An evaluation of oxidative and nitrosative stress in children-who-stutter and its relationship to severity

Stuttering: A Disorder of Energy Supply to Neurons?

Stuttering is a disorder characterized by intermittent loss of volitional control of speech movements. This hypothesis and theory article focuses on the proposal that stuttering may be related to an impairment of the energy supply to neurons. Findings from electroencephalography (EEG), brain imaging, genetics, and biochemistry are reviewed: (1) Analyses of the EEG spectra at rest have repeatedly reported reduced power in the beta band, which is compatible with indications of reduced metabolism. (2) Studies of the absolute level of regional cerebral blood flow (rCBF) show conflicting findings, with two studies reporting reduced rCBF in the frontal lobe, and two studies, based on a different method, reporting no group differences. This contradiction has not yet been resolved. (3) The pattern of reduction in the studies reporting reduced rCBF corresponds to the regional pattern of the glycolytic index (GI; Vaishnavi et al., 2010). High regional GI indicates high reliance on non-oxidative metabolism, i.e., glycolysis. (4) Variants of the gene ARNT2 have been associated with stuttering. This gene is primarily expressed in the brain, with a pattern roughly corresponding to the pattern of regional GI. A central function of the ARNT2 protein is to act as one part of a sensor system indicating low levels of oxygen in brain tissue and to activate appropriate responses, including activation of glycolysis. (5) It has been established that genes related to the functions of the lysosomes are implicated in some cases of stuttering. It is possible that these gene variants result in a reduced peak rate of energy supply to neurons. (6) Lastly, there are indications of interactions between the metabolic system and the dopamine system: for example, it is known that acute hypoxia results in an elevated tonic level of dopamine in the synapses. Will mild chronic limitations of energy supply also result in elevated levels of dopamine? The indications of such interaction effects suggest that the metabolic theory of stuttering should be explored in parallel with the exploration of the dopaminergic theory.

Evaluating parents' reactions to Children's stuttering using a Persian version of reaction to Speech Disfluency Scale

OBJECTIVES

Stuttering is one of the most common speech disorders with many negative effects on children and their parents. The parents play a very important role in the treatment and management of children's stuttering. The parents' reactions to children's stuttering are pivotal in the exacerbation or improvement of stuttering. The present study aimed to investigate the parents' reactions to their children's stuttering using the Persian version of Reaction to Speech Disfluency Scale (RSDS).

METHODS

The present study was conducted in two stages; phase 1: translation and cultural adaptation of RSDS into Persian and phase 2: investigation of the reaction of parents to children's stuttering using the RSDS. The first phase of the study included the following steps, forward translation, backward translation, content validity, face validity, and reliability of the scale using internal consistency and test-retest reliability. The second phase of the study was to examine the reactions of 110 parents of 3-6-year-old children who stutter by using the RSDS. Data were analyzed using SPSS software.

RESULTS

The results of translation and cultural adaptation of the RSDS showed that the Persian version of RSDS has suitable validity. The internal consistency (Cronbach's alpha = 0.94) and the test-retest reliability (ICC = 0.98) were also appropriate for this scale. The most reactions of parents to children's stuttering were cognitive, emotional, and behavioral, respectively. The results of evaluating the maternal and paternal reactions separately indicated that the highest value of paternal reaction score was cognitive, behavioral and emotional reactions, respectively, while the highest value of maternal reaction score was cognitive, emotional and behavioral reactions, respectively. Differences between fathers and mothers were statistically significant only in emotional reaction subscale (P < 0.001). The mean overall score of the RSDS for all parents was 29, as well as 27.72 and 30.27 in fathers and mothers groups, respectively, but this differences between groups not statistically significant (P = 0.12). Comparing the scores between parents of boys and girls who stutter showed that the mean overall scores of cognitive, emotional, and behavioral subscales, and overall scores in the parents of girls who stutter was higher than in the parents of boys who stutter, and this difference was statistically significant in the emotional subscale and the overall score between the two groups (P < 0.05).

CONCLUSION

The parental cognitive and behavioral reactions to children's stuttering had the maximum and minimum frequency, respectively. The paternal reactions to their children's stuttering were different from maternal reactions. The parents of girls who stutter in all subscales had a greater reaction compared to the parents of boys who stutter. Given the importance of the reactions of parents to their children's stuttering, the results of the present study can help to complete the information of therapists and researchers in this field.

An evaluation of G-protein coupled membrane estrogen receptor-1 level in stuttering

OBJECTIVE

Stuttering is a widespread but little understood disease. There has been a recent increase in neuropathophysiological, genetic, and biochemical studies related to the etiopathogenesis. As developmental stuttering continues in adult males, hormonal factors are thought to have an effect. In this study, an evaluation was made for the first time of serum GPER-1 level in patients with a stutter.

STUDY DESIGN

Prospective case control.

MATERIALS AND METHODS

The study included 30 patients with a stutter, aged < 18 years, and 35 age-matched children as the control group. The Stuttering Severity Instrument-3 form was administered to the patients. Evaluations were made of serum GPER-1, TSH, estradiol, prolactin, and progesterone and testosterone levels.

RESULTS

GPER-1 level was determined as 0.51 (0.42-0.67) ng/mL in the patients and as 0.19 (0.13-0.25) ng/mL in the control group, and the difference was statistically significant (p < 0.001). A statistically significant difference was determined between genders with GPER-1 level of 0.56 (0.44-0.68) ng/mL in the male stuttering patient group and 0.44 (0.35-0.49) ng/mL in the female patient group (p = 0.026). Differential diagnosis with ROC analysis for the serum GPER-1 levels was statistically significant [Area under the ROC curve (AUC): 0.998, confidence interval, CI 0.992-1.000, p < 0.001].

CONCLUSION

The GPER-1 levels of the stuttering patients were found to be higher than those of the control group and GPER-1 levels of male patients were higher than those of females. As GPER-1 has high sensitivity and sensitivity, it could be considered important in the diagnosis and treatment of stuttering.