Developmental Stuttering: MRI Studies in Children

描述（由申请人提供）：有令人信服的新证据表明，患有持续性发育性口吃（PDS）的成年人在容积MRI上的大脑外侧裂周围言语、语言和运动区存在异常解剖，但这些成像方法尚未用于研究口吃和不口吃的儿童。由于最近有强有力的证据表明PDS儿童可能与短暂性发育性口吃（TDS）儿童在遗传上不同，因此研究这两组儿童非常重要，因为目前还不清楚他们在大脑形态学方面是否也有生物学上的差异。该项目的主要目的是使用体内容积MRI方法研究PDS儿童（n=30），TDS儿童（n=30）和正常流利儿童（n= 30）的语言，语言和运动区域，这些儿童在性别，利手，年龄和教育方面相匹配。本研究将研究由外部语言回路和内部语音-运动回路构成的口吃模型所涉及的感兴趣区域，包括：（1） 大脑外侧裂周围言语-语言区（外语言环）;（2）皮质-皮质下运动区（内发声环）。据推测，不对称模式的侧裂周和运动区将被破坏的儿童口吃，和异常的解剖结构定义为改变体积和干扰的脑回模式可能会解离与PDS和控制的儿童与TDS。然而，目前尚不清楚PDS组是否与TDS组相比具有不同的解剖特征，或者PDS组是否与TDS组相比具有更多的解剖异常。解剖区域可能一致偏离，表明严重程度的影响，或特定区域可能独立偏离，表明多种组合导致口吃。我们将调查是否特定区域更有可能是非典型的严重不流利的受试者，或是否特定的配置与特定的口吃症状或言语运动控制的措施。我们还感兴趣的是，是否有不同的解剖特征，在亚组 因为我们发现PDS的成年人在这些变量上有重要的差异。这些拟议的研究将提供一个生物学框架，以了解更多关于口吃儿童和不口吃儿童的大脑形态学，提供信息以制定有针对性的行为和药物干预措施，并可能导致早期发现有发育性口吃风险的儿童。

DESCRIPTION (provided by applicant): There is compelling new evidence that adults with persistent developmental stuttering (PDS) have anomalous anatomy in perisylvian speech, language, and motor areas on volumetric MRI, but these imaging methods have not been used to study children who do and do not stutter. Because of recent strong evidence that children with PDS are likely to be genetically different from children with transient developmental stuttering (TDS), it is important to study these two groups as it is unclear whether they are also biologically distinct in terms of brain morphology. The major aim of this project is to use in vivo volumetric MRI methods to study speech, language, and motor regions in children with PDS (n=30), children with TDS (n=30) and normally fluent children (n=30) matched for sex, handedness, age, and education. Regions of interest (R0ls) implicated by a model of stuttering positing an outer linguistic and an inner phonological-motor loop will be studied, including: (1) perisylvian speech-language areas (outer linguistic loop), and (2) cortical-subcortical motor areas (inner phonatory loop). It is hypothesized that asymmetry patterns of perisylvian and motor regions will be disrupted in children who stutter, and anomalous anatomy defined as altered volumes and disturbed gyral patterns may dissociate the children with TDS from those with PDS and from controls. It is unclear, however, whether the PDS group will have distinct anatomic features compared to the TDS group, or whether the PDS group will have more anatomic anomalies compared to the TDS group. Anatomical regions may deviate in concert, suggesting a severity effect, or specific regions may deviate independently, suggesting that multiple combinations result in stuttering. We will investigate whether specific regions are more likely to be atypical in severely dysfluent subjects, or whether specific configurations are associated with specific stuttering symptoms or with measures of speech motor control. We are also interested in whether there are distinct anatomical features within subgroups based on sex, and hand preference, because we found important differences in adults with PDS based on these variables. These proposed studies will provide a biological framework to learn more about brain morphology in children who do and do not stutter, provide information to develop targeted behavioral and pharmacological interventions, and may lead to earlier detection of children at risk for developmental stuttering.