinical entity related to pontine infarction. Author(s): Glass JD, Levey AI, Rothstein JD. Source: Annals of Neurology. 1990 May; 27(5): 487-94. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2360789

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The dysarthria-clumsy hand syndrome: ataxic or bradykinetic hand? Author(s): Grandas F, Villanueva JA, Mateo D, Gimenez-Roldan S. Source: Annals of Neurology. 1991 September; 30(3): 430-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1952833

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The effect of botulinum toxin A on the vocal symptoms of spastic dysarthria: a case study. Author(s): McHenry M, Whatman J, Pou A. Source: Journal of Voice : Official Journal of the Voice Foundation. 2002 March; 16(1): 124-31. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12002879

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The effect of pacing strategies on the variability of speech movement sequences in dysarthria. Author(s): McHenry MA. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2003 June; 46(3): 70210. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14696996

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The effects of familiarization on intelligibility and lexical segmentation in hypokinetic and ataxic dysarthria. Author(s): Liss JM, Spitzer SM, Caviness JN, Adler C. Source: The Journal of the Acoustical Society of America. 2002 December; 112(6): 302230. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12509024

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The effects of speech and language therapy for a case of dysarthria associated with Parkinson's disease. Author(s): Le Dorze G, Dionne L, Ryalls J, Julien M, Ouellet L. Source: Eur J Disord Commun. 1992; 27(4): 313-24. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1308695

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The efficacy of oro-facial and articulation exercises in dysarthria following stroke. Author(s): Robertson S. Source: International Journal of Language & Communication Disorders / Royal College of Speech & Language Therapists. 2001; 36 Suppl: 292-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11340799

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The influence of speaking rate on articulatory hypokinesia in parkinsonian dysarthria. Author(s): Caligiuri MP. Source: Brain and Language. 1989 April; 36(3): 493-502. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2706450

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The relationship between perception and acoustics for a high-low vowel contrast produced by speakers with dysarthria. Author(s): Bunton K, Weismer G. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2001 December; 44(6): 1215-28. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11776360

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The side and somatotopical location of single small infarcts in the corona radiata and pontine base in relation to contralateral limb paresis and dysarthria. Author(s): Tohgi H, Takahashi S, Takahashi H, Tamura K, Yonezawa H. Source: European Neurology. 1996; 36(6): 338-42. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8954300

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The syndrome of 'cerebellar' mutism and subsequent dysarthria. Author(s): van Dongen HR, Catsman-Berrevoets CE, van Mourik M. Source: Neurology. 1994 November; 44(11): 2040-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7969956

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The use of the Mayo Clinic system for differential diagnosis of dysarthria. Author(s): Simmons KC, Mayo R. Source: Journal of Communication Disorders. 1997 March-April; 30(2): 117-31; Quiz 1312. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9100127

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Toward phonetic intelligibility testing in dysarthria. Author(s): Kent RD, Weismer G, Kent JF, Rosenbek JC. Source: J Speech Hear Disord. 1989 November; 54(4): 482-99. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2811329

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Transient loss of speech followed by dysarthria after removal of posterior fossa tumour. Author(s): Catsman-Berrevoets CE, van Dongen HR, Zwetsloot CP. Source: Developmental Medicine and Child Neurology. 1992 December; 34(12): 1102-9. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1451941

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Transient muteness followed by dysarthria in patients with pontomesencephalic stroke. Report of two cases. Author(s): Orefice G, Fragassi NA, Lanzillo R, Castellano A, Grossi D. Source: Cerebrovascular Diseases (Basel, Switzerland). 1999 March-April; 9(2): 124-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9973657

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Traumatic versus perinatally acquired dysarthria: assessment by means of speech-like maximum performance tasks. Author(s): Wit J, Maassen B, Gabreels F, Thoonen G, de Swart B. Source: Developmental Medicine and Child Neurology. 1994 March; 36(3): 221-9. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8138071

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Treatment efficacy: dysarthria. Author(s): Yorkston KM. Source: Journal of Speech and Hearing Research. 1996 October; 39(5): S46-57. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8898266

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Treatment issues in severe dysarthria: comments on Simpson, Till & Goff. Author(s): Frumkin JR, Cohen CG. Source: J Speech Hear Disord. 1990 May; 55(2): 364-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2139483

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Treatment of dysarthria: a case report. Author(s): Hartman DE, Day M, Pecora R. Source: Journal of Communication Disorders. 1979 April; 12(2): 167-73. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=429607

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Treatment of non fluent speech resulting from neurological disease--treatment of dysarthria. Author(s): Allan CM. Source: Br J Disord Commun. 1970 April; 5(1): 3-5. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=5504026

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Tremor of tongue and dysarthria as the sole manifestation of Wilson's disease. Author(s): Topaloglu H, Gucuyener K, Orkun C, Renda Y. Source: Clinical Neurology and Neurosurgery. 1990; 92(3): 295-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2171843

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Tumour type and size are high risk factors for the syndrome of "cerebellar" mutism and subsequent dysarthria. Author(s): Catsman-Berrevoets CE, Van Dongen HR, Mulder PG, Paz y Geuze D, Paquier PF, Lequin MH. Source: Journal of Neurology, Neurosurgery, and Psychiatry. 1999 December; 67(6): 7557. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10567492

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Unusual cause of dysarthria in a patient with cerebrovascular disease. Author(s): Coulter CL, Kaneshige AM, Wyatt WM. Source: Archives of Neurology. 1997 May; 54(5): 515-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9152104

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Use of palatal lift and palatal augmentation prostheses to improve dysarthria in patients with amyotrophic lateral sclerosis: a case series. Author(s): Esposito SJ, Mitsumoto H, Shanks M. Source: The Journal of Prosthetic Dentistry. 2000 January; 83(1): 90-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10633027

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Variability in the perceptual and physiological features of dysarthria following severe closed head injury: an examination of five cases. Author(s): Theodoros DG, Murdoch BE, Stokes PD. Source: Brain Injury : [bi]. 1995 October; 9(7): 671-96. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8680396

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Variability in upper motor neurone-type dysarthria: an examination of five cases with dysarthria following cerebrovascular accident. Author(s): Thompson EC, Murdoch BE, Theodoros DG. Source: Eur J Disord Commun. 1997; 32(4): 397-427. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9519116

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Vertex evoked potentials to tonal, verbal and white noise stimuli in children with developmental dysphasia and dysarthria. Author(s): Novak A. Source: Folia Phoniatr (Basel). 1991; 43(5): 215-9. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1725517

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Vocal tract steadiness: a measure of phonatory and upper airway motor control during phonation in dysarthria. Author(s): Zwirner P, Barnes GJ. Source: Journal of Speech and Hearing Research. 1992 August; 35(4): 761-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1405531

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Voice dysfunction in dysarthria: application of the Multi-Dimensional Voice Program. Author(s): Kent RD, Vorperian HK, Kent JF, Duffy JR. Source: Journal of Communication Disorders. 2003 July-August; 36(4): 281-306. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12837587

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Voice onset time in ataxic dysarthria. Author(s): Ackermann H, Hertrich I. Source: Brain and Language. 1997 February 15; 56(3): 321-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9070415

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Voice tremor and dysarthria. Author(s): Metter EJ. Source: Neurology. 1987 September; 37(9): 1570-1. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3627470

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VOT and dysarthria: a descriptive study. Author(s): Morris RJ. Source: Journal of Communication Disorders. 1989 February; 22(1): 23-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2715378

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Vowel distortion in traumatic dysarthria: a formant study. Author(s): Ziegler W, von Cramon D. Source: Phonetica. 1983; 40(1): 63-78. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6844418

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Vowel distortion in traumatic dysarthria: lip rounding versus tongue advancement. Author(s): Ziegler W, von Cramon D. Source: Phonetica. 1983; 40(4): 312-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6657760

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CHAPTER 2. NUTRITION AND DYSARTHRIA Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and dysarthria.

Finding Nutrition Studies on Dysarthria The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “dysarthria” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “dysarthria” (or a synonym): •

The case of the lawyer's lugubrious language: dysarthria plus primary progressive aphasia or dysarthria plus dementia? Author(s): Department of Communication Science and Disorders, University of Pittsburgh, PA 15260, USA. Source: McNeil, M R Semin-Speech-Lang. 1998; 19(1): 49-57; quiz 57-8 0734-0478

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

Nutrition

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WebMDHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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CHAPTER 3. ALTERNATIVE MEDICINE AND DYSARTHRIA Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to dysarthria. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to dysarthria and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “dysarthria” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to dysarthria: •

A case of adrenocortical carcinoma associated with recurrence after laparoscopic surgery. Author(s): Iino K, Oki Y, Sasano H. Source: Clinical Endocrinology. 2000 August; 53(2): 243-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10931107

•

A microcomputer-based wearable biofeedback device to improve transfer of treatment in parkinsonian dysarthria. Author(s): Rubow R, Swift E. Source: J Speech Hear Disord. 1985 May; 50(2): 178-85. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=3990263

•

Abnormal uptake of technetium-99m hexakis-2-methoxyisobutylisonitrile in a primary cardiac lymphoma.

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Author(s): Medolago G, Virotta G, Piti A, Tespili M, D'Adda F, Rottoli MR, Comotti B, Motta T, Orlandi C, Bertocchi C. Source: European Journal of Nuclear Medicine. 1992; 19(3): 222-5. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=1533370 •

Acquired epileptiform opercular syndrome: a second case report, review of the literature, and comparison to the Landau-Kleffner syndrome. Author(s): Shafrir Y, Prensky AL. Source: Epilepsia. 1995 October; 36(10): 1050-7. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7555956

•

Acute cerebellar syndrome following intermediate-dose cytarabine. Author(s): Yeshurun M, Marsot Dupuch K. Source: British Journal of Haematology. 2001 June; 113(4): 846. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11442472

•

Acute deterioration of Charcot-Marie-Tooth disease IA (CMT IA) following 2 mg of vincristine chemotherapy. Author(s): Hildebrandt G, Holler E, Woenkhaus M, Quarch G, Reichle A, Schalke B, Andreesen R. Source: Annals of Oncology : Official Journal of the European Society for Medical Oncology / Esmo. 2000 June; 11(6): 743-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10942065

•

Auditory rhythmicity enhances movement and speech motor control in patients with Parkinson's disease. Author(s): Thaut MH, McIntosh KW, McIntosh GC, Hoemberg V. Source: Funct Neurol. 2001 April-June; 16(2): 163-72. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11495422

•

Bilateral contemporaneous posteroventral pallidotomy for the treatment of Parkinson's disease: neuropsychological and neurological side effects. Report of four cases and review of the literature. Author(s): Ghika J, Ghika-Schmid F, Fankhauser H, Assal G, Vingerhoets F, Albanese A, Bogousslavsky J, Favre J. Source: Journal of Neurosurgery. 1999 August; 91(2): 313-21. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10433321

•

Cerebellar ataxia. Author(s): Perlman SL. Source: Current Treatment Options in Neurology. 2000 May; 2(3): 215-224. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11096749

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•

Chiropractic complications. Another case report. Author(s): Soragna D, Montalbetti L, Bo P, Sibilla L, Savoldi F. Source: Acta Neurol (Napoli). 1993 April; 15(2): 145-50. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8328326

•

Dysarthria and oropharyngeal reflexology: a review. Author(s): MYSAK ED. Source: J Speech Hear Disord. 1963 August; 28: 252-60. No Abstract Available. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14048988

•

Dysarthria in adults: physiologic approach to rehabilitation. Author(s): Netsell R, Daniel B. Source: Archives of Physical Medicine and Rehabilitation. 1979 November; 60(11): 502-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=508076

•

EMG biofeedback in the modification of hypertonia in spastic dysarthria: case report. Author(s): Nemec RE, Cohen K. Source: Archives of Physical Medicine and Rehabilitation. 1984 February; 65(2): 103-4. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6696603

•

EMG biofeedback in the treatment of dysarthria. Author(s): Gentil M, Aucouturier JL, Delong V, Sambuis E. Source: Folia Phoniatrica Et Logopaedica : Official Organ of the International Association of Logopedics and Phoniatrics (Ialp). 1994; 46(4): 188-92. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8069360

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EPG treatment of a child with the Worster-Drought syndrome. Author(s): MorganBarry RA. Source: Eur J Disord Commun. 1995; 30(2): 256-63. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7492856

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Frontal lobe contributions to theory of mind. Author(s): Stone VE, Baron-Cohen S, Knight RT. Source: Journal of Cognitive Neuroscience. 1998 September; 10(5): 640-56. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9802997

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Irinotecan-induced dysarthria. Author(s): Baz DV, Bofill JS, Nogueira JA. Source: Journal of the National Cancer Institute. 2001 September 19; 93(18): 1419-20. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11562394

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Isodense cerebellar hematoma. Author(s): Jacome DE. Source: Neurology. 1983 September; 33(9): 1201-3. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6684255

•

Kinematic, acoustic, and perceptual analyses of connected speech produced by parkinsonian and normal geriatric adults. Author(s): Forrest K, Weismer G, Turner GS. Source: The Journal of the Acoustical Society of America. 1989 June; 85(6): 2608-22. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2745883

•

Long-term treatment of severe dysarthria: a case study. Author(s): Simpson MB, Till JA, Goff AM. Source: J Speech Hear Disord. 1988 November; 53(4): 433-40. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=2972886

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Orofacial myofunctional therapy in dysarthria: a study on speech intelligibility. Author(s): Ray J. Source: Int J Orofacial Myology. 2002 November; 28: 39-48. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=12572259

•

Paraneoplastic cerebellar degeneration: a rare presentation of Hodgkin's disease. Author(s): Krishnan K, Bockenstedt P. Source: Clinical and Laboratory Haematology. 1994 December; 16(4): 359-62. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7537642

•

Rapid normalization of visual evoked potentials by picoTesla range magnetic fields in chronic progressive multiple sclerosis. Author(s): Sandyk R. Source: The International Journal of Neuroscience. 1994 August; 77(3-4): 243-59. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7814217

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Raynaud's phenomenon progressing to gangrene after vincristine and bleomycin therapy. Author(s): Elomaa I, Pajunen M, Virkkunen P. Source: Acta Med Scand. 1984; 216(3): 323-6. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6208757

•

Real-time continuous visual biofeedback in the treatment of speech breathing disorders following childhood traumatic brain injury: report of one case. Author(s): Murdoch BE, Pitt G, Theodoros DG, Ward EC.

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Source: Pediatric Rehabilitation. 1999 January-March; 3(1): 5-20. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10367289 •

Reduction of hemifacial spasm and dysarthria following EMG biofeedback. Author(s): Rubow RT, Rosenbek JC, Collins MJ, Celesia GG. Source: J Speech Hear Disord. 1984 February; 49(1): 26-33. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6545665

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Speech rehabilitation in dysarthria. Author(s): Gentil M. Source: Folia Phoniatr (Basel). 1993; 45(1): 31-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=8482572

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Stroke following chiropractic manipulation. Report of 3 cases and review of the literature. Author(s): Jeret JS, Bluth M. Source: Cerebrovascular Diseases (Basel, Switzerland). 2002; 13(3): 210-3. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11914540

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T acute lymphoblastic leukemia in ataxia-telangiectasia. Report of a case characterized by monoclonal antibodies. Author(s): Vitolo U, Marmont F, Ciocca Vasino MA, Falda M, Genetta C, Caligaris Cappio F, Bergui L, Paolino W. Source: Haematologica. 1984 November-December; 69(6): 695-700. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=6441746

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The articulatory loop: study of the subcortical connectivity by electrostimulation. Author(s): Duffau H, Gatignol P, Denvil D, Lopes M, Capelle L. Source: Neuroreport. 2003 October 27; 14(15): 2005-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=14561939

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The case of the lawyer's lugubrious language: dysarthria plus primary progressive aphasia or dysarthria plus dementia? Author(s): McNeil MR. Source: Seminars in Speech and Language. 1998; 19(1): 49-57; Quiz 57-8. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9519392

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The dental prosthesis used for intraoral muscle therapy in the rehabilitation of the stroke patient. A preliminary research study. Author(s): Light J, Edelman SB, Alba A.

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Source: The New York State Dental Journal. 2001 May; 67(5): 22-7. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=11452747 •

Therapeutic efficacy of transcranial magnetic stimulation for hereditary spinocerebellar degeneration. Author(s): Shimizu H, Tsuda T, Shiga Y, Miyazawa K, Onodera Y, Matsuzaki M, Nakashima I, Furukawa K, Aoki M, Kato H, Yamazaki T, Itoyama Y. Source: The Tohoku Journal of Experimental Medicine. 1999 November; 189(3): 203-11. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=10674722

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Transient neurological disturbances induced by the chemotherapy of high-dose methotrexate for osteogenic sarcoma. Author(s): Kiu MC, Liaw CC, Yang TS, Lai GM, Hsi SN, Lu CS. Source: Anti-Cancer Drugs. 1994 August; 5(4): 480-2. Erratum In: Anticancer Drugs 1994 December; 5(6): 676. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=7949255

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Treatment of hypertonicity in muscles of lip retraction. Author(s): Hand CR, Burns MO, Ireland E. Source: Biofeedback Self Regul. 1979 June; 4(2): 171-81. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=476192

•

Vertebral artery dissection. Author(s): Showalter W, Esekogwu V, Newton KI, Henderson SO. Source: Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine. 1997 October; 4(10): 991-5. Review. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=A bstract&list_uids=9332633

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

•

AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

•

Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

•

Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON DYSARTHRIA Overview In this chapter, we will give you a bibliography on recent dissertations relating to dysarthria. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “dysarthria” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on dysarthria, we have not necessarily excluded nonmedical dissertations in this bibliography.

Dissertations on Dysarthria ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to dysarthria. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

A modern approach to dysarthria classification by Castillo Guerra, Eduardo, PhD from the University of New Brunswick (Canada), 2003, 385 pages http://wwwlib.umi.com/dissertations/fullcit/NQ87626

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. PATENTS ON DYSARTHRIA Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.5 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “dysarthria” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on dysarthria, we have not necessarily excluded nonmedical patents in this bibliography.

Patent Applications on Dysarthria As of December 2000, U.S. patent applications are open to public viewing.6 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to dysarthria:

5Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm. 6 This has been a common practice outside the United States prior to December 2000.

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METHOD OF RESTORING SPEECH FUNCTIONS IN PATIENTS SUFFERING FROM VARIOUS FORMS OF DYSARTHRIA, AND DYSARTHRIA PROBES Inventor(s): CHAHINE, ELVINA IVANOVNA; (CHICAGO, IL) Correspondence: Anderson Kill & Olick,pc; 1251 Ave OF The Americas; New York; NY; 10020-1182; US Patent Application Number: 20010020141 Date filed: April 28, 1998 Abstract: A method for restoring speech functions in patients having various forms of dysarthria by way of successively carrying out the cosmetic massage of the face, the point massage of biologically active points of the face, cervical-collar region, arms and articulation organs, articulation-mimic gymnastics followed by voice exercises. The point massage is carried out by successively pressing, pricking, stroking for 1-5 seconds 3-5 times for 3-5 points, by sequentially alternating same and by adding 1-2 points. Pair points are massaged with two probes simultaneously.Dysarthria probes for carrying out a method for restoring speech functions by way of exerting a reflex action on the patient's biologically active points, which comprise a rod and an operating part whose configuration is varied in relation to the patient's clinical profile, for example, in the form of a ball, a sphere, an oval, a two-prong unit or a three-prong unit.The operating parts of the probes are made of ebonite, copper, titanum and/or stainless steel and can be dismantled. Excerpt(s): The invention relates to medicine, more specifically to treatment of speech disorders, e.g. various forms of dysarthria. Defects of pronunciation in case of dysarthria are due to the organically insufficient innervation of organs of speech most frequently as a result of paresis and the muscular paralysis of articulation organs. Characteristic for dysarthria is a limited mobility of speech organs: the soft palate, tongue and lips because of affection of muscles. Very popular in practical medicine are methods for normalising a patient's speech, which include the preliminary examination of the patient and the subsequent mimic muscle gymnastics, teaching the patient how to pronounce syllables using pedagogic methods and also elements of breathing exercises (cf. The book by F. A. Rau et al. "Methods of teaching deaf-mutes to pronounce", 1948, Uchpedgiz, Moscow, page 178). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with dysarthria, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “dysarthria” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on dysarthria. You can also use this procedure to view pending patent applications concerning dysarthria. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 6. BOOKS ON DYSARTHRIA Overview This chapter provides bibliographic book references relating to dysarthria. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on dysarthria include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “dysarthria” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on dysarthria: •

Motor Speech Disorders: Advances in Assessment and Treatment Source: Baltimore, MD: Paul H. Brookes Publishing Company. 1994. 288 p. Contact: Available from Paul H. Brookes Publishing Company. P.O. Box 10624, Baltimore, MD 21285-0624. (800) 638-3775. Fax (410) 337-8539. E-mail: [email protected]. Website: www.brookespublishing.com. PRICE: $38.00. ISBN: 1557661375. Summary: This book is based on selected papers given at the Conference on Motor Speech Disorders held in 1992 at Boulder, Colorado. The book presents seventeen chapters organized into four sections: perspectives on motor speech disorders, clinical characteristics, advances in diagnostic assessment, and approaches to treatment. Specific topics covered include: dysarthria from the viewpoint of individuals with dysarthria; classification of individuals with dysarthria; spasmodic torticollis; Parkinsonian dysarthria; vowel variability in developmental apraxia of speech; the application of

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instrumental techniques in the assessment of dysarthria; accelerometric difference index for subjects with normal and hypernasal speech; increasing the efficiency of articulatory force testing of adults with traumatic brain injury; tongue function testing in Parkinson's disease; semantic context and speech intelligibility; CPAP therapy for treating hypernasality following closed head injury; accelerating speech in hypokinetic dysarthria; and the effects of syllable characteristics and training on speaking rate in a child with dysarthria secondary to near-drowning. Each chapter includes extensive references and a subject index concludes the text. •

Quick Reference to Speech-Language Pathology Source: Gaithersburg, MD: Aspen Publishers, Inc. 1999. 414 p. Contact: Available from Aspen Publishers, Inc. 200 Orchard Ridge Drive, Suite 200, Gaithersburg, MD 20878. (800) 638-8437. Website: www.aspenpublishers.com. PRICE: $41.00. ISBN: 0834212781. Summary: This book offers a quick reference to the disorders, syndromes, and conditions seen among clients served by speech language pathologists. The book is organized by a classification of syndromes and conditions rather than by type of communication disorder. This allows clinicians preparing for a new admission to make a quick comparison between a stated diagnosis and information in the book relating to the diagnosis. It also recognizes that many conditions require intervention for more than one type of communication disorder. The entry for each disorder includes the name of the disorder, followed by any abbreviation or alternative names; a brief description of the overall characteristics of the disorder; a review of the etiology (causes) of the condition; a listing of the speech and language characteristics associated with the condition; a listing of other symptoms and characteristics associated with the condition; assessment, including specific assessment instruments; intervention techniques, both general and specific; results of recent studies; information on the prognosis for the condition as a whole; and references. Disorders are categorized in ten chapters: developmental disorders, inherited and congenital disorders or abnormalities, neurological disorders, psychosocial and psychiatric disorders, metabolic and endocrine disorders, musculoskeletal and connective tissue disorders, sensory disorders, otolaryngology and head and neck cancers, infectious disease, and burns. The book includes 9 appendices which offer a listing of the types of dysarthria, a description of pragmatic skills, factors in assessment for augmentative and alternative communication (AAC), a bibliography on facilitated communication (FC), suggested reading lists, a bibliography of authors, a list of unpublished tests, a list of assessment instruments, and a list of publishers. The text concludes with a subject index.

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Family Guide to Surviving Stroke and Communication Disorders Source: Needham Heights, MA: Allyn and Bacon. 1999. 273 p. Contact: Available from Allyn and Bacon. 160 Gould Street, Needham Heights, MA 02194. (800) 278-3525. Website: www.abacon.com. PRICE: $20.95. ISBN: 0205285384. Summary: This book offers families practical information on stroke related communication disorders, particularly aphasia, apraxia, and dysarthrias. Through nontechnical terms, a short story, case studies, questions and answers, and examples, the book engages families, stroke and rehabilitation specialists, and counselors on a journey toward understanding and healing. Twelve chapters cover stroke and the ability to communicate, the loss of language, motor speech disorders, complications, loss of awareness, thinking without language, depression and the stroke survivor, anxiety and

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the stroke survivor, maintaining relationships, accepting unwanted change, and speech and language rehabilitation. The book includes a glossary of stroke terminology and a subject index. Appendices offer lists of associations and agencies, resources for further reading and research, and a list of aphasia community groups. •

Developmental Motor Speech Disorders Source: San Diego, CA: Singular Publishing Group, Inc. 1993. 283 p. Contact: Available from Singular Publishing Group, Inc. 401 West 'A' Street, Suite 325, San Diego, CA 92101-7904. (800) 521-8545 or (619) 238-6777. Fax (800) 774-8398 or (619) 238-6789. E-mail: [email protected]. Website: www.singpub.com. PRICE: $42.50 plus shipping and handling. ISBN: 1879105926. Summary: This book presents nine chapters, divided into three sections, on developmental motor speech disorders. Chapter 1 presents a historical perspective focusing on traditional views of developmental dysarthria and apraxia of speech. A neurolinguistic perspective is offered in Chapter 2, in which the underpinnings of an explanatory model are reviewed. This chapter portrays the potential for multiple, interactive problems to exist in the child with a developmental motor speech disorder. A motolinguistic model is presented in Chapter 3. Based on the neurolinguistic principles offered in Chapter 2, this model presents a simplified conceptualization of a continuum of motor and language behaviors. Basic definitions and expected performance profiles are delineated in consideration of this model. Chapters 4 through 7 present performance characteristics of the child with a developmental motor speech disorder. Most of this information is based on work in the area of apraxia of speech, but, when possible, interpretations relevant to dysarthria are offered. Finally, Chapters 8 and 9 offer strategies for clinical assessment of and intervention for the child with a developmental motor speech disorder. A subject index concludes the volume. 6 appendices. 225 references. (AA-M).

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Desk Reference of Assessment Instruments in Speech and Language Source: San Antonio, TX: Communication Skill Builders. 1996. 416 p. Contact: Available from Communication Skill Builders. Psychological Corporation, Order Service Center, 555 Academic Court, San Antonio, TX 78204-2498. (800) 211-8378; TTY (800) 723-1318; Fax (800) 232-1223. PRICE: $59.00 plus shipping and handling. ISBN: 0761632255. Summary: This book, written for clinicians, students, and researchers in speechlanguage pathology, presents detailed reviews of more than ninety commercially available assessment instruments in speech and language. The authors provide a description of the instrument content, a qualitative evaluation of its effectiveness, and information on publishers and prices. Treatment areas covered include language, articulation, phonology, aphasia, dysarthria, apraxia, head injury, fluency, voice, oral motor skills, auditory processing, early childhood, and special needs. An appendix lists the tests alphabetically by title and includes information about the category, age range, publisher, and price; a second appendix lists publisher's addresses. 113 references. (AAM).

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Communication Problems After a Brain Injury or Stroke Source: Washington, DC: American Association of Retired Persons (AARP). 1994. 12 p.

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Contact: Available from Pritchett and Hull Associates, Inc. 3440 Oakcliff Road, N.E., Suite 110, Atlanta, GA 30340-3079. (800) 241-4925. PRICE: $3.20 for health professionals; $6.25 retail; plus shipping and handling. ISBN: 0939838443. Summary: This booklet is written to help patients and their families and caregivers understand common communication problems that can occur after a brain injury or stroke. Topics include communication and the brain, what happens to the brain during a stroke, the symptoms of communication disorders, using gestures as a basic way to communicate, the role of the speech language pathologist or therapist, aphasia, dysarthria, apraxia, cognitive problems, writing, understanding speech, memory problems, and getting respite. For each of the common communication problems, the authors provide communication strategies to address the disorder. The booklet is illustrated with cartoon-like line drawings depicting a variety of ethnic groups. •

Hegde's Pocket Guide to Treatment in Speech-Language Pathology. 2nd edition Source: San Diego, CA: Singular Publishing Group. 2001. 576 p. Contact: Available from Thomson Learning Group. P.O. Box 6904, Florence, KY 41022. (800) 842-3636. Fax (606) 647-5963. Website: www.singpub.com. PRICE: $49.95 plus shipping and handling. ISBN: 0769301592. Summary: This pocket guide to treatment procedures in speech language pathology has been designed for clinical practitioners and students in communicative disorders. The guidebook combines a specialized dictionary of terms, clinical resource book, and information typical to textbooks and manuals on treatment. By avoiding theoretical background and controversies, the guide gives the essence of treatment in a step by step format that promotes easy understanding and ready reference just before beginning treatment. Major topics covered are: aphasia (impairment of language comprehension), apraxia of speech (neurogenic speech disorder), articulation and phonological disorders, cerebral palsy, cleft palate, cluttering, dementia, dysarthria (motor speech disorder), dysphagia (swallowing disorders), hearing impairment, language disorders in children, laryngectomy (removal of the larynx), right hemisphere syndrome, stuttering, traumatic brain injury (TBI), and voice disorders. Under each of the main entries for these major disorders, the clinician may then look up subentries or specific types of disorders.

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Neuromotor Speech Disorders: Nature, Assessment, and Management Source: Baltimore, MD: Paul H. Brookes Publishing Company. 1998. 339 p. Contact: Available from Paul H. Brookes Publishing Company. P.O. Box 10624, Baltimore, MD 21285-0624. (800) 638-3775. Fax (410) 337-8539. E-mail: [email protected]. Website: www.brookespublishing.com. PRICE: $44.95 plus shipping and handling. ISBN: 1557663262. Summary: This textbook is a compilation of research of interest to speech language pathologists, health care professionals, basic researchers, and students who treat or study pathologies of motor systems affecting speech communication. The 18 chapters contain information about the basic nature of speech motor processes and methods by which they are evaluated; mechanisms of their breakdown in neuropathology; and resultant consequences for the physiological production, acoustic transmission, and understandability of disordered speech. In addition, specific information on the clinical characteristics and management of specific neuromotor speech disorders (e.g., the various dysarthrias, apraxia of speech, spasmodic dysphonia) is presented. One section discusses intelligibility, acceptability, and naturalness (three chapters); another

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addresses controversial issues in dysphonia (three chapters). Each chapter, written by specialists in the field, includes references, and the text concludes with a subject index. •

Essentials for Speech-Language Pathologists Source: San Diego, CA: Singular Publishing Group. 2001. 468 p. Contact: Available from Thomson Learning Group. P.O. Box 6904, Florence, KY 41022. (800) 842-3636. Fax (606) 647-5963. Website: www.singpub.com. PRICE: $49.95 plus shipping and handling. ISBN: 0769300715. Summary: This textbook is designed to help new professionals with the transition to clinical practice in speech language pathology. The text focuses on professional issues with American Speech-Language-Hearing Association (ASHA) guidelines and practice standards, followed by case law and legislation that dictate professional practice in educational and health care settings, as well as a review of the most common communicative disorders and corresponding assessment and treatment guidelines. Specific disorders covered include aphasia, apraxia, articulation and phonological disorders, attention deficit (hyperactivity) disorder, augmentative and alternative communication (AAC), autism, cleft lip and cleft palate, dementias, dysarthria, dysphagia in adults, fluency disorders, hearing loss, language disorders in children, laryngectomy, multicultural issues in speech language pathology, pediatric feeding problems, reading and spelling disorders, syndromes, traumatic brain injury, and voice disorders. The assessment portion of each chapter reviews basic testing protocol related to the disorder. In some cases, the names of published tests are provided, as well as informal procedures that can be used to assess clients with the disorder. The text concludes with two appendixes: first, standard reading passages used for a variety of assessments; and second a list of resources, including web sites, addresses, and telephone numbers of information organizations; ordering information for AAC devices and laryngectomy equipment; and the names, addresses, and telephone numbers of various companies that offer assessment and therapy materials. A list of references and a subject index conclude the book. The text is recommended reading for students and professionals who are preparing to take the Praxis Examination in Speech Language Pathology. 390 references.

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Management of Speech and Swallowing in Degenerative Diseases Source: San Antonio, TX: Communication Skill Builders. 1995. 272 p. Contact: Available from Communication Skill Builders. Psychological Corporation, Order Service Center, 555 Academic Court, San Antonio, TX 78204-2498. Voice (800) 2118378; TTY (800) 723-1318; Fax (800) 232-1223. PRICE: $45.00 plus shipping and handling. Order Number 076-1677-364-MS799. Summary: This textbook outlines the management of speech and swallowing in degenerative diseases. The authors note that the ability to communicate is critical for people with life-threatening conditions. With loss of communication, they can no longer control their health care, make necessary financial and legal arrangements, or remain close to the family and friends whose support they need. The ability to eat safely is no less critical. When eating becomes so difficult that it loses all enjoyment, patients usually eat too little and their health rapidly declines. The book discusses the role of the speech language pathologist in speech and swallowing intervention for four degenerative diseases: amyotrophic lateral sclerosis (ALS), Huntington's disease, Parkinson's disease, and multiple sclerosis (MS). The authors present compensatory techniques for the typical features of each dysarthria and illustrate how to introduce augmentative

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communication gradually to supplement natural speech, ensuring a smooth transition to nonvocal communication. The authors stress the importance of maintaining adequate hydration and caloric intake in the face of progressive dysphagia. For each stage of involvement, they suggest compensatory strategies and dietary modifications to implement to allow the patient to eat as safely and independently as possible. Each chapter concludes with references. The book concludes with patient and family handouts, a glossary of terms, and a subject index. (AA-M). •

Communication for the Speechless. 3rd ed Source: Needham Heights, MA: Allyn and Bacon. 1995. 413 p. Contact: Available from Allyn and Bacon. 160 Gould Street, Needham, MA 02194-2310. (800) 278-3525 or (617) 455-1200; Fax (515) 284-2607. PRICE: $50.85 plus shipping and handling. ISBN: 0013184874. Summary: This textbook provides information about augmentative and alternative communications methods used for children and adults with essentially normal hearing who are without speech. Their speech disorders may have resulted from one or a combination of several conditions, including severe dysarthria, severe verbal apraxia, aphasia, glossectomy, tracheostomy, dysphonia, severe mental retardation, or childhood autism. The first section defines augmentative communication strategies. The author indicates how such strategies have been used with several clinical populations, describes the need for a communication rather than a speech orientation when dealing with persons from these populations, and summarizes the relevant outcome literature. The second section describes and evaluates the various gestural (unaided), gesturalassisted (aided) and neuro-assisted (aided) communication strategies that have been developed. Finally, the author describes an evaluation procedure for selecting the appropriate communication strategy or strategies for each client. The book contains a comprehensive bibliography, a list of sources of materials for teaching the use of augmentative communication strategies, a list of sources of 'components' for communication aids, and a detailed subject index. 2300 references.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “dysarthria” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “dysarthria” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “dysarthria” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

* Dysarthria Examination Battery; ISBN: 0761671811; http://www.amazon.com/exec/obidos/ASIN/0761671811/icongroupinterna

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Cases in Neurogenic Communicative Disorders: A Workbook : And Aphasia, Aprazia of Speech, and Dysarthria Samples : Audiotape, Manual and Test Stimul by James P. Dworkin; ISBN: 1565933109; http://www.amazon.com/exec/obidos/ASIN/1565933109/icongroupinterna

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Disorders of Articulation: Aspects of Dysarthria and Verbal Dyspraxia (Disorders of Human Communication 7) by Margaret Edwards; ISBN: 0387817875; http://www.amazon.com/exec/obidos/ASIN/0387817875/icongroupinterna

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Frenchay Dysarthria Assessment by Pamela M. Enderby; ISBN: 0890792933; http://www.amazon.com/exec/obidos/ASIN/0890792933/icongroupinterna

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From the Brain to the Mouth: Acquired Dysarthria and Dysfluency in Adults (Neuropsychology and Cognition, Vol. 12) by Yvan Lebrun; ISBN: 0792344278; http://www.amazon.com/exec/obidos/ASIN/0792344278/icongroupinterna

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Guide to Dysarthria Management: A Client-Clinician Approach by Monique S. Kaye; ISBN: 1888222441; http://www.amazon.com/exec/obidos/ASIN/1888222441/icongroupinterna

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Speech Practice Manual for Dysarthria Apraxia and Other Disorders of Articulation: Compare and Contrast by Robert L. Keith, Jack E. Thomas; ISBN: 1556641346; http://www.amazon.com/exec/obidos/ASIN/1556641346/icongroupinterna

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Working with Dysarthrics: A Practical Guide to Therapy for Dysarthria (Working With. Series) by Sandra Robertson, Fay Thomson; ISBN: 0863880347; http://www.amazon.com/exec/obidos/ASIN/0863880347/icongroupinterna

Chapters on Dysarthria In order to find chapters that specifically relate to dysarthria, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and dysarthria using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “dysarthria” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on dysarthria: •

Dysarthria Source: in Vinson, B.P. Essentials for Speech-Language Pathologists. San Diego, CA: Singular Publishing Group. 2001. p. 223-228. Contact: Available from Thomson Learning Group. P.O. Box 6904, Florence, KY 41022. (800) 842-3636. Fax (606) 647-5963. Website: www.singpub.com. PRICE: $49.95 plus shipping and handling. ISBN: 0769300715. Summary: Dysarthria is a group of motor speech disorders that result in lack of muscular control of the speech mechanism, because of damage to the central or peripheral nervous system. This chapter on dysarthria is from a textbook that is designed to help new professionals with the transition to clinical practice in speech language pathology. The author defines dysarthria and diagnostic criteria, then discusses assessment issues, including the types of tasks the client should be asked to perform and how to assess speech and vocal quality. The second section of the chapter focuses on treatment options. In dysarthria, the primary problem is the weakness of the muscle. Therefore, therapy should address improving the muscle strength. Respiration and resonation should be addressed first, followed by phonation, then articulation and prosody. 4 tables.

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Dysphagia and Dysarthria: The Role of the Speech-Language Pathologist Source: in Mitsumoto, H.; Norris, F.H., Jr. Amyotrophic Lateral Sclerosis: A Comprehensive Guide to Management. New York, NY: Demos Vermande. 1994. p. 6375. Contact: Available from Demos Vermade. 386 Park Avenue South, Suite 201, New York, NY 10016. (800) 532-8663 or (212) 683-0072; Fax (212) 683-0118. PRICE: $39.95 plus shipping and handling. ISBN: 0939957582. Summary: This chapter, from a guide to the management of patients with amyotrophic lateral sclerosis (ALS), describes the role of the speech-language pathologist, particularly in treating the dysphagia and dysarthria common to ALS. Concerns specific to the speech-language pathologists (SLP) are the effects of the disease on the patient's oral mechanism, communicative abilities, and deglutition. Furthermore, the SLP address the familial and psychosocial issues surrounding speech and swallowing compromise. The author presents a model for the diagnosis and treatment of the ALS patient, dealing with the issues within the scope of practice of the SLP, based on the author's clinical experience. The author notes that the manifestations of ALS (oral mechanism compromise, communicative disorder, dysphagia, and family issues) are more dramatic in clinical presentation and become more crucial when confronted with a patient presenting with bulbar symptomatology either initially or progressively. Paradoxically, it is the progressively bulbar nature of ALS that has fostered innovative and adaptive diagnostic and therapeutic methods, resulting in improved quality of life throughout the remaining life span. The author emphasizes the need for therapy to adapt to the progressive nature of the disease, in order to achieve the best possible quality of life for the patient. 9 references. (AA-M).

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Dysarthria-Apraxia Source: in Harris, L.G.; Shelton, I.S. Desk Reference of Assessments in Speech-Language. Tucson, AZ: Communication Skill Builders. 1993. p. 165-174. Contact: Available from Communication Skill Builders. 3830 East Bellvue, P.O. Box 42050, Tucson, AZ 85733. Voice (602) 323-7500; Fax (606) 325-0306. PRICE: $59.00 plus shipping and handling. ISBN: 0884506320. Summary: This chapter, from a reference book on current speech and language testing instruments, presents detailed reviews of assessments in the area of dysarthria/apraxia. Four instruments are reviewed, including the Apraxia Battery for Adults; the Assessment of Intelligibility of Dysarthric Speakers; Frenchay Dysarthria Assessment; and the Screening Test for Developmental Apraxia of Speech. For each entry, the authors provide a detailed description of the instrument content, an evaluation of its effectiveness, and current information on publishers and prices. The chapter also includes details regarding standardization data (reliability and validity), administrative considerations, and scoring.

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CHAPTER 7. MULTIMEDIA ON DYSARTHRIA Overview In this chapter, we show you how to keep current on multimedia sources of information on dysarthria. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Video Recordings An excellent source of multimedia information on dysarthria is the Combined Health Information Database. You will need to limit your search to “Videorecording” and “dysarthria” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find video productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Videorecording (videotape, videocassette, etc.).” Type “dysarthria” (or synonyms) into the “For these words:” box. The following is a typical result when searching for video recordings on dysarthria: •

Identification of Motor Speech Disorders Source: Rockville, MD: American Speech-Hearing-Language Association (ASHA). 1997. (videocassette and study guide). Contact: Available from American Speech-Language-Hearing Association (ASHA). Product Sales, 10801 Rockville Pike, Rockville, MD 20852. (888) 498-6699. TTY (301) 8970157. Website: www.asha.org. PRICE: $120.00 for ASHA members; $130.00 for nonmembers; plus shipping and handling. ISBN: 1580410103. Summary: This video conference (designed for self study) offers an opportunity for clinicians to sharpen their ability to differentially diagnose motor speech disorders (the dysarthria and apraxia of speech). This includes presentation and subsequent discussion of numerous audio and videotape samples of people with a wide variety of motor speech disorders (MSD). Clinicians are asked to identify salient and confirmatory features of the speech disorders and to draw conclusions about the type of MSD and its implications for lesion localization. Clinicians are taught to express their diagnostic

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conclusions in a manner that can assist in the localization and diagnosis of neurologic disease. Topics covered in the manual and accompanying videotape include: the importance of this differential diagnosis of MSDs, basic categorization and definitions of the dysarthrias, assessment principles and procedures, flaccid dysarthria, spastic dysarthria, ataxic dysarthria, hypokinetic dysarthria, hyperkinetic dysarthria, unilateral upper motor neuron dysarthria, mixed dysarthria, and apraxia of speech. The self study unit includes a pretraining assessment and a posttraining assessment. In addition, the manual offers reprinted articles that are relevant to the diagnosis of MSDs. 11 appendices. 16 references. •

Clinical Application of Speech Acoustic Analysis Source: Tucson, AZ: National Center for Neurogenic Communication Disorders, University of Arizona. 1998. (videocassette). Contact: Available from National Center for Neurogenic Communication Disorders, University of Arizona. P.O. Box 210071, Tucson, AZ 85721-0071. (520) 621-1472. Fax (520) 621-2226. PRICE: $25.00 plus shipping and handling. Order Number TR-44. Summary: This videotape program, which is part of the Telerounds videoconference series from the National Center for Neurogenic Communication Disorders at the University of Arizona (funded partly by NIDCD), discusses the clinical application of speech acoustic analysis. The speaker begins with a discussion of the purpose of speech science research. The speaker explains that acoustic analysis may serve as a bridge between a patient's intelligibility deficit and any articular or laryngeal problems that are causing the deficit. The presentation then focuses on the clinical application of speech acoustic analysis to articulating behavior and the application of speech acoustic analysis for vowel articulation. The speaker demonstrates the ease of actual measurement of vowel format and explains how the measured data can be graphically displayed and used for clinical purposes. The presentation uses examples from the speech of persons with mixed dysarthria to illustrate the clinical potential of speech acoustic analysis. The program concludes by answering questions asked by the host and phoned in by the teleconference audience and by providing information about joining Centernet, the online forum operated by the Center.

Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “dysarthria” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on dysarthria: •

Dysarthria: Differential Diagnosis Source: Bisbee, AZ: Imaginart Communication Products. 199x. (audiocassette). Contact: Available from Imaginart Communication Products. 307 Arizona Street, Bisbee, AZ 85603. (800) 828-1376; Fax (602) 432-5134. PRICE: $22.95 (U.S.); $30.95 (Canada); plus shipping and handling. Stock Number 4031M.

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Summary: This audiocassette features over 50 patient recordings that demonstrate the major types of dysarthria: flaccid, spastic, ataxic, hypokinetic, and several hyperkinetic dysarthrias. The accompanying guide explains the location of the lesion and characteristics of that dysarthria. The tape is narrated by a specialist in dysarthria. On the tape, the physician also describes the simple test he gives each patient. The recordings are included to prepare listeners to use this simple test and help them learn to diagnose dysarthrias.

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CHAPTER 8. PERIODICALS AND NEWS ON DYSARTHRIA Overview In this chapter, we suggest a number of news sources and present various periodicals that cover dysarthria.

News Services and Press Releases One of the simplest ways of tracking press releases on dysarthria is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “dysarthria” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to dysarthria. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “dysarthria” (or synonyms). The NIH Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date

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at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “dysarthria” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “dysarthria” (or synonyms). If you know the name of a company that is relevant to dysarthria, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “dysarthria” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “dysarthria” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on dysarthria:

Periodicals and News

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Speech After Stroke: Rehabilitation Enhances Recovery and Lifestyle Source: Mayo Clinic Health Letter. 14(8): 1-3. August 1996. Contact: Available from Mayo Foundation for Medical Education and Research. 200 First Street, S.W., Rochester, MN 55905. (800) 633-4567. PRICE: $3.00 for single copy of newsletter plus shipping and handling. Summary: This newsletter article describes advances in post-stroke speech and language rehabilitation. Topics include how stroke damages brain cells; the three main strokerelated communication disorders, aphasia, dysarthria, and apraxia; how speech rehabilitation can enhance quality of life for people who have had a stroke; diagnosing speech and language problems; the components of a speech rehabilitation program, including exercise and practice, and the use of picture cards, picture boards, workbooks, and computers; and the psychosocial impact of recovering from a stroke. One sidebar outlines the role of family and friends in the recovery process.

Academic Periodicals covering Dysarthria Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to dysarthria. In addition to these sources, you can search for articles covering dysarthria that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute7: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

7

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.8 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:9 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

8

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 9 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway10 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.11 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “dysarthria” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 2586 48 19 12 253 2918

HSTAT12 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.13 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.14 Simply search by “dysarthria” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

10

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

11

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 12 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 13 14

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists15 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.16 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.17 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

15 Adapted 16

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 17 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on dysarthria can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to dysarthria. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to dysarthria. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “dysarthria”:

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Degenerative Nerve Diseases http://www.nlm.nih.gov/medlineplus/degenerativenervediseases.html Genetic Brain Disorders http://www.nlm.nih.gov/medlineplus/geneticbraindisorders.html Speech and Communication Disorders http://www.nlm.nih.gov/medlineplus/speechandcommunicationdisorders.html Tremor http://www.nlm.nih.gov/medlineplus/tremor.html You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on dysarthria. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Dysarthria: Understanding This Speech Problem Source: San Bruno, CA: Krames Communications. 1997. [4 p.]. Contact: Available from Krames Communications. Order Department, 1100 Grundy Lane, San Bruno, CA 94066-9821. (800) 333-3032; Fax (415) 244-4512. PRICE: Single copy free; $20.00 per pack of 50 brochures. Item Number 9433-LNZL. Summary: This brochure explains dysarthria, a speech problem caused by a lack of control over muscles in the face and mouth. This problem may occur when the brain is damaged by injury or illness. A person who has dysarthria knows which words to use, but may not be able to make the right sounds. The brochure lists the common signs of dysarthria and describes the role of speech language therapy in the rehabilitation work of persons with dysarthria. The brochure includes a sidebar offering strategies for family members or caregivers who wish to help the person with dysarthria practice his or her communication skills. The brochure is illustrated with full-color drawings of patients in speech therapy settings. One section briefly describes the related problems of aphasia (trouble using language) and dysphagia (swallowing difficulty).

•

Dysarthria: A Guide for the Patient and Family Source: Stow, OH: Interactive Therapeutics, Inc. 1993. 30 p.

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Contact: Available from Interactive Therapeutics, Inc. P.O. Box 1805, Stow, OH 44224. (800) 253-5111 or (216) 688-1371; Fax (330) 923-3030; E-mail: [email protected]. PRICE: $4.50 each for 1 to 25 copies; bulk rates available. Summary: This patient education booklet describes dysarthria, a group of speech disorders resulting from disturbed muscular control of the speech mechanism. The booklet presents information in seven chapters: definitions, causes, what it sounds like to have dysarthria, other side effects of the disorder, treatment options, self-care and family participation in care, and community support options. The booklet concludes with a glossary and a list of recommended resources for additional reading. The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to dysarthria. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to dysarthria. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with dysarthria.

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The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about dysarthria. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “dysarthria” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “dysarthria”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “dysarthria” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “dysarthria” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.18

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

18

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)19: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

19

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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•

Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

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New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

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New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

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Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

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Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

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Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

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Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

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Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

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Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

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Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

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Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

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Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

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Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

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Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

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Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

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Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

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Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

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MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

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Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

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Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

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On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

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Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

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Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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DYSARTHRIA DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Aberrant: Wandering or deviating from the usual or normal course. [EU] Acetylcholine: A neurotransmitter. Acetylcholine in vertebrates is the major transmitter at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system. It is generally not used as an administered drug because it is broken down very rapidly by cholinesterases, but it is useful in some ophthalmological applications. [NIH] Acetylcholinesterase: An enzyme that catalyzes the hydrolysis of acetylcholine to choline and acetate. In the CNS, this enzyme plays a role in the function of peripheral neuromuscular junctions. EC 3.1.1.7. [NIH] Acoustic: Having to do with sound or hearing. [NIH] Actin: Essential component of the cell skeleton. [NIH] Acute lymphoblastic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphocytic leukemia. [NIH] Acute lymphocytic leukemia: ALL. A quickly progressing disease in which too many immature white blood cells called lymphoblasts are found in the blood and bone marrow. Also called acute lymphoblastic leukemia. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Agarose: A polysaccharide complex, free of nitrogen and prepared from agar-agar which is produced by certain seaweeds (red algae). It dissolves in warm water to form a viscid solution. [NIH] Airway: A device for securing unobstructed passage of air into and out of the lungs during general anesthesia. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH]

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Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amphetamines: Analogs or derivatives of amphetamine. Many are sympathomimetics and central nervous system stimulators causing excitation, vasopression, bronchodilation, and to varying degrees, anorexia, analepsis, nasal decongestion, and some smooth muscle relaxation. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]

Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. [NIH] Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Antibiotics: Substances produced by microorganisms that can inhibit or suppress the growth of other microorganisms. [NIH] Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Anticoagulant: A drug that helps prevent blood clots from forming. Also called a blood thinner. [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antimetabolite: A chemical that is very similar to one required in a normal biochemical reaction in cells. Antimetabolites can stop or slow down the reaction. [NIH] Antineoplastic: Inhibiting or preventing the development of neoplasms, checking the maturation and proliferation of malignant cells. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are

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highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU] Aphasia: A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia. [NIH] Applicability: A list of the commodities to which the candidate method can be applied as presented or with minor modifications. [NIH] Apraxia: Loss of ability to perform purposeful movements, in the absence of paralysis or sensory disturbance, caused by lesions in the cortex. [NIH] Aqueous: Having to do with water. [NIH] Arteries: The vessels carrying blood away from the heart. [NIH] Arteritis: Inflammation of an artery. [NIH] Artery: Vessel-carrying blood from the heart to various parts of the body. [NIH] Articular: Of or pertaining to a joint. [EU] Articulation: The relationship of two bodies by means of a moveable joint. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH]

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Ataxia: Impairment of the ability to perform smoothly coordinated voluntary movements. This condition may affect the limbs, trunk, eyes, pharnyx, larnyx, and other structures. Ataxia may result from impaired sensory or motor function. Sensory ataxia may result from posterior column injury or peripheral nerve diseases. Motor ataxia may be associated with cerebellar diseases; cerebral cortex diseases; thalamic diseases; basal ganglia diseases; injury to the red nucleus; and other conditions. [NIH] Atrial: Pertaining to an atrium. [EU] Atrophy: Decrease in the size of a cell, tissue, organ, or multiple organs, associated with a variety of pathological conditions such as abnormal cellular changes, ischemia, malnutrition, or hormonal changes. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic Nervous System: The enteric, parasympathetic, and sympathetic nervous systems taken together. Generally speaking, the autonomic nervous system regulates the internal environment during both peaceful activity and physical or emotional stress. Autonomic activity is controlled and integrated by the central nervous system, especially the hypothalamus and the solitary nucleus, which receive information relayed from visceral afferents; these and related central and sensory structures are sometimes (but not here) considered to be part of the autonomic nervous system itself. [NIH] Axons: Nerve fibers that are capable of rapidly conducting impulses away from the neuron cell body. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Balloon Occlusion: Use of a balloon catheter to block the flow of blood through an artery or vein. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Basal Ganglia Diseases: Diseases of the basal ganglia including the putamen; globus pallidus; claustrum; amygdala; and caudate nucleus. Dyskinesias (most notably involuntary movements and alterations of the rate of movement) represent the primary clinical manifestations of these disorders. Common etiologies include cerebrovascular disease; neurodegenerative diseases; and craniocerebral trauma. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Basilar Artery: The artery formed by the union of the right and left vertebral arteries; it runs from the lower to the upper border of the pons, where it bifurcates into the two posterior cerebral arteries. [NIH] Bewilderment: Impairment or loss of will power. [NIH] Bilateral: Affecting both the right and left side of body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH]

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Biogenic Monoamines: Biogenic amines having only one amine moiety. Included in this group are all natural monoamines formed by the enzymatic decarboxylation of natural amino acids. [NIH] Biomechanics: The study of the application of mechanical laws and the action of forces to living structures. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bladder: The organ that stores urine. [NIH] Bleomycin: A complex of related glycopeptide antibiotics from Streptomyces verticillus consisting of bleomycin A2 and B2. It inhibits DNA metabolism and is used as an antineoplastic, especially for solid tumors. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blot: To transfer DNA, RNA, or proteins to an immobilizing matrix such as nitrocellulose. [NIH]

Blotting, Western: Identification of proteins or peptides that have been electrophoretically separated by blotting and transferred to strips of nitrocellulose paper. The blots are then detected by radiolabeled antibody probes. [NIH] Bone Marrow: The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. [NIH] Bone Marrow Transplantation: The transference of bone marrow from one human or animal to another. [NIH] Bradykinesia: Abnormal slowness of movement; sluggishness of physical and mental responses. [EU] Brain Diseases: Pathologic conditions affecting the brain, which is composed of the intracranial components of the central nervous system. This includes (but is not limited to) the cerebral cortex; intracranial white matter; basal ganglia; thalamus; hypothalamus; brain stem; and cerebellum. [NIH] Brain Stem: The part of the brain that connects the cerebral hemispheres with the spinal cord. It consists of the mesencephalon, pons, and medulla oblongata. [NIH] Breathing Exercises: Therapeutic exercises aimed to deepen inspiration or expiration or even to alter the rate and rhythm of respiration. [NIH] Bulbar: Pertaining to a bulb; pertaining to or involving the medulla oblongata, as bulbar paralysis. [EU] Calcification: Deposits of calcium in the tissues of the breast. Calcification in the breast can be seen on a mammogram, but cannot be detected by touch. There are two types of breast calcification, macrocalcification and microcalcification. Macrocalcifications are large deposits and are usually not related to cancer. Microcalcifications are specks of calcium that may be found in an area of rapidly dividing cells. Many microcalcifications clustered together may

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be a sign of cancer. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Caloric intake: Refers to the number of calories (energy content) consumed. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. [NIH] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Cardiac: Having to do with the heart. [NIH] Cardiomyopathy: A general diagnostic term designating primary myocardial disease, often of obscure or unknown etiology. [EU] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catheter: A flexible tube used to deliver fluids into or withdraw fluids from the body. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Cycle: The complex series of phenomena, occurring between the end of one cell division and the end of the next, by which cellular material is divided between daughter cells. [NIH] Cell Respiration: The metabolic process of all living cells (animal and plant) in which oxygen is used to provide a source of energy for the cell. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebellum: Part of the metencephalon that lies in the posterior cranial fossa behind the

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brain stem. It is concerned with the coordination of movement. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Arteries: The arteries supplying the cerebral cortex. [NIH] Cerebral Cortex: The thin layer of gray matter on the surface of the cerebral hemisphere that develops from the telencephalon and folds into gyri. It reaches its highest development in man and is responsible for intellectual faculties and higher mental functions. [NIH] Cerebral hemispheres: The two halves of the cerebrum, the part of the brain that controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. The right hemisphere controls muscle movement on the left side of the body, and the left hemisphere controls muscle movement on the right side of the body. [NIH] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Chemotherapy: Treatment with anticancer drugs. [NIH] Chin: The anatomical frontal portion of the mandible, also known as the mentum, that contains the line of fusion of the two separate halves of the mandible (symphysis menti). This line of fusion divides inferiorly to enclose a triangular area called the mental protuberance. On each side, inferior to the second premolar tooth, is the mental foramen for the passage of blood vessels and a nerve. [NIH] Chiropractic: A system of treating bodily disorders by manipulation of the spine and other parts, based on the belief that the cause is the abnormal functioning of a nerve. [NIH] Choline: A basic constituent of lecithin that is found in many plants and animal organs. It is important as a precursor of acetylcholine, as a methyl donor in various metabolic processes, and in lipid metabolism. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Disease: Disease or ailment of long duration. [NIH] Cleft Lip: Congenital defect in the upper lip where the maxillary prominence fails to merge with the merged medial nasal prominences. It is thought to be caused by faulty migration of the mesoderm in the head region. [NIH] Cleft Palate: Congenital fissure of the soft and/or hard palate, due to faulty fusion. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clonazepam: An anticonvulsant used for several types of seizures, including myotonic or

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atonic seizures, photosensitive epilepsy, and absence seizures, although tolerance may develop. It is seldom effective in generalized tonic-clonic or partial seizures. The mechanism of action appears to involve the enhancement of gaba receptor responses. [NIH] Clonic: Pertaining to or of the nature of clonus. [EU] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Collapse: 1. A state of extreme prostration and depression, with failure of circulation. 2. Abnormal falling in of the walls of any part of organ. [EU] Communication Disorders: Disorders of verbal and nonverbal communication caused by receptive or expressive language disorders, cognitive dysfunction (e.g., mental retardation), psychiatric conditions, and hearing disorders. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH]

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Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Conjugated: Acting or operating as if joined; simultaneous. [EU] Conjunctiva: The mucous membrane that lines the inner surface of the eyelids and the anterior part of the sclera. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constriction: The act of constricting. [NIH] Continuum: An area over which the vegetation or animal population is of constantly changing composition so that homogeneous, separate communities cannot be distinguished. [NIH]

Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Contralateral: Having to do with the opposite side of the body. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Corpus: The body of the uterus. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Cranial: Pertaining to the cranium, or to the anterior (in animals) or superior (in humans) end of the body. [EU] Cues: Signals for an action; that specific portion of a perceptual field or pattern of stimuli to which a subject has learned to respond. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cutaneous: Having to do with the skin. [NIH] Cytarabine: An anticancer drug that belongs to the family of drugs called antimetabolites. [NIH]

Cytokines: Non-antibody proteins secreted by inflammatory leukocytes and some non-

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leukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialized glands. They generally act locally in a paracrine or autocrine rather than endocrine manner. [NIH] Degenerative: Undergoing degeneration : tending to degenerate; having the character of or involving degeneration; causing or tending to cause degeneration. [EU] Deglutition: The process or the act of swallowing. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Diabetes Insipidus: A metabolic disorder due to disorders in the production or release of vasopressin. It is characterized by the chronic excretion of large amounts of low specific gravity urine and great thirst. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diffusion: The tendency of a gas or solute to pass from a point of higher pressure or concentration to a point of lower pressure or concentration and to distribute itself throughout the available space; a major mechanism of biological transport. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Discrete: Made up of separate parts or characterized by lesions which do not become blended; not running together; separate. [NIH] Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis. [NIH] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Dissection: Cutting up of an organism for study. [NIH]

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Disseminated sclerosis: Hardening of tissue due to inflammation. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Double-blind: Pertaining to a clinical trial or other experiment in which neither the subject nor the person administering treatment knows which treatment any particular subject is receiving. [EU] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysphagia: Difficulty in swallowing. [EU] Dysphonia: Difficulty or pain in speaking; impairment of the voice. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Efferent: Nerve fibers which conduct impulses from the central nervous system to muscles and glands. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electromagnetic Fields: Fields representing the joint interplay of electric and magnetic forces. [NIH] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Embolus: Bit of foreign matter which enters the blood stream at one point and is carried until it is lodged or impacted in an artery and obstructs it. It may be a blood clot, an air bubble, fat or other tissue, or clumps of bacteria. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epiphyseal: Pertaining to or of the nature of an epiphysis. [EU] Epiphyses: The head of a long bone that is separated from the shaft by the epiphyseal plate until bone growth stops. At that time, the plate disappears and the head and shaft are

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united. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Ethnic Groups: A group of people with a common cultural heritage that sets them apart from others in a variety of social relationships. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Expert Systems: Computer programs based on knowledge developed from consultation with experts on a problem, and the processing and/or formalizing of this knowledge using these programs in such a manner that the problems may be solved. [NIH] Expiration: The act of breathing out, or expelling air from the lungs. [EU] Expiratory: The volume of air which leaves the breathing organs in each expiration. [NIH] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Extraocular: External to or outside of the eye. [NIH] Extravasation: A discharge or escape, as of blood, from a vessel into the tissues. [EU] Extremity: A limb; an arm or leg (membrum); sometimes applied specifically to a hand or foot. [EU] Eye Movements: Voluntary or reflex-controlled movements of the eye. [NIH] Facial: Of or pertaining to the face. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Flaccid: Weak, lax and soft. [EU] Flecainide: A potent anti-arrhythmia agent, effective in a wide range of ventricular and atrial arrhythmias and tachycardias. Paradoxically, however, in myocardial infarct patients with either symptomatic or asymptomatic arrhythmia, flecainide exacerbates the arrhythmia and is not recommended for use in these patients. [NIH] Fossa: A cavity, depression, or pit. [NIH] Free Radicals: Highly reactive molecules with an unsatisfied electron valence pair. Free radicals are produced in both normal and pathological processes. They are proven or suspected agents of tissue damage in a wide variety of circumstances including radiation, damage from environment chemicals, and aging. Natural and pharmacological prevention of free radical damage is being actively investigated. [NIH] Functional magnetic resonance imaging: A noninvasive tool used to observe functioning in

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the brain or other organs by detecting changes in chemical composition, blood flow, or both. [NIH]

Fuzzy Logic: Approximate, quantitative reasoning that is concerned with the linguistic ambiguity which exists in natural or synthetic language. At its core are variables such as good, bad, and young as well as modifiers such as more, less, and very. These ordinary terms represent fuzzy sets in a particular problem. Fuzzy logic plays a key role in many medical expert systems. [NIH] GABA: The most common inhibitory neurotransmitter in the central nervous system. [NIH] Gait: Manner or style of walking. [NIH] Gait Ataxia: Impairment of the ability to coordinate the movements required for normal ambulation which may result from impairments of motor function or sensory feedback. This condition may be associated with brain diseases (including cerebellar diseases and basal ganglia diseases); spinal cord diseases; or peripheral nervous system diseases. [NIH] Ganglia: Clusters of multipolar neurons surrounded by a capsule of loosely organized connective tissue located outside the central nervous system. [NIH] Ganglioside: Protein kinase C's inhibitor which reduces ischemia-related brain damage. [NIH]

Gangrene: Death and putrefaction of tissue usually due to a loss of blood supply. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gene Therapy: The introduction of new genes into cells for the purpose of treating disease by restoring or adding gene expression. Techniques include insertion of retroviral vectors, transfection, homologous recombination, and injection of new genes into the nuclei of single cell embryos. The entire gene therapy process may consist of multiple steps. The new genes may be introduced into proliferating cells in vivo (e.g., bone marrow) or in vitro (e.g., fibroblast cultures) and the modified cells transferred to the site where the gene expression is required. Gene therapy may be particularly useful for treating enzyme deficiency diseases, hemoglobinopathies, and leukemias and may also prove useful in restoring drug sensitivity, particularly for leukemia. [NIH] Genetic Screening: Searching a population or individuals for persons possessing certain genotypes or karyotypes that: (1) are already associated with disease or predispose to disease; (2) may lead to disease in their descendants; or (3) produce other variations not known to be associated with disease. Genetic screening may be directed toward identifying phenotypic expression of genetic traits. It includes prenatal genetic screening. [NIH] Genetics: The biological science that deals with the phenomena and mechanisms of heredity. [NIH] Genotype: The genetic constitution of the individual; the characterization of the genes. [NIH] Geriatric: Pertaining to the treatment of the aged. [EU] Gestures: Movement of a part of the body for the purpose of communication. [NIH] Globus Pallidus: The representation of the phylogenetically oldest part of the corpus striatum called the paleostriatum. It forms the smaller, more medial part of the lentiform nucleus. [NIH] Glossectomy: Amputation of the tongue. [NIH]

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Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Habitual: Of the nature of a habit; according to habit; established by or repeated by force of habit, customary. [EU] Haloperidol: Butyrophenone derivative. [NIH] Handicap: A handicap occurs as a result of disability, but disability does not always constitute a handicap. A handicap may be said to exist when a disability causes a substantial and continuing reduction in a person's capacity to function socially and vocationally. [NIH] Hearing Disorders: Conditions that impair the transmission or perception of auditory impulses and information from the level of the ear to the temporal cortices, including the sensorineural pathways. [NIH] Heat Stroke: A condition characterized by cessation of sweating, hot dry skin, delirium, collapse, and coma and resulting from prolonged exposure to high environmental temperature. [NIH] Hematoma: An extravasation of blood localized in an organ, space, or tissue. [NIH] Hemiparesis: The weakness or paralysis affecting one side of the body. [NIH] Hemoglobinopathies: A group of inherited disorders characterized by structural alterations within the hemoglobin molecule. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Hereditary: Of, relating to, or denoting factors that can be transmitted genetically from one generation to another. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Homogeneous: Consisting of or composed of similar elements or ingredients; of a uniform quality throughout. [EU] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird

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and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hormonal: Pertaining to or of the nature of a hormone. [EU] Hybrid: Cross fertilization between two varieties or, more usually, two species of vines, see also crossing. [NIH] Hydration: Combining with water. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrolysis: The process of cleaving a chemical compound by the addition of a molecule of water. [NIH] Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other conditions. [NIH] Idiopathic: Describes a disease of unknown cause. [NIH] Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunoblotting: Immunologic methods for isolating and quantitatively measuring immunoreactive substances. When used with immune reagents such as monoclonal antibodies, the process is known generically as western blot analysis (blotting, western). [NIH]

Immunodiffusion: Technique involving the diffusion of antigen or antibody through a semisolid medium, usually agar or agarose gel, with the result being a precipitin reaction. [NIH]

Immunoelectrophoresis: A technique that combines protein electrophoresis and double immunodiffusion. In this procedure proteins are first separated by gel electrophoresis (usually agarose), then made visible by immunodiffusion of specific antibodies. A distinct elliptical precipitin arc results for each protein detectable by the antisera. [NIH] Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunosuppressant: An agent capable of suppressing immune responses. [EU] Immunosuppressive: Describes the ability to lower immune system responses. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Incision: A cut made in the body during surgery. [NIH] Incompetence: Physical or mental inadequacy or insufficiency. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins,

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intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infiltration: The diffusion or accumulation in a tissue or cells of substances not normal to it or in amounts of the normal. Also, the material so accumulated. [EU] Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Internal Capsule: White matter pathway, flanked by nuclear masses, consisting of both afferent and efferent fibers projecting between the cerebral cortex and the brainstem. It consists of three distinct parts: an anterior limb, posterior limb, and genu. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestines: The section of the alimentary canal from the stomach to the anus. It includes the large intestine and small intestine. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Invasive: 1. Having the quality of invasiveness. 2. Involving puncture or incision of the skin or insertion of an instrument or foreign material into the body; said of diagnostic techniques. [EU]

Involuntary: Reaction occurring without intention or volition. [NIH] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Ischemia: Deficiency of blood in a part, due to functional constriction or actual obstruction of a blood vessel. [EU] Ischemic stroke: A condition in which the blood supply to part of the brain is cut off. Also called "plug-type" strokes. Blocked arteries starve areas of the brain controlling sight, speech, sensation, and movement so that these functions are partially or completely lost. Ischemic stroke is the most common type of stroke, accounting for 80 percent of all strokes. Most ischemic strokes are caused by a blood clot called a thrombus, which blocks blood flow in the arteries feeding the brain, usually the carotid artery in the neck, the major vessel

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bringing blood to the brain. When it becomes blocked, the risk of stroke is very high. [NIH] Karyotypes: The characteristic chromosome complement of an individual, race, or species as defined by their number, size, shape, etc. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Language Development: The gradual expansion in complexity and meaning of symbols and sounds as perceived and interpreted by the individual through a maturational and learning process. Stages in development include babbling, cooing, word imitation with cognition, and use of short sentences. [NIH] Language Development Disorders: Conditions characterized by language abilities (comprehension and expression of speech and writing) that are below the expected level for a given age, generally in the absence of an intellectual impairment. These conditions may be associated with deafness; brain diseases; mental disorders; or environmental factors. [NIH] Language Disorders: Conditions characterized by deficiencies of comprehension or expression of written and spoken forms of language. These include acquired and developmental disorders. [NIH] Language Therapy: Rehabilitation of persons with language disorders or training of children with language development disorders. [NIH] Laryngeal: Having to do with the larynx. [NIH] Laryngectomy: Total or partial excision of the larynx. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Lassitude: Weakness; exhaustion. [EU] Lesion: An area of abnormal tissue change. [NIH] Leucocyte: All the white cells of the blood and their precursors (myeloid cell series, lymphoid cell series) but commonly used to indicate granulocytes exclusive of lymphocytes. [NIH]

Leukaemia: An acute or chronic disease of unknown cause in man and other warm-blooded animals that involves the blood-forming organs, is characterized by an abnormal increase in the number of leucocytes in the tissues of the body with or without a corresponding increase of those in the circulating blood, and is classified according of the type leucocyte most prominently involved. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipid Peroxidation: Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]

Lithium Carbonate: A lithium salt, classified as a mood-stabilizing agent. Lithium ion alters the metabolism of biogenic monoamines in the central nervous system, and affects multiple neurotransmission systems. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood

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and aids in digestion by secreting bile. [NIH] Lobe: A portion of an organ such as the liver, lung, breast, or brain. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Loop: A wire usually of platinum bent at one end into a small loop (usually 4 mm inside diameter) and used in transferring microorganisms. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphoblastic: One of the most aggressive types of non-Hodgkin lymphoma. [NIH] Lymphoblasts: Interferon produced predominantly by leucocyte cells. [NIH] Lymphocytes: White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each); those with characteristics of neither major class are called null cells. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Lymphoma: A general term for various neoplastic diseases of the lymphoid tissue. [NIH] Macroglia: A type of neuroglia composed of astrocytes. [NIH] Macrophage: A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells. [NIH] Macula: A stain, spot, or thickening. Often used alone to refer to the macula retinae. [EU] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Malignant tumor: A tumor capable of metastasizing. [NIH] Malnutrition: A condition caused by not eating enough food or not eating a balanced diet. [NIH]

Mammogram: An x-ray of the breast. [NIH] Manic: Affected with mania. [EU] Manifest: Being the part or aspect of a phenomenon that is directly observable : concretely expressed in behaviour. [EU] Mastication: The act and process of chewing and grinding food in the mouth. [NIH] Maxillary: Pertaining to the maxilla : the irregularly shaped bone that with its fellow forms the upper jaw. [EU]

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Medial: Lying near the midsaggital plane of the body; opposed to lateral. [NIH] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Mental: Pertaining to the mind; psychic. 2. (L. mentum chin) pertaining to the chin. [EU] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]

Mesoderm: The middle germ layer of the embryo. [NIH] Metabolic disorder: A condition in which normal metabolic processes are disrupted, usually because of a missing enzyme. [NIH] Methotrexate: An antineoplastic antimetabolite with immunosuppressant properties. It is an inhibitor of dihydrofolate reductase and prevents the formation of tetrahydrofolate, necessary for synthesis of thymidylate, an essential component of DNA. [NIH] Metoclopramide: A dopamine D2 antagonist that is used as an antiemetic. [NIH] Microbe: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Microcalcifications: Tiny deposits of calcium in the breast that cannot be felt but can be detected on a mammogram. A cluster of these very small specks of calcium may indicate that cancer is present. [NIH] Microglia: The third type of glial cell, along with astrocytes and oligodendrocytes (which together form the macroglia). Microglia vary in appearance depending on developmental stage, functional state, and anatomical location; subtype terms include ramified, perivascular, ameboid, resting, and activated. Microglia clearly are capable of phagocytosis and play an important role in a wide spectrum of neuropathologies. They have also been suggested to act in several other roles including in secretion (e.g., of cytokines and neural growth factors), in immunological processing (e.g., antigen presentation), and in central nervous system development and remodeling. [NIH] Microscopy: The application of microscope magnification to the study of materials that cannot be properly seen by the unaided eye. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Mitochondria: Parts of a cell where aerobic production (also known as cell respiration) takes place. [NIH] Mitochondrial Swelling: Increase in volume of mitochondria due to an influx of fluid; it occurs in hypotonic solutions due to osmotic pressure and in isotonic solutions as a result of altered permeability of the membranes of respiring mitochondria. [NIH]

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Mobility: Capability of movement, of being moved, or of flowing freely. [EU] Modeling: A treatment procedure whereby the therapist presents the target behavior which the learner is to imitate and make part of his repertoire. [NIH] Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoclonal: An antibody produced by culturing a single type of cell. It therefore consists of a single species of immunoglobulin molecules. [NIH] Monoclonal antibodies: Laboratory-produced substances that can locate and bind to cancer cells wherever they are in the body. Many monoclonal antibodies are used in cancer detection or therapy; each one recognizes a different protein on certain cancer cells. Monoclonal antibodies can be used alone, or they can be used to deliver drugs, toxins, or radioactive material directly to a tumor. [NIH] Monocyte: A type of white blood cell. [NIH] Mononuclear: A cell with one nucleus. [NIH] Motor Endplate: The specialized postsynaptic region of a muscle cell. The motor endplate is immediately across the synaptic cleft from the presynaptic axon terminal. Among its anatomical specializations are junctional folds which harbor a high density of cholinergic receptors. [NIH] Motor nerve: An efferent nerve conveying an impulse that excites muscular contraction. [NIH]

Motor Skills: Performance of complex motor acts. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Muscle Fibers: Large single cells, either cylindrical or prismatic in shape, that form the basic unit of muscle tissue. They consist of a soft contractile substance enclosed in a tubular sheath. [NIH] Muscular Diseases: Acquired, familial, and congenital disorders of skeletal muscle and smooth muscle. [NIH] Musculature: The muscular apparatus of the body, or of any part of it. [EU] Mutism: Inability or refusal to speak. [EU] Myelin: The fatty substance that covers and protects nerves. [NIH] Myoclonus: Involuntary shock-like contractions, irregular in rhythm and amplitude,

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followed by relaxation, of a muscle or a group of muscles. This condition may be a feature of some central nervous systems diseases (e.g., epilepsy, myoclonic). Nocturnal myoclonus may represent a normal physiologic event or occur as the principal feature of the nocturnal myoclonus syndrome. (From Adams et al., Principles of Neurology, 6th ed, pp102-3). [NIH] Myosin: Chief protein in muscle and the main constituent of the thick filaments of muscle fibers. In conjunction with actin, it is responsible for the contraction and relaxation of muscles. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Neostriatum: The phylogenetically newer part of the corpus striatum consisting of the caudate nucleus and putamen. It is often called simply the striatum. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neurodegenerative Diseases: Hereditary and sporadic conditions which are characterized by progressive nervous system dysfunction. These disorders are often associated with atrophy of the affected central or peripheral nervous system structures. [NIH] Neurogenic: Loss of bladder control caused by damage to the nerves controlling the bladder. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neurologic: Having to do with nerves or the nervous system. [NIH] Neuromuscular: Pertaining to muscles and nerves. [EU] Neuromuscular Junction: The synapse between a neuron and a muscle. [NIH] Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropathy: A problem in any part of the nervous system except the brain and spinal cord. Neuropathies can be caused by infection, toxic substances, or disease. [NIH] Neurosyphilis: A late form of syphilis that affects the brain and may lead to dementia and death. [NIH] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Nuclear: A test of the structure, blood flow, and function of the kidneys. The doctor injects a mildly radioactive solution into an arm vein and uses x-rays to monitor its progress through

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the kidneys. [NIH] Nuclear Proteins: Proteins found in the nucleus of a cell. Do not confuse with nucleoproteins which are proteins conjugated with nucleic acids, that are not necessarily present in the nucleus. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleoproteins: Proteins conjugated with nucleic acids. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nystagmus: An involuntary, rapid, rhythmic movement of the eyeball, which may be horizontal, vertical, rotatory, or mixed, i.e., of two varieties. [EU] Oculomotor: Cranial nerve III. It originate from the lower ventral surface of the midbrain and is classified as a motor nerve. [NIH] Orofacial: Of or relating to the mouth and face. [EU] Osteogenic sarcoma: A malignant tumor of the bone. Also called osteosarcoma. [NIH] Osteosarcoma: A cancer of the bone that affects primarily children and adolescents. Also called osteogenic sarcoma. [NIH] Otolaryngology: A surgical specialty concerned with the study and treatment of disorders of the ear, nose, and throat. [NIH] Ovum: A female germ cell extruded from the ovary at ovulation. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi). [NIH] Oxygen Consumption: The oxygen consumption is determined by calculating the difference between the amount of oxygen inhaled and exhaled. [NIH] Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paraparesis: Mild to moderate loss of bilateral lower extremity motor function, which may be a manifestation of spinal cord diseases; peripheral nervous system diseases; muscular diseases; intracranial hypertension; parasagittal brain lesions; and other conditions. [NIH]

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Paraplegia: Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with spinal cord diseases, although brain diseases; peripheral nervous system diseases; neuromuscular diseases; and muscular diseases may also cause bilateral leg weakness. [NIH] Paresis: A general term referring to a mild to moderate degree of muscular weakness, occasionally used as a synonym for paralysis (severe or complete loss of motor function). In the older literature, paresis often referred specifically to paretic neurosyphilis. "General paresis" and "general paralysis" may still carry that connotation. Bilateral lower extremity paresis is referred to as paraparesis. [NIH] Parkinsonian Disorders: A group of disorders which feature impaired motor control characterized by bradykinesia, muscle rigidity; tremor, and postural instability. Parkinsonian diseases are generally divided into primary parkinsonism (see Parkinson disease), secondary parkinsonism (see Parkinson disease, secondary) and inherited forms. These conditions are associated with dysfunction of dopaminergic or closely related motor integration neuronal pathways in the basal ganglia. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Pathologies: The study of abnormality, especially the study of diseases. [NIH] Pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope. [NIH] Pathophysiology: Altered functions in an individual or an organ due to disease. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols. [NIH] Peduncle: A narrow supporting part, a stem. [NIH] Penicillamine: 3-Mercapto-D-valine. The most characteristic degradation product of the penicillin antibiotics. It is used as an antirheumatic and as a chelating agent in Wilson's disease. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Periodicity: The tendency of a phenomenon to recur at regular intervals; in biological systems, the recurrence of certain activities (including hormonal, cellular, neural) may be annual, seasonal, monthly, daily, or more frequently (ultradian). [NIH] Peripheral blood: Blood circulating throughout the body. [NIH] Peripheral Nerves: The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and

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connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. [NIH] Peripheral Nervous System: The nervous system outside of the brain and spinal cord. The peripheral nervous system has autonomic and somatic divisions. The autonomic nervous system includes the enteric, parasympathetic, and sympathetic subdivisions. The somatic nervous system includes the cranial and spinal nerves and their ganglia and the peripheral sensory receptors. [NIH] Peripheral Nervous System Diseases: Diseases of the peripheral nerves external to the brain and spinal cord, which includes diseases of the nerve roots, ganglia, plexi, autonomic nerves, sensory nerves, and motor nerves. [NIH] Perivascular: Situated around a vessel. [EU] Phagocytosis: The engulfing of microorganisms, other cells, and foreign particles by phagocytic cells. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phenotype: The outward appearance of the individual. It is the product of interactions between genes and between the genotype and the environment. This includes the killer phenotype, characteristic of yeasts. [NIH] Phonation: The process of producing vocal sounds by means of vocal cords vibrating in an expiratory blast of air. [NIH] Physical Therapy: The restoration of function and the prevention of disability following disease or injury with the use of light, heat, cold, water, electricity, ultrasound, and exercise. [NIH]

Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Pitch: The subjective awareness of the frequency or spectral distribution of a sound. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Pneumonia: Inflammation of the lungs. [NIH] Point Mutation: A mutation caused by the substitution of one nucleotide for another. This results in the DNA molecule having a change in a single base pair. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Pontine: A brain region involved in the detection and processing of taste. [NIH] Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Postural: Pertaining to posture or position. [EU] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the

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convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from incidence, which refers to the number of new cases in the population at a given time. [NIH] Professional Practice: The use of one's knowledge in a particular profession. It includes, in the case of the field of biomedicine, professional activities related to health care and the actual performance of the duties related to the provision of health care. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prosthesis: An artificial replacement of a part of the body. [NIH] Protein C: A vitamin-K dependent zymogen present in the blood, which, upon activation by thrombin and thrombomodulin exerts anticoagulant properties by inactivating factors Va and VIIIa at the rate-limiting steps of thrombin formation. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Pseudobulbar Palsy: Disease of the peripheral nervous system occurring usually after many years of increased lead absorption. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Puberty: The period during which the secondary sex characteristics begin to develop and the capability of sexual reproduction is attained. [EU] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Putamen: The largest and most lateral of the basal ganglia lying between the lateral medullary lamina of the globus pallidus and the external capsule. It is part of the neostriatum and forms part of the lentiform nucleus along with the globus pallidus. [NIH] Putrefaction: The process of decomposition of animal and vegetable matter by living organisms. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radiata: The hyaline or faintly radially striated oesinophilic membrane in immediate contact with the outer wall of the ovum. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the

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waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Recombination: The formation of new combinations of genes as a result of segregation in crosses between genetically different parents; also the rearrangement of linked genes due to crossing-over. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Reductase: Enzyme converting testosterone to dihydrotestosterone. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Retina: The ten-layered nervous tissue membrane of the eye. It is continuous with the optic nerve and receives images of external objects and transmits visual impulses to the brain. Its outer surface is in contact with the choroid and the inner surface with the vitreous body. The outer-most layer is pigmented, whereas the inner nine layers are transparent. [NIH] Retinae: A congenital notch or cleft of the retina, usually located inferiorly. [NIH] Retinal: 1. Pertaining to the retina. 2. The aldehyde of retinol, derived by the oxidative enzymatic splitting of absorbed dietary carotene, and having vitamin A activity. In the retina, retinal combines with opsins to form visual pigments. One isomer, 11-cis retinal combines with opsin in the rods (scotopsin) to form rhodopsin, or visual purple. Another, all-trans retinal (trans-r.); visual yellow; xanthopsin) results from the bleaching of rhodopsin by light, in which the 11-cis form is converted to the all-trans form. Retinal also combines with opsins in the cones (photopsins) to form the three pigments responsible for colour vision. Called also retinal, and retinene1. [EU]

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Retraction: 1. The act of drawing back; the condition of being drawn back. 2. Distal movement of teeth, usually accomplished with an orthodontic appliance. [EU] Retrospective: Looking back at events that have already taken place. [NIH] Retroviral vector: RNA from a virus that is used to insert genetic material into cells. [NIH] Rhythmicity: Regular periodicity. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Sarcoma: A connective tissue neoplasm formed by proliferation of mesodermal cells; it is usually highly malignant. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Segmental: Describing or pertaining to a structure which is repeated in similar form in successive segments of an organism, or which is undergoing segmentation. [NIH] Segmentation: The process by which muscles in the intestines move food and wastes through the body. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Sensory loss: A disease of the nerves whereby the myelin or insulating sheath of myelin on the nerves does not stay intact and the messages from the brain to the muscles through the nerves are not carried properly. [NIH] Sequencing: The determination of the order of nucleotides in a DNA or RNA chain. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sharpness: The apparent blurring of the border between two adjacent areas of a radiograph having different optical densities. [NIH] Shock: The general bodily disturbance following a severe injury; an emotional or moral upset occasioned by some disturbing or unexpected experience; disruption of the circulation, which can upset all body functions: sometimes referred to as circulatory shock. [NIH]

Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Signs and Symptoms: Clinical manifestations that can be either objective when observed by a physician, or subjective when perceived by the patient. [NIH] Skeletal: Having to do with the skeleton (boney part of the body). [NIH]

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Skull: The skeleton of the head including the bones of the face and the bones enclosing the brain. [NIH] Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Solid tumor: Cancer of body tissues other than blood, bone marrow, or the lymphatic system. [NIH] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve skeletal muscle or smooth muscle. [NIH] Spasmodic: Of the nature of a spasm. [EU] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Speech Disorders: Acquired or developmental conditions marked by an impaired ability to comprehend or generate spoken forms of language. [NIH] Speech Intelligibility: Ability to make speech sounds that are recognizable. [NIH] Speech Perception: The process whereby an utterance is decoded into a representation in terms of linguistic units (sequences of phonetic segments which combine to form lexical and grammatical morphemes). [NIH] Speech-Language Pathology: The study of speech or language disorders and their diagnosis and correction. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Spinal Cord Diseases: Pathologic conditions which feature spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord. [NIH]

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Spinal Nerves: The 31 paired peripheral nerves formed by the union of the dorsal and ventral spinal roots from each spinal cord segment. The spinal nerve plexuses and the spinal roots are also included. [NIH] Spirometry: Measurement of volume of air inhaled or exhaled by the lung. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenomegaly: Enlargement of the spleen. [NIH] Sporadic: Neither endemic nor epidemic; occurring occasionally in a random or isolated manner. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Steel: A tough, malleable, iron-based alloy containing up to, but no more than, two percent carbon and often other metals. It is used in medicine and dentistry in implants and instrumentation. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subspecies: A category intermediate in rank between species and variety, based on a smaller number of correlated characters than are used to differentiate species and generally conditioned by geographical and/or ecological occurrence. [NIH] Supplementation: Adding nutrients to the diet. [NIH] Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Symptomatology: 1. That branch of medicine with treats of symptoms; the systematic discussion of symptoms. 2. The combined symptoms of a disease. [EU] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Tacrolimus: A macrolide isolated from the culture broth of a strain of Streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Technetium: The first artificially produced element and a radioactive fission product of uranium. The stablest isotope has a mass number 99 and is used diagnostically as a radioactive imaging agent. Technetium has the atomic symbol Tc, atomic number 43, and atomic weight 98.91. [NIH] Telangiectasia: The permanent enlargement of blood vessels, causing redness in the skin or

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mucous membranes. [NIH] Telencephalon: Paired anteriolateral evaginations of the prosencephalon plus the lamina terminalis. The cerebral hemispheres are derived from it. Many authors consider cerebrum a synonymous term to telencephalon, though a minority include diencephalon as part of the cerebrum (Anthoney, 1994). [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Thalamic Diseases: Disorders of the centrally located thalamus, which integrates a wide range of cortical and subcortical information. Manifestations include sensory loss, movement disorders; ataxia, pain syndromes, visual disorders, a variety of neuropsychological conditions, and coma. Relatively common etiologies include cerebrovascular disorders; craniocerebral trauma; brain neoplasms; brain hypoxia; intracranial hemorrhages; and infectious processes. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thermal: Pertaining to or characterized by heat. [EU] Thrombin: An enzyme formed from prothrombin that converts fibrinogen to fibrin. (Dorland, 27th ed) EC 3.4.21.5. [NIH] Thrombomodulin: A cell surface glycoprotein of endothelial cells that binds thrombin and serves as a cofactor in the activation of protein C and its regulation of blood coagulation. [NIH]

Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tonal: Based on special tests used for a topographic diagnosis of perceptive deafness (damage of the Corti organ, peripheral or central damage, i. e. the auditive cortex). [NIH] Tone: 1. The normal degree of vigour and tension; in muscle, the resistance to passive elongation or stretch; tonus. 2. A particular quality of sound or of voice. 3. To make permanent, or to change, the colour of silver stain by chemical treatment, usually with a heavy metal. [EU] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Tonicity: The normal state of muscular tension. [NIH] Torsion: A twisting or rotation of a bodily part or member on its axis. [NIH] Torticollis: Wryneck; a contracted state of the cervical muscles, producing twisting of the neck and an unnatural position of the head. [EU] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU]

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Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxin: A poison; frequently used to refer specifically to a protein produced by some higher plants, certain animals, and pathogenic bacteria, which is highly toxic for other living organisms. Such substances are differentiated from the simple chemical poisons and the vegetable alkaloids by their high molecular weight and antigenicity. [EU] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Tracheostomy: Surgical formation of an opening into the trachea through the neck, or the opening so created. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Tricyclic: Containing three fused rings or closed chains in the molecular structure. [EU] Trigeminal: Cranial nerve V. It is sensory for the eyeball, the conjunctiva, the eyebrow, the skin of face and scalp, the teeth, the mucous membranes in the mouth and nose, and is motor to the muscles of mastication. [NIH] Tumour: 1. Swelling, one of the cardinal signs of inflammations; morbid enlargement. 2. A new growth of tissue in which the multiplication of cells is uncontrolled and progressive; called also neoplasm. [EU] Uranium: A radioactive element of the actinide series of metals. It has an atomic symbol U, atomic number 92, and atomic weight 238.03. U-235 is used as the fissionable fuel in nuclear weapons and as fuel in nuclear power reactors. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Valine: A branched-chain essential amino acid that has stimulant activity. It promotes muscle growth and tissue repair. It is a precursor in the penicillin biosynthetic pathway. [NIH]

Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vegetative: 1. Concerned with growth and with nutrition. 2. Functioning involuntarily or unconsciously, as the vegetative nervous system. 3. Resting; denoting the portion of a cell cycle during which the cell is not involved in replication. 4. Of, pertaining to, or characteristic of plants. [EU]

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Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventricular: Pertaining to a ventricle. [EU] Vertebrae: A bony unit of the segmented spinal column. [NIH] Vertebral: Of or pertaining to a vertebra. [EU] Vestibular: Pertaining to or toward a vestibule. In dental anatomy, used to refer to the tooth surface directed toward the vestibule of the mouth. [EU] Vestibule: A small, oval, bony chamber of the labyrinth. The vestibule contains the utricle and saccule, organs which are part of the balancing apparatus of the ear. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Vinca Alkaloids: A class of alkaloids from the genus of apocyanaceous woody herbs including periwinkles. They are some of the most useful antineoplastic agents. [NIH] Vincristine: An anticancer drug that belongs to the family of plant drugs called vinca alkaloids. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Visual Acuity: Acuteness or clearness of vision, especially of form vision, which is dependent mainly on the sharpness of the retinal focus. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vocal cord: The vocal folds of the larynx. [NIH] Voice Disorders: Disorders of voice pitch, loudness, or quality. Dysphonia refers to impaired utterance of sounds by the vocal folds. [NIH] Voice Quality: Voice quality is that component of speech which gives the primary distinction to a given speaker's voice when pitch and loudness are excluded. It involves both phonatory and resonatory characteristics. Some of the descriptions of voice quality are harshness, breathiness and nasality. [NIH] Volition: Voluntary activity without external compulsion. [NIH] White blood cell: A type of cell in the immune system that helps the body fight infection and disease. White blood cells include lymphocytes, granulocytes, macrophages, and others. [NIH]

X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH] Yeasts: A general term for single-celled rounded fungi that reproduce by budding. Brewers' and bakers' yeasts are Saccharomyces cerevisiae; therapeutic dried yeast is dried yeast. [NIH] Zymogen: Inactive form of an enzyme which can then be converted to the active form, usually by excision of a polypeptide, e. g. trypsinogen is the zymogen of trypsin. [NIH]

137

INDEX A Aberrant, 15, 105 Acetylcholine, 105, 111 Acetylcholinesterase, 17, 105 Acoustic, 4, 5, 8, 9, 11, 12, 15, 16, 20, 21, 22, 24, 31, 43, 44, 45, 60, 72, 78, 105 Actin, 105, 125 Acute lymphoblastic leukemia, 61, 105 Acute lymphocytic leukemia, 105 Adjustment, 3, 105 Adverse Effect, 105, 131 Aerobic, 105, 123 Afferent, 105, 120 Agarose, 105, 119 Airway, 50, 105 Algorithms, 12, 105, 109 Alkaloid, 105, 112 Alternative medicine, 82, 105 Amino Acids, 106, 109, 127, 129 Amphetamines, 106, 112 Amygdala, 106, 108, 134 Analysis of Variance, 9, 106 Anatomical, 17, 106, 111, 119, 123, 124, 131 Anesthesia, 22, 105, 106 Antibiotics, 106, 109, 127 Antibodies, 106, 119, 124 Antibody, 106, 109, 112, 113, 119, 120, 124 Anticoagulant, 106, 129 Anticonvulsant, 106, 111 Antiemetic, 106, 107, 123 Antigen, 106, 112, 119, 120, 123 Antimetabolite, 106, 123 Antineoplastic, 106, 109, 123, 136 Antioxidant, 8, 106, 126 Antipsychotic, 107, 125 Anxiety, 70, 107 Apathy, 107, 125 Aphasia, 12, 13, 21, 34, 46, 54, 61, 70, 71, 72, 73, 74, 83, 94, 107 Applicability, 16, 107 Apraxia, 12, 13, 22, 25, 26, 37, 39, 40, 45, 69, 70, 71, 72, 73, 74, 75, 76, 77, 83, 107 Aqueous, 107, 108 Arteries, 107, 108, 109, 111, 120 Arteritis, 27, 107 Artery, 62, 107, 108, 115, 120 Articular, 78, 107

Articulation, 28, 37, 47, 68, 71, 72, 73, 75, 78, 107 Assay, 10, 107 Astrocytes, 107, 122, 123 Asymptomatic, 107, 116 Ataxia, 7, 8, 10, 13, 18, 26, 30, 32, 37, 38, 58, 61, 108, 134 Atrial, 108, 116 Atrophy, 23, 108, 125 Auditory, 4, 12, 14, 43, 58, 71, 108, 118 Autoimmune disease, 108, 124 Autonomic Nervous System, 108, 128 Axons, 108, 128 B Bacteria, 106, 108, 115, 123, 132, 135 Balloon Occlusion, 27, 108 Basal Ganglia, 14, 107, 108, 109, 117, 119, 127, 129 Basal Ganglia Diseases, 108, 117, 119 Base, 17, 47, 108, 114, 121, 128, 134 Basilar Artery, 27, 108 Bewilderment, 108, 113 Bilateral, 28, 30, 58, 108, 126, 127 Bile, 108, 122 Biogenic Monoamines, 109, 121 Biomechanics, 17, 109 Biotechnology, 18, 82, 89, 109 Bladder, 109, 124, 125, 135 Bleomycin, 60, 109 Blood vessel, 109, 111, 120, 132, 133, 134, 135 Blot, 109, 119 Blotting, Western, 109, 119 Bone Marrow, 15, 105, 109, 117, 132 Bone Marrow Transplantation, 15, 109 Bradykinesia, 109, 127 Brain Diseases, 109, 117, 121, 127 Brain Stem, 15, 37, 109, 111 Breathing Exercises, 68, 109 Bulbar, 13, 33, 76, 109 C Calcification, 32, 109 Calcium, 109, 110, 112, 123 Caloric intake, 74, 110 Carbohydrate, 110, 118 Carbon Dioxide, 110, 130 Carcinogenic, 110, 120 Carcinoma, 57, 110

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Dysarthria

Cardiac, 57, 110 Cardiomyopathy, 10, 110 Case report, 4, 23, 24, 26, 29, 37, 41, 44, 49, 58, 59, 110 Case series, 49, 110 Catheter, 108, 110 Caudal, 110, 128 Cell Cycle, 110, 135 Cell Respiration, 110, 123, 130 Central Nervous System, 18, 105, 106, 108, 109, 110, 112, 115, 117, 121, 123, 124, 125, 128 Cerebellar Diseases, 108, 110, 117, 135 Cerebellum, 7, 14, 15, 109, 110, 128, 130 Cerebral, 4, 9, 20, 21, 23, 28, 30, 35, 36, 39, 42, 72, 108, 109, 111, 114, 116, 120, 132, 134 Cerebral Arteries, 108, 111 Cerebral Cortex, 108, 109, 111, 116, 120 Cerebral hemispheres, 108, 109, 111, 134 Cerebral Palsy, 4, 9, 20, 21, 28, 39, 42, 72, 111, 132 Cerebrovascular, 25, 36, 48, 49, 50, 61, 108, 111, 134 Cerebrum, 111, 134 Cervical, 43, 68, 111, 134 Cervix, 111 Character, 111, 114 Chemotherapy, 58, 62, 111 Chin, 111, 123 Chiropractic, 59, 61, 111 Choline, 105, 111 Cholinergic, 107, 111, 124 Chronic, 9, 23, 32, 33, 37, 60, 111, 114, 120, 121 Chronic Disease, 111, 121 Cleft Lip, 73, 111 Cleft Palate, 72, 73, 111 Clinical trial, 5, 8, 89, 111, 115, 127, 129, 130 Clonazepam, 19, 111 Clonic, 112 Cloning, 109, 112 Coca, 112 Cocaine, 30, 112 Cognition, 75, 112, 121, 125 Collapse, 112, 118 Communication Disorders, 12, 13, 16, 19, 23, 25, 28, 29, 33, 34, 44, 47, 48, 49, 50, 70, 72, 78, 83, 88, 94, 112 Complement, 112, 113, 121

Complementary and alternative medicine, 57, 63, 112 Complementary medicine, 57, 113 Computational Biology, 89, 113 Concomitant, 6, 10, 13, 113 Confusion, 13, 113, 114, 125 Conjugated, 113, 126 Conjunctiva, 113, 135 Connective Tissue, 17, 70, 109, 113, 116, 117, 122, 128, 131 Connective Tissue Cells, 113 Consciousness, 113, 114 Constriction, 113, 120 Continuum, 71, 113 Contraindications, ii, 113 Contralateral, 47, 113, 130 Coordination, 6, 34, 111, 113, 124 Corpus, 12, 113, 117, 125 Cortex, 40, 107, 113, 130, 134 Cortical, 14, 23, 42, 113, 131, 134 Cranial, 110, 113, 126, 127, 128, 135 Cues, 9, 11, 16, 113 Curative, 113, 134 Cutaneous, 21, 32, 113 Cytarabine, 58, 113 Cytokines, 113, 123 D Degenerative, 73, 94, 114 Deglutition, 76, 114 Delirium, 107, 114, 118 Dementia, 14, 19, 20, 41, 54, 61, 72, 107, 114, 125 Dendrites, 114, 125 Depressive Disorder, 114, 121 Diabetes Insipidus, 32, 114 Diabetes Mellitus, 10, 114, 118, 120 Diagnostic procedure, 67, 82, 114 Diffusion, 114, 119, 120 Digestion, 108, 114, 122, 133 Direct, iii, 25, 114, 115, 130 Discrete, 15, 114 Disease Progression, 6, 13, 114 Disorientation, 113, 114 Dissection, 17, 62, 114 Disseminated sclerosis, 39, 115 Dopamine, 107, 112, 115, 123 Dorsal, 115, 128, 133 Double-blind, 19, 115 Drug Interactions, 115 Dyskinesia, 32, 42, 107, 115 Dysphagia, 18, 22, 24, 26, 30, 32, 38, 41, 43, 72, 73, 74, 76, 94, 115

139

Dysphonia, 12, 72, 74, 115, 136 Dystonia, 29, 107, 115 E Efferent, 115, 120, 124 Efficacy, 4, 9, 15, 47, 48, 62, 115 Electromagnetic Fields, 42, 115 Electrons, 107, 108, 115, 120, 126, 130 Electrophoresis, 115, 119 Embolus, 115, 119 Environmental Health, 88, 90, 115 Enzyme, 105, 115, 117, 123, 130, 134, 136 Epiphyseal, 115 Epiphyses, 43, 115 Erythrocytes, 109, 116 Ethnic Groups, 72, 116 Exhaustion, 116, 121 Expert Systems, 116, 117 Expiration, 109, 116, 130 Expiratory, 116, 128 Extracellular, 107, 113, 116 Extracellular Matrix, 113, 116 Extraocular, 7, 116 Extravasation, 116, 118 Extremity, 116, 126, 127 Eye Movements, 7, 116 F Facial, 18, 25, 31, 42, 47, 116 Family Planning, 89, 116 Fat, 109, 115, 116, 121, 124, 132 Fatigue, 6, 116 Fibrosis, 116, 131 Fissure, 111, 116 Flaccid, 78, 79, 116 Flecainide, 26, 116 Fossa, 26, 37, 48, 110, 116 Free Radicals, 106, 116 Functional magnetic resonance imaging, 14, 23, 116 Fuzzy Logic, 12, 117 G GABA, 112, 117 Gait, 13, 19, 110, 117 Gait Ataxia, 13, 110, 117 Ganglia, 15, 105, 108, 117, 125, 128 Ganglioside, 15, 117 Gangrene, 60, 117 Gene, 10, 13, 15, 109, 117 Gene Expression, 117 Gene Therapy, 15, 117 Genetic Screening, 10, 117 Genetics, 7, 33, 43, 117 Genotype, 117, 128

Geriatric, 41, 60, 117 Gestures, 72, 117 Globus Pallidus, 108, 117, 129 Glossectomy, 74, 117 Glucose, 10, 114, 118, 120 Glucose Intolerance, 114, 118 Glucose tolerance, 10, 118 Glucose Tolerance Test, 118 Governing Board, 118, 128 Growth factors, 118, 123 H Habitual, 8, 9, 111, 118 Haloperidol, 39, 118 Handicap, 3, 118 Hearing Disorders, 112, 118 Heat Stroke, 34, 118 Hematoma, 60, 118 Hemiparesis, 40, 118 Hemoglobinopathies, 117, 118 Hemorrhage, 29, 40, 42, 118, 133 Hepatic, 114, 118 Hereditary, 8, 10, 19, 62, 118, 125 Heredity, 117, 118 Homogeneous, 7, 113, 118 Homologous, 117, 118, 133 Hormonal, 108, 119, 127 Hybrid, 8, 119 Hydration, 74, 119 Hydrogen, 108, 110, 119, 121, 124, 126 Hydrolysis, 105, 119 Hypokinesia, 47, 119, 127 I Idiopathic, 4, 16, 119 Immune system, 119, 122, 124, 135, 136 Immunoblotting, 17, 119 Immunodiffusion, 119 Immunoelectrophoresis, 17, 119 Immunohistochemistry, 17, 119 Immunosuppressant, 119, 123 Immunosuppressive, 119, 133 Impairment, 3, 4, 11, 16, 24, 28, 44, 72, 108, 114, 115, 117, 119, 121, 123 In vitro, 8, 117, 119, 133 In vivo, 117, 119, 133 Incision, 119, 120 Incompetence, 36, 119 Infarction, 28, 30, 34, 40, 41, 46, 119 Infection, 114, 119, 122, 125, 127, 136 Infiltration, 15, 120 Inflammation, 15, 107, 115, 116, 120, 128 Ingestion, 118, 120 Initiation, 14, 120

140

Dysarthria

Innervation, 68, 120 Insulator, 120, 124 Insulin, 118, 120 Intermittent, 7, 120 Internal Capsule, 41, 120 Intestinal, 118, 120 Intestines, 120, 131 Intravenous, 25, 120 Intrinsic, 9, 120 Invasive, 7, 120, 122 Involuntary, 19, 108, 120, 124, 126, 130, 132 Ions, 108, 119, 120, 124 Ischemia, 23, 108, 117, 120 Ischemic stroke, 27, 120 K Karyotypes, 117, 121 Kb, 88, 121 L Language Development, 121 Language Development Disorders, 121 Language Disorders, 72, 73, 112, 121, 132 Language Therapy, 4, 19, 43, 44, 47, 94, 121 Laryngeal, 38, 78, 121 Laryngectomy, 72, 73, 121 Larynx, 17, 72, 121, 135, 136 Lassitude, 6, 121 Lesion, 11, 23, 27, 77, 79, 121, 122, 133 Leucocyte, 121, 122 Leukaemia, 37, 121 Leukemia, 117, 121 Lip, 35, 36, 37, 51, 62, 111, 121 Lipid, 111, 120, 121, 124, 126 Lipid Peroxidation, 121, 126 Lithium, 29, 39, 107, 121 Lithium Carbonate, 29, 39, 121 Liver, 26, 108, 118, 121, 122 Lobe, 59, 106, 122 Localization, 77, 119, 122 Localized, 118, 120, 122, 128 Loop, 61, 122 Lymph, 111, 122 Lymph node, 111, 122 Lymphoblastic, 122 Lymphoblasts, 105, 122 Lymphocytes, 106, 121, 122, 133, 136 Lymphoid, 106, 121, 122 Lymphoma, 21, 57, 122 M Macroglia, 122, 123 Macrophage, 15, 122

Macula, 14, 122 Magnetic Resonance Imaging, 7, 122 Malignant, 106, 122, 125, 126, 131 Malignant tumor, 122, 126 Malnutrition, 108, 122 Mammogram, 109, 122, 123 Manic, 107, 121, 122 Manifest, 7, 122 Mastication, 122, 135 Maxillary, 111, 122 Medial, 111, 117, 123 MEDLINE, 89, 123 Medullary, 123, 129 Membrane, 107, 112, 113, 116, 121, 123, 129, 130 Memory, 72, 114, 123 Meninges, 110, 123, 132 Mental, iv, 5, 14, 20, 33, 74, 88, 90, 109, 111, 112, 113, 114, 116, 119, 121, 123, 129 Mental Disorders, 119, 121, 123, 129 Mental Retardation, 33, 74, 112, 123 Mesoderm, 111, 123 Metabolic disorder, 114, 123 Methotrexate, 21, 62, 123 Metoclopramide, 23, 36, 123 Microbe, 123, 134 Microcalcifications, 109, 123 Microglia, 15, 107, 123 Microscopy, 17, 123 Migration, 111, 123 Mitochondria, 8, 123 Mitochondrial Swelling, 123, 125 Mobility, 68, 124 Modeling, 14, 124 Modification, 16, 37, 59, 124, 129 Molecular, 13, 17, 89, 91, 109, 113, 124, 135 Molecular Structure, 124, 135 Molecule, 106, 108, 112, 118, 119, 124, 126, 128, 130 Monitor, 124, 125 Monoclonal, 61, 119, 124 Monoclonal antibodies, 61, 119, 124 Monocyte, 15, 124 Mononuclear, 15, 124 Motor Endplate, 17, 124 Motor nerve, 124, 126, 128 Motor Skills, 71, 124 Multiple sclerosis, 11, 28, 42, 46, 60, 73, 124 Muscle Fibers, 17, 124, 125 Muscular Diseases, 124, 126, 127 Musculature, 119, 124

141

Mutism, 23, 37, 47, 49, 124 Myelin, 124, 131 Myoclonus, 38, 124 Myosin, 17, 125 N Necrosis, 29, 119, 125 Neoplasm, 125, 131, 135 Neostriatum, 125, 129 Nervous System, 8, 105, 108, 110, 125, 128, 135 Networks, 12, 14, 125 Neural, 12, 14, 105, 123, 125, 127 Neurodegenerative Diseases, 7, 108, 125 Neurogenic, 5, 13, 16, 72, 74, 78, 125 Neuroleptic, 42, 107, 125 Neurologic, 8, 11, 21, 78, 125 Neuromuscular, 25, 105, 125, 127 Neuromuscular Junction, 105, 125 Neuronal, 8, 15, 125, 127 Neurons, 7, 8, 13, 15, 112, 114, 117, 125, 133 Neuropathy, 8, 125 Neurosyphilis, 125, 127 Neurotoxicity, 21, 26, 125 Nonverbal Communication, 112, 125 Nuclear, 13, 58, 108, 115, 120, 125, 126, 135 Nuclear Proteins, 13, 126 Nuclei, 106, 115, 117, 122, 126 Nucleic acid, 126 Nucleoproteins, 126 Nucleus, 8, 10, 13, 30, 31, 45, 108, 117, 122, 124, 125, 126, 129, 134 Nystagmus, 13, 32, 126 O Oculomotor, 7, 126 Orofacial, 26, 40, 60, 126 Osteogenic sarcoma, 62, 126 Osteosarcoma, 126 Otolaryngology, 17, 27, 30, 36, 70, 126 Ovum, 126, 129 Oxidation, 107, 121, 126 Oxidative Stress, 8, 126 Oxygen Consumption, 126, 130 P Palate, 41, 68, 111, 126 Palliative, 126, 134 Palsy, 4, 20, 24, 37, 126 Paralysis, 20, 68, 107, 109, 118, 126, 127, 132 Paraparesis, 126, 127 Paraplegia, 32, 33, 43, 127 Paresis, 19, 30, 42, 47, 68, 127

Parkinsonian Disorders, 41, 127 Parkinsonism, 107, 127 Pathologic, 13, 109, 127, 132 Pathologies, 11, 72, 127 Pathologist, 72, 73, 76, 127 Pathophysiology, 12, 18, 39, 127 Patient Education, 94, 95, 98, 100, 103, 127 Patient Selection, 19, 127 Peduncle, 30, 127, 130 Penicillamine, 31, 127 Penicillin, 127, 135 Peptide, 127, 129 Perception, 14, 15, 16, 47, 118, 127 Periodicity, 127, 131 Peripheral blood, 15, 127 Peripheral Nerves, 10, 127, 128, 133 Peripheral Nervous System, 75, 117, 125, 126, 127, 128, 129 Peripheral Nervous System Diseases, 117, 126, 127, 128 Perivascular, 123, 128 Phagocytosis, 123, 128 Pharmacologic, 106, 128, 135 Phenotype, 8, 15, 128 Phonation, 50, 75, 128 Physical Therapy, 4, 128 Physiologic, 6, 12, 40, 59, 119, 125, 128, 130, 135 Pitch, 11, 128, 136 Plants, 105, 110, 111, 112, 118, 128, 135 Pneumonia, 113, 128 Point Mutation, 8, 128 Pons, 108, 109, 128 Pontine, 40, 46, 47, 128 Posterior, 26, 37, 48, 108, 110, 115, 120, 126, 128 Postsynaptic, 124, 128 Postural, 7, 127, 128 Practice Guidelines, 90, 128 Prenatal, 117, 129 Presynaptic, 124, 129 Prevalence, 10, 40, 129 Professional Practice, 73, 129 Progression, 7, 13, 41, 129 Progressive, 7, 10, 18, 24, 29, 32, 33, 37, 41, 43, 44, 54, 60, 61, 74, 76, 114, 125, 129, 135 Prosthesis, 44, 61, 129 Protein C, 13, 129 Protein S, 109, 129 Proteins, 10, 106, 109, 112, 113, 119, 124, 126, 127, 129

142

Dysarthria

Protocol, 11, 73, 129 Pseudobulbar Palsy, 24, 129 Psychiatric, 46, 70, 112, 123, 129 Psychiatry, 19, 22, 24, 25, 29, 30, 33, 34, 35, 38, 39, 41, 42, 49, 129 Psychic, 123, 129, 131 Puberty, 10, 129 Public Policy, 89, 129 Putamen, 29, 108, 125, 129 Putrefaction, 117, 129 Q Quality of Life, 10, 76, 83, 129 R Radiata, 41, 47, 129 Radiation, 116, 129, 130, 136 Radioactive, 119, 124, 125, 130, 133, 135 Randomized, 115, 130 Receptor, 106, 112, 115, 130 Recombination, 117, 130 Recurrence, 57, 127, 130 Red Nucleus, 108, 130 Reductase, 123, 130 Refer, 1, 112, 122, 125, 130, 135, 136 Reflex, 21, 59, 68, 116, 130 Regimen, 115, 130 Reliability, 76, 130 Remission, 130 Respiration, 4, 27, 75, 109, 110, 124, 130 Retina, 130, 131 Retinae, 122, 130 Retinal, 130, 136 Retraction, 62, 131 Retrospective, 8, 131 Retroviral vector, 117, 131 Rhythmicity, 58, 131 Rigidity, 20, 127, 128, 131 Risk factor, 8, 49, 131 Rod, 68, 131 S Sarcoma, 131 Sclerosis, 4, 5, 6, 8, 23, 31, 40, 42, 45, 49, 73, 76, 124, 131 Screening, 10, 76, 111, 117, 131 Secretion, 123, 131 Segmental, 6, 11, 15, 16, 29, 131 Segmentation, 15, 47, 131 Seizures, 111, 114, 131 Sensory loss, 10, 131, 134 Sequencing, 14, 131 Sex Characteristics, 129, 131 Sharpness, 131, 136 Shock, 124, 131, 135

Side effect, 29, 58, 95, 105, 107, 131, 134 Signs and Symptoms, 10, 130, 131 Skeletal, 10, 124, 131, 132 Skull, 132, 134 Smooth muscle, 106, 113, 124, 132 Social Environment, 129, 132 Soft tissue, 109, 132 Solid tumor, 109, 132 Somatic, 128, 132 Spasm, 61, 132 Spasmodic, 12, 69, 72, 132 Spastic, 4, 19, 32, 33, 36, 43, 45, 46, 59, 78, 79, 132 Spasticity, 132 Specialist, 79, 96, 132 Species, 8, 119, 121, 123, 124, 132, 133, 135, 136 Spectrum, 123, 132 Speech Disorders, 5, 12, 16, 39, 68, 69, 70, 71, 72, 74, 75, 77, 95, 132 Speech Intelligibility, 5, 9, 11, 16, 25, 31, 60, 70, 132 Speech Perception, 14, 15, 16, 132 Speech-Language Pathology, 4, 70, 71, 72, 132 Sphincter, 121, 132 Spinal cord, 15, 107, 109, 110, 117, 123, 125, 126, 127, 128, 130, 132, 133 Spinal Cord Diseases, 117, 126, 127, 132 Spinal Nerves, 127, 128, 133 Spirometry, 4, 133 Spleen, 133 Splenomegaly, 19, 133 Sporadic, 125, 133 Staging, 4, 133 Steel, 68, 133 Stimulus, 120, 130, 133 Stomach, 118, 120, 133 Stress, 8, 11, 74, 108, 126, 133 Stroke, 3, 4, 11, 13, 19, 21, 22, 23, 26, 33, 35, 42, 43, 45, 47, 48, 61, 70, 71, 72, 83, 88, 120, 133 Subspecies, 132, 133 Supplementation, 9, 33, 133 Symptomatic, 45, 116, 133 Symptomatology, 76, 133 Synaptic, 124, 133 T Tacrolimus, 25, 133 Tardive, 29, 32, 42, 107, 133 Technetium, 57, 133 Telangiectasia, 61, 133

143

Telencephalon, 108, 111, 134 Temporal, 9, 31, 45, 46, 106, 118, 134 Thalamic, 28, 108, 134 Thalamic Diseases, 108, 134 Therapeutics, 94, 95, 134 Thermal, 14, 134 Thrombin, 129, 134 Thrombomodulin, 129, 134 Thrombosis, 129, 133, 134 Tissue, 17, 106, 108, 109, 113, 114, 115, 116, 117, 118, 120, 121, 122, 123, 124, 125, 128, 130, 131, 132, 134, 135 Tolerance, 112, 118, 134 Tonal, 50, 134 Tone, 132, 134 Tonic, 17, 112, 134 Tonicity, 115, 134 Torsion, 119, 134 Torticollis, 69, 134 Toxic, iv, 125, 134, 135 Toxicity, 26, 115, 134 Toxicology, 90, 135 Toxin, 46, 134, 135 Trachea, 121, 135 Tracheostomy, 74, 135 Transfection, 109, 117, 135 Transplantation, 17, 26, 135 Trauma, 108, 114, 125, 134, 135 Tremor, 49, 50, 94, 127, 135 Tricyclic, 29, 135 Trigeminal, 15, 135 Tumour, 26, 37, 48, 49, 135

U Uranium, 133, 135 Urine, 109, 114, 135 Uterus, 111, 113, 135 V Vaccine, 129, 135 Valine, 127, 135 Vascular, 119, 120, 132, 135 Vegetative, 15, 135 Vein, 108, 120, 125, 136 Ventral, 126, 128, 133, 136 Ventricular, 116, 136 Vertebrae, 132, 136 Vertebral, 62, 108, 136 Vestibular, 7, 136 Vestibule, 136 Veterinary Medicine, 89, 136 Vinca Alkaloids, 136 Vincristine, 58, 60, 136 Virulence, 134, 136 Visual Acuity, 10, 136 Vitro, 136 Vocal cord, 128, 136 Voice Disorders, 72, 73, 136 Voice Quality, 11, 136 Volition, 120, 136 W White blood cell, 105, 106, 122, 124, 136 X X-ray, 5, 34, 122, 125, 136 Y Yeasts, 128, 136 Z Zymogen, 129, 136

144

Dysarthria