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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] [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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2
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G D, B H S, Gajbe U, Singh BR, Sawal A, Balwir T. The Role of Basal Ganglia and Its Neuronal Connections in the Development of Stuttering: A Review Article. Cureus 2022; 14:e28653. [PMID: 36196326 PMCID: PMC9525748 DOI: 10.7759/cureus.28653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/31/2022] [Indexed: 11/05/2022] Open
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Reinvestigating the Neural Bases Involved in Speech Production of Stutterers: An ALE Meta-Analysis. Brain Sci 2022; 12:brainsci12081030. [PMID: 36009093 PMCID: PMC9406059 DOI: 10.3390/brainsci12081030] [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: 06/09/2022] [Revised: 07/25/2022] [Accepted: 08/02/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Stuttering is characterized by dysfluency and difficulty in speech production. Previous research has found abnormalities in the neural function of various brain areas during speech production tasks. However, the cognitive neural mechanism of stuttering has still not been fully determined. Method: Activation likelihood estimation analysis was performed to provide neural imaging evidence on neural bases by reanalyzing published studies. Results: Our analysis revealed overactivation in the bilateral posterior superior temporal gyrus, inferior frontal gyrus, medial frontal gyrus, precentral gyrus, postcentral gyrus, basal ganglia, and cerebellum, and deactivation in the anterior superior temporal gyrus and middle temporal gyrus among the stutterers. The overactivated regions might indicate a greater demand in feedforward planning in speech production, while the deactivated regions might indicate dysfunction in the auditory feedback system among stutterers. Conclusions: Our findings provide updated and direct evidence on the multi-level impairment (feedforward and feedback systems) of stutterers during speech production and show that the corresponding neural bases were differentiated.
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Bayat M, Boostani R, Sabeti M, Yadegari F, Taghavi M, Pirmoradi M, Chakrabarti P, Nami M. Speech Related Anxiety in Adults Who Stutter. J PSYCHOPHYSIOL 2022. [DOI: 10.1027/0269-8803/a000305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The relationship between anxiety and stuttering has always been a topic of debate with a great emphasis on research focused on examining whether speech-related anxiety can exacerbate stuttering. This investigation compares some speech-related anticipatory anxiety indices in fluent and dysfluent utterances in adults who stutter (AWS). We scored the level of cognitive speech-related anxiety (anticipatory anxiety) using a self-reporting method and also evaluated the autonomic aspects of anxiety (state anxiety) through recording changes in Galvanic Skin Response (GSR) signals. Explaining the link between stuttering and anxiety is expected to assist practitioners in stuttering assessment and subsequent treatment strategies. Phasic GSR values of six events related to answering the verbal stimuli through fluent and dysfluent responses were registered to measure sympathetic arousal as an index of state anxiety in 20 AWS ( Mage = 35 ± 4 years, range: 21–42). To quantitatively examine the cognitive aspects of speech-related anticipatory anxiety, two questionnaires were rated by participants addressing the stuttering anticipation and semantic difficulty of verbal stimuli. GSR measures of fluent events were significantly higher than dysfluent counterparts within time windows before and during answering aloud the verbal stimuli ( p < .001). Later in the experiment, GSR values of dysfluent events were found to be higher than their fluent counterparts ( p < .001). Stuttering anticipation yielded a weak negative meaningful correlation with the scores of fluency ( r = −0.283, p = .046) and a positive yet nonsignificant correlation with the stuttering scores. The semantic difficulty had a moderately significant correlation with stuttering anticipation ( r = 0.354, p = .012) but not a meaningful correlation with fluency state. Autonomic and cognitive indices of speech-related anticipatory anxiety are not robust predictors of fluency. Anxiety seems to be more of a consequence of stuttering than a cause.
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Affiliation(s)
- Masoumeh Bayat
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Boostani
- Head of Biomedical Engineering Group, Faculty of Electrical and Computer Engineering, Shiraz University, Shiraz, Iran
| | - Malihe Sabeti
- Department of Computer Engineering, Islamic Azad University, North-Tehran Branch, Tehran, Iran
| | - Fariba Yadegari
- Department of Speech and Language Pathology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mahsa Taghavi
- Psychiatry group, medical school, Islamic Azad University, Kazeroon Branch, Kazeroon, Iran
| | - Mohammadreza Pirmoradi
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- ITM SLS, Baroda University, Vadodara, Gujarat, India
- Dana Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran
- Society for Brain Mapping and Therapeutics, Brain Mapping Foundation, Los Angeles, CA, USA
- Harvard Alumni for Mental Health, Harvard University, Boston, MA, USA
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Lu Y, Wiltshire CEE, Watkins KE, Chiew M, Goldstein L. Characteristics of articulatory gestures in stuttered speech: A case study using real-time magnetic resonance imaging. JOURNAL OF COMMUNICATION DISORDERS 2022; 97:106213. [PMID: 35397388 DOI: 10.1016/j.jcomdis.2022.106213] [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] [Received: 04/30/2021] [Revised: 02/09/2022] [Accepted: 03/14/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Most of the previous articulatory studies of stuttering have focussed on the fluent speech of people who stutter. However, to better understand what causes the actual moments of stuttering, it is necessary to probe articulatory behaviors during stuttered speech. We examined the supralaryngeal articulatory characteristics of stuttered speech using real-time structural magnetic resonance imaging (RT-MRI). We investigated how articulatory gestures differ across stuttered and fluent speech of the same speaker. METHODS Vocal tract movements of an adult man who stutters during a pseudoword reading task were recorded using RT-MRI. Four regions of interest (ROIs) were defined on RT-MRI image sequences around the lips, tongue tip, tongue body, and velum. The variation of pixel intensity in each ROI over time provided an estimate of the movement of these four articulators. RESULTS All disfluencies occurred on syllable-initial consonants. Three articulatory patterns were identified. Pattern 1 showed smooth gestural formation and release like fluent speech. Patterns 2 and 3 showed delayed release of gestures due to articulator fixation or oscillation respectively. Block and prolongation corresponded to either pattern 1 or 2. Repetition corresponded to pattern 3 or a mix of patterns. Gestures for disfluent consonants typically exhibited a greater constriction than fluent gestures, which was rarely corrected during disfluencies. Gestures for the upcoming vowel were initiated and executed during these consonant disfluencies, achieving a tongue body position similar to the fluent counterpart. CONCLUSION Different perceptual types of disfluencies did not necessarily result from distinct articulatory patterns, highlighting the importance of collecting articulatory data of stuttering. Disfluencies on syllable-initial consonants were related to the delayed release and the overshoot of consonant gestures, rather than the delayed initiation of vowel gestures. This suggests that stuttering does not arise from problems with planning the vowel gestures, but rather with releasing the overly constricted consonant gestures.
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Affiliation(s)
- Yijing Lu
- Department of Linguistics, University of Southern California, United States.
| | - Charlotte E E Wiltshire
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, United Kingdom.
| | - Kate E Watkins
- Wellcome Centre for Integrative Neuroimaging, Department of Experimental Psychology, University of Oxford, United Kingdom.
| | - Mark Chiew
- Wellcome Centre for Integrative Neuroimaging, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom.
| | - Louis Goldstein
- Department of Linguistics, University of Southern California, United States.
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Loucks TM, Pelczarski KM, Lomheim H, Aalto D. Speech kinematic variability in adults who stutter is influenced by treatment and speaking style. JOURNAL OF COMMUNICATION DISORDERS 2022; 96:106194. [PMID: 35134668 DOI: 10.1016/j.jcomdis.2022.106194] [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: 04/29/2021] [Revised: 01/21/2022] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
AIM We tested whether completion of the Comprehensive Stuttering Program (CSP) is associated with a reduction in speech kinematic variability relative to pre-treatment when adults who stutter (AWS) use a casual speaking manner or fluency skills. RATIONAL Kinematic variability is higher in AWS suggesting a sensorimotor vulnerability; however, it is not clear whether high variability is a trait related to the underlying disorder or reflects the mutable state of stuttering. Speech restructuring intervention such as the CSP could support more consistent articulatory control and stable movement patterns. METHODOLOGY Thirteen AWS were tested before and after completing the CSP while 11 adults who do not stutter (AWNS) completed a single session. Participants were instructed to use a casual manner of speaking in the first post-treatment session. In the second post-treatment condition, the AWS employed their fluency skills at a control speaking rate. An optical tracking system captured lower lip movements while participants spoke two English phrases and a complex nonword. Across-utterance kinematic variability was measured using the spatiotemporal index (STI) and within-utterance variability was measured with recurrence quantification analysis (RQA). RESULTS There was a positive treatment outcome based on significant reductions in percentage syllables stuttered (%SS) during speaking and reading, decreases in stuttering severity and improved perceptions of stuttering and communication confidence. The STI of the AWS decreased significantly after treatment for both speaking styles. The RQA variables indicated that AWS used a less stereotyped and more flexible manner of speaking in the casual condition after treatment, but speech movement regularity increased when using fluency skills. CONCLUSIONS The AWS showed a significant decrease in labial kinematic variability alongside a successful treatment outcome involving speech restructuring and cognitive behavioral techniques. These changes in across-utterance and within-utterance kinematic indices demonstrate that effective stuttering treatment can promote speech motor stability along with fluent speech.
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Affiliation(s)
- Torrey M Loucks
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, 8205 114St, 2-70 Corbett Hall, Edmonton, Alberta, T6G 2G4, Canada; Clinic Director, Faculty of Rehabilitation Medicine, Institute for Stuttering Treatment and Research, Reception Office # 2-18 Corbett Hall, University of Alberta, Edmonton, Alberta, T6G 2G4, Canada.
| | - Kristin M Pelczarski
- Communication Sciences and Disorders, Kansas State University, 1406 Campus Creek Road, Manhattan, KS, 66506, United States.
| | - Holly Lomheim
- Clinic Director, Faculty of Rehabilitation Medicine, Institute for Stuttering Treatment and Research, Reception Office # 2-18 Corbett Hall, University of Alberta, Edmonton, Alberta, T6G 2G4, Canada.
| | - Daniel Aalto
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, 8205 114St, 2-70 Corbett Hall, Edmonton, Alberta, T6G 2G4, Canada.
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Toyomura A, Fujii T, Sowman PF. Performance of Bimanual Finger Coordination Tasks in Speakers Who Stutter. Front Psychol 2021; 12:679607. [PMID: 34630201 PMCID: PMC8495154 DOI: 10.3389/fpsyg.2021.679607] [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: 03/12/2021] [Accepted: 08/12/2021] [Indexed: 11/13/2022] Open
Abstract
Stuttering is a neurodevelopmental speech disorder characterized by the symptoms of speech repetition, prolongation, and blocking. Stuttering-related dysfluency can be transiently alleviated by providing an external timing signal such as a metronome or the voice of another person. Therefore, the existence of a core motor timing deficit in stuttering has been speculated. If this is the case, then motoric behaviors other than speech should be disrupted in stuttering. This study examined motoric performance on four complex bimanual tasks in 37 adults who stutter and 31 fluent controls. Two tasks utilized bimanual rotation to examine motor dexterity, and two tasks used the bimanual mirror and parallel tapping movements to examine timing control ability. Video-based analyses were conducted to determine performance accuracy and speed. The results showed that individuals who stutter performed worse than fluent speakers on tapping tasks but not on bimanual rotation tasks. These results suggest stuttering is associated with timing control for general motor behavior.
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Affiliation(s)
- Akira Toyomura
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan.,Research Center for Advanced Technologies, Tokyo Denki University, Inzai, Japan
| | | | - Paul F Sowman
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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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: 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: 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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Masapollo M, Segawa JA, Beal DS, Tourville JA, Nieto-Castañón A, Heyne M, Frankford SA, Guenther FH. Behavioral and neural correlates of speech motor sequence learning in stuttering and neurotypical speakers: an fMRI investigation. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2021; 2:106-137. [PMID: 34296194 PMCID: PMC8294667 DOI: 10.1162/nol_a_00027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Stuttering is a neurodevelopmental disorder characterized by impaired production of coordinated articulatory movements needed for fluent speech. It is currently unknown whether these abnormal production characteristics reflect disruptions to brain mechanisms underlying the acquisition and/or execution of speech motor sequences. To dissociate learning and control processes, we used a motor sequence learning paradigm to examine the behavioral and neural correlates of learning to produce novel phoneme sequences in adults who stutter (AWS) and neurotypical controls. Participants intensively practiced producing pseudowords containing non-native consonant clusters (e.g., "gvasf") over two days. The behavioral results indicated that although the two experimental groups showed comparable learning trajectories, AWS performed significantly worse on the task prior to and after speech motor practice. Using functional magnetic resonance imaging (fMRI), the authors compared brain activity during articulation of the practiced words and a set of novel pseudowords (matched in phonetic complexity). FMRI analyses revealed no differences between AWS and controls in cortical or subcortical regions; both groups showed comparable increases in activation in left-lateralized brain areas implicated in phonological working memory and speech motor planning during production of the novel sequences compared to the practiced sequences. Moreover, activation in left-lateralized basal ganglia sites was negatively correlated with in-scanner mean disfluency in AWS. Collectively, these findings demonstrate that AWS exhibit no deficit in constructing new speech motor sequences but do show impaired execution of these sequences before and after they have been acquired and consolidated.
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Affiliation(s)
- Matthew Masapollo
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL
| | - Jennifer A. Segawa
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA
- Departments of Neuroscience and Biology, Stonehill College, Easton, MA
| | - Deryk S. Beal
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA
- Department of Speech-Language Pathology, University of Toronto, Toronto, Canada
| | - Jason A. Tourville
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA
| | | | - Matthias Heyne
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA
| | - Saul A. Frankford
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA
| | - Frank H. Guenther
- Department of Speech, Language and Hearing Sciences, Boston University, Boston, MA
- Department of Biomedical Engineering, Boston University, Boston, MA
- Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA
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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: 4] [Impact Index Per Article: 1.3] [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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Frankford SA, Nieto-Castañón A, Tourville JA, Guenther FH. Reliability of single-subject neural activation patterns in speech production tasks. BRAIN AND LANGUAGE 2021; 212:104881. [PMID: 33278802 PMCID: PMC7781091 DOI: 10.1016/j.bandl.2020.104881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/25/2020] [Accepted: 11/06/2020] [Indexed: 06/12/2023]
Abstract
Speech neuroimaging research targeting individual speakers could help elucidate differences that may be crucial to understanding speech disorders. However, this research necessitates reliable brain activation across multiple speech production sessions. In the present study, we evaluated the reliability of speech-related brain activity measured by functional magnetic resonance imaging data from twenty neuro-typical subjects who participated in two experiments involving reading aloud simple speech stimuli. Using traditional methods like the Dice and intraclass correlation coefficients, we found that most individuals displayed moderate to high reliability. We also found that a novel machine-learning subject classifier could identify these individuals by their speech activation patterns with 97% accuracy from among a dataset of seventy-five subjects. These results suggest that single-subject speech research would yield valid results and that investigations into the reliability of speech activation in people with speech disorders are warranted.
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Affiliation(s)
- Saul A Frankford
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Alfonso Nieto-Castañón
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA
| | - Jason A Tourville
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Frank H Guenther
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA; Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA; Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA.
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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: 13] [Impact Index Per Article: 3.3] [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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Alencar PBAD, Palharini TA, Silva LMD, Oliveira CMCD, Berti LC. Indicators of speech fluency in stuttering and in phonological disorder. Codas 2020; 32:e20190002. [PMID: 32267336 DOI: 10.1590/2317-1782/20192019002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 06/12/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To identify the indicators of speech fluency that differs subjects with stuttering, with phonological disorder, and with the two disorders in comorbidity. METHODS Thirty subjects aged 4-11 years old were divided into 3 groups, each one with 10 subjects: groups with developmental stuttering (SG), phonological disorder (PDG), and with two diagnoses in comorbidity (SPDG) participated in this study. The procedures were speech fluency and phonology evaluation. The data were submitted to statistical analysis. RESULTS Subjects from SG and SPDG showed a greater occurrence of stuttering-like disfluencies and total of disfluencies in relation to the subjects with PDG. Regarding to the other disfluencies, the three groups were similar. Subjects with PDG showed fewer monosyllabic word repetitions, part of word repetition and prolongations in relation to subjects from SG and SPDG. Blocks occurred more frequently in the two groups with stuttering (SG and SPDG) than in the group with PDG. Interjection occurred more frequently in subjects from SG than in PDG. CONCLUSION The PDG was the most differentiated in quantitative and qualitative terms in the three groups analyzed. The similarities and differences between the groups will assist the differential diagnosis and, consequently, will enable improved therapy. The presence of blocks represents an important marker for the diagnosis of stuttering.
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Affiliation(s)
| | - Talissa Almeida Palharini
- Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Marília (SP), Brasil
| | - Lídia Maurício da Silva
- Instituto de Biociências, Letras e Ciências Exatas, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, São José do Rio Preto (SP), Brasil
| | | | - Larissa Cristina Berti
- Faculdade de Filosofia e Ciências, Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Marília (SP), Brasil
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Walsh B, Usler E. Physiological Correlates of Fluent and Stuttered Speech Production in Preschool Children Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:4309-4323. [PMID: 31805242 PMCID: PMC7201324 DOI: 10.1044/2019_jslhr-s-19-0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Purpose The purpose of this study was to compare physiological indices of sympathetic nervous system arousal recorded during fluent and stuttered utterances in a preschool children who stutter (CWS). Method Twenty-two 4- to 5-year-old CWS participated in the experiment. We recorded children's skin conductance response amplitude and frequency, blood pulse volume amplitude, and pulse rate as they completed a picture description task. We then compared indices of phasic sympathetic arousal recorded during stuttered versus fluent utterances. In addition, children's communication attitudes were evaluated with a self-report measure. Results We detected significantly higher sympathetic arousal during stuttered utterances compared to fluent utterances. Specifically, we found larger skin conductance responses occurring at an increased frequency and decreased blood pulse volume amplitudes during stuttered speech. The behavioral measure indicated a negative communication attitude in only one-third of the participants. Conclusion Our findings suggest that preschool CWS may exhibit higher levels of sympathetic arousal during stuttered speech compared to when they are speaking fluently. We discuss the potential impact of increased sympathetic arousal on speech regulatory mechanisms in early childhood stuttering and present questions to guide future research.
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Affiliation(s)
- Bridget Walsh
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Evan Usler
- Department of Communication Sciences and Disorders, University of Delaware, Newark
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Sengupta R, Yaruss JS, Loucks TM, Gracco VL, Pelczarski K, Nasir SM. Theta Modulated Neural Phase Coherence Facilitates Speech Fluency in Adults Who Stutter. Front Hum Neurosci 2019; 13:394. [PMID: 31798431 PMCID: PMC6878001 DOI: 10.3389/fnhum.2019.00394] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/22/2019] [Indexed: 12/03/2022] Open
Abstract
Adults who stutter (AWS) display altered patterns of neural phase coherence within the speech motor system preceding disfluencies. These altered patterns may distinguish fluent speech episodes from disfluent ones. Phase coherence is relevant to the study of stuttering because it reflects neural communication within brain networks. In this follow-up study, the oscillatory cortical dynamics preceding fluent speech in AWS and adults who do not stutter (AWNS) were examined during a single-word delayed reading task using electroencephalographic (EEG) techniques. Compared to AWNS, fluent speech preparation in AWS was characterized by a decrease in theta-gamma phase coherence and a corresponding increase in theta-beta coherence level. Higher spectral powers in the beta and gamma bands were also observed preceding fluent utterances by AWS. Overall, there was altered neural communication during speech planning in AWS that provides novel evidence for atypical allocation of feedforward control by AWS even before fluent utterances.
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Affiliation(s)
- Ranit Sengupta
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - J Scott Yaruss
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, United States
| | - Torrey M Loucks
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.,Institute for Stuttering Treatment and Research, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - Kristin Pelczarski
- School of Family Studies and Human Services, Kansas State University, Manhattan, KS, United States
| | - Sazzad M Nasir
- Haskins Laboratories, New Haven, CT, United States.,Indiana Academy, Ball State University, Muncie, IN, United States
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Busan P, Del Ben G, Russo LR, Bernardini S, Natarelli G, Arcara G, Manganotti P, Battaglini PP. Stuttering as a matter of delay in neural activation: A combined TMS/EEG study. Clin Neurophysiol 2019; 130:61-76. [DOI: 10.1016/j.clinph.2018.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 08/27/2018] [Accepted: 10/15/2018] [Indexed: 10/27/2022]
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Connally EL, Ward D, Pliatsikas C, Finnegan S, Jenkinson M, Boyles R, Watkins KE. Separation of trait and state in stuttering. Hum Brain Mapp 2018; 39:3109-3126. [PMID: 29624772 PMCID: PMC6055715 DOI: 10.1002/hbm.24063] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 02/21/2018] [Accepted: 03/19/2018] [Indexed: 01/22/2023] Open
Abstract
Stuttering is a disorder in which the smooth flow of speech is interrupted. People who stutter show structural and functional abnormalities in the speech and motor system. It is unclear whether functional differences reflect general traits of the disorder or are specifically related to the dysfluent speech state. We used a hierarchical approach to separate state and trait effects within stuttering. We collected sparse-sampled functional MRI during two overt speech tasks (sentence reading and picture description) in 17 people who stutter and 16 fluent controls. Separate analyses identified indicators of: (1) general traits of people who stutter; (2) frequency of dysfluent speech states in subgroups of people who stutter; and (3) the differences between fluent and dysfluent states in people who stutter. We found that reduced activation of left auditory cortex, inferior frontal cortex bilaterally, and medial cerebellum were general traits that distinguished fluent speech in people who stutter from that of controls. The stuttering subgroup with higher frequency of dysfluent states during scanning (n = 9) had reduced activation in the right subcortical grey matter, left temporo-occipital cortex, the cingulate cortex, and medial parieto-occipital cortex relative to the subgroup who were more fluent (n = 8). Finally, during dysfluent states relative to fluent ones, there was greater activation of inferior frontal and premotor cortex extending into the frontal operculum, bilaterally. The above differences were seen across both tasks. Subcortical state effects differed according to the task. Overall, our data emphasise the independence of trait and state effects in stuttering.
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Affiliation(s)
- Emily L Connally
- Wellcome Centre for Integrative Neuroimaging, University of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyUniversity of OxfordOxfordUnited Kingdom
| | - David Ward
- School of Psychology and Clinical Language SciencesUniversity of Reading, ReadingUnited Kingdom
| | - Christos Pliatsikas
- School of Psychology and Clinical Language SciencesUniversity of Reading, ReadingUnited Kingdom
| | - Sarah Finnegan
- Nuffield Department of Clinical Neurosciences, University of OxfordOxfordUnited Kingdom
| | - Mark Jenkinson
- Wellcome Centre for Integrative Neuroimaging, University of OxfordOxfordUnited Kingdom
- Nuffield Department of Clinical Neurosciences, University of OxfordOxfordUnited Kingdom
| | - Rowan Boyles
- Department of Experimental PsychologyUniversity of OxfordOxfordUnited Kingdom
| | - Kate E Watkins
- Wellcome Centre for Integrative Neuroimaging, University of OxfordOxfordUnited Kingdom
- Department of Experimental PsychologyUniversity of OxfordOxfordUnited Kingdom
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