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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: 0] [Impact Index Per Article: 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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Jannati A, Ryan MA, Kaye HL, Tsuboyama M, Rotenberg A. Biomarkers Obtained by Transcranial Magnetic Stimulation in Neurodevelopmental Disorders. J Clin Neurophysiol 2022; 39:135-148. [PMID: 34366399 PMCID: PMC8810902 DOI: 10.1097/wnp.0000000000000784] [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] [Indexed: 02/03/2023] Open
Abstract
SUMMARY Transcranial magnetic stimulation (TMS) is a method for focal brain stimulation that is based on the principle of electromagnetic induction where small intracranial electric currents are generated by a powerful fluctuating magnetic field. Over the past three decades, TMS has shown promise in the diagnosis, monitoring, and treatment of neurological and psychiatric disorders in adults. However, the use of TMS in children has been more limited. We provide a brief introduction to the TMS technique; common TMS protocols including single-pulse TMS, paired-pulse TMS, paired associative stimulation, and repetitive TMS; and relevant TMS-derived neurophysiological measurements including resting and active motor threshold, cortical silent period, paired-pulse TMS measures of intracortical inhibition and facilitation, and plasticity metrics after repetitive TMS. We then discuss the biomarker applications of TMS in a few representative neurodevelopmental disorders including autism spectrum disorder, fragile X syndrome, attention-deficit hyperactivity disorder, Tourette syndrome, and developmental stuttering.
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Affiliation(s)
- Ali Jannati
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Mary A. Ryan
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Harper Lee Kaye
- Behavioral Neuroscience Program, Division of Medical Sciences, Boston University School of Medicine, Boston, USA
| | - Melissa Tsuboyama
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexander Rotenberg
- Neuromodulation Program and Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
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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: 1.0] [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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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: 0.8] [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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Sommer M, Omer S, Wolff von Gudenberg A, Paulus W. Hand Motor Cortex Excitability During Speaking in Persistent Developmental Stuttering. Front Hum Neurosci 2019; 13:349. [PMID: 31636556 PMCID: PMC6788188 DOI: 10.3389/fnhum.2019.00349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 09/20/2019] [Indexed: 11/18/2022] Open
Abstract
Persistent developmental stuttering (PDS) is a speech fluency disorder characterized by intermittent involuntary breakdowns of speech motor control, possibly related to motor cortex excitability. Whether motor cortex dysfunction extends into hand representations is unclear. We here studied task-dependent modulations of hand motor cortex excitability in 10 right-handed adults who stutter (AWS) and 13 age- and sex-matched fluent speaking control participants (ANS), covering a wide range of tasks in an exploratory study. Before, during and after a null speech/rest task, spontaneous speech, solo reading, chorus reading, singing, and non-verbal orofacial movements, transcranial magnetic stimulation was applied over the primary motor cortex and motor evoked potentials (MEPs) were recorded from the abductor digiti minimi muscle of either hand. In both groups, motor threshold was lower in the left than in the right motor cortex. During task performance, MEP amplitudes increased in both groups. A post hoc comparison of spontaneous speech and non-verbal orofacial movements yielded an interaction of group by task with AWS showing larger than ANS MEP amplitude increase in spontaneous speech, but a smaller than ANS MEP amplitude increase in non-verbal orofacial movements. We conclude that hemispheric specialization of hand motor representation is similar for both groups. Spontaneous speech as well as non-verbal orofacial movements are the orofacial tasks that merit further study. The excessive motor cortex facilitation could be reflecting a stronger activation of non-speech muscles during AWS’s speech.
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Affiliation(s)
- Martin Sommer
- Department of Clinical Neurophysiology, University of Göttingen, Göttingen, Germany
| | - Sherko Omer
- Department of Clinical Neurophysiology, University of Göttingen, Göttingen, Germany
| | | | - Walter Paulus
- Department of Clinical Neurophysiology, University of Göttingen, Göttingen, Germany
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Dinoto A, Busan P, Formaggio E, Bertolotti C, Menichelli A, Stokelj D, Manganotti P. Stuttering-like hesitation in speech during acute/post-acute phase of immune-mediated encephalitis. JOURNAL OF FLUENCY DISORDERS 2018; 58:70-76. [PMID: 30220403 DOI: 10.1016/j.jfludis.2018.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/08/2018] [Accepted: 09/05/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Neurogenic stuttering may be evident after a lesion/dysfunction of wider neural networks. Here we present a case of acquired stuttering as the consequence of immune-mediated encephalitis. METHODS The case of a 71-year old male who complained about the progressive onset of stuttering and disequilibrium as the consequence of immune-mediated encephalitis, is here reported. Administration of corticosteroid methylprednisolone was useful to recover from impairments. An in depth analysis of the electroencephalography (relative power of brain rhythms and source localization) during different phases of the disease/treatment was also realized. RESULTS The patient showed a stuttering-like slowed speech with blocks and repetitions, especially at the beginning of words/sentences, with associated movements of the oro-facial muscles. Speech and general motor skills resulted slowed in their preparation/execution phases. Electroencephalography showed a "slowed" pattern, with delta/theta waves mainly in the prefrontal cortex and in sensorimotor networks. CONCLUSION This case reports a probable immune-mediated encephalitis that resulted in acquired stuttering. The effect of "slowed" oscillatory brain activity on motor skills requesting sequencing and fine coordination (e.g. speech) could result in less "synchronized" systems, easily prone to disruptions.
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Affiliation(s)
- Alessandro Dinoto
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy.
| | - Pierpaolo Busan
- Fondazione Ospedale San Camillo IRCCS, Via Alberoni 70, 30126, Venice, Italy.
| | - Emanuela Formaggio
- Fondazione Ospedale San Camillo IRCCS, Via Alberoni 70, 30126, Venice, Italy.
| | - Claudio Bertolotti
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy.
| | - Alina Menichelli
- Neuropsychological Unit, Department of Rehabilitation Medicine, ASUI Trieste, Strada di Fiume 447, 34100, Trieste, Italy.
| | - David Stokelj
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy.
| | - Paolo Manganotti
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy.
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Etchell AC, Civier O, Ballard KJ, Sowman PF. A systematic literature review of neuroimaging research on developmental stuttering between 1995 and 2016. JOURNAL OF FLUENCY DISORDERS 2018; 55:6-45. [PMID: 28778745 DOI: 10.1016/j.jfludis.2017.03.007] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 01/25/2017] [Accepted: 03/06/2017] [Indexed: 05/14/2023]
Abstract
PURPOSE Stuttering is a disorder that affects millions of people all over the world. Over the past two decades, there has been a great deal of interest in investigating the neural basis of the disorder. This systematic literature review is intended to provide a comprehensive summary of the neuroimaging literature on developmental stuttering. It is a resource for researchers to quickly and easily identify relevant studies for their areas of interest and enable them to determine the most appropriate methodology to utilize in their work. The review also highlights gaps in the literature in terms of methodology and areas of research. METHODS We conducted a systematic literature review on neuroimaging studies on developmental stuttering according to the PRISMA guidelines. We searched for articles in the pubmed database containing "stuttering" OR "stammering" AND either "MRI", "PET", "EEG", "MEG", "TMS"or "brain" that were published between 1995/01/01 and 2016/01/01. RESULTS The search returned a total of 359 items with an additional 26 identified from a manual search. Of these, there were a total of 111 full text articles that met criteria for inclusion in the systematic literature review. We also discuss neuroimaging studies on developmental stuttering published throughout 2016. The discussion of the results is organized first by methodology and second by population (i.e., adults or children) and includes tables that contain all items returned by the search. CONCLUSIONS There are widespread abnormalities in the structural architecture and functional organization of the brains of adults and children who stutter. These are evident not only in speech tasks, but also non-speech tasks. Future research should make greater use of functional neuroimaging and noninvasive brain stimulation, and employ structural methodologies that have greater sensitivity. Newly planned studies should also investigate sex differences, focus on augmenting treatment, examine moments of dysfluency and longitudinally or cross-sectionally investigate developmental trajectories in stuttering.
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Affiliation(s)
- Andrew C Etchell
- Department of Psychiatry, University of Michigan, MI, United States; Department of Cognitive Science, Macquarie University, Sydney, Australia.
| | - Oren Civier
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel; Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Rehovot, Israel
| | - Kirrie J Ballard
- Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - Paul F Sowman
- Department of Cognitive Science, Macquarie University, Sydney, Australia
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Busan P, Battaglini P, Sommer M. Transcranial magnetic stimulation in developmental stuttering: Relations with previous neurophysiological research and future perspectives. Clin Neurophysiol 2017; 128:952-964. [DOI: 10.1016/j.clinph.2017.03.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 03/14/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
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Busan P, Del Ben G, Bernardini S, Natarelli G, Bencich M, Monti F, Manganotti P, Battaglini PP. Altered Modulation of Silent Period in Tongue Motor Cortex of Persistent Developmental Stuttering in Relation to Stuttering Severity. PLoS One 2016; 11:e0163959. [PMID: 27711148 PMCID: PMC5053488 DOI: 10.1371/journal.pone.0163959] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/16/2016] [Indexed: 12/20/2022] Open
Abstract
Motor balance in developmental stuttering (DS) was investigated with Transcranial Magnetic Stimulation (TMS), with the aim to define novel neural markers of persistent DS in adulthood. Eleven DS adult males were evaluated with TMS on tongue primary motor cortex, compared to 15 matched fluent speakers, in a “state” condition (i.e. stutterers vs. fluent speakers, no overt stuttering). Motor and silent period thresholds (SPT), recruitment curves, and silent period durations were acquired by recording tongue motor evoked potentials. Tongue silent period duration was increased in DS, especially in the left hemisphere (P<0.05; Hedge’s g or Cohen’s dunbiased = 1.054, i.e. large effect size), suggesting a “state” condition of higher intracortical inhibition in left motor cortex networks. Differences in motor thresholds (different excitatory/inhibitory ratios in DS) were evident, as well as significant differences in SPT. In fluent speakers, the left hemisphere may be marginally more excitable than the right one in motor thresholds at lower muscular activation, while active motor thresholds and SPT were higher in the left hemisphere of DS with respect to the right one, resulting also in a positive correlation with stuttering severity. Pre-TMS electromyography data gave overlapping evidence. Findings suggest the existence of a complex intracortical balance in DS tongue primary motor cortex, with a particular interplay between excitatory and inhibitory mechanisms, also in neural substrates related to silent periods. Findings are discussed with respect to functional and structural impairments in stuttering, and are also proposed as novel neural markers of a stuttering “state” in persistent DS, helping to define more focused treatments (e.g. neuro-modulation).
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Affiliation(s)
- Pierpaolo Busan
- IRCCS Fondazione Ospedale San Camillo, Venice, Italy
- * E-mail:
| | - Giovanni Del Ben
- B.R.A.I.N. Center for Neuroscience, Department of Life Sciences, University of Trieste, Trieste, Italy
| | | | - Giulia Natarelli
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Marco Bencich
- B.R.A.I.N. Center for Neuroscience, Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Fabrizio Monti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Paolo Manganotti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Piero Paolo Battaglini
- B.R.A.I.N. Center for Neuroscience, Department of Life Sciences, University of Trieste, Trieste, Italy
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Rogić Vidaković M, Jerković A, Jurić T, Vujović I, Šoda J, Erceg N, Bubić A, Zmajević Schönwald M, Lioumis P, Gabelica D, Đogaš Z. Neurophysiologic markers of primary motor cortex for laryngeal muscles and premotor cortex in caudal opercular part of inferior frontal gyrus investigated in motor speech disorder: a navigated transcranial magnetic stimulation (TMS) study. Cogn Process 2016; 17:429-442. [PMID: 27130564 DOI: 10.1007/s10339-016-0766-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/18/2016] [Indexed: 11/24/2022]
Abstract
Transcranial magnetic stimulation studies have so far reported the results of mapping the primary motor cortex (M1) for hand and tongue muscles in stuttering disorder. This study was designed to evaluate the feasibility of repetitive navigated transcranial magnetic stimulation (rTMS) for locating the M1 for laryngeal muscle and premotor cortical area in the caudal opercular part of inferior frontal gyrus, corresponding to Broca's area in stuttering subjects by applying new methodology for mapping these motor speech areas. Sixteen stuttering and eleven control subjects underwent rTMS motor speech mapping using modified patterned rTMS. The subjects performed visual object naming task during rTMS applied to the (a) left M1 for laryngeal muscles for recording corticobulbar motor-evoked potentials (CoMEP) from cricothyroid muscle and (b) left premotor cortical area in the caudal opercular part of inferior frontal gyrus while recording long latency responses (LLR) from cricothyroid muscle. The latency of CoMEP in control subjects was 11.75 ± 2.07 ms and CoMEP amplitude was 294.47 ± 208.87 µV, and in stuttering subjects CoMEP latency was 12.13 ± 0.75 ms and 504.64 ± 487.93 µV CoMEP amplitude. The latency of LLR in control subjects was 52.8 ± 8.6 ms and 54.95 ± 4.86 in stuttering subjects. No significant differences were found in CoMEP latency, CoMEP amplitude, and LLR latency between stuttering and control-fluent speakers. These results indicate there are probably no differences in stuttering compared to controls in functional anatomy of the pathway used for transmission of information from premotor cortex to the M1 cortices for laryngeal muscle representation and from there via corticobulbar tract to laryngeal muscles.
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Affiliation(s)
- Maja Rogić Vidaković
- School of Medicine, Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, University of Split, Šoltanska 2, 21000, Split, Croatia.
| | - Ana Jerković
- Faculty of Philosophy, University of Zagreb, Ivana Lučića 3, 10000, Zagreb, Croatia
| | - Tomislav Jurić
- Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, Department of Electronics, University of Split, R. Boškovića 32, Split, Croatia
| | - Igor Vujović
- Faculty of Maritime Studies, Signal Processing, Analysis and Advanced Diagnostics Research and Education Laboratory (SPAADREL), University of Split, Ruđera-Boškovića 37, Split, Croatia
| | - Joško Šoda
- Faculty of Maritime Studies, Signal Processing, Analysis and Advanced Diagnostics Research and Education Laboratory (SPAADREL), University of Split, Ruđera-Boškovića 37, Split, Croatia
| | - Nikola Erceg
- Faculty of Humanities and Social Sciences, University of Split, Put iza nove bolnice 10 C, Split, Croatia
| | - Andreja Bubić
- Faculty of Humanities and Social Sciences, University of Split, Put iza nove bolnice 10 C, Split, Croatia
| | - Marina Zmajević Schönwald
- Clinical Medical Centre "Sisters of Mercy", Department of Neurosurgery, Clinical Unit for Intraoperative Neurophysiologic Monitoring, Vinogradska 29 A, Zagreb, Croatia
| | - Pantelis Lioumis
- Bio Mag Laboratory HUS Medical Imaging center, Helsinki University Hospital, P.O. Box 340, 00029, HUS, Helsinki, Finland
| | - Dragan Gabelica
- School of Medicine, Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, University of Split, Šoltanska 2, 21000, Split, Croatia.,SGM Medical Monitoring, Grge Novaka 22A, 21000, Split, Croatia
| | - Zoran Đogaš
- School of Medicine, Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, University of Split, Šoltanska 2, 21000, Split, Croatia
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Alm PA, Karlsson R, Sundberg M, Axelson HW. Hemispheric lateralization of motor thresholds in relation to stuttering. PLoS One 2013; 8:e76824. [PMID: 24146930 PMCID: PMC3795648 DOI: 10.1371/journal.pone.0076824] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 08/28/2013] [Indexed: 11/19/2022] Open
Abstract
Stuttering is a complex speech disorder. Previous studies indicate a tendency towards elevated motor threshold for the left hemisphere, as measured using transcranial magnetic stimulation (TMS). This may reflect a monohemispheric motor system impairment. The purpose of the study was to investigate the relative side-to-side difference (asymmetry) and the absolute levels of motor threshold for the hand area, using TMS in adults who stutter (n = 15) and in controls (n = 15). In accordance with the hypothesis, the groups differed significantly regarding the relative side-to-side difference of finger motor threshold (p = 0.0026), with the stuttering group showing higher motor threshold of the left hemisphere in relation to the right. Also the absolute level of the finger motor threshold for the left hemisphere differed between the groups (p = 0.049). The obtained results, together with previous investigations, provide support for the hypothesis that stuttering tends to be related to left hemisphere motor impairment, and possibly to a dysfunctional state of bilateral speech motor control.
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Affiliation(s)
- Per A. Alm
- Department of Neuroscience, Speech and Language Pathology, Uppsala University, Uppsala, Sweden
| | - Ragnhild Karlsson
- Department of Neuroscience, Speech and Language Pathology, Uppsala University, Uppsala, Sweden
| | - Madeleine Sundberg
- Department of Neuroscience, Speech and Language Pathology, Uppsala University, Uppsala, Sweden
| | - Hans W. Axelson
- Department of Neuroscience, Clinical Neurophysiology, Uppsala University, Uppsala, Sweden
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Busan P, D'Ausilio A, Borelli M, Monti F, Pelamatti G, Pizzolato G, Fadiga L. Motor excitability evaluation in developmental stuttering: A transcranial magnetic stimulation study. Cortex 2013; 49:781-92. [DOI: 10.1016/j.cortex.2011.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 07/15/2011] [Accepted: 12/07/2011] [Indexed: 11/16/2022]
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13
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Etchell AC, Sowman PF, Johnson BW. “Shut up!” An electrophysiological study investigating the neural correlates of vocal inhibition. Neuropsychologia 2012; 50:129-38. [DOI: 10.1016/j.neuropsychologia.2011.11.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Revised: 11/08/2011] [Accepted: 11/09/2011] [Indexed: 11/28/2022]
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Neef N, Paulus W, Neef A, von Gudenberg AW, Sommer M. Reduced intracortical inhibition and facilitation in the primary motor tongue representation of adults who stutter. Clin Neurophysiol 2011; 122:1802-11. [PMID: 21377925 DOI: 10.1016/j.clinph.2011.02.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 02/02/2011] [Accepted: 02/04/2011] [Indexed: 10/18/2022]
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Sommer M, Knappmeyer K, Hunter EJ, Gudenberg AW, Neef N, Paulus W. Normal interhemispheric inhibition in persistent developmental stuttering. Mov Disord 2009; 24:769-73. [PMID: 19224611 DOI: 10.1002/mds.22383] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Imaging studies suggest a right hemispheric (pre)motor overactivity in patients with persistent developmental stuttering (PDS). The interhemispheric inhibition (IHI) studied with transcranial magnetic stimulation is an established measure of the interplay between right and left motor areas. We assessed IHI in 15 young male adults with PDS and 15 age-matched fluent-speaking subjects. We additionally studied the ipsilateral silent period (iSP) duration. We found no significant between-group difference for IHI or for iSP duration. We conclude that the interplay between the primary motor cortices is normal in patients with PDS. The abnormal right motor and premotor activity observed in functional imaging studies on PDS are not likely to reflect altered primary motor cortex excitability, but are likely to have a different origin.
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Affiliation(s)
- Martin Sommer
- Department of Clinical Neurophysiology, University of Göttingen, Göttingen, Germany.
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Lu C, Ning N, Peng D, Ding G, Li K, Yang Y, Lin C. The role of large-scale neural interactions for developmental stuttering. Neuroscience 2009; 161:1008-26. [PMID: 19364522 DOI: 10.1016/j.neuroscience.2009.04.020] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2008] [Revised: 03/30/2009] [Accepted: 04/06/2009] [Indexed: 12/21/2022]
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Alm PA. Stuttering and the basal ganglia circuits: a critical review of possible relations. JOURNAL OF COMMUNICATION DISORDERS 2004; 37:325-69. [PMID: 15159193 DOI: 10.1016/j.jcomdis.2004.03.001] [Citation(s) in RCA: 319] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2003] [Revised: 02/12/2004] [Accepted: 03/16/2004] [Indexed: 05/23/2023]
Abstract
UNLABELLED The possible relation between stuttering and the basal ganglia is discussed. Important clues to the pathophysiology of stuttering are given by conditions known to alleviate dysfluency, like the rhythm effect, chorus speech, and singing. Information regarding pharmacologic trials, lesion studies, brain imaging, genetics, and developmental changes of the nervous system is reviewed. The symptoms of stuttering are compared with basal ganglia motor disorders like Parkinson's disease and dystonia. It is proposed that the basal ganglia-thalamocortical motor circuits through the putamen are likely to play a key role in stuttering. The core dysfunction in stuttering is suggested to be impaired ability of the basal ganglia to produce timing cues for the initiation of the next motor segment in speech. Similarities between stuttering and dystonia are indicated, and possible relations to the dopamine system are discussed, as well as the interaction between the cerebral cortex and the basal ganglia. Behavioral and pharmacologic information suggests the existence of subtypes of stuttering. LEARNING OUTCOMES As a result of this activity, the reader will (1) become familiar with the research regarding the basal ganglia system relating to speech motor control; (2) become familiar with the research on stuttering with indications of basal ganglia involvement; and (3) be able to discuss basal ganglia mechanisms with relevance for theory of stuttering.
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Affiliation(s)
- Per A Alm
- Department of Clinical Neuroscience, Lund University, Lund, Sweden.
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Ludlow CL, Loucks T. Stuttering: a dynamic motor control disorder. JOURNAL OF FLUENCY DISORDERS 2003; 28:273-95; quiz 295. [PMID: 14643066 DOI: 10.1016/j.jfludis.2003.07.001] [Citation(s) in RCA: 73] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
UNLABELLED The purpose of this review is to determine what neural mechanisms may be dysfunctional in stuttering. Three sources of evidence are reviewed. First, studies of dynamic inter-relationships among brain regions during normal speech and in persons who stutter (PWS) suggest that the timing of neural activity in different regions may be abnormal in PWS. Second, the brain lesions associated with acquired stuttering are reviewed. These indicate that in a high percentage of cases, the primary speech and language regions are not affected but lesions involve other structures, such as the basal ganglia, which may modulate the primary speech and language regions. Third, to characterize the motor control disorder in stuttering, similarities and differences from focal dystonias such as spasmodic dysphonia (SD) and Tourette's syndrome (TS) are reviewed. This review indicates that the central control abnormalities in stuttering are not due to disturbance in one particular brain region but rather a system dysfunction that interferes with rapid and dynamic speech processing for production. EDUCATIONAL OBJECTIVES The reader will be able to describe: (1) the similarities and differences between stuttering and other speech motor control disorders, (2) which brain lesions are most likely to produce acquired stuttering in adults, and (3) what type of brain abnormality most likely underlies stuttering.
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Affiliation(s)
- Christy L Ludlow
- Laryngeal and Speech Section, Clinical Neurosciences Program, National Institute of Neurological Disorders and Stroke, Bethesda, MD 20892-1416, USA.
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