Mulligan H F, Anderson T J, Jones R D, Williams M J, Donaldson I M
Christchurch Centre, School of Physiotherapy, University of Otago, PO Box 4345, Christchurch, New Zealand.
Int J Neurosci. 2001 Jul;109(1-2):23-46. doi: 10.3109/00207450108986523.
Studies using modern imaging techniques suggest that, in developmental stuttering, there is dysfunction within the cortical and subcortical areas of the motor control system wider than that pertaining to speech motor control alone. If this is the case, one might expect motor deficits extending beyond and unrelated to the production of speech in people who stutter. This study explored this proposal by investigating the presence and characteristics of involuntary movements accompanying stuttering. Sixteen adults with developmental stuttering and 16 controls matched for age and sex were audio-videotaped during 5 minutes of conversational speech and reading a passage of 350 words. Audio-data were examined for dysfluencies. Movements of the face, head and upper body considered involuntary and not part of normal facial expression or gesture and not part of the mechanics of speech were identified and described from muted video-data. Subjects who stuttered had a higher proportion of classic (within-word) dysfluencies accompanied by involuntary movements (IMs) than controls during speech (24.4% vs. 4.5%, p = .054) and reading (28.6% vs. 4.9%, p = .033). There was no difference in proportion of classic dysfluencies accompanied by IMs between speech and reading for either group. IMs were also seen in both groups during fluent speech, with a similar incidence during free speech (3.9% vs. 3.0%, NS) but a greater incidence in the subjects who stuttered during reading (2.4% vs. 0.8%, p = .03). In contrast, there was no difference between the two groups for IMs accompanying normal (between-word) dysfluencies. This suggests that classic and normal dysfluency and their accompanying IMs have different etiologies. The notion that stuttering and IMs are due to altered function in a motor control system wider than that of speech motor control alone is supported by a higher incidence of IMs in people who stutter during both classic dysfluencies and fluent speech.
运用现代成像技术开展的研究表明，在发育性口吃中，运动控制系统的皮质和皮质下区域存在功能障碍，其范围比仅与言语运动控制相关的功能障碍更为广泛。倘若如此，人们可能会预期口吃者存在超出言语产生范围且与之无关的运动缺陷。本研究通过调查口吃时伴随的不自主运动的存在情况及特征，对这一假设进行了探究。16名患有发育性口吃的成年人以及16名年龄和性别相匹配的对照组在进行5分钟对话性言语及朗读一篇350字短文的过程中被录像。对音频数据进行不流畅性检查。从静音视频数据中识别并描述面部、头部和上身的运动，这些运动被视为不自主运动，不属于正常面部表情或手势的一部分，也不属于言语机制的一部分。口吃的受试者在言语过程中（24.4%对4.5%，p = 0.054）和朗读过程中（28.6%对4.9%，p = 0.033），伴有不自主运动（IMs）的典型（词内）不流畅性比例高于对照组。两组在言语和朗读过程中，伴有IMs的典型不流畅性比例均无差异。在流畅言语过程中，两组也都出现了IMs，自由言语过程中的发生率相似（3.9%对3.0%，无显著差异），但口吃受试者在朗读过程中的发生率更高（2.4%对0.8%，p = 0.03）。相比之下，两组在伴有正常（词间）不流畅性的IMs方面没有差异。这表明典型和正常不流畅性及其伴随的IMs具有不同的病因。口吃和IMs是由于比仅言语运动控制更广泛的运动控制系统功能改变所致这一观点，得到了口吃者在典型不流畅性和流畅言语过程中IMs发生率更高的支持。
