Central Nervous System Control of Voice and Swallowing.

This review of the central nervous control systems for voice and swallowing has suggested that the traditional concepts of a separation between cortical and limbic and brain stem control should be refined and be more integrative. For voice production, a separation of the nonhuman vocalization system from the human learned voice production system has been posited based primarily on studies of nonhuman primates. However, recent humans studies of emotionally based vocalizations and human volitional voice production have shown more integration between these two systems than previously proposed. Recent human studies have shown that reflexive vocalization as well as learned voice production not involving speech involve a common integrative system. However, recent studies of nonhuman primates have provided evidence that some cortical activity vocalization and cortical changes occur with training during vocal behavior. For swallowing, evidence from the macaque and functional brain imaging in humans indicates that the control for the pharyngeal phase of swallowing is not primarily under brain stem mechanisms as previously proposed. Studies suggest that the initiation and patterning of swallowing for the pharyngeal phase is also under active cortical control for both spontaneous as well as volitional swallowing in awake humans and nonhuman primates.