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Rombouts E, Borry P. The disabling nature of hope in discovering a biological explanation of stuttering. JOURNAL OF FLUENCY DISORDERS 2022; 72:105906. [PMID: 35421761 DOI: 10.1016/j.jfludis.2022.105906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/26/2022] [Accepted: 03/31/2022] [Indexed: 06/14/2023]
Abstract
Discovering developmental stuttering's biological explanation has been an enduring concern. Novel advances in genomics and neuroscience are making it possible to isolate and pinpoint genetic and brain differences implicated in stuttering. This is giving rise to a hope that, in the future, dysfluency could be better managed if stuttering's biological basis could be better understood. Concurrent to this, there is another hope rising: a hope of a future where differing fluencies would not be viewed through a reductive lens of biology and associated pathologies. The central aim of this paper is to edge out ethical implications of novel research into stuttering's biological explanation. In doing so, the paper proposes to look beyond the bifurcation sketched by the medical and social model of disability. The paper demonstrates how the scientific hope of discovering stuttering's biological explanation acts as an accessory of disablement due to the language of 'lack' and 'deficit' employed in reporting scientific findings and proposes participatory research with people who stutter as an antidote to manage this disablement.
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Affiliation(s)
- Ellen Rombouts
- Department of Neurosciences, Experimental Otorinolaryngology, KU Leuven, Belgium.
| | - Pascal Borry
- Centre for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Belgium.
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SheikhBahaei S, Farhan M, Maguire GA. Improvement of stuttering after administration of methylphenidate - a case report. PERSONALIZED MEDICINE IN PSYCHIATRY 2022; 31-32. [PMID: 35237733 PMCID: PMC8881904 DOI: 10.1016/j.pmip.2022.100092] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Ekhart C, van Hunsel F, van Harten P, van Baarsen J, Yingying T, Bast B. Drug-Induced Stuttering: Occurrence and Possible Pathways. Front Psychiatry 2021; 12:692568. [PMID: 34512414 PMCID: PMC8423914 DOI: 10.3389/fpsyt.2021.692568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Stuttering is a well-known condition that affects mainly children. Often, they recover as they get older. However, a drug-induced form of stuttering may occur at any age. The aim of the present study was to detect drugs that have been associated with stuttering and discuss the mechanisms involved. Method: A descriptive study based on reports submitted to the global pharmacovigilance database VigiBase of the WHO was conducted. Results: A total of 3,385 reports of dysphemia were retrieved from VigiBase. These reports were contributed by 51 countries. Antiepileptics, antidepressants, immunosuppressants, antipsychotics, and centrally acting sympathomimetics were among the most frequently implicated drugs. Conclusion: A wide variety of drugs has been linked to the occurrence or recurrence of stuttering. Several mechanisms, such as increased dopamine levels, reduction of GABA, anticholinergic properties of drugs, or changes in serotonin levels, have been associated with the development of drug-induced stuttering. Paradoxically, agents known to reduce stuttering in some people may induce it in others.
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Affiliation(s)
- Corine Ekhart
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | | | - Peter van Harten
- Research Department, Psychiatric Centre GGz Centraal, Innova, Amersfoort, Netherlands.,Department of Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | | | - Tan Yingying
- Linguistic Institute, Shanghai International Studies University, Shanghai, China
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Trenque T, Morel A, Trenque A, Azzouz B. Drug induced stuttering: pharmacovigilance data. Expert Opin Drug Saf 2020; 20:373-378. [PMID: 33337944 DOI: 10.1080/14740338.2021.1867101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Stuttering is a speech disorder characterized by poor fluency of speech despite the speech production organs being normal. Numerous factors contribute to stuttering, and it may also be an iatrogenic effect of certain drugs. The aim of this study was to investigate the association between stuttering and drug exposure.Research design and methods: We investigated the association between drugs and stuttering. We analyzed reports in the World Health Organization global individual case safety reports database (Vigibase) up to 31 May 2020 with the MedDRA lower level terms 'stutter' and 'stuttering.' The association between a drug and the occurrence of the adverse drug reaction was estimated by disproportionality analysis. Reporting odds ratios (ROR) were calculated with 95% confidence intervals.Results: In total, 724 notifications were identified using the MedDRA terms selected. The main drugs implicated were methylphenidate (ROR = 19.58; 95% CI: 13.3-28.8), topiramate (ROR = 12.5; 95% CI: 7.1-22.1), olanzapine (ROR = 12; 95% CI: 8-17.9) and golimumab (ROR = 10.2; 95% CI: 5.5-19.1).Conclusions: When stuttering occurs in a patient treated by drugs affecting neurotransmission, a drug-induced origin of the stutter should be considered.
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Affiliation(s)
- Thierry Trenque
- Reims University Hospitals, Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Reims, France.,Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
| | - Aurore Morel
- Reims University Hospitals, Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Reims, France
| | - Agathe Trenque
- Reims University Hospitals, Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Reims, France
| | - Brahim Azzouz
- Reims University Hospitals, Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Reims, France.,Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
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Trenque T, Claustre G, Herlem E, Djerada Z, Trenque A, Morel A, Azzouz B. Methylphenidate and stuttering. Br J Clin Pharmacol 2019; 85:2634-2637. [PMID: 31418914 DOI: 10.1111/bcp.14097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/05/2019] [Accepted: 08/04/2019] [Indexed: 12/29/2022] Open
Affiliation(s)
- Thierry Trenque
- Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Reims University Hospitals, Reims, France.,Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
| | - Gwladys Claustre
- Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Reims University Hospitals, Reims, France
| | - Emmanuelle Herlem
- Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Reims University Hospitals, Reims, France
| | - Zoubir Djerada
- Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Reims University Hospitals, Reims, France
| | - Agathe Trenque
- Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Reims University Hospitals, Reims, France
| | - Aurore Morel
- Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Reims University Hospitals, Reims, France
| | - Brahim Azzouz
- Regional Centre for Pharmacovigilance and Pharmacoepidemiology, Reims University Hospitals, Reims, France.,Faculty of Medicine, University of Reims Champagne-Ardenne, Reims, France
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Sowman PF, Ryan M, Johnson BW, Savage G, Crain S, Harrison E, Martin E, Burianová H. Grey matter volume differences in the left caudate nucleus of people who stutter. BRAIN AND LANGUAGE 2017; 164:9-15. [PMID: 27693846 DOI: 10.1016/j.bandl.2016.08.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 08/22/2016] [Accepted: 08/28/2016] [Indexed: 06/06/2023]
Abstract
The cause of stuttering has many theoretical explanations. A number of research groups have suggested changes in the volume and/or function of the striatum as a causal agent. Two recent studies in children and one in adults who stutter (AWS) report differences in striatal volume compared that seen in controls; however, the laterality and nature of this anatomical volume difference is not consistent across studies. The current study investigated whether a reduction in striatal grey matter volume, comparable to that seen in children who stutter (CWS), would be found in AWS. Such a finding would support claims that an anatomical striatal anomaly plays a causal role in stuttering. We used voxel-based morphometry to examine the structure of the striatum in a group of AWS and compared it to that in a group of matched adult control subjects. Results showed a statistically significant group difference for the left caudate nucleus, with smaller mean volume in the group of AWS. The caudate nucleus, one of three main structures within the striatum, is thought to be critical for the planning and modulation of movement sequencing. The difference in striatal volume found here aligns with theoretical accounts of stuttering, which suggest it is a motor control disorder that arises from deficient articulatory movement selection and sequencing. Whilst the current study provides further evidence of a striatal volume difference in stuttering at the group level compared to controls, the significant overlap between AWS and controls suggests this difference is unlikely to be diagnostic of stuttering.
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Affiliation(s)
- Paul F Sowman
- Department of Cognitive Science, Macquarie University, New South Wales 2109, Australia; Australian Research Council Centre of Excellence in Cognition and Its Disorders, Australia; Perception and Action Research Centre, Faculty of Human Sciences, Macquarie University, New South Wales 2109, Australia.
| | - Margaret Ryan
- Department of Cognitive Science, Macquarie University, New South Wales 2109, Australia; Australian Research Council Centre of Excellence in Cognition and Its Disorders, Australia
| | - Blake W Johnson
- Department of Cognitive Science, Macquarie University, New South Wales 2109, Australia; Australian Research Council Centre of Excellence in Cognition and Its Disorders, Australia
| | - Greg Savage
- Australian Research Council Centre of Excellence in Cognition and Its Disorders, Australia; Department of Psychology, Macquarie University, New South Wales 2109, Australia
| | - Stephen Crain
- Australian Research Council Centre of Excellence in Cognition and Its Disorders, Australia; Department of Linguistics, Macquarie University, New South Wales 2109, Australia
| | - Elisabeth Harrison
- Department of Linguistics, Macquarie University, New South Wales 2109, Australia
| | - Erin Martin
- Department of Cognitive Science, Macquarie University, New South Wales 2109, Australia
| | - Hana Burianová
- Centre for Advanced Imaging, The University of Queensland, Queensland 4072, Australia
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Abstract
As the first drug to see widespread use for the treatment of attention deficit hyperactivity disorder (ADHD), methylphenidate was the forerunner and catalyst to the modern era of rapidly increasing diagnosis, treatment, and medication development for this condition. During its often controversial history, it has variously elucidated the importance of dopamine signaling in memory and attention, provoked concerns about pharmaceutical cognitive enhancement, driven innovation in controlled-release technologies and enantiospecific therapeutics, and stimulated debate about the impact of pharmaceutical sales techniques on the practice of medicine. In this Review, we will illustrate the history and importance of methylphenidate to ADHD treatment and neuroscience in general, as well as provide key information about its synthesis, structure-activity relationship, pharmacological activity, metabolism, manufacturing, FDA-approved indications, and adverse effects.
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Affiliation(s)
- Cody J. Wenthur
- Department of Chemistry, The Scripps Research Institute, La Jolla, California 92037, United States
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