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)的成年人在体积磁共振成像上存在发育性口吃(PDS)周围语言、语言和运动区的异常解剖，但这些成像方法尚未用于研究有口吃和不口吃的儿童。由于最近有强有力的证据表明，患有PDS的儿童可能与患有短暂性发育性口吃(TDS)的儿童在基因上存在差异，因此研究这两组儿童非常重要，因为尚不清楚他们在脑形态方面是否也具有生物学上的差异。该项目的主要目的是使用活体体积磁共振方法研究在性别、利手、年龄和教育程度匹配的PDS儿童(n=30)、TDS儿童(n=30)和正常流利儿童(n=30)的言语、语言和运动区。我们将研究由外部语言和内部语音-运动环构成的口吃模型所涉及的感兴趣区(R0)，包括：(1) (2)皮质-皮质下运动区(内发声环)。据推测，口吃儿童的坐骨神经和运动区的不对称模式将被破坏，定义为体积改变和脑回模式障碍的异常解剖结构可能会将患有TDS的儿童与PDS儿童和对照组分离开来。然而，目前尚不清楚与TDS组相比，PDS组是否会有明显的解剖特征，或者与TDS组相比，PDS组是否会有更多的解剖异常。解剖区域可能会一致偏离，这意味着严重影响，或者特定区域可能独立偏离，这表明多种组合会导致口吃。我们将调查在严重不流利的受试者中，特定区域是否更有可能是非典型的，或者特定的配置是否与特定的口吃症状或言语运动控制措施有关。我们还感兴趣的是，在亚群中是否有明显的解剖特征 基于性别和手的偏好，因为我们基于这些变量发现了患有PDS的成年人的重要差异。这些拟议的研究将提供一个生物学框架，以更多地了解患有和不患有口吃的儿童的大脑形态，为制定有针对性的行为和药物干预措施提供信息，并可能导致更早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.