Abnormal auditory synchronization in stuttering: A magnetoencephalographic study. _ AUDITIVO
Hear Res. 2017 Feb;344:82-89. doi: 10.1016/j.heares.2016.10.027. Epub 2016 Nov 5.
Kikuchi Y, Okamoto T, Ogata K, Hagiwara K, Umezaki T, Kenjo M, Nakagawa T, Tobimatsu S.
Kyushu University, Fukuoka, Japan; Fukuoka Sanno Hospital, Fukuoka, Japan; International University of Health and Welfare, Fukuoka, Japan; University of Teacher Education Fukuoka, Fukuoka, Japan.
In a previous magnetoencephalographic study, we showed both functional and structural reorganization of the right auditory cortex and impaired left auditory cortex function in people who stutter (PWS). In the present work, we reevaluated the same dataset to further investigate how the right and left auditory cortices interact to compensate for stuttering. We evaluated bilateral N100m latencies as well as indices of local and inter-hemispheric phase synchronization of the auditory cortices. The left N100m latency was significantly prolonged relative to the right N100m latency in PWS, while healthy control participants did not show any inter-hemispheric differences in latency. A phase-locking factor (PLF) analysis, which indicates the degree of local phase synchronization, demonstrated enhanced alpha-band synchrony in the right auditory area of PWS. A phase-locking value (PLV) analysis of inter-hemispheric synchronization demonstrated significant elevations in the beta band between the right and left auditory cortices in PWS. In addition, right PLF and PLVs were positively correlated with stuttering frequency in PWS. Taken together, our data suggest that increased right hemispheric local phase synchronization and increased inter-hemispheric phase synchronization are electrophysiological correlates of a compensatory mechanism for impaired left auditory processing in PWS.
PMID: 27825021 DOI: 10.1016/j.heares.2016.10.027
A country-wide probability sample of public attitudes toward stuttering in Portugal - SOCIAL
J Fluency Disord. 2017 Jun;52:37-52. Epub 2017 Mar 6.
Valente ARS, St Louis KO, Leahy M, Hall A, Jesus LMT.
University of Aveiro, Aveiro, Portugal; West Virginia University, Morgantown, WV, USA; Trinity College Dublin, Dublin, Ireland.
BACKGROUND: Negative public attitudes toward stuttering have been widely reported, although differences among countries and regions exist. Clear reasons for these differences remain obscure.
PURPOSE: Published research is unavailable on public attitudes toward stuttering in Portugal as well as a representative sample that explores stuttering attitudes in an entire country. This study sought to (a) determine the feasibility of a country-wide probability sampling scheme to measure public stuttering attitudes in Portugal using a standard instrument (the Public Opinion Survey of Human Attributes-Stuttering [POSHA-S]) and (b) identify demographic variables that predict Portuguese attitudes.
METHODS: The POSHA-S was translated to European Portuguese through a five-step process. Thereafter, a local administrative office-based, three-stage, cluster, probability sampling scheme was carried out to obtain 311 adult respondents who filled out the questionnaire.
RESULTS: The Portuguese population held stuttering attitudes that were generally within the average range of those observed from numerous previous POSHA-S samples. Demographic variables that predicted more versus less positive stuttering attitudes were respondents' age, region of the country, years of school completed, working situation, and number of languages spoken. Non-predicting variables were respondents' sex, marital status, and parental status.
CONCLUSION: A local administrative office-based, probability sampling scheme generated a respondent profile similar to census data and indicated that Portuguese attitudes are generally typical.
PMID: 28576292 DOI: 10.1016/j.jfludis.2017.03.001
ACTH has beneficial effects on stuttering in ADHD and ASD patients with ESES: A retrospective study. - FARMACOLOGIA
Brain Dev. 2017 Feb;39(2):130-137. Epub 2016 Sep 16.
Altunel A, Sever A, Altunel EÖ.
Istanbul University, Fatih, Istanbul, Turkey; Kadikoy Florence Nightingale Hospital, Kadikoy, Istanbul, Turkey; Suadiye Mah, Kadikoy, Istanbul, Turkey.
INTRODUCTION: Etiology of stuttering remains unknown and no pharmacologic intervention has been approved for treatment. We aimed to evaluate EEG parameters and the effect of adrenocorticotropic hormone (ACTH) therapy in stuttering.
METHODS: In this retrospective study, 25 patients with attention deficit and hyperactivity (ADHD) or autism spectrum disorder (ASD), and comorbid stuttering were followed and treated with ACTH for electrical status epilepticus in sleep (ESES). Sleep EEGs were recorded at referral and follow-up visits and short courses of ACTH were administered when spike-wave index (SWI) was ⩾15%. The assessment of treatment effectiveness was based on reduction in SWI, and the clinician-reported improvement in stuttering, and ADHD or ASD. Statistical analyses were conducted in order to investigate the relationship between the clinical and EEG parameters.
RESULTS: Following treatment with ACTH, a reduction in SWI in all the patients was accompanied by a 72% improvement in ADHD or ASD, and 83.8% improvement in stuttering. Twelve of the 25 patients with stuttering showed complete treatment response. Linear regressions established that SWI at final visit significantly predicted improvement in ADHD or ASD, and in stuttering. If symptoms had recurred, improvement was once again achieved with repeated ACTH therapies. Stuttering always improved prior to, and recurred following ADHD or ASD.
CONCLUSION: The underlying etiology leading to ESES may play a significant role in the pathophysiology of stuttering and connect stuttering to other developmental disorders. ACTH therapy has beneficial effects on stuttering and improves EEG parameters.
PMID: 27645286 DOI: 10.1016/j.braindev.2016.09.001
A comparison of attitudes towards stuttering of non-stuttering preschoolers in the United States and Turkey. - SOCIAL
S Afr J Commun Disord. 2017 Apr 21;64(1):e1-e11.
Weidner ME, St Louis KO, Nakisci E, Ozdemir RS.
Department of Communication Disorders, Marshall University
BACKGROUND AND OBJECTIVES: Extensive research documents ubiquitous negative attitudes towards stuttering, but when and how they develop is unclear. This non-experimental, comparative study examined US and Turkish preschoolers to explore the origin of stuttering attitudes cross-culturally.
METHOD: The authors compared stuttering attitudes of 28 US and 31 Turkish non-stuttering preschoolers on English and Turkish versions of experimental prototypes of the newly developed Public Opinion Survey on Human Attributes-Stuttering/Child (POSHA-S/Child). Children first watched a short video of two stuttering avatar characters and then answered oral questions about stuttering. Parents completed a demographic questionnaire. Differences in the US and Turkish POSHA-S/Child means were calculated using the Mann-Whitney U test.
RESULTS: Attitudes of the US and Turkish children were remarkably similar. Children rated most of the items negatively but also rated some items as neutral or positive. They held relatively more negative attitudes towards traits and personalities of children who stutter yet relatively more positive attitudes towards stuttering children's potential.
CONCLUSION: Stuttering attitudes in children appear to be partly independent of culture.
A Lag in Speech Motor Coordination During Sentence Production Is Associated With Stuttering Persistence in Young Children - INFANTIL
J Speech Lang Hear Res. 2017 Jan 1;60(1):51-61.
Usler E, Smith A, Weber C.
Purdue University, West Lafayette, IN.
PURPOSE: The purpose of this study was to determine if indices of speech motor coordination during the production of sentences varying in sentence length and syntactic complexity were associated with stuttering persistence versus recovery in 5- to 7-year-old children.
METHODS: We compared children with persistent stuttering (CWS-Per) with children who had recovered (CWS-Rec), and children who do not stutter (CWNS). A kinematic measure of articulatory coordination, lip aperture variability (LAVar), and overall movement duration were computed for perceptually fluent sentence productions varying in length and syntactic complexity.
RESULTS: CWS-Per exhibited higher LAVar across sentence types compared to CWS-Rec and CWNS. For the participants who successfully completed the experimental paradigm, the demands of increasing sentence length and syntactic complexity did not appear to disproportionately affect the speech motor coordination of CWS-Per compared to their recovered and fluent peers. However, a subset of CWS-Per failed to produce the required number of accurate utterances.
CONCLUSIONS: These findings support our hypothesis that the speech motor coordination of school-age CWS-Per, on average, is less refined and less mature compared to CWS-Rec and CWNS. Childhood recovery from stuttering is characterized, in part, by overcoming an earlier occurring maturational lag in speech motor development.
PMID: 28056137 DOI: 10.1044/2016_JSLHR-S-15-0367
Altered morphology of the nucleus accumbens in persistent developmental stuttering. - NEUROCIÊNCIAS
J Fluency Disord. 2017 May 24. pii: S0094-730X(16)30120-6. [Epub ahead of print]
Neef NE, Bütfering C, Auer T, Metzger FL, Euler HA, Frahm J, Paulus W, Sommer M.
Georg August University, Göttingen, Germany; Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Georg August University, Göttingen, Germany; MRC Cognition and Brain Sciences Unit, Cambridge, UK; University of Bochum, Bochum, Germany.; Max-Planck-Institut für biophysikalische Chemie, Göttingen, Germany.
PURPOSE: Neuroimaging studies in persistent developmental stuttering repeatedly report altered basal ganglia functions. Together with thalamus and cerebellum, these structures mediate sensorimotor functions and thus represent a plausible link between stuttering and neuroanatomy. However, stuttering is a complex, multifactorial disorder. Besides sensorimotor functions, emotional and social-motivational factors constitute major aspects of the disorder. Here, we investigated cortical and subcortical gray matter regions to study whether persistent developmental stuttering is also linked to alterations of limbic structures.
METHODS: The study included 33 right-handed participants who stutter and 34 right-handed control participants matched for sex, age, and education. Structural images were acquired using magnetic resonance imaging to estimate volumetric characteristics of the nucleus accumbens, hippocampus, amygdala, pallidum, putamen, caudate nucleus, and thalamus.
RESULTS: Volumetric comparisons and vertex-based shape comparisons revealed structural differences. The right nucleus accumbens was larger in participants who stutter compared to controls.
CONCLUSION: Recent theories of basal ganglia functions suggest that the nucleus accumbens is a motivation-to-movement interface. A speaker intends to reach communicative goals, but stuttering can derail these efforts. It is therefore highly plausible to find alterations in the motivation-to-movement interface in stuttering. While behavioral studies of stuttering sought to find links between the limbic and sensorimotor system, we provide the first neuroimaging evidence of alterations in the limbic system. Thus, our findings might initialize a unified neurobiological framework of persistent developmental stuttering that integrates sensorimotor and social-motivational neuroanatomical circuitries.
PMID: 28595893 DOI: 10.1016/j.jfludis.2017.04.002
An Automatic Prolongation Detection Approach in Continuous Speech With Robustness Against Speaking Rate Variations. - AVALIAÇÃO
J Med Signals Sens. 2017 Jan-Mar;7(1):1-7.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394801/
Esmaili I, Dabanloo NJ, Vali M.
Islamic Azad University, Tehran, Iran; University of Technology, Tehran, Iran
In recent years, many methods have been introduced for supporting the diagnosis of stuttering for automatic detection of prolongation in the speech of people who stutter. However, less attention has been paid to treatment processes in which clients learn to speak more slowly. The aim of this study was to develop a method to help speech-language pathologists (SLPs) during diagnosis and treatment sessions. To this end, speech signals were initially parameterized to perceptual linear predictive (PLP) features. To detect the prolonged segments, the similarities between successive frames of speech signals were calculated based on correlation similarity measures. The segments were labeled as prolongation when the duration of highly similar successive frames exceeded a threshold specified by the speaking rate. The proposed method was evaluated by UCLASS and self-recorded Persian speech databases. The results were also compared with three high-performance studies in automatic prolongation detection. The best accuracies of prolongation detection were 99 and 97.1% for UCLASS and Persian databases, respectively. The proposed method also indicated promising robustness against artificial variation of speaking rate from 70 to 130% of normal speaking rate.
PMID: 28487827 PMCID: PMC5394801
An exploration of the mechanisms of change following an integrated group intervention for stuttering, as perceived by school-aged children who stutter (CWS).- INFANTIL
J Fluency Disord. 2017 Mar;51:8-23. Epub 2016 Oct 31.
Caughter S, Dunsmuir S.
Michael Palin Centre, UK; University College London, UK.
PURPOSE: To explore the process of change and role of resilience following an integrated group intervention for children who stutter (CWS).
METHOD: Using an exploratory multiple case study design, this research sought to identify the most significant changes perceived by seven participants following therapy, the mechanisms of change, and the role of resilience in the process of change. Quantitative measurements of resilience were combined with qualitative analysis of semi-structured interviews.
RESULTS: Thematic analysis of qualitative data showed that cognitive and emotional change was a key driver for therapeutic change, enabled by the shared experience of the group and a positive therapeutic environment. These changes were generalised into clients' real-world experiences, facilitated by their support network. Quantitative data demonstrated a statistically reliable positive change in overall Resiliency scores for four participants and reduced impact of stuttering scores on OASES-S for all participants, maintained at 12 month follow-up.
CONCLUSIONS: This study demonstrates the importance of adopting an integrated approach in therapy for CWS, which incorporates Cognitive Behavioural Therapy (CBT) as a key component, to facilitate change and build resilience. These results are unique to this cohort of CWS and further investigation into the use of CBT and the process of change may be warranted.
EDUCATIONAL OBJECTIVES: The reader will be able to (1) describe the integrated intervention used in this study (2) define the most significant change following therapy for the participants involved (3) summarise the key factors that facilitated change during the therapy process (as perceived by the participants).
PMID: 28212721 DOI: 10.1016/j.jfludis.2016.10.003
Anomalous network architecture of the resting brain in children who stutter - INFANTIL
J Fluency Disord. 2017 Jan 25. [Epub ahead of print]
Chang SE, Angstadt M, Chow HM, Etchell AC, Garnett EO, Choo AL, Kessler D, Welsh RC, Sripada C
University of Michigan, Ann Arbor, MI, United States; California State University East Bay, Hayward, CA, United States; University of Utah, Salt Lake City, UT, United States.
PURPOSE: We combined a large longitudinal neuroimaging dataset that includes children who do and do not stutter and a whole-brain network analysis in order to examine the intra- and inter-network connectivity changes associated with stuttering. Additionally, we asked whether whole brain connectivity patterns observed at the initial year of scanning could predict persistent stuttering in later years.
METHODS: A total of 224 high-quality resting state fMRI scans collected from 84 children (42 stuttering, 42 controls) were entered into an independent component analysis (ICA), yielding a number of distinct network connectivity maps ("components") as well as expression scores for each component that quantified the degree to which it is expressed for each child. These expression scores were compared between stuttering and control groups' first scans. In a second analysis, we examined whether the components that were most predictive of stuttering status also predicted persistence in stuttering.
RESULTS: Stuttering status, as well as stuttering persistence, were associated with aberrant network connectivity involving the default mode network and its connectivity with attention, somatomotor, and frontoparietal networks. The results suggest developmental alterations in the balance of integration and segregation of large-scale neural networks that support proficient task performance including fluent speech motor control.
CONCLUSIONS: This study supports the view that stuttering is a complex neurodevelopmental disorder and provides comprehensive brain network maps that substantiate past theories emphasizing the importance of considering situational, emotional, attentional and linguistic factors in explaining the basis for stuttering onset, persistence, and recovery.
PMID: 28214015 DOI: 10.1016/j.jfludis.2017.01.002
Anxiety in 11-Year-Old Children Who Stutter: Findings From a Prospective Longitudinal Community Sample. - EMOCIONAL
J Speech Lang Hear Res. 2017 Apr 16:1-12. [Epub ahead of print]
Smith KA, Iverach L, O'Brian S, Mensah F, Kefalianos E, Hearne A, Reilly S.
Royal Children's Hospital, Parkville, Victoria, Australia; University of Melbourne, Victoria, Australia; The University of Sydney, Lidcombe, Australia; Macquarie University, North Ryde, Australia; Massey University, Albany, New Zealand; Griffith University, Southport, Australia.
PURPOSE: To examine if a community sample of 11-year-old children with persistent stuttering have higher anxiety than children who have recovered from stuttering and nonstuttering controls.
METHOD: Participants in a community cohort study were categorized into 3 groups: (a) those with persistent stuttering, (b) those with recovered stuttering, and (c) nonstuttering controls. Linear regression modeling compared outcomes on measures of child anxiety and emotional and behavioral functioning for the 3 groups.
RESULTS: Without adjustment for covariates (unadjusted analyses), the group with persistent stuttering showed significantly increased anxiety compared with the recovered stuttering group and nonstuttering controls. The group with persistent stuttering had a higher number of children with autism spectrum disorder and/or learning difficulties. Once these variables were included as covariates in subsequent analysis, there was no difference in anxiety, emotional and behavioral functioning, or temperament among groups.
CONCLUSION: Although recognized to be associated with stuttering in clinical samples, anxiety was not higher in school-age children who stutter in a community cohort. It may be that anxiety develops later or is less marked in community cohorts compared with clinical samples. We did, however, observe higher anxiety scores in those children who stuttered and had autism spectrum disorder or learning difficulties. Implications and recommendations for research are discussed.
PMID: 28418529 DOI: 10.1044/2016_JSLHR-S-16-0035
A pilot study into a possible relationship between diet and stuttering - AMBIENTAL
J Fluency Disord. 2017 Jun;52:25-36. Epub 2017 Mar 2.
Hum J, Rietveld T, Wiedijk P, van Lieshout P.
University of Toronto, Canada; Radboud University, The Netherlands.
PURPOSE: There are theoretical and empirical reasons to consider a potential role for copper metabolism in the brain in how it could influence stuttering. However, a link between stuttering and dietary intake has never been researched in a systematic way. This pilot study therefore aimed to explore a possible association between ingested amounts of copper and thiamine (vitamin B1) with stuttering frequency using a double blind cross-over longitudinal paradigm.
METHODS: 19 adults who stutter between 20 and 51 years old filled out an online survey for 9 consecutive weeks. The survey consisted of self-assessed fluency and mood state scales, as well as food journals. After 4 weeks, the participants consumed either copper or thiamine supplements for 2 weeks, followed by a 1-week washout period, and another period of two weeks taking the other supplement. Formal speech assessments were done pre/post baseline and at the end of each supplement intake. Participants were not informed about the nature of the supplements during the experiment and the investigators were blinded to the order of the supplements.
RESULTS: The results demonstrated that copper and thiamine had no measurable effect on the amount of stuttering (self and formal assessments) but there was a moderate, significant correlation between mood state and fluency.
CONCLUSION: The findings do not support notions of dietary influences of ingested copper or thiamine on stuttering but do provide modest support for a relationship between variations in stuttering and self-perceived anxiety.
PMID: 28576291 DOI: 10.1016/j.jfludis.2017.02.004
A preliminary study on the neural oscillatory characteristics of motor preparation prior to dysfluent and fluent utterances in adults who stutter. - NEUROCIÊNCIAS
J Fluency Disord. 2017 May 17. pii: S0094-730X(16)30067-5. [Epub ahead of print]
Mersov A, Cheyne D, Jobst C, De Nil L.
University of Toronto, Toronto, ON, Canada; Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.
PURPOSE: Recent literature on speech production in adults who stutter (AWS) has begun to investigate the neural mechanisms characterizing speech-motor preparation prior to speech onset. Compelling evidence has suggested that stuttering is associated with atypical processing within cortical and sub-cortical motor networks, particularly in the beta frequency range, that is effective before speech production even begins. Due to low stuttering frequency in experimental settings, however, the literature has so far predominantly reported on fluent speech production in AWS. Consequently, we have limited understanding of the way in which fluent speech processing in AWS is disturbed leading to a dysfluency. This preliminary study aims to characterize neural motor preparation prior to stuttered utterances in AWS.
METHODS: Eight AWS participated in the study. A total of 336 stuttered utterances were compared to the participants' own fluent utterance productions. Beta oscillatory activity was analyzed with magnetoencephalography (MEG) and localized using minimum-variance beamforming.
RESULTS: Preparation for speech production induced beta suppression in the bilateral premotor and motor cortex prior to speech onset. Although the data revealed some interesting trends, no significant differences between fluent and stuttered utterances were present. This may be due to a relatively low and variable number of stuttered trials analyzed in individual subjects.
CONCLUSION: While the lack of significant differences may have resulted from the relatively low numbers of stuttered utterances across subjects, the observed trends demonstrated that the proposed methodology and experimental paradigm is a promising approach for future studies aiming to characterize differences between stuttered and fluent speech.
PMID: 28577876 DOI: 10.1016/j.jfludis.2017.05.003
A real-time phoneme counting algorithm and application for speech rate monitoring - TERAPIA
J Fluency Disord. 2017 Mar;51:60-68. Epub 2017 Jan 15.
Aharonson V, Aharonson E, Raichlin-Levi K, Sotzianu A, Amir O, Ovadia-Blechman Z.
Afeka Tel Aviv Academic College of Engineering, Israel; University of the Witwatersrand, Johannesburg, South Africa; Tel Aviv University, Israel.
Adults who stutter can learn to control and improve their speech fluency by modifying their speaking rate. Existing speech therapy technologies can assist this practice by monitoring speaking rate and providing feedback to the patient, but cannot provide an accurate, quantitative measurement of speaking rate. Moreover, most technologies are too complex and costly to be used for home practice. We developed an algorithm and a smartphone application that monitor a patient's speaking rate in real time and provide user-friendly feedback to both patient and therapist. Our speaking rate computation is performed by a phoneme counting algorithm which implements spectral transition measure extraction to estimate phoneme boundaries. The algorithm is implemented in real time in a mobile application that presents its results in a user-friendly interface. The application incorporates two modes: one provides the patient with visual feedback of his/her speech rate for self-practice and another provides the speech therapist with recordings, speech rate analysis and tools to manage the patient's practice. The algorithm's phoneme counting accuracy was validated on ten healthy subjects who read a paragraph at slow, normal and fast paces, and was compared to manual counting of speech experts. Test-retest and intra-counter reliability were assessed. Preliminary results indicate differences of -4% to 11% between automatic and human phoneme counting. Differences were largest for slow speech. The application can thus provide reliable, user-friendly, real-time feedback for speaking rate control practice.
PMID: 28159356 DOI: 10.1016/j.jfludis.2017.01.001
A speech and psychological profile of treatment-seeking adolescents who stutter - EMOCIONAL
J Fluency Disord. 2017 Mar;51:24-38. Epub 2016 Nov 17.
Iverach L, Lowe R, Jones M, O'Brian S, Menzies RG, Packman A, Onslow M.
The University of Sydney, Lidcombe, Australia; University of Queensland, Australia.
PURPOSE: The purpose of this study was to evaluate the relationship between stuttering severity, psychological functioning, and overall impact of stuttering, in a large sample of adolescents who stutter.
METHOD: Participants were 102 adolescents (11-17 years) seeking speech treatment for stuttering, including 86 boys and 16 girls, classified into younger (11-14 years, n=57) and older (15-17 years, n=45) adolescents. Linear regression models were used to evaluate the relationship between speech and psychological variables and overall impact of stuttering.
RESULTS: The impact of stuttering during adolescence is influenced by a complex interplay of speech and psychological variables. Anxiety and depression scores fell within normal limits. However, higher self-reported stuttering severity predicted higher anxiety and internalizing problems. Boys reported externalizing problems-aggression, rule-breaking-in the clinical range, and girls reported total problems in the borderline-clinical range. Overall, higher scores on measures of anxiety, stuttering severity, and speech dissatisfaction predicted a more negative overall impact of stuttering.
CONCLUSION: To our knowledge, this is the largest cohort study of adolescents who stutter. Higher stuttering severity, speech dissatisfaction, and anxiety predicted a more negative overall impact of stuttering, indicating the importance of carefully managing the speech and psychological needs of adolescents who stutter. Further research is needed to understand the relationship between stuttering and externalizing problems for adolescent boys who stutter.
PMID: 28212718 DOI: 10.1016/j.jfludis.2016.11.001
Atypical brain activation in children who stutter in a visual Go/Nogo task: An ERP study - INFANTIL
Clin Neurophysiol. 2017 Jan;128(1):194-203. Epub 2016 Nov 17.
Piispala J, Määttä S, Pääkkönen A, Bloigu R, Kallio M, Jansson-Verkasalo E.
Oulu University Hospital, Finland; Kuopio University Hospital, Kuopio, Finland; University of Eastern Finland, Kuopio, Finland; University of Oulu, Finland; University of Turku, Finland.
OBJECTIVE: The aim of the study was to investigate inhibitory control by evaluating possible differences in the strength and distribution of the brain activity in a visual Go/Nogo task in children who stutter (CWS) compared to typically developing children (TDC).
METHODS: Eleven CWS and 19 TDC participated. Event related potentials (ERP) were recorded using a 64-channel EEG-cap during an equiprobable visual Go/Nogo task. The global field power (GFP) as well as the mean amplitudes in the P3 time frame were compared between groups. Additionally, the potential maps of the groups were investigated visually in the N2 and P3 time windows.
RESULTS: The groups differed significantly in the right frontal area especially in the Nogo condition (p<0.001) with CWS showing smaller (less positive) mean amplitudes, most likely due to a prolonged and asymmetrical N2 component. Also the fronto-central Nogo P3 component was rather indistinct in CWS, but easily recognizable in TDC in the potential maps.
CONCLUSIONS: The CWS show atypical brain activation compared to the TDC in a Go/Nogo task as indexed by the excessive N2-related activity in both conditions and reduced P3-related activity in Nogo condition.
SIGNIFICANCE: These findings indicate atypical stimulus evaluation and response inhibition processes in CWS.
PMID: 27919012 DOI: 10.1016/j.clinph.2016.11.006
Auditory-motor adaptation is reduced in adults who stutter but not in children who stutter. - AUDITIVO
Dev Sci. 2017 Mar 2. [Epub ahead of print]
Daliri A, Wieland EA, Cai S, Guenther FH, Chang SE.
Boston University, Boston, MA, USA; Arizona State University, Tempe, AZ, USA; Michigan State University, East Lansing, MI, USA; Google, Cambridge, MA, USA.
Previous studies have shown that adults who stutter produce smaller corrective motor responses to compensate for unexpected auditory perturbations in comparison to adults who do not stutter, suggesting that stuttering may be associated with deficits in integration of auditory feedback for online speech monitoring. In this study, we examined whether stuttering is also associated with deficiencies in integrating and using discrepancies between expected and received auditory feedback to adaptively update motor programs for accurate speech production. Using a sensorimotor adaptation paradigm, we measured adaptive speech responses to auditory formant frequency perturbations in adults and children who stutter and their matched nonstuttering controls. We found that the magnitude of the speech adaptive response for children who stutter did not differ from that of fluent children. However, the adaptation magnitude of adults who stutter in response to auditory perturbation was significantly smaller than the adaptation magnitude of adults who do not stutter. Together these results indicate that stuttering is associated with deficits in integrating discrepancies between predicted and received auditory feedback to calibrate the speech production system in adults but not children. This auditory-motor integration deficit thus appears to be a compensatory effect that develops over years of stuttering.
PMID: 28256029 DOI: 10.1111/desc.12521
Childhood Laryngeal Dystonia Following Bilateral Globus Pallidus Abnormality: A Case Study and Review of Literature. - OUTRAS ÁREAS
Iran J Otorhinolaryngol. 2017 Jan;29(90):47-52.
Free PMC Article - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5307305/pdf/ijo-29-047.pdf
Saeedi Borujeni MJ, Esfandiary E, Almasi-Dooghaee M.
Isfahan University of Medical Sciences, Isfahan, Iran; Iran University of Medical Sciences, Tehran, Iran.
INTRODUCTION: Dystonia is a disorder of movement caused by various etiologies. Laryngeal dystonia is caused by the spasm of laryngeal muscles. It is a disorder caused by vocal fold movement in which excessive adduction or abduction of the vocal folds occurs during speech. The pathophysiology of this type of dystonia is not fully known. Some researchers have suggested that basal ganglia structures and their connections with cortical areas have been involved in the pathogenesis of dystonia.
CASE REPORT: In this paper a 7.5-year-old boy suffering from laryngeal dystonia with bilateral lesions in Globus Pallidus is presented. The patient also suffered from swallowing problems, monotone voice, vocal tremor, hypersensitivity of gag reflex, and stuttering. Drug treatment failed to cure him; therefore, he was referred to rehabilitation therapy.
CONCLUSION: In conclusion, special attention should be brought upon laryngeal dystonia, especially in patients showing Extra-pyramidal symptoms and/or abnormalities of the basal ganglia. In children, laryngeal dystonia may be potentially fatal. Lack of consideration for this condition during rehabilitation therapy can lead to serious consequences for a child.
PMID: 28229063 PMCID: PMC5307305
Children who stutter show reduced action-related activity in the rostral cingulate zone - INFANTIL
Neuropsychologia. 2017 Feb;96:213-221. Epub 2017 Jan 21.
Harrewijn A, Schel MA, Boelens H, Nater CM, Haggard P, Crone EA.
Leiden University, the Netherlands; Spraak-, Taal- Stottercentrum Rijnland, Oegstgeest, the Netherlands; University College London, United Kingdom.
Previous studies have indicated that children who stutter show not only speech-related problems, but also wider difficulties in self-control. In this study we test the novel hypothesis that children who stutter may experience difficulties with inhibitory control over voluntary actions. We used functional MRI to compare brain activity between children who stutter and children who do not stutter in a task that captures key cognitive aspects of voluntary action control. Participants performed a rolling marble task, in which they were instructed to press a key to stop a rolling marble from crashing on some of the trials (instructed action condition). They were also asked to choose voluntarily whether to execute or inhibit this prepotent response in other trials (volition condition). Children who stutter reported less motor and cognitive impulsivity and had shorter stop-signal reaction times when controlled for IQ, consistent with greater inhibition, compared to children who do not stutter. At the neural level, children who stutter showed decreased activation in the rostral cingulate zone during voluntary action selection compared to children who do not stutter. This effect was more pronounced for children who were rated as showing more stuttered syllables in the stutter screening, and was furthermore correlated with stop-signal reaction times and impulsivity ratings. These findings suggest that stuttering in childhood could reflect wider difficulties in self-control, also in the non-verbal domain. Understanding these neural mechanisms could potentially lead to more focused treatments of stuttering.
PMID: 28115192 DOI: 10.1016/j.neuropsychologia.2017.01.022
[Indexed for MEDLINE]
Comparing acceptance and rejection in the classroom interaction of students who stutter and their peers: A social network analysis - SOCIAL
J Fluency Disord. 2017 Jun;52:13-24. Epub 2017 Mar 1.
Adriaensens S, Van Waes S, Struyf E.
University of Antwerp, Antwerp, Belgium.
PURPOSE: Recent work has reported adverse effects of students' stuttering on their social and emotional functioning at school. Yet, few studies have provided an in-depth examination of classroom interaction of students who stutter (SWS). The current study uses a network perspective to compare acceptance and rejection in the classroom interaction between SWS and their peers in secondary education.
METHODS: The sample comprised 22 SWS and 403 non-stuttering peers (22 classes) of secondary education in Flanders (Belgium). Students' nominations regarding three acceptance and three rejection criteria were combined. Social network analysis offered procedures that considered direct and indirect interaction between all classmates.
RESULTS: We found few significant differences: SWS and their peers were distributed similarly across positive and negative status groups. Both considered and were considered by, on average, six or seven classmates as 'a friend', who they liked and could count on, and nominated or were nominated by one or two classmates as 'no friend', somebody who they disliked and could not count on. On average, SWS and their classmates also did not differ in terms of structural position in the class group (degree, closeness and betweenness), reciprocated rejection, and clique size. However, SWS do tend to be slightly more stringent or more careful in nominating peers, which led to fewer reciprocated friendships.
CONCLUSION: Our results suggest that SWS are quite accepted by peers in secondary education in Flanders. Such positive peer interaction can create a supportive and encouraging climate for SWS to deal with specific challenges.
PMID: 28576290 DOI: 10.1016/j.jfludis.2017.02.002
Comparison between the speech performance of fluent speakers and individuals who stutter. - FALA
[Article in English, Portuguese]
Codas. 2017 Mar 16;29(2):e20160136. doi: 10.1590/2317-1782/20172016136
Free full text inglês: http://www.scielo.br/pdf/codas/v29n2/en_2317-1782-codas-2317-178220172016136.pdf
Free full text português: http://www.scielo.br/pdf/codas/v29n2/2317-1782-codas-2317-178220172016136.pdf
Costa JB, Ritto AP, Juste FS, Andrade CR.
Universidade de São Paulo - USP - São Paulo (SP), Brasil.
PURPOSE: The aim of this study was to compare the speech performance of fluent speakers and individuals who stutter during spontaneous speech, automatic speech, and singing.
METHODS: The study sample was composed of 34 adults, 17 individuals who stutter and 17 fluent controls, matched for gender and age. The speech performance of participants was compared by means of three tasks: monologue, automatic speech, and singing. The following aspects were assessed: total number of common disruptions and total number of stuttering-like disruptions.
RESULTS: Statistically significant difference was observed only for the monologue task in both intra- and inter-group comparisons.
CONCLUSION: The outcomes of this study indicate that tasks of higher motor and melodic complexities, such as the monologue task, negatively affect the speech fluency of both fluent speakers and individuals who stutter.
PMID: 28327784 DOI: 10.1590/2317-1782/20172016136
Cortical auditory evoked potentials in children who stutter - AUDITIVO
Int J Pediatr Otorhinolaryngol. 2017 Jun;97:93-101. Epub 2017 Apr 3.
Ismail N, Sallam Y, Behery R, Al Boghdady A.
Faculty of Medicine, AlAzhar University, Egypt; New Mansoura General Hospital, Egypt.
INTRODUCTION: It has been hypothesized that impaired auditory processing influence the occurrence of stuttering. Also, it is suggested that speech perception in children who stutter differed from normal. Auditory processing should be investigated in children who stutter shortly after the onset of stuttering in order to evaluate the extent to which impaired auditory processing contributes to the development of stuttering. CAEPs provide the necessary temporal and spatial resolution to detect differences in auditory processing and the neural activity that is related or time-locked to the auditory stimulus. The primary goal of the present study was to determine the difference in latency and amplitude of P1-N2 complex between children who stutter and non-stuttering children in response to speech stimuli.
MATERIAL & METHODS: This case-control study was performed over 60children, 30were non-stuttering children (control group) and 30were children who stutter (study group) ranging in severity from Bloodstien I to Bloodstien IV in the age range of 8-18 years.
RESULTS: CAEPs of children who stutter with stuttering severity Bloodstien IV showed significant prolonged latencies and reduced amplitudes when blocks and IPDs were the most predominant core behaviors. P1 and N1 were prolonged in concomitant behaviors.
CONCLUSION: It could be speculated that speech processing was affected in children who stutter with stuttering severity Bloodstien IV at the level of early perceptual auditory cortex.
PMID: 28483259 DOI: 10.1016/j.ijporl.2017.03.030
Cortical dynamics of disfluency in adults who stutter. - NEUROCIÊNCIAS
Physiol Rep. 2017 May;5(9).
Free PMC Article: http://physreports.physiology.org/content/physreports/5/9/e13194.full.pdf
Sengupta R, Shah S, Loucks TMJ, Pelczarski K, Scott Yaruss J, Gore K, Nasir SM.
Northwestern University, Evanston, Illinois; University of Illinois at Urbana-Champaign, Champaign, Illinois; Kansas State University, Manhattan, Kansas; University of Pittsburgh, Pittsburgh, Pennsylvania; speech IRL, Chicago, Illinois.
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.
PMID: 28483857 PMCID: PMC5430117 DOI: 10.14814/phy2.13194
Disfluency characteristics of children with attention-deficit/hyperactivity disorder symptoms - INFANTIL
J Commun Disord. 2017 Jan - Feb;65:54-64. Epub 2016 Dec 21.
Lee H, Sim H, Lee E, Choi D.
Ewha Womans University, Seoul, Republic of Korea; Jeju Choonkang Rehabilitation Hospital, Jeju, Republic of Korea; Dankook University, Gyeonggi-do, Republic of Korea; University of South Alabama, AL, United States.
The purpose of the current study was to investigate the characteristics of speech disfluency in 15 children with attention-deficit/hyperactivity disorder (ADHD) symptoms and 15 age-matched control children. Reading, story retelling, and picture description tasks were used to elicit utterances from the participants. The findings indicated that children with ADHD symptoms produced significantly more stuttering-like disfluencies (SLD) and other disfluencies (OD) when compared to the control group during all three tasks. Further statistical analysis showed that children with ADHD symptoms produced more OD during the story retelling task than the other two tasks, whereas no significant differences in OD were observed among the three tasks in the control children. Finally, children with ADHD symptoms exhibited a higher proportion of SLD in total disfluencies (TD) than the control children. These results are consistent with previous studies that children with ADHD are disfluent in their verbal production. Furthermore, children with ADHD symptoms seem to be more vulnerable to a speaking task that places greater demands on their attentional resources for language production, resulting in increased speech disfluencies.
PMID: 28038762 DOI: 10.1016/j.jcomdis.2016.12.001
EEG Mu (µ) rhythm spectra and oscillatory activity differentiate stuttering from non-stuttering adults. - AUDITIVO
Neuroimage. 2017 Apr 9. pii: S1053-8119(17)30314-2. [Epub ahead of print]
Saltuklaroglu T, Harkrider AW, Thornton D, Jenson D, Kittilstved T.
University of Tennessee Health Science Center, Knoxville, TN 37996, USA.
Stuttering is linked to sensorimotor deficits related to internal modeling mechanisms. This study compared spectral power and oscillatory activity of EEG mu (μ) rhythms between persons who stutter (PWS) and controls in listening and auditory discrimination tasks. EEG data were analyzed from passive listening in noise and accurate (same/different) discrimination of tones or syllables in quiet and noisy backgrounds. Independent component analysis identified left and/or right μ rhythms with characteristic alpha (α) and beta (β) peaks localized to premotor/motor regions in 23 of 27 people who stutter (PWS) and 24 of 27 controls. PWS produced μ spectra with reduced β amplitudes across conditions, suggesting reduced forward modeling capacity. Group time-frequency differences were associated with noisy conditions only. PWS showed increased μ-β desynchronization when listening to noise and early in discrimination events, suggesting evidence of heightened motor activity that might be related to forward modeling deficits. PWS also showed reduced μ-α synchronization in discrimination conditions, indicating reduced sensory gating. Together these findings indicate spectral and oscillatory analyses of μ rhythms are sensitive to stuttering. More specifically, they can reveal stuttering-related sensorimotor processing differences in listening and auditory discrimination that also may be influenced by basal ganglia deficits.
PMID: 28400266 DOI: 10.1016/j.neuroimage.2017.04.022
Estimates of functional cerebral hemispheric differences in monolingual and bilingual people who stutter: Dual-task paradigm. - LINGUAGEM
Clin Linguist Phon. 2017 Apr 14:1-15. [Epub ahead of print]
Kornisch M, Robb MP, Jones RD.
McGill University , Montreal , Québec , Canada; University of Canterbury , Christchurch , New Zealand.
The inter-relationship of stuttering and bilingualism to functional cerebral hemispheric processing was examined on a dual-task paradigm. Eighty native German (L1) speakers, half of whom were sequential bilinguals (L2 = English), were recruited. The participants (mean age = 38.9 years) were organised into four different groups according to speech status and language ability: 20 bilinguals who stutter (BWS), 20 monolinguals who stutter (MWS), 20 bilinguals who do not stutter (BWNS), and 20 monolinguals who do not stutter (MWNS). All participants completed a dual-task paradigm involving simultaneous speaking and finger tapping. No performance differences between BWS and BWNS were found. In contrast, MWS showed greater dual-task interference compared to BWS and MWNS, as well as greater right- than left-hand disruption. A prevailing finding was that bilingualism seems to offset deficits in executive functioning associated with stuttering. Cognitive reserve may have been reflected in the present study, resulting in a bilingual advantage.
PMID: 28409657 DOI: 10.1080/02699206.2017.1305448
Estimates of functional cerebral hemispheric differences in monolingual and bilingual people who stutter: Visual hemifield paradigm - OUTROS
Clin Linguist Phon. 2017;31(4):251-265. Epub 2016 Oct 20.
Kornisch M, Robb MP, Jones RD.
University of Canterbury , Christchurch , Canterbury , New Zealand; McGill University , Montréal , Québec , Canada.
The relationship between stuttering and bilingualism to functional cerebral hemispheric processing was examined using a visual hemifield paradigm. Eighty native German speakers, half of whom were also proficient speakers of English as a second language (L2), were recruited. The participants were organised into four different groups according to speech status and language ability: 20 monolinguals who stutter, 20 bilinguals who stutter, 20 monolinguals who do not stutter, and 20 bilinguals who do not stutter. All participants completed a task involving selective identification of common objects simultaneously presented to both visual fields. Overall, an LVF advantage was observed across all groups with no significant group differences in regard to hemispheric asymmetry. However, both bilingual groups showed faster reaction times and fewer identification errors than the two monolingual groups. A prevailing finding was that bilingualism seems to offset deficits in executive functioning associated with stuttering. Hence, the results lend support to previous findings implicating the benefits of bilingualism.
PMID: 27763772 DOI: 10.1080/02699206.2016.1240236
Evidence for the treatment of co-occurring stuttering and speech sound disorder: A clinical case series. - TERAPIA
Int J Speech Lang Pathol. 2017 Mar 14:1-14. [Epub ahead of print]
Unicomb R, Hewat S, Spencer E, Harrison E.
The University of Newcastle , Newcastle , Australia;, Macquarie University , Sydney , Australia.
PURPOSE: There is a paucity of evidence to guide treatment for children with co-occurring stuttering and speech sound disorder. Some guidelines suggest treating the two disorders simultaneously using indirect treatment approaches; however, the research supporting these recommendations is over 20 years old. In this clinical case series, we investigate whether these co-occurring disorders could be treated concurrently using direct treatment approaches supported by up-to-date, high-level evidence, and whether this could be done in an efficacious, safe and efficient manner.
METHOD: Five pre-school-aged participants received individual concurrent, direct intervention for both stuttering and speech sound disorder. All participants used the Lidcombe Program, as manualised. Direct treatment for speech sound disorder was individualised based on analysis of each child's sound system.
RESULT: At 12 months post commencement of treatment, all except one participant had completed the Lidcombe Program, and were less than 1.0% syllables stuttered on samples gathered within and beyond the clinic. These four participants completed Stage 1 of the Lidcombe Program in between 14 and 22 clinic visits, consistent with current benchmark data for this programme. At the same assessment point, all five participants exhibited significant increases in percentage of consonants correct and were in alignment with age-expected estimates of this measure. Further, they were treated in an average number of clinic visits that compares favourably with other research on treatment for speech sound disorder.
CONCLUSION: These preliminary results indicate that young children with co-occurring stuttering and speech sound disorder may be treated concurrently using direct treatment approaches. This method of service delivery may have implications for cost and time efficiency and may also address the crucial need for early intervention in both disorders. These positive findings highlight the need for further research in the area and contribute to the limited evidence base.
PMID: 28290729 DOI: 10.1080/17549507.2017.1293735
Explicit and Implicit Verbal Response Inhibition in Preschool-Age Children Who Stutter. - LINGUAGEM
J Speech Lang Hear Res. 2017 Apr 14;60(4):836-852.
Anderson JD, Wagovich SA
Indiana University, Bloomington; University of Missouri, Columbia.
PURPOSE: The purpose of this study was to examine (a) explicit and implicit verbal response inhibition in preschool children who do stutter (CWS) and do not stutter (CWNS) and (b) the relationship between response inhibition and language skills.
METHOD: Participants were 41 CWS and 41 CWNS between the ages of 3;1 and 6;1 (years;months). Explicit verbal response inhibition was measured using a computerized version of the grass-snow task (Carlson & Moses, 2001), and implicit verbal response inhibition was measured using the baa-meow task. Main dependent variables were reaction time and accuracy.
RESULTS: The CWS were significantly less accurate than the CWNS on the implicit task, but not the explicit task. The CWS also exhibited slower reaction times than the CWNS on both tasks. Between-group differences in performance could not be attributed to working memory demands. Overall, children's performance on the inhibition tasks corresponded with parents' perceptions of their children's inhibition skills in daily life.
CONCLUSIONS: CWS are less effective and efficient than CWNS in suppressing a dominant response while executing a conflicting response in the verbal domain.
PMID: 28384673 DOI: 10.1044/2016_JSLHR-S-16-0135
Exploring risk factors for stuttering development in Parkinson disease after deep brain stimulation. - OUTRAS ÁREAS
Parkinsonism Relat Disord. 2017 May;38:85-89. Epub 2017 Feb 20.
Picillo M, Vincos GB, Sammartino F, Lozano AM, Fasano A.
University of Salerno, Salerno, Italy; Universidad la Sabana, Bogota, Colombia; University of Toronto, Canada; Krembil Research Institute, Toronto, Ontario, Canada.
BACKGROUND: Stuttering is a speech disorder with disruption of verbal fluency, occasionally present in Parkinson's disease (PD). PD co-incident stuttering may either worsen or improve after Deep Brain Stimulation (DBS).
METHODS: Sixteen out of 453 PD patients (3.5%) exhibited stuttering after DBS (PD-S) and were compared with a group of patients without stuttering (PD-NS) using non-parametric statistics.
RESULTS: After DBS, stuttering worsened in 3 out of 4 patients with co-incidental stuttering. Most PD-S underwent subthalamic (STN) DBS, but 4 were implanted in the globus pallidus (GPi). Nine out of 16 PD-S (56.3%) reported a positive familial history for stuttering compared to none of the PD-NS. PD-S were mainly male (81.3%) with slight worse motor features compared to PD-NS.
CONCLUSION: Herein, we describe a group of PD patients developing stuttering after DBS and report the presence of a positive familial history for stuttering as the most relevant risk factor, suggesting a possible underlying genetic cause. The fact that stuttering occurred after either STN or GPi DBS is an argument against the impact of medication reduction on stuttering.
PMID: 28237852 DOI: 10.1016/j.parkreldis.2017.02.015
Factitious Disorder Presenting with Stuttering in Two Adolescents: The Importance of Psychoeducation - EMOCIONAL
Noro Psikiyatr Ars. 2017 Mar;54(1):87-89. Epub 2017 Mar 1.
Bolat N1, Yalçin Ö2.
İzmir Tepecik Training and Research Hospital, İzmir, Turkey;, Bakırköy Psychiatric Hospital, İstanbul, Turkey.
A factitious disorder (FD) is a diagnostic entity in which patients intentionally act physically or mentally ill without obvious benefits and without being consciously aware of a clear underlying motive. Most pediatric FD cases have been reported as Munchausen syndrome by Proxy; however, pediatric disease symptoms can also be intentionally falsified by child and adolescent patients. To our knowledge, in the medical literature, an FD patient presenting with stuttering has not been previously reported. In this case report, we aimed to discuss the diagnosis and treatment process of FDs in children and adolescents by reporting the cases of two FD patients presenting with stuttering according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition. Both patients improved with psychoeducation and early confrontation.
PMID: 28566966 PMCID: PMC5439479 DOI: 10.5152/npa.2017.12349
Fear of Negative Evaluation, Trait Anxiety, and Judgment Bias in Adults who Stutter. - EMOCIONAL
Am J Speech Lang Pathol. 2017 May 17;26(2):498-510.
Brundage SB, Winters KL, Beilby JM.
George Washington University, Washington, DC; Curtin University, Perth, Australia.
PURPOSE: Persons who stutter (PWS) and those with social anxiety disorder may exhibit fear of negative evaluation (FNE) and anxiety in social situations. However, the information processing biases that perpetuate these characteristics have had limited investigation. This study investigated judgment bias in social situations.
METHOD: Participants included 50 adults who stutter and 45 age- and gender-matched fluent persons who do not stutter (PWNS), who made up the control group. Participants completed the Interpretation and Judgmental Questionnaire (Voncken, Bögels, & deVries, 2003), and threat scores were calculated.
RESULTS: There were no significant differences between PWS and PWNS in social threat or nonsocial threat scores. When the PWS group was divided on the basis of FNE and compared with PWNS participants without heightened anxiety (n = 35), the PWS with high FNE had significantly higher total social threat scores than the PWS with low FNE. The three groups did not differ in threat ratings for ambiguous or profoundly negative social situations.
CONCLUSIONS: Judgment bias in PWS is mediated by the magnitude of FNE present; not all PWS exhibit judgment bias for social situations. Treatment implications include the need for psychosocial support addressing the negative impacts on quality of life and restrictions on social engagement that stuttering may cause in some individuals.
PMID: 28475659 DOI: 10.1044/2017_AJSLP-16-0129
FOXP2 variants in 14 individuals with developmental speech and language disorders broaden the mutational and clinical spectrum. - GENÉTICA
J Med Genet. 2017 Jan;54(1):64-72. Epub 2016 Aug 29.
Reuter MS, Riess A, Moog U, Briggs TA, Chandler KE, Rauch A, Stampfer M, Steindl K, Gläser D, Joset P; DDD Study, Krumbiegel M, Rabe H, Schulte-Mattler U, Bauer P, Beck-Wödl S, Kohlhase J, Reis A, Zweier C.
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; University of Tübingen, Tübingen, Germany; Heidelberg University, Heidelberg, Germany; Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK; University of Manchester, Manchester, UK; University of Zurich, Schlieren-Zurich, Switzerland; Genetikum, Neu-Ulm, Germany; Kinderzentrum St. Martin, Regensburg, Germany; Centre for Human Genetics, Freiburg, Germany.
BACKGROUND: Disruptions of the FOXP2 gene, encoding a forkhead transcription factor, are the first known monogenic cause of a speech and language disorder. So far, mainly chromosomal rearrangements such as translocations or larger deletions affecting FOXP2 have been reported. Intragenic deletions or convincingly pathogenic point mutations in FOXP2 have up to date only been reported in three families. We thus aimed at a further characterisation of the mutational and clinical spectrum.
METHODS: Chromosomal microarray testing, trio exome sequencing, multigene panel sequencing and targeted sequencing of FOXP2 were performed in individuals with variable developmental disorders, and speech and language deficits.
RESULTS: We identified four different truncating mutations, two novel missense mutations within the forkhead domain and an intragenic deletion in FOXP2 in 14 individuals from eight unrelated families. Mutations occurred de novo in four families and were inherited from an affected parent in the other four. All index patients presented with various manifestations of language and speech impairment. Apart from two individuals with normal onset of speech, age of first words was between 4 and 7 years. Articulation difficulties such as slurred speech, dyspraxia, stuttering and poor pronunciation were frequently noted. Motor development was normal or only mildly delayed. Mild cognitive impairment was reported for most individuals.
CONCLUSIONS: By identifying intragenic deletions or mutations in 14 individuals from eight unrelated families with variable developmental delay/cognitive impairment and speech and language deficits, we considerably broaden the mutational and clinical spectrum associated with aberrations in FOXP2.
PMID: 27572252 DOI: 10.1136/jmedgenet-2016-104094
[PubMed - in process]
Genetic contributions to stuttering: the current evidence. - GENÉTICA
Mol Genet Genomic Med. 2017 Feb 19;5(2):95-102.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370225/pdf/MGG3-5-95.pdf
Frigerio-Domingues C, Drayna D.
National Institute on Deafness and Other Communication Disorders Porter Neuroscience Research Center National Institutes of Health.
Evidence for genetic factors in persistent developmental stuttering has accumulated over the past four decades, and the genes that underlie this disorder are starting to be identified. The genes identified to date, all point to deficits in intracellular trafficking in this disorder.
PMID: 28361094 PMCID: PMC5370225 DOI: 10.1002/mgg3.276
Grey matter volume differences in the left caudate nucleus of people who stutter - NEUROCIÊNCIAS
Brain Lang. 2017 Jan;164:9-15. Epub 2016 Sep 29.
Free Full Text: http://ac.els-cdn.com/S0093934X1530016X/1-s2.0-S0093934X1530016X-main.pdf?_tid=3d654a5a-58fe-11e7-8bfc-00000aacb35e&acdnat=1498323643_fbbbfb27fe54dc1a34b41a5164a4b266
Sowman PF, Ryan M, Johnson BW, Savage G, Crain S, Harrison E, Martin E, Burianová H.
Macquarie University, Australia; Australian Research Council Centre of Excellence in Cognition and Its Disorders, Australia; The University of Queensland, Australia.
The cause of stuttering has many theoretical explanations. A number of research groups have suggested changes in the volume and/or function of the striatum as a causal agent. Two recent studies in children and one in adults who stutter (AWS) report differences in striatal volume compared that seen in controls; however, the laterality and nature of this anatomical volume difference is not consistent across studies. The current study investigated whether a reduction in striatal grey matter volume, comparable to that seen in children who stutter (CWS), would be found in AWS. Such a finding would support claims that an anatomical striatal anomaly plays a causal role in stuttering. We used voxel-based morphometry to examine the structure of the striatum in a group of AWS and compared it to that in a group of matched adult control subjects. Results showed a statistically significant group difference for the left caudate nucleus, with smaller mean volume in the group of AWS. The caudate nucleus, one of three main structures within the striatum, is thought to be critical for the planning and modulation of movement sequencing. The difference in striatal volume found here aligns with theoretical accounts of stuttering, which suggest it is a motor control disorder that arises from deficient articulatory movement selection and sequencing. Whilst the current study provides further evidence of a striatal volume difference in stuttering at the group level compared to controls, the significant overlap between AWS and controls suggests this difference is unlikely to be diagnostic of stuttering.
PMID: 27693846 DOI: 10.1016/j.bandl.2016.08.009
Hemodynamics of speech production: An fNIRS investigation of children who stutter - INFANTIL
Sci Rep. 2017 Jun 22;7(1):4034.
Walsh B, Tian F, Tourville JA, Yücel MA, Kuczek T, Bostian AJ.
Purdue University, West Lafayette, IN, USA; University of Texas Arlington, Arlington, TX, USA.; Boston University, Boston, MA, USA; Harvard Medical School, MA, USA.
Stuttering affects nearly 1% of the population worldwide and often has life-altering negative consequences, including poorer mental health and emotional well-being, and reduced educational and employment achievements. Over two decades of neuroimaging research reveals clear anatomical and physiological differences in the speech neural networks of adults who stutter. However, there have been few neurophysiological investigations of speech production in children who stutter. Using functional near-infrared spectroscopy (fNIRS), we examined hemodynamic responses over neural regions integral to fluent speech production including inferior frontal gyrus, premotor cortex, and superior temporal gyrus during a picture description task. Thirty-two children (16 stuttering and 16 controls) aged 7-11 years participated in the study. We found distinctly different speech-related hemodynamic responses in the group of children who stutter compared to the control group. Whereas controls showed significant activation over left dorsal inferior frontal gyrus and left premotor cortex, children who stutter exhibited deactivation over these left hemisphere regions. This investigation of neural activation during natural, connected speech production in children who stutter demonstrates that in childhood stuttering, atypical functional organization for speech production is present and suggests promise for the use of fNIRS during natural speech production in future research with typical and atypical child populations.
PMID: 28642548 DOI: 10.1038/s41598-017-04357-6
Impact of Internet Gambling on Mental and Psychological Health of Children of Various Ages - AMBIENTE
Georgian Med News. 2017 Mar;(264):50-53.
Khundadze M, Geladze N, Kapanadze N.
Tbilisi State Medical University, Department of Child Neurology, Georgia.
The aim of the study was to assess the impact of internet gambling on children's mental and physical health and find correlation between the age, duration of internet use and type of comorbidity associated with internet gambling. The study assessed 50 patients with internet gambling (35 boys, 15 girls) from 2013-2016 y. The age range was 3-15 years. 15 patients were from 3-7 y of age, 20 patients from 7-12 y and 15 - from 12-15 y of age. The core problem common for all patients were internet overuse by computer games, mobile device and other gadgets. The main problem occurring in these children were insomnia, language delay, stuttering, behavioral disturbances, aggressive behavior phobias. These complaints were correlated with age of patients. The group of patients from 3-7 years of age exhibited sleep disturbances and language impairment, mainly presented with stuttering. The complaints occurring in children from 7-12 y of age are: tics, insomnia, phobias, emotional disturbances, daily fatigue, and attention-deficit. The group of children aged 12-15 years mainly revealed poor academic performance, refuse to play sport games, refuse to play music, insomnia, aggressive behavior, attention deficit, conflict with parents, coprolalia. Thus internet overuse affects physical and psychological aspects of child development which has to be managed by parental and psychologist's joint effort.
Intragenic CNTNAP2 Deletions: A Bridge Too Far? - GENÉTICA
Mol Syndromol. 2017 May;8(3):118-130. Epub 2017 Feb 10.
Free Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5448439/pdf/msy-0008-0118.pdf
Department of Human Genetics, University of Würzburg, Würzburg, Germany.
Intragenic deletions of the contactin-associated protein-like 2 gene (CNTNAP2) have been found in patients with Gilles de la Tourette syndrome, intellectual disability (ID), obsessive compulsive disorder, cortical dysplasia-focal epilepsy syndrome, autism, schizophrenia, Pitt-Hopkins syndrome, stuttering, and attention deficit hyperactivity disorder. A variety of molecular mechanisms, such as loss of transcription factor binding sites and perturbation of penetrance and expressivity, have been proposed to account for the phenotypic variability resulting from CNTNAP2 mutations. Deletions of both CNTNAP2 alleles produced truncated proteins lacking the transmembrane or some of the extracellular domains, or no protein at all. This observation can be extended to heterozygous intragenic deletions by assuming that such deletion-containing alleles lead to expression of a Caspr2 protein lacking one or several extracellular domains. Such altered forms of Capr2 proteins will lack the ability to bridge the intercellular space between neurons by binding to partners, such as CNTN1, CNTN2, DLG1, and DLG4. This presumed effect of intragenic deletions of CNTNAP2, and possibly other genes involved in connecting neuronal cells, represents a molecular basis for the postulated neuronal hypoconnectivity in autism and probably other neurodevelopmental disorders, including epilepsy, ID, language impairments and schizophrenia. Thus, CNTNAP2 may represent a paradigmatic case of a gene functioning as a node in a genetic and cellular network governing brain development and acquisition of higher cognitive functions.
PMID: 28588433 PMCID: PMC5448439 [Available on 2017-11-01] DOI: 10.1159/000456021
Investigating the feasibility of using transcranial direct current stimulation to enhance fluency in people who stutter - TERAPIA
Brain Lang. 2017 Jan;164:68-76. Epub 2016 Oct 31.
Free PMC Article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5240850/
Chesters J, Watkins KE, Möttönen R.
University of Oxford, Oxford, UK.
Developmental stuttering is a disorder of speech fluency affecting 1% of the adult population. Long-term reductions in stuttering are difficult for adults to achieve with behavioural therapies. We investigated whether a single session of transcranial direct current stimulation (TDCS) could improve fluency in people who stutter (PWS). In separate sessions, either anodal TDCS (1mA for 20min) or sham stimulation was applied over the left inferior frontal cortex while PWS read sentences aloud. Fluency was induced during the stimulation period by using choral speech, that is, participants read in unison with another speaker. Stuttering frequency during sentence reading, paragraph reading and conversation was measured at baseline and at two outcome time points: immediately after the stimulation period and 1h later. Stuttering was reduced significantly at both outcome time points for the sentence-reading task, presumably due to practice, but not during the paragraph reading or conversation tasks. None of the outcome measures were significantly modulated by anodal TDCS. Although the results of this single-session study showed no significant TDCS-induced improvements in fluency, there were some indications that further research is warranted. We discuss factors that we believe may have obscured the expected positive effects of TDCS on fluency, such as heterogeneity in stuttering severity for the sample and variations across sessions. Consideration of such factors may inform future studies aimed at determining the potential of TDCS in the treatment of developmental stuttering.
PMID: 27810647 PMCID: PMC5240850 DOI: 10.1016/j.bandl.2016.10.003
Japanese normative data for the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) Scales for adults who stutter - AVALIAÇÃO
J Fluency Disord. 2017 Mar;51:1-7. Epub 2016 Nov 5.
Chu SY, Sakai N, Mori K, Iverach L.
Universiti Kebangsaan Malaysia; National Rehabilitation Center for Persons with Disabilities, , Japan; The University of Sydney, Australia; Macquarie University, Australia.
PURPOSE: This study reports Japanese normative data for the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) scales. We outline the translation process, and evaluate the psychometric properties of the Japanese version of the UTBAS scales.
METHODS: The translation of the UTBAS scales into Japanese (UTBAS-J) was completed using the standard forward-backward translation process, and was administered to 130 Japanese adults who stutter. To validate the UTBAS-J scales, scores for the Japanese and Australian cohorts were compared. Spearman correlations were conducted between the UTBAS-J and the Modified Erickson Communication Attitude scale (S-24), the self-assessment scale of speech (SA scale), and age. The test-retest reliability and internal consistency of the UTBAS-J were assessed. Independent t-tests were conducted to evaluate the differences in the UTBAS-J scales according to gender, speech treatment experience, and stuttering self-help group participation experience.
RESULTS: The UTBAS-J showed good test-retest reliability, high internal consistency, and moderate to high significant correlations with S-24 and SA scale. A weak correlation was found between the UTBAS-J scales with age. No significant relationships were found between UTBAS-J scores, gender and speech treatment experience. However, those who participated in the stuttering self-help group demonstrated lower UTBAS-J scores than those who did not.
CONCLUSION: Given the current scarcity of clinical assessment tools for adults who stutter in Japan, the UTBAS-J holds promise as an assessment tool and outcome measure for use in clinical and research environments.
PMID: 28212717 DOI: 10.1016/j.jfludis.2016.09.006
Language skills of children during the first 12 months after stuttering onset. - LINGUAGEM
J Fluency Disord. 2017 Mar;51:39-49. Epub 2016 Dec 26.
Watts A, Eadie P, Block S, Mensah F, Reilly S.
Royal Children's Hospital, Flemington Rd., Parkville, Australia; University of Melbourne, Australia; La Trobe University, Bundoora, Australia; Griffith University, Australia.
PURPOSE: To describe the language development in a sample of young children who stutter during the first 12 months after stuttering onset was reported.
METHODS: Language production was analysed in a sample of 66 children who stuttered (aged 2-4 years). The sample were identified from a pre-existing prospective, community based longitudinal cohort. Data were collected at three time points within the first year after stuttering onset. Stuttering severity was measured, and global indicators of expressive language proficiency (length of utterances and grammatical complexity) were derived from the samples and summarised. Language production abilities of the children who stutter were contrasted with normative data.
RESULTS: The majority of children's stuttering was rated as mild in severity, with more than 83% of participants demonstrating very mild or mild stuttering at each of the time points studied. The participants demonstrated developmentally appropriate spoken language skills comparable with available normative data.
CONCLUSION: In the first year following the report of stuttering onset, the language skills of the children who were stuttering progressed in a manner that is consistent with developmental expectations.
PMID: 28212719 DOI: 10.1016/j.jfludis.2016.12.001
Maintenance of Social Anxiety in Stuttering: A Cognitive-Behavioral Model. - EMOCIONAL
Am J Speech Lang Pathol. 2017 Mar 23:1-17. [Epub ahead of print]
Iverach L, Rapee RM, Wong QJ, Lowe R.
Macquarie University, Sydney, Australia; The University of Sydney.
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.
PMID: 28334398 DOI: 10.1044/2016_AJSLP-16-0033
Manganese exposure and neurotoxic effects in children. - GAGUEIRA ADQUIRIDA
Environ Res. 2017 May;155:380-384. Epub 2017 Mar 10.
Bjørklund G, Chartrand MS, Aaseth J.
Council for Nutritional and Environmental Medicine, Mo i Rana, Norway; DigiCare Behavioral Research, Casa Grande, AZ, USA; Department of Public Health, Hedmark University of Applied Sciences, Elverum, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway.
Manganese (Mn) is the fifth most abundant metal on earth. Although it is a well understood essential trace element, in excess, Mn is neurotoxic. Initial toxic symptoms associated with Mn are of psychiatric nature and are clinically defined as locura manganica. Neurological signs of Mn toxicity include dystonia, progressive bradykinesia, and disturbance of gait, slurring, and stuttering of speech with diminished volume. Studies indicate that children who ingested Mn in the drinking water (WMn) at or above a level of 0.241mg/L for a minimum of three years performed more poorly in school as measured by mastery of language, mathematics, and in their overall grade average. The Mn-exposed children also performed more poorly on a battery of neurobehavioral tests. It was also found a significant association between higher WMn and lower cognitive performance, verbal function, and full-scale intelligence quotient (IQ) scores. Young children appear to make up a vulnerable group in exposed populations. Toxicity of WMn is a problem particularly in areas of industrial waste or where Mn is leaching from the soil into public drinking water. Practical and cost-effective approaches are available to remove Mn from drinking water. It is crucial to protect developing brains against Mn toxicity.
PMID: 28282629 DOI: 10.1016/j.envres.2017.03.003
Man stops stuttering with alcohol dependence drug - FARMACOLOGIA
BMJ. 2017 May 11;357:j2328.
The muscle relaxant drug baclofen may help people who stutter, researchers have said, after a man given the drug in a clinical trial on alcohol dependence spoke fluently and then stuttered again when he stopped taking it.
Reporting their findings in BMJ Case Reports,1 researchers from the Netherlands warned that the result would need to be confirmed in clinical trials, but they cited plausible biological reasons for their observations.
Baclofen is a muscle relaxant used to treat the muscle spasticity caused by conditions such as multiple sclerosis and spinal cord diseases
Overexpression of human NR2B receptor subunit in LMAN causes stuttering and song sequence changes in adult zebra finches - OUTROS
Sci Rep. 2017 Apr 21;7(1):942.
Free full text: https://www.nature.com/articles/s41598-017-00519-8
Chakraborty M, Chen LF, Fridel EE, Klein ME, Senft RA, Sarkar A, Jarvis ED.
Duke University Medical Center, Durham, NC, USA; Howard Hughes Medical Institute, Chevy Chase, MD, USA; Harvard University, Cambridge, MA, USA; The Rockefeller University, New York, NY, USA.
Zebra finches (Taeniopygia guttata) learn to produce songs in a manner reminiscent of spoken language development in humans. One candidate gene implicated in influencing learning is the N-methyl-D-aspartate (NMDA) subtype 2B glutamate receptor (NR2B). Consistent with this idea, NR2B levels are high in the song learning nucleus LMAN (lateral magnocellular nucleus of the anterior nidopallium) during juvenile vocal learning, and decreases to low levels in adults after learning is complete and the song becomes more stereotyped. To test for the role of NR2B in generating song plasticity, we manipulated NR2B expression in LMAN of adult male zebra finches by increasing its protein levels to those found in juvenile birds, using a lentivirus containing the full-length coding sequence of the human NR2B subunit. We found that increased NR2B expression in adult LMAN induced increases in song sequence diversity and slower song tempo more similar to juvenile songs, but also increased syllable repetitions similar to stuttering. We did not observe these effects in control birds with overexpression of NR2B outside of LMAN or with the green fluorescent protein (GFP) in LMAN. Our results suggest that low NR2B subunit expression in adult LMAN is important in conserving features of stereotyped adult courtship song.
PMID: 28432288 DOI: 10.1038/s41598-017-00519-8
Proton Chemical Shift Imaging of the Brain in Pediatric and Adult Developmental Stuttering - NEUROCIÊNCIAS
JAMA Psychiatry. 2017 Jan 1;74(1):85-94.
O'Neill J, Dong Z, Bansal R, Ivanov I, Hao X, Desai J, Pozzi E, Peterson BS.
University of California-Los Angeles Semel Institute for Neuroscience, Los Angeles; Columbia University, New York, New York; New York State Psychiatric Institute, New York; University of Southern California, Los Angeles; Children's Hospital Los Angeles, Los Angeles, California; Icahn School of Medicine at Mount Sinai, New York, New York.
IMPORTANCE: Developmental stuttering is a neuropsychiatric condition of incompletely understood brain origin. Our recent functional magnetic resonance imaging study indicates a possible partial basis of stuttering in circuits enacting self-regulation of motor activity, attention, and emotion.
OBJECTIVE: To further characterize the neurophysiology of stuttering through in vivo assay of neurometabolites in suspect brain regions.
DESIGN, SETTING, AND PARTICIPANTS: Proton chemical shift imaging of the brain was performed in a case-control study of children and adults with and without stuttering. Recruitment, assessment, and magnetic resonance imaging were performed in an academic research setting.
MAIN OUTCOMES AND MEASURES: Ratios of N-acetyl-aspartate plus N-acetyl-aspartyl-glutamate (NAA) to creatine (Cr) and choline compounds (Cho) to Cr in widespread cerebral cortical, white matter, and subcortical regions were analyzed using region of interest and data-driven voxel-based approaches.
RESULTS: Forty-seven children and adolescents aged 5 to 17 years (22 with stuttering and 25 without) and 47 adults aged 21 to 51 years (20 with stuttering and 27 without) were recruited between June 2008 and March 2013. The mean (SD) ages of those in the stuttering and control groups were 12.2 (4.2) years and 13.4 (3.2) years, respectively, for the pediatric cohort and 31.4 (7.5) years and 30.5 (9.9) years, respectively, for the adult cohort. Region of interest-based findings included lower group mean NAA:Cr ratio in stuttering than nonstuttering participants in the right inferior frontal cortex (-7.3%; P = .02), inferior frontal white matter (-11.4%; P < .001), and caudate (-10.6%; P = .04), while the Cho:Cr ratio was higher in the bilateral superior temporal cortex (left: +10.0%; P = .03 and right: +10.8%; P = .01), superior temporal white matter (left: +14.6%; P = .003 and right: +9.5%; P = .02), and thalamus (left: +11.6%; P = .002 and right: +11.1%; P = .001). False discovery rate-corrected voxel-based findings were highly consistent with region of interest findings. Additional voxel-based findings in the stuttering sample included higher NAA:Cr and Cho:Cr ratios (regression coefficient, 197.4-275; P < .001) in the posterior cingulate, lateral parietal, hippocampal, and parahippocampal cortices and amygdala, as well as lower NAA:Cr and Cho:Cr ratios (regression coefficient, 119.8-275; P < .001) in the superior frontal and frontal polar cortices. Affected regions comprised nodes of the Bohland speech-production (motor activity regulation), default-mode (attention regulation), and emotional-memory (emotion regulation) networks. Regional correlations were also observed between local metabolites and stuttering severity (r = 0.40-0.52; P = .001-.02).
CONCLUSIONS AND RELEVANCE: This spectroscopy study of stuttering demonstrates brainwide neurometabolite alterations, including several regions implicated by other neuroimaging modalities. Prior ascription of a role in stuttering to inferior frontal and superior temporal gyri, caudate, and other structures is affirmed. Consistent with prior functional magnetic resonance imaging findings, these results further intimate neurometabolic aberrations in stuttering in brain circuits subserving self-regulation of speech production, attention, and emotion.
PMID: 27893013 DOI: 10.1001/jamapsychiatry.2016.3199
Psychological counseling as an adjunct to stuttering treatment: Clients' experiences and perceptions - EMOCIONAL
J Fluency Disord. 2017 Jun;52:1-12. Epub 2017 Feb 5.
Lindsay A, Langevin M
University of Alberta, Canada.
PURPOSE: Stuttering can trigger anxiety and other psychological and emotional reactions, and limit participation in society. It is possible that psychological counseling could enhance stuttering treatment outcomes; however, little is known about how clients view such counseling. The purpose of this study was to gain an understanding of clients' experiences with, and perceptions of, a psychological counseling service that was offered as an optional adjunct to speech therapy for stuttering.
METHOD: Nine individuals who stutter (13-38 years old) participated in semi-structured interviews. Six participants had taken part in psychological counseling; three participants did not do so. Interview data were analyzed using grounded theory as a guiding framework.
RESULTS: Four thematic clusters emerged from participants' accounts: insights into personal decision-making, why others may not participate in counseling, psychological counseling as a worthwhile part of therapy, and counseling as a necessary component in a stuttering treatment program.
CONCLUSION: In addition to experiencing barriers and facilitators to help-seeking that are reported in related fields, participants accounts also revealed novel facilitators (i.e., a 'why not' mentality and the importance of having a pre-existing relationship with the clinician who offered the service) and barriers (i.e., viewing the service as a 'limited resource,' and, the overwhelming nature of intensive stuttering treatment programs). Findings suggest that clients value the option to access psychological counseling with trained mental health professionals to support the stuttering treatment provided by speech-language pathologists. Participants made recommendations for the integration of psychological counseling into stuttering treatment programs.
PMID: 28576289 DOI: 10.1016/j.jfludis.2017.01.003
Reduced perfusion in Broca's area in developmental stuttering - NEUROCIÊNCIAS
Hum Brain Mapp. 2017 Apr;38(4):1865-1874. doi: 10.1002/hbm.23487. Epub 2016 Dec 30.
Desai J, Huo Y, Wang Z, Bansal R, Williams SC, Lythgoe D, Zelaya FO, Peterson BS.
Children's Hospital Los Angeles, California; University of Southern California, Los Angeles, California; Columbia University, New York, New York; King's College, London, United Kingdom.
OBJECTIVE: To study resting cerebral blood flow in children and adults with developmental stuttering.
METHODS: We acquired pulsed arterial spin labeling magnetic resonance imaging data in 26 participants with stuttering and 36 healthy, fluent controls. While covarying for age, sex, and IQ, we compared perfusion values voxel-wise across diagnostic groups and assessed correlations of perfusion with stuttering severity within the stuttering group and with measures of motor speed in both groups.
RESULTS: We detected lower regional Cerebral Blood Flow (rCBF) at rest in the stuttering group compared with healthy controls in Broca's area bilaterally and the superior frontal gyrus. rCBF values in Broca's area bilaterally correlated inversely with the severity of stuttering and extended posteriorly into other portions of the language loop. We also found increased rCBF in cerebellar nuclei and parietal cortex in the stuttering group compared with healthy controls. Findings were unchanged in child-only analyses and when excluding participants with comorbid illnesses or those taking medication.
CONCLUSIONS: rCBF is reduced in Broca's region in persons who stutter. More severe stuttering is associated with even greater reductions in rCBF to Broca's region, additive to the underlying putative trait reduction in rCBF relative to control values. Moreover, a greater abnormality in rCBF in the posterior language loop is associated with more severe symptoms, suggesting that a common pathophysiology throughout the language loop likely contributes to stuttering severity. Hum Brain Mapp 38:1865-1874, 2017. © 2017 Wiley Periodicals, Inc.
PMID: 28035724 PMCID: PMC5342907 [Available on 2018-04-01] DOI: 10.1002/hbm.23487
Reorganization of brain function after a short-term behavioral intervention for stuttering - TERAPIA
Brain Lang. 2017 May;168:12-22. Epub 2017 Jan 21.
Lu C, Zheng L, Long Y, Yan Q, Ding G, Liu L, Peng D, Howell P.
Beijing Normal University, Beijing, China; Stuttering Therapy Center, Beijing, China; University College London, UK.
This study investigated changes in brain function that occurred over a 7-day behavioral intervention for adults who stutter (AWS). Thirteen AWS received the intervention (AWS+), and 13 AWS did not receive the intervention (AWS-). There were 13 fluent controls (FC-). All participants were scanned before and after the intervention. Whole-brain analysis pre-intervention showed significant differences in task-related brain activation between AWS and FC- in the right inferior frontal cortex (IFC) and left middle temporal cortex, but there were no differences between the two AWS groups. Across the 7-day period of the intervention, AWS+ alone showed a significant increase of brain activation in the left ventral IFC/insula. There were no changes in brain function for the other two groups. Further analysis revealed that the change did not correlate with resting-state functional connectivity (RSFC) that AWS showed in the cerebellum (Lu et al., 2012). However, both changes in task-related brain function and RSFC correlated with changes in speech fluency level. Together, these findings suggest that functional reorganization in a brain region close to the left IFC that shows anomalous function in AWS, occurs after a short-term behavioral intervention for stuttering.
PMID: 28113105 DOI: 10.1016/j.bandl.2017.01.001
Research about suppression effect and auditory processing in individuals who stutter. - AUDITIVO
Codas. 2017 May 22;29(3):e20160230.
Free full text - Inglês - http://www.scielo.br/pdf/codas/v29n3/en_2317-1782-codas-29-3-e20160230.pdf
Free full text - Português - http://www.scielo.br/pdf/codas/v29n3/2317-1782-codas-29-3-e20160230.pdf
Arcuri CF1, Schiefer AM1, Azevedo MF1.
Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil.
PURPOSE: To verify the auditory processing abilities and occurrence of the suppression effect of Otoacoustic Emissions (OAE) in individuals who stutter.
METHODS: The study sample comprised 15 adult individuals who stutter, aged 18-40 years, with stuttering severity ranging from mild to severe, paired according to gender, age, and schooling with individuals without speech complaint or disorder. All participants underwent conventional clinical evaluation, specific stuttering assessment, and basic (audiometry, imitanciometry, and measurement of acoustic reflexes) and specific (auditory processing evaluation and measurement of suppression effect of OAEs) audiological assessments. Data were statistically analyzed with application of the Fisher's Exact Test and the Mann-Whitney Test.
RESULTS: The group of individuals who stutter (Study Group - SG) presented higher incidence of auditory processing disorders. The auditory processing assessments used to differentiate the groups of stutterers and non-stutterers (Control Group - CG) were the Nonverbal Dichotic Test and the Frequency Pattern Test. The SG presented higher incidence of absence of suppression effect of OAEs, indicating abnormal functioning of the efferent medial olivocochlear system.
CONCLUSION: The auditory processing abilities investigated in this study differentiate individuals who stutter from non-stutterers, with greater changes in the first. Functioning of the efferent medial olivocochlear system showed a deficit in stutterers, indicating difficulties in auditory discrimination, especially in the presence of noise.
PMID: 28538833 DOI: 10.1590/2317-1782/20172016230
Safety Behaviors and Stuttering. - EMOCIONAL
J Speech Lang Hear Res. 2017 May 24;60(5):1246-1253.
Lowe R, Helgadottir F, Menzies R, Heard R, O'Brian S, Packman A, Onslow M.
The University of Sydney, Australia; The Vancouver CBT Centre, Canada.
PURPOSE: Those who are socially anxious may use safety behaviors during feared social interactions to prevent negative outcomes. Safety behaviors are associated with anxiety maintenance and poorer treatment outcomes because they prevent fear extinction. Social anxiety disorder is often comorbid with stuttering. Speech pathologists reported in a recent publication (Helgadottir, Menzies, Onslow, Packman, & O'Brian, 2014a) that they often recommended procedures for clients that could be safety behaviors. This study investigated the self-reported use of safety behaviors by adults who stutter.
METHOD: Participants were 133 adults who stutter enrolled in an online cognitive-behavior therapy program. Participants completed a questionnaire about their use of potential safety behaviors when anxious during social encounters. Correlations were computed between safety behaviors and pretreatment scores on measures of fear of negative evaluation and negative cognitions.
RESULTS: Of 133 participants, 132 reported that they used safety behaviors. Many of the safety behaviors correlated with higher scores for fear of negative evaluation and negative cognitions.
CONCLUSIONS: Adults who stutter report using safety behaviors, and their use is associated with pretreatment fear of negative evaluation and unhelpful thoughts about stuttering. These results suggest that the negative effects of safety behaviors may extend to those who stutter, and further research is needed.
PMID: 28525541 DOI: 10.1044/2016_JSLHR-S-16-0055
Speaking fluently with baclofen? - FARMACOLOGIA
BMJ Case Rep. 2017 May 11;2017.
Beraha E, Bodewits P, van den Brink W, Wiers R.
Universiteit van Amsterdam, Amsterdam, The Netherlands; The Home Clinic, Weesp, The Netherlands; Academical Medical Centre (AMC), Amsterdam, The Netherlands
Baclofen is a new and promising pharmacological compound for the treatment of alcohol dependence (AD). Although several randomised trials found a reduction of craving and higher abstinence rates with low and high doses of baclofen, others failed to show positive effects. In this case study, the successful treatment of a patient with AD with daily 120 mg of baclofen is described. In addition to a decrease in alcohol use, we observed the cessation of stuttering during treatment with baclofen, reoccurrence of stuttering following discontinuation, and cessation of stuttering after reinstatement of the treatment. Based on this observation, the direct effects of baclofen on muscle relaxation and anxiety reduction and its indirect effect on dopaminergic inhibition, we believe that baclofen might be a new treatment for stuttering. Further research into the effect of baclofen on stuttering is warranted.
PMID: 28495786 DOI: 10.1136/bcr-2016-218714
Speaking-related changes in cortical functional connectivity associated with assisted and spontaneous recovery from developmental stuttering. - TERAPIA
J Fluency Disord. 2017 Feb 13. pii: S0094-730X(16)30094-8. [Epub ahead of print]
Kell CA, Neumann K, Behrens M, von Gudenberg AW, Giraud AL.
Goethe University, Frankfurt, Germany; Ruhr University Bochum, Bochum, Germany; Institut der Kasseler Stottertherapie, Bad Emstal, Germany; Université de Genève, Switzerland.
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.
PMID: 28216127 DOI: 10.1016/j.jfludis.2017.02.001
Speech Timing Deficit of Stuttering: Evidence from Contingent Negative Variations - CONCEITO
PLoS One. 2017 Jan 9;12(1):e0168836.
Free PMC Article
Ning N, Peng D, Liu X, Yang S.
Soochow University, Suzhou, Jiang Su, China; Beijing Normal University, Beijing, China.
The aim of the present study was to investigate the speech preparation processes of adults who stutter (AWS). Fifteen AWS and fifteen adults with fluent speech (AFS) participated in the experiment. The event-related potentials (ERPs) were recorded in a foreperiod paradigm. The warning signal (S1) was a color square, and the following imperative stimulus (S2) was either a white square (the Go signal that required participants to name the color of S1) or a white dot (the NoGo signal that prevents participants from speaking). Three differences were found between AWS and AFS. First, the mean amplitude of the ERP component parietal positivity elicited by S1 (S1-P3) was smaller in AWS than in AFS, which implies that AWS may have deficits in investing working memory on phonological programming. Second, the topographic shift from the early phase to the late phase of contingent negative variation occurred earlier for AWS than for AFS, thus suggesting that the motor preparation process is promoted in AWS. Third, the NoGo effect in the ERP component parietal positivity elicited by S2 (S2-P3) was larger for AFS than for AWS, indicating that AWS have difficulties in inhibiting a planned speech response. These results provide a full picture of the speech preparation and response inhibition processes of AWS. The relationship among these three findings is discussed. However, as stuttering was not manipulated in this study, it is still unclear whether the effects are the causes or the results of stuttering. Further studies are suggested to explore the relationship between stuttering and the effects found in the present study.
PMID: 28068353 PMCID: PMC5221803 DOI: 10.1371/journal.pone.0168836
Stuttering as a trait or a state revisited: motor system involvement in persistent developmental stuttering.
Eur J Neurosci. 2017 Feb;45(4):622-624.
Belyk M, Kraft SJ, Brown S.
McMaster University, Hamilton, ON, Canada; Maastricht University, Maastricht, The Netherlands; Wayne State University, Detroit, MI, USA.
Stuttering as a trait or state - an ALE meta-analysis of neuroimaging studies. [Eur J Neurosci. 2015]
PMID: 28191730 DOI: 10.1111/ejn.13512
Stuttering in relation to the morphophonemics of Kannada - LINGUÍSTICA
Clin Linguist Phon. 2017;31(4):313-329. Epub 2016 Dec 12.
Venkatagiri HS, Nataraja NP, Deepthi M.
Iowa State University , Ames , Iowa , USA; JSS Institute of Speech and Hearing , Mysore , India.
The present study investigated the effect of certain unique morphophonemic features of Kannada words on the rate of stutters in a group of 22 adolescent and adult persons who stuttered in an oral reading task. A linear regression analysis showed that word length ranging from 1 to 8 syllables was a potent variable in the occurrence of stutters accounting for 25.3% of stutters. A composite index of morphophonemic complexity with points assigned for sandhi, geminates, consonant clusters, and number of morphemes accounted for a small 7.5% variability in observed stutter rates. Sandhi words and the hybrid content-function words were no more effective than other words in determining stutter rates. Results are discussed in relation to past findings for other languages and current neurolinguistic models of speech production.
PMID: 27936963 DOI: 10.1080/02699206.2016.1259353
Stuttering treatment and brain research in adults: A still unfolding relationship. - TERAPIA
J Fluency Disord. 2017 Feb 28. pii: S0094-730X(16)30126-7. [Epub ahead of print]
Ingham RJ, Ingham JC, Euler HA, Neumann K.
University of California, Santa Barbara, USA; Ruhr University Bochum, Bochum, Germany.
PURPOSE: Brain imaging and brain stimulation procedures have now been used for more than two decades to investigate the neural systems that contribute to the occurrence of stuttering in adults, and to identify processes that might enhance recovery from stuttering. The purpose of this paper is to review the extent to which these dual lines of research with adults who stutter have intersected and whether they are contributing towards the alleviation of this impairment.
METHOD: Several areas of research are reviewed in order to determine whether research on the neurology of stuttering is showing any potential for advancing the treatment of this communication disorder: (a) attempts to discover the neurology of stuttering, (b) neural changes associated with treated recovery, and (c) direct neural intervention.
RESULTS AND CONCLUSIONS: Although much has been learned about the neural underpinnings of stuttering, little research in any of the reviewed areas has thus far contributed to the advancement of stuttering treatment. Much of the research on the neurology of stuttering that does have therapy potential has been largely driven by a speech-motor model that is designed to account for the efficacy of fluency-inducing strategies and strategies that have been shown to yield therapy benefits. Investigations on methods that will induce neuroplasticity are overdue. Strategies profitable with other disorders have only occasionally been employed. However, there are signs that investigations on the neurology of adults who have recovered from stuttering are slowly being recognized for their potential in this regard.
PMID: 28413060 DOI: 10.1016/j.jfludis.2017.02.003
Temperament and Early Stuttering Development: Cross-Sectional Findings From a Community Cohort. - EMOCIONAL
J Speech Lang Hear Res. 2017 Apr 14;60(4):772-784.
Kefalianos E, Onslow M, Ukoumunne OC, Block S, Reilly S.
University of Melbourne, Parkville, Victoria, Australia; Murdoch Childrens Research Institute, Parkville, Victoria, Australia; University of Sydney, New South Wales, Australia; University of Exeter Medical School, University of Exeter, Devon, United Kingdom; La Trobe University, Melbourne, Victoria, Australia; Griffith University, Nathan, Queensland, Australia.
PURPOSE: The purpose of this study was to ascertain if there is an association between stuttering severity and behaviors and the expression of temperament characteristics, including precursors of anxiety.
METHOD: We studied temperament characteristics of a prospectively recruited community cohort of children who stutter (N = 173) at ages 3, 4, and 6 years using the Short Temperament Scale STS (Prior, Sanson, Smart & Oberklaid, 2000).
RESULTS: Six of 131 statistical tests of association between stuttering severity and behaviors and temperament traits were statistically significant at the 5% level, which was no more than expected by chance alone.
CONCLUSIONS: On the basis of parent responses to the STS, preschoolers who exhibited different levels of stuttering severity and behaviors did not generally express temperament traits differently from one another. Stuttering severity and stuttering behaviors were not associated with the precursors of anxiety. Overall, taking multiple tests into consideration, results show little evidence of association between stuttering severity and temperament up to 4 years of age or between stuttering behaviors and temperament up to 6 years of age.
PMID: 28359081 DOI: 10.1044/2016_JSLHR-S-15-0196
The Effects of Parent-Focused Slow Relaxed Speech Intervention on Articulation Rate, Response Time Latency, and Fluency in Preschool Children Who Stutter. - TERAPIA
J Speech Lang Hear Res. 2017 Apr 14;60(4):794-809.
Sawyer J, Matteson C, Ou H, Nagase T.
Illinois State University, Normal; Independent Provider, New Lenox, IL.
PURPOSE: This study investigated the effects of an intervention to reduce caregivers' articulation rates with children who stutter on (a) disfluency, (b) caregiver and child's articulation rates, and (c) caregiver and child's response time latency (RTL).
METHOD: Seventeen caregivers and their preschool children who stuttered participated in a group study of treatment outcomes. One speech sample was collected as a baseline, and 2 samples were collected after treatment. Posttreatment samples were of caregivers speaking as they typically would and using reduced articulation rates.
RESULTS: Caregivers reduced articulation rates significantly in the 2 posttreatment samples, and a significant decrease of stuttering-like disfluencies (SLD) was found in the children in those 2 samples. No direct relationship was found between the caregiver's articulation rate and RTL, and there was a small correlation of RTL with the lower levels of SLD found postintervention. No significant relationships were found between the reduced levels of SLD and articulation rates for either caregivers or children.
CONCLUSIONS: Results suggest caregivers can be trained to slow their speech, and children increased their fluency at the end of a program designed to slow caregiver articulation. The intentionally slower rate of the caregivers, however, was not significantly related to fluency.
PMID: 28289751 DOI: 10.1044/2016_JSLHR-S-16-0002
The Effects of Pitch Shifts on Delay-Induced Changes in Vocal Sequencing in a Songbird - OUTROS
eNeuro. 2017 Jan 20;4(1).
Free PMC Article
Wyatt M, Berthiaume EA, Kelly CW, Sober SJ.
Emory University , Atlanta, GA
Like human speech, vocal behavior in songbirds depends critically on auditory feedback. In both humans and songbirds, vocal skills are acquired by a process of imitation whereby current vocal production is compared to an acoustic target. Similarly, performance in adulthood relies strongly on auditory feedback, and online manipulations of auditory signals can dramatically alter acoustic production even after vocalizations have been well learned. Artificially delaying auditory feedback can disrupt both speech and birdsong, and internal delays in auditory feedback have been hypothesized as a cause of vocal dysfluency in persons who stutter. Furthermore, in both song and speech, online shifts of the pitch (fundamental frequency) of auditory feedback lead to compensatory changes in vocal pitch for small perturbations, but larger pitch shifts produce smaller changes in vocal output. Intriguingly, large pitch shifts can partially restore normal speech in some dysfluent speakers, suggesting that the effects of auditory feedback delays might be ameliorated by online pitch manipulations. Although birdsong provides a promising model system for understanding speech production, the interactions between sensory feedback delays and pitch shifts have not yet been assessed in songbirds. To investigate this, we asked whether the addition of a pitch shift modulates delay-induced changes in Bengalese finch song, hypothesizing that pitch shifts would reduce the effects of feedback delays. Compared with the effects of delays alone, combined delays and pitch shifts resulted in a significant reduction in behavioral changes in one type of sequencing (branch points) but not another (distribution of repeated syllables).
PMID: 28144622 PMCID: PMC5247619 DOI: 10.1523/ENEURO.0254-16.2017
The Effects of Self-Disclosure on Male and Female Perceptions of Individuals Who Stutter - SOCIAL
Am J Speech Lang Pathol. 2017 Feb 1;26(1):69-80.
Byrd CT, McGill M, Gkalitsiou Z, Cappellini C.
The University of Texas at Austin.
PURPOSE: The purpose of this study was to examine the influence of self-disclosure on observers' perceptions of persons who stutter.
METHOD: Participants (N = 173) were randomly assigned to view 2 of 4 possible videos (i.e., male self-disclosure, male no self-disclosure, female self-disclosure, and female no self-disclosure). After viewing both videos, participants completed a survey assessing their perceptions of the speakers.
RESULTS: Controlling for observer and speaker gender, listeners were more likely to select speakers who self-disclosed their stuttering as more friendly, outgoing, and confident compared with speakers who did not self-disclose. Observers were more likely to select speakers who did not self-disclose as unfriendly and shy compared with speakers who used a self-disclosure statement. Controlling for self-disclosure and observer gender, observers were less likely to choose the female speaker as friendlier, outgoing, and confident compared with the male speaker. Observers also were more likely to select the female speaker as unfriendly, shy, unintelligent, and insecure compared with the male speaker and were more likely to report that they were more distracted when viewing the videos.
CONCLUSION: Results lend support to the effectiveness of self-disclosure as a technique that persons who stutter can use to positively influence the perceptions of listeners.
PMID: 28056467 DOI: 10.1044/2016_AJSLP-15-0164
The Japanese version of the overall assessment of the speaker's experience of stuttering for adults (OASES-A-J): Translation and psychometric evaluation - SOCIAL
J Fluency Disord. 2017 Mar;51:50-59. Epub 2017 Jan 9.
Sakai N, Chu SY, Mori K, Yaruss JS.
National Rehabilitation Center for Persons with Disabilities (NRCD), Japan; Universiti Kebangsaan Malaysia; Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia; University of Pittsburgh, Pittsburgh, PA, United States.
PURPOSE: This study evaluates the psychometric performance of the Japanese version of the Overall Assessment of the Speaker's Experience of Stuttering for Adults (OASES-A), a comprehensive assessment tool of individuals who stutter.
METHODS: The OASES-A-J was administered to 200 adults who stutter in Japan. All respondents also evaluated their own speech (SA scale), satisfaction of their own speech (SS scale) and the Japanese translation version of the Modified Erickson Communication Attitude scale (S-24). The test-retest reliability and internal consistency of the OASES-A-J were assessed. To examine the concurrent validity of the questionnaire, Pearson correlation was conducted between the OASES-A-J Impact score and the S-24 scale, SA scale and SS scale. In addition, Pearson correlation among the impact scores of each section and total were calculated to examine the construct validity.
RESULTS: The OASES-A-J showed a good test-retest reliability (r=0.81-0.95) and high internal consistency (α>0.80). Concurrent validity was moderate to high (0.55-0.75). Construct validity was confirmed by the relation between internal consistency in each section and correlation among sections' impact scores. Japanese adults showed higher negative impact for 'General Information', 'Reactions to Stuttering' and 'Quality of Life' sections.
CONCLUSION: These results suggest that the OASES-A-J is a reliable and valid instrument to measure the impact of stuttering on Japanese adults who stutter. The OASES-A-J could be used as a clinical tool in Japanese stuttering field.
PMID: 28212720 DOI: 10.1016/j.jfludis.2016.11.002
The Relationship Between Grammatical Development and Disfluencies in Preschool Children Who Stutter and Those Who Recover. - TERAPIA
Am J Speech Lang Pathol. 2017 Feb 1;26(1):44-56.
Hollister J, Van Horne AO, Zebrowski P.
Loma Linda University, CA; University of Iowa, Iowa City.
PURPOSE: The dual diathesis stressor model indicates that a mismatch between a child's endogenous linguistic abilities and exogenous linguistic contexts is one factor that contributes to stuttering behavior. In the present study, we used a developmental framework to investigate if reducing the gap between endogenous and exogenous linguistics factors would result in less disfluency for typical children, children who recover from stuttering (CWS-R), and children who persist.
METHOD: Children between 28 and 43 months of age participated in this study: 8 typical children, 5 CWS-R, and 8 children who persist. The children were followed for 18 months with language samples collected every 6 months. The Index of Productive Syntax (Scarborough, 1990) served as a measure of endogenous grammatical ability. Length and complexity of active declarative sentences served as a measure of exogenous linguistic demand. A hierarchical linear model analysis was conducted using a mixed-model approach.
RESULTS: The results partially corroborate the dual diathesis stressor model. Disfluencies significantly decreased in CWS-R as grammatical abilities (not age) increased. Language development may serve as a protective factor or catalyst for recovery for CWS-R. As grammatical ability grew and the gap between linguistic ability and demand decreased; however, none of the three groups was more likely to produce disfluencies in longer and more complex utterances.
PMID: 27936278 DOI: 10.1044/2016_AJSLP-15-0022
The relationship between the experience of stuttering and demographic characteristics of adults who stutter - SOCIAL
J Fluency Disord. 2017 Jun;52:53-63. Epub 2017 Apr 13.
Freud D, Kichin-Brin M, Ezrati-Vinacour R, Roziner I, Amir O.
Tel-Aviv University, Israel.
PURPOSE: This study aims to examine the association between adults' experience of stuttering and their age, gender and marital status, as well as to evaluate the psychometric properties of the Hebrew version of the OASES-A.
METHODS: The Hebrew version of the OASES-A was administered to 91 adults-who-stutter. The validity of the translated version was evaluated using a subset of 43 participants, who also completed three additional instruments: (a) a Perceived Stuttering Severity (PSS) self-rating scale, (b) the Situation Avoidance Behavior Checklist (SABC), (c) the Students Life Satisfaction scale (SLSS). Finally, the correlations between the participants' OASES-A scores and their age, gender and marital status were calculated.
RESULTS: A negative correlation was found between the participants' OASES-A impact scores and their age (p<0.01). In addition, married participants exhibited lower OASES-A impact scores compared with unmarried participants (p<0.05). On the other hand, the speakers' gender was not associated with OASES-A impact scores.
RESULTS: revealed high internal consistency of the Hebrew OASES-A, and moderate to strong correlations with the additional examined instruments. Finally, results of the Hebrew version of the questionnaire were comparable with those obtained in other languages.
CONCLUSION: Our results indicated that, within our cohort, age and marital status are significantly associated with the personal experience of stuttering, whereas gender is not. In addition, the Hebrew version of the OASES-A is valid and comparable with equivalent versions in other languages. This facilitates the application of the OASES-A in future clinical and research settings.
PMID: 28576293 DOI: 10.1016/j.jfludis.2017.03.008
The role of anxiety in stuttering: Evidence from functional connectivity. - EMOCIONAL
Neuroscience. 2017 Mar 27;346:216-225. Epub 2016 Dec 2.
Yang Y, Jia F, Siok WT, Tan LH.
Shenzhen Institute of Neuroscience, Shenzhen, China; University of Hong Kong, Hong Kong; Shenzhen University Health Science Center, China; Guangdong Key Laboratory of Biomedical Information Detection and Ultrasound Imaging, Shenzhen, China.
Persistent developmental stuttering is a neurologically based speech disorder associated with cognitive-linguistic, motor and emotional abnormalities. Previous studies investigating the relationship between anxiety and stuttering have yielded mixed results, but it has not yet been examined whether anxiety influences brain activity underlying stuttering. Here, using functional magnetic resonance imaging (fMRI), we investigated the functional connectivity associated with state anxiety in a syllable repetition task, and trait anxiety during rest in adults who stutter (N=19) and fluent controls (N=19). During the speech task, people who stutter (PWS) showed increased functional connectivity of the right amygdala with the prefrontal gyrus (the left ventromedial frontal gyrus and right middle frontal gyrus) and the left insula compared to controls. During rest, PWS showed stronger functional connectivity between the right hippocampus and the left orbital frontal gyrus, and between the left hippocampus and left motor areas than controls. Taken together, our results suggest aberrant bottom-up and/or top-down interactions for anxiety regulation, which might be responsible for the higher level of state anxiety during speech and for the anxiety-prone trait in PWS. To our knowledge, this is the first study to examine the neural underpinnings of anxiety in PWS, thus yielding new insight into the causes of stuttering which might aid strategies for the diagnosis and treatment of stuttering.
PMID: 27919696 DOI: 10.1016/j.neuroscience.2016.11.033
Transcranial magnetic stimulation in developmental stuttering: Relations with previous neurophysiological research and future perspectives. - NEUROCIÊNCIAS
Clin Neurophysiol. 2017 Apr 3;128(6):952-964.[Epub ahead of print]
Busan P, Battaglini PP, Sommer M.
IRCCS Fondazione Ospedale San Camillo, Venice, Italy; University of Trieste, Trieste, Italy; Georg-August-University, Göttingen, Germany.
Developmental stuttering (DS) is a disruption of the rhythm of speech, and affected people may be unable to execute fluent voluntary speech. There are still questions about the exact causes of DS. Evidence suggests there are differences in the structure and functioning of motor systems used for preparing, executing, and controlling motor acts, especially when they are speech related. Much research has been obtained using neuroimaging methods, ranging from functional magnetic resonance to diffusion tensor imaging and electroencephalography/ magnetoencephalography. Studies using transcranial magnetic stimulation (TMS) in DS have been uncommon until recently. This is surprising considering the relationship between the functionality of the motor system and DS, and the wide use of TMS in motor-related disturbances such as Parkinson's Disease, Tourette's Syndrome, and dystonia. Consequently, TMS could shed further light on motor aspects of DS. The present work aims to investigate the use of TMS for understanding DS neural mechanisms by reviewing TMS papers in the DS field. Until now, TMS has contributed to the understanding of the excitatory/inhibitory ratio of DS motor functioning, also helping to better understand and critically review evidence about stuttering mechanisms obtained from different techniques, which allowed the investigation of cortico-basal-thalamo-cortical and white matter/connection dysfunctions.
PMID: 28431323 DOI: 10.1016/j.clinph.2017.03.039
Using critical realistic evaluation to support translation of research into clinical practice. - TERAPIA
Int J Speech Lang Pathol. 2017 Apr 10:1-9. [Epub ahead of print]
Swift MC, Langevin M, Clark AM.
Flinders University , Adelaide , SA , Australia.; University of Alberta , Edmonton , AB , Canada , and.
A challenge that speech-language pathologists (SLPs) face is the translation of research into clinical practice. While randomised controlled trials (RCTs) are often touted as the "gold standard" of efficacy research, much valuable information is lost through the process; RCTs by nature are designed to wash out individual client factors and contexts that might influence the outcome in order to present the "true" impact of the intervention. However, in the area of behavioural interventions, the interaction of client factors and contexts with the treatment agent can substantially influence the outcome. This paper provides an overview of the theoretical background and methods involved in critical realistic evaluation (CRE) and discusses its current and potential application to speech-language pathology. CRE is based on the premise that a behavioural intervention cannot be evaluated without considering the context in which it was provided. While the ways in which contextual aspects and treatment mechanisms interact may seem endless, CRE methodology attempts to operationalise them into hypotheses to be empirically tested. Research based on these principles has the potential to support clinical translation of research outcomes and reduce the costs of unsuccessful treatment attempts for SLPs, clients and the service provider.
PMID: 28394187 DOI: 10.1080/17549507.2017.1309067
Using Network Science Measures to Predict the Lexical Decision Performance of Adults Who Stutter. - LINGUÍSTICA
J Speech Lang Hear Res. 2017 Jun 15:1-8. [Epub ahead of print]
Castro N, Pelczarski KM, Vitevitch MS.
University of Kansas, Lawrence; Kansas State University, Manhattan.
PURPOSE: Methods from network science have examined various aspects of language processing. Clinical populations may also benefit from these novel analyses. Phonological and lexical factors have been examined in adults who stutter (AWS) as potential contributing factors to stuttering, although differences reported are often subtle. We reexamined the performance of AWS and adults who do not stutter (AWNS) from a previously conducted lexical decision task in an attempt to determine if network science measures would provide additional insight into the phonological network of AWS beyond traditional psycholinguistic measures.
METHOD: Multiple regression was used to examine the influence of several traditional psycholinguistic measures as well as several new measures from network science on response times.
RESULTS: AWS responded to low-frequency words more slowly than AWNS; responses for both groups were equivalent for high-frequency words. AWS responded to shorter words more slowly than AWNS, producing a reverse word-length effect. For the network measures, degree/neighborhood density and closeness centrality, but not whether a word was inside or outside the giant component, influenced response times similarly between groups.
CONCLUSIONS: Network analyses suggest that multiple levels of the phonological network might influence phonological processing, not just the micro-level traditionally considered by mainstream psycholinguistics.
PMID: 28614847 DOI: 10.1044/2017_JSLHR-S-16-0298
Using the OASES-A to illustrate how network analysis can be applied to understand the experience of stuttering. - AVALIAÇÃO
J Commun Disord. 2017 Jan - Feb;65:1-9. Epub 2016 Nov 21.
Siew CS, Pelczarski KM, Yaruss JS, Vitevitch MS.
University of Kansas, United States; Kansas State University, United States; University of Pittsburgh, United States.
PURPOSE: Network science uses mathematical and computational techniques to examine how individual entities in a system, represented by nodes, interact, as represented by connections between nodes. This approach has been used by Cramer et al. (2010) to make "symptom networks" to examine various psychological disorders. In the present analysis we examined a network created from the items in the Overall Assessment of the Speaker's Experience of Stuttering-Adult (OASES-A), a commonly used measure for evaluating adverse impact in the lives of people who stutter.
METHOD: The items of the OASES-A were represented as nodes in the network. Connections between nodes were placed if responses to those two items in the OASES-A had a correlation coefficient greater than ±0.5. Several network analyses revealed which nodes were "important" in the network.
RESULTS: Several centrally located nodes and "key players" in the network were identified. A community detection analysis found groupings of nodes that differed slightly from the subheadings of the OASES-A.
CONCLUSIONS: Centrally located nodes and "key players" in the network may help clinicians prioritize treatment. The different community structure found for people who stutter suggests that the way people who stutter view stuttering may differ from the way that scientists and clinicians view stuttering. Finally, the present analyses illustrate how the network approach might be applied to other speech, language, and hearing disorders to better understand how those disorders are experienced and to provide insights for their treatment.
PMID: 27907811 DOI: 10.1016/j.jcomdis.2016.11.001
White matter developmental trajectories associated with persistence and recovery of childhood stuttering. - NEUROCIÊNCIAS
Hum Brain Mapp. 2017 Apr 8. [Epub ahead of print]
Chow HM, Chang SE.
University of Michigan, Ann Arbor, Michigan.
Stuttering affects the fundamental human ability of fluent speech production, and can have a significant negative impact on an individual's psychosocial development. While the disorder affects about 5% of all preschool children, approximately 80% of them recover naturally within a few years of stuttering onset. The pathophysiology and neuroanatomical development trajectories associated with persistence and recovery of stuttering are still largely unknown. Here, the first mixed longitudinal diffusion tensor imaging (DTI) study of childhood stuttering has been reported. A total of 195 high quality DTI scans from 35 children who stutter (CWS) and 43 controls between 3 and 12 years of age were acquired, with an average of three scans per child, each collected approximately a year apart. Fractional anisotropy (FA), a measure reflecting white matter structural coherence, was analyzed voxel-wise to examine group and age-related differences using a linear mixed-effects (LME) model. Results showed that CWS exhibited decreased FA relative to controls in the left arcuate fasciculus, underlying the inferior parietal and posterior temporal areas, and the mid body of corpus callosum. Further, white matter developmental trajectories reflecting growth rate of these tract regions differentiated children with persistent stuttering from those who recovered from stuttering. Specifically, a reduction in FA growth rate (i.e., slower FA growth with age) in persistent children relative to fluent controls in the left arcuate fasciculus and corpus callosum was found, which was not evident in recovered children. These findings provide first glimpses into the possible neural mechanisms of onset, persistence, and recovery of childhood stuttering.
PMID: 28390149 DOI: 10.1002/hbm.23590
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