1
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Bowers A, Hudock D. Lower nonword syllable sequence repetition accuracy in adults who stutter is related to differences in audio-motor oscillations. Neuropsychologia 2024; 199:108906. [PMID: 38740180 DOI: 10.1016/j.neuropsychologia.2024.108906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 03/05/2024] [Accepted: 05/06/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE The goal of this study was to use independent component analysis (ICA) of high-density electroencephalography (EEG) to investigate whether differences in audio-motor neural oscillations are related to nonword syllable repetition accuracy in a group of adults who stutter compared to typically fluent speakers. METHODS EEG was recorded using 128 channels from 23 typically fluent speakers and 23 adults who stutter matched for age, sex, and handedness. EEG was recorded during delayed, 2 and 4 bilabial nonword syllable repetition conditions. Scalp-topography, dipole source estimates, and power spectral density (PSD) were computed for each independent component (IC) and used to cluster similar ICs across participants. Event-related spectral perturbations (ERSPs) were computed for each IC cluster to examine changes over time in the repetition conditions and to examine how dynamic changes in ERSPs are related to syllable repetition accuracy. RESULTS Findings indicated significantly lower accuracy on a measure of percentage correct trials in the AWS group and for a normalized measure of syllable load performance across conditions. Analysis of ERSPs revealed significantly lower alpha/beta ERD in left and right μ ICs and in left and right posterior temporal lobe α ICs in AWS compared to TFS (CC p < 0.05). Pearson correlations with %CT for frequency across time showed strong relationships with accuracy (FWE<0.05) during maintenance in the TFS group and during execution in the AWS group. CONCLUSIONS Findings implicate lower alpha/beta ERD (8-30 Hz) during syllable encoding over posterior temporal ICs and execution in left temporal/sensorimotor components. Strong correlations with accuracy and interindividual differences in ∼6-8 Hz ERSPs during execution implicate differences in motor and auditory-sensory monitoring during syllable sequence execution in AWS.
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Affiliation(s)
- Andrew Bowers
- University of Arkansas, 275 Epley Center, 606 North Razorback Rd. Fayetteville AR, 72701, United States.
| | - Daniel Hudock
- Idaho State University, 921 S. 8th Ave, Mailstop 8116, Pocatello, ID 83209, United States
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2
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Miller HE, Garnett EO, Heller Murray ES, Nieto-Castañón A, Tourville JA, Chang SE, Guenther FH. A comparison of structural morphometry in children and adults with persistent developmental stuttering. Brain Commun 2023; 5:fcad301. [PMID: 38025273 PMCID: PMC10653153 DOI: 10.1093/braincomms/fcad301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 10/07/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
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.
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Affiliation(s)
- Hilary E Miller
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA
| | - Emily O Garnett
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
| | - Elizabeth S Heller Murray
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA
- Department of Communication Sciences & Disorders, Temple University, Philadelphia, PA 19122, 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
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Communication Disorders, Ewha Womans University, Seoul 03760, Korea
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI 48824, 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
- The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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3
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Papadatou-Pastou M, Papadopoulou AK, Samsouris C, Mundorf A, Valtou MM, Ocklenburg S. Hand Preference in Stuttering: Meta-Analyses. Neuropsychol Rev 2023:10.1007/s11065-023-09617-z. [PMID: 37796428 DOI: 10.1007/s11065-023-09617-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/24/2023] [Indexed: 10/06/2023]
Abstract
Reduced hemispheric asymmetries, as well as their behavioral manifestation in the form of atypical handedness (i.e., non-right, left-, or mixed-handedness), are linked to neurodevelopmental disorders, such as autism spectrum disorder, and several psychiatric disorders, such as schizophrenia. One neurodevelopmental disorder that is associated with reduced hemispheric asymmetries, but for which findings on behavioral laterality are conflicting, is stuttering. Here, we report a series of meta-analyses of studies that report handedness (assessed as hand preference) levels in individuals who stutter (otherwise healthy) compared to controls. For this purpose, articles were identified via a search in PubMed, Scopus, and PsycInfo (13 June 2023). On the basis of k = 52 identified studies totaling n = 2590 individuals who stutter and n = 17,148 controls, five random effects meta-analyses were conducted: four using the odds ratio [left-handers (forced choice); left-handers (extreme); mixed-handers; non-right-handers vs. total)] and one using the standardized difference in means as the effect size. We did not find evidence of a left (extreme)- or mixed-handedness difference or a difference in mean handedness scores, but evidence did emerge, when it came to left-handedness (forced-choice) and (inconclusively for) non-right-handedness. Risk-of-bias analysis was not deemed necessary in the context of these meta-analyses. Differences in hand skill or strength of handedness could not be assessed as no pertinent studies were located. Severity of stuttering could not be used s a moderator, as too few studies broke down their data according to severity. Our findings do not allow for firm conclusions to be drawn on whether stuttering is associated with reduced hemispheric asymmetries, at least when it comes to their behavioral manifestation.
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Affiliation(s)
- Marietta Papadatou-Pastou
- National and Kapodistrian University of Athens, Athens, Greece.
- Biomedical Research Foundation, Academy of Athens, Athens, Greece.
| | | | - Christos Samsouris
- National and Kapodistrian University of Athens, Athens, Greece
- Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Annakarina Mundorf
- Institute for Systems Medicine and Department of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | | | - Sebastian Ocklenburg
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
- ICAN Institute for Cognitive and Affective Neuroscience, Medical School Hamburg, Hamburg, Germany
- Institute of Cognitive Neuroscience, Biopsychology, Department of Psychology, Ruhr-University Bochum, Bochum, Germany
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4
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Neef NE, Angstadt M, Koenraads SPC, Chang SE. Dissecting structural connectivity of the left and right inferior frontal cortex in children who stutter. Cereb Cortex 2023; 33:4085-4100. [PMID: 36057839 PMCID: PMC10068293 DOI: 10.1093/cercor/bhac328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/12/2022] Open
Abstract
Inferior frontal cortex pars opercularis (IFCop) features a distinct cerebral dominance and vast functional heterogeneity. Left and right IFCop are implicated in developmental stuttering. Weak left IFCop connections and divergent connectivity of hyperactive right IFCop regions have been related to impeded speech. Here, we reanalyzed diffusion magnetic resonance imaging data from 83 children (41 stuttering). We generated connection probability maps of functionally segregated area 44 parcels and calculated hemisphere-wise analyses of variance. Children who stutter showed reduced connectivity of executive, rostral-motor, and caudal-motor corticostriatal projections from the left IFCop. We discuss this finding in the context of tracing studies from the macaque area 44, which leads to the need to reconsider current models of speech motor control. Unlike the left, the right IFCop revealed increased connectivity of the inferior posterior ventral parcel and decreased connectivity of the posterior dorsal parcel with the anterior insula, particularly in stuttering boys. This divergent connectivity pattern in young children adds to the debate on potential core deficits in stuttering and challenges the theory that right hemisphere differences might exclusively indicate compensatory changes that evolve from lifelong exposure. Instead, early right prefrontal connectivity differences may reflect additional brain signatures of aberrant cognition-emotion-action influencing speech motor control.
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Affiliation(s)
- Nicole E Neef
- Institute for Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA
| | - Simone P C Koenraads
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, the Netherlands
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, Wytemaweg 80, 3015 CNRotterdam, the Netherlands
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48105, USA
- Department of Communicative Sciences and Disorders, Michigan State University, 1026 Red Cedar Road, East Lansing, MI 48824, USA
- Cognitive Imaging Research Center, Department of Radiology, Michigan State University, 846 Service Road, East Lansing, MI 48824, USA
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5
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Gastaldon S, Busan P, Arcara G, Peressotti F. Inefficient speech-motor control affects predictive speech comprehension: atypical electrophysiological correlates in stuttering. Cereb Cortex 2023:6995383. [PMID: 36682885 DOI: 10.1093/cercor/bhad004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/24/2023] Open
Abstract
Listeners predict upcoming information during language comprehension. However, how this ability is implemented is still largely unknown. Here, we tested the hypothesis proposing that language production mechanisms have a role in prediction. We studied 2 electroencephalographic correlates of predictability during speech comprehension-pre-target alpha-beta (8-30 Hz) power decrease and the post-target N400 event-related potential effect-in a population with impaired speech-motor control, i.e. adults who stutter (AWS), compared to typically fluent adults (TFA). Participants listened to sentences that could either constrain towards a target word or not, modulating its predictability. As a complementary task, participants also performed context-driven word production. Compared to TFA, AWS not only displayed atypical neural responses in production, but, critically, they showed a different pattern also in comprehension. Specifically, while TFA showed the expected pre-target power decrease, AWS showed a power increase in frontal regions, associated with speech-motor control. In addition, the post-target N400 effect was reduced for AWS with respect to TFA. Finally, we found that production and comprehension power changes were positively correlated in TFA, but not in AWS. Overall, the results support the idea that processes and neural structures prominently devoted to speech planning also support prediction during speech comprehension.
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Affiliation(s)
- Simone Gastaldon
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione (DPSS), University of Padova, Via Venezia 8, Padova (PD) 35131, Italy.,Padova Neuroscience Center (PNC), University of Padova, Via Giuseppe Orus 2/B, Padova (PD) 35131, Italy
| | - Pierpaolo Busan
- IRCCS Ospedale San Camillo, Via Alberoni 70, Lido (VE) 30126, Italy
| | - Giorgio Arcara
- IRCCS Ospedale San Camillo, Via Alberoni 70, Lido (VE) 30126, Italy
| | - Francesca Peressotti
- Dipartimento di Psicologia dello Sviluppo e della Socializzazione (DPSS), University of Padova, Via Venezia 8, Padova (PD) 35131, Italy.,Padova Neuroscience Center (PNC), University of Padova, Via Giuseppe Orus 2/B, Padova (PD) 35131, Italy.,Centro Interdipartimentale di Ricerca "I-APPROVE-International Auditory Processing Project in Venice", University of Padova, Via Belzoni 160, Padova (PD) 35121, Italy
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6
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Johnson CA, Liu Y, Waller N, Chang SE. Tract profiles of the cerebellar peduncles in children who stutter. Brain Struct Funct 2022; 227:1773-1787. [PMID: 35220486 PMCID: PMC9743081 DOI: 10.1007/s00429-022-02471-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 02/07/2022] [Indexed: 12/14/2022]
Abstract
Cerebellar-cortical loops comprise critical neural circuitry that supports self-initiated movements and motor adjustments in response to perceived errors, functions that are affected in stuttering. It is unknown whether structural aspects of cerebellar circuitry are affected in stuttering, particularly in children close to symptom onset. Here we examined white matter diffusivity characteristics of the three cerebellar peduncles (CPs) based on diffusion MRI (dMRI) data collected from 41 children who stutter (CWS) and 42 controls in the 3-11 years range. We hypothesized that CWS would exhibit decreased fractional anisotropy (FA) in the right CPs given the contralateral connectivity of the cerebellar-cortical loops and past reports of structural differences in left cortical areas in stuttering speakers. Automatic Fiber Quantification (AFQ) was used to track and segment cerebellar white matter pathways and to extract diffusivity measures. We found significant group differences for FA in the right inferior CP (ICP) only: controls showed significantly higher FA in the right ventral ICP compared to CWS, controlling for age, sex, and verbal IQ. Furthermore, FA of right ICP was negatively correlated with stuttering frequency in CWS. These results suggest an early developmental difference in the right ICP for CWS compared to age-matched peers, which may indicate an alteration in error processing, a function previously linked to the ICP. Lower FA here may impact error monitoring and sensory input processing to guide motor corrections. Further longitudinal investigations in children may provide additional insights into how CP development links to stuttering persistence and recovery.
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Affiliation(s)
- Chelsea A Johnson
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, USA
| | - Yanni Liu
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Noah Waller
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
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7
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Neef NE, Korzeczek A, Primaßin A, Wolff von Gudenberg A, Dechent P, Riedel CH, Paulus W, Sommer M. White matter tract strength correlates with therapy outcome in persistent developmental stuttering. Hum Brain Mapp 2022; 43:3357-3374. [PMID: 35415866 PMCID: PMC9248304 DOI: 10.1002/hbm.25853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 11/11/2022] Open
Abstract
Persistent stuttering is a prevalent neurodevelopmental speech disorder, which presents with involuntary speech blocks, sound and syllable repetitions, and sound prolongations. Affected individuals often struggle with negative feelings, elevated anxiety, and low self-esteem. Neuroimaging studies frequently link persistent stuttering with cortical alterations and dysfunctional cortico-basal ganglia-thalamocortical loops; dMRI data also point toward connectivity changes of the superior longitudinal fasciculus (SLF) and the frontal aslant tract (FAT). Both tracts are involved in speech and language functions, and the FAT also supports inhibitory control and conflict monitoring. Whether the two tracts are involved in therapy-associated improvements and how they relate to therapeutic outcomes is currently unknown. Here, we analyzed dMRI data of 22 patients who participated in a fluency-shaping program, 18 patients not participating in therapy, and 27 fluent control participants, measured 1 year apart. We used diffusion tractography to segment the SLF and FAT bilaterally and to quantify their microstructural properties before and after a fluency-shaping program. Participants learned to speak with soft articulation, pitch, and voicing during a 2-week on-site boot camp and computer-assisted biofeedback-based daily training for 1 year. Therapy had no impact on the microstructural properties of the two tracts. Yet, after therapy, stuttering severity correlated positively with left SLF fractional anisotropy, whereas relief from the social-emotional burden to stutter correlated negatively with right FAT fractional anisotropy. Thus, posttreatment, speech motor performance relates to the left dorsal stream, while the experience of the adverse impact of stuttering relates to the structure recently associated with conflict monitoring and action inhibition.
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Affiliation(s)
- Nicole E Neef
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany.,Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Alexandra Korzeczek
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Annika Primaßin
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.,Fachbereich Gesundheit, FH Münster University of Applied Sciences, Münster, Germany
| | | | - Peter Dechent
- Department of Cognitive Neurology, MR Research in Neurosciences, University Medical Center Göttingen, Göttingen, Germany
| | - Christian Heiner Riedel
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Göttingen, Göttingen, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Martin Sommer
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany.,Department of Neurology, University Medical Center Göttingen, Göttingen, Germany.,Department of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
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8
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Korzeczek A, Neef NE, Steinmann I, Paulus W, Sommer M. Stuttering severity relates to frontotemporal low-beta synchronization during pre-speech preparation. Clin Neurophysiol 2022; 138:84-96. [DOI: 10.1016/j.clinph.2022.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 12/15/2022]
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9
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Jossinger S, Sares A, Zislis A, Sury D, Gracco V, Ben-Shachar M. White matter correlates of sensorimotor synchronization in persistent developmental stuttering. JOURNAL OF COMMUNICATION DISORDERS 2022; 95:106169. [PMID: 34856426 PMCID: PMC8821245 DOI: 10.1016/j.jcomdis.2021.106169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 10/25/2021] [Accepted: 11/11/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Individuals with persistent developmental stuttering display deficits in aligning motor actions to external cues (i.e., sensorimotor synchronization). Diffusion imaging studies point to stuttering-associated differences in dorsal, not ventral, white matter pathways, and in the cerebellar peduncles. Here, we studied microstructural white matter differences between adults who stutter (AWS) and fluent speakers using two complementary approaches to: (a) assess previously reported group differences in white matter diffusivity, and (b) evaluate the relationship between white matter diffusivity and sensorimotor synchronization in each group. METHODS Participants completed a sensorimotor synchronization task and a diffusion MRI scan. We identified the cerebellar peduncles and major dorsal- and ventral-stream language pathways in each individual and assessed correlations between sensorimotor synchronization and diffusion measures along the tracts. RESULTS The results demonstrated group differences in dorsal, not ventral, language tracts, in alignment with prior reports. Specifically, AWS had significantly lower fractional anisotropy (FA) in the left arcuate fasciculus, and significantly higher mean diffusivity (MD) in the bilateral frontal aslant tract compared to fluent speakers, while no significant group difference was detected in the inferior fronto-occipital fasciculus. We also found significant group differences in both FA and MD of the left middle cerebellar peduncle. Comparing patterns of association with sensorimotor synchronization revealed a novel double dissociation: MD within the left inferior cerebellar peduncle was significantly correlated with mean asynchrony in AWS but not in fluent speakers, while FA within the left arcuate fasciculus was significantly correlated with mean asynchrony in fluent speakers, but not in AWS. CONCLUSIONS Our results support the view that stuttering involves altered connectivity in dorsal tracts and that AWS may rely more heavily on cerebellar tracts to process timing information. Evaluating microstructural associations with sensitive behavioral measures provides a powerful tool for discovering additional functional differences in the underlying connectivity in AWS.
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Affiliation(s)
- Sivan Jossinger
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel.
| | - Anastasia Sares
- Department of Psychology, Concordia University, Montréal, Canada; Centre for Research on Brain, Language and Music, McGill University, Montréal, Canada
| | - Avital Zislis
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Dana Sury
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Vincent Gracco
- Centre for Research on Brain, Language and Music, McGill University, Montréal, Canada; School of Communication Sciences and Disorders, McGill University, Montréal, Canada; Haskins Laboratories, New Haven, CT, United States
| | - Michal Ben-Shachar
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel; The Department of English Literature and Linguistics, Bar-Ilan University, Ramat-Gan, Israel
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10
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Thompson-Lake DGY, Scerri TS, Block S, Turner SJ, Reilly S, Kefalianos E, Bonthrone AF, Helbig I, Bahlo M, Scheffer IE, Hildebrand MS, Liégeois FJ, Morgan AT. Atypical development of Broca's area in a large family with inherited stuttering. Brain 2021; 145:1177-1188. [PMID: 35296891 PMCID: PMC9724773 DOI: 10.1093/brain/awab364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/09/2021] [Accepted: 08/24/2021] [Indexed: 01/18/2023] Open
Abstract
Developmental stuttering is a condition of speech dysfluency, characterized by pauses, blocks, prolongations and sound or syllable repetitions. It affects around 1% of the population, with potential detrimental effects on mental health and long-term employment. Accumulating evidence points to a genetic aetiology, yet gene-brain associations remain poorly understood due to a lack of MRI studies in affected families. Here we report the first neuroimaging study of developmental stuttering in a family with autosomal dominant inheritance of persistent stuttering. We studied a four-generation family, 16 family members were included in genotyping analysis. T1-weighted and diffusion-weighted MRI scans were conducted on seven family members (six male; aged 9-63 years) with two age and sex matched controls without stuttering (n = 14). Using Freesurfer, we analysed cortical morphology (cortical thickness, surface area and local gyrification index) and basal ganglia volumes. White matter integrity in key speech and language tracts (i.e. frontal aslant tract and arcuate fasciculus) was also analysed using MRtrix and probabilistic tractography. We identified a significant age by group interaction effect for cortical thickness in the left hemisphere pars opercularis (Broca's area). In affected family members this region failed to follow the typical trajectory of age-related thinning observed in controls. Surface area analysis revealed the middle frontal gyrus region was reduced bilaterally in the family (all cortical morphometry significance levels set at a vertex-wise threshold of P < 0.01, corrected for multiple comparisons). Both the left and right globus pallidus were larger in the family than in the control group (left P = 0.017; right P = 0.037), and a larger right globus pallidus was associated with more severe stuttering (rho = 0.86, P = 0.01). No white matter differences were identified. Genotyping identified novel loci on chromosomes 1 and 4 that map with the stuttering phenotype. Our findings denote disruption within the cortico-basal ganglia-thalamo-cortical network. The lack of typical development of these structures reflects the anatomical basis of the abnormal inhibitory control network between Broca's area and the striatum underpinning stuttering in these individuals. This is the first evidence of a neural phenotype in a family with an autosomal dominantly inherited stuttering.
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Affiliation(s)
| | - Thomas S Scerri
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville 3052, Australia,Department of Medical Biology, University of Melbourne, 1G Royal Parade, Parkville 305, Australia
| | - Susan Block
- Discipline of Speech Pathology, School of Allied Health, Human Services & Sport, La Trobe University, Bundoora 3086, Australia
| | - Samantha J Turner
- Speech and Language, Murdoch Children’s Research Institute, Parkville 3052, Australia
| | - Sheena Reilly
- Speech and Language, Murdoch Children’s Research Institute, Parkville 3052, Australia,Menzies Health Institute Queensland, Griffith University, Southport 4215, Australia
| | - Elaina Kefalianos
- Speech and Language, Murdoch Children’s Research Institute, Parkville 3052, Australia,Department of Audiology and Speech Pathology, University of Melbourne, Parkville 3052, Australia
| | | | - Ingo Helbig
- Division of Neurology, Children’s Hospital of Philadelphia, Philadelphia, PA 19104USA,The Epilepsy NeuroGenetics Initiative, Children's Hospital of Philadelphia, Philadelphia, PA 19104USA,Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104USA,Department of Neurology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA 19104USA
| | - Melanie Bahlo
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, 1G Royal Parade, Parkville 3052, Australia,Department of Medical Biology, University of Melbourne, 1G Royal Parade, Parkville 305, Australia
| | - Ingrid E Scheffer
- Department of Medicine, University of Melbourne, Austin Hospital, Heidelberg 3084, Australia,Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Parkville 3052, Australia,Murdoch Children’s Research Institute, Parkville 3052, Australia,Florey Institute of Neuroscience and Mental Health, Parkville 3052, Australia
| | - Michael S Hildebrand
- Department of Medicine, University of Melbourne, Austin Hospital, Heidelberg 3084, Australia,Murdoch Children’s Research Institute, Parkville 3052, Australia
| | | | - Angela T Morgan
- Correspondence to: Angela T. Morgan Murdoch Children’s Research Institute Parkville 3052, Australia E-mail:
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11
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Boley N, Patil S, Garnett EO, Li H, Chugani DC, Chang SE, Chow HM. Association Between Gray Matter Volume Variations and Energy Utilization in the Brain: Implications for Developmental Stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2317-2324. [PMID: 33719533 PMCID: PMC8740693 DOI: 10.1044/2020_jslhr-20-00325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/23/2020] [Accepted: 10/02/2020] [Indexed: 06/12/2023]
Abstract
Purpose The biological mechanisms underlying developmental stuttering remain unclear. In a previous investigation, we showed that there is significant spatial correspondence between regional gray matter structural anomalies and the expression of genes linked to energy metabolism. In the current study, we sought to further examine the relationship between structural anomalies in the brain in children with persistent stuttering and brain regional energy metabolism. Method High-resolution structural MRI scans were acquired from 26 persistent stuttering and 44 typically developing children. Voxel-based morphometry was used to quantify the between-group gray matter volume (GMV) differences across the whole brain. Group differences in GMV were then compared with published values for the pattern of glucose metabolism measured via F18 fluorodeoxyglucose uptake in the brains of 29 healthy volunteers using positron emission tomography. Results A significant positive correlation between GMV differences and F18 fluorodeoxyglucose uptake was found in the left hemisphere (ρ = .36, p < .01), where speech-motor and language processing are typically localized. No such correlation was observed in the right hemisphere (ρ = .05, p = .70). Conclusions Corroborating our previous gene expression studies, the results of the current study suggest a potential connection between energy metabolism and stuttering. Brain regions with high energy utilization may be particularly vulnerable to anatomical changes associated with stuttering. Such changes may be further exacerbated when there are sharp increases in brain energy utilization, which coincides with the developmental period of rapid speech/language acquisition and the onset of stuttering during childhood. Supplemental Material https://doi.org/10.23641/asha.14110454.
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Affiliation(s)
- Nathaniel Boley
- The Institute for Biomedical Sciences, School of Medicine and Health Sciences, The George Washington University, Washington, DC
- Katzin Diagnostic & Research PET/MRI Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Sanath Patil
- Katzin Diagnostic & Research PET/MRI Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
- Premedical-Medical Program, Eberly College of Science, The Pennsylvania State University, University Park
| | - Emily O. Garnett
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
| | - Hua Li
- Katzin Diagnostic & Research PET/MRI Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Diane C. Chugani
- Department of Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor
- Cognitive Imaging Research Center, Department of Radiology, College of Osteopathic Medicine, Michigan State University, East Lansing
- Department of Communicative Sciences and Disorders, College of Communication Arts and Sciences, Michigan State University, East Lansing
| | - Ho Ming Chow
- Katzin Diagnostic & Research PET/MRI Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE
- Department of Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark
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12
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Tung H, Lin WH, Lan TH, Hsieh PF, Chiang MC, Lin YY, Peng SJ. Network reorganization during verbal fluency task in fronto-temporal epilepsy: A functional near-infrared spectroscopy study. J Psychiatr Res 2021; 138:541-549. [PMID: 33990025 DOI: 10.1016/j.jpsychires.2021.05.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/25/2021] [Accepted: 05/01/2021] [Indexed: 10/21/2022]
Abstract
This is the first study to use functional near-infrared spectroscopy (fNIRS) to investigate how the lateralization of the epileptogenic zone affects the reconfiguration of task-related network patterns. Eleven left fronto-temporal epilepsy (L-FTE) and 11 right fronto-temporal epilepsy (R-FTE), as well as 22 age- and gender-matched controls, were enrolled. Signals from 52-channel fNIRS were recorded while the subject was undertaking verbal fluency tasks (VFTs), which included categorical (CFT) and letter (LFT) fluency tasks. Three analytic methods were used to study the network topology: network-based analysis, hub identification, and proportional threshold to select the top 20% strongest connections for both graph theory parameters and clinical correlation. Performance of CFT is accomplished primarily using the ventral pathway, and bilateral ventral pathways are augmented in fronto-temporal epilepsy patients by strengthening the inter-hemispheric connections, especially for R-FTE. LFT mainly employed the dorsal pathway, and further prioritized the left dorsal pathway in strengthening intra-hemispheric connections in fronto-temporal epilepsy, especially L-FTE. The top 20% of the strongest connections only present differences in CFT network compared with the controls. R-FTE increased inter-hemispheric network density, while L-FTE decreased inter-hemispheric average characteristic path length. Accumulative seizure burden only affects L-FTE network. Better LFT performance and longer educational years seem to promote left fronto-temporal networks, and decreased the demand from RR intra-hemispheric connectivity in L-FTE. LFT scores in R-FTE are maintained by preserved RR intra-hemispheric networks. However, CFT scores and educational years seem to have no effect on the CFT network topology in both FTE.
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Affiliation(s)
- Hsin Tung
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taiwan; Center of Faculty Development, Taichung Veterans General Hospital, Taiwan; Division of Epilepsy, Neurological Institute, Taichung Veterans General Hospital, Taiwan
| | - Wei-Hao Lin
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tsuo-Hung Lan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
| | - Peiyuan F Hsieh
- Division of Epilepsy, Neurological Institute, Taichung Veterans General Hospital, Taiwan
| | - Ming-Chang Chiang
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yung-Yang Lin
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taiwan; Department of Critical Care Medicine, Taipei Veterans General Hospital, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Syu-Jyun Peng
- Professional Master Program in Artificial Intelligence in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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13
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Speech rate association with cerebellar white-matter diffusivity in adults with persistent developmental stuttering. Brain Struct Funct 2021; 226:801-816. [PMID: 33538875 DOI: 10.1007/s00429-020-02210-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
Speech rate is a basic characteristic of language production, which affects the speaker's intelligibility and communication efficiency. Various speech disorders, including persistent developmental stuttering, present altered speech rate. Specifically, adults who stutter (AWS) typically exhibit a slower speech rate compared to fluent speakers. Evidence from imaging studies suggests that the cerebellum contributes to the paced production of speech. People who stutter show structural and functional abnormalities in the cerebellum. However, the involvement of the cerebellar pathways in controlling speech rate remains unexplored. Here, we assess the association of the cerebellar peduncles with speech rate in AWS and control speakers. Diffusion MRI and speech-rate data were collected in 42 participants (23 AWS, 19 controls). We used deterministic tractography with Automatic Fiber segmentation and Quantification (AFQ) to identify the superior, middle, and inferior cerebellar peduncles (SCP, MCP, ICP) bilaterally, and quantified fractional anisotropy (FA) and mean diffusivity (MD) along each tract. No significant differences were observed between AWS and controls in the diffusivity values of the cerebellar peduncles. However, AWS demonstrated a significant negative association between speech rate and FA within the left ICP, a major cerebellar pathway that transmits sensory feedback signals from the olivary nucleus into the cerebellum. The involvement of the ICP in controlling speech production in AWS is compatible with the view that stuttering stems from hyperactive speech monitoring, where even minor deviations from the speech plan are considered as errors. In conclusion, our findings suggest a plausible neural mechanism for speech rate reduction observed in AWS.
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14
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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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15
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Koenraads SPC, van der Schroeff MP, van Ingen G, Lamballais S, Tiemeier H, Baatenburg de Jong RJ, White T, Franken MC, Muetzel RL. Structural brain differences in pre-adolescents who persist in and recover from stuttering. NEUROIMAGE-CLINICAL 2020; 27:102334. [PMID: 32650280 PMCID: PMC7341447 DOI: 10.1016/j.nicl.2020.102334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/19/2020] [Accepted: 06/26/2020] [Indexed: 01/18/2023]
Abstract
Brain (micro-)structural differences were found in pre-adolescents who stutter. Persistency was associated with marginally smaller left frontal gray matter volume. Recovery was associated with higher mean diffusivity in white matter tracts. Distinct brain structures implicated in persistence and recovery of stuttering.
Background Stuttering is a complex speech fluency disorder occurring in childhood. In young children, stuttering has been associated with speech-related auditory and motor areas of the brain. During transition into adolescence, the majority of children who stutter (75–80%) will experience remission of their symptoms. The current study evaluated brain (micro-)structural differences between pre-adolescents who persisted in stuttering, those who recovered, and fluently speaking controls. Methods This study was embedded in the Generation R Study, a population-based cohort in the Netherlands of children followed from pregnancy onwards. Neuroimaging was performed in 2211 children (mean age: 10 years, range 8–12), of whom 20 persisted in and 77 recovered from stuttering. Brain structure (e.g., gray matter) and microstructure (e.g., diffusion tensor imaging) differences between groups were tested using multiple linear regression. Results Pre-adolescents who persisted in stuttering had marginally lower left superior frontal gray matter volume compared to those with no history of stuttering (β −1344, 95%CI −2407;-280), and those who recovered (β −1825, 95%CI −2999;-650). Pre-adolescents who recovered, compared to those with no history of stuttering, had higher mean diffusivity in the forceps major (β 0.002, 95%CI 0.001;0.004), bilateral superior longitudinal fasciculi (β 0.001, 95%CI 0.000;0.001), left corticospinal tract (β 0.003, 95%CI 0.002;0.004), and right inferior longitudinal fasciculus (β 0.001, 95%CI 0.000;0.001). Conclusion Findings suggest that relatively small difference in prefrontal gray matter volume is associated with persistent stuttering, and alterations in white matter tracts are apparent in individuals who recovered. The findings further strengthen the potential relevance of brain (micro-)structure in persistence and recovery from stuttering in pre-adolescents.
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Affiliation(s)
- S P C Koenraads
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - M P van der Schroeff
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - G van Ingen
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands; The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - S Lamballais
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - H Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - R J Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - T White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - M C Franken
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - R L Muetzel
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, the Netherlands
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16
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Abstract
There are functional and anatomical distinctions between the neural systems involved in the recognition of sounds in the environment and those involved in the sensorimotor guidance of sound production and the spatial processing of sound. Evidence for the separation of these processes has historically come from disparate literatures on the perception and production of speech, music and other sounds. More recent evidence indicates that there are computational distinctions between the rostral and caudal primate auditory cortex that may underlie functional differences in auditory processing. These functional differences may originate from differences in the response times and temporal profiles of neurons in the rostral and caudal auditory cortex, suggesting that computational accounts of primate auditory pathways should focus on the implications of these temporal response differences.
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17
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Garnett EO, Chow HM, Nieto-Castañón A, Tourville JA, Guenther FH, Chang SE. Anomalous morphology in left hemisphere motor and premotor cortex of children who stutter. Brain 2019; 141:2670-2684. [PMID: 30084910 DOI: 10.1093/brain/awy199] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 06/04/2018] [Indexed: 02/06/2023] Open
Abstract
Stuttering is a neurodevelopmental disorder that affects the smooth flow of speech production. Stuttering onset occurs during a dynamic period of development when children first start learning to formulate sentences. Although most children grow out of stuttering naturally, ∼1% of all children develop persistent stuttering that can lead to significant psychosocial consequences throughout one's life. To date, few studies have examined neural bases of stuttering in children who stutter, and even fewer have examined the basis for natural recovery versus persistence of stuttering. Here we report the first study to conduct surface-based analysis of the brain morphometric measures in children who stutter. We used FreeSurfer to extract cortical size and shape measures from structural MRI scans collected from the initial year of a longitudinal study involving 70 children (36 stuttering, 34 controls) in the 3-10-year range. The stuttering group was further divided into two groups: persistent and recovered, based on their later longitudinal visits that allowed determination of their eventual clinical outcome. A region of interest analysis that focused on the left hemisphere speech network and a whole-brain exploratory analysis were conducted to examine group differences and group × age interaction effects. We found that the persistent group could be differentiated from the control and recovered groups by reduced cortical thickness in left motor and lateral premotor cortical regions. The recovered group showed an age-related decrease in local gyrification in the left medial premotor cortex (supplementary motor area and and pre-supplementary motor area). These results provide strong evidence of a primary deficit in the left hemisphere speech network, specifically involving lateral premotor cortex and primary motor cortex, in persistent developmental stuttering. Results further point to a possible compensatory mechanism involving left medial premotor cortex in those who recover from childhood stuttering.
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Affiliation(s)
- Emily O Garnett
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Ho Ming Chow
- Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE, USA
| | | | - Jason A Tourville
- Department of Speech Language and Hearing Sciences, Boston University, Boston, MA, USA
| | - Frank H Guenther
- Department of Speech Language and Hearing Sciences, Boston University, Boston, MA, USA.,Department of Biomedical Engineering, Boston University, Boston, MA, USA
| | - Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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18
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Chernoff BL, Sims MH, Smith SO, Pilcher WH, Mahon BZ. Direct electrical stimulation of the left frontal aslant tract disrupts sentence planning without affecting articulation. Cogn Neuropsychol 2019; 36:178-192. [PMID: 31210568 PMCID: PMC6744286 DOI: 10.1080/02643294.2019.1619544] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 02/22/2019] [Accepted: 04/26/2019] [Indexed: 10/26/2022]
Abstract
Sentence production involves mapping from deep structures that specify meaning and thematic roles to surface structures that specify the order and sequencing of production ready elements. We propose that the frontal aslant tract is a key pathway for sequencing complex actions with deep hierarchical structure. In the domain of language, and primarily with respect to the left FAT, we refer to this as the 'Syntagmatic Constraints On Positional Elements' (SCOPE) hypothesis. One prediction made by the SCOPE hypothesis is that disruption of the frontal aslant tract should disrupt sentence production at grammatical phrase boundaries, with no disruption of articulatory processes. We test this prediction in a patient undergoing direct electrical stimulation mapping of the frontal aslant tract during an awake craniotomy to remove a left frontal brain tumor. We found that stimulation of the left FAT prolonged inter-word durations at the start of grammatical phrases, while inter-word durations internal to noun phrases were unaffected, and there was no effect on intra-word articulatory duration. These results provide initial support for the SCOPE hypothesis, and motivate novel directions for future research to explore the functions of this recently discovered component of the language system.
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Affiliation(s)
| | - Max H. Sims
- Department of Neurology, University of Rochester, USA
| | - Susan O. Smith
- Department of Neurosurgery, University of Rochester Medical Center, USA
| | | | - Bradford Z. Mahon
- Department of Psychology, Carnegie Mellon University, USA
- Department of Neurology, University of Rochester, USA
- Department of Neurosurgery, University of Rochester Medical Center, USA
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19
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Neef NE, Anwander A, Bütfering C, Schmidt-Samoa C, Friederici AD, Paulus W, Sommer M. Structural connectivity of right frontal hyperactive areas scales with stuttering severity. Brain 2019; 141:191-204. [PMID: 29228195 PMCID: PMC5837552 DOI: 10.1093/brain/awx316] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 10/11/2017] [Indexed: 11/14/2022] Open
Abstract
A neuronal sign of persistent developmental stuttering is the magnified coactivation of right frontal brain regions during speech production. Whether and how stuttering severity relates to the connection strength of these hyperactive right frontal areas to other brain areas is an open question. Scrutinizing such brain–behaviour and structure–function relationships aims at disentangling suspected underlying neuronal mechanisms of stuttering. Here, we acquired diffusion-weighted and functional images from 31 adults who stutter and 34 matched control participants. Using a newly developed structural connectivity measure, we calculated voxel-wise correlations between connection strength and stuttering severity within tract volumes that originated from functionally hyperactive right frontal regions. Correlation analyses revealed that with increasing speech motor deficits the connection strength increased in the right frontal aslant tract, the right anterior thalamic radiation, and in U-shaped projections underneath the right precentral sulcus. In contrast, with decreasing speech motor deficits connection strength increased in the right uncinate fasciculus. Additional group comparisons of whole-brain white matter skeletons replicated the previously reported reduction of fractional anisotropy in the left and right superior longitudinal fasciculus as well as at the junction of right frontal aslant tract and right superior longitudinal fasciculus in adults who stutter compared to control participants. Overall, our investigation suggests that right fronto-temporal networks play a compensatory role as a fluency enhancing mechanism. In contrast, the increased connection strength within subcortical-cortical pathways may be implied in an overly active global response suppression mechanism in stuttering. Altogether, this combined functional MRI–diffusion tensor imaging study disentangles different networks involved in the neuronal underpinnings of the speech motor deficit in persistent developmental stuttering.
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Affiliation(s)
- Nicole E Neef
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Alfred Anwander
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Christoph Bütfering
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Angela D Friederici
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
| | - Martin Sommer
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany
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20
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Dick AS, Garic D, Graziano P, Tremblay P. The frontal aslant tract (FAT) and its role in speech, language and executive function. Cortex 2018; 111:148-163. [PMID: 30481666 DOI: 10.1016/j.cortex.2018.10.015] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 08/27/2018] [Accepted: 10/18/2018] [Indexed: 12/15/2022]
Abstract
In this review, we examine the structural connectivity of a recently-identified fiber pathway, the frontal aslant tract (FAT), and explore its function. We first review structural connectivity studies using tract-tracing methods in non-human primates, and diffusion-weighted imaging and electrostimulation in humans. These studies suggest a monosynaptic connection exists between the lateral inferior frontal gyrus and the pre-supplementary and supplementary motor areas of the medial superior frontal gyrus. This connection is termed the FAT. We then review research on the left FAT's putative role in supporting speech and language function, with particular focus on speech initiation, stuttering and verbal fluency. Next, we review research on the right FAT's putative role supporting executive function, namely inhibitory control and conflict monitoring for action. We summarize the extant body of empirical work by suggesting that the FAT plays a domain general role in the planning, timing, and coordination of sequential motor movements through the resolution of competition among potential motor plans. However, we also propose some domain specialization across the hemispheres. On the left hemisphere, the circuit is proposed to be specialized for speech actions. On the right hemisphere, the circuit is proposed to be specialized for general action control of the organism, especially in the visuo-spatial domain. We close the review with a discussion of the clinical significance of the FAT, and suggestions for further research on the pathway.
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Affiliation(s)
| | - Dea Garic
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Paulo Graziano
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Pascale Tremblay
- Departement de Readaptation, Université Laval, Quebec City, Quebec, Canada; CERVO Brain Research Center, Quebec City, Canada
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21
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Piispala J, Starck T, Jansson-Verkasalo E, Kallio M. Decreased occipital alpha oscillation in children who stutter during a visual Go/Nogo task. Clin Neurophysiol 2018; 129:1971-1980. [PMID: 30029047 DOI: 10.1016/j.clinph.2018.06.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 05/18/2018] [Accepted: 06/14/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Our goal was to discover attention- and inhibitory control-related differences in the main oscillations of the brain of children who stutter (CWS) compared to typically developed children (TDC). METHODS We performed a time-frequency analysis using wavelets, fast Fourier transformation (FFT) and the Alpha/Theta power ratio of EEG data collected during a visual Go/Nogo task in 7-9 year old CWS and TDC, including also the time window between consecutive tasks. RESULTS CWS showed significantly reduced occipital alpha power and Alpha/Theta ratio in the "resting" or preparatory period between visual stimuli especially in the Nogo condition. CONCLUSIONS The CWS demonstrate reduced inhibition of the visual cortex and information processing in the absence of visual stimuli, which may be related to problems in attentional gating. SIGNIFICANCE Occipital alpha oscillation is elementary in the control and inhibition of visual attention and the lack of occipital alpha modulation indicate fundamental differences in the regulation of visual information processing in CWS. Our findings support the view of stuttering as part of a wide-ranging brain dysfunction most likely involving also attentional and inhibitory networks.
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Affiliation(s)
- Johanna Piispala
- Department of Clinical Neurophysiology, Oulu University Hospital, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland.
| | - Tuomo Starck
- Department of Clinical Neurophysiology, Oulu University Hospital, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland.
| | - Eira Jansson-Verkasalo
- Department of Psychology and Speech-Language Pathology, Speech-Language Pathology, University of Turku, Finland.
| | - Mika Kallio
- Department of Clinical Neurophysiology, Oulu University Hospital, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland.
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22
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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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Kronfeld-Duenias V, Civier O, Amir O, Ezrati-Vinacour R, Ben-Shachar M. White matter pathways in persistent developmental stuttering: Lessons from tractography. JOURNAL OF FLUENCY DISORDERS 2018; 55:68-83. [PMID: 29050641 DOI: 10.1016/j.jfludis.2017.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 04/18/2017] [Accepted: 09/05/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Fluent speech production relies on the coordinated processing of multiple brain regions. This highlights the role of neural pathways that connect distinct brain regions in producing fluent speech. Here, we aim to investigate the role of the white matter pathways in persistent developmental stuttering (PDS), where speech fluency is disrupted. METHODS We use diffusion weighted imaging and tractography to compare the white matter properties between adults who do and do not stutter. We compare the diffusion properties along 18 major cerebral white matter pathways. We complement the analysis with an overview of the methodology and a roadmap of the pathways implicated in PDS according to the existing literature. RESULTS We report differences in the microstructural properties of the anterior callosum, the right inferior longitudinal fasciculus and the right cingulum in people who stutter compared with fluent controls. CONCLUSIONS Persistent developmental stuttering is consistently associated with differences in bilateral distributed networks. We review evidence showing that PDS involves differences in bilateral dorsal fronto-temporal and fronto-parietal pathways, in callosal pathways, in several motor pathways and in basal ganglia connections. This entails an important role for long range white matter pathways in this disorder. Using a wide-lens analysis, we demonstrate differences in additional, right hemispheric pathways, which go beyond the replicable findings in the literature. This suggests that the affected circuits may extend beyond the known language and motor pathways.
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Affiliation(s)
- Vered Kronfeld-Duenias
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel.
| | - Oren Civier
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
| | - Ofer Amir
- The Department of Communication Disorders, Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Ruth Ezrati-Vinacour
- The Department of Communication Disorders, Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Michal Ben-Shachar
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel; The Department of English Literature and Linguistics, Bar-Ilan University, Ramat-Gan, Israel.
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24
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Daliri A, Max L. Stuttering adults' lack of pre-speech auditory modulation normalizes when speaking with delayed auditory feedback. Cortex 2018; 99:55-68. [PMID: 29169049 PMCID: PMC5801108 DOI: 10.1016/j.cortex.2017.10.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/06/2017] [Accepted: 10/20/2017] [Indexed: 01/14/2023]
Abstract
Auditory modulation during speech movement planning is limited in adults who stutter (AWS), but the functional relevance of the phenomenon itself remains unknown. We investigated for AWS and adults who do not stutter (AWNS) (a) a potential relationship between pre-speech auditory modulation and auditory feedback contributions to speech motor learning and (b) the effect on pre-speech auditory modulation of real-time versus delayed auditory feedback. Experiment I used a sensorimotor adaptation paradigm to estimate auditory-motor speech learning. Using acoustic speech recordings, we quantified subjects' formant frequency adjustments across trials when continually exposed to formant-shifted auditory feedback. In Experiment II, we used electroencephalography to determine the same subjects' extent of pre-speech auditory modulation (reductions in auditory evoked potential N1 amplitude) when probe tones were delivered prior to speaking versus not speaking. To manipulate subjects' ability to monitor real-time feedback, we included speaking conditions with non-altered auditory feedback (NAF) and delayed auditory feedback (DAF). Experiment I showed that auditory-motor learning was limited for AWS versus AWNS, and the extent of learning was negatively correlated with stuttering frequency. Experiment II yielded several key findings: (a) our prior finding of limited pre-speech auditory modulation in AWS was replicated; (b) DAF caused a decrease in auditory modulation for most AWNS but an increase for most AWS; and (c) for AWS, the amount of auditory modulation when speaking with DAF was positively correlated with stuttering frequency. Lastly, AWNS showed no correlation between pre-speech auditory modulation (Experiment II) and extent of auditory-motor learning (Experiment I) whereas AWS showed a negative correlation between these measures. Thus, findings suggest that AWS show deficits in both pre-speech auditory modulation and auditory-motor learning; however, limited pre-speech modulation is not directly related to limited auditory-motor adaptation; and in AWS, DAF paradoxically tends to normalize their otherwise limited pre-speech auditory modulation.
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Affiliation(s)
- Ayoub Daliri
- Arizona State University, Tempe, AZ, United States.
| | - Ludo Max
- University of Washington, Seattle, WA, United States; Haskins Laboratories, New Haven, CT, United States
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Metzger FL, Auer T, Helms G, Paulus W, Frahm J, Sommer M, Neef NE. Shifted dynamic interactions between subcortical nuclei and inferior frontal gyri during response preparation in persistent developmental stuttering. Brain Struct Funct 2017; 223:165-182. [PMID: 28741037 PMCID: PMC5772149 DOI: 10.1007/s00429-017-1476-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 07/07/2017] [Indexed: 11/29/2022]
Abstract
Persistent developmental stuttering is associated with basal ganglia dysfunction or dopamine dysregulation. Here, we studied whole-brain functional connectivity to test how basal ganglia structures coordinate and reorganize sensorimotor brain networks in stuttering. To this end, adults who stutter and fluent speakers (control participants) performed a response anticipation paradigm in the MRI scanner. The preparation of a manual Go/No-Go response reliably produced activity in the basal ganglia and thalamus and particularly in the substantia nigra. Strikingly, in adults who stutter, substantia nigra activity correlated positively with stuttering severity. Furthermore, functional connectivity analyses yielded altered task-related network formations in adults who stutter compared to fluent speakers. Specifically, in adults who stutter, the globus pallidus and the thalamus showed increased network synchronization with the inferior frontal gyrus. This implies dynamic shifts in the response preparation-related network organization through the basal ganglia in the context of a non-speech motor task in stuttering. Here we discuss current findings in the traditional framework of how D1 and D2 receptor activity shapes focused movement selection, thereby suggesting a disproportional involvement of the direct and the indirect pathway in stuttering.
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Affiliation(s)
- F Luise Metzger
- Department of Clinical Neurophysiology, Georg August University, Göttingen, Germany
| | - Tibor Auer
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für Biophysikalische Chemie, Göttingen, Germany.,MRC Cognition and Brain Sciences Unit, Cambridge, UK.,Department of Psychology, Royal Holloway, University of London, Egham, UK
| | - Gunther Helms
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Walter Paulus
- Department of Clinical Neurophysiology, Georg August University, Göttingen, Germany
| | - Jens Frahm
- Biomedizinische NMR Forschungs GmbH am Max-Planck-Institut für Biophysikalische Chemie, Göttingen, Germany
| | - Martin Sommer
- Department of Clinical Neurophysiology, Georg August University, Göttingen, Germany
| | - Nicole E Neef
- Department of Clinical Neurophysiology, Georg August University, Göttingen, Germany. .,Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1a, 04103, Leipzig, Germany.
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26
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The dorsal language pathways in stuttering: Response to commentary. Cortex 2017; 90:169-172. [PMID: 28325499 DOI: 10.1016/j.cortex.2017.01.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/30/2017] [Indexed: 11/22/2022]
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27
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The dorsal pathways: A comment on Kronfeld-Duenias et al. Cortex 2016; 90:166-168. [PMID: 27814889 DOI: 10.1016/j.cortex.2016.09.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 09/20/2016] [Accepted: 09/23/2016] [Indexed: 01/05/2023]
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