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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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Pasculli G, Busan P, Jackson ES, Alm PA, De Gregorio D, Maguire GA, Goodwin GM, Gobbi G, Erritzoe D, Carhart-Harris RL. Psychedelics in developmental stuttering to modulate brain functioning: a new therapeutic perspective? Front Hum Neurosci 2024; 18:1402549. [PMID: 38962146 PMCID: PMC11221540 DOI: 10.3389/fnhum.2024.1402549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 05/27/2024] [Indexed: 07/05/2024] Open
Abstract
Developmental stuttering (DS) is a neurodevelopmental speech-motor disorder characterized by symptoms such as blocks, repetitions, and prolongations. Persistent DS often has a significant negative impact on quality of life, and interventions for it have limited efficacy. Herein, we briefly review existing research on the neurophysiological underpinnings of DS -specifically, brain metabolic and default mode/social-cognitive networks (DMN/SCN) anomalies- arguing that psychedelic compounds might be considered and investigated (e.g., in randomized clinical trials) for treatment of DS. The neural background of DS is likely to be heterogeneous, and some contribution from genetically determinants of metabolic deficiencies in the basal ganglia and speech-motor cortical regions are thought to play a role in appearance of DS symptoms, which possibly results in a cascade of events contributing to impairments in speech-motor execution. In persistent DS, the difficulties of speech are often linked to a series of associated aspects such as social anxiety and social avoidance. In this context, the SCN and DMN (also influencing a series of fronto-parietal, somato-motor, and attentional networks) may have a role in worsening dysfluencies. Interestingly, brain metabolism and SCN/DMN connectivity can be modified by psychedelics, which have been shown to improve clinical evidence of some psychiatric conditions (e.g., depression, post-traumatic stress disorder, etc.) associated with psychological constructs such as rumination and social anxiety, which also tend to be present in persistent DS. To date, while there have been no controlled trials on the effects of psychedelics in DS, anecdotal evidence suggests that these agents may have beneficial effects on stuttering and its associated characteristics. We suggest that psychedelics warrant investigation in DS.
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Affiliation(s)
- Giuseppe Pasculli
- Department of Computer, Control, and Management Engineering (DIAG), La Sapienza University, Rome, Italy
- Italian Society of Psychedelic Medicine (Società Italiana di Medicina Psichedelica–SIMePsi), Bari, Italy
| | | | - Eric S. Jackson
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
| | - Per A. Alm
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Danilo De Gregorio
- IRCCS, San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Gerald A. Maguire
- School of Medicine, American University of Health Sciences, Signal Hill, CA, United States
- CenExel CIT Research, Riverside, CA, United States
| | - Guy M. Goodwin
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - David Erritzoe
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Robin L. Carhart-Harris
- Department of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
- Psychedelics Division, Neuroscape, University of California, San Francisco, CA, United States
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Theys C, Jaakkola E, Melzer TR, De Nil LF, Guenther FH, Cohen AL, Fox MD, Joutsa J. Localization of stuttering based on causal brain lesions. Brain 2024; 147:2203-2213. [PMID: 38797521 PMCID: PMC11146419 DOI: 10.1093/brain/awae059] [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: 09/10/2023] [Revised: 01/23/2024] [Accepted: 02/06/2024] [Indexed: 05/29/2024] Open
Abstract
Stuttering affects approximately 1 in 100 adults and can result in significant communication problems and social anxiety. It most often occurs as a developmental disorder but can also be caused by focal brain damage. These latter cases may lend unique insight into the brain regions causing stuttering. Here, we investigated the neuroanatomical substrate of stuttering using three independent datasets: (i) case reports from the published literature of acquired neurogenic stuttering following stroke (n = 20, 14 males/six females, 16-77 years); (ii) a clinical single study cohort with acquired neurogenic stuttering following stroke (n = 20, 13 males/seven females, 45-87 years); and (iii) adults with persistent developmental stuttering (n = 20, 14 males/six females, 18-43 years). We used the first two datasets and lesion network mapping to test whether lesions causing acquired stuttering map to a common brain network. We then used the third dataset to test whether this lesion-based network was relevant to developmental stuttering. In our literature dataset, we found that lesions causing stuttering occurred in multiple heterogeneous brain regions, but these lesion locations were all functionally connected to a common network centred around the left putamen, including the claustrum, amygdalostriatal transition area and other adjacent areas. This finding was shown to be specific for stuttering (PFWE < 0.05) and reproducible in our independent clinical cohort of patients with stroke-induced stuttering (PFWE < 0.05), resulting in a common acquired stuttering network across both stroke datasets. Within the common acquired stuttering network, we found a significant association between grey matter volume and stuttering impact for adults with persistent developmental stuttering in the left posteroventral putamen, extending into the adjacent claustrum and amygdalostriatal transition area (PFWE < 0.05). We conclude that lesions causing acquired neurogenic stuttering map to a common brain network, centred to the left putamen, claustrum and amygdalostriatal transition area. The association of this lesion-based network with symptom severity in developmental stuttering suggests a shared neuroanatomy across aetiologies.
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Affiliation(s)
- Catherine Theys
- School of Psychology, Speech and Hearing, University of Canterbury, 8140 Christchurch, New Zealand
- New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, 8140 Christchurch, New Zealand
- New Zealand Brain Research Institute, 8011 Christchurch, New Zealand
| | - Elina Jaakkola
- Turku Brain and Mind Center, Clinical Neurosciences, University of Turku, 20014 Turku, Finland
- Department of Psychiatry, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland
| | - Tracy R Melzer
- School of Psychology, Speech and Hearing, University of Canterbury, 8140 Christchurch, New Zealand
- New Zealand Brain Research Institute, 8011 Christchurch, New Zealand
- Department of Medicine, University of Otago, 8011 Christchurch, New Zealand
- RHCNZ—Pacific Radiology Canterbury, 8031 Christchurch, New Zealand
| | - Luc F De Nil
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON M5G 1V7, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Frank H Guenther
- Departments of Speech, Language and Hearing Sciences and Biomedical Engineering, Boston University, Boston, MA 02215, USA
- The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Alexander L Cohen
- Department of Neurology, Boston Children’s Hospital, Boston, MA 02115, USA
- Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Michael D Fox
- Center for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston, MA 02115, USA
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Juho Joutsa
- Turku Brain and Mind Center, Clinical Neurosciences, University of Turku, 20014 Turku, Finland
- Turku PET Centre, Neurocenter, Turku University Hospital, 20014 Turku, Finland
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Lazzari G, van de Vorst R, van Vugt FT, Lega C. Subtle Patterns of Altered Responsiveness to Delayed Auditory Feedback during Finger Tapping in People Who Stutter. Brain Sci 2024; 14:472. [PMID: 38790451 PMCID: PMC11120293 DOI: 10.3390/brainsci14050472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024] Open
Abstract
Differences in sensorimotor integration mechanisms have been observed between people who stutter (PWS) and controls who do not. Delayed auditory feedback (DAF) introduces timing discrepancies between perception and action, disrupting sequence production in verbal and non-verbal domains. While DAF consistently enhances speech fluency in PWS, its impact on non-verbal sensorimotor synchronization abilities remains unexplored. A total of 11 PWS and 13 matched controls completed five tasks: (1) unpaced tapping; (2) synchronization-continuation task (SCT) without auditory feedback; (3) SCT with DAF, with instruction either to align the sound in time with the metronome; or (4) to ignore the sound and align their physical tap to the metronome. Additionally, we measured participants' sensitivity to detecting delayed feedback using a (5) delay discrimination task. Results showed that DAF significantly affected performance in controls as a function of delay duration, despite being irrelevant to the task. Conversely, PWS performance remained stable across delays. When auditory feedback was absent, no differences were found between PWS and controls. Moreover, PWS were less able to detect delays in speech and tapping tasks. These findings show subtle differences in non-verbal sensorimotor performance between PWS and controls, specifically when action-perception loops are disrupted by delays, contributing to models of sensorimotor integration in stuttering.
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Affiliation(s)
- Giorgio Lazzari
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
| | - Robert van de Vorst
- Centre for Research on Brain, Language and Music (CRBLM), Montreal, QC H3A 1G1, Canada; (R.v.d.V.); (F.T.v.V.)
- School of Communication Sciences and Disorders, McGill University, Montreal, QC H3G 1Y6, Canada
| | - Floris T. van Vugt
- Centre for Research on Brain, Language and Music (CRBLM), Montreal, QC H3A 1G1, Canada; (R.v.d.V.); (F.T.v.V.)
- Psychology Department, University of Montreal, Montreal, QC H3T 1J4, Canada
- International Laboratory for Brain, Music and Sound Research (BRAMS), Montreal, QC H3T 1J4, Canada
| | - Carlotta Lega
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy;
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Bayat M, Boostani R, Sabeti M, Yadegari F, Pirmoradi M, Rao KS, Nami M. Source Localization and Spectrum Analyzing of EEG in Stuttering State upon Dysfluent Utterances. Clin EEG Neurosci 2024; 55:371-383. [PMID: 36627837 DOI: 10.1177/15500594221150638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Purpose: The present study which addressed adults who stutter (AWS) attempted to investigate power spectral dynamics in the stuttering state by answering the questions using quantitative electroencephalography (qEEG). Method: A 64-channel electroencephalography (EEG) setup was used for data acquisition at 20 AWS. Since the speech, especially stuttering, causes significant noise in the EEG, 2 conditions of speech preparation (SP) and imagined speech (IS) were considered. EEG signals were decomposed into 6 bands. The corresponding sources were localized using the standard low-resolution electromagnetic tomography (sLORETA) tool in both fluent and dysfluent states. Results: Significant differences were noted after analyzing the time-locked EEG signals in fluent and dysfluent utterances. Consistent with previous studies, poor alpha and beta suppression in SP and IS conditions were localized in the left frontotemporal areas in a dysfluent state. This was partly true for the right frontal regions. In the theta range, disfluency was concurrence with increased activation in the left and right motor areas. Increased delta power in the left and right motor areas as well as increased beta2 power over left parietal regions was notable EEG features upon fluent speech. Conclusion: Based on the present findings and those of earlier studies, explaining the neural circuitries involved in stuttering probably requires an examination of the entire frequency spectrum involved in speech.
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Affiliation(s)
- Masoumeh Bayat
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Boostani
- Department of Computer Sciences and Engineering, School of Engineering, Shiraz University, Shiraz, Iran
| | - Malihe Sabeti
- Department of Computer Engineering, Islamic Azad University, North Tehran Branch, Tehran, Iran
| | - Fariba Yadegari
- Department of Speech and Language Pathology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammadreza Pirmoradi
- Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - K S Rao
- Neuroscience Center, INDICASAT-AIP, Panama City, Republic of Panama
| | - Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Neuroscience Center, INDICASAT-AIP, Panama City, Republic of Panama
- Dana Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran
- Academy of Health, Senses Cultural Foundation, Sacramento, CA, USA
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Kapur N, Kemp S. Words Matter: "Functional Neurologic Disorder" or "Functional Symptom Disorder"? Neurol Clin Pract 2024; 14:e200238. [PMID: 38250138 PMCID: PMC10795004 DOI: 10.1212/cpj.0000000000200238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/20/2023] [Indexed: 01/23/2024]
Affiliation(s)
- Narinder Kapur
- University College London (NK); Leeds Beckett University (SK)
| | - Steven Kemp
- University College London (NK); Leeds Beckett University (SK)
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Schwartze M, Kotz SA. Timing Patterns in the Extended Basal Ganglia System. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1455:275-282. [PMID: 38918357 DOI: 10.1007/978-3-031-60183-5_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
The human brain is a constructive organ. It generates predictions to modulate its functioning and continuously adapts to a dynamic environment. Increasingly, the temporal dimension of motor and non-motor behaviour is recognised as a key component of this predictive bias. Nevertheless, the intricate interplay of the neural mechanisms that encode, decode and evaluate temporal information to give rise to a sense of time and control over sensorimotor timing remains largely elusive. Among several brain systems, the basal ganglia have been consistently linked to interval- and beat-based timing operations. Considering the tight embedding of the basal ganglia into multiple complex neurofunctional networks, it is clear that they have to interact with other proximate and distal brain systems. While the primary target of basal ganglia output is the thalamus, many regions connect to the striatum of the basal ganglia, their main input relay. This establishes widespread connectivity, forming the basis for first- and second-order interactions with other systems implicated in timing such as the cerebellum and supplementary motor areas. However, next to this structural interconnectivity, additional functions need to be considered to better understand their contribution to temporally predictive adaptation. To this end, we develop the concept of interval-based patterning, conceived as a temporally explicit hierarchical sequencing operation that underlies motor and non-motor behaviour as a common interpretation of basal ganglia function.
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Affiliation(s)
- Michael Schwartze
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Sonja A Kotz
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.
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Busan P, Moret B, Formaggio E, Riavis L, Pisciotta C, Masina F, Manganotti P, Campana G. High definition-transcranial random noise stimulation to improve speech fluency in persistent developmental stuttering: A case study. Clin Neurophysiol 2023; 152:71-74. [PMID: 37343446 DOI: 10.1016/j.clinph.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/24/2023] [Accepted: 06/01/2023] [Indexed: 06/23/2023]
Affiliation(s)
| | - Beatrice Moret
- IRCCS Ospedale San Camillo, Venice, Italy; Department of General Psychology, University of Padua, Padua, Italy
| | - Emanuela Formaggio
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Padua, Italy
| | | | | | | | - Paolo Manganotti
- Department of Medicine, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Gianluca Campana
- Department of General Psychology, University of Padua, Padua, Italy
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Frankford SA, Cai S, Nieto-Castañón A, Guenther FH. Auditory feedback control in adults who stutter during metronome-paced speech I. Timing Perturbation. JOURNAL OF FLUENCY DISORDERS 2023; 75:105943. [PMID: 36423506 PMCID: PMC9974758 DOI: 10.1016/j.jfludis.2022.105943] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 10/26/2022] [Accepted: 11/14/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE This study determined whether adults who stutter (AWS) exhibit deficits in responding to an auditory feedback timing perturbation, and whether external timing cues, which increase fluency, attenuate any disruptions due to altered temporal auditory feedback. METHODS Fifteen AWS and sixteen adults who do not stutter (ANS) read aloud a multisyllabic sentence either with normal pacing or with each syllable paced at the rate of a metronome. On random trials, an auditory feedback timing perturbation was applied, and timing responses were compared between groups and pacing conditions. RESULTS Both groups responded to the timing perturbation by delaying subsequent syllable boundaries, and there were no significant differences between groups in either pacing condition. Furthermore, no response differences were found between normally paced and metronome-paced conditions. CONCLUSION These findings are interpreted as showing that 1) AWS respond normally to pure timing perturbations, and 2) metronome-paced speech has no effect on online speech timing control as assessed in the present experiment.
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Affiliation(s)
- Saul A Frankford
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Shanqing Cai
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Alfonso Nieto-Castañón
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, 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.
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Furlanis G, Busan P, Formaggio E, Menichelli A, Lunardelli A, Ajcevic M, Pesavento V, Manganotti P. Stuttering-Like Dysfluencies as a Consequence of Long COVID-19. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:415-430. [PMID: 36749838 DOI: 10.1044/2022_jslhr-22-00381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE We present two patients who developed neurogenic stuttering after long COVID-19 related to SARS-CoV-2 infection. METHODS AND RESULTS Both patients experienced both physical (e.g., fatigue) and cognitive difficulties, which led to impaired function of attention, lexical retrieval, and memory consolidation. Both patients had new-onset stuttering-like speech dysfluencies: Blocks and repetitions were especially evident at the initial part of words and sentences, sometimes accompanied by effortful and associated movements (e.g., facial grimaces and oro-facial movements). Neuropsychological evaluations confirmed the presence of difficulties in cognitive tasks, while neurophysiological evaluations (i.e., electroencephalography) suggested the presence of "slowed" patterns of brain activity. Neurogenic stuttering and cognitive difficulties were evident for 4-5 months after negativization of SARS-CoV-2 nasopharyngeal swab, with gradual improvement and near-to-complete recovery. CONCLUSIONS It is now evident that SARS-CoV-2 infection may significantly involve the central nervous system, also resulting in severe and long-term consequences, even if the precise mechanisms are still unknown. In the present report, long COVID-19 resulted in neurogenic stuttering, as the likely consequence of a "slowed" metabolism of (pre)frontal and sensorimotor brain regions (as suggested by the present and previous clinical evidence). As a consequence, the pathophysiological mechanisms related to the appearance of neurogenic stuttering have been hypothesized, which help to better understand the broader and possible neurological consequences of COVID-19.
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Affiliation(s)
- Giovanni Furlanis
- Clinical Unit of Neurology, University Hospital and Health Services of Trieste, ASUGI, Italy
- Department of Medicine, Surgical and Health Sciences, University of Trieste, Italy
| | | | - Emanuela Formaggio
- Department of Neuroscience, Section of Rehabilitation, University of Padua, Italy
| | - Alina Menichelli
- Neuropsychological Service, Clinical Unit of Rehabilitation, University Hospital and Health Services of Trieste, ASUGI, Italy
| | - Alberta Lunardelli
- Neuropsychological Service, Clinical Unit of Rehabilitation, University Hospital and Health Services of Trieste, ASUGI, Italy
| | - Milos Ajcevic
- Department of Engineering and Architecture, University of Trieste, Italy
| | - Valentina Pesavento
- Neuropsychological Service, Clinical Unit of Rehabilitation, University Hospital and Health Services of Trieste, ASUGI, Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, University Hospital and Health Services of Trieste, ASUGI, Italy
- Department of Medicine, Surgical and Health Sciences, University of Trieste, Italy
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Rhythmic tapping difficulties in adults who stutter: A deficit in beat perception, motor execution, or sensorimotor integration? PLoS One 2023; 18:e0276691. [PMID: 36735662 PMCID: PMC9897587 DOI: 10.1371/journal.pone.0276691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 10/11/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES The study aims to better understand the rhythmic abilities of people who stutter and to identify which processes potentially are impaired in this population: (1) beat perception and reproduction; (2) the execution of movements, in particular their initiation; (3) sensorimotor integration. MATERIAL AND METHOD Finger tapping behavior of 16 adults who stutter (PWS) was compared with that of 16 matching controls (PNS) in five rhythmic tasks of various complexity: three synchronization tasks - a simple 1:1 isochronous pattern, a complex non-isochronous pattern, and a 4 tap:1 beat isochronous pattern -, a reaction task to an aperiodic and unpredictable pattern, and a reproduction task of an isochronous pattern after passively listening. RESULTS PWS were able to reproduce an isochronous pattern on their own, without external auditory stimuli, with similar accuracy as PNS, but with increased variability. This group difference in variability was observed immediately after passive listening, without prior motor engagement, and was not enhanced or reduced after several seconds of tapping. Although PWS showed increased tapping variability in the reproduction task as well as in synchronization tasks, this timing variability did not correlate significantly with the variability in reaction times or tapping force. Compared to PNS, PWS exhibited larger negative mean asynchronies, and increased synchronization variability in synchronization tasks. These group differences were not affected by beat hierarchy (i.e., "strong" vs. "weak" beats), pattern complexity (non-isochronous vs. isochronous) or presence versus absence of external auditory stimulus (1:1 vs. 1:4 isochronous pattern). Differences between PWS and PNS were not enhanced or reduced with sensorimotor learning, over the first taps of a synchronization task. CONCLUSION Our observations support the hypothesis of a deficit in neuronal oscillators coupling in production, but not in perception, of rhythmic patterns, and a larger delay in multi-modal feedback processing for PWS.
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Garnett EO, McAuley JD, Wieland EA, Chow HM, Zhu DC, Dilley LC, Chang SE. Auditory rhythm discrimination in adults who stutter: An fMRI study. BRAIN AND LANGUAGE 2023; 236:105219. [PMID: 36577315 DOI: 10.1016/j.bandl.2022.105219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 11/09/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Rhythm perception deficits have been linked to neurodevelopmental disorders affecting speech and language. Children who stutter have shown poorer rhythm discrimination and attenuated functional connectivity in rhythm-related brain areas, which may negatively impact timing control required for speech. It is unclear whether adults who stutter (AWS), who are likely to have acquired compensatory adaptations in response to rhythm processing/timing deficits, are similarly affected. We compared rhythm discrimination in AWS and controls (total n = 36) during fMRI in two matched conditions: simple rhythms that consistently reinforced a periodic beat, and complex rhythms that did not (requiring greater reliance on internal timing). Consistent with an internal beat deficit hypothesis, behavioral results showed poorer complex rhythm discrimination for AWS than controls. In AWS, greater stuttering severity was associated with poorer rhythm discrimination. AWS showed increased activity within beat-based timing regions and increased functional connectivity between putamen and cerebellum (supporting interval-based timing) for simple rhythms.
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Affiliation(s)
- Emily O Garnett
- University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA.
| | - J Devin McAuley
- Michigan State University, 619 Red Cedar Rd, East Lansing, MI 48864, USA
| | | | - Ho Ming Chow
- University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA; University of Delaware, Tower at STAR, 100 Discovery Blvd, Newark, DE 19713, USA
| | - David C Zhu
- Michigan State University, Radiology Building, 846 Service Road, East Lansing, MI 48824, USA
| | - Laura C Dilley
- Michigan State University, 619 Red Cedar Rd, East Lansing, MI 48864, USA
| | - Soo-Eun Chang
- University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA
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Frankford SA, Cai S, Nieto-Castañón A, Guenther FH. Auditory feedback control in adults who stutter during metronome-paced speech II. Formant Perturbation. JOURNAL OF FLUENCY DISORDERS 2022; 74:105928. [PMID: 36063640 PMCID: PMC9930613 DOI: 10.1016/j.jfludis.2022.105928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 07/11/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE Prior work has shown that Adults who stutter (AWS) have reduced and delayed responses to auditory feedback perturbations. This study aimed to determine whether external timing cues, which increase fluency, resolve auditory feedback processing disruptions. METHODS Fifteen AWS and sixteen adults who do not stutter (ANS) read aloud a multisyllabic sentence either with natural stress and timing or with each syllable paced at the rate of a metronome. On random trials, an auditory feedback formant perturbation was applied, and formant responses were compared between groups and pacing conditions. RESULTS During normally paced speech, ANS showed a significant compensatory response to the perturbation by the end of the perturbed vowel, while AWS did not. In the metronome-paced condition, which significantly reduced the disfluency rate, the opposite was true: AWS showed a significant response by the end of the vowel, while ANS did not. CONCLUSION These findings indicate a potential link between the reduction in stuttering found during metronome-paced speech and changes in auditory motor integration in AWS.
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Affiliation(s)
- Saul A Frankford
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Shanqing Cai
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, USA.
| | - Alfonso Nieto-Castañón
- Department of Speech, Language, & Hearing Sciences, Boston University, Boston, MA 02215, 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.
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14
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Garnett EO, Chow HM, Limb S, Liu Y, Chang SE. Neural activity during solo and choral reading: A functional magnetic resonance imaging study of overt continuous speech production in adults who stutter. Front Hum Neurosci 2022; 16:894676. [PMID: 35937674 PMCID: PMC9353050 DOI: 10.3389/fnhum.2022.894676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 06/27/2022] [Indexed: 01/22/2023] Open
Abstract
Previous neuroimaging investigations of overt speech production in adults who stutter (AWS) found increased motor and decreased auditory activity compared to controls. Activity in the auditory cortex is heightened, however, under fluency-inducing conditions in which AWS temporarily become fluent while synchronizing their speech with an external rhythm, such as a metronome or another speaker. These findings suggest that stuttering is associated with disrupted auditory motor integration. Technical challenges in acquiring neuroimaging data during continuous overt speech production have limited experimental paradigms to short or covert speech tasks. Such paradigms are not ideal, as stuttering primarily occurs during longer speaking tasks. To address this gap, we used a validated spatial ICA technique designed to address speech movement artifacts during functional magnetic resonance imaging (fMRI) scanning. We compared brain activity and functional connectivity of the left auditory cortex during continuous speech production in two conditions: solo (stutter-prone) and choral (fluency-inducing) reading tasks. Overall, brain activity differences in AWS relative to controls in the two conditions were similar, showing expected patterns of hyperactivity in premotor/motor regions but underactivity in auditory regions. Functional connectivity of the left auditory cortex (STG) showed that within the AWS group there was increased correlated activity with the right insula and inferior frontal area during choral speech. The AWS also exhibited heightened connectivity between left STG and key regions of the default mode network (DMN) during solo speech. These findings indicate possible interference by the DMN during natural, stuttering-prone speech in AWS, and that enhanced coordination between auditory and motor regions may support fluent speech.
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Affiliation(s)
- Emily O. Garnett
- Michigan Medicine, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- *Correspondence: Emily O. Garnett,
| | - Ho Ming Chow
- Michigan Medicine, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
- Department of Communication Sciences and Disorders, University of Delaware, Newark, DE, United States
| | - Sarah Limb
- Michigan Medicine, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Yanni Liu
- Michigan Medicine, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Soo-Eun Chang
- Michigan Medicine, Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
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15
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Assaneo MF, Ripollés P, Tichenor SE, Yaruss JS, Jackson ES. The Relationship Between Auditory-Motor Integration, Interoceptive Awareness, and Self-Reported Stuttering Severity. Front Integr Neurosci 2022; 16:869571. [PMID: 35600224 PMCID: PMC9120354 DOI: 10.3389/fnint.2022.869571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Stuttering is a neurodevelopmental speech disorder associated with motor timing that differs from non-stutterers. While neurodevelopmental disorders impacted by timing are associated with compromised auditory-motor integration and interoception, the interplay between those abilities and stuttering remains unexplored. Here, we studied the relationships between speech auditory-motor synchronization (a proxy for auditory-motor integration), interoceptive awareness, and self-reported stuttering severity using remotely delivered assessments. Results indicate that in general, stutterers and non-stutterers exhibit similar auditory-motor integration and interoceptive abilities. However, while speech auditory-motor synchrony (i.e., integration) and interoceptive awareness were not related, speech synchrony was inversely related to the speaker’s perception of stuttering severity as perceived by others, and interoceptive awareness was inversely related to self-reported stuttering impact. These findings support claims that stuttering is a heterogeneous, multi-faceted disorder such that uncorrelated auditory-motor integration and interoception measurements predicted different aspects of stuttering, suggesting two unrelated sources of timing differences associated with the disorder.
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Affiliation(s)
- M. Florencia Assaneo
- Institute of Neurobiology, National Autonomous University of Mexico, Querétaro, Mexico
- *Correspondence: M. Florencia Assaneo Eric S. Jackson
| | - Pablo Ripollés
- Department of Psychology, New York University, New York, NY, United States
- Music and Audio Research Lab, New York University, New York, NY, United States
- Center for Music, Language and Emotion, New York University, New York, NY, United States
| | - Seth E. Tichenor
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA, United States
| | - J. Scott Yaruss
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, United States
| | - Eric S. Jackson
- Department of Communicative Sciences and Disorders, New York University, New York, NY, United States
- *Correspondence: M. Florencia Assaneo Eric S. Jackson
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16
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Gracco VL, Sares AG, Koirala N. Structural brain network topological alterations in stuttering adults. Brain Commun 2022; 4:fcac058. [PMID: 35368614 PMCID: PMC8971894 DOI: 10.1093/braincomms/fcac058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/06/2022] [Accepted: 03/08/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Persistent developmental stuttering is a speech disorder that primarily affects normal speech fluency but encompasses a complex set of symptoms ranging from reduced sensorimotor integration to socioemotional challenges. Here, we investigated the whole brain structural connectome and its topological alterations in adults who stutter. Diffusion weighted imaging data of 33 subjects (13 adults who stutter and 20 fluent speakers) was obtained along with a stuttering severity evaluation. The structural brain network properties were analyzed using Network-based statistics and graph theoretical measures particularly focusing on community structure, network hubs and controllability. Bayesian power estimation was used to assess the reliability of the structural connectivity differences by examining the effect size. The analysis revealed reliable and wide-spread decreases in connectivity for adults who stutter in regions associated with sensorimotor, cognitive, emotional, and memory-related functions. The community detection algorithms revealed different subnetworks for fluent speakers and adults who stutter, indicating considerable network adaptation in adults who stutter. Average and modal controllability differed between groups in a subnetwork encompassing frontal brain regions and parts of the basal ganglia.
The results revealed extensive structural network alterations and substantial adaptation in neural architecture in adults who stutter well beyond the sensorimotor network. These findings highlight the impact of the neurodevelopmental effects of persistent stuttering on neural organization and the importance of examining the full structural connectome and the network alterations that underscore the behavioral phenotype.
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Affiliation(s)
- Vincent L. Gracco
- Haskins Laboratories, New Haven, CT, USA
- School of Communication Sciences & Disorders, McGill University, Montreal, Canada
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17
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Alm PA. The Dopamine System and Automatization of Movement Sequences: A Review With Relevance for Speech and Stuttering. Front Hum Neurosci 2021; 15:661880. [PMID: 34924974 PMCID: PMC8675130 DOI: 10.3389/fnhum.2021.661880] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 10/12/2021] [Indexed: 12/28/2022] Open
Abstract
The last decades of research have gradually elucidated the complex functions of the dopamine system in the vertebrate brain. The multiple roles of dopamine in motor function, learning, attention, motivation, and the emotions have been difficult to reconcile. A broad and detailed understanding of the physiology of cerebral dopamine is of importance in understanding a range of human disorders. One of the core functions of dopamine involves the basal ganglia and the learning and execution of automatized sequences of movements. Speech is one of the most complex and highly automatized sequential motor behaviors, though the exact roles that the basal ganglia and dopamine play in speech have been difficult to determine. Stuttering is a speech disorder that has been hypothesized to be related to the functions of the basal ganglia and dopamine. The aim of this review was to provide an overview of the current understanding of the cerebral dopamine system, in particular the mechanisms related to motor learning and the execution of movement sequences. The primary aim was not to review research on speech and stuttering, but to provide a platform of neurophysiological mechanisms, which may be utilized for further research and theoretical development on speech, speech disorders, and other behavioral disorders. Stuttering and speech are discussed here only briefly. The review indicates that a primary mechanism for the automatization of movement sequences is the merging of isolated movements into chunks that can be executed as units. In turn, chunks can be utilized hierarchically, as building blocks of longer chunks. It is likely that these mechanisms apply also to speech, so that frequent syllables and words are produced as motor chunks. It is further indicated that the main learning principle for sequence learning is reinforcement learning, with the phasic release of dopamine as the primary teaching signal indicating successful sequences. It is proposed that the dynamics of the dopamine system constitute the main neural basis underlying the situational variability of stuttering.
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Affiliation(s)
- Per A Alm
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
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18
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Toyomura A, Fujii T, Sowman PF. Performance of Bimanual Finger Coordination Tasks in Speakers Who Stutter. Front Psychol 2021; 12:679607. [PMID: 34630201 PMCID: PMC8495154 DOI: 10.3389/fpsyg.2021.679607] [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: 03/12/2021] [Accepted: 08/12/2021] [Indexed: 11/13/2022] Open
Abstract
Stuttering is a neurodevelopmental speech disorder characterized by the symptoms of speech repetition, prolongation, and blocking. Stuttering-related dysfluency can be transiently alleviated by providing an external timing signal such as a metronome or the voice of another person. Therefore, the existence of a core motor timing deficit in stuttering has been speculated. If this is the case, then motoric behaviors other than speech should be disrupted in stuttering. This study examined motoric performance on four complex bimanual tasks in 37 adults who stutter and 31 fluent controls. Two tasks utilized bimanual rotation to examine motor dexterity, and two tasks used the bimanual mirror and parallel tapping movements to examine timing control ability. Video-based analyses were conducted to determine performance accuracy and speed. The results showed that individuals who stutter performed worse than fluent speakers on tapping tasks but not on bimanual rotation tasks. These results suggest stuttering is associated with timing control for general motor behavior.
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Affiliation(s)
- Akira Toyomura
- Graduate School of Health Sciences, Gunma University, Maebashi, Japan.,Research Center for Advanced Technologies, Tokyo Denki University, Inzai, Japan
| | | | - Paul F Sowman
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
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19
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Busan P, Moret B, Masina F, Del Ben G, Campana G. Speech Fluency Improvement in Developmental Stuttering Using Non-invasive Brain Stimulation: Insights From Available Evidence. Front Hum Neurosci 2021; 15:662016. [PMID: 34456692 PMCID: PMC8386014 DOI: 10.3389/fnhum.2021.662016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 07/12/2021] [Indexed: 11/21/2022] Open
Abstract
Developmental stuttering (DS) is a disturbance of the normal rhythm of speech that may be interpreted as very debilitating in the most affected cases. Interventions for DS are historically based on the behavioral modifications of speech patterns (e.g., through speech therapy), which are useful to regain a better speech fluency. However, a great variability in intervention outcomes is normally observed, and no definitive evidence is currently available to resolve stuttering, especially in the case of its persistence in adulthood. In the last few decades, DS has been increasingly considered as a functional disturbance, affecting the correct programming of complex motor sequences such as speech. Compatibly, understanding of the neurophysiological bases of DS has dramatically improved, thanks to neuroimaging, and techniques able to interact with neural tissue functioning [e.g., non-invasive brain stimulation (NIBS)]. In this context, the dysfunctional activity of the cortico-basal-thalamo-cortical networks, as well as the defective patterns of connectivity, seems to play a key role, especially in sensorimotor networks. As a consequence, a direct action on the functionality of "defective" or "impaired" brain circuits may help people who stutter to manage dysfluencies in a better way. This may also "potentiate" available interventions, thus favoring more stable outcomes of speech fluency. Attempts aiming at modulating (and improving) brain functioning of people who stutter, realized by using NIBS, are quickly increasing. Here, we will review these recent advancements being applied to the treatment of DS. Insights will be useful not only to assess whether the speech fluency of people who stutter may be ameliorated by acting directly on brain functioning but also will provide further suggestions about the complex and dynamic pathophysiology of DS, where causal effects and "adaptive''/''maladaptive" compensation mechanisms may be strongly overlapped. In conclusion, this review focuses future research toward more specific, targeted, and effective interventions for DS, based on neuromodulation of brain functioning.
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Affiliation(s)
| | | | | | - Giovanni Del Ben
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Gianluca Campana
- Department of General Psychology, University of Padua, Padua, Italy
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20
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Frankford SA, Heller Murray ES, Masapollo M, Cai S, Tourville JA, Nieto-Castañón A, Guenther FH. The Neural Circuitry Underlying the "Rhythm Effect" in Stuttering. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2325-2346. [PMID: 33887150 PMCID: PMC8740675 DOI: 10.1044/2021_jslhr-20-00328] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 12/23/2020] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
Purpose Stuttering is characterized by intermittent speech disfluencies, which are dramatically reduced when speakers synchronize their speech with a steady beat. The goal of this study was to characterize the neural underpinnings of this phenomenon using functional magnetic resonance imaging. Method Data were collected from 16 adults who stutter and 17 adults who do not stutter while they read sentences aloud either in a normal, self-paced fashion or paced by the beat of a series of isochronous tones ("rhythmic"). Task activation and task-based functional connectivity analyses were carried out to compare neural responses between speaking conditions and groups after controlling for speaking rate. Results Adults who stutter produced fewer disfluent trials in the rhythmic condition than in the normal condition. Adults who stutter did not have any significant changes in activation between the rhythmic condition and the normal condition, but when groups were collapsed, participants had greater activation in the rhythmic condition in regions associated with speech sequencing, sensory feedback control, and timing perception. Adults who stutter also demonstrated increased functional connectivity among cerebellar regions during rhythmic speech as compared to normal speech and decreased connectivity between the left inferior cerebellum and the left prefrontal cortex. Conclusions Modulation of connectivity in the cerebellum and prefrontal cortex during rhythmic speech suggests that this fluency-inducing technique activates a compensatory timing system in the cerebellum and potentially modulates top-down motor control and attentional systems. These findings corroborate previous work associating the cerebellum with fluency in adults who stutter and indicate that the cerebellum may be targeted to enhance future therapeutic interventions. Supplemental Material https://doi.org/10.23641/asha.14417681.
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Affiliation(s)
- Saul A. Frankford
- Department of Speech, Language & Hearing Sciences, Boston University, MA
| | | | - Matthew Masapollo
- Department of Speech, Language & Hearing Sciences, Boston University, MA
| | - Shanqing Cai
- Department of Speech, Language & Hearing Sciences, Boston University, MA
| | - Jason A. Tourville
- Department of Speech, Language & Hearing Sciences, Boston University, MA
| | | | - Frank H. Guenther
- Department of Speech, Language & Hearing Sciences, Boston University, MA
- Department of Biomedical Engineering, Boston University, MA
- Department of Radiology, Massachusetts General Hospital, Boston
- The Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge
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21
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Mollaei F, Mersov A, Woodbury M, Jobst C, Cheyne D, De Nil L. White matter microstructural differences underlying beta oscillations during speech in adults who stutter. BRAIN AND LANGUAGE 2021; 215:104921. [PMID: 33550120 DOI: 10.1016/j.bandl.2021.104921] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/14/2020] [Accepted: 01/18/2021] [Indexed: 06/12/2023]
Abstract
The basal ganglia-thalamocortical (BGTC) loop may underlie speech deficits in developmental stuttering. In this study, we investigated the relationship between abnormal cortical neural oscillations and structural integrity alterations in adults who stutter (AWS) using a novel magnetoencephalography (MEG) guided tractography approach. Beta oscillations were analyzed using sensorimotor speech MEG, and white matter pathways were examined using tract-based spatial statistics (TBSS) and probabilistic tractography in 11 AWS and 11 fluent speakers. TBSS analysis revealed overlap between cortical regions of increased beta suppression localized to the mouth motor area and a reduced fractional anisotropy (FA) in the AWS group. MEG-guided tractography showed reduced FA within the BGTC loop from left putamen to subject-specific MEG peak. This is the first study to provide evidence that structural abnormalities may be associated with functional deficits in stuttering and reflect a network deficit within the BGTC loop that includes areas of the left ventral premotor cortex and putamen.
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Affiliation(s)
- Fatemeh Mollaei
- Department of Speech-Language Pathology, University of Toronto, 500 University Street, Toronto, Ontario M5G 1V7, Canada; Program in Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada.
| | - Anna Mersov
- Department of Speech-Language Pathology, University of Toronto, 500 University Street, Toronto, Ontario M5G 1V7, Canada
| | - Merron Woodbury
- Program in Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada
| | - Cecilia Jobst
- Program in Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada
| | - Douglas Cheyne
- Department of Speech-Language Pathology, University of Toronto, 500 University Street, Toronto, Ontario M5G 1V7, Canada; Program in Neurosciences and Mental Health, The Hospital for Sick Children Research Institute, Toronto, Ontario M5G 0A4, Canada; Institute of Medical Sciences and Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5S 2J7, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario M5T 1W7, Canada
| | - Luc De Nil
- Department of Speech-Language Pathology, University of Toronto, 500 University Street, Toronto, Ontario M5G 1V7, Canada; Rehabilitation Sciences Institute, Toronto, Ontario M5G 1V7, Canada
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22
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Tendera A, Wells R, Belyk M, Varyvoda D, Boliek CA, Beal DS. Motor sequence learning in children with recovered and persistent developmental stuttering: preliminary findings. JOURNAL OF FLUENCY DISORDERS 2020; 66:105800. [PMID: 33207289 DOI: 10.1016/j.jfludis.2020.105800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 09/09/2020] [Accepted: 10/26/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE Previous studies have associated developmental stuttering with difficulty learning new motor skills. We investigated non-speech motor sequence learning in children with persistent developmental stuttering (CWS), children who have recovered from developmental stuttering (CRS) and typically developing controls (CON). METHODS Over the course of two days, participants completed the Multi-Finger Sequencing Task, consisting of repeated trials of a10-element sequence, interspersed with trials of random sequences of the same length. We evaluated motor sequence learning using accuracy and response synchrony, a timing measure for evaluation of sequencing timing. We examined error types as well as recognition and recall of the repeated sequences. RESULTS CWS demonstrated lower performance accuracy than CON and CRS on the first day of the finger tapping experiment but improved to the performance level of CON and CRS on the second day. Response synchrony showed no overall difference among CWS, CRS and CON. Learning scores of repeated sequences did not differ from learning scores of random sequences in CWS, CRS and CON. CON and CRS demonstrated an adaptive strategy to response errors, whereas CWS maintained a high percentage of corrected errors for both days. CONCLUSIONS Our study examined non-speech sequence learning across CWS, CRS and CON. Our preliminary findings support the idea that developmental stuttering is not associated with sequence learning per se but rather with general fine motor performance difficulties.
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Affiliation(s)
- A Tendera
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - R Wells
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - M Belyk
- Department of Speech, Hearing, and Phonetic Sciences, Faculty of Psychology and Language, University College London, UK
| | - D Varyvoda
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - C A Boliek
- Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada; Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - D S Beal
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Department of Communication Sciences and Disorders, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada; Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada; Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Canada; Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada; Institute for Stuttering Treatment and Research, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada.
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23
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Oschkinat M, Hoole P. Compensation to real-time temporal auditory feedback perturbation depends on syllable position. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2020; 148:1478. [PMID: 33003874 DOI: 10.1121/10.0001765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 07/29/2020] [Indexed: 06/11/2023]
Abstract
Auditory feedback perturbations involving spectral shifts indicated a crucial contribution of auditory feedback to planning and execution of speech. However, much less is known about the contribution of auditory feedback with respect to temporal properties of speech. The current study aimed at providing insight into the representation of temporal properties of speech and the relevance of auditory feedback for speech timing. Real-time auditory feedback perturbations were applied in the temporal domain, viz., stretching and compressing of consonant-consonant-vowel (CCV) durations in onset + nucleus vs vowel-consonant-consonant (VCC) durations in nucleus + coda. Since CCV forms a gesturally more cohesive and stable structure than VCC, greater articulatory adjustments to nucleus + coda (VCC) perturbation were expected. The results show that speakers compensate for focal temporal feedback alterations. Responses to VCC perturbation were greater than to CCV perturbation, suggesting less deformability of onsets when confronted with temporally perturbed auditory feedback. Further, responses to CCV perturbation rather reflected within-trial reactive compensation, whereas VCC compensation was more pronounced and indicative of adaptive behavior. Accordingly, planning and execution of temporal properties of speech are indeed guided by auditory feedback, but the precise nature of the reaction to perturbations is linked to the structural position in the syllable and the associated feedforward timing strategies.
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Affiliation(s)
- Miriam Oschkinat
- Institute of Phonetics and Speech Processing, Ludwig Maximilian University of Munich, Schellingstrasse 3, Munich, 80799, Germany
| | - Philip Hoole
- Institute of Phonetics and Speech Processing, Ludwig Maximilian University of Munich, Schellingstrasse 3, Munich, 80799, Germany
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24
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Verdurand M, Rossato S, Zmarich C. Coarticulatory Aspects of the Fluent Speech of French and Italian People Who Stutter Under Altered Auditory Feedback. Front Psychol 2020; 11:1745. [PMID: 32793069 PMCID: PMC7390966 DOI: 10.3389/fpsyg.2020.01745] [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: 11/30/2019] [Accepted: 06/24/2020] [Indexed: 12/03/2022] Open
Abstract
A number of studies have shown that phonetic peculiarities, especially at the coarticulation level, exist in the disfluent as well as in the perceptively fluent speech of people who stutter (PWS). However, results from fluent speech are very disparate and not easily interpretable. Are the coarticulatory features observed in fluent speech of PWS a manifestation of the disorder, or rather a compensation for the disorder itself? The purpose of the present study is to investigate the coarticulatory behavior in the fluent speech of PWS in the attempt to answer the question on its symptomatic or adaptive nature. In order to achieve this, we have studied the speech of 21 adult PWS (10 French and 11 Italian) compared to that of 20 fluent adults (10 French and 10 Italian). The participants had to repeat simple CV syllables in short carrier sentences, where C = /b, d, g/ and V = /a, i, u/. Crucially, this repetition task was performed in order to compare fluent speech coarticulation of PWS to that of PWNS, and to compare the coarticulation of PWS under a condition with normal auditory feedback (NAF) and under a fluency-enhancing condition due to an altered auditory feedback (AAF). This is the first study, to our knowledge, to investigate the coarticulation behavior under AAF. The degree of coarticulation was measured by means of the Locus Equations (LE). The coarticulation degree observed in fluent PWS speech is lower than that of the PWNS, and, more importantly, in AAF condition, PWS coarticulation appears even weaker than in the NAF condition. The results allow to interpret the lower degree of coarticulation found in fluent speech of PWS under NAF condition as a compensation for the disorder, based on the fact that PWS’s coarticulation is weakening in fluency-enhancing conditions, further away from the degree of coarticulation observed in PWNS. Since a lower degree of coarticulation is associated to a greater separation between the places of articulation of the consonant and the vowel, these results are compatible with the hypothesis that larger articulatory movements could be responsible for the stabilization of the PWS speech motor system, increasing the kinesthetic feedback from the effector system. This interpretation shares with a number of relatively recent proposal the idea that stuttering derives from an impaired feedforward (open-loop) control system, which makes PWS rely more heavily on a feedback-based (closed loop) motor control strategy.
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Affiliation(s)
- Marine Verdurand
- Speech Therapy Study, Cabestany, France.,Université Grenoble Alpes, CNRS, Grenoble INP, LIG, Grenoble, France
| | - Solange Rossato
- Université Grenoble Alpes, CNRS, Grenoble INP, LIG, Grenoble, France
| | - Claudio Zmarich
- Institute of Cognitive Sciences and Technologies, National Research Council, Padua, Italy
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25
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Busan P, Del Ben G, Tantone A, Halaj L, Bernardini S, Natarelli G, Manganotti P, Battaglini PP. Effect of muscular activation on surrounding motor networks in developmental stuttering: A TMS study. BRAIN AND LANGUAGE 2020; 205:104774. [PMID: 32135384 DOI: 10.1016/j.bandl.2020.104774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 01/05/2020] [Accepted: 02/17/2020] [Indexed: 06/10/2023]
Abstract
Previous studies regarding developmental stuttering (DS) suggest that motor neural networks are strongly affected. Transcranial magnetic stimulation (TMS) was used to investigate neural activation of the primary motor cortex in DS during movement execution, and the influence of muscle representations involved in movements on "surrounding" ones. TMS was applied over the contralateral abductor digiti minimi (ADM) motor representation, at rest and during the movement of homologue first dorsal interosseous muscles (tonic contraction, phasic movements cued by acoustic signalling, and "self-paced" movements). Results highlighted a lower cortico-spinal excitability of ADM in the left hemisphere of stutterers, and an enhanced intracortical inhibition in their right motor cortex (in comparison to fluent speakers). Abnormal intracortical functioning was especially evident during phasic contractions cued by "external" acoustic signals. An exaggerated inhibition of muscles not directly involved in intended movements, in stuttering, may be useful to obtain more efficient motor control. This was stronger during contractions cued by "external" signals, highlighting mechanisms likely used by stutterers during fluency-evoking conditions.
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Affiliation(s)
- Pierpaolo Busan
- IRCCS Ospedale San Camillo, via Alberoni 70, 30126 Venice, Italy.
| | - Giovanni Del Ben
- Department of Life Sciences, University of Trieste, via Fleming 22, 34100 Trieste, Italy.
| | - Antonietta Tantone
- Department of Life Sciences, University of Trieste, via Fleming 22, 34100 Trieste, Italy
| | - Livia Halaj
- Department of Life Sciences, University of Trieste, via Fleming 22, 34100 Trieste, Italy
| | | | - Giulia Natarelli
- Department of Developmental and Social Psychology, University of Padua, via Venezia 8, 35100 Padua, Italy.
| | - Paolo Manganotti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
| | - Piero Paolo Battaglini
- Department of Life Sciences, University of Trieste, via Fleming 22, 34100 Trieste, Italy.
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26
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Busan P. Developmental stuttering and the role of the supplementary motor cortex. JOURNAL OF FLUENCY DISORDERS 2020; 64:105763. [PMID: 32361030 DOI: 10.1016/j.jfludis.2020.105763] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 04/05/2020] [Accepted: 04/08/2020] [Indexed: 06/11/2023]
Abstract
Developmental stuttering is a frequent neurodevelopmental disorder with a complex neurobiological basis. Robust neural markers of stuttering include imbalanced activity of speech and motor related brain regions, and their impaired structural connectivity. The dynamic interaction of cortical regions is regulated by the cortico-basal ganglia-thalamo-cortical system with the supplementary motor area constituting a crucial cortical site. The SMA integrates information from different neural circuits, and manages information about motor programs such as self-initiated movements, motor sequences, and motor learning. Abnormal functioning of SMA is increasingly reported in stuttering, and has been recently indicated as an additional "neural marker" of DS: anatomical and functional data have documented abnormal structure and activity of the SMA, especially in motor and speech networks. Its connectivity is often impaired, especially when considering networks of the left hemisphere. Compatibly, recent data suggest that, in DS, SMA is part of a poorly synchronized neural network, thus resulting in a likely substrate for the appearance of DS symptoms. However, as evident when considering neural models of stuttering, the role of SMA has not been fully clarified. Herein, the available evidence is reviewed, which highlights the role of the SMA in DS as a neural "hub", receiving and conveying altered information, thus "gating" the release of correct or abnormal motor plans.
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27
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Plamondon M, Grondin S. Counting fast or slow, aloud or silently? A comparison of adult stutterers and non-stutterers. Cogn Process 2020; 21:461-467. [PMID: 32180059 DOI: 10.1007/s10339-020-00955-x] [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: 12/11/2019] [Accepted: 01/27/2020] [Indexed: 10/24/2022]
Abstract
This study assesses factors influencing the capacity to maintain a steady rhythm during explicit counting activities. There are three counting paces (count every 800, 1200, or 1600 ms) and three experimental conditions (count silently, aloud and aloud in the presence of someone). The study also assesses the effect of a speech disorder, namely stuttering, on this counting ability by comparing the performance of a group of adult stutterers (n = 21) to that of a group of adult non-stutterers (n = 24). For temporal variability, in addition to replicating the fact that counting more slowly leads to lower performance, the results show that there are benefits to expect when participants count aloud instead of silently. There is no main effect of group, but the interaction between the experimental condition, the counting pace, and the group is significant. Adult non-stutterers are better than adult stutterers in the silent and long time-interval conditions (1600 ms). The significantly higher variability at 1600 ms indicates a loss of efficiency in the capacity to keep time constant when counting is slow, and it is in this condition that stutterers will gain the most benefits from counting aloud instead of silently.
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Affiliation(s)
- Mathieu Plamondon
- École de Psychologie, Université Laval, 2325 Rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada
| | - Simon Grondin
- École de Psychologie, Université Laval, 2325 Rue des Bibliothèques, Quebec, QC, G1V 0A6, Canada.
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28
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Iimura D, Asakura N, Sasaoka T, Inui T. Abnormal Sensorimotor Integration in Adults Who Stutter: A Behavioral Study by Adaptation of Delayed Auditory Feedback. Front Psychol 2019; 10:2440. [PMID: 31736833 PMCID: PMC6834693 DOI: 10.3389/fpsyg.2019.02440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/14/2019] [Indexed: 12/15/2022] Open
Abstract
Stuttering is a fluency disorder, partially alleviated during altered auditory feedback, suggesting abnormal sensorimotor integration in adults who stutter (AWS). As weighting of multiple integrating-information sources would be decided based on their reliabilities, the use of external (auditory feedback) and internal information (prediction of sensory consequences) could correlate with speech processing. We hypothesized that abnormal auditory-feedback processing in AWS could be related to decrease in internal processing precision. We used a perceptual-adaptation experiment of delayed auditory feedback (DAF) to verify the hypothesis. Seventeen AWS and 17 adults who do not stutter (ANS) were required to say “ah” and judge the simultaneity between their motor sensations and vocal sounds in each stimulus onset asynchrony (SOA) (0, 25, 50, 75, 100, 125, or 150 ms) after inducing adaptation of DAF (three conditions with 0-, 66-, or 133-ms delay). While no adaptation occurred during the 0 ms condition, perceptual change in simultaneity judgment (adaptation effect) occurred during the 66 and 133 ms conditions. The simultaneity judgments following exposure in each SOA were fitted to the psychometric function in each condition for the AWS and ANS groups. We calculated the μ (signifying the point of subjective simultaneity and adaptation-effect degree) and σ (signifying the detecting precision) of each function and analyzed them by parametric analyses. For the μ, participant groups and adaptation conditions showed a significant interaction; the adaptation effect was greater in the AWS than in the ANS group. Additionally, the μ and σ were only positively correlated in the AWS group. The point of subjective simultaneity for auditory delay by inducing DAF was higher in AWS than in ANS, indicating that perception of simultaneity in AWS was influenced by DAF to a greater extent. Moreover, the significant positive correlation between the μ and σ in AWS showed that the more imprecise the internal auditory processing, the more AWS relied on auditory feedback. It is suggested that the reliability of internal information differed within the AWS group, and AWS with reduced internal reliability appeared to compensate by relying to a great extent on auditory feedback information.
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Affiliation(s)
- Daichi Iimura
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan.,Domo-Work (Specified Nonprofit Corporation), Tokyo, Japan
| | - Nobuhiko Asakura
- Center for Mathematical Modeling and Data Science, Osaka University, Osaka, Japan
| | - Takafumi Sasaoka
- Brain, Mind and KANSEI Sciences Research Center, Hiroshima University, Hiroshima, Japan
| | - Toshio Inui
- Department of Psychology, Otemon Gakuin University, Osaka, Japan
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29
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Ravignani A, Dalla Bella S, Falk S, Kello CT, Noriega F, Kotz SA. Rhythm in speech and animal vocalizations: a cross-species perspective. Ann N Y Acad Sci 2019; 1453:79-98. [PMID: 31237365 PMCID: PMC6851814 DOI: 10.1111/nyas.14166] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/14/2019] [Accepted: 05/24/2019] [Indexed: 12/31/2022]
Abstract
Why does human speech have rhythm? As we cannot travel back in time to witness how speech developed its rhythmic properties and why humans have the cognitive skills to process them, we rely on alternative methods to find out. One powerful tool is the comparative approach: studying the presence or absence of cognitive/behavioral traits in other species to determine which traits are shared between species and which are recent human inventions. Vocalizations of many species exhibit temporal structure, but little is known about how these rhythmic structures evolved, are perceived and produced, their biological and developmental bases, and communicative functions. We review the literature on rhythm in speech and animal vocalizations as a first step toward understanding similarities and differences across species. We extend this review to quantitative techniques that are useful for computing rhythmic structure in acoustic sequences and hence facilitate cross-species research. We report links between vocal perception and motor coordination and the differentiation of rhythm based on hierarchical temporal structure. While still far from a complete cross-species perspective of speech rhythm, our review puts some pieces of the puzzle together.
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Affiliation(s)
- Andrea Ravignani
- Artificial Intelligence LaboratoryVrije Universiteit BrusselBrusselsBelgium
- Institute for Advanced StudyUniversity of AmsterdamAmsterdamthe Netherlands
| | - Simone Dalla Bella
- International Laboratory for BrainMusic and Sound Research (BRAMS)MontréalQuebecCanada
- Department of PsychologyUniversity of MontrealMontréalQuebecCanada
- Department of Cognitive PsychologyWarsawPoland
| | - Simone Falk
- International Laboratory for BrainMusic and Sound Research (BRAMS)MontréalQuebecCanada
- Laboratoire de Phonétique et Phonologie, UMR 7018, CNRS/Université Sorbonne Nouvelle Paris‐3Institut de Linguistique et Phonétique générales et appliquéesParisFrance
| | | | - Florencia Noriega
- Chair for Network DynamicsCenter for Advancing Electronics Dresden (CFAED), TU DresdenDresdenGermany
- CODE University of Applied SciencesBerlinGermany
| | - Sonja A. Kotz
- International Laboratory for BrainMusic and Sound Research (BRAMS)MontréalQuebecCanada
- Basic and Applied NeuroDynamics Laboratory, Faculty of Psychology and Neuroscience, Department of Neuropsychology and PsychopharmacologyMaastricht UniversityMaastrichtthe Netherlands
- Department of NeuropsychologyMax‐Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
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30
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Mohammadi H, Papadatou-Pastou M. Cerebral laterality as assessed by hand preference measures and developmental stuttering. Laterality 2019; 25:127-149. [PMID: 31144576 DOI: 10.1080/1357650x.2019.1621329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The causes of developmental stuttering, a neurodevelopmental communicative disorder, have not been elucidated to date. Neuroimaging studies suggest that atypical cerebral laterality could be one of such causal factors. Moreover, handedness, a behavioural index for cerebral laterality, has been linked to stuttering and recovery from it. However, findings are conflicting, possibly due to sample selection procedures, which typically rely on self-reported stuttering, and to the fact that handedness is typically assessed with regards to its direction rather than degree. We investigated the possible relationship between handedness and stuttering. This is the first study where children who stutter (CWS) were selected using clinical criteria as well as speech samples and where a non-Western population was studied. Findings from 83 CWS aged 3-9 years (mean = 6.43, SD = 1.84) and 90 age- and sex-matched children who do not stutter (mean = 6.45, SD = 1.71) revealed no differences in their hand preference scores as evaluated by parent-completed Edinburgh Handedness Inventory, for both direction and degree. The severity of stuttering was not found to correlate with the degree of handedness. We suggest that parents and professionals not treat left- or mixed-hand preference as a reason for concern with regards to stuttering.
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Affiliation(s)
- Hiwa Mohammadi
- Department of Neurology & Sleep Disorders Research Center, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Marietta Papadatou-Pastou
- School of Education, Faculty of Primary Education, National and Kapodistrian University of Athens, Athens, Greece
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31
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Sares AG, Deroche MLD, Shiller DM, Gracco VL. Adults who stutter and metronome synchronization: evidence for a nonspeech timing deficit. Ann N Y Acad Sci 2019; 1449:56-69. [PMID: 31144336 DOI: 10.1111/nyas.14117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 04/16/2019] [Accepted: 04/21/2019] [Indexed: 12/30/2022]
Abstract
Speech timing deficits have been proposed as a causal factor in the disorder of stuttering. The question of whether individuals who stutter have deficits in nonspeech timing is one that has been revisited often, with conflicting results. Here, we uncover subtle differences in a manual metronome synchronization task that included tempo changes with adults who stutter and fluent speakers. We used sensitive circular statistics to examine both asynchrony and consistency in motor production. While both groups displayed a classic negative mean asynchrony (tapping before the beat), individuals who stutter anticipated the beat even more than their fluent peers, and their consistency was particularly affected at slow tempi. Surprisingly, individuals who stutter did not have problems with interval correction at tempo changes. We also examined the influence of music experience on synchronization behavior in both groups. While music perception and training were related to synchronization behavior in fluent participants, these correlations were not present for the stuttering group; however, one measure of stuttering severity (self-rated severity) was negatively correlated with music training. Overall, we found subtle differences in paced auditory-motor synchronization in individuals who stutter, consistent with a timing problem extending to nonspeech.
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Affiliation(s)
- Anastasia G Sares
- Integrated Program in Neuroscience, Montréal, Quebec, Canada.,Centre for Research on Brain, Language and Music, McGill University, Montréal, Quebec, Canada
| | - Mickael L D Deroche
- School of Communication Sciences and Disorders, Montréal, Quebec, Canada.,Centre for Research on Brain, Language and Music, McGill University, Montréal, Quebec, Canada
| | - Douglas M Shiller
- Centre for Research on Brain, Language and Music, McGill University, Montréal, Quebec, Canada.,École d'orthophonie et d'audiologie, Université de Montréal, Montréal, Quebec, Canada
| | - Vincent L Gracco
- Integrated Program in Neuroscience, Montréal, Quebec, Canada.,School of Communication Sciences and Disorders, Montréal, Quebec, Canada.,Centre for Research on Brain, Language and Music, McGill University, Montréal, Quebec, Canada.,Haskins Laboratories, New Haven, Connecticut
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32
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Devaraju DS, Maruthy S, Kumar AU. Detection of Gap and Modulations: Auditory Temporal Resolution Deficits in Adults Who Stutter. Folia Phoniatr Logop 2019; 72:13-21. [PMID: 31132766 DOI: 10.1159/000499565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 03/12/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Recent models of speech production suggest a link between speech production and perception. Persons with stuttering are known to have deficits in sensorimotor timing and exhibit auditory processing problems. Most of the earlier studies have focused on assessing temporal ordering in adults who stutter (AWS), but limited attempts have been made to document temporal resolution abilities in AWS. METHODS A group of 16 AWS and 16 age- and gender-matched adults who do not stutter (AWNS) were recruited for the study. Temporal resolution abilities were assessed using the Gap Detection Test and temporal modulation transfer function (TMTF). RESULTS The results revealed significant differences in TMTF between AWS and AWNS, but no differences were found in the gap detection thresholds. CONCLUSIONS Results suggest that the sensory representations of the temporal modulations are compromised in AWS, which may contribute to the programming of rhythmic movements during speech planning.
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Affiliation(s)
- Dhatri S Devaraju
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Mysuru, India,
| | - Santosh Maruthy
- Department of Speech Language Sciences, All India Institute of Speech and Hearing, Manasagangothri, Mysuru, India
| | - Ajith U Kumar
- Department of Audiology, All India Institute of Speech and Hearing, Manasagangothri, Mysuru, India
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33
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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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34
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Yada Y, Tomisato S, Hashimoto RI. Online cathodal transcranial direct current stimulation to the right homologue of Broca's area improves speech fluency in people who stutter. Psychiatry Clin Neurosci 2019; 73:63-69. [PMID: 30379387 DOI: 10.1111/pcn.12796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 10/04/2018] [Accepted: 10/29/2018] [Indexed: 12/14/2022]
Abstract
AIM Previous functional imaging studies demonstrate that people who stutter (PWS) exhibit over- and under-activation of Broca's and Wernicke's areas and their right hemisphere homologues when speaking. However, it is unclear whether this altered activation represents the neural cause of speech dysfluency or a secondary compensatory activation in PWS. To clarify the functional significance of the altered activation pattern in classic language areas and their right homologues, we examined whether the severity of stuttering was affected when the activation of these areas was modulated by brain stimulation. METHODS While PWS read passages aloud, we applied transcranial direct current stimulation (tDCS) using electrode montages that included an anodal or cathodal electrode placed over one of the language areas and its right hemisphere homologue, with the second electrode placed over the contralateral supraorbital region. Each participant underwent both anodal and cathodal tDCS sessions, each of which included a sham stimulation. Effects of stimulation polarity and electrode location on the frequency of stuttering were analyzed. RESULTS We observed a significant interaction between polarity and location on the frequency of stuttering. Follow-up analyses revealed that a tDCS montage including the cathodal electrode over right Broca's area (RB) significantly reduced the frequency of stuttering. CONCLUSION The results indicated that stuttering severity was ameliorated when overactivation in RB was reduced by tDCS. This observation further suggests that speech dysfluency in PWS may be caused either by functional alteration in RB or by abnormal activation in speech motor control areas that are connected with RB.
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Affiliation(s)
- Yasuto Yada
- Department of Language Sciences, Graduate School of Humanities, Tokyo Metropolitan University, Tokyo, Japan.,Department of Otolaryngology, Nihon Kokan Hospital, Kanagawa, Japan
| | - Shuta Tomisato
- Department of Otolaryngology, Nihon Kokan Hospital, Kanagawa, Japan
| | - Ryu-Ichiro Hashimoto
- Department of Language Sciences, Graduate School of Humanities, Tokyo Metropolitan University, Tokyo, Japan
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35
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Busan P, Del Ben G, Russo LR, Bernardini S, Natarelli G, Arcara G, Manganotti P, Battaglini PP. Stuttering as a matter of delay in neural activation: A combined TMS/EEG study. Clin Neurophysiol 2019; 130:61-76. [DOI: 10.1016/j.clinph.2018.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 08/27/2018] [Accepted: 10/15/2018] [Indexed: 10/27/2022]
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36
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Dinoto A, Busan P, Formaggio E, Bertolotti C, Menichelli A, Stokelj D, Manganotti P. Stuttering-like hesitation in speech during acute/post-acute phase of immune-mediated encephalitis. JOURNAL OF FLUENCY DISORDERS 2018; 58:70-76. [PMID: 30220403 DOI: 10.1016/j.jfludis.2018.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/08/2018] [Accepted: 09/05/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Neurogenic stuttering may be evident after a lesion/dysfunction of wider neural networks. Here we present a case of acquired stuttering as the consequence of immune-mediated encephalitis. METHODS The case of a 71-year old male who complained about the progressive onset of stuttering and disequilibrium as the consequence of immune-mediated encephalitis, is here reported. Administration of corticosteroid methylprednisolone was useful to recover from impairments. An in depth analysis of the electroencephalography (relative power of brain rhythms and source localization) during different phases of the disease/treatment was also realized. RESULTS The patient showed a stuttering-like slowed speech with blocks and repetitions, especially at the beginning of words/sentences, with associated movements of the oro-facial muscles. Speech and general motor skills resulted slowed in their preparation/execution phases. Electroencephalography showed a "slowed" pattern, with delta/theta waves mainly in the prefrontal cortex and in sensorimotor networks. CONCLUSION This case reports a probable immune-mediated encephalitis that resulted in acquired stuttering. The effect of "slowed" oscillatory brain activity on motor skills requesting sequencing and fine coordination (e.g. speech) could result in less "synchronized" systems, easily prone to disruptions.
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Affiliation(s)
- Alessandro Dinoto
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy.
| | - Pierpaolo Busan
- Fondazione Ospedale San Camillo IRCCS, Via Alberoni 70, 30126, Venice, Italy.
| | - Emanuela Formaggio
- Fondazione Ospedale San Camillo IRCCS, Via Alberoni 70, 30126, Venice, Italy.
| | - Claudio Bertolotti
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy.
| | - Alina Menichelli
- Neuropsychological Unit, Department of Rehabilitation Medicine, ASUI Trieste, Strada di Fiume 447, 34100, Trieste, Italy.
| | - David Stokelj
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy.
| | - Paolo Manganotti
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy.
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37
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Chang SE, Garnett EO, Etchell A, Chow HM. Functional and Neuroanatomical Bases of Developmental Stuttering: Current Insights. Neuroscientist 2018; 25:566-582. [PMID: 30264661 DOI: 10.1177/1073858418803594] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Affecting 5% of all preschool-aged children and 1% of the general population, developmental stuttering-also called childhood-onset fluency disorder-is a complex, multifactorial neurodevelopmental disorder characterized by frequent disruption of the fluent flow of speech. Over the past two decades, neuroimaging studies of both children and adults who stutter have begun to provide significant insights into the neurobiological bases of stuttering. This review highlights convergent findings from this body of literature with a focus on functional and structural neuroimaging results that are supported by theoretically driven neurocomputational models of speech production. Updated views on possible mechanisms of stuttering onset and persistence, and perspectives on promising areas for future research into the mechanisms of stuttering, are discussed.
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Affiliation(s)
- Soo-Eun Chang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Emily O Garnett
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Andrew Etchell
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Ho Ming Chow
- Nemours/Alfred I. DuPont Hospital for Children, Wilmington, DE, USA
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38
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Coalson GA, Byrd CT, Treleaven SB, Dang L. Segmental and metrical complexity during non-word repetition in adults who stutter. CLINICAL LINGUISTICS & PHONETICS 2018; 33:256-278. [PMID: 30084671 DOI: 10.1080/02699206.2018.1504988] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 06/08/2023]
Abstract
Non-word repetition is weaker for adults who stutter (AWS) compared to adults who do not stutter (AWNS) as phonological demands increase. However, non-word stimuli used in previous studies varied by length, but did not vary with regard to segmental or metrical complexity. The purpose of the present study was to examine the unique influence of these two distinct types of complexity on non-word repetition in AWS and AWNS via administration of the Test of Phonological Structure (TOPhS). Twenty-four adults (12 AWNS, 12 AWS) repeated 96 non-words within a soundproof booth immediately after auditory presentation. All 96 non-word targets included on the TOPhS were one to four syllables in length and ranked based on segmental complexity (simple, moderate and complex) and metrical complexity (simple, moderate and complex). No main effect of metrical complexity was detected between groups, and no differences in accuracy were observed for non-words with simple or moderate segmental complexity. However, AWS were significantly more likely to produce a phonemic error when repeating words with complex segmental structure than AWNS, irrespective of metrical complexity. Segmental complexity may contribute to the differences in phonological working memory in AWS when controlling for metrical complexity and length.
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Affiliation(s)
- Geoffrey A Coalson
- a Department of Communication Sciences and Disorders , Louisiana State University , Baton Rouge , LA , USA
| | - Courtney T Byrd
- b Department of Communication Sciences and Disorders , The University of Texas at Austin , Austin , TX , USA
| | - Shanley B Treleaven
- a Department of Communication Sciences and Disorders , Louisiana State University , Baton Rouge , LA , USA
| | - Lillian Dang
- a Department of Communication Sciences and Disorders , Louisiana State University , Baton Rouge , LA , USA
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Eggers K, De Nil LF, Van den Bergh BRH. Exogenously triggered response inhibition in developmental stuttering. JOURNAL OF FLUENCY DISORDERS 2018; 56:33-44. [PMID: 29494965 DOI: 10.1016/j.jfludis.2018.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 11/08/2017] [Accepted: 02/16/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of the present study was to examine relations between children's exogenously triggered response inhibition and stuttering. METHOD Participants were 18 children who stutter (CWS; mean age = 9;01 years) and 18 children who not stutter (CWNS; mean age = 9;01 years). Participants were matched on age (±3 months) and gender. Response inhibition was assessed by a stop signal task (Verbruggen, Logan, & Stevens, 2008). RESULTS Results suggest that CWS, compared to CWNS, perform comparable to CWNS in a task where response control is externally triggered. CONCLUSIONS Our findings seem to indicate that previous questionnaire-based findings (Eggers, De Nil, & Van den Bergh, 2010) of a decreased efficiency of response inhibition cannot be generalized to all types of response inhibition.
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Affiliation(s)
- Kurt Eggers
- Dept. of Speech-Language Therapy, Thomas More University College, Belgium; Experimental Otorinolaryngology, Dept. of Neurosciences, University of Leuven, Belgium; Dept. of Psychology and Speech-Language Pathology, University of Turku, Finland.
| | - Luc F De Nil
- Experimental Otorinolaryngology, Dept. of Neurosciences, University of Leuven, Belgium; Dept. of Speech-Language Pathology, University of Toronto, Canada.
| | - Bea R H Van den Bergh
- Dept. of Psychology, Tilburg University, The Netherlands; Dept. of Psychology, University of Leuven, Belgium.
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Iverach L, Jones M, Lowe R, O'Brian S, Menzies RG, Packman A, Onslow M. Comparison of adults who stutter with and without social anxiety disorder. JOURNAL OF FLUENCY DISORDERS 2018; 56:55-68. [PMID: 29602052 DOI: 10.1016/j.jfludis.2018.03.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/09/2018] [Accepted: 01/16/2018] [Indexed: 05/14/2023]
Abstract
PURPOSE Social anxiety disorder is a debilitating anxiety disorder associated with significant life impairment. The purpose of the present study is to evaluate overall functioning for adults who stutter with and without a diagnosis of social anxiety disorder. METHOD Participants were 275 adults who stuttered (18-80 years), including 219 males (79.6%) and 56 females (20.4%), who were enrolled to commence speech treatment for stuttering. Comparisons were made between participants diagnosed with social anxiety disorder (n = 82, 29.8%) and those without that diagnosis (n = 193, 70.2%). RESULTS Although the socially anxious group was significantly younger than the non-socially anxious group, no other demographic differences were found. When compared to the non-socially anxious group, the socially anxious group did not demonstrate significantly higher self-reported stuttering severity or percentage of syllables stuttered. Yet the socially anxious group reported more speech dissatisfaction and avoidance of speaking situations, significantly more psychological problems, and a greater negative impact of stuttering. CONCLUSION Significant differences in speech and psychological variables between groups suggest that, despite not demonstrating more severe stuttering, socially anxious adults who stutter demonstrate more psychological difficulties and have a more negative view of their speech. The present findings suggest that the demographic status of adults who stutter is not worse for those with social anxiety disorder. These findings pertain to a clinical sample, and cannot be generalized to the wider population of adults who stutter from the general community. Further research is needed to understand the longer-term impact of social anxiety disorder for those who stutter.
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Affiliation(s)
- Lisa Iverach
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Mark Jones
- School of Public Health, University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD, 4006, Australia.
| | - Robyn Lowe
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Susan O'Brian
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Ross G Menzies
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Ann Packman
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Mark Onslow
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
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Ghaderi AH, Andevari MN, Sowman PF. Evidence for a Resting State Network Abnormality in Adults Who Stutter. Front Integr Neurosci 2018; 12:16. [PMID: 29755328 PMCID: PMC5934488 DOI: 10.3389/fnint.2018.00016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/10/2018] [Indexed: 01/21/2023] Open
Abstract
Neural network-based investigations of stuttering have begun to provide a possible integrative account for the large number of brain-based anomalies associated with stuttering. Here we used resting-state EEG to investigate functional brain networks in adults who stutter (AWS). Participants were 19 AWS and 52 age-, and gender-matched normally fluent speakers. EEGs were recorded and connectivity matrices were generated by LORETA in the theta (4-8 Hz), alpha (8-12 Hz), beta1 (12-20 Hz), and beta2 (20-30 Hz) bands. Small-world propensity (SWP), shortest path, and clustering coefficients were computed for weighted graphs. Minimum spanning tree analysis was also performed and measures were compared by non-parametric permutation test. The results show that small-world topology was evident in the functional networks of all participants. Three graph indices (diameter, clustering coefficient, and shortest path) exhibited significant differences between groups in the theta band and one [maximum betweenness centrality (BC)] measure was significantly different between groups in the beta2 band. AWS show higher BC than control in right temporal and inferior frontal areas and lower BC in the right primary motor cortex. Abnormal functional networks during rest state suggest an anomaly of DMN activity in AWS. Furthermore, functional segregation/integration deficits in the theta network are evident in AWS. These deficits reinforce the hypothesis that there is a neural basis for abnormal executive function in AWS. Increased beta2 BC in the right speech-motor related areas confirms previous evidence that right audio-speech areas are over-activated in AWS. Decreased beta2 BC in the right primary motor cortex is discussed in relation to abnormal neural mechanisms associated with time perception in AWS.
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Affiliation(s)
- Amir H. Ghaderi
- Cognitive Neuroscience Laboratory, University of Tabriz, Tabriz, Iran
- Iranian Neuro-wave Laboratory, Center of Isfahan, Isfahan, Iran
| | - Masoud N. Andevari
- Iranian Neuro-wave Laboratory, Center of Isfahan, Isfahan, Iran
- Department of Physics, School of Basic Science, Babol Noshirvani University of Technology, Babol, Iran
| | - Paul F. Sowman
- Department of Cognitive Science, Faculty of Human Sciences, Macquarie University, Sydney, NSW, Australia
- ARC Centre of Excellence in Cognition and its Disorders, Macquarie University, Sydney, NSW, Australia
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Iverach L, Jones M, Lowe R, O'Brian S, Menzies RG, Packman A, Onslow M. Characteristics of adults who stutter by treatments sought. LOGOP PHONIATR VOCO 2018; 44:134-142. [PMID: 29569967 DOI: 10.1080/14015439.2018.1452976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Several treatment approaches are available for adults who stutter, including speech treatment, cognitive behaviour therapy (CBT) treatment for anxiety, and a combination of both. It is useful to determine whether any differences exist between adults who stutter enrolled in different types of treatment. Therefore, the purpose of this study was to compare demographic, speech, and psychological characteristics of adults who stutter enrolled in speech, psychological, and combined treatment programs. Participants were 288 adults who stuttered (18-80 years) enrolled in one of three different treatment programs: Speech Treatment for stuttering (n = 134), Anxiety Treatment for anxiety about stuttering (n = 70), or Speech Treatment for Stuttering With or Without Anxiety Treatment (n = 84). Participants completed a range of demographic, speech, and psychological measures prior to the start of treatment. A significantly higher proportion of participants in the Anxiety Treatment group were in a personal relationship than the other treatment groups. The Anxiety Treatment group had higher average age than the other treatment groups. The Speech Treatment group also demonstrated significantly higher self-rated stuttering severity than the Anxiety Treatment group, even though there were no significant difference between groups for clinician-rated percentage of syllables stuttered. Although most characteristics of adults who stuttered did not vary by treatment type, the present findings suggest that adults who stutter enrolled in speech treatment perceived their stuttering as more severe, which may have prompted treatment seeking. Further research is needed regarding the supportive influence of personal relationship for those with the disorder.
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Affiliation(s)
- Lisa Iverach
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
| | - Mark Jones
- b School of Public Health , University of Queensland , Herston , Australia
| | - Robyn Lowe
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
| | - Susan O'Brian
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
| | - Ross G Menzies
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
| | - Ann Packman
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
| | - Mark Onslow
- a Australian Stuttering Research Centre , The University of Sydney , Lidcombe , Australia
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Sengupta R, Shah S, Loucks TMJ, Pelczarski K, Scott Yaruss J, Gore K, Nasir SM. Cortical dynamics of disfluency in adults who stutter. Physiol Rep 2018; 5:5/9/e13194. [PMID: 28483857 PMCID: PMC5430117 DOI: 10.14814/phy2.13194] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 01/27/2017] [Indexed: 01/21/2023] Open
Abstract
Stuttering is a disorder of speech production whose origins have been traced to the central nervous system. One of the factors that may underlie stuttering is aberrant neural miscommunication within the speech motor network. It is thus argued that disfluency (any interruption in the forward flow of speech) in adults who stutter (AWS) could be associated with anomalous cortical dynamics. Aberrant brain activity has been demonstrated in AWS in the absence of overt disfluency, but recording neural activity during disfluency is more challenging. The paradigm adopted here took an important step that involved overt reading of long and complex speech tokens under continuous EEG recording. Anomalies in cortical dynamics preceding disfluency were assessed by subtracting out neural activity for fluent utterances from their disfluent counterparts. Differences in EEG spectral power involving alpha, beta, and gamma bands, as well as anomalies in phase-coherence involving the gamma band, were observed prior to the production of the disfluent utterances. These findings provide novel evidence for compromised cortical dynamics that directly precede disfluency in AWS.
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Affiliation(s)
- Ranit Sengupta
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
| | - Shalin Shah
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
| | - Torrey M J Loucks
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Kristin Pelczarski
- School of Family Studies and Human Services, Kansas State University, Manhattan, Kansas
| | - J Scott Yaruss
- Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Sazzad M Nasir
- Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois
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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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Kell CA, Neumann K, Behrens M, von Gudenberg AW, Giraud AL. Speaking-related changes in cortical functional connectivity associated with assisted and spontaneous recovery from developmental stuttering. JOURNAL OF FLUENCY DISORDERS 2018; 55:135-144. [PMID: 28216127 DOI: 10.1016/j.jfludis.2017.02.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 12/15/2016] [Accepted: 02/08/2017] [Indexed: 06/06/2023]
Abstract
We previously reported speaking-related activity changes associated with assisted recovery induced by a fluency shaping therapy program and unassisted recovery from developmental stuttering (Kell et al., Brain 2009). While assisted recovery re-lateralized activity to the left hemisphere, unassisted recovery was specifically associated with the activation of the left BA 47/12 in the lateral orbitofrontal cortex. These findings suggested plastic changes in speaking-related functional connectivity between left hemispheric speech network nodes. We reanalyzed these data involving 13 stuttering men before and after fluency shaping, 13 men who recovered spontaneously from their stuttering, and 13 male control participants, and examined functional connectivity during overt vs. covert reading by means of psychophysiological interactions computed across left cortical regions involved in articulation control. Persistent stuttering was associated with reduced auditory-motor coupling and enhanced integration of somatosensory feedback between the supramarginal gyrus and the prefrontal cortex. Assisted recovery reduced this hyper-connectivity and increased functional connectivity between the articulatory motor cortex and the auditory feedback processing anterior superior temporal gyrus. In spontaneous recovery, both auditory-motor coupling and integration of somatosensory feedback were normalized. In addition, activity in the left orbitofrontal cortex and superior cerebellum appeared uncoupled from the rest of the speech production network. These data suggest that therapy and spontaneous recovery normalizes the left hemispheric speaking-related activity via an improvement of auditory-motor mapping. By contrast, long-lasting unassisted recovery from stuttering is additionally supported by a functional isolation of the superior cerebellum from the rest of the speech production network, through the pivotal left BA 47/12.
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Affiliation(s)
- Christian A Kell
- Brain Imaging Center and Department of Neurology, Goethe University, Frankfurt, Germany.
| | - Katrin Neumann
- Department of Phoniatrics and Pediatric Audiology, Clinic of Otorhinolaryngology, Head and Neck Surgery, St. Elisabeth-Hospital, Ruhr University Bochum, Bochum, Germany
| | - Marion Behrens
- Brain Imaging Center and Department of Neurology, Goethe University, Frankfurt, Germany
| | | | - Anne-Lise Giraud
- Département des Neuroscience Fondamentales, Université de Genève, Switzerland
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An evaluation of oxidative and nitrosative stress in children-who-stutter and its relationship to severity. Int J Pediatr Otorhinolaryngol 2017; 99:17-23. [PMID: 28688559 DOI: 10.1016/j.ijporl.2017.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 05/18/2017] [Accepted: 05/22/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Although there has been much research into the cause of stuttering, it has not yet been fully clarified. There is known to be a close relationship between stress severity and stuttering. The aim of this study was to evaluate the levels of oxidative and nitrosative stress by comparing a stuttering group and a control group. It was also aimed to evaluate the relationship between the oxidative and nitrosative stress levels and the severity of the stutter. METHODS The study included a total of 80 individuals, comprising a study group of 40 and a control group of 40. The severity of the stutter in the patient group was evaluated with the Stuttering Severity Instrument 3 (SSI). Blood samples were taken from both the patient and control groups and malondialdehyde (MDA), 3 nitrotyrosine (3-NT), nitric oxide (NO), catalase (CAT), and superoxide dismutase (SOD) concentrations were examined. RESULTS In the stuttering patients, MDA, 3-NT, NO, CAT, and SOD activity were determined to be statistically significantly higher than those of the control group (all p:0.001). In the ROC analysis, there was good diagnostic value for NO, with the area under the curve as 1.0. A direct, positive, statistically significant correlation was determined between SSI points and MDA values (r = 0.317, p = 0.046). CONCLUSION The results of the study showed that the oxidative and nitrosative stress levels of the stuttering patients were higher than those of the control group. With 100% sensitivity and specificity, it is thought that NO in particular could be important for the diagnosis and treatment of these patients. As the severity of the stutter increased, so there was an increase in MDA, suggesting that MDA is important in stuttering.
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Qiao J, Wang Z, Zhao G, Huo Y, Herder CL, Sikora CO, Peterson BS. Functional neural circuits that underlie developmental stuttering. PLoS One 2017; 12:e0179255. [PMID: 28759567 PMCID: PMC5536300 DOI: 10.1371/journal.pone.0179255] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 05/28/2017] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to identify differences in functional and effective brain connectivity between persons who stutter (PWS) and typically developing (TD) fluent speakers, and to assess whether those differences can serve as biomarkers to distinguish PWS from TD controls. We acquired resting-state functional magnetic resonance imaging data in 44 PWS and 50 TD controls. We then used Independent Component Analysis (ICA) together with Hierarchical Partner Matching (HPM) to identify networks of robust, functionally connected brain regions that were highly reproducible across participants, and we assessed whether connectivity differed significantly across diagnostic groups. We then used Granger Causality (GC) to study the causal interactions (effective connectivity) between the regions that ICA and HPM identified. Finally, we used a kernel support vector machine to assess how well these measures of functional connectivity and granger causality discriminate PWS from TD controls. Functional connectivity was stronger in PWS compared with TD controls in the supplementary motor area (SMA) and primary motor cortices, but weaker in inferior frontal cortex (IFG, Broca’s area), caudate, putamen, and thalamus. Additionally, causal influences were significantly weaker in PWS from the IFG to SMA, and from the basal ganglia to IFG through the thalamus, compared to TD controls. ICA and GC indices together yielded an accuracy of 92.7% in classifying PWS from TD controls. Our findings suggest the presence of dysfunctional circuits that support speech planning and timing cues for the initiation and execution of motor sequences in PWS. Our high accuracy of classification further suggests that these aberrant brain features may serve as robust biomarkers for PWS.
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Affiliation(s)
- Jianping Qiao
- School of Physics and Electronics, Shandong Province Key Laboratory of Medical Physics and Image Processing Technology, Institute of Data Science and Technology, Shandong Normal University, Jinan, China
- Department of Psychiatry, Columbia University, New York, NY, United States of America
| | - Zhishun Wang
- Department of Psychiatry, Columbia University, New York, NY, United States of America
- * E-mail: (ZW); (GZ)
| | - Guihu Zhao
- School of Information Science and Engineering, Central South University, Changsha, China
- * E-mail: (ZW); (GZ)
| | - Yuankai Huo
- Department of Psychiatry, Columbia University, New York, NY, United States of America
| | - Carl L. Herder
- American Institute for Stuttering, New York, NY, United States of America
| | - Chamonix O. Sikora
- American Institute for Stuttering, New York, NY, United States of America
| | - Bradley S. Peterson
- Institute for the Developing Mind, Children’s Hospital Los Angeles, CA, United States of America
- Department of Psychiatry, Keck School of Medicine at the University of Southern California, Los Angeles, CA, United States of America
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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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Busan P, Battaglini P, Sommer M. Transcranial magnetic stimulation in developmental stuttering: Relations with previous neurophysiological research and future perspectives. Clin Neurophysiol 2017; 128:952-964. [DOI: 10.1016/j.clinph.2017.03.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 03/14/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
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50
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Iverach L, Rapee RM, Wong QJJ, Lowe R. Maintenance of Social Anxiety in Stuttering: A Cognitive-Behavioral Model. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:540-556. [PMID: 28334398 DOI: 10.1044/2016_ajslp-16-0033] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 10/07/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE Stuttering is a speech disorder frequently accompanied by anxiety in social-evaluative situations. A growing body of research has confirmed a significant rate of social anxiety disorder among adults who stutter. Social anxiety disorder is a chronic and disabling anxiety disorder associated with substantial life impairment. Several influential models have described cognitive-behavioral factors that contribute to the maintenance of social anxiety in nonstuttering populations. The purpose of the present article is to apply these leading models to the experience of social anxiety for people who stutter. METHOD Components from existing models were applied to stuttering in order to determine cognitive-behavioral processes that occur before, during, and after social-evaluative situations, which may increase the likelihood of stuttering-related social fears persisting. RESULTS Maintenance of social anxiety in stuttering may be influenced by a host of interrelated factors, including fear of negative evaluation, negative social-evaluative cognitions, attentional biases, self-focused attention, safety behaviors, and anticipatory and postevent processing. CONCLUSION Given the chronic nature of social anxiety disorder, identifying factors that contribute to the persistence of stuttering-related social fears has the potential to inform clinical practice and the development of psychological treatment programs to address the speech and psychological needs of people who stutter with social anxiety.
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Affiliation(s)
- Lisa Iverach
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, AustraliaAustralian Stuttering Research Centre, The University of Sydney
| | - Ronald M Rapee
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Quincy J J Wong
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Robyn Lowe
- Australian Stuttering Research Centre, The University of Sydney
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