There is growing evidence that motor and speech disorders co-occur during development. In the present study, we investigated whether stuttering, a developmental speech disorder, is associated with a predictive timing deficit in childhood and adolescence. By testing sensorimotor synchronization abilities, we aimed to assess whether predictive timing is dysfunctional in young participants who stutter (8–16 years). Twenty German children and adolescents who stutter and 43 non-stuttering participants matched for age and musical training were tested on their ability to synchronize their finger taps with periodic tone sequences and with a musical beat. Forty percent of children and 90% of adolescents who stutter displayed poor synchronization with both metronome and musical stimuli, falling below 2.5% of the estimated population based on the performance of the group without the disorder. Synchronization deficits were characterized by either lower synchronization accuracy or lower consistency or both. Lower accuracy resulted in an over-anticipation of the pacing event in participants who stutter. Moreover, individual profiles revealed that lower consistency was typical of participants that were severely stuttering. These findings support the idea that malfunctioning predictive timing during auditory–motor coupling plays a role in stuttering in children and adolescents.

No abstract

No abstract

A prominent theory of developmental stuttering highlights (dys-)function of the basal ganglia (and in particular the ventral striatum) as a main neural mechanism behind this speech disorder. Although the theory is intriguing, studies on gray matter volume differences in the basal ganglia between people who stutter and control persons have reported heterogeneous findings, either showing more or less gray matter volume of the aforementioned brain structure across the brain's hemispheres. Moreover, some studies did not observe any differences at all. From today's perspective several of the earlier studies are rather underpowered and also used less powerful statistical approaches to investigate differences in brain structure between people who stutter and controls. Therefore, the present study contrasted a comparably larger sample of n = 36 people who stutter with n = 34 control persons and applied the state of the art DARTEL algorithm (Diffeomorphic Anatomical Registration Through Exponentiated Lie algebra) to analyze the available brain data. In the present data set stuttering was associated with higher gray matter volume of the right caudate and putamen region of the basal ganglia in patients. Our observation strongly supports a recent finding reporting a larger nucleus accumbens in the right hemisphere in people who stutter when compared to control persons. The present findings are discussed in the context of both compensatory effects of the brain and putative therapeutic effects due to treatment of stuttering.

Zusammenfassung. Hirnverletzte Patienten mit besonders schwer ausgeprägten Störungen in kognitiven Funktionen, wie z. B. Orientierungs- und Gedächtnisleistungen, Aufmerksamkeits- und Exekutivleistungen, Wahrnehmungsverarbeitung und Kommunikation benötigen im Anschluss an die Akutversorgung möglichst zeitnah intensive stationäre Neurorehabilitation. Nicht selten scheitert die Integration dieser Patientengruppe in klassische Rehabilitationssettings aufgrund deliranter Symptomatik, starker Antriebsminderung oder Agitiertheit, fehlendem Störungsbewusstsein sowie fremd- und selbstgefährdendem Verhalten im Rahmen reduzierter Verhaltenssteuerung und Impulskontrolle. Die stationäre Neurorehabilitation dieser Patientenklientel erfordert daher ein flexibel am individuellen Bedarf orientiertes milieutherapeutisches Stationssetting, spezialisierte therapeutische, medizinische und pflegerische Angebote sowie ein eng kooperierendes interdisziplinäres Behandlungsteam. Der intensive Einbezug des sozialen und familiären Kontextes sowie ein langfristig angelegtes Rehabilitationskonzept sind von besonders hoher Bedeutung. Zielsetzung ist die Reduktion von nicht indizierten Verlegungen neurologischer Patienten in psychiatrische Behandlungsformen und Institutionen der Langzeitpflege sowie die Einleitung der Reintegration in den prämorbiden Lebenskontext.