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Expletives: Neurolinguistic and
neurobehavioral inquiries into swearing
Article in Brain Research Reviews · December 1999
DOI: 10.1016/S0165-0173(99)00060-0 · Source: PubMed

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Brain Research Reviews 31 Ž1999. 83–104
www.elsevier.comrlocaterbres

Full-length review

Expletives: neurolinguistic and neurobehavioral perspectives on
swearing
D. Van Lancker
b

a,b,)

, J.L. Cummings

c

a
Department of Neurology, UniÕersity of Southern California, Los Angeles, CA, USA
Department of Speech-Language Pathology and Audiology, New York UniÕersity, School of Education, 719 Broadway, Suite 200, New York, NY, 10003,
USA
c
Departments of Neurology and Psychiatry and BiobehaÕioral Sciences, UniÕersity of California at Los Angeles, Los Angeles, CA, USA

Accepted 5 October 1999

Abstract
Severe aphasia, adult left hemispherectomy, Gilles de la Tourette syndrome ŽGTS., and other neurological disorders have in common
an increased use of swearwords. There are shared linguistic features in common across these language behaviors, as well as important
differences. We explore the nature of swearing in normal human communication, and then compare the clinical presentations of
selectively preserved, impaired and augmented swearing. These neurolinguistic observations, considered along with related neuroanatomical and neurochemical information, provide the basis for considering the neurobiological foundation of various types of swearing
behaviors. q 1999 Elsevier Science B.V. All rights reserved.
Keywords: Neural basis of behavior cursing; Aphasia; Gilles de la Tourette’s syndrome; Coprolalia; Basal ganglia; Limbic system

Contents
1. Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Swearing in normal individuals . . . . . . . . . . . . . . . . . .
3. Swearing in aphasia following stroke and left hemispherectomy .
4. Gilles de la Tourette syndrome ŽGTS. . . . . . . . . . . . . . . .
5. Exploring coprolalia in GTS: does the Markov model work? . . .
6. Comparison of swearing in aphasia and GTS . . . . . . . . . . .
7. Emotional and prosodic processing . . . . . . . . . . . . . . . .
8. Cerebral laterality . . . . . . . . . . . . . . . . . . . . . . . . .
9. Pathological basis to GTS: a basal-ganglia disorder . . . . . . . .
10. Limbic system-basal ganglia hypothesis . . . . . . . . . . . . . .
11. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . .
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1. Background
Swearing, the use of deistic, visceral and other taboo
words and phrases, has long held a unique and colorful
)

Corresponding author. Department of Speech-Language Pathology
and Audiology, New York University, School of Education, 719 Broadway, Suite 200, New York, NY, 10003, USA. Fax: q1-212-995-4356;
e-mail: diana.vanlancker@nyu.edu

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status in language behavior. Public awareness of swearing
is far keener than, say, interest in relative clauses or the
semantic features of nouns, yet the topic is much less
studied. Swearing and related verbal usage has ubiquitous
social, legal and political implications, which have touched
each and every person at some time or other. Laws against
swearing in public still exist in some states and, informally, fines may be incurred in social settings w126x.
Knowledge of swearwords takes hold early in child lan-

0165-0173r99r$ - see front matter q 1999 Elsevier Science B.V. All rights reserved.
PII: S 0 1 6 5 - 0 1 7 3 Ž 9 9 . 0 0 0 6 0 - 0

Neurological treatments of emotional behaviors discuss related phenomena. Pathological use of expletives and taboo words and phrases is a key feature of Gilles de la Tourette syndrome ŽGTS. sex. ‘‘shiver my timbers’’. flux of popular terms.124.g. except for swearing.’’ We will consider subdivisions as they are useful to this analysis. King William of Orange was said to use his native language.. they do so at different times.210x normal swearing patterns has appeared. in various contexts.123x. characterization and classification of swearwords is itself daunting. Tardive Tourettism. there are only a few sets of available recorded data on the incidence or frequency of use of taboo expressions across contemporary population samples. which he did in English w65x.. spinal cord patients w149x. ‘‘God’’. ‘‘Bloody’’ and its variants. including racial and ethnic slurs... 8. Foote and Woodward w94x asked college students to list words ‘‘obscene to you’’ using both written and tape-re- .. Excessive swearing occurs in traumatic brain injury w267x and in paraplegic.g. which has clinical similarities to GTS w144. Van Lancker. even the most modern.g.181x and contemporary w80. Descriptive work on historical w123. ‘‘gracious’’. ‘‘ virtually all societies.. Ž13. Sacred places Že.226x. In his book on the history of swearing. Although crosslinguistic surveys are few. madness.. Particular atten- tion is commonly paid to the genitals and related regions in insult behavior. Given the range and variety of observations. French. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 guage development w117x and often quickly achieves a solid status in the second language learner w181x. w20x. Ref.101. the topic appears to be linguistically and neurologically complex.L. essentially because they are considered shocking or obscene. de Klerk w139x investigated use of expletives by male and female adolescents of differing social and educational backgrounds. Even more dramatically. It occurs in the elderly in association with depression w43.139. Oaths by natural objects Žsun. Ž14. such as pathological laughing and crying. Despite its obvious role in normal and impaired communication.. and in part to a belief that swearing is peripheral to more interesting aspects of communicative behaviors. Saints. Ž8.... Supernatural or infernal powers Že. sometimes with coprolalia. excretion and nationality. Ž4. According to Hughes. We call this large set of words ‘‘expletives’’. and ‘‘ visceral’’ Žbody functions-related.. Ž12. and variations in social attitudes toward the words considered ‘‘taboo’’ further complicate the matter w97. Steadman w240x approached the topic by asking subjects to compile lists of taboo words. serious study of the neurology of swearing behavior is lacking. Some manifestations of swearing behaviors in clinical settings may be reactive to the disease condition. Swearing in normal individuals The definition. and admittedly using a circular definition. in stark contrast to the remaining speech and language disability. but not swearing Že...130–132. dementia w239x and klazomania w16x. Name of valued personal attributes Že. Ancestors and heroes. Although etymologies and historical examples from literary sources are readily available. Data reviewed by Flynn w92x suggest that sex-related insults are a cultural universal. Hughes w123x observes that ‘‘Swearing draws upon such powerful and incongruous resonators as religion.. swearing takes a prominent role in various neuropathologies of language.. ‘‘mackerel’’.84 D. has been reported following use of neuroleptics w15. w123x. cursing Ž‘‘damn you’’.. Swearwords and phrases are produced with normal articulation and prosody. ‘‘by the royal robe’’. Animals. and sufficient observations from neurological patients have accumulated to merit an overview and exploration of the neurology of swearing.g. Whatever the reasons for a traditional lack of explanatory commentary on swearing..264x. encephalitis w118x. and oaths Ž‘‘by God’’.73x including in a Japanese patient w141x. especially Sydenham’s chorea. w222x and certain other movement disorders. Ž2.’’ ‘‘anal-erythral terms’’ and ‘‘genital words’’. males provided the greater number. Ž5. He offers fourteen categories of swearwords that have been utilized through the ages: Ž1. Ž7. This neglect is due possibly in part to a universal negative response to use of swearwords. addressing this question is warranted to advance understanding of the neurobiology of communicative behavior. Sacred matters of religion Že. Euphemisms.. but the actual array of expletives extends into many semantic domains. products Ž‘‘goose’’. Montagu w181x distinguishes between swearing Ž‘‘damn it’’. Ž11. Vulgar or obscene words Žbody parts.g. Classical divinities Ž‘‘by Jove’’. Ž9. ‘‘swearwords’’ or ‘‘taboo expressions’’. Ž3. German ‘‘Donnerwetter’’. ‘‘Jerusalem’’. retain some taboos against swearing’’ Žp.g. Future life Ž‘‘Heavens’’. It is the use more than the item itself that determines the swear-like force of the expression. Ž6. For example. Post-ictal swearing has been reported in epilepsy w50. with varying emotive content to the expressions. ‘‘holy mass’’.. A 15th class may be added: social insults. plants... For our purposes. wEnglish ‘‘thunderstorm’’x. and we refer to this activity as ‘‘swearing’’ or ‘‘cursing. Ž10.221x.. Shortly after the Norman Conquest of England. 3. Ruler or authority Že. and found differences associated with gender and ‘‘social power’’. encompassing an extraordinary variety of attitudes’’ Žp. A useful division breaks the types of words used into the categories of ‘‘deistic’’ Žreligion-related. observations by anthropologists suggest that most people in most cultures use expletives w181x.. 2. it is sufficient to identify the group of words that are socially opprobrious. Miscellaneous phrases having unusual force Ž‘‘hang it’’. J. Gallahorn w101x divides his data on normal swearing into three categories: ‘‘curse words. ‘‘maidenhead’’. swearing is frequently one of a small set of speech functions — ‘‘automatic speech’’ — selectively preserved in the severely aphasic patient.

which Gallahorn classified into ‘‘curse words. 270.. w131x Žg..motherfucker Ž23. Ža. while others are merely ‘‘preferred’’ by them ŽRef..95. crap Ž41.45. Christ Ž16. Jesus ŽChrist. nigger Ž8. Jesus Christ Ž3.76.. shaft Ž1.. A study by Gallahorn w101x tabulated and analyzed use of taboo words by psychiatric ward personnel at psychiatric staff meetings. slut Ž2. The most frequent exemplars of each class. w244x. or sentence schema has its own shape and variations: for example. God Ž68.. son of a bitch Ž2.. with counts in parentheses. godwdamnx.. laid Ž1. four 1st-year residents. fuck Ž2... screw Ž11.. pissed off Ž10.. bastard Ž3. A similar. damn Ž22. To discuss the grammar of swearwords. table Ž4...32.. which could be classified into two general types: ‘‘religious profanities and obscenities related to physical acts and organs’’ Žp. These authors classified the items into ‘‘denotative classes’’ called ‘‘body process’’.. w162x.. five aides and occasional other nurses. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 corded response formats. piss Ž2. fascist Ž2.’’ where the first slot can Table 1 Data on normal occurrences of swearing Ždescending order of frequency. blows Ž1. some of which are peculiar to them’’.. spic Ž2. shack up Ž1.. and other variables.. but more examples of obscene language were produced by males than females. dildo Ž1. Each word. fuck Ž24.. goddamn Ž4. Four nonswear words were included fuck Ž33... Van Lancker. whore Ž3. God.. bitch.72.. can Ž3. Nine most frequent swear words by college students ŽRef.. dipshit Ž1.86.. 372 taboo words were used. account for 57% of the observations...23. crap. fuckin’ Ž2. piece of ass Ž1... bastard Ž5. dirty Ž4. bullshit Ž4. peckerhead Ž1. damn Ž87. phrase. Jew Ž1. hellŽ5. context. shit Ž15. bitch Ž13. p.L. The top ten swearwords of West Coast speakers ages 70 and under obtained from field observations are shown in Table 1f w131x. p. Jesus.30. asshole Ž17... in Table 1.. 364. piss Ž1. ‘‘ethnic-racial slur’’.73. Žshown as Table 1c.. bastard Ž12. p. Mode of production did not affect quantity of responses. prick Ž2. wet dream Ž1. giving frequency counts of specific expletives as correlated with speaker’s gender. cock. To explore the words people use privately. but would not use in polite company or when speaking before an audience’’ Žp..44. butt Ž3. ass Ž6. hell Ž50.93. Normal usage survey ŽRef. asshole Ž2. balls Ž2. ‘‘body product’’. the head nurse.. Žb.. 26 swear words. bitch Ž17. Subjects were asked to rate the words for frequency of personal use and for offensiveness.. survey questionnaires were administered to an elderly population in western Massachusetts. ‘‘social deviation’’. ass Ž3. Ž28... hot pants Ž2.05. briefer survey was conducted by Nuwer w192x. in order of frequency. with more words on days with specific issues. theme. who attended the meeting. ass Ž9.. Taylor utilized the notion of ‘‘schemata’’..... Perusal of the grammar of expletives reveals that taboo words appear to function differently from other words.. shit.. shit Ž33.52. The results are summarized in Table 1g. motherfucker Ž1.D. J. Top 10 swear words of West Coast speakers Žages 1–70.45. bitch Ž4......tits Ž2.. three staff nurses.. shit Ž3. balls Ž1. and that males curse more than females.... nigger Ž1.. cunt Ž23. damn Ž5. son of a bitch Ž19... age.. A large field study of cursing language used in public by speakers over the age of 45 revealed that most cursing is made up of 18 words ŽTable 1d.. fuck Ž1.. bullshit Ž15. fart Ž2. 311. Nursing home residents... ‘‘Curse words’’ were most commonly produced. w94x.45..12. ‘‘ancestral allusion’’..98.. prick. ass Ž19.. rated for frequency in personal use in an elderly population in western Massachusetts w132x.82. pimp Ž1. Interestingly. or formulae. Four most frequently used words Žhell. bastard Ž25. w101x. 18.. bullshit Ž3. analerythral. Žfrequency 1 meant ‘‘never’’ and 9 meant ‘‘ very often’’. and ‘‘unclassified’’. cock Ž1. fart hell Ž45.33... blowjob Ž1.28. the phrase schema ‘‘rrin therrhell Žheck.. 364. shit and Jesus wChristx.. Data from nursing home residents Žover age 70.17. Žc... whore Ž2..21. Gallahorn noted daily events on ward..13. consisting of the ward chief. hell. fuck.. ass.86. whore Ž10.. damn Ž27.. danger Ž4. come Ž1. damn.33. are similar ŽTable 1e. bitch Ž3.. shit Ž33... averaging 2. w192x.. Ž3. Twenty-eight different words were produced. and genital words’’.. ass Ž22. the time spent discussing a patient. who asked 30 neurologically normal subjects to list the words ‘‘he or she would use when upset... p. Twelve words resulted from this survey. son of a bitch Ž1. 177.. . son of a bitch Ž3. bitch Ž25.. damn Ž45.63.28. Ž33.9 each meeting Žsee Table 1b. and the taboo words used. shit Ž129. flower Ž4. slut Ž2. bastard Ž1. pig Ž3. shit Ž33. queer Ž2. expletive usage diminished during socially stressful periods on the psychiatric ward. hell Ž84.. God Ždamn. During 128 days.. A wide variety of different types of swearwords occur among the 10 most frequently used. Žd.. God Ž34. developed by Lyons ŽRef. He noted who used the words and to whom they were addressed. containing 26 taboo words derived from Jay’s previous field studies w132x. A linguistic analysis of swearing in Australian English noted that swearwords ‘‘combine morphologically and syntactically with other items in a number of interesting ways. ‘‘body part’’.. p. fag Ž1. Jesus ŽChrist. aides.11.. God damn Ž15. asshole Ž6. and social workers... ‘‘animal’’. Linguistic analysis of expletives has been sparse. ‘‘religious blasphemy’’... reamed Ž1. fuck Ž212. over age 70 w132x Žf.. 85 The most extensive survey work has been done by Jay w130–132x. ‘‘Public production lexicon’’ of 18 unique words by speakers over the age of 45 w132x Že. Swear words spoken by psychiatric ward personnel in 6-month period ŽRef.51. are given as Ža. 364....95.. hell Ž60... prick Ž2.

He produced no speech other than ‘‘well’’.. because current linguistic theory characterizes the sentence ŽS. in contrast to the view of Jackson. use of it Žp.g.’s swearing remains to be studied. my God’’ and ‘‘Oh my goodness will’’. 6. When asked to read the written word ‘‘shit’’ aloud. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 be filled by ‘‘how’’.. ya know.. Rather than calling the utterances in which words like ‘‘fuck’’ and ‘‘damn’’ appear ‘‘sentences’’. etc. was unable to speak. etc. and in attempts to talk. and the two expletives ‘‘goddammit’’ and ‘‘shit’’ w256x. and a verb phrase ŽVP. Jackson also cites Trousseau’s reports of patients saying ‘‘sacre nom de Dieu’’ Ža French expletive. investigators examining usage in British English and German have recently performed new surveys of residual expressions spoken by persons with severe aphasia ŽTable 2. But in discussing recurrent utterances. This observation is striking in global aphasia. These utterances simply express a favorable or unfavorable attitude on the part of the speaker towards the thing or things denoted by the noun phrase’’ Žp. ‘‘yeah’’.. discrepancy seen in R. pronounced with errors in articulation and in speech melody. ‘‘automatic’’ material. This is a bold claim. and his auditory–verbal language comprehension was severely limited. Whether this damage is specific to the spontaneous Žor automatic.N.. 230. it is not possible to include adverbial elements Že.. Swearing in aphasia following stroke and left hemispherectomy As stated by Jackson w128x. by definition. ‘‘why’’. ‘‘bloody’’.N. Critchley observed that the utterance repertory of the patient can ‘‘largely fulfill the wishes and needs of the patient’’. 172–204. he discusses a patient with one recurrent utterance who also ‘‘swore when vexed’’ Žp.. pause-fillers Žwell. as in ‘‘fuck you’’. ‘‘no’’. However. 184. Later. rather like ‘‘Oh my God’’ in English. temporal and parietal areas of the left hemisphere. Van Lancker. and expletives flow fluently with effortlessly normal articulation and prosody w248x. and that the swearing behaviors in Australian English can be well specified for descriptive and pedagogical purposes. that recurrent utterances. the resultant phrase does not have the external syntax of a VP Žverb phrase. the second.. as being made up of a noun phrase ŽNP. although his affective response to the request indicated he had comprehended the written word.. leaving only expletives... each VP has a verb ŽV..N. Jackson’s interpretation of the use of recurrent utterances was that the severely aphasic patient had lost the ability to ‘‘propositionalize’’.. A chronically aphasic patient we studied made liberal use of the expression ‘‘Jesus Christ’’. a speechless patient may retain the word ‘‘no’’. not the propositional. Lum and . 160. can be used voluntarily. R. ‘‘by midnight’’. including ‘‘damn’’ and ‘‘Goddamn’’. w64x. 160. including that when the word is combined with other words. Dong w79x identified a category of words — certain expletives — that do not fit anywhere in this characterization. when used in apparently sentential frames. he was unable to produce the spoken word. and yet have only the interjectional or emotional. sustained damage to the supplementary motor area on the left hemisphere. is not a verb. ‘‘The speechless patient may occasionally swear’’ Žp. diagnosed with global aphasia following a stroke that involved frontal. where speech is effortful and limited to high frequency single words and short phrases. produced fluently in comparison with his otherwise severe word finding difficulties and effortful speech. in answer to questions. Taylor concludes that people swear according to certain types of rules. ŽRef. with the former being ‘‘expressive’’ and the latter ‘‘communicative’’ ŽRef.. ‘‘yes’’. versus elicited Žvolitional. days of the week.. This conclusion is based on a number of linguistic arguments. including counting from one to ten and other serial speech Žalphabet.. functions as a verb. and the second with ‘‘fuckin’’. expletives were deemed essentially to be ‘‘involuntary’’. Thus. Thus there is linguistic evidence that expletives form a separate class in human language. J. the one with the meaning ‘‘fornicate’’. where speech is almost nonexistent. the basic unit of language. Dong w79x argued that there are two words of the form ‘‘fuck’’. R. or ‘‘fuck these problems’’. Thus.N. In varying combinations in different persons with aphasia. Another patient said ‘‘Oh.N. 229. and in nonfluent aphasia. sacon’’ Žp.. including swearing. Another produced the term ‘‘shit’’ fluently and liberally. which is known to play an important role in speech initiation. it has been noted commonly that persons with aphasia emit preserved and fully intact utterances classified as ‘‘automatic speech’’. Patient R. ‘‘what’’. literally ‘‘sacred name of God’’. used these expressions spontaneously and expressively. 3. Dong recommends the term ‘‘epithet’’. 173. despite intense effort and concentration over several attempts. w64x.. and that the taboo words themselves be called ‘‘quasi-verbs’’. still another’s exclusive utterance was ‘‘pooh’’. p. In his view. In his treatise ‘‘On affectations of speech from disease of the brain’’ in the section on recurrent utterances Žpp. ‘‘flamin’’. In the decades since these early observations. These expressions. was unable to produce these utterances on command. only one of these. p. Following up on the anecdotal observations by Critchley w64x and Jackson w128x of aphasic swearing. and another the abbreviated version ‘‘Sacon. for example. These words were produced with good articulation and prosody.. or repeat. R. interjections and oaths. Sentence schemata can be specified in the same way. This suggests. familiar expressions Žhow are you. We have had reports of ‘‘motherfucker’’ as a recurrent utterance in American english speakers with severe aphasia.L. have ‘‘neither a declarative nor interrogative nor imperative meaning. although superficially appearing to be a verb.86 D. name.. Critchley w64x elaborated on the notions of ‘‘automatic’’ and ‘‘propositional’’ speech.

global or Wernicke’s aphasia. now wait a minute. and expletives formed the second most frequent Ž11r75. policeman. macht nix Ždoesn’t matter. weiss es nicht Ždon’t know. you can’t Ich bin ŽI am. two two two. fucking fucking hell cor blimey. washing machine. Mama-Oma Žma-grandma. Other categories of recurrent utterances were proper nouns Ž5r75. Results indicated that left anterior regions in and near Broca’s area Žareas 44 and 45. bitte sehr Žplease. The majority of ‘‘lexical automatisms’’ Žthese authors’ terms for the term ‘‘real word recurrent utterances’’ used by Code. such as ‘‘ach je’’ ŽOh Lord. In the first actual catalogue of recurrent utterances. and other Ž22r75. so Žso. fuck off. better better. milk. who suffered aphasia due to a cerebral vascular accident. or sing familiar songs. away away away. BBC Heidi. pardon for you. falling into seven categories.. I said. impairment of counting.. Hans nein Hanni.. Although much has been written in clinical descriptions about preserved production of ‘‘automatic speech’’. so and so. bilingual in Hebrew and French. Moni I’m a stane.. repeating familiar phrases. conduction. yep. Bayern.. and other overlearned expressions.. A functional imaging study compared counting 1–10 with generating names of animals. na na na Žwellrnow. I bin to town. were activated during the animal naming task.. Dir Žyou.. Six patients showed a clear ‘‘nonpropositional advantage’’. Žsee Table 2. repetitions Ž14r75. Blanken w24x.. ya yawohl Žyes indeed.. well I know.58x.. I want to one two. A second study of aphasic speech targeted native speakers of German w23–25x.. From a survey study utilizing this patient population... nein nein nein. and ‘‘also’’ Žwell. factory. Žsee Table 2. ach Žohroh really. to recite familiar verses. Percy’s died. Mama. sewing machine Das war wesentlich wichtig gewesen Žthis was essentially important. and ‘‘ach Gottchen’’ Žoh God. I told you. also Žwell. A 75-year-old. in contrast to prestroke function. see Refs. alright.. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 87 Table 2 Recurrent utterances in severe aphasia: Britisha and Germanb corpora Swear words British German Interjections and greetings British German Numeral British German Sentence-stems British German Proper names British German Other British German a b bloody hell. zacki zacki Žquick quick. Hebrew.D. so so. ya. Hallo Žhello. Žthat is all behind us. bloody hell bugger. das ist alles hinten. I try one two.. I did not hear. because.. doch Žbutryet. little has appeared regarding the observe. I will arbeiten und lernen ŽI want to work and study. I can talk. na also Žthere you are. J.. today... following a stroke to the right basal ganglia w235x. compared with sentence completion for propositional expressions w252x. and naming a picture with help of a familiar phrase. so. documented from 30 patients were emotional expressions. ach Gottchen Žoh God. nicht traurig sein Ždon’t be sad. Monika.. Broca’s. piano.. tingaling. but not during counting by normal subjects w254x. Nonpropositional tasks were counting 1–10. ŽNonlexical recurrent utterances also occur. Code w60x concluded that utterances of the isolated right hemisphere consist primarily of automatic and nonpropositional speech Žp. I want to. Mittag Žnoon. Pronounq verb was the most common Žpresent in 14 of 75 patients. three three.L.. fuck fuck fuck. reciting the days of the week. w27. Wednesday. such as ‘‘tja’’ Žwell. counting 1–10 and naming a picture with the help of a familiar phrases reliably differentiated between nonpropositional and propositional speech behaviors. danke danke. Bauern Žfarmers. oh boy ach je Žoh Lord. so so so Žso. ‘‘natuerlich’’ Žof course.. In his overview of linguistic output observed in adults who have undergone a left hemispherectomy. down. John.. Ellis w160x studied nonpropositional speech in aphasia in British English using six tasks. I think one two drei Žthree. nee Žnope. siehste Žyou see. 36 female. yes yes yes. ja ja Žyes yes. One exception comes from a case of a loss of some types of overlearned speech behaviors.. A similar investigation revealed superior sentence completion for familiar idiomatic expressions as a form of nonpropositional speech. because. Code w57x. including well known prayers and blessings in his native language. The propositional match for counting. Bill. off. was unable. paper and pencil. on the corner. Code tabulated a list of real word recurrent utterances.. natuerlich Žof course. was reading the individual Arabic numbers. yesrno Ž4r75.. and interjections. It’s a pity pity pity. 331. I can try. count 1–20. carefully designed to permit a comparison with ‘‘propositional’’ speech ability... and nursery rhymes. I can’t... somewhere somewhere. sister sister tja Žwell. Sie Sie. Code w57x reported on 69 ‘‘real word recurrent utterances’’ produced by 75 adult speakers of British English Ž39 male. money. Parrot. in 28 patients with anomic. Reisen Žtrips. oil. Billy. months of the year. oh you bugger. swearing. no. I can talk and I try. for example.. so. off. time a time.. numbers Ž5r75. goody goody. Of the six tasks. right-handed man. Van Lancker. funny thing funny thing. He could no ..

Gilles de la Tourette syndrome (GTS) GTS is a movement disorder first described by Itard w127x and Gilles de la Tourette w104x. was interviewed by N. The patient was right handed.. no’’. house. had correct rhythm but not the correct words. 4. Well-preserved swearing occurred in E. and ‘‘tsk’’. in a 5-min videotaped interview Time Expletive Spont words Pausefills Sentence init 0 goddammit goddammit one three I. and ‘‘oh’’.and polysyllabic words Žbook. November. E. measuring tape. was unable to name any of 4 target items Žsafety pin. and ‘‘well. leading to near total extirpation of propositional speech. left thalamus and basal ganglia w232. 1772. and ‘‘no place’’. ‘‘boy’’. ‘‘president’’ was repeated as pres-en-dent.. and many instances of ‘‘ah’’. no place well.233x.. featuring seven productions of ‘‘Goddammit!’’. clock. numerous nonverbal communicative vocalizations occurred during the interview. E. such as ‘‘shema Yisrael’’. The most prevalent speech was swearing. ‘‘well.duh safe safety tape de-ve-lop sandwich Pres-en-dent vegent-lich No-vem November s-no tape neah ugh laugh sigh ah sigh mmsigh tsk whaa nah wha tape measI don’t I couldn’t say in then watch laugh goddammit 5 look-y goddammit ahh clock longer recite familiar blessings. he repeated mono. in comparison to other speech Žspontaneous or repeated. develop.’s ability to swear. In the 6 min interview there is a discrepancy in speech production ability related to type of utterance. following neurosurgical removal of his left hemisphere. or intonation Žp. yes 3 4 Response uh 1 2 Naming target shit goddammit safety pin measuring tape oh. yes ah oh ah sood Rep target Rep response Nonverbal vocs book house NoÕember deÕelop remember President constitution deÕelop remember NoÕember m-book uh-house uh mm duhh uh. noting E... 18 months after surgery. as un boy well I can’t that’s a goddammit no eh ah god– goddammit uh nah ah um mm uh oh. a righthanded adult. His spontaneous words were ‘‘one’’. uncertain and dysfluent.C.C. ‘‘I’’. and there was no left-handedness in his family w266x. Geschwind 5 months after neurosurgical removal of his left hemisphere Žsee Table 3. brief laughter.C. yes’’. ‘‘three’’. with articulatory effort and errors Že. Similar observations were made by Zangwill w266x who interviewed E. the speech quality was better..L. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 88 Table 3 Transcription of utterances by EC Žadult left hemispherectomy.. Com- . 1772. one of ‘‘God!’’ and one instance of ‘‘shit’’ in the 5-min session ŽTable 3. which was usually effortful. watch. word order. such as sighs. some of which had been his habit to say daily since he was a young child. Although he had not used expletives a great deal prior to his brain lesion. and brought to modern understanding by Shapiro and Shapiro w222x.C. postmorbidly he no longer cursed or swore. In addition.D. such as ‘‘um’’. he also ‘‘could not provide the correct expletive for situations described to him nor could he complete a curse’’ Žp. Van Lancker. limbic forebrain.C. following development of an infiltrating tumor. yes no well. His attempts at longer prayers. and sounded normal. Besides the greater quantity noted for expletives over other types of speech. and pause fillers.. The surgery included removal of all four left cerebral lobes.g. J.

. q Shapiro et al. svin Žswine. buceta Žcunt. riccione Žfaggot.220. bosta Žshit... pis Žpiss... As clinicopathological correlates dis- Table 4 Reported GTS expressions across languages GTS s number of GTS patients with coprolalia. w141x Ž1 Tardive GTS..169x Ž1 GTS.. i Marneros w165x Ž1 GTS. Hure. bastard. homosexual.. j Lieh-Mak et al. l Perera w196x. mother-fucker. damn fool. hostia Žhost...218. shit ŽAmerican Sign Language. Scheisse Žshit. depending on the nature and age of the 89 population. huththi Žwhore. ... queer. w85x with coprolalia.. no seas malcreado Ždon’t be bad.. joder Žfuck. coitus... rov Žass. minchione Žstupid cunt. porra Žsperm. The vocal tics required for diagnosis of the disorder are classified as a hyperkinetic motor speech disorder w71x. wop Ždescending order of frequency....y Japann – p USAq – w a fuck. cunt. ass. kusobaa Žshit grandma. batidoras national. ajo ajo. de puta. taci.. va tomar no cu Žfuck off.146x w151. k Singer w231x Ž3 GTS.t you fucking idiot. sukebe Žlecherous. chin chin Žcock.129. fem. stupid. smettila. f Asam and Traeger w10x Ž1 GTS.109.. bowel movement. Sgu Žby God. doody. Van Lancker.. fu . c Cardoso et al.... fu . pik Žcock. n Kuniyoshi et al. caralho Žcock... providing a listing of coprolalic expressions in order of frequency ŽTable 4. rat. is present in approximately 25–50% of persons with GTS.. y de Divitiis w78x.. Eingeschlagene Schaedeldecke Žsmashed skull. nigger. v Wallen and Areneta w258x Ž1 GTS. w fuck.. shit. Lees and Tolosa.. m Escalar et al. shi . p Nomura and Segawa w190x Ž4 GTS. w Milman w177x Ž4 GTS. cono Žcunt. shit on youv fucka.. and numerous others Žfor reviews see Refs. bastard. faggot. . tiu Žfuck. imbecillaccio Žstop it. figlio di puttana Žson of a bitch. assholeu fuck you. Žfucking.. genitalia. shit Ždescending order of frequency..186. Fangu Žfuck in Italian... r Lucas w158x Ž4 GTS.56.. hijo Žson. Žfucking. . tui ma Žmotherfucker. bitch. q God damn it. Ž2 GTS... Leiche Žcorpse. and how the clinical population is sampled. gylle Žmanure. hu.. cojones Žballs.. t Nuwer w192x Ž12 GTS.. blow-me. bitch.183.’’ ‘‘behave properly. .. serve me coffee Nutte. zoccola Žwhore. fem. fisse. shui Žbum.. . screw. Prostituierte Žwhore. cock.. cunt. w147x Ž1 GTS... tits. d Reuger et al.. w152x Ž20 GTS. o Nishida w189x Ž1 GTS. bakatara Žstupid. cunt s fuck. x Lees et al... cocksucker. . ass. g Hering w120x Ž1 GTS.. sod. schmuck. fuck.. shit. Ž17 GTS. cacete. kaeft Žshut up. pussy... 1986.. vaffan’culo Žfuck you. e Asam w7x Ž1 GTS. Incidence analyses w223x performed in 146 GTS patients ŽRef. Žfemale sexual parts..106. imbecile. w155x Ž9 GTS. w227x Ž85 GTS.86. The clinical symptom of coprolalia.. or foul speaking. b . Perera Ž1983. w48x Ž9 GTS. chikusho Žson of a whore. tiu Žfuck. stronzo Žpiece of shit. ‘‘shut up..239. suck Ždescending order of frequency....L. whether in cross-section or longitudinally. h Beckers w18x Ž2 GTS. x Lang et al. verfaulte Knochen Žrotten bones. w44.. UK a Spainb Brazil c Denmark d Perue Germany f – i Hong Kong j – k Sri Lankal Italy m.. fart. cock.... . dick. penis.D.112. s Martindale w168. ‘‘other four-letter expressions’’ r ŽFuck my Žyour. Arshloch Žasshole. minchia Žcunt. Žfucking. bastardo Žbastard. J.. merda.. rognoso scabby Žwith scabs. cockey.88. mierda Žshit.. w87x Ž2 GTS. Tod Ždeath. kusse Žcunt. carajo.. whore.’’ ‘‘Why are you such a nuisance’’ shit ŽIndian English. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 ings and Comings w63x. pregnant-mother. documented the highest frequency terms and the range of terms that have been reported to occur. 1993 Ž8 GTS.. bunda Žass. 195.. prick.. .. fag. maricon Žfag. cock. fihlo de puta Žson of a whore.247x. piss. dobusu Žugly. cretinaccio Žshut up. tiu so Žaunt fucker.. u Caplan et al. w47x Ž1 GTS.. puta Žwhore.

palabras soeces’’ Ž‘‘screams and insults.. all pointing to variants of expletives but lacking specific examples. at least two studies have reported coprolalia in GTS w49x with one study reporting that 60% of the GTS subjects used coprolalic expressions w180x. and we indicate when coprolalia was reported without specific instances. Czechoslovakia Ž n s 4. A few unusual examples from a Peruvian report include ‘‘no seas malcreado’’ Ždon’t be bad. in three patients. but do not list the actual words. 60% of whom had single or multiple word coprolalic expressions. wassholex. .141. Boshes w32x described ‘‘Jamie’’. who responded to our inquiry by letter by providing the specific words in Indian English and Sinhalese spoken by his young subjects Žgiven in Table 4. ‘‘shut up. head and shoulder movements. Germany Ž n s 57. are best characterized as obscene or socially taboo terms. inarticulate sounds. 16–17. These signs are to be distinguished from copropraxia.107. and examples are given w48.. stupid’’. and other motor tics in GTS as variants in a hyperkinetic syndrome. In Japanese patients.. Besides this work. This practice retards our ability to perform linguistic analysis of the specific utterances. but the authors did not provide examples of specific vocalizations in the different languages. Coprolalic signing has included signs for ‘‘fuck’’ and ‘‘shit’’ w147x. A few such examples differ somewhat in that they take the form of imperatives Ž‘‘taci. Nutte wprostitutex. de Divitiis w78x provided specific coprolalic examples of a 23-year-old male GTS patient in a letter responding to our request Žsee Table 4. Briones et al.102. primarily with sexual content.56. Spanish examples are given in Singer w226x. it may be most useful to view verbal.203x. GTS patients followed a stereotypical chronological sequence. Many authors refrain in this manner from giving specific coprolalic examples. United Kingdom Ž n s 54. A child in Ireland displayed tics accompanied by cursing which was disruptive socially w161x.258x and coprolalic American Sign Language examples w147x. Perusal of Table 4 reveals that the vocalized words encountered as part of the clinical presentation in GTS. several other authors have provided American English examples w47.214x. Certain terms occur across several patients ŽArshloch. ‘‘bursts of foul language’’.. with examples given w48x. Tod wdeathx.. another gives the example ‘‘trois fois par semaine’’ Žthree times a week.242x. Two patients in Sri Lanka were described by Perera w196x. GTS in the Middle East has been reported w85. yes’’ and ‘‘no. authentic barbarisms. vocal.120. Coprolalia has been reported in Italy w77x with examples w87x.. this patient had French parents w89x. Eastern Europe Ž n s 25. sometimes as social slurs or insults. and Hungary Ž n s 1.154x. and ‘‘serve me coffee’’ w269x Žsee Table 4. Van Lancker. The most frequent coprolalic items observed clinically in the UK are provided by Lees w151x.158. 245. with simple involuntary facial.53x. Pary w195x reports ‘‘episodic cursing’’. had copro- lalia w81x. Hong Kong Ž n s 2.. screams. we document all specific instances to gain insight into the phenomena of neurological swearing. w265x. whether described as a category or in specific terms. and a Brazilian patient with coprolalia and compulsive screaming is described without examples w111x. no’’. Five reports of 38 Polish w29. with minor appearance of imperatives Žshut-up.187. coprolalia is reported w136x. and. Japan Ž n s 2. Insight into the nature of swearing in GTS can be obtained by crosslinguistic investigation... South America.18. 28% of Brazilian GTS patients had coprolalia. 177.. However.90 D.231x in Hong Kong... Clinical descriptions appear in publications from Israel w100. Lees et al. Poland Ž n s 2. autenticas barbaridades. France Ž n s 107. Chinese investigators reported on five w156x and then on 18 GTS patients w155.L. The Danish study of 65 patients lists specific coprolalic utterances w202x. but specific words are not listed. In this article. A Dutch coprolalic patient is described w238x. the only examples given are the Russian words for ‘‘yes.. 715. and for Canadian English. A GTS patient from Guyana. nonverbal vocalizations. vile words’’ Žpp.5x.190x. Scandinavia Ž n s 9. w152x provide a listing of British coprolalic utterances. in another study. A British study includes the utterance ‘‘maman’’ Žmama. that may be self-directed.110. Italy Ž n s 46. A Russian report w172x reviewed eight patients from 9–13 years.. It was reported that approximately 60% of patients sampled in the US w193x. the obscene gestures that also occur in GTS. Cross-cultural clinical commonalities in patients with GTS were observed as early as 1973.140. An important contribution to our understanding comes from the American coprolalic linguistic corpus of Shapiro et al. but no examples were given w217x. J. and as the variants wax and wane within patients. Eapen and Srinath w82x reported coprolalia in an Indian subject but no examples were given. w223x. while others occur in a single person ŽLeiche wcorpsex. India Ž n s 5. Cases have been described for English spoken in Australia w51. Several French cases indicate usage of coprolalia w119x or ‘‘obscene words’’ w153x. Four Argentinean cases were described w175x.165. Other Portuguese language cases have been described w93x. The New Zealand English report speaks of ‘‘fourletter obscenities’’ in a GTS patient w114x. cretinnacio’’.189. A 37-year-old Turkish male with GTS and spinal muscular atrophy had coprolalia. Scheisse. Three papers describe patients in Czechoslovakia w90.. had coprolalia w1.209. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 tinguishing the various clinical manifestations of the movement disorder have not been established.. who ‘‘swore continuously’’ and ‘‘spewed forth an uncontrollable string of obscenities’’ Žp. All examples gleaned from the international literature are given in Table 4.268x and Russian w11x patients mention ‘‘bad’’ or ‘‘obscene’’ words. w37x describe ‘‘gritas y insultas. Numerous papers from Germany provide clinical descriptions and some offer specific coprolalic utterances w7–10.

the phoneme frequency data for conversational American English presented in Kent w137x calculates f at 3% of sounds. Van Lancker. only two vowels and the final t or d rank in the first three phonemes in phoneme frequency counts. which is structured on several hierarchical levels w54. cunt’’ required a two-limited finite state grammar. 6. and at least one step beyond immediately constrained transitional states. and m are the six most frequent sounds in word-initial position. th Žas in then. contain initial phonetic elements of f. and k. Nor could the coprolalic productions be characterized by a one-limited grammar Ž‘‘one in which every word is constrained only by the preceding word’’.14. Thus.D. 7. except for the list assembled by Nuwer w192x. linguists have explained in detail why Markov processes.. k.72 for th. and nt at 4. only approximates a GTS vocalization.122. the vowels are 1st and 9th. the example given by Nuwer of ‘‘third order probabilistic computer-generated strings of letters’’ is unconvincing Žp. respectively. w91x. Numerous frequency listings make possible an objective evaluation of phonemes involved in frequent coprolalic utterances Že.40. a similar result appears from choosing the first 3 1–2 syllable words ŽNutte wwhorex. reveals that w.. place.. Hure wwhorex. In contrast. The numerous other coprolalic utterances. Thus.74. Even if that were not the case.27.89 for m Žsee Table 5. sh.98. While ih is ranked highest Ž10..176x. This hypothesis suggests that randomly generated strings of letters or phonemes utilizing higher order probability tables. noting their initial sounds are f.L.38 for w. my. the hypothesis would have to explain why the other combinations Žseen probabilistically. J. are unaccounted for. In summary. 12 sounds rank between 9th and 18th in phoneme frequency counts. 6. These productions could not be described by ‘‘a grammar in which any tic element may follow any other’’ — a zero-limited grammar Žp.86 for t. which is a level of structure well beyond free combination of elements. and a few other miscellaneous items. p. relevant letter frequency is not among the highest for these words. The coprolalic productions of one GTS patient were analyzed by Martindale w168x Žsee Table 4. examine the three most common coprolalic utterances given in Table 4. SE KIN HE SPER GOT IN THE WORSE FART YOUESS WELL DIN OPTION IN ITIMENTRAND TWO AS TO BE JURGAINS FART ASSE GIVE ONEGS LOVE BE HALLETURN MAY POCK MOUNT ME SAM WE SNOTLEAKETIFULN’T MIGH TOON’T MIT BAR SOMADE SAM SAY It is unconvincing because only one of the phonetic combinations alleged to represent GTS vocalizations appears on the clinical coprolalic listings in Table 4. First. 95.g. t. are irrelevant to speech and language. Added to this range . sh at 1% of sounds. having ratings of 9. d. which occurs in a low position on the descending frequency lists in Table 4. y. on a frequency table for spoken English.96. We find that N is ranked 2. Similarly. w105. Further.. p. k and b. and 9th Žrating s 5. 271..21 for d.65x. the phonetic composition of the most often observed GTS verbal tics in English does not consist of the most frequent phonemes in English. of 19 consonants and vowels making up the three most frequent coprolalic words in American and British English. w46. Žyour. T is ranked 6. 99... who found that the tics and tic strings Žconsisting of from 1–7 words. 5. which occur in 14th Žrating s 3. 366. and comparing them to a mean frequency of occurrence of letters in a German text ŽRef. because tic elements are constrained by more than merely the words preceding them. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 phrases of morbid content Ždeath. exhibited a complex syntax. R is ranked 3. An analysis of relative occurrence of speech sounds as determined from telephone conversations ŽRef. having exclusively transitional-probabilistic properties. is 11th out of a total of 18 vowels. and L is ranked 11 Žsee Table 5. H is ranked 7. Again.157x.76. Arshloch wassholex.48 for y. including the multisyllabic expressions. Medial vowels are uh and ih. respectively on the phoneme frequency list.. t. where more weight is given to those units with a higher probability of occurrence.. According to Fry’s w98x analysis of the frequency of British vowels and consonants in conversation Žreproduced in Refs. Thus the various permutations of the coprolalic utterance ‘‘Fuck your Žmy.55. and the second randomly generated item Žasse. Exploring coprolalia in GTS: does the Markov model work? The claim that observed coprolalic utterances in English GTS speakers can be explained by elementary phonatory positioning w192x related to Markov processes of random sequencing has been championed in the GTS literature. While too few German examples are available in the literature to determine a definitive frequency ranking of coprolalic utterances. uh Žat 4. 6. and 5. Refs. 18th Žrating s 1. facts derived from the statistical ranking of phoneme frequencies do not descriptively account for the phonetic shapes of the three most often used coprolalic utterances in either British or American English. A is ranked 9. w122x.. For coprolalic consonants in final position. the ‘‘top’’ three coprolalic words w223x Žsee Table 4 under USA... 91 fucking Žfucking. t at 14.. do not occur as part of the GTS repertory Žor speech performances generally. and a similar result appears for the consonants: f and k are 9th and 14th. can account for coprolalic productions. Fletcher’s chart w91x for final consonants places k at 2. Of these 19 phonemes.. and nt. This claim is untenable for at least five reasons. Secondly.85.30. the sounds of American coprobalic items are actually among the less probable to occur in American speech. and k at 5% of sounds. For British English.

Sound-type Rank Sound-type pin pine pan pen peel pool pot pane pole pawn pun pull pout par pair purr pew poise 10.09 0. It is the notion of a particular semantic category. ‘‘serve me coffee’’. not a probabilistic tendency toward an accidental concatenation of sounds.86 6.81 2.54 2. ‘‘Germanic’’ utterances. the Markov model is unable to account for coprolalic utterances.42 5. This fact of semantic category overrides any contribution of recurring or ‘‘more frequent’’ phonological elements to the classification.89 5.32 0.19 w t th Žthen. ‘‘fuck’’ and ‘‘cunt’’.37 1.09 2. German: written text Letter Frequency Letter Frequency E N R I S T D H A U L C 147 004 88 351 68 577 63 770 53 881 47 310 43 854 43 554 43 309 31 877 29 312 26 733 G M O B Z W F K V UE P AE 26 672 21 336 17 717 15 972 14 225 14 201 13 598 9558 7350 5799 4992 4907 pothesis was that coprolalic productions in English constitute ancient.00 1. In conclusion. r m k w z v b f p h ng g sh j dj ch th Žthin.10 Sound % sof a bit b et bite but b ait b eat b awd f ather h awed hoot 10. supports the role of the semantic category Žobscenity. This co-occurring behavior lends further support to the notion that it is a semantic-cognitive category that is involved.38 0.79 1.13 1.25 1.46 2. and given the signed forms. constitute an obvious content category of obscene or taboo words of highly diversely configured phonetic composition.14 0.15 1.25 0.31 3. sexual terms. zh 14. We conclude that phoneme or letter frequency counts are not germane to coprolalic utterances.33 4.05 12. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 92 of relatively low probabilities is the uniqueness of the letter combinations.69 1.27 7.72 6.21 4.99 4.78 4.51 3.15 4. .60 0.. the facts do not meet the presumptions.44 6.64 4.30 13.97 1.55 5.60 6.13 Final Consonant Sound-type Rank t r n l z m d v ng s f th Žwith.04 0. words with socially taboo andror emotionally charged meanings.05 0.55 0. copropraxic behaviors of sexual touching and obscene hand gestures are common.01 Table 5 Žcontinued.37 0..66 3.D. as a fourth point. In addition.46 4.14 4.24 0.83 1. zh All vowels % 7.34 0.53 0.40 6..96 1. An occasionally expressed corollary of the Markov hyTable 5 Phoneme and letter frequency tables After Fletcher w91x American English conversation Vowels Initial consonants Žarticles excluded.52 8.42 0.96 0. p ch b g sh j th Žmyth. An explanation for swearing in GTS that is based in neurobiology and not involving probabilities is presented below. Finally. British english conversion All consonants Sound n t d s l th Žthen. that accounts for nearly all coprolalic items.45 1.65 1.46 1.74 1.. we nonetheless note that the phonetic elements form a coherent phrase Že.58 6.26 5.83 0.89 6. also.74 8.97 1.81 3.78 2. co-occur with coprolalic productions. Two highly popular coprolalic utterances. even the monosyllabic examples. that is.14 2.38 7. formed of naturally vocalized. Here.21 5. After Hoermann w122x. not phonetic shape. y d m h k s n b g l f r p th Žthin.75 5.22 3.48 6.56 3.71 1.48 4.96 2. not a probabilistic string. including nonIndoeuropean languages.01 5.88 0. In rare cases where the coprolalic utterance falls outside of the semantic category of taboo words. A third counterargument against the Markov proposal arises from observations of semantic consistency. Van Lancker. actions and mental events conceptually related to the most common coprolalic semantic subcategory.58 6.02 1. The variety of coprolalic utterances across languages as shown in Table 4.78 1.02 After Fry w98x.74 4. ‘‘gutteral’’ phonetic elements.37 1.26 0. J.24 1. the report of coprolalic signing w147x removes the symbolic output completely from the realm of letter or phonemic strings.g.L.80 0.44 4.33 2.57 3. are not attested in Old English w65x. sh v f ch z zh Rank 9.41 0.31 1. Žas in self-directed imperatives or morbid phrases.23 3.75 1. That is.

In the aphasic and left hemispherectomized adult speakers... Unfortunately. namely. A comparison of GTS vocal Žverbal and nonverbal. and response cries constitutes a special variety of impulsive. As coprolalic vocalizations often occur during ongoing conversation. mildly or intensely. in GTS. p. The notion of normal use of vocalizations has been described by Goffman w108x. psychic. In a survey. Ž‘‘fine’’. and if the sensations involve the pharynx or larynx. Patients report that they first feel an urge. The nonverbal tic frequent in GTS was also observed in normal speakers. larynx. w28x. Other questions pertain to how GTS vocalizations compare to vocal tics occurring in normal speech production. ‘‘fake’’ for the more offensive word ‘‘fuck’’. vocalized ones’’ Žp. there is no available corpus of aphasic recurrent utterances for American English.6 per minute. along with facial and other gesturing. One study evaluating verbal tics in three GTS subjects reported that two of the subjects produced 70% of tics at natural pausing points. and fluency. 1345. What is not known is whether a typical recurrent utterance can be elicited from .L. Neither a substitution process nor compensatory shouting is observed in aphasia. Persons with coprolalia have been reported to utilize euphemisms in place of the socially offensive term w165x. vocalization. but. and pronouns. often in strings.143. they appeared to occur at points of low information or uncertainty. One patient describing personal inner experiences stated that ‘‘coprolalia is a response to the TS sensitization of the vocal tissues used in forming sounds.59x. giving an overview of GTS for the general public. 25% feel that the sensation will be relieved by tics. and thus it is necessary to compare the larger GTS coprolalic corpus for American English w223x with the British corpus for aphasia provided by Code w57. The overview of crosslinguistic coprolalic utterances provided above will help explore questions about the clinical presentation of vocalizations in GTS. Swearing in aphasia is best explained by stating that the word choice is fixed but the use is somewhat volitional in spontaneous speech. occur most prominently in aphasia and GTS. 76% experience a sensa- 93 tion preceding the tics. Sensations are described as generalized. A similar process may be underway in the observation that some persons with GTS ‘‘shout’’ words regularly occurring in sentences w50. but verbal tics occurred only in GTS speakers Žabout 35%.. blurted actions. to perform a movement Že. before and after clauses. and by Darwin w72x who discusses the universality of sound emission as emotional expression. and sometimes unintelligible. which is very strong. Martindale w169x studied the syntactic and semantic correlates of verbal tics in a two h sample of speech in a GTS subject.g. Many reports of coprolalic utterances in GTS describe them as distortions: they are overly loud. ‘‘wunderbar’’ Ž‘‘wonderful’’. Another difference lies in ‘‘substitution’’ behavior.D. conversational speech in which it is occurring. In another patient. Listings for both speech pathologies are available in German for comparison. w159x. The volitional component of tics is said to distinguish GTS vocal tic production from abnormal motor behaviors in the choreas w145.. expressed with aberrant voice quality. for example. tics with measures of the same behaviors taken from normal speakers was conducted w159x. p. w147x 71% of GTS patients were found to have a ‘‘feeling that tics are imminent’’.. relative to the ongoing. while speech of the patient with GTS is otherwise normal Žbut see Ref. most vocal tics were produced at the beginnings or ends of a speech clause. tongue. imprecations. Van Lancker. then ‘‘ vocalizations may be produced’’ Žw143x..220. 116. who states that ‘‘the public utterance of self-talk. ‘‘schoen’’. Swearwords have in common that they are socially taboo utterances. often before conjunctions Žand. for example. those to be avoided in ‘‘polite company’’. Differences are found in the manner and in the content of speech performance for these terms. prosody.. Ž‘‘good’’. normally in articulation. swearwords Žtaboo expressions. and then they ‘‘ voluntarily’’ perform the movement w41. Tics were produced at the rate of 4. the coprolalic expression is defective in articulation and prosody.145x. Another important difference in manner of production between adult aphasia and GTS lies in the ‘‘sensory’’ factor proposed for tic behaviors in GTS. imprecisely articulated. 733. swearwords are overproduced in the context of functional speech.. In aphasia. using ‘‘gut’’.193x. and ‘‘Arshloch’’ Ž‘‘Asshole’’. for ‘‘Scheisse’’ Ž‘‘shit’’. suggesting that GTS may involve a ‘‘sensory reflex arc’’ and that the effect of the injection is to reduce ‘‘local build-up of tension or muscle contraction’’ on the laryngeal area w219x. and focal. somewhat less during the clause. swearing is produced Žnearly. and that are therefore. Comparison of swearing in aphasia and GTS Among speech pathologies. Here we explore the similarities and differences in swearword presentation in the two conditions.259x. In another study. tissues and air impinge on each other to activate a single sensory site’’ ŽRef. but this has not been studied directly. states that some persons with GTS learn to mask words. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 6. in that the recurrent utterance can be used expressively. There is no evidence or suggestion of a comparable premonitory sensory component to swearing behavior in aphasia. swearing is selectively preserved in the context of severely impoverished speech. A small number of tics were produced in silence w159x. saying. Shimberg w225x. ‘‘offensive’’ terms. while the third subject produced most tics within stressed words w95x. teeth. or ‘‘shouted’’. J. several studies have evaluated whether or how their occurrence is related to linguistic structure.212. In the GTS speaker. coprolalic practice was reduced by injection into vocal folds of botulinim toxin. possibly to accommodate the coprolalic inpulse in this other way. somewhere in the mouth or throat Žlips.

on its own. especially in the presence of the clinician w31x. presumably attributable to lower acceptability of swearing in Asian culture. Coprolalia in GTS has been reported to wax and wane w263x. there is no report of recurrent automatic speech or residual swearing in sign w19x. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 the aphasic speaker. OCD. in an opposite presentation.. some role of psychological factors is recognized by most persons working with GTS sufferers w125x. and that coprolalic behavior progresses from a stage of volition or semivolition to compulsion. is no longer seriously held. Some patients report having a related thought Že. However.191x. GTS vocal phenomena often are reported to begin as partial.241x. who learned fluent sign in her late teens.L. often appears clinically in association with GTS w68. behind the utterance for a while. aphasic swearing appears to maintain a more stable course. Hong Kong. ‘‘shit’’ appears in both conditions. without the sense of inner tension that accompanies spontaneous coprolalia. a significant interface between neurological and psychiatric features is compelling. These two are the . focused studies on this question have not yet been done.g.. little change in swearing occurs. and these developed into coprolalia. In British. w161x reported a success of family therapy in reducing tics and coprolalic utterances in an 11-year-old child. Beckers w18x gives a strongly psychodynamic interpretation of the clinical presentations of five patients. Tables of data on swearing in British. Brazil. Bruun and Budman w38x observe ‘‘fewer tics in the office setting than reported by history’’ Žp. Physiological versus psychiatric variables are of differing significance in GTS and aphasia. Aphasic speakers generally emerge from the acute phase with a fixed repertory of recurrent utterances. less swearing has been reported for German. seeing a role for psychological factors in the genesis of tic symptomatology.96x. El-Assra w85x states that ‘‘her condition started seven years previously when she became extremely frightened one night by a group of cockroaches in a dark toilet’’. GTS patients may no longer be aware of the quantity of their vocalizations. Longitudinal studies identify other differences between swearing in GTS and aphasia. In the chronic patient. authentic semantic content. Environmental conditions exacerbate or ameliorate the intensity of the symptoms w225x. J.94 D. One or both words occur in various instantiations in most other languages reporting GTS examples: Spain.. and which eventually may evolve to propositionally formed expressions w2x. Given that the content of the verbal tics is primarily the feature of social offensiveness. While careful studies still are needed. which include copropraxia. as it were. Milman w177x reported that three of four boys with coprolalia also had ‘‘body anxiety and sexual anxiety’’ Žp. the compulsive vocal emissions were temporarily reduced w10x.whether hershe can produce the utterance on command. Cultural factors have been said to influence coprolalic output. Van Lancker. in aphasia. soft and indistinct sounds. Voluntary and spontaneous tics may use different underlying mechanisms. followed by multiple tics of neck. although he reported psychotherapy not to be useful in these cases. significant differences appear in GTS versus aphasic swearing. and appears to be a much more significant factor in GTS than aphasia. and American Sign Language. though to a lesser extent. Onset of symptoms is often associated with a traumatic incident w263x. German and American samples in aphasia and GTS reveal little overlap in pathological swearing. Refs. by definition.. with ‘‘quasicoprolalia’’ in Japanese and other Asian GTS cases w129. for example. Coprolalic signing has been reported w147x in a hearing young adult female with GTS and verbal coprolalia. in American English. or. which may change and grow somewhat with time.than American-speaking aphasic patients. ‘‘fuck’’ appears in both pathological conditions. Lumsden et al. Žp. and without the phonetic distortion. In contrast.. EEG studies w193x reported an absence of the pre-movement potential normally associated with voluntary motor acts prior to GTS tics. soon utterances appeared. Indeed. many authors view an array of motor and behavioral abnormalities as constituting a spectrum of related phenomena Že. GTS patients have been repeatedly demonstrated to easily produce their coprolalic utterance at will and on command. such as hostility toward a parent as the cause of the verbal tics. The patient exhibited facial tics four days later. Some authors have speculated that the process is one of a change from a willed act to a motor habit. w62. 894. Meyer and Rose w174x report psychological factors as contributing to the clinical picture in GTS. Even though the previously held exclusive role of psychoanalytic explanations for coprolalia. shoulders and hands. and coprolalia. which develop eventually into louder and clearer vocalizations. In discussing GTS symptoms. in his case report of a 13-year-old Saudi female patient. coprolalia may be ‘‘worse at home when the individual feels safer’’ Žp. 113. until the patient reported no longer being able to say the word.g. Although studies of aphasic signing deficits following left hemisphere damage in deaf persons have appeared w121x. and then eventually the coprolalic utterance proceeds motorically. 31. 397. In contrast. eliciting numerous repetitions of the affected utterance. Pitman and Jenike w199x studied a patient with obsessive-compulsive disorder ŽOCD. that this process is more rapid in GTS sufferers than in normal persons. Similarly. 28. At the later stages. For example.. a neuropsychiatric condition.. which suggested that the tics are not generated through normal motor pathways utilized for willed human movements Žp. Following these therapeutic sessions. worse in the presence of others w85x. Sri Lanka. One study utilized a habituation technique as therapy for coprolalia. and they note the ability of children to mask their symptoms by use of social setting affects aphasic swearing. Thus to the extent that we can locate swearing behavior on a spectrum from ‘‘ voluntary’’ to ‘‘involuntary’’. Germany.

but including an array of nonverbal vocal sounds.201. Thus the psychosocial dimensions associated with coprolalia are not present in aphasic swearing. yesrno. has not been investigated in GTS. For focal 95 damage to the left hemisphere. habitual ‘‘island’’ preservation of motor patterns appear to more essentially underlie the swearing behavior. One study w75x using the Profile of Nonverbal Sensitivity ŽPONS.36. However. aphasic. there are differences in content of the swearword corpus for each group. and a large class of miscellaneous words and phrases ŽTable 2. Heightened social awareness may be a right hemisphere property w237.216x and in neurological subjects. abnormalities involving loudness. in association with a right basal ganglia lesion w235x.133. linguistic vocalizations. or other factors — has remained elusive. with findings of an effect of either left or right hemisphere andror a basal ganglia damage on prosodic ability. Frustration. In a further difference.170... the notion of an interaction of basal ganglia and right hemisphere is attractive.251x. and masking of the form of the residual utterance in aphasia does not occur. Emotional and prosodic processing There have been ample reports of emotional processing by the right hemisphere w33. As mentioned above. We have previously concluded that specified semantic content is a key parameter in GTS coprolalia. ‘‘pregnant-mother’’. Aphasic speakers retain a set of ‘‘automatic utterances’’ which include swearwords as the second most common type. changes in speech prosody production w138. Studies of emotional prosodic comprehension in GTS are rare. visceral and sexually charged obscenities and insults predominate in a spectrum with nonverbal vocal and manual gestures ŽTable 4. and the genuine expression of emotion. Some greater role of the right hemisphere has been reported in prosodic performance. Habitual vocal–motor patterns may help originate and maintain the vocalizations.40.55. In left hemisphere dysfunction.255x and comprehension occur with damage to either hemisphere w257x as well as to subcortical structures w45. the melody of speech. These kinds of words and these gestures are not characteristic of aphasic speech. acoustic. in GTS. in studies of brain damage. ‘‘homosexual’’. In severe aphasia. Emotional changes also are associated with basal ganglia disorders w170x. Van Lancker.211x. taboo expressions emphasize swearwords ‘‘of frustration’’ Ž‘‘fuck’’. Prosody. This has been recently a major field of study. although the reason for this finding — whether attributable to cognitive. In contrast.246. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 words all groups have in common. while GTS vocalizations concentrate on sexually offensive terms.69x. Coprolalic frequency is influenced by social setting..260x as well as proposals that right hemisphere dysfunction contributes to psychoaffective disorders w70x. Other studies of persons with basal ganglia disease have reported deficient emotional-prosodic comprehension. and GTS patients. whether the movements were of the hyperkinetic variety. ‘‘goddammit’’. variability with social setting is not prominent.250..67x. Taboo expressions are hyperactivated in GTS. Singing of familiar songs is often intact in aphasia. propositional speech and thus remains uniquely available.253x.. Persons with GTS are able to transmute. Prosodic production in speech.. The clinical-linguistic observations are consistent with the notion of hyperactivation or release from inhibition of emotionally and sexually charged behaviors in GTS.66.70. mask and postpone the vocalizations.. emerges importantly in emotional speech. proper nouns. can and does often trigger the production of the expressions. although a highly active field of study in normal speakers w215. This notion is consistent with frequent reports of sexual preoccupation and copropractic movements involving sexual gestures w62. test of nonverbal communication w208x found no deficits in comprehension of emotional meanings in speech prosody in five patients with GTS and coprolalia. Perusal of Tables 1–4 allow comparison of reported swearing Žor coprolalic. a role of the right hemisphere is likely. and a subset of these are preserved in left hemisphere damage and removal. Acoustic analyses of these expressions would be of great interest. Behaviors in GTS extend to sexual content in copropraxia and mental coprolalia. swearing most likely appears because it is stored and processed differently from newly created. there are numerous reports of changes in mood and motivation w22. 7. ‘‘shit’’. For patients with left hemisphere damage.D.61. extending sometimes to those not commonly used as swearwords Že. and pitch are observed in the pathological verbal– vocal expressions of GTS. behaviors of normal. Parkinson’s disease w26. timing. However.g. J. crosslinguistic cultural differences in production frequency of expletives have been reported Žcf. numbers. differences between English and German corpora. we propose that overlearned motor patterns best explain these phenomena. No such associated behaviors are observed in focal left hemisphere disease. as in Huntington’s patients w234x or hypokinetic.L. With one report of deficient swearing Žand other automatic speech behaviors. Since selectively preserved swearing is seen in extensive damage to the left hemisphere as well in the left hemispherectomized adult. Thus the notion of a hyperactivation of sexual-emotional processing in vocal and gestural behaviors is useful in accounting for many of the clinical symptoms. Normal adults use the more mildly obscene terms in most surveys ŽTable 1. impressionistically.173. aphasic recurrent utterances include social interjections. While in aphasic swearing. in adult left hemispherectomy and in selective anesthetization of the left hemisphere in Wada . Studies of the linguistic vocalizations of GTS are complete enough to conclude that sexual-emotional content characterizes the coprolalia. sentence stems.

Older studies reported higher glucose metabolism in the basal ganglia of GTS patients. and inferior corpus striatum w51x. and putamen in patients with GTS w262x. In contrast.34x. others suggested that small cells in the corpus striatum were decreased in size and density w263x. Neuropathological studies of GTS are inconclusive w227x. there is increasingly compelling evidence that GTS is a basal ganglia disorder. Disordered biogenic amine metabolism also is supported by reduced levels of homovanillic acid in cerebral spinal fluid of patients with GTS w42. Despite these inconsistencies. and syllables. meningitic and vascular changes throughout the brain in the second case. Taken together with the clinical response to dopamine blocking agents such as pimozide evidenced by most patients with GTS w202x. In vivo studies of dopamine receptor binding revealed increased D2 dopamine receptor binding in the head of the caudate nucleus and increased dopamine transporter activity in this same area w164.84. More recently. Braun et al. and caudal orbitofrontal cortices’’ Žp. considered with known differences between left and right hemisphere processing. Devin- sky w74x proposed midbrain involvement as the site of damage. morphemes. The effectiveness of neuroleptics gave the first clue to these mechanisms w148x. words making up propositional language are composed of the building blocks of phonemes. Correlative hypometabolism appears in bilateral temporal lobes of GTS subjects w84x. studies of brain metabolism and brain blood flow have shown diminished perfusion and glucose metabolic activity in the caudate nuclei and variably in the thalamus. the available evidence strongly supports dysfunction of the striatal structures including caudate. the right hemisphere is important for broader aspects of communication w249–251x. globus pallidus. appears to remain apart from propositional language function. w35x studied 18 GTS patients Žaged 18–49. and left hemispherectomized adult patients.96 D. This theoretical possibility is supported by the observations of intact swearing in severe aphasia Žfollowing extensive left hemisphere damage.150. Of many GTS patients studied with computerized tomograph ŽCT. Pathological basis to GTS: a basal-ganglia disorder While there is no doubt that brain damage underlies swearing behaviors in aphasia. the left hemisphere specializes in analyzing sequences. J. similarities between GTS and encephalitis lethargica. putamen. lenticular nuclei.182.52. and globus pallidum compared with controls w198x. Cerebral laterality While the left hemisphere mediates most linguistic behaviors. and no changes in the third. it is only more recently agreed that a neurochemicalrneurophysiological disorder underlies GTS w150x. only 10% have shown abnormalities. Evidence for a genetic basis of the disease further supports this view w142. like swearing. Activated brain imaging findings are inconsistent. other studies by the same group found glucose metabolic rates to be lower than normal subjects in frontal. especially those with . and dorsolateral pre-frontal cortex w83. lead to a consideration of the right hemisphere as a more likely candidate in modulating the motoric production of expletives. 151. A recent post-mortem study showed abnormalities in the globus pallidus with profoundly diminished dynorphin-like immuno-staining in this region w116x. Van Lancker. Singing.262x. cingulate insular cortex. ‘‘nonanalytic’’ stimulus. 8. in that expletives make up a unitary. Although no reproducible autopsy changes have been described that definitely localize the pathology of GTS to a basal ganglia region.. this proposal was based on metabolic abnormalities implicating the midbrain. which can be rearranged in various ways. midbrain involvement. which in all likelihood is stored and processed as a whole. was also later proposed from radiologic data w213x. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 testing w113x. 9. several lines of evidence support the basal ganglia as the principal location of dysfunction in GTS. Shapiro and Shapiro w222x and others point to the effectiveness of neuroleptics.229x. and reported an association of clinical symptoms with ‘‘increasing. These generally accepted facts about hemispheric specialization pertain to our review of swearing. reports of singing ability in GTS have not appeared. Examination of three GTS patients at autopsy revealed meningitic thickenings in the region of exit of the facial nerve in one case. In visual and auditory domains.261x. prosodic studies of coprolalia and swearing in aphasia would be of value and interest in understanding these behaviors. Baxter and Guze w17x found higher glucose metabolic rates in the putamen of GTS patients compared to normal subjects. but also tend to implicate basal subcortical structures.236x. A post-mortem study of three patients with GTS revealed significantly increased dopamine uptake carrier sites in the caudate and putamen w230x. and these appear in various brain systems w17x.L. Right hemisphere behavioral functions appear to differ from those mediated in the left hemisphere with regard to type of stimulus preferred w6. lateral. apparently dysfunctional synaptic activity in the medial. Since data are available on prosodic function in various other neurological diseases. anterior cingulate. while the right hemisphere gives evidence of a superiority in processing patterns.21. cerebral laterality studies consistently show a superiority for right hemisphere processing of the configurational aspect of stimuli w30.194x. Simply stated. and brain stimulation studies w135x. Studies using magnetic resonance imaging show reduced volumes of the caudate nuclei. with a focus on the periaquaductal gray matter. The differences between expletives and composed words and phrases..

social behavior. corpus callosum. unilateral. preparation for action. and involved in planning.66x. amygdala w115x. and the establishment and selection of emotional responses Žw211x. The basal ganglia are increasingly recognized to have important roles in cognitive. amygdala. hypothalamus. the basal ganglia are said to provide an internal timing cue to the supplementary motor to release an action. Palumbo et al. A similar and related dichotomy is proposed for learning and memory. The basal ganglia in concert with limbic activity account together for coprolalic production w185x. Georgiou et al.. Based on his observations on animal vocalization. Stimulation of anterior cingulate cortex in humans has been associated with licking. Singer w228x assigns an important role in GTS to frontal-subcortical circuits based on evidence from dopaminergic neurotransmission. ego-dystonic type manifested in GTS appears to be at least partly a manifestation of basal ganglia dysfunction. The basal ganglia receive abundant projections from the limbic system. and substantia nigra are positioned in frontal-subcortical circuits between frontal cortical regions and thalamic nuclei. p. and behavioral functions as well as in motor activity. midbrain as important in tics w197x. vocalization and human speech are dichotomous.. as implicating dopamine dysfunction in GTS. touching lips. Ž190. dysfunction of the basal ganglia simultaneously produces abnormalities of limbic system function and of limbically mediated emotional activities. ventral septal region. Ploog w200x reported from animal studies that vocalization following brain stimulation occurred only in subcortical cites. the two disparate systems proposed w178. Nespoulous and Lecours w188x propose a limbic source of coprolalic speech. In Macaque monkeys. while human speech was considered to be primarily cortically represented. diagonal band-substantia innominata.76x. Marsden w166x stated that ‘‘the basal ganglia are responsible for the automatic execution of learned motor plans’’ Žp. From many kinds of evidence. The limbic system has been implicated in emotional vocalization in animals. and other stereotyped GTS movements. Thus. Robinson w25.g. putamen. Studies of three cases of tic disorder associated with pediatric cerebral malignancies suggested a role for ventral striatum. Other disorders such as Sydenham’s chorea. Limbic system-basal ganglia hypothesis The caudate.167x. The effect of basal ganglia damage on speech and language function has been described w39.L. globus pallidus. memories as distinctive from those for establishing new learning or ‘‘declarative’’ memories w4x.. Simply stated. emotional vocalization occurs with stimulation of the anterior cingulate gyrus.. coprolalia of the involuntary. Copious interconnections between basal ganglia sensorimotor and limbic pathways are known from neuroanatomical studies: basal ganglia Žcaudate nucleus.45. the formulation of strategies and responses. the coprolalic phenomena are thus attributed to a motivational disorder involving limbic projections to striatum. and anterior inferior temporal cortex w134x. and a newer system which is cortical. The nucleus accumbens receives inputs from several limbic structures: anterior cingulate. septum. w194x reviewed a large number of cases and proposed a ‘‘developmental basal ganglia syndrome’’ underlying GTS and related disorders. w103x present evidence that GTS involves ‘‘dysfunction of basal ganglia and interconnections with frontal lobes’’ Žp. A number of studies point to a disorder of the cingulate gyrus — a critical component of the limbic system — in GTS. A recent review of behaviors associated with the basal ganglia included aspects of motor control.206. Several patients have been treated by stereotaxic surgery directed toward the limbic system Že. and post encephalitic Parkinsonism. orbitofrontal cortex. nucleus accumbens. Similarly. Similarly. studies with the squirrel monkey revealed that emotional vocalization occurred with stimulation of the hypothalamus. 10. Following successful treatment of GTS by bilateral limbic leukotomy. hemiballismus. the basal ganglia are associated with motor programs that are well established w99.179x are those for establishing habitual patterns or ‘‘nondeclarative’’ Žalso called ‘‘procedural’’. Following a notion first proposed by Balthasar w14x in 1957. Baev w12. Thus.207x has proposed two levels of the nervous system involved in human speechrlanguage behavior: an older system. also involve the basal ganglia. 514. midline thalamus. and which is capable of emotive speech behavior. and it is known that the anterior cingulate cortex receives dopamine innervation from the midbrain w243x. and the frontal-subcortical circuits integrate limbic input in the orbitofrontal-subcortical circuit and the anterior cingulate-subcortical circuit w115x forming at least five structurally and functionally separate ‘‘circuits’’ w3. and the tegmentum w205x. carbon monoxide intoxication.D. In one model of basal ganglia function.. putamen. which terminates in cingulate gyrus at the bilateral. and substantia nigra. amygdala. w77x. w204x proposed the importance of cingulate cortex in the mediation of emotionally charged language. Robertson 97 et al. Basal ganglia function with integrated limbic components form a likely origin for expletives: these are habitual motor programs with emotional content. Van Lancker. Myers w184x similarly proposed that Žanimal. where coprolalia has been reported. globus pallidus. substantia innominata. rostral end of limbic system. These cortical-striatal-pallidal-thalamic circuits mediate executive function.13x proposes that the basal ganglia provide a ‘‘model’’ of the motor behavior to be executed. cingulate cortex. and diverse aspects of emotion w66x. thalamus. hippocampus. motivation. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 dopamine D2 blocking effects. ventral anterior and midline nuclei of the thalamus. 20. Parallel as well as multiple reciprocally connected structures lead to optimal conditions for ‘‘cros- . J. emotional. are richly interconnected with limbic structures.

the cortical system also may be impaired. Van Lancker. in their model. Following comparisons of language versus speech behaviors in GTS subjects. poststroke hemiballismus. coprolalia in humans might represent the abnormal release of vocalizations mediated by limbic system structures and normally intended to perform the social functions of repulsing intruders and expressing anger and dissatisfaction. However.. and limbic function of the basal ganglia’’ Žw115x. and the known circuitry of frontal-subcortical connections w171x. sensory inputs. Ego-alien coprolalia is distinctly uncommon and is confined to a few neurological diseases. who suggested that GTS reflects a disorder not only in the motor domain. it appears that the most frequent expletives Ž‘‘damn’’. The role of basal ganglia in initiating motor behaviors w167x. Baxter and Guze w17x focus on a functional neuroanatomical involvement of the basal ganglia. compared to fuller information in normal subjects speaking American English. This type of cursing differs from the involuntary ego-dystonic type of coprolalia. in whom left hemispheric areas mediating propositional speech are dysfunctional. in which speech production is separate from personal intentionality. and possibly even ’thoughts. and GTS speakers provided in Tables 1–4 shows notable similarities as well as differences in the respective taboo word repertories. was well described in post-encephalitic Parkinsonism.’ They propose that it is ‘‘impairment in these gating and screening functions of the striatum’’ which results the variety of expressed phenomena in GTS.163x. to suppression of the supplementary motor area. ‘‘fuck’’. occur in all three conditions. These authors noted that the stereotypic speech. p. while sexual taboo items predominate in normal and GTS speakers. noncompositional structure of the stimulus. Too little is known about swearing in aphasia. from their language studies. From this perspective. they also suggested that in GTS. w159x proposed that the pathology may involve an imbalance between cortical and limbic systems for processing speech and language in GTS. language. aphasic. However.. With yet so little known of relevant neurological mechanisms. The verbal form is unitary. Conclusion Swearing is a common human act and is frequent in neurological disorders such as spinal cord injury. one for emotional vocalization and the other for propositional speech. Comparison of documented expletives for normal. A somewhat related proposal comes from Nauta w185x. with fewer such items uttered in aphasia. head trauma. The considerable evidence of basal ganglia dysfunction in GTS implicates those structures in concert with limbic activity. and written expression’’. as well as the unitary. and has been noted in cases of secondary GTS produced by herpes encephalitis. which include both motor behaviors and sensations Žp. Ludlow et al. The ego dystonic. resulting in ‘‘paucity of speech. not compositional Ži. and therefore ‘‘fail to be further modified into purposive behavior’’ Žp. 11. Cummingsr Brain Research ReÕiews 31 (1999) 83–104 stalk’’. ‘‘shit’’. Sydenham’s chorea. with only the British and German corpora available. there also are substantial shared features: both use some of the same words. Voluntary normal cursing and cursing in aphasia may share the anatomy and physiology of coprolalia. cognitive. 261. is not generated by combining smaller. syllables and morphemes.. such that pathologies could produce ‘‘a variety of symptoms relating to the motor. aphasic and coprolalic cursing have in common the expression of certain identical linguistic productions. may have access to structures mediating limbic vocaliza- . A similar view emerged from specific studies of GTS verbal behaviors. accounting for the independence of the two sets of symptoms’’ Žp. pointing to well-known circuitry involved in the ’gating’ and ’screening’ of motor outputs. Normal. We hypothesize that coprolalia represents a limbic vocal tic whose unique content is informed by the social and emotional communicative purposes of limbic vocalizations. provide the basis for positing hyperactivated initiation of emotionally charged.. 360. in contrast to words in the propositional language system. with the current data. alien nature of coprolalia in GTS and related syndromes stems from the involuntary occurrence of these vocalizations analogous to the involuntary occurrence of the motor tics. The purpose of animal vocalization is nearly exclusively social in nature with some vocalizations indicating anger and warning and others facilitating social interactions w75. while the ‘‘production of stereotypic sets of behaviors is heightened through increased activation of the cingulate gyrus.224x. 299. More complete information might change the picture. and head injury w16. This may be due.L. and aphasia where patients experience frustration and evidence the emotion through cursing. but in the motivational mechanisms of the limbic system. The suppression of one region may be independent of the increased activation of the other. gestural and motor behaviors of GTS may be produced without inhibition by the cortical system. Despite the differences between normal cursing and coprolalia. such as phonemes.. our conclusions about brain-behavior correlates are of necessity speculative.98 D. permutable units. and thus possibly draws on right hemisphere cortical mechanisms for execution. and both normal cursing and coprolalia depend on invoking the emotional signaling systems — use of verbal cries andror taboo words — in the communicative act. carbon monoxide poisoning. the words have a highly emotional content. Coprolalia is most common in GTS..e. 360. and limbic system in GTS. overlearned vocal output as pathophysiological basis of coprolalia. Comparison of animal and human communicative behaviors suggest that two functional systems. Persons suffering from aphasia. prefrontal cortex. may exist. and a now broad reportage of linguistic backgrounds for coprolalia. J.

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