Aberrant auditory processing and atypical planum temporale in developmental stuttering
Aberrant auditory processing and atypical planum temporale in developmental stuttering
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DOI：
10.1212/01.wnl.0000142993.33158.2a
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发表时间：
2004-11-09
期刊：
影响因子：
9.9
通讯作者：
Heilman, KM
中科院分区：
文献类型：
--
作者：
Foundas, AL;Bollich, AM;Heilman, KM
目的：了解与对照受试者相比，患有持续性发育性口吃和听觉颞叶皮层非典型解剖结构的人是否会因延迟听觉反馈（delayed auditory feedback，EFL）而导致流畅性的变化。背景：口吃改善了许多口吃者的流利性，并导致一些正常人的流利性障碍。颞平面（PT）是听觉颞叶皮层的一部分，在某些口吃的成年人中是解剖学上不典型的，不典型的解剖学可能导致功能异常。因此，表现出这种矛盾反应的人可能是那些具有非典型解剖结构的人。研究方法：实验对象为患有发展性口吃的成年人（n = 14），对照组（n = 14）在年龄、性别、教育程度和利手方面相匹配。获得所有受试者的体积MRI扫描，并测量右半球和左半球的PT。基于这些扫描，受试者被分类为典型（CMPT不对称）或非典型（CMPT不对称）。散文段落在基线时阅读，与非改变反馈（NAF），并在这三个条件下，流畅性进行了测量。结果：在基线时，发育性口吃的成年人比对照组更不流利（p < 0.0005）。对照组的流利性没有显著变化，但在发育性口吃的成年人中，流利性得到了改善（p < 0.0005）。在口吃组中，流畅性增强与非典型（右侧）PT不对称相关，而典型（左侧）PT不对称的存在与流畅性的任何显着变化无关。与具有典型PT解剖结构的实验受试者相比，具有非典型PT不对称的个体在基线时也具有更严重的口吃。结论：在患有持续性发育性口吃和非典型PT解剖的成人中，流利性可以通过吞咽改善。这些表现出改善的实验受试者在基线时有更严重的口吃。异常PT解剖可能是某些个体发育性口吃的神经风险。虽然有许多解释是站得住脚的，但可能是非典型的BMPT不对称性可能会改变言语反馈，用BMPT治疗可能会让这些人得到补偿。
Objective: To learn if people with persistent developmental stuttering and atypical anatomy of their auditory temporal cortex have, when compared to control subjects, changes in fluency induced with delayed auditory feedback (DAF). Background: DAF improves fluency in many individuals who stutter, and induces dysfluency in some normal people. The planum temporale ( PT), a portion of auditory temporal cortex, is anatomically atypical in some adults who stutter and atypical anatomy might induce aberrant function. Thus, the people who demonstrate the paradoxical response to DAF might be those who have atypical anatomy. Methods: Experimental subjects were adults with developmental stuttering (n = 14) and control subjects (n = 14) matched for age, sex, education, and handedness. Volumetric MRI scans of all subjects were obtained and the PT was measured in the right and left hemispheres. Based on these scans, subjects were classified as typical ( leftward PT asymmetry) or atypical (rightward PT asymmetry). Prose passages were read at baseline, with non-altered feedback (NAF), and with DAF, and fluency was measured in these three conditions. Results: At baseline the adults with developmental stuttering were significantly more dysfluent than controls (p < 0.0005). Controls' fluency did not significantly change with DAF, but DAF improved fluency in adults with developmental stuttering (p < 0.0005). In the stutter group enhanced fluency was associated with atypical ( rightward) PT asymmetry, and the presence of typical ( leftward) PT asymmetry was not associated with any significant change in fluency. The individuals with atypical PT asymmetry also had more severe stuttering at baseline compared to the experimental subjects with typical PT anatomy. Conclusions: In adults with persistent developmental stuttering and atypical PT anatomy, fluency is improved with DAF. These experimental subjects who showed improvement had more severe stuttering at baseline. Anomalous PT anatomy may be a neural risk for developmental stuttering in some individuals. Although a number of explanations are tenable, it may be that atypical rightward PT asymmetry may alter speech feedback, and treatment with DAF might allow these people to compensate.