Behavioral and neural correlates of speech motor sequence learning in stuttering and neurotypical speakers: an fMRI investigation

Dataset for Evaluating the Production of Phonotactically Legal and Illegal Pseudowords

The "MEG-GLOUPS" dataset offers a curated collection of raw magnetoencephalography recordings from seventeen French participants engaged in a pseudoword learning task as well as resting-state activity before and after the task. A dataset called Gloups with the same participants and a similar learning task adapted to functional magnetic resonance imaging is already available. In the learning task, participants were instructed to pronounce monosyllabic pseudowords, which were presented both visually and auditorily. These pseudowords were either phonotactically legal or illegal in the participants' native language, French. We organized the dataset according to the Brain Imaging Data Structure (BIDS), pre-processed the data and performed a minimal analysis of Event-Related Fields (ERFs), to ensure data quality and integrity of the dataset. This data collection includes comprehensive descriptions of the theoretical background, methods, data recordings, and technical validation.

Evidence for planning and motor subtypes of stuttering based on resting state functional connectivity

We tested the hypothesis, generated from the Gradient Order Directions Into Velocities of Articulators (GODIVA) model, that adults who stutter (AWS) may comprise subtypes based on differing connectivity within the cortico-basal ganglia planning or motor loop. Resting state functional connectivity from 91 AWS and 79 controls was measured for all GODIVA model connections. Based on a principal components analysis, two connections accounted for most of the connectivity variability in AWS: left thalamus - left posterior inferior frontal sulcus (planning loop component) and left supplementary motor area - left ventral premotor cortex (motor loop component). A k-means clustering algorithm using the two connections revealed three clusters of AWS. Cluster 1 was significantly different from controls in both connections; Cluster 2 was significantly different in only the planning loop; and Cluster 3 was significantly different in only the motor loop. These findings suggest the presence of planning and motor subtypes of stuttering.

Knowns and unknowns about the neurobiology of stuttering

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.

Disentangling Effects of Memory Storage and Inter-articulator Coordination on Generalization in Speech Motor Sequence Learning

Generalization in motor control is the extent to which motor learning affects movements in situations different than those in which it originally occurred. Recent data on orofacial speech movements indicates that motor sequence learning generalizes to novel syllable sequences containing phonotactically illegal, but previously practiced, consonant clusters. Practicing an entire syllable, however, results in even larger performance gains compared to practicing just its clusters. These patterns of generalization could reflect language-general changes in phonological memory storage and/or inter-articulator coordination during motor sequence learning. To disentangle these factors, we conducted two experiments in which talkers intensively practiced producing novel syllables containing illegal onset and coda clusters over two consecutive days. During the practice phases of both experiments, we observed that, through repetition, talkers gradually produced the syllables with fewer errors, indicative of learning. After learning, talkers were tested for generalization to single syllables (Experiment 1) or syllable pairs (Experiment 2) that overlapped to varying degrees with the practiced syllables. Across both experiments, we found that performance improvements from practicing syllables with illegal clusters partially generalized to novel syllables that contained those clusters, but performance was more error prone if the clusters occurred in a different syllable position (onset versus coda) as in practice, demonstrating that inter-articulator coordination is contextually sensitive. Furthermore, changing the position of a cluster was found to be more deleterious to motor performance during the production of the second syllables in syllable pairs, which required talkers to store more phonological material in memory prior to articulation, compared to single syllables. This interaction effect reveals a complex interplay between memory storage and inter-articulator coordination on generalization in speech motor sequence learning.

A comparison of structural morphometry in children and adults with persistent developmental stuttering

This cross-sectional study aimed to differentiate earlier occurring neuroanatomical differences that may reflect core deficits in stuttering versus changes associated with a longer duration of stuttering by analysing structural morphometry in a large sample of children and adults who stutter and age-matched controls. Whole-brain T1-weighted structural scans were obtained from 166 individuals who stutter (74 children, 92 adults; ages 3-58) and 191 controls (92 children, 99 adults; ages 3-53) from eight prior studies in our laboratories. Mean size and gyrification measures were extracted using FreeSurfer software for each cortical region of interest. FreeSurfer software was also used to generate subcortical volumes for regions in the automatic subcortical segmentation. For cortical analyses, separate ANOVA analyses of size (surface area, cortical thickness) and gyrification (local gyrification index) measures were conducted to test for a main effect of diagnosis (stuttering, control) and the interaction of diagnosis-group with age-group (children, adults) across cortical regions. Cortical analyses were first conducted across a set of regions that comprise the speech network and then in a second whole-brain analysis. Next, separate ANOVA analyses of volume were conducted across subcortical regions in each hemisphere. False discovery rate corrections were applied for all analyses. Additionally, we tested for correlations between structural morphometry and stuttering severity. Analyses revealed thinner cortex in children who stutter compared with controls in several key speech-planning regions, with significant correlations between cortical thickness and stuttering severity. These differences in cortical size were not present in adults who stutter, who instead showed reduced gyrification in the right inferior frontal gyrus. Findings suggest that early cortical anomalies in key speech planning regions may be associated with stuttering onset. Persistent stuttering into adulthood may result from network-level dysfunction instead of focal differences in cortical morphometry. Adults who stutter may also have a more heterogeneous neural presentation than children who stutter due to their unique lived experiences.

Neurocomputational modeling of speech motor development

This review describes a computational approach for modeling the development of speech motor control in infants. We address the development of two levels of control: articulation of individual speech sounds (defined here as phonemes, syllables, or words for which there is an optimized motor program) and production of sound sequences such as phrases or sentences. We describe the DIVA model of speech motor control and its application to the problem of learning individual sounds in the infant's native language. Then we describe the GODIVA model, an extension of DIVA, and how chunking of frequently produced phoneme sequences is implemented within it.

Neural Changes in Children With Residual Speech Sound Disorder After Ultrasound Biofeedback Speech Therapy

PURPOSE

Children with residual speech sound disorders (RSSD) have shown differences in neural function for speech production, as compared to their typical peers; however, information about how these differences may change over time and relative to speech therapy is needed. To address this gap, we used functional magnetic resonance imaging (fMRI) to examine functional activation and connectivity on adaptations of the syllable repetition task (SRT-Early Sounds and SRT-Late Sounds) in children with RSSD before and after a speech therapy program.

METHOD

Sixteen children with RSSD completed an fMRI experiment before (Time 1) and after (Time 2) a speech therapy program with ultrasound visual feedback for /ɹ/ misarticulation. Progress in therapy was measured via perceptual ratings of productions of untreated /ɹ/ word probes. To control for practice effects and developmental change in patterns of activation and connectivity, 17 children with typical speech development (TD) completed the fMRI at Time 1 and Time 2. Functional activation was analyzed using a region-of-interest approach and functional connectivity was analyzed using a seed-to-voxel approach.

RESULTS

Children with RSSD showed a range of responses to therapy. After correcting for multiple comparisons, we did not observe any statistically significant cross-sectional differences or longitudinal changes in functional activation. A negative relationship between therapy effect size and functional activation in the left visual association cortex was on the SRT-Late Sounds after therapy, but it did not survive correction for multiple comparisons. Significant longitudinal changes in functional connectivity were observed for the RSSD group on SRT-Early Sounds and SRT-Late Sounds, as well as for the TD group on the SRT-Early Sounds. RSSD and TD groups showed connectivity differences near the left insula on the SRT-Late Sounds at Time 2.

CONCLUSION

RSSD and treatment with ultrasound visual feedback may thus be associated with neural differences in speech motor and visual association processes recruited for speech production.

Factors Affecting Nonnative Consonant Cluster Learning

PURPOSE

Nonnative consonant cluster learning has become a useful experimental approach for learning about speech motor learning, and we sought to enhance our understanding of this area and to establish best practices for this type of research.

METHOD

One hundred twenty individuals completed a nonnative consonant cluster learning task within a speech motor learning paradigm. Following a brief prepractice, participants then practiced the production of eight word-initial nonnative consonant clusters embedded in bisyllabic nonwords (e.g., GD in /gdivu/). The clusters ranged in difficulty according to linguistic typology and sonority sequencing. Acquisition was operationalized as the change across the practice section and learning was assessed with two retention sessions (R1: 30 min after practice; R2: 2 days after practice). We evaluated changes in accuracy as well as in the acoustic details of the cluster production at each time point.

RESULTS

Overall, participants improved in their production of the consonant clusters. Accuracy increased, and duration measures decreased in specific measures associated with cluster production. The change in coordination measured in the acoustics changed both for clusters that were incorrectly produced and for those that were correctly produced, indicating continued motor learning even in accurate tokens.

CONCLUSIONS

These results aid our understanding of the complexity of nonnative consonant cluster learning. In particular, both factors related to both phonological and speech motor control properties affect the learning of novel speech sequences.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21844185.

Brain activity during the preparation and production of spontaneous speech in children with persistent stuttering

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.

Interarticulator Speech Coordination: Timing Is of the Essence

PURPOSE

In skilled speech production, sets of articulators, such as the jaw, tongue, and lips, work cooperatively to achieve task-specific movement goals, despite rampant contextual variation. Efforts to understand these functional units, termed coordinative structures, have focused on identifying the essential control parameters responsible for allowing articulators to achieve these goals, with some research focusing on temporal parameters (relative timing of movements) and other research focusing on spatiotemporal parameters (phase angle of movement onset for one articulator, relative to another). Here, both types of parameters were investigated and compared in detail.

METHOD

Ten talkers recorded nonsense, disyllabic /tV#Cat/ utterances using electromagnetic articulography, with alternative V (/ɑ/-/ɛ/) and C (/t/-/d/), across variation in rate (fast-slow) and stress (first syllable stressed-unstressed). Two measures were obtained: (a) the timing of tongue-tip raising onset for medial C, relative to jaw opening-closing cycles and (b) the angle of tongue-tip raising onset, relative to the jaw phase plane.

RESULTS

Results showed that any manipulation that shortened the jaw opening-closing cycle reduced both the relative timing and phase angle of the tongue-tip movement onset, but relative timing of tongue-tip movement onset scaled more consistently with jaw opening-closing across rate and stress variation.

CONCLUSION

These findings suggest the existence of an intrinsic timing mechanism (or "central clock") that is the primary control parameter for coordinative structures, with online compensation then allowing these structures to achieve their goals spatially.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22144259.

Explicit benefits: Motor sequence acquisition and short-term retention in adults who do and do not stutter

Motor sequencing skills have been found to distinguish individuals who experience developmental stuttering from those who do not stutter, with these differences extending to non-verbal sequencing behaviour. Previous research has focused on measures of reaction time and practice under externally cued conditions to decipher the motor learning abilities of persons who stutter. Without the confounds of extraneous demands and sensorimotor processing, we investigated motor sequence learning under conditions of explicit awareness and focused practice among adults with persistent development stuttering. Across two consecutive practice sessions, 18 adults who stutter (AWS) and 18 adults who do not stutter (ANS) performed the finger-to-thumb opposition sequencing (FOS) task. Both groups demonstrated significant within-session performance improvements, as evidenced by fast on-line learning of finger sequences on day one. Additionally, neither participant group showed deterioration of their learning gains the following day, indicating a relative stabilization of finger sequencing performance during the off-line period. These findings suggest that under explicit and focused conditions, early motor learning gains and their short-term retention do not differ between AWS and ANS. Additional factors influencing motor sequencing performance, such as task complexity and saturation of learning, are also considered. Further research into explicit motor learning and its generalization following extended practice and follow-up in persons who stutter is warranted. The potential benefits of motor practice generalizability among individuals who stutter and its relevance to supporting treatment outcomes are suggested as future areas of investigation.

Motor Memory Consolidation Deficits in Parkinson's Disease: A Systematic Review with Meta-Analysis

BACKGROUND

The ability to encode and consolidate motor memories is essential for persons with Parkinson's disease (PD), who usually experience a progressive loss of motor function. Deficits in memory encoding, usually expressed as poorer rates of skill improvement during motor practice, have been reported in these patients. Whether motor memory consolidation (i.e., motor skill retention) is also impaired is unknown.

OBJECTIVE

To determine whether motor memory consolidation is impaired in PD compared to neurologically intact individuals.

METHODS

We conducted a pre-registered systematic review (PROSPERO: CRD42020222433) following PRISMA guidelines that included 46 studies.

RESULTS

Meta-analyses revealed that persons with PD have deficits in retaining motor skills (SMD = -0.17; 95% CI = -0.32, -0.02; p = 0.0225). However, these deficits are task-specific, affecting sensory motor (SMD = -0.31; 95% CI -0.47, -0.15; p = 0.0002) and visuomotor adaptation (SMD = -1.55; 95% CI = -2.32, -0.79; p = 0.0001) tasks, but not sequential fine motor (SMD = 0.17; 95% CI = -0.05, 0.39; p = 0.1292) and gross motor tasks (SMD = 0.04; 95% CI = -0.25, 0.33; p = 0.7771). Importantly, deficits became non-significant when augmented feedback during practice was provided, and additional motor practice sessions reduced deficits in sensory motor tasks. Meta-regression analyses confirmed that deficits were independent of performance during encoding, as well as disease duration and severity.

CONCLUSION

Our results align with the neurodegenerative models of PD progression and motor learning frameworks and emphasize the importance of developing targeted interventions to enhance motor memory consolidation in PD.

Differences in implicit motor learning between adults who do and do not stutter

Implicit learning allows us to acquire complex motor skills through repeated exposure to sensory cues and repetition of motor behaviours, without awareness or effort. Implicit learning is also critical to the incremental fine-tuning of the perceptual-motor system. To understand how implicit learning and associated domain-general learning processes may contribute to motor learning differences in people who stutter, we investigated implicit finger-sequencing skills in adults who do (AWS) and do not stutter (ANS) on an Alternating Serial Reaction Time task. Our results demonstrated that, while all participants showed evidence of significant sequence-specific learning in their speed of performance, male AWS were slower and made fewer sequence-specific learning gains than their ANS counterparts. Although there were no learning gains evident in accuracy of performance, AWS performed the implicit learning task more accurately than ANS, overall. These findings may have implications for sex-based differences in the experience of developmental stuttering, for the successful acquisition of complex motor skills during development by individuals who stutter, and for the updating and automatization of speech motor plans during the therapeutic process.

The Dopamine System and Automatization of Movement Sequences: A Review With Relevance for Speech and Stuttering

The last decades of research have gradually elucidated the complex functions of the dopamine system in the vertebrate brain. The multiple roles of dopamine in motor function, learning, attention, motivation, and the emotions have been difficult to reconcile. A broad and detailed understanding of the physiology of cerebral dopamine is of importance in understanding a range of human disorders. One of the core functions of dopamine involves the basal ganglia and the learning and execution of automatized sequences of movements. Speech is one of the most complex and highly automatized sequential motor behaviors, though the exact roles that the basal ganglia and dopamine play in speech have been difficult to determine. Stuttering is a speech disorder that has been hypothesized to be related to the functions of the basal ganglia and dopamine. The aim of this review was to provide an overview of the current understanding of the cerebral dopamine system, in particular the mechanisms related to motor learning and the execution of movement sequences. The primary aim was not to review research on speech and stuttering, but to provide a platform of neurophysiological mechanisms, which may be utilized for further research and theoretical development on speech, speech disorders, and other behavioral disorders. Stuttering and speech are discussed here only briefly. The review indicates that a primary mechanism for the automatization of movement sequences is the merging of isolated movements into chunks that can be executed as units. In turn, chunks can be utilized hierarchically, as building blocks of longer chunks. It is likely that these mechanisms apply also to speech, so that frequent syllables and words are produced as motor chunks. It is further indicated that the main learning principle for sequence learning is reinforcement learning, with the phasic release of dopamine as the primary teaching signal indicating successful sequences. It is proposed that the dynamics of the dopamine system constitute the main neural basis underlying the situational variability of stuttering.

Fluency shaping increases integration of the command-to-execution and the auditory-to-motor pathways in persistent developmental stuttering

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.