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Rasoli Jokar AH, Bayat B, Ghadami A, Dehkordi MS. Efficacy of Noninvasive Brain Stimulation Techniques in Managing Stuttering Behaviors: A Systematic Review and Meta-Regression Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2025; 68:1803-1820. [PMID: 40100765 DOI: 10.1044/2025_jslhr-24-00750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/20/2025]
Abstract
PURPOSE This systematic review and meta-regression analysis investigated the overall effectiveness of noninvasive brain stimulation (NIBS) techniques in managing stuttering behaviors. METHOD A total of 290 papers were initially identified through a comprehensive database search, and after applying inclusion and exclusion criteria, 15 studies were selected for the final analysis. These studies evaluated NIBS techniques both as standalone interventions and in combination with speech therapy techniques. The random-effects meta-analysis was done to investigate the effect of neuromodulation techniques on reducing severity and frequency of stuttering behaviors. In addition, meta-regression and subgroup analyses were conducted to identify the effective techniques and explore potential moderators, such as intervention type, age group, and outcome measures. RESULTS The random-effects meta-analysis revealed a significant positive effect of neuromodulation techniques on reducing stuttering severity and frequency. Meta-regression showed that transcranial direct current stimulation (tDCS) had the most significant effect in reducing stuttering severity and frequency among standalone interventions. Combined therapy approaches, which paired NIBS with speech therapy, resulted in the most substantial improvements overall. Sensitivity analyses confirmed the robustness of the results despite minor heterogeneity across studies. CONCLUSIONS NIBS, particularly tDCS, shows promise as an effective intervention for stuttering. When combined with behavioral therapies, NIBS offers enhanced benefits, supporting its role as an adjunctive treatment in clinical practice. Further large-scale studies are recommended to confirm the long-term efficacy, refine treatment protocols, and explore optimal stimulation parameters for improved outcomes.
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Affiliation(s)
| | - Behnaz Bayat
- Green Speech Start-Up, Hamilton, Ontario, Canada
| | - Ali Ghadami
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
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Chang SE, Below JE, Chow HM, Guenther FH, Hampton Wray AM, Jackson ES, Max L, Neef NE, SheikhBahaei S, Shekim L, Tichenor SE, Walsh B, Watkins KE, Yaruss JS, Bernstein Ratner N. Stuttering: Our Current Knowledge, Research Opportunities, and Ways to Address Critical Gaps. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2025; 6:nol_a_00162. [PMID: 40201450 PMCID: PMC11977836 DOI: 10.1162/nol_a_00162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 01/28/2025] [Indexed: 04/10/2025]
Abstract
Our understanding of the neurobiological bases of stuttering remains limited, hampering development of effective treatments that are informed by basic science. Stuttering affects more than 5% of all preschool-age children and remains chronic in approximately 1% of adults worldwide. As a condition that affects a most fundamental human ability to engage in fluid and spontaneous verbal communication, stuttering can have substantial psychosocial, occupational, and educational impacts on those who are affected. This article summarizes invited talks and breakout sessions that were held in June 2023 as part of a 2-day workshop sponsored by the US National Institute on Deafness and Other Communication Disorders. The workshop encompassed topics including neurobiology, genetics, speech motor control, cognitive, social, and emotional impacts, and intervention. Updates on current research in these areas were summarized by each speaker, and critical gaps and priorities for future research were raised, and then discussed by participants. Research talks were followed by smaller, moderated breakout sessions intended to elicit diverse perspectives, including on the matter of defining therapeutic targets for stuttering. A major concern that emerged following participant discussion was whether priorities for treatment in older children and adults should focus on targeting core speech symptoms of stuttering, or on embracing effective communication regardless of whether the speaker exhibits overt stuttering. This article concludes with accumulated convergent points endorsed by most attendees on research and clinical priorities that may lead to breakthroughs with substantial potential to contribute to bettering the lives of those living with this complex speech disorder.
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Affiliation(s)
- Soo-Eun Chang
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Communication Disorders, Ewha Womans University, Seoul, South Korea
| | - Jennifer E. Below
- The Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ho Ming Chow
- Department of Communication Sciences and Disorders, University of Delaware, Newark, DE, USA
| | - Frank H. Guenther
- Departments of Speech, Language, & Hearing Sciences and Biomedical Engineering, Boston University, Boston, MA, USA
| | - Amanda M. Hampton Wray
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - Eric S. Jackson
- Department of Communicative Sciences and Disorders, New York University, New York, NY, USA
| | - Ludo Max
- Department of Speech & Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Nicole E. Neef
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Georg August University, Göttingen, Germany
| | - Shahriar SheikhBahaei
- Neuron-Glia Signaling and Circuits Unit, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, USA
- Department of Neurobiology and Behavior, Center for Nervous System Disorders, Stony Brook University, Stony Brook, NY, USA
| | - Lana Shekim
- National Institute on Deafness and other Communication Disorders (NIDCD), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Seth E. Tichenor
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA, USA
| | - Bridget Walsh
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA
| | - Kate E. Watkins
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - J. Scott Yaruss
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA
| | - Nan Bernstein Ratner
- Department of Hearing and Speech Sciences & Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, USA
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Chang SE, Jackson ES, Santayana G, Zavos G, Onslow M. Contemporary clinical conversations about stuttering: What does brain imaging research mean to clinicians? INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2025; 27:265-271. [PMID: 38530287 PMCID: PMC11659841 DOI: 10.1080/17549507.2024.2327472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
PURPOSE To discuss among neuroscientists and community speech-language pathologists what brain imaging research means to clinicians. METHOD Two university neuroscientists and two speech-language pathologists in private practice discussed the matter. Written conversational turns in an exchange were limited to 100 words each. When that written dialogue was concluded, each participant provided 200 words of final reflection about the matter. RESULT For now, neuroscience treatments are not available for clinicians to use. But sometime in the future, a critical mass of neuroscientists will likely produce such treatments. The neuroscientists expressed diverse views about the methods that might be used for that to occur. CONCLUSION Neuroscience does have practical clinical application at present and, in a way, that does not exclude a concurrent influence of the social model of disability. As such, the current practices of clinicians are supported by basic neuroscience research.
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Affiliation(s)
- Soo-Eun Chang
- University of Michigan, Department of Psychiatry, Michigan, USA
- Ewha Womans University, Department of Communication Disorders, Seoul, Korea
| | - Eric S. Jackson
- New York University, Communicative Sciences and Disorders, New York, USA
| | | | | | - Mark Onslow
- University of Technology Sydney, Australian Stuttering Research Centre, NSW, Australia
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Ma D, Wang L, Liu S, Ma X, Jia F, Hua Y, Liao Y, Qu H. Brain anatomy differences in Chinese children who stutter: a preliminary study. Front Neurol 2025; 16:1483157. [PMID: 39931552 PMCID: PMC11807804 DOI: 10.3389/fneur.2025.1483157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Accepted: 01/10/2025] [Indexed: 02/13/2025] Open
Abstract
Background and purpose It is unknown the neural mechanisms of developmental stuttering (DS). The aim of this study was to investigate the changes in the structural morphology of the brain in Chinese children who stutter. Methods A case-control study was conducted to collect magnetic resonance imaging data from stuttering and non-stuttering children, thereby analyzing whole-brain gray matter volume and cortical morphological changes in stuttering children. Results A total of 108 subjects were recruited (stuttering group: control group = 1:1). Comparing to healthy controls, the gray matter volume was significantly decreased in right temporal gyrus and bilateral cerebellum. Additionally, there was a significant reduction in cortical folds in the right insula and right superior temporal gyrus. Moreover, the gray matter volume of the right cerebellum and right temporal gyrus is related to the severity score of stuttering. Conclusion The present study proposes that the neural mechanisms underlying DS are intricately linked to the cortico-basal ganglia-thalamo-cortical loop and the dorsal language pathway. This finding is expected to provide reference value for the clinical treatment of DS.
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Affiliation(s)
- Dan Ma
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Lingling Wang
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Sai Liu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - XinMao Ma
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Fenglin Jia
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yimin Hua
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi Liao
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Haibo Qu
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China
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Chaudhary C, Praharaj SK, Krishnan G. Exploring the nature of stuttering through a behavioral-neuro-modulation intervention program in bilinguals with stuttering. Codas 2025; 37:e20240186. [PMID: 39879430 PMCID: PMC11781365 DOI: 10.1590/2317-1782/e20240186en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 07/23/2024] [Indexed: 01/31/2025] Open
Abstract
PURPOSE Investigations on identifying the nature of stuttering present varying views. The argument remains whether the stuttering dysfluencies have a motor or a linguistic foundation. Though stuttering is considered a speech-motor disorder, linguistic factors are increasingly reported to play a role in stuttering. Current literature points towards deficits in speech-related motor areas of the brain to abnormalities in linguistic planning and phonological memory playing a role in stuttering. Examining cross-linguistic generalization of treatment gains from treated to untreated language in bilinguals who stutter may provide a unique opportunity to explore the motor and linguistic factors in stuttering. METHODS In the current study, we explored this potential by experimentally controlling the language of treatment in bilinguals with stuttering (BWS). We hypothesized that if the dysfluencies in stuttering arise from the underlying motor deficits, then the language of treatment would not play a significant role in cross-linguistic generalization. Sixteen BWS were given transcranial direct current stimulation (tDCS) along with behavioral intervention for three weeks. The language of treatment was randomized, wherein participants in one group received behavioral intervention in their dominant language and the other in their non-dominant language. RESULTS Results showed that participants in both groups showed a reduction in their stuttering dysfluencies (% stuttered syllables) regardless of the language of treatment, and the treatment gains were generalized to the non-treated language. CONCLUSION Linguistic factors such as language dominance and structure of languages did not surface to play a role in the generalization, signaling the motoric nature of dysfluencies in stuttering.
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Affiliation(s)
- Chanchal Chaudhary
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
- Department of Audiology and Speech-Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Samir Kumar Praharaj
- Department of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Gopee Krishnan
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Pruett DG, Hunter C, Scartozzi A, Shaw DM, Kraft SJ, Jones RM, Shuey MM, Below JE. Characterizing drug-induced stuttering in electronic health records. JOURNAL OF COMMUNICATION DISORDERS 2025; 113:106475. [PMID: 39615072 PMCID: PMC11948996 DOI: 10.1016/j.jcomdis.2024.106475] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 10/29/2024] [Accepted: 11/01/2024] [Indexed: 02/09/2025]
Abstract
PURPOSE Drug-induced stuttering is a phenomenon where the onset of stuttered speech is caused by exposure to pharmaceutical chemical substances. This acquired form of stuttering features many of the same overt speech behaviors as developmental stuttering. Investigations of drug-induced stuttering have been limited to adverse drug reaction reports and case studies. This study leveraged electronic health records (EHRs) at a major university medical center to identify drug-induced stuttering within medical notes, followed by classification of implicated drug types. METHODS A previous systematic EHR review of approximately 3 million individuals to identify cases of developmental stuttering resulted in 40 suspected cases of drug-induced stuttering. In the present study, these cases were reviewed comprehensively to evaluate: name, class, and mechanism of action of suspected drug, level of evidence for the implicated drug as a causal agent, therapeutic measures taken, and progression or remission of stuttering. RESULTS Eighteen different drugs were linked to possible drug-induced stuttering in 22 individuals. Antiseizure agents, CNS stimulants, and antidepressants were the most common drug classes implicated in drug-induced stuttering. topiramate (Topamax) was the most commonly implicated drug across all records reviewed. CONCLUSIONS This study represents the first analysis of health system data examining drugs implicated in drug-induced stuttering in a clinical setting. Augmenting previous case reports and database reviews, a variety of drugs were identified; however, improved reporting of drug-associated speech fluency changes within the EHR are needed to further amass evidence for suspected drugs and their associated epidemiological and clinical characteristics.
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Affiliation(s)
- Dillon G Pruett
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, USA.
| | - Christine Hunter
- Lipscomb University College of Pharmacy and Health Sciences, USA
| | - Alyssa Scartozzi
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, USA
| | - Douglas M Shaw
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, USA
| | - Shelly Jo Kraft
- Department of Communication Sciences and Disorders, Wayne State University, USA
| | - Robin M Jones
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, USA
| | - Megan M Shuey
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, USA
| | - Jennifer E Below
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, USA
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Ishii R, Ueda M. Unraveling the neurophysiological intricacies of stuttering through sensorimotor oscillations. Clin Neurophysiol 2025; 169:74-75. [PMID: 39592338 DOI: 10.1016/j.clinph.2024.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Revised: 11/13/2024] [Accepted: 11/14/2024] [Indexed: 11/28/2024]
Affiliation(s)
- Ryouhei Ishii
- Department of Occupational Therapy, Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, Japan; Department of Psychiatry, Graduate School of Medicine, Osaka University, Suita, Japan.
| | - Masaya Ueda
- Department of Occupational Therapy, Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, Japan
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Gastaldon S, Busan P, Molinaro N, Lizarazu M. Cortical Tracking of Speech Is Reduced in Adults Who Stutter When Listening for Speaking. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:4339-4357. [PMID: 39437265 DOI: 10.1044/2024_jslhr-24-00227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2024]
Abstract
PURPOSE The purpose of this study was to investigate cortical tracking of speech (CTS) in adults who stutter (AWS) compared to typically fluent adults (TFAs) to test the involvement of the speech-motor network in tracking rhythmic speech information. METHOD Participants' electroencephalogram was recorded while they simply listened to sentences (listening only) or completed them by naming a picture (listening for speaking), thus manipulating the upcoming involvement of speech production. We analyzed speech-brain coherence and brain connectivity during listening. RESULTS During the listening-for-speaking task, AWS exhibited reduced CTS in the 3- to 5-Hz range (theta), corresponding to the syllabic rhythm. The effect was localized in the left inferior parietal and right pre/supplementary motor regions. Connectivity analyses revealed that TFAs had stronger information transfer in the theta range in both tasks in fronto-temporo-parietal regions. When considering the whole sample of participants, increased connectivity from the right superior temporal cortex to the left sensorimotor cortex was correlated with faster naming times in the listening-for-speaking task. CONCLUSIONS Atypical speech-motor functioning in stuttering impacts speech perception, especially in situations requiring articulatory alertness. The involvement of frontal and (pre)motor regions in CTS in TFAs is highlighted. Further investigation is needed into speech perception in individuals with speech-motor deficits, especially when smooth transitioning between listening and speaking is required, such as in real-life conversational settings. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.27234885.
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Affiliation(s)
- Simone Gastaldon
- Department of Developmental and Social Psychology, University of Padua, Italy
- Padova Neuroscience Center, University of Padua, Italy
| | - Pierpaolo Busan
- Department of Medical, Surgical and Health Sciences, University of Trieste, Italy
| | - Nicola Molinaro
- Basque Center on Cognition, Brain and Language, Donostia-San Sebastián, Spain
- Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - Mikel Lizarazu
- Basque Center on Cognition, Brain and Language, Donostia-San Sebastián, Spain
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Demirel B, Chesters J, Connally EL, Gough PM, Ward D, Howell P, Watkins KE. No evidence of altered language laterality in people who stutter across different brain imaging studies of speech and language. Brain Commun 2024; 6:fcae305. [PMID: 39346021 PMCID: PMC11430911 DOI: 10.1093/braincomms/fcae305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 06/03/2024] [Accepted: 09/11/2024] [Indexed: 10/01/2024] Open
Abstract
A long-standing neurobiological explanation of stuttering is the incomplete cerebral dominance theory, which refers to competition between two hemispheres for 'dominance' over handedness and speech, causing altered language lateralization. Renewed interest in these ideas came from brain imaging findings in people who stutter of increased activity in the right hemisphere during speech production or of shifts in activity from right to left when fluency increased. Here, we revisited this theory using functional MRI data from children and adults who stutter, and typically fluent speakers (119 participants in total) during four different speech and language tasks: overt sentence reading, overt picture description, covert sentence reading and covert auditory naming. Laterality indices were calculated for the frontal and temporal lobes using the laterality index toolbox running in Statistical Parametric Mapping. We also repeated the analyses with more specific language regions, namely the pars opercularis (Brodmann area 44) and pars triangularis (Brodmann area 45). Laterality indices in people who stutter and typically fluent speakers did not differ, and Bayesian analyses provided moderate to anecdotal levels of support for the null hypothesis (i.e. no differences in laterality in people who stutter compared with typically fluent speakers). The proportions of the people who stutter and typically fluent speakers who were left lateralized or had atypical rightward or bilateral lateralization did not differ. We found no support for the theory that language laterality is reduced or differs in people who stutter compared with typically fluent speakers.
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Affiliation(s)
- Birtan Demirel
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX2 6GG, UK
| | - Jennifer Chesters
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX2 6GG, UK
| | - Emily L Connally
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX2 6GG, UK
| | - Patricia M Gough
- School of Psychology, University College Dublin, Dublin DN720/PCS2, Ireland
| | - David Ward
- School of Psychology & Clinical Language Sciences, University of Reading, Reading RG6 6AL, UK
| | - Peter Howell
- Experimental Psychology, Psychology & Language Sciences, University College London, London WC1E 6BT, UK
| | - Kate E Watkins
- Department of Experimental Psychology, Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford OX2 6GG, UK
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Medina AM, Mead JS, Moore S. Perceptions of and beliefs about stuttering in the Hispanic/Latino community. JOURNAL OF COMMUNICATION DISORDERS 2024; 111:106456. [PMID: 39154581 DOI: 10.1016/j.jcomdis.2024.106456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 08/02/2024] [Accepted: 08/06/2024] [Indexed: 08/20/2024]
Abstract
PURPOSE The aim of this exploratory study was to investigate perceptions of people who stutter and beliefs about the causes and cures of stuttering within the Hispanic/Latino community. METHODS Respondents who were 18 or older and of Hispanic/Latino origin were invited to respond to a 24-question online survey. Questions involved exploring familiarity with and beliefs regarding etiologies, treatment approaches, treatment providers, stereotypes, and perceptions of people who stutter. Data from 151 respondents were analyzed using descriptive statistics. RESULTS Results revealed that the most commonly held beliefs regarding the causes of stuttering were being "born with it", an "emotional disturbance or trauma", a "brain disorder", and/ or a "sensory impairment". The most frequently cited beliefs regarding treating stuttering were "therapy", "rehabilitation", and "tell them to slow down". Over 75 % of respondents believed that "speech therapists" can cure or treat stuttering. Respondents' perceptions of people who stutter are that they are generally "nervous" and "shy". CONCLUSIONS Common beliefs and perceptions relative to stuttering were identified in the Hispanic/Latino community. The beliefs one holds about the cause of stuttering as well as their negative perceptions of stutterers may contribute to the continued stigmatization of people who stutter. Implications are discussed regarding the need for culturally appropriate education for individuals who stutter, their families, and the general public.
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Affiliation(s)
- Angela M Medina
- Department of Communication Sciences and Disorders, 11200 SW 8 Street - AHC 3 Miami, FL, USA.
| | - Jean S Mead
- Department of Communication Sciences and Disorders, 11200 SW 8 Street - AHC 3 Miami, FL, USA
| | - Stefanie Moore
- Department of Biostatistics, 11200 SW 8 Street - AHC 5 Miami, FL, USA; Florida International University, Miami, FL, USA
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Kuhn YA, Egger S, Bugnon M, Lehmann N, Taubert M, Taube W. Age-related decline in GABAergic intracortical inhibition can be counteracted by long-term learning of balance skills. J Physiol 2024; 602:3737-3753. [PMID: 38949035 DOI: 10.1113/jp285706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 06/11/2024] [Indexed: 07/02/2024] Open
Abstract
Ageing induces a decline in GABAergic intracortical inhibition, which seems to be associated not only with decremental changes in well-being, sleep quality, cognition and pain management but also with impaired motor control. So far, little is known regarding whether targeted interventions can prevent the decline of intracortical inhibition in the primary motor cortex in the elderly. Therefore, the present study investigated whether age-related cortical dis-inhibition could be reversed after 6 months of balance learning and whether improvements in postural control correlated with the extent of reversed dis-inhibition. The results demonstrated that intracortical inhibition can be upregulated in elderly subjects after long-term balance learning and revealed a correlation between changes in balance performance and intracortical inhibition. This is the first study to show physical activity-related upregulation of GABAergic inhibition in a population with chronic dis-inhibition and may therefore be seminal for many pathologies in which the equilibrium between inhibitory and excitatory neurotransmitters is disturbed. KEY POINTS: Ageing induces a decline in GABAergic intracortical inhibition. So far, little is known regarding whether targeted interventions can prevent the decline of intracortical inhibition in the primary motor cortex in the elderly. After 6 months of balance learning, intracortical inhibition can be upregulated in elderly subjects. The results of this study also revealed a correlation between changes in balance performance and intracortical inhibition. This is the first study to show physical activity-related upregulation of GABAergic inhibition in a population with chronic dis-inhibition.
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Affiliation(s)
- Yves-Alain Kuhn
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Sven Egger
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Matteo Bugnon
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Nico Lehmann
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
- Department of Sport Science, Institute III, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Collaborative Research Center 1436 Neural Resources of Cognition, Otto von Guericke University, Magdeburg, Germany
| | - Marco Taubert
- Department of Sport Science, Institute III, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany
- Collaborative Research Center 1436 Neural Resources of Cognition, Otto von Guericke University, Magdeburg, Germany
- Center for Behavioral and Brain Science (CBBS), Otto von Guericke University, Universitätsplatz 2, Magdeburg, Germany
| | - Wolfgang Taube
- Department of Neurosciences and Movement Science, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
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Kinahan SP, Saidi P, Daliri A, Liss J, Berisha V. Electroencephalographic Classification Reveals Atypical Speech Motor Planning in Stuttering Adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2053-2076. [PMID: 38924389 PMCID: PMC11253807 DOI: 10.1044/2024_jslhr-23-00635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/23/2024] [Accepted: 04/09/2024] [Indexed: 06/28/2024]
Abstract
PURPOSE This study explores speech motor planning in adults who stutter (AWS) and adults who do not stutter (ANS) by applying machine learning algorithms to electroencephalographic (EEG) signals. In this study, we developed a technique to holistically examine neural activity differences in speaking and silent reading conditions across the entire cortical surface. This approach allows us to test the hypothesis that AWS will exhibit lower separability of the speech motor planning condition. METHOD We used the silent reading condition as a control condition to isolate speech motor planning activity. We classified EEG signals from AWS and ANS individuals into speaking and silent reading categories using kernel support vector machines. We used relative complexities of the learned classifiers to compare speech motor planning discernibility for both classes. RESULTS AWS group classifiers require a more complex decision boundary to separate speech motor planning and silent reading classes. CONCLUSIONS These findings indicate that the EEG signals associated with speech motor planning are less discernible in AWS, which may result from altered neuronal dynamics in AWS. Our results support the hypothesis that AWS exhibit lower inherent separability of the silent reading and speech motor planning conditions. Further investigation may identify and compare the features leveraged for speech motor classification in AWS and ANS. These observations may have clinical value for developing novel speech therapies or assistive devices for AWS.
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Affiliation(s)
- Sean P. Kinahan
- College of Health Solutions, Arizona State University, Tempe
- School of Computing and Augmented Intelligence, Arizona State University, Tempe
| | - Pouria Saidi
- School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe
| | - Ayoub Daliri
- College of Health Solutions, Arizona State University, Tempe
| | - Julie Liss
- Department of Speech and Hearing Science, Arizona State University, Tempe
| | - Visar Berisha
- College of Health Solutions, Arizona State University, Tempe
- School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe
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Pasculli G, Busan P, Jackson ES, Alm PA, De Gregorio D, Maguire GA, Goodwin GM, Gobbi G, Erritzoe D, Carhart-Harris RL. Psychedelics in developmental stuttering to modulate brain functioning: a new therapeutic perspective? Front Hum Neurosci 2024; 18:1402549. [PMID: 38962146 PMCID: PMC11221540 DOI: 10.3389/fnhum.2024.1402549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Developmental stuttering (DS) is a neurodevelopmental speech-motor disorder characterized by symptoms such as blocks, repetitions, and prolongations. Persistent DS often has a significant negative impact on quality of life, and interventions for it have limited efficacy. Herein, we briefly review existing research on the neurophysiological underpinnings of DS -specifically, brain metabolic and default mode/social-cognitive networks (DMN/SCN) anomalies- arguing that psychedelic compounds might be considered and investigated (e.g., in randomized clinical trials) for treatment of DS. The neural background of DS is likely to be heterogeneous, and some contribution from genetically determinants of metabolic deficiencies in the basal ganglia and speech-motor cortical regions are thought to play a role in appearance of DS symptoms, which possibly results in a cascade of events contributing to impairments in speech-motor execution. In persistent DS, the difficulties of speech are often linked to a series of associated aspects such as social anxiety and social avoidance. In this context, the SCN and DMN (also influencing a series of fronto-parietal, somato-motor, and attentional networks) may have a role in worsening dysfluencies. Interestingly, brain metabolism and SCN/DMN connectivity can be modified by psychedelics, which have been shown to improve clinical evidence of some psychiatric conditions (e.g., depression, post-traumatic stress disorder, etc.) associated with psychological constructs such as rumination and social anxiety, which also tend to be present in persistent DS. To date, while there have been no controlled trials on the effects of psychedelics in DS, anecdotal evidence suggests that these agents may have beneficial effects on stuttering and its associated characteristics. We suggest that psychedelics warrant investigation in DS.
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Affiliation(s)
- Giuseppe Pasculli
- Department of Computer, Control, and Management Engineering (DIAG), La Sapienza University, Rome, Italy
- Italian Society of Psychedelic Medicine (Società Italiana di Medicina Psichedelica–SIMePsi), Bari, Italy
| | | | - Eric S. Jackson
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
| | - Per A. Alm
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Danilo De Gregorio
- IRCCS, San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Gerald A. Maguire
- School of Medicine, American University of Health Sciences, Signal Hill, CA, United States
- CenExel CIT Research, Riverside, CA, United States
| | - Guy M. Goodwin
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - David Erritzoe
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Robin L. Carhart-Harris
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
- Psychedelics Division, Neuroscape, University of California, San Francisco, CA, United States
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14
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Cai H, Dong J, Mei L, Feng G, Li L, Wang G, Yan H. Functional and structural abnormalities of the speech disorders: a multimodal activation likelihood estimation meta-analysis. Cereb Cortex 2024; 34:bhae075. [PMID: 38466117 DOI: 10.1093/cercor/bhae075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Speech disorders are associated with different degrees of functional and structural abnormalities. However, the abnormalities associated with specific disorders, and the common abnormalities shown by all disorders, remain unclear. Herein, a meta-analysis was conducted to integrate the results of 70 studies that compared 1843 speech disorder patients (dysarthria, dysphonia, stuttering, and aphasia) to 1950 healthy controls in terms of brain activity, functional connectivity, gray matter, and white matter fractional anisotropy. The analysis revealed that compared to controls, the dysarthria group showed higher activity in the left superior temporal gyrus and lower activity in the left postcentral gyrus. The dysphonia group had higher activity in the right precentral and postcentral gyrus. The stuttering group had higher activity in the right inferior frontal gyrus and lower activity in the left inferior frontal gyrus. The aphasia group showed lower activity in the bilateral anterior cingulate gyrus and left superior frontal gyrus. Across the four disorders, there were concurrent lower activity, gray matter, and fractional anisotropy in motor and auditory cortices, and stronger connectivity between the default mode network and frontoparietal network. These findings enhance our understanding of the neural basis of speech disorders, potentially aiding clinical diagnosis and intervention.
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Affiliation(s)
- Hao Cai
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi'an International Studies University, Xi'an 710128, China
| | - Jie Dong
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi'an International Studies University, Xi'an 710128, China
| | - Leilei Mei
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents (South China Normal University); School of Psychology; Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou 510631, China
| | - Genyi Feng
- Imaging Department, Xi'an GEM Flower Changqing Hospital, Xi'an 710201, China
| | - Lili Li
- Speech Language Therapy Department, Shaanxi Provincial Rehabilitation Hospital, Xi'an 710065, China
| | - Gang Wang
- Imaging Department, Xi'an GEM Flower Changqing Hospital, Xi'an 710201, China
| | - Hao Yan
- Key Laboratory for Artificial Intelligence and Cognitive Neuroscience of Language, Xi'an International Studies University, Xi'an 710128, China
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Neef NE, Chang SE. Knowns and unknowns about the neurobiology of stuttering. PLoS Biol 2024; 22:e3002492. [PMID: 38386639 PMCID: PMC10883586 DOI: 10.1371/journal.pbio.3002492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Stuttering occurs in early childhood during a dynamic phase of brain and behavioral development. The latest studies examining children at ages close to this critical developmental period have identified early brain alterations that are most likely linked to stuttering, while spontaneous recovery appears related to increased inter-area connectivity. By contrast, therapy-driven improvement in adults is associated with a functional reorganization within and beyond the speech network. The etiology of stuttering, however, remains enigmatic. This Unsolved Mystery highlights critical questions and points to neuroimaging findings that could inspire future research to uncover how genetics, interacting neural hierarchies, social context, and reward circuitry contribute to the many facets of stuttering.
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Affiliation(s)
- Nicole E. Neef
- Institute for Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, United States of America
- Department of Communication Disorders, Ewha Womans University, Seoul, Korea
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Matsuhashi K, Itahashi T, Aoki R, Hashimoto RI. Meta-analysis of structural integrity of white matter and functional connectivity in developmental stuttering. Brain Res Bull 2023; 205:110827. [PMID: 38013029 DOI: 10.1016/j.brainresbull.2023.110827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 11/29/2023]
Abstract
Developmental stuttering is a speech disfluency disorder characterized by repetitions, prolongations, and blocks of speech. While a number of neuroimaging studies have identified alterations in localized brain activation during speaking in persons with stuttering (PWS), it is unclear whether neuroimaging evidence converges on alterations in structural integrity of white matter and functional connectivity (FC) among multiple regions involved in supporting fluent speech. In the present study, we conducted coordinate-based meta-analyses according to the PRISMA guidelines for available publications that studied fractional anisotropy (FA) using tract-based spatial statistics (TBSS) for structural integrity and the seed-based voxel-wise FC analyses. The search retrieved 11 publications for the TBSS FA studies, 29 seed-based FC datasets from 6 publications for the resting-state, and 29 datasets from 6 publications for the task-based studies. The meta-analysis of TBSS FA revealed that PWS exhibited FA reductions in the middle and posterior segments of the left superior longitudinal fasciculus. Furthermore, the analysis of resting-state FC demonstrated that PWS had reduced FC in the right supplementary motor area and inferior parietal cortex, whereas an increase in FC was observed in the left cerebellum crus I. Conversely, we observed increased FC for task-based FC in regions implicated in speech production or sequential movements, including the anterior cingulate cortex, posterior insula, and bilateral cerebellum crus I in PWS. Functional network characterization of the altered FCs revealed that the sets of reduced resting-state and increased task-based FCs were largely distinct, but the somatomotor and striatum/thalamus networks were foci of alterations in both conditions. These observations indicate that developmental stuttering is characterized by structural and functional alterations in multiple brain networks that support speech fluency or sequential motor processes, including cortico-cortical and subcortical connections.
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Affiliation(s)
- Kengo Matsuhashi
- Department of Language Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Takashi Itahashi
- Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
| | - Ryuta Aoki
- Department of Language Sciences, Tokyo Metropolitan University, Tokyo, Japan; Medical Institute of Developmental Disabilities Research, Showa University, Tokyo, Japan
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Caruso VC, Wray AH, Lescht E, Chang SE. Neural oscillatory activity and connectivity in children who stutter during a non-speech motor task. J Neurodev Disord 2023; 15:40. [PMID: 37964200 PMCID: PMC10647051 DOI: 10.1186/s11689-023-09507-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 10/25/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Neural motor control rests on the dynamic interaction of cortical and subcortical regions, which is reflected in the modulation of oscillatory activity and connectivity in multiple frequency bands. Motor control is thought to be compromised in developmental stuttering, particularly involving circuits in the left hemisphere that support speech, movement initiation, and timing control. However, to date, evidence comes from adult studies, with a limited understanding of motor processes in childhood, closer to the onset of stuttering. METHODS We investigated the neural control of movement initiation in children who stutter and children who do not stutter by evaluating transient changes in EEG oscillatory activity (power, phase locking to button press) and connectivity (phase synchronization) during a simple button press motor task. We compared temporal changes in these oscillatory dynamics between the left and right hemispheres and between children who stutter and children who do not stutter, using mixed-model analysis of variance. RESULTS We found reduced modulation of left hemisphere oscillatory power, phase locking to button press and phase connectivity in children who stutter compared to children who do not stutter, consistent with previous findings of dysfunction within the left sensorimotor circuits. Interhemispheric connectivity was weaker at lower frequencies (delta, theta) and stronger in the beta band in children who stutter than in children who do not stutter. CONCLUSIONS Taken together, these findings indicate weaker engagement of the contralateral left motor network in children who stutter even during low-demand non-speech tasks, and suggest that the right hemisphere might be recruited to support sensorimotor processing in childhood stuttering. Differences in oscillatory dynamics occurred despite comparable task performance between groups, indicating that an altered balance of cortical activity might be a core aspect of stuttering, observable during normal motor behavior.
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Affiliation(s)
- Valeria C Caruso
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
| | - Amanda Hampton Wray
- Department of Communication Science & Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erica Lescht
- Department of Communication Science & Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Communication Disorders, Ewha Womans University, Seoul, South Korea
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18
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Jaballah F, Aissa A, Ouali U, Zgueb Y, Jomli R. Clozapine-Induced Stuttering: Case Report and Literature Review. PHARMACOPSYCHIATRY 2023; 56:240-243. [PMID: 37944562 DOI: 10.1055/a-2189-5597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Affiliation(s)
- Fares Jaballah
- Avicenna Department (A), Razi Hospital, Tunis-El Manar University, Tunisia
| | - Amina Aissa
- Avicenna Department (A), Razi Hospital, Tunis-El Manar University, Tunisia
| | - Uta Ouali
- Avicenna Department (A), Razi Hospital, Tunis-El Manar University, Tunisia
| | - Yosra Zgueb
- Avicenna Department (A), Razi Hospital, Tunis-El Manar University, Tunisia
| | - Rabaa Jomli
- Avicenna Department (A), Razi Hospital, Tunis-El Manar University, Tunisia
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Medeiros W, Barros T, Caixeta FV. Bibliometric mapping of non-invasive brain stimulation techniques (NIBS) for fluent speech production. Front Hum Neurosci 2023; 17:1164890. [PMID: 37425291 PMCID: PMC10323431 DOI: 10.3389/fnhum.2023.1164890] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/30/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Language production is a finely regulated process, with many aspects which still elude comprehension. From a motor perspective, speech involves over a hundred different muscles functioning in coordination. As science and technology evolve, new approaches are used to study speech production and treat its disorders, and there is growing interest in the use of non-invasive modulation by means of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). Methods Here we analyzed data obtained from Scopus (Elsevier) using VOSViewer to provide an overview of bibliographic mapping of citation, co-occurrence of keywords, co-citation and bibliographic coupling of non-invasive brain stimulation (NIBS) use in speech research. Results In total, 253 documents were found, being 55% from only three countries (USA, Germany and Italy), with emerging economies such as Brazil and China becoming relevant in this topic recently. Most documents were published in this last decade, with 2022 being the most productive yet, showing brain stimulation has untapped potential for the speech research field. Discussion Keyword analysis indicates a move away from basic research on the motor control in healthy speech, toward clinical applications such as stuttering and aphasia treatment. We also observe a recent trend in cerebellar modulation for clinical treatment. Finally, we discuss how NIBS have established over the years and gained prominence as tools in speech therapy and research, and highlight potential methodological possibilities for future research.
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Chow HM, Garnett EO, Ratner NB, Chang SE. Brain activity during the preparation and production of spontaneous speech in children with persistent stuttering. Neuroimage Clin 2023; 38:103413. [PMID: 37099876 PMCID: PMC10149502 DOI: 10.1016/j.nicl.2023.103413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/10/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023]
Abstract
Speech production forms the basis for human verbal communication. Though fluent speech production is effortless and automatic for most people, it is disrupted in speakers who stutter, who experience difficulties especially during spontaneous speech and at utterance onsets. Brain areas comprising the basal ganglia thalamocortical (BGTC) motor loop have been a focus of interest in the context of stuttering, given this circuit's critical role in initiating and sequencing connected speech. Despite the importance of better understanding the role of the BGTC motor loop in supporting overt, spontaneous speech production, capturing brain activity during speech has been challenging to date, due to fMRI artifacts associated with severe head motions during speech production. Here, using an advanced technique that removes speech-related artifacts from fMRI signals, we examined brain activity occurring immediately before, and during, overt spontaneous speech production in 22 children with persistent stuttering (CWS) and 18 children who do not stutter (controls) in the 5-to-12-year age range. Brain activity during speech production was compared in two conditions: spontaneous speech (i.e., requiring language formulation) and automatic speech (i.e., overlearned word sequences). Compared to controls, CWS exhibited significantly reduced left premotor activation during spontaneous speech production but not during automatic speech. Moreover, CWS showed an age-related reduction in left putamen and thalamus activation during speech preparation. These results provide further evidence that stuttering is associated with functional deficits in the BGTC motor loop, which are exacerbated during spontaneous speech production.
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21
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Chow HM, Garnett EO, Koenraads SPC, Chang SE. Brain developmental trajectories associated with childhood stuttering persistence and recovery. Dev Cogn Neurosci 2023; 60:101224. [PMID: 36863188 PMCID: PMC9986501 DOI: 10.1016/j.dcn.2023.101224] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/11/2023] [Accepted: 02/25/2023] [Indexed: 02/27/2023] Open
Abstract
Stuttering is a neurodevelopmental disorder affecting 5-8 % of preschool-age children, continuing into adulthood in 1 % of the population. The neural mechanisms underlying persistence and recovery from stuttering remain unclear and little information exists on neurodevelopmental anomalies in children who stutter (CWS) during preschool age, when stuttering symptoms typically first emerge. Here we present findings from the largest longitudinal study of childhood stuttering to date, comparing children with persistent stuttering (pCWS) and those who later recovered from stuttering (rCWS) with age-matched fluent peers, to examine the developmental trajectories of both gray matter volume (GMV) and white matter volume (WMV) using voxel-based morphometry. A total of 470 MRI scans were analyzed from 95 CWS (72 pCWS and 23 rCWS) and 95 fluent peers between 3 and 12 years of age. We examined overall group and group by age interactions in GMV and WMV in preschool age (3-5 years old) and school age (6-12 years old) CWS and controls, controlling for sex, IQ, intracranial volume, and socioeconomic status. The results provide broad support for a possible basal ganglia-thalamocortical (BGTC) network deficit starting in the earliest phases of the disorder and point to normalization or compensation of earlier occurring structural changes associated with stuttering recovery.
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Affiliation(s)
- Ho Ming Chow
- University of Delaware, Department of Communication Sciences and Disorders, Newark, DE 19713, USA
| | - Emily O Garnett
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | | | - Soo-Eun Chang
- Department of Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
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22
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Almudhi A, Gabr SA. Associations between glutamic acid decarboxylase antibodies, oxidative stress markers, and cognitive capacity in adolescents who stutter. Saudi J Biol Sci 2023; 30:103580. [PMID: 36844638 PMCID: PMC9943924 DOI: 10.1016/j.sjbs.2023.103580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/04/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
In this study, we amid to evaluate the correlation between the change in the expressed levels of anti-GAD antibodies titers, oxidative stress markers, cytokines markers, and cognitive capacity in adolescents with mild stuttering. Eighty participants (60 male/20 female) with the age range of 10-18 years with moderate stutteringparticipated in this study. To assess the stuttering and cognitive function, stutteringseverity instrument (SSI-4; 4th edit.)and the LOTCA-7 scores assessment were applied respectively in all subjects. In addition, serum GAD antibodies, cytokines like TNF-α, CRP,and IL-6 withtotal antioxidant capacity and nitric oxide as oxidative stress markers were estimated using calorimetry and immunoassay techniques.The results showed that good cognitive capacity was reported in about 56.25 % of the study population (n = 45) with a 117.52 ± 6.3 mean LOTCA-7 score. However, abnormal cognitive function was identified in 43.75 % of the study population (n = 35); they were categorized into moderate (score 62-92, n = 35), and poor (score 31-62; n = 10). There were significant associations between cognitive capacity reported and all biomarkers. The expression of GAD antibodies is significantly associated with the degree of cognitive capacity among students with stuttering. Significant association with the reduction (P = 0.01) in LOTCA-7 score domains, particularly orientation, thinking operations, attention, and concentration among students with variable cognitive capacity compared to controls. In addition, the expressed higher GAD antibodies in students with moderate and poor cognitive capacity showed to be significantly correlated with both elevated concentrations of cytokines; TNF-α, CRP, and IL-6, and the reduction of TAC and nitric oxide (NO) respectively. This study concludes that abnormality of cognitive capacity showed to be associated with higher expression of GAD antibodies, cytokines, and oxidative stress in school students with moderate stuttering.
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Affiliation(s)
- Abdulaziz Almudhi
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia,Speech Language Pathology Unit, King Khalid University, Abha 61481, Saudi Arabia,Corresponding author at: Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.
| | - Sami A. Gabr
- Department of Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura 35511, Egypt
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Gastaldon S, Busan P, Arcara G, Peressotti F. Inefficient speech-motor control affects predictive speech comprehension: atypical electrophysiological correlates in stuttering. Cereb Cortex 2023:6995383. [PMID: 36682885 DOI: 10.1093/cercor/bhad004] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/24/2023] Open
Abstract
Listeners predict upcoming information during language comprehension. However, how this ability is implemented is still largely unknown. Here, we tested the hypothesis proposing that language production mechanisms have a role in prediction. We studied 2 electroencephalographic correlates of predictability during speech comprehension-pre-target alpha-beta (8-30 Hz) power decrease and the post-target N400 event-related potential effect-in a population with impaired speech-motor control, i.e. adults who stutter (AWS), compared to typically fluent adults (TFA). Participants listened to sentences that could either constrain towards a target word or not, modulating its predictability. As a complementary task, participants also performed context-driven word production. Compared to TFA, AWS not only displayed atypical neural responses in production, but, critically, they showed a different pattern also in comprehension. Specifically, while TFA showed the expected pre-target power decrease, AWS showed a power increase in frontal regions, associated with speech-motor control. In addition, the post-target N400 effect was reduced for AWS with respect to TFA. Finally, we found that production and comprehension power changes were positively correlated in TFA, but not in AWS. Overall, the results support the idea that processes and neural structures prominently devoted to speech planning also support prediction during speech comprehension.
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Affiliation(s)
- Simone Gastaldon
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione (DPSS), University of Padova, Via Venezia 8, Padova (PD) 35131, Italy.,Padova Neuroscience Center (PNC), University of Padova, Via Giuseppe Orus 2/B, Padova (PD) 35131, Italy
| | - Pierpaolo Busan
- IRCCS Ospedale San Camillo, Via Alberoni 70, Lido (VE) 30126, Italy
| | - Giorgio Arcara
- IRCCS Ospedale San Camillo, Via Alberoni 70, Lido (VE) 30126, Italy
| | - Francesca Peressotti
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione (DPSS), University of Padova, Via Venezia 8, Padova (PD) 35131, Italy.,Padova Neuroscience Center (PNC), University of Padova, Via Giuseppe Orus 2/B, Padova (PD) 35131, Italy.,Centro Interdipartimentale di Ricerca "I-APPROVE-International Auditory Processing Project in Venice", University of Padova, Via Belzoni 160, Padova (PD) 35121, Italy
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Garnett EO, Chow HM, Limb S, Liu Y, Chang SE. Neural activity during solo and choral reading: A functional magnetic resonance imaging study of overt continuous speech production in adults who stutter. Front Hum Neurosci 2022; 16:894676. [PMID: 35937674 PMCID: PMC9353050 DOI: 10.3389/fnhum.2022.894676] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/27/2022] [Indexed: 01/22/2023] Open
Abstract
Previous neuroimaging investigations of overt speech production in adults who stutter (AWS) found increased motor and decreased auditory activity compared to controls. Activity in the auditory cortex is heightened, however, under fluency-inducing conditions in which AWS temporarily become fluent while synchronizing their speech with an external rhythm, such as a metronome or another speaker. These findings suggest that stuttering is associated with disrupted auditory motor integration. Technical challenges in acquiring neuroimaging data during continuous overt speech production have limited experimental paradigms to short or covert speech tasks. Such paradigms are not ideal, as stuttering primarily occurs during longer speaking tasks. To address this gap, we used a validated spatial ICA technique designed to address speech movement artifacts during functional magnetic resonance imaging (fMRI) scanning. We compared brain activity and functional connectivity of the left auditory cortex during continuous speech production in two conditions: solo (stutter-prone) and choral (fluency-inducing) reading tasks. Overall, brain activity differences in AWS relative to controls in the two conditions were similar, showing expected patterns of hyperactivity in premotor/motor regions but underactivity in auditory regions. Functional connectivity of the left auditory cortex (STG) showed that within the AWS group there was increased correlated activity with the right insula and inferior frontal area during choral speech. The AWS also exhibited heightened connectivity between left STG and key regions of the default mode network (DMN) during solo speech. These findings indicate possible interference by the DMN during natural, stuttering-prone speech in AWS, and that enhanced coordination between auditory and motor regions may support fluent speech.
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Affiliation(s)
- Emily O. Garnett
- Michigan Medicine, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Ho Ming Chow
- Michigan Medicine, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Department of Communication Sciences and Disorders, University of Delaware, Newark, DE, United States
| | - Sarah Limb
- Michigan Medicine, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Yanni Liu
- Michigan Medicine, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Soo-Eun Chang
- Michigan Medicine, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
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25
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Li R, Zhang C, Rao Y, Yuan TF. Deep brain stimulation of fornix for memory improvement in Alzheimer's disease: A critical review. Ageing Res Rev 2022; 79:101668. [PMID: 35705176 DOI: 10.1016/j.arr.2022.101668] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 05/16/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
Memory reflects the brain function in encoding, storage and retrieval of the data or information, which is a fundamental ability for any live organism. The development of approaches to improve memory attracts much attention due to the underlying mechanistic insight and therapeutic potential to treat neurodegenerative diseases with memory loss, such as Alzheimer's disease (AD). Deep brain stimulation (DBS), a reversible, adjustable, and non-ablative therapy, has been shown to be safe and effective in many clinical trials for neurodegenerative and neuropsychiatric disorders. Among all potential regions with access to invasive electrodes, fornix is considered as it is the major afferent and efferent connection of the hippocampus known to be closely associated with learning and memory. Indeed, clinical trials have demonstrated that fornix DBS globally improved cognitive function in a subset of patients with AD, indicating fornix can serve as a potential target for neurosurgical intervention in treating memory impairment in AD. The present review aims to provide a better understanding of recent progresses in the application of fornix DBS for ameliorating memory impairments in AD patients.
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Affiliation(s)
- Ruofan Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chencheng Zhang
- Department of Neurosurgery, Center for Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanxia Rao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Laboratory Animal Science, Fudan University, China.
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China.
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26
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Moein N, Rostami R, Mohamadi R, Zomorrodi R, Nitsche M, Ostadi A, Shabani M. Electrophysiological correlates of stuttering severity: An ERP study. J Clin Neurosci 2022; 101:80-88. [PMID: 35561434 DOI: 10.1016/j.jocn.2022.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 02/28/2022] [Accepted: 03/11/2022] [Indexed: 12/01/2022]
Abstract
Although a variety of theories have been proposed to explain the etiology of stuttering, the exact neurological origin of it is still uncertain. The aim of this study is to investigate the correlation between stuttering severity and ERP measures. The population of this study consisted of 12 adults with moderate, 12 adults with severe stuttering, and 12 fluent speakers as the control group. ERPs were recorded during an auditory task in which subjects should determine an oddball stimulus. The result of mismatch negativity (MMN) amplitude analysis revealed significant differences between severe stuttering and fluent speakers groups and between two stuttering groups. Moreover, the result showed significant differences between the three study groups for P300 amplitude. The findings of the present study suggest that the differences in ERP components are existed not only between people who stutter and fluent speakers but also between people with different levels of stuttering severity.
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Affiliation(s)
- Narges Moein
- Department of Speech-Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Madadkaran St., Shahnazari Ave., Mirdamad Blvd., Madar Sq., Tehran, Iran
| | - Reza Rostami
- Faculty of Psychology and Education, University of Tehran, Dr. Kardan St., Jalal-Al-e-Ahmed Ave., Chamran Hwy., Tehran, Iran.
| | - Reyhane Mohamadi
- Department of Speech-Language Pathology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran; Rehabilitation Research Center, Iran University of Medical Sciences, Madadkaran St., Shahnazari Ave., Mirdamad Blvd., Madar Sq., Tehran, Iran.
| | - Reza Zomorrodi
- Temerty Centre for Therapeutic Brain Intervention, University of Toronto, Russell St., Toronto, ON, Canada.
| | - Michael Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors. Ardeystrasse 67, Dortmund, Germany.
| | - Amir Ostadi
- University of Waterloo, All in Electrical Engineering, Waterloo, ON, Canada
| | - Mohsen Shabani
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
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27
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Neef NE, Korzeczek A, Primaßin A, Wolff von Gudenberg A, Dechent P, Riedel CH, Paulus W, Sommer M. White matter tract strength correlates with therapy outcome in persistent developmental stuttering. Hum Brain Mapp 2022; 43:3357-3374. [PMID: 35415866 PMCID: PMC9248304 DOI: 10.1002/hbm.25853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 11/11/2022] Open
Abstract
Persistent stuttering is a prevalent neurodevelopmental speech disorder, which presents with involuntary speech blocks, sound and syllable repetitions, and sound prolongations. Affected individuals often struggle with negative feelings, elevated anxiety, and low self-esteem. Neuroimaging studies frequently link persistent stuttering with cortical alterations and dysfunctional cortico-basal ganglia-thalamocortical loops; dMRI data also point toward connectivity changes of the superior longitudinal fasciculus (SLF) and the frontal aslant tract (FAT). Both tracts are involved in speech and language functions, and the FAT also supports inhibitory control and conflict monitoring. Whether the two tracts are involved in therapy-associated improvements and how they relate to therapeutic outcomes is currently unknown. Here, we analyzed dMRI data of 22 patients who participated in a fluency-shaping program, 18 patients not participating in therapy, and 27 fluent control participants, measured 1 year apart. We used diffusion tractography to segment the SLF and FAT bilaterally and to quantify their microstructural properties before and after a fluency-shaping program. Participants learned to speak with soft articulation, pitch, and voicing during a 2-week on-site boot camp and computer-assisted biofeedback-based daily training for 1 year. Therapy had no impact on the microstructural properties of the two tracts. Yet, after therapy, stuttering severity correlated positively with left SLF fractional anisotropy, whereas relief from the social-emotional burden to stutter correlated negatively with right FAT fractional anisotropy. Thus, posttreatment, speech motor performance relates to the left dorsal stream, while the experience of the adverse impact of stuttering relates to the structure recently associated with conflict monitoring and action inhibition.
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Affiliation(s)
- Nicole E Neef
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany.,Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Alexandra Korzeczek
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Annika Primaßin
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.,Fachbereich Gesundheit, FH Münster University of Applied Sciences, Münster, Germany
| | | | - Peter Dechent
- Department of Cognitive Neurology, MR Research in Neurosciences, University Medical Center Göttingen, Göttingen, Germany
| | - Christian Heiner Riedel
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Martin Sommer
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.,Department of Neurology, University Medical Center Göttingen, Göttingen, Germany.,Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
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28
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White matter connectivity in neonates at risk of stuttering: Preliminary data. Neurosci Lett 2022; 781:136655. [DOI: 10.1016/j.neulet.2022.136655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 02/15/2022] [Accepted: 04/20/2022] [Indexed: 11/24/2022]
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Gracco VL, Sares AG, Koirala N. Structural brain network topological alterations in stuttering adults. Brain Commun 2022; 4:fcac058. [PMID: 35368614 PMCID: PMC8971894 DOI: 10.1093/braincomms/fcac058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/06/2022] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Persistent developmental stuttering is a speech disorder that primarily affects normal speech fluency but encompasses a complex set of symptoms ranging from reduced sensorimotor integration to socioemotional challenges. Here, we investigated the whole brain structural connectome and its topological alterations in adults who stutter. Diffusion weighted imaging data of 33 subjects (13 adults who stutter and 20 fluent speakers) was obtained along with a stuttering severity evaluation. The structural brain network properties were analyzed using Network-based statistics and graph theoretical measures particularly focusing on community structure, network hubs and controllability. Bayesian power estimation was used to assess the reliability of the structural connectivity differences by examining the effect size. The analysis revealed reliable and wide-spread decreases in connectivity for adults who stutter in regions associated with sensorimotor, cognitive, emotional, and memory-related functions. The community detection algorithms revealed different subnetworks for fluent speakers and adults who stutter, indicating considerable network adaptation in adults who stutter. Average and modal controllability differed between groups in a subnetwork encompassing frontal brain regions and parts of the basal ganglia.
The results revealed extensive structural network alterations and substantial adaptation in neural architecture in adults who stutter well beyond the sensorimotor network. These findings highlight the impact of the neurodevelopmental effects of persistent stuttering on neural organization and the importance of examining the full structural connectome and the network alterations that underscore the behavioral phenotype.
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Affiliation(s)
- Vincent L. Gracco
- Haskins Laboratories, New Haven, CT, USA
- School of Communication Sciences & Disorders, McGill University, Montreal, Canada
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30
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Zhao Y, Yang L, Gong G, Cao Q, Liu J. Identify aberrant white matter microstructure in ASD, ADHD and other neurodevelopmental disorders: A meta-analysis of diffusion tensor imaging studies. Prog Neuropsychopharmacol Biol Psychiatry 2022; 113:110477. [PMID: 34798202 DOI: 10.1016/j.pnpbp.2021.110477] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/26/2021] [Accepted: 11/11/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Neurodevelopmental disorders (NDDs) usually present overlapping symptoms. Abnormal white matter (WM) microstructure has been found in these disorders. Identification of common and unique neural abnormalities across NDDs could provide further insight into the underlying pathophysiological mechanisms. METHODS We performed a voxel-based meta-analysis of whole-brain diffusion tensor imaging (DTI) studies in autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and other NDDs. A systematic literature search was conducted through March 2020 to identify studies that compared measures of WM microstructure between patients with NDDs and neurotypical controls. Peak voxel coordinates were meta-analyzed via anisotropic effect size-signed differential mapping (AES-SDM) as well as activation likelihood estimation (ALE). RESULTS Our final sample included a total of 4137 subjects from 66 studies across five NDDs. Fractional anisotropy (FA) reductions were found in the splenium of the CC in ADHD, and the genu and splenium of CC in ASD. And mean diffusivity (MD) increases were shown in posterior thalamic radiation in ASD. No consistent abnormalities were detected in specific learning disorder, motor disorder or communication disorder. Significant differences between child/adolescent and adult patients were found within the CC across NDDs, reflective of aberrant neurodevelopmental processes in NDDs. CONCLUSIONS The current study demonstrated atypical WM patterns in ASD, ADHD and other NDDs. Microstructural abnormalities in the splenium of the CC were possibly shared among ASD and ADHD.
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Affiliation(s)
- Yilu Zhao
- The Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health, (Peking University), Beijing, China
| | - Li Yang
- The Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health, (Peking University), Beijing, China
| | - Gaolang Gong
- State Key Laboratory of Cognitive Neuroscience and Learning & IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China; Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
| | - Qingjiu Cao
- The Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health, (Peking University), Beijing, China.
| | - Jing Liu
- The Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Centre for Mental Disorders (Peking University Sixth Hospital), NHC Key Laboratory of Mental Health, (Peking University), Beijing, China.
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31
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Korzeczek A, Neef NE, Steinmann I, Paulus W, Sommer M. Stuttering severity relates to frontotemporal low-beta synchronization during pre-speech preparation. Clin Neurophysiol 2022; 138:84-96. [DOI: 10.1016/j.clinph.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 12/15/2022]
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32
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Nikvarz N, Sabouri S. Drug-induced stuttering: A comprehensive literature review. World J Psychiatry 2022; 12:236-263. [PMID: 35317340 PMCID: PMC8900588 DOI: 10.5498/wjp.v12.i2.236] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/29/2021] [Accepted: 12/25/2021] [Indexed: 02/06/2023] Open
Abstract
Drug-induced stuttering (DIS) is a type of neurogenic stuttering (NS). Although DIS has not been reported as frequently as other cases of NS in the literature, it is not a negligible adverse drug reaction (ADR) which can significantly affect the quality of life if not treated. This literature review aims to evaluate the epidemiological and clinical characteristics of DIS and suggests some pathophysiological mechanisms for this ADR. Relevant English-language reports in Google Scholar, PubMed, Web of Science, and Scopus were identified and assessed without time restriction. Finally, a total of 62 reports were included. Twenty-seven drugs caused 86 episodes of stuttering in 82 cases. The most episodes of DIS were related to antipsychotic drugs (57%), mostly including clozapine, followed by central nervous system agents (11.6%) and anticonvulsant drugs (9.3%). The majority of the cases were male and between the ages of 31 and 40 years. Repetitions were the most frequent core manifestations of DIS. In 55.8% of the episodes of DIS, the offending drug was withdrawn to manage stuttering, which resulted in significant improvement or complete relief of stuttering in all cases. Based on the suggested pathophysiological mechanisms for developmental stuttering and neurotransmitters dysfunctions involved in speech dysfluency, it seems that the abnormalities of several neurotransmitters, especially dopamine and glutamate, in different circuits and areas of the brain, including cortico-basal ganglia-thalamocortical loop and white matter fiber tracts, may be engaged in the pathogenesis of DIS.
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Affiliation(s)
- Naemeh Nikvarz
- Department of Clinical Pharmacy, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman 7616911319, Iran
| | - Salehe Sabouri
- Neuroscience Research Center, Institute of Neuropharmacology, Kerman 7616911319, Iran
- Department of Pharmaceutical Biotechnology, Kerman University of Medical Sciences, Kerman 7616911319, Iran
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33
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Korzeczek A, Primaßin A, Wolff von Gudenberg A, Dechent P, Paulus W, Sommer M, Neef NE. Fluency shaping increases integration of the command-to-execution and the auditory-to-motor pathways in persistent developmental stuttering. Neuroimage 2021; 245:118736. [PMID: 34798230 DOI: 10.1016/j.neuroimage.2021.118736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/10/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022] Open
Abstract
Fluency-shaping enhances the speech fluency of persons who stutter, yet underlying conditions and neuroplasticity-related mechanisms are largely unknown. While speech production-related brain activity in stuttering is well studied, it is unclear whether therapy repairs networks of altered sensorimotor integration, imprecise neural timing and sequencing, faulty error monitoring, or insufficient speech planning. Here, we tested the impact of one-year fluency-shaping therapy on resting-state fMRI connectivity within sets of brain regions subserving these speech functions. We analyzed resting-state data of 22 patients who participated in a fluency-shaping program, 18 patients not participating in therapy, and 28 fluent control participants, measured one year apart. Improved fluency was accompanied by an increased connectivity within the sensorimotor integration network. Specifically, two connections were strengthened; the left inferior frontal gyrus showed increased connectivity with the precentral gyrus at the representation of the left laryngeal motor cortex, and the left inferior frontal gyrus showed increased connectivity with the right superior temporal gyrus. Thus, therapy-associated neural remediation was based on a strengthened integration of the command-to-execution pathway together with an increased auditory-to-motor coupling. Since we investigated task-free brain activity, we assume that our findings are not biased to network activity involved in compensation but represent long-term focal neuroplasticity effects.
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Affiliation(s)
- Alexandra Korzeczek
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.
| | - Annika Primaßin
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany; FH Münster University of Applied Sciences, Münster School of Health (MSH), Münster, Germany.
| | | | - Peter Dechent
- Department of Cognitive Neurology, MR Research in Neurosciences, University Medical Center Göttingen, Göttingen, Germany.
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.
| | - Martin Sommer
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany; Department of Neurology, University Medical Center Göttingen, Germany; Department of Geriatrics, University Medical Center Göttingen, Germany.
| | - Nicole E Neef
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany; Department of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Germany.
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34
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Reif AE, Goberman AM. Linguistic features of dysfluencies in Parkinson Disease. JOURNAL OF FLUENCY DISORDERS 2021; 70:105845. [PMID: 33780692 DOI: 10.1016/j.jfludis.2021.105845] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/23/2020] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE The purpose of this study was to examine dysfluency characteristics of individuals with Parkinson Disease (PD) relative to linguistic features of grammatical class and position within word. Few studies have reported dysfluency characteristics of PD relative to these characteristics. Those that do report on these characteristics include one case study and a study of six individuals with PD. No previous research is known to have examined dysfluency related to grammatical class and position within words for a large sample of individuals with PD. METHOD Dysfluencies from 32 individuals with PD were analyzed according to position within a word and grammatical class. RESULTS Participants produced significantly more dysfluencies in the initial position of words compared to medial or final positions, and a significantly higher percent dysfluency for content words versus function words. CONCLUSION Effects of linguistic features of grammatical class and position within a word on dysfluencies are present within a population with PD and are similar to the linguistic features associated with developmental stuttering. Clinical implications of the effect of linguistic features on speech dysfluencies in PD are discussed.
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Affiliation(s)
- Angela E Reif
- School of Speech-Language Pathology and Audiology, The University of Akron, United States.
| | - Alexander M Goberman
- Graduate College, Department of Communication Sciences and Disorders, Bowling Green State University, United States
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35
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Cler GJ, Krishnan S, Papp D, Wiltshire CEE, Chesters J, Watkins KE. Elevated iron concentration in putamen and cortical speech motor network in developmental stuttering. Brain 2021; 144:2979-2984. [PMID: 34750604 PMCID: PMC8634076 DOI: 10.1093/brain/awab283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 06/17/2021] [Accepted: 07/16/2021] [Indexed: 11/12/2022] Open
Abstract
Theoretical accounts of developmental stuttering implicate dysfunctional cortico-striatal-thalamo-cortical motor loops through the putamen. However, the analysis of conventional MRI brain scans in individuals who stutter has failed to yield strong support for this theory in terms of reliable differences in the structure or function of the basal ganglia. Here, we performed quantitative mapping of brain tissue, which can be used to measure iron content alongside markers sensitive to myelin and thereby offers particular sensitivity to the measurement of iron-rich structures such as the basal ganglia. Analysis of these quantitative maps in 41 men and women who stutter and 32 individuals who are typically fluent revealed significant group differences in maps of R2*, indicative of higher iron content in individuals who stutter in the left putamen and in left hemisphere cortical regions important for speech motor control. Higher iron levels in brain tissue in individuals who stutter could reflect elevated dopamine levels or lysosomal dysfunction, both of which are implicated in stuttering. This study represents the first use of these quantitative measures in developmental stuttering and provides new evidence of microstructural differences in the basal ganglia and connected frontal cortical regions.
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Affiliation(s)
- Gabriel J Cler
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK
| | - Saloni Krishnan
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK
- Department of Psychology, Royal Holloway, University of London, Egham Hill, Surrey TW20 0EX, UK
| | - Daniel Papp
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford OX3 9DU, UK
| | - Charlotte E E Wiltshire
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK
| | - Jennifer Chesters
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK
- Bristol Speech and Language Therapy Research Unit, North Bristol NHS Trust, Bristol BS10 5NB, UK
| | - Kate E Watkins
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK
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Chow HM, Li H, Liu S, Frigerio-Domingues C, Drayna D. Neuroanatomical anomalies associated with rare AP4E1 mutations in people who stutter. Brain Commun 2021; 3:fcab266. [PMID: 34859215 PMCID: PMC8633735 DOI: 10.1093/braincomms/fcab266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 08/23/2021] [Accepted: 09/17/2021] [Indexed: 11/17/2022] Open
Abstract
Developmental stuttering is a common speech disorder with strong genetic underpinnings. Recently, stuttering has been associated with mutations in genes involved in lysosomal enzyme trafficking. However, how these mutations affect the brains of people who stutter remains largely unknown. In this study, we compared grey matter volume and white matter fractional anisotropy between a unique group of seven subjects who stutter and carry the same rare heterozygous AP4E1 coding mutations and seven unrelated controls without such variants. The carriers of the AP4E1 mutations are members of a large Cameroonian family in which the association between AP4E1 and persistent stuttering was previously identified. Compared to controls, mutation carriers showed reduced grey matter volume in the thalamus, visual areas and the posterior cingulate cortex. Moreover, reduced fractional anisotropy was observed in the corpus callosum, consistent with the results of previous neuroimaging studies of people who stutter with unknown genetic backgrounds. Analysis of gene expression data showed that these structural differences appeared at the locations in which expression of AP4E1 is relatively high. Moreover, the pattern of grey matter volume differences was significantly associated with AP4E1 expression across the left supratentorial regions. This spatial congruency further supports the connection between AP4E1 mutations and the observed structural differences.
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Affiliation(s)
- Ho Ming Chow
- Department of Communication Sciences and Disorders, University of Delaware, Newark, DE 19713, USA
- Katzin Diagnostic & Research PET/MR Center, Nemours/Alfred duPont Hospital for Children, Wilmington, DE 19803, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
- Section on Genetics of Communication Disorders, NIDCD/NIH, Bethesda, MD 20892, USA
| | - Hua Li
- Katzin Diagnostic & Research PET/MR Center, Nemours/Alfred duPont Hospital for Children, Wilmington, DE 19803, USA
| | - Siyuan Liu
- Section on Developmental Neurogenomics, NIMH/NIH, Bethesda, MD 20892, USA
| | | | - Dennis Drayna
- Section on Genetics of Communication Disorders, NIDCD/NIH, Bethesda, MD 20892, USA
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Gattie M, Lieven EVM, Kluk K. Weak Vestibular Response in Persistent Developmental Stuttering. Front Integr Neurosci 2021; 15:662127. [PMID: 34594189 PMCID: PMC8477904 DOI: 10.3389/fnint.2021.662127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 06/14/2021] [Indexed: 11/24/2022] Open
Abstract
Vibrational energy created at the larynx during speech will deflect vestibular mechanoreceptors in humans (Todd et al., 2008; Curthoys, 2017; Curthoys et al., 2019). Vestibular-evoked myogenic potential (VEMP), an indirect measure of vestibular function, was assessed in 15 participants who stutter, with a non-stutter control group of 15 participants paired on age and sex. VEMP amplitude was 8.5 dB smaller in the stutter group than the non-stutter group (p = 0.035, 95% CI [−0.9, −16.1], t = −2.1, d = −0.8, conditional R2 = 0.88). The finding is subclinical as regards gravitoinertial function, and is interpreted with regard to speech-motor function in stuttering. There is overlap between brain areas receiving vestibular innervation, and brain areas identified as important in studies of persistent developmental stuttering. These include the auditory brainstem, cerebellar vermis, and the temporo-parietal junction. The finding supports the disruptive rhythm hypothesis (Howell et al., 1983; Howell, 2004) in which sensory inputs additional to own speech audition are fluency-enhancing when they coordinate with ongoing speech.
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Affiliation(s)
- Max Gattie
- Manchester Centre for Audiology and Deafness (ManCAD), The University of Manchester, Manchester, United Kingdom
| | - Elena V M Lieven
- Child Study Centre, The University of Manchester, Manchester, United Kingdom.,The ESRC International Centre for Language and Communicative Development (LuCiD), The University of Manchester, Manchester, United Kingdom
| | - Karolina Kluk
- Manchester Centre for Audiology and Deafness (ManCAD), The University of Manchester, Manchester, United Kingdom
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Busan P, Moret B, Masina F, Del Ben G, Campana G. Speech Fluency Improvement in Developmental Stuttering Using Non-invasive Brain Stimulation: Insights From Available Evidence. Front Hum Neurosci 2021; 15:662016. [PMID: 34456692 PMCID: PMC8386014 DOI: 10.3389/fnhum.2021.662016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 07/12/2021] [Indexed: 11/21/2022] Open
Abstract
Developmental stuttering (DS) is a disturbance of the normal rhythm of speech that may be interpreted as very debilitating in the most affected cases. Interventions for DS are historically based on the behavioral modifications of speech patterns (e.g., through speech therapy), which are useful to regain a better speech fluency. However, a great variability in intervention outcomes is normally observed, and no definitive evidence is currently available to resolve stuttering, especially in the case of its persistence in adulthood. In the last few decades, DS has been increasingly considered as a functional disturbance, affecting the correct programming of complex motor sequences such as speech. Compatibly, understanding of the neurophysiological bases of DS has dramatically improved, thanks to neuroimaging, and techniques able to interact with neural tissue functioning [e.g., non-invasive brain stimulation (NIBS)]. In this context, the dysfunctional activity of the cortico-basal-thalamo-cortical networks, as well as the defective patterns of connectivity, seems to play a key role, especially in sensorimotor networks. As a consequence, a direct action on the functionality of "defective" or "impaired" brain circuits may help people who stutter to manage dysfluencies in a better way. This may also "potentiate" available interventions, thus favoring more stable outcomes of speech fluency. Attempts aiming at modulating (and improving) brain functioning of people who stutter, realized by using NIBS, are quickly increasing. Here, we will review these recent advancements being applied to the treatment of DS. Insights will be useful not only to assess whether the speech fluency of people who stutter may be ameliorated by acting directly on brain functioning but also will provide further suggestions about the complex and dynamic pathophysiology of DS, where causal effects and "adaptive''/''maladaptive" compensation mechanisms may be strongly overlapped. In conclusion, this review focuses future research toward more specific, targeted, and effective interventions for DS, based on neuromodulation of brain functioning.
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Affiliation(s)
| | | | | | - Giovanni Del Ben
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Gianluca Campana
- Department of General Psychology, University of Padua, Padua, Italy
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Wiltshire CEE, Chiew M, Chesters J, Healy MP, Watkins KE. Speech Movement Variability in People Who Stutter: A Vocal Tract Magnetic Resonance Imaging Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2438-2452. [PMID: 34157239 PMCID: PMC8323486 DOI: 10.1044/2021_jslhr-20-00507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 01/29/2021] [Accepted: 03/01/2021] [Indexed: 06/01/2023]
Abstract
Purpose People who stutter (PWS) have more unstable speech motor systems than people who are typically fluent (PWTF). Here, we used real-time magnetic resonance imaging (MRI) of the vocal tract to assess variability and duration of movements of different articulators in PWS and PWTF during fluent speech production. Method The vocal tracts of 28 adults with moderate to severe stuttering and 20 PWTF were scanned using MRI while repeating simple and complex pseudowords. Midsagittal images of the vocal tract from lips to larynx were reconstructed at 33.3 frames per second. For each participant, we measured the variability and duration of movements across multiple repetitions of the pseudowords in three selected articulators: the lips, tongue body, and velum. Results PWS showed significantly greater speech movement variability than PWTF during fluent repetitions of pseudowords. The group difference was most evident for measurements of lip aperture using these stimuli, as reported previously, but here, we report that movements of the tongue body and velum were also affected during the same utterances. Variability was not affected by phonological complexity. Speech movement variability was unrelated to stuttering severity within the PWS group. PWS also showed longer speech movement durations relative to PWTF for fluent repetitions of multisyllabic pseudowords, and this group difference was even more evident as complexity increased. Conclusions Using real-time MRI of the vocal tract, we found that PWS produced more variable movements than PWTF even during fluent productions of simple pseudowords. PWS also took longer to produce multisyllabic words relative to PWTF, particularly when words were more complex. This indicates general, trait-level differences in the control of the articulators between PWS and PWTF. Supplemental Material https://doi.org/10.23641/asha.14782092.
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Affiliation(s)
- Charlotte E. E. Wiltshire
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, United Kingdom
| | - Mark Chiew
- Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom
| | - Jennifer Chesters
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, United Kingdom
| | - Máiréad P. Healy
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, United Kingdom
| | - Kate E. Watkins
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, Radcliffe Observatory Quarter, University of Oxford, United Kingdom
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Boley N, Patil S, Garnett EO, Li H, Chugani DC, Chang SE, Chow HM. Association Between Gray Matter Volume Variations and Energy Utilization in the Brain: Implications for Developmental Stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2317-2324. [PMID: 33719533 PMCID: PMC8740693 DOI: 10.1044/2020_jslhr-20-00325] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/23/2020] [Accepted: 10/02/2020] [Indexed: 06/12/2023]
Abstract
Purpose The biological mechanisms underlying developmental stuttering remain unclear. In a previous investigation, we showed that there is significant spatial correspondence between regional gray matter structural anomalies and the expression of genes linked to energy metabolism. In the current study, we sought to further examine the relationship between structural anomalies in the brain in children with persistent stuttering and brain regional energy metabolism. Method High-resolution structural MRI scans were acquired from 26 persistent stuttering and 44 typically developing children. Voxel-based morphometry was used to quantify the between-group gray matter volume (GMV) differences across the whole brain. Group differences in GMV were then compared with published values for the pattern of glucose metabolism measured via F18 fluorodeoxyglucose uptake in the brains of 29 healthy volunteers using positron emission tomography. Results A significant positive correlation between GMV differences and F18 fluorodeoxyglucose uptake was found in the left hemisphere (ρ = .36, p < .01), where speech-motor and language processing are typically localized. No such correlation was observed in the right hemisphere (ρ = .05, p = .70). Conclusions Corroborating our previous gene expression studies, the results of the current study suggest a potential connection between energy metabolism and stuttering. Brain regions with high energy utilization may be particularly vulnerable to anatomical changes associated with stuttering. Such changes may be further exacerbated when there are sharp increases in brain energy utilization, which coincides with the developmental period of rapid speech/language acquisition and the onset of stuttering during childhood. Supplemental Material https://doi.org/10.23641/asha.14110454.
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Affiliation(s)
- Nathaniel Boley
- The Institute for Biomedical Sciences, School of Medicine and Health Sciences, The George Washington University, Washington, DC
- Katzin Diagnostic & Research PET/MRI Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Sanath Patil
- Katzin Diagnostic & Research PET/MRI Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
- Premedical-Medical Program, Eberly College of Science, The Pennsylvania State University, University Park
| | - Emily O. Garnett
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Hua Li
- Katzin Diagnostic & Research PET/MRI Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Diane C. Chugani
- Department of Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
- Cognitive Imaging Research Center, Department of Radiology, College of Osteopathic Medicine, Michigan State University, East Lansing
- Department of Communicative Sciences and Disorders, College of Communication Arts and Sciences, Michigan State University, East Lansing
| | - Ho Ming Chow
- Katzin Diagnostic & Research PET/MRI Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
- Department of Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark
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Sommer M, Waltersbacher A, Schlotmann A, Schröder H, Strzelczyk A. Prevalence and Therapy Rates for Stuttering, Cluttering, and Developmental Disorders of Speech and Language: Evaluation of German Health Insurance Data. Front Hum Neurosci 2021; 15:645292. [PMID: 33912020 PMCID: PMC8071871 DOI: 10.3389/fnhum.2021.645292] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose To evaluate the prevalence and treatment patterns of speech and language disorders in Germany. Methods A retrospective analysis of data collected from 32% of the German population, insured by the statutory German health insurance (AOK, Local Health Care Funds). We used The International Statistical Classification of Diseases and Related Health Problems, 10th revision, German Modification (ICD-10 GM) codes for stuttering (F98.5), cluttering (F98.6), and developmental disorders of speech and language (F80) to identify prevalent and newly diagnosed cases each year. Prescription and speech therapy reimbursement data were used to evaluate treatment patterns. Results In 2017, 27,977 patients of all ages were diagnosed with stuttering (21,045 males, 75% and 6,932 females, 25%). Stuttering prevalence peaks at age 5 years (boys, 0.89% and girls, 0.40%). Cluttering was diagnosed in 1,800 patients of all ages (1,287 males, 71.5% and 513 females, 28.5%). Developmental disorders of speech and language were identified in 555,774 AOK-insurants (61.2% males and 38.8% females). Treatment data indicate a substantial proportion newly diagnosed stuttering individuals receive treatment (up to 45% of 6-year-old patients), with slightly fewer than 20 sessions per year, on average. We confirmed a previous study showing increased rates of atopic disorders and neurological and psychiatric comorbidities in individuals with stuttering, cluttering, and developmental disorders of speech and language. Conclusion This is the first nationwide study using health insurance data to analyze the prevalence and newly diagnosed cases of a speech and language disorder. Prevalence and gender ratio data were consistent with the international literature. The crude prevalence of developmental disorders of speech and language increased from 2015 to 2018, whereas the crude prevalence for stuttering remained stable. For cluttering, the numbers were too low to draw reliable conclusions. Proportional treatment allocation for stuttering peaked at 6 years of age, which is the school entrance year, and is later than the prevalence peak of stuttering.
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Affiliation(s)
- Martin Sommer
- Bundesvereinigung Stottern & Selbsthilfe e.V., German Stuttering Association, Cologne, Germany.,Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.,Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Andrea Waltersbacher
- Wissenschaftliches Institut der AOK (WIdO), AOK Research Institute, Berlin, Germany
| | - Andreas Schlotmann
- Wissenschaftliches Institut der AOK (WIdO), AOK Research Institute, Berlin, Germany
| | - Helmut Schröder
- Wissenschaftliches Institut der AOK (WIdO), AOK Research Institute, Berlin, Germany
| | - Adam Strzelczyk
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology and Neurosurgery, Goethe University Frankfurt, Frankfurt, Germany
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Maguire GA, Yoo BR, SheikhBahaei S. Investigation of Risperidone Treatment Associated With Enhanced Brain Activity in Patients Who Stutter. Front Neurosci 2021; 15:598949. [PMID: 33642973 PMCID: PMC7906995 DOI: 10.3389/fnins.2021.598949] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 01/21/2021] [Indexed: 12/15/2022] Open
Abstract
Stuttering is a childhood onset fluency disorder that leads to impairment in speech. A randomized, double-blinded placebo-controlled study was conducted with 10 adult subjects to observe the effects of risperidone (a dopamine receptor 2/serotonin receptor 2 antagonist) on brain metabolism, using [18F] deoxyglucose as the marker. At baseline and after 6 weeks of taking risperidone (0.5–2.0 mg/day) or a placebo pill, participants were assigned to a solo reading aloud task for 30 min and subsequently underwent a 90-min positron emission tomography scan. Paired t-tests were performed to compare the pre-treatment vs. post-treatment in groups. After imaging and analysis, the blind was broken, which revealed an equal number of subjects of those on risperidone and those on placebo. There were no significant differences in the baseline scans taken before medication randomization. However, scans taken after active treatment demonstrated higher glucose uptake in the specific regions of the brain for those in the risperidone treatment group (p < 0.05). Risperidone treatment was associated with increased metabolism in the left striatum, which consists of the caudate and putamen, and the Broca’s area. The current study strengthens previous research that suggests the role of elevated dopamine activity and striatal hypometabolism in stuttering. We propose that the mechanism of risperidone’s action in stuttering, in part, involves increased metabolism of striatal astrocytes. We conclude that using neuroimaging techniques to visualize changes in the brain of those who stutter can provide valuable insights into the pathophysiology of the disorder and guide the development of future interventions.
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Affiliation(s)
- Gerald A Maguire
- School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Bo Ram Yoo
- School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Shahriar SheikhBahaei
- National Institute of Neurological Disorders and Stroke/National Institutes of Health, Bethesda, MD, United States
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Neef NE, Primaßin A, von Gudenberg AW, Dechent P, Riedel C, Paulus W, Sommer M. Two cortical representations of voice control are differentially involved in speech fluency. Brain Commun 2021; 3:fcaa232. [PMID: 33959707 PMCID: PMC8088816 DOI: 10.1093/braincomms/fcaa232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/29/2020] [Accepted: 12/01/2020] [Indexed: 01/01/2023] Open
Abstract
Recent studies have identified two distinct cortical representations of voice control in humans, the ventral and the dorsal laryngeal motor cortex. Strikingly, while persistent developmental stuttering has been linked to a white-matter deficit in the ventral laryngeal motor cortex, intensive fluency-shaping intervention modulated the functional connectivity of the dorsal laryngeal motor cortical network. Currently, it is unknown whether the underlying structural network organization of these two laryngeal representations is distinct or differently shaped by stuttering intervention. Using probabilistic diffusion tractography in 22 individuals who stutter and participated in a fluency shaping intervention, in 18 individuals who stutter and did not participate in the intervention and in 28 control participants, we here compare structural networks of the dorsal laryngeal motor cortex and the ventral laryngeal motor cortex and test intervention-related white-matter changes. We show (i) that all participants have weaker ventral laryngeal motor cortex connections compared to the dorsal laryngeal motor cortex network, regardless of speech fluency, (ii) connections of the ventral laryngeal motor cortex were stronger in fluent speakers, (iii) the connectivity profile of the ventral laryngeal motor cortex predicted stuttering severity (iv) but the ventral laryngeal motor cortex network is resistant to a fluency shaping intervention. Our findings substantiate a weaker structural organization of the ventral laryngeal motor cortical network in developmental stuttering and imply that assisted recovery supports neural compensation rather than normalization. Moreover, the resulting dissociation provides evidence for functionally segregated roles of the ventral laryngeal motor cortical and dorsal laryngeal motor cortical networks.
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Affiliation(s)
- Nicole E Neef
- Department of Clinical Neurophysiology, Georg August University, Göttingen 37075, Germany
- Department of Diagnostic and Interventional Neuroradiology, Georg August University, Göttingen 37075, Germany
| | - Annika Primaßin
- Department of Clinical Neurophysiology, Georg August University, Göttingen 37075, Germany
| | | | - Peter Dechent
- Department of Cognitive Neurology, MR Research in Neurosciences, Georg August University, Göttingen 37075, Germany
| | - Christian Riedel
- Department of Diagnostic and Interventional Neuroradiology, Georg August University, Göttingen 37075, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, Georg August University, Göttingen 37075, Germany
| | - Martin Sommer
- Department of Clinical Neurophysiology, Georg August University, Göttingen 37075, Germany
- Department of Neurology, Georg August University, Göttingen 37075, Germany
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Maxfield ND. Inhibitory Control of Lexical Selection in Adults who Stutter. JOURNAL OF FLUENCY DISORDERS 2020; 66:105780. [PMID: 32950028 PMCID: PMC7704578 DOI: 10.1016/j.jfludis.2020.105780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 06/01/2023]
Abstract
PURPOSE Based on previous evidence that lexical selection may operate differently in adults who stutter (AWS) versus typically-fluent adults (TFA), and that atypical attentional processing may be a contributing factor, the purpose of this study was to investigate inhibitory control of lexical selection in AWS. METHOD 12 AWS and 12 TFA completed two tasks. One was a picture naming task featuring High and Low Agreement object naming. Naming accuracy and reaction times (RT), and event-related potentials (ERPs) time-locked to picture onset, were recorded. Second was a flanker task featuring Congruent and Incongruent arrow arrays. Push-button accuracy and RTs, and ERPs time-locked to arrow array onset, were recorded. RESULTS Low Agreement pictures were named less accurately and slower than High Agreement pictures in both Groups. The magnitude of the Agreement effect on naming RTs was larger in AWS versus TFA. Delta-plot analysis revealed that the Agreement effect was positively correlated with individual differences in inhibition in TFA but not in AWS. Moreover, Low Agreement pictures elicited negative-going ERP activity relative to High Agreement pictures in both Groups. However, the scalp topography of this effect was markedly reduced in AWS versus TFA. For the Flanker task, Congruency affected push-button accuracy and RTs, and N2 amplitudes, similarly between groups. CONCLUSIONS Results point to a selective deficit in inhibitory control of lexical selection in AWS. Potential pathways between diminished inhibitory control of lexical selection, speech motor control and stuttering are discussed.
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Affiliation(s)
- Nathan D Maxfield
- University of South Florida, Department of Communication Sciences & Disorders, 4202 East Fowler Avenue, PCD1017, Tampa, FL, 33620, United States.
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Choo AL, Smith SA, Li H. Associations between stuttering, comorbid conditions and executive function in children: a population-based study. BMC Psychol 2020; 8:113. [PMID: 33129350 PMCID: PMC7603732 DOI: 10.1186/s40359-020-00481-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/22/2020] [Indexed: 12/19/2022] Open
Abstract
Background The aim of this study was to investigate the relationship between executive function (EF), stuttering, and comorbidity by examining children who stutter (CWS) and children who do not stutter (CWNS) with and without comorbid conditions. Data from the National Health Interview Survey were used to examine behavioral manifestations of EF, such as inattention and self-regulation, in CWS and CWNS. Methods The sample included 2258 CWS (girls = 638, boys = 1620), and 117,725 CWNS (girls = 57,512; boys = 60,213). EF, and the presence of stuttering and comorbid conditions were based on parent report. Descriptive statistics were used to describe the distribution of stuttering and comorbidity across group and sex. Regression analyses were to determine the effects of stuttering and comorbidity on EF, and the relationship between EF and socioemotional competence. Results Results point to weaker EF in CWS compared to CWNS. Also, having comorbid conditions was also associated with weaker EF. CWS with comorbidity showed the weakest EF compared to CWNS with and without comorbidity, and CWS without comorbidity. Children with stronger EF showed higher socioemotional competence. A majority (60.32%) of CWS had at least one other comorbid condition in addition to stuttering. Boys who stutter were more likely to have comorbid conditions compared to girls who stutter. Conclusion Present findings suggest that comorbidity is a common feature in CWS. Stuttering and comorbid conditions negatively impact EF.
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Affiliation(s)
- Ai Leen Choo
- Department of Communication Sciences and Disorders, Georgia State University, 30 Pryor St SW, Atlanta, GA, 30303, USA.
| | - Sara Ashley Smith
- Department of Teaching and Learning, University of South Florida, Tampa, FL, 33620, USA
| | - Hongli Li
- Department of Educational Policy Studies, Georgia State University, 30 Pryor St SW, Atlanta, GA, 30303, USA
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Chow HM, Garnett EO, Li H, Etchell A, Sepulcre J, Drayna D, Chugani D, Chang SE. Linking Lysosomal Enzyme Targeting Genes and Energy Metabolism with Altered Gray Matter Volume in Children with Persistent Stuttering. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2020; 1:365-380. [PMID: 34041495 PMCID: PMC8138901 DOI: 10.1162/nol_a_00017] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 05/13/2020] [Indexed: 04/12/2023]
Abstract
Developmental stuttering is a childhood onset neurodevelopmental disorder with an unclear etiology. Subtle changes in brain structure and function are present in both children and adults who stutter. It is a highly heritable disorder, and 12-20% of stuttering cases may carry a mutation in one of four genes involved in intracellular trafficking. To better understand the relationship between genetics and neuroanatomical changes, we used gene expression data from the Allen Institute for Brain Science and voxel-based morphometry to investigate the spatial correspondence between gene expression patterns and differences in gray matter volume between children with persistent stuttering (n = 26, and 87 scans) and their fluent peers (n = 44, and 139 scans). We found that the expression patterns of two stuttering-related genes (GNPTG and NAGPA) from the Allen Institute data exhibited a strong positive spatial correlation with the magnitude of between-group gray matter volume differences. Additional gene set enrichment analyses revealed that genes whose expression was highly correlated with the gray matter volume differences were enriched for glycolysis and oxidative metabolism in mitochondria. Because our current study did not examine the participants' genomes, these results cannot establish the direct association between genetic mutations and gray matter volume differences in stuttering. However, our results support further study of the involvement of lysosomal enzyme targeting genes, as well as energy metabolism in stuttering. Future studies assessing variations of these genes in the participants' genomes may lead to increased understanding of the biological mechanisms of the observed spatial relationship between gene expression and gray matter volume.
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Affiliation(s)
- Ho Ming Chow
- Department of Communication Sciences and Disorders, University of Delaware, Newark, DE
- Katzin Diagnostic & Research PET/MRI Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
- * Corresponding Author:
| | | | - Hua Li
- Katzin Diagnostic & Research PET/MRI Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Andrew Etchell
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Jorge Sepulcre
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Dennis Drayna
- National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, MD
| | - Diane Chugani
- Department of Communication Sciences and Disorders, University of Delaware, Newark, DE
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
- Cognitive Imaging Research Center, Department of Radiology, Michigan State University, East Lansing, MI
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI
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Busan P, Del Ben G, Tantone A, Halaj L, Bernardini S, Natarelli G, Manganotti P, Battaglini PP. Effect of muscular activation on surrounding motor networks in developmental stuttering: A TMS study. BRAIN AND LANGUAGE 2020; 205:104774. [PMID: 32135384 DOI: 10.1016/j.bandl.2020.104774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 01/05/2020] [Accepted: 02/17/2020] [Indexed: 06/10/2023]
Abstract
Previous studies regarding developmental stuttering (DS) suggest that motor neural networks are strongly affected. Transcranial magnetic stimulation (TMS) was used to investigate neural activation of the primary motor cortex in DS during movement execution, and the influence of muscle representations involved in movements on "surrounding" ones. TMS was applied over the contralateral abductor digiti minimi (ADM) motor representation, at rest and during the movement of homologue first dorsal interosseous muscles (tonic contraction, phasic movements cued by acoustic signalling, and "self-paced" movements). Results highlighted a lower cortico-spinal excitability of ADM in the left hemisphere of stutterers, and an enhanced intracortical inhibition in their right motor cortex (in comparison to fluent speakers). Abnormal intracortical functioning was especially evident during phasic contractions cued by "external" acoustic signals. An exaggerated inhibition of muscles not directly involved in intended movements, in stuttering, may be useful to obtain more efficient motor control. This was stronger during contractions cued by "external" signals, highlighting mechanisms likely used by stutterers during fluency-evoking conditions.
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Affiliation(s)
- Pierpaolo Busan
- IRCCS Ospedale San Camillo, via Alberoni 70, 30126 Venice, Italy.
| | - Giovanni Del Ben
- Department of Life Sciences, University of Trieste, via Fleming 22, 34100 Trieste, Italy.
| | - Antonietta Tantone
- Department of Life Sciences, University of Trieste, via Fleming 22, 34100 Trieste, Italy
| | - Livia Halaj
- Department of Life Sciences, University of Trieste, via Fleming 22, 34100 Trieste, Italy
| | | | - Giulia Natarelli
- Department of Developmental and Social Psychology, University of Padua, via Venezia 8, 35100 Padua, Italy.
| | - Paolo Manganotti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
| | - Piero Paolo Battaglini
- Department of Life Sciences, University of Trieste, via Fleming 22, 34100 Trieste, Italy.
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Busan P. Developmental stuttering and the role of the supplementary motor cortex. JOURNAL OF FLUENCY DISORDERS 2020; 64:105763. [PMID: 32361030 DOI: 10.1016/j.jfludis.2020.105763] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 04/05/2020] [Accepted: 04/08/2020] [Indexed: 06/11/2023]
Abstract
Developmental stuttering is a frequent neurodevelopmental disorder with a complex neurobiological basis. Robust neural markers of stuttering include imbalanced activity of speech and motor related brain regions, and their impaired structural connectivity. The dynamic interaction of cortical regions is regulated by the cortico-basal ganglia-thalamo-cortical system with the supplementary motor area constituting a crucial cortical site. The SMA integrates information from different neural circuits, and manages information about motor programs such as self-initiated movements, motor sequences, and motor learning. Abnormal functioning of SMA is increasingly reported in stuttering, and has been recently indicated as an additional "neural marker" of DS: anatomical and functional data have documented abnormal structure and activity of the SMA, especially in motor and speech networks. Its connectivity is often impaired, especially when considering networks of the left hemisphere. Compatibly, recent data suggest that, in DS, SMA is part of a poorly synchronized neural network, thus resulting in a likely substrate for the appearance of DS symptoms. However, as evident when considering neural models of stuttering, the role of SMA has not been fully clarified. Herein, the available evidence is reviewed, which highlights the role of the SMA in DS as a neural "hub", receiving and conveying altered information, thus "gating" the release of correct or abnormal motor plans.
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Ghazavi M, Rastgu F, Nasiri J, Yaghini O. Efficacy of Levetiracetam in Treatment of Childhood Stuttering. Int J Prev Med 2020; 11:17. [PMID: 32175057 PMCID: PMC7050220 DOI: 10.4103/ijpvm.ijpvm_354_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 12/12/2018] [Indexed: 11/24/2022] Open
Abstract
Background: Stuttering is a kind of speech disorder that affects about 1% of total population. As the origin of this disorder is not obviously diagnosed yet, various remedies have been practiced and among them different medicines have been studied, but unfortunately no significant effective drugs have been recognized yet. As stuttering imposes a great social and mental costs to the patients and their families, finding an effective medicine will help significantly. In this study we have focused on the effects of levetiracetam (LEV) treatment on children suffering from stuttering. Methods: In this clinical trial study, 30 children aged > 3 years (median 3.8 years) with stuttering and abnormal sleep electroencephalogram (EEG) were treated by LEV and followed-up for a minimum period of 6 weeks. The starting dose of 20 mg/kg/day was increased at an interval of 1 week by 20 mg/kg/day, if necessary, up to maximum dose of 60 mg/kg/day. Results: Overall LEV was effective in 70% of patients, decreasing stuttering to at least 50%. Three children (10%) became stuttering-free and only in one (3.3%) child an increase in stuttering was observed. There were statistically significant differences for efficacy in the presence of variables such as age groups, seizure, stuttering family history, and EEG data. Conclusions: LEV is an effective drug for treatment of childhood stuttering in those that have abnormal sleep EEG.
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Affiliation(s)
- Mohammadreza Ghazavi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan, Iran.,Department of Pediatric Neurology, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fateme Rastgu
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan, Iran.,Department of Pediatric Neurology, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jafar Nasiri
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan, Iran.,Department of Pediatric Neurology, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Omid Yaghini
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan, Iran.,Department of Pediatric Neurology, Imam Hossein Children's Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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Sares AG, Deroche MLD, Ohashi H, Shiller DM, Gracco VL. Neural Correlates of Vocal Pitch Compensation in Individuals Who Stutter. Front Hum Neurosci 2020; 14:18. [PMID: 32161525 PMCID: PMC7053555 DOI: 10.3389/fnhum.2020.00018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/17/2020] [Indexed: 02/06/2023] Open
Abstract
Stuttering is a disorder that impacts the smooth flow of speech production and is associated with a deficit in sensorimotor integration. In a previous experiment, individuals who stutter were able to vocally compensate for pitch shifts in their auditory feedback, but they exhibited more variability in the timing of their corrective responses. In the current study, we focused on the neural correlates of the task using functional MRI. Participants produced a vowel sound in the scanner while hearing their own voice in real time through headphones. On some trials, the audio was shifted up or down in pitch, eliciting a corrective vocal response. Contrasting pitch-shifted vs. unshifted trials revealed bilateral superior temporal activation over all the participants. However, the groups differed in the activation of middle temporal gyrus and superior frontal gyrus [Brodmann area 10 (BA 10)], with individuals who stutter displaying deactivation while controls displayed activation. In addition to the standard univariate general linear modeling approach, we employed a data-driven technique (independent component analysis, or ICA) to separate task activity into functional networks. Among the networks most correlated with the experimental time course, there was a combined auditory-motor network in controls, but the two networks remained separable for individuals who stuttered. The decoupling of these networks may account for temporal variability in pitch compensation reported in our previous work, and supports the idea that neural network coherence is disturbed in the stuttering brain.
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Affiliation(s)
- Anastasia G. Sares
- Speech Motor Control Lab, Integrated Program in Neuroscience and School of Communication Sciences and Disorders, McGill University, Montreal, QC, Canada
- Centre for Research on Brain, Language, and Music, Montreal, QC, Canada
| | - Mickael L. D. Deroche
- Centre for Research on Brain, Language, and Music, Montreal, QC, Canada
- Laboratory for Hearing and Cognition, Department of Psychology, Concordia University, Montreal, QC, Canada
| | | | - Douglas M. Shiller
- Centre for Research on Brain, Language, and Music, Montreal, QC, Canada
- École d’orthophonie et d’audiologie, Université de Montréal, Montreal, QC, Canada
| | - Vincent L. Gracco
- Speech Motor Control Lab, Integrated Program in Neuroscience and School of Communication Sciences and Disorders, McGill University, Montreal, QC, Canada
- Centre for Research on Brain, Language, and Music, Montreal, QC, Canada
- Haskins Laboratories, New Haven, CT, United States
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