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This paper investigates the hypothesis that stuttering may result in part from impaired readout of feedforward control of speech, which forces persons who stutter (PWS) to produce speech with a motor strategy that is weighted too much toward auditory feedback control. Over-reliance on feedback control leads to production errors which, if they grow large enough, can cause the motor system to "reset" and repeat the current syllable. This hypothesis is investigated using computer simulations of a "neurally impaired" version of the DIVA model, a neural network model of speech acquisition and production. The model's outputs are compared to published acoustic data from PWS' fluent speech, and to combined acoustic and articulatory movement data collected from the dysfluent speech of one PWS. The simulations mimic the errors observed in the PWS subject's speech, as well as the repairs of these errors. Additional simulations were able to account for enhancements of fluency gained by slowed/prolonged speech and masking noise. Together these results support the hypothesis that many dysfluencies in stuttering are due to a bias away from feedforward control and toward feedback control. EDUCATIONAL OBJECTIVES The reader will be able to (a) describe the contribution of auditory feedback control and feedforward control to normal and stuttered speech production, (b) understand the neural modeling approach to speech production and its application to stuttering, and (c) explain how the DIVA model accounts for enhancements of fluency gained by slowed/prolonged speech and masking noise.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers

A typical white-matter integrity and elevated dopamine levels have been reported for individuals who stutter. We investigated how such abnormalities may lead to speech dysfluencies due to their effects on a syllable-sequencing circuit that consists of basal ganglia (BG), thalamus, and left ventral premotor cortex (vPMC). “Neurally impaired” versions of the neurocomputational speech production model GODIVA were utilized to test two hypotheses: (1) that white-matter abnormalities disturb the circuit via corticostriatal projections carrying copies of executed motor commands, and (2) that dopaminergic abnormalities disturb the circuit via the striatum. Simulation results support both hypotheses: in both scenarios, the neural abnormalities delay readout of the next syllable’s motor program, leading to dysfluency. The results also account for brain imaging findings during dysfluent speech. It is concluded that each of the two abnormality types can cause stuttering moments, probably by affecting the same BG-thalamus-vPMC circuit.

The frontal aslant tract (FAT) is a pathway that connects the inferior frontal gyrus with the supplementary motor area (SMA) and pre-SMA. The FAT was recently identified and introduced as part of a "motor stream" that plays an important role in speech production. In this study, we use diffusion imaging to examine the hypothesis that the FAT underlies speech fluency, by studying its properties in individuals with persistent developmental stuttering, a speech disorder that disrupts the production of fluent speech. We use tractography to quantify the volume and diffusion properties of the FAT in a group of adults who stutter (AWS) and fluent controls. Additionally, we use tractography to extract these measures from the corticospinal tract (CST), a well-known component of the motor system. We compute diffusion measures in multiple points along the tracts, and examine the correlation between these diffusion measures and behavioral measures of speech fluency. Our data show increased mean diffusivity in bilateral FAT of AWS compared with controls. In addition, the results show regions within the left FAT and the left CST where diffusivity values are increased in AWS compared with controls. Last, we report that in AWS, diffusivity values measured within sub-regions of the left FAT negatively correlate with speech fluency. Our findings are the first to relate the FAT with fluent speech production in stuttering, thus adding to the current knowledge of the functional role that this tract plays in speech production and to the literature of the etiology of persistent developmental stuttering.

There are widespread abnormalities in the structural architecture and functional organization of the brains of adults and children who stutter. These are evident not only in speech tasks, but also non-speech tasks. Future research should make greater use of functional neuroimaging and noninvasive brain stimulation, and employ structural methodologies that have greater sensitivity. Newly planned studies should also investigate sex differences, focus on augmenting treatment, examine moments of dysfluency and longitudinally or cross-sectionally investigate developmental trajectories in stuttering.