Foundas Anne L, Corey David M, Hurley Megan M, Heilman Kenneth M
Department of Psychiatry and Neurology, Tulane University Health Sciences Center, 1440 Canal Street, TB52, New Orleans, LA 70112, USA.
Cogn Behav Neurol. 2004 Dec;17(4):224-32.
The major aim of this study was to determine whether adults with persistent developmental stuttering have atypical auditory processing.
Stuttering has been attributed to aberrant hemispheric dominance, and auditory processing deficits have been found in some adults who stutter. Dichotic listening, an indirect measure of auditory processing, has not been used to study auditory laterality in right- and left-handers who stutter. Because left-handers and people who stutter may have aberrant hemispheric dominance, it is important to examine auditory neural systems in right- and left-handed people who do and do not stutter.
Adults with persistent developmental stuttering (n = 18) and matched controls (n = 28) were studied by simultaneous binaural (dichotic) presentation of consonant-vowel stimuli in three attention conditions: nondirected attention, attention directed right, and attention directed left. Sex-handedness groups (stutter and control) included right-handed men and women and left-handed men, but not left-handed women because this stutter subgroup could not be recruited. To study ear advantage and auditory laterality, two dependent measures were examined: percent left and right ear responses and lateralization shift magnitude. Potential relationships between degree of handedness and dichotic listening measures were also examined.
Matched controls and right-handed men who stutter had the expected right-ear advantage (REA) in the nondirected attention condition. In contrast, left-handed men who stutter had a left-ear advantage (LEA), and right-handed women who stutter did not have a lateral ear bias in the nondirected attention condition. Right-handed women who stutter had the greatest tendency to hear a sound that was not presented to either ear, and were relatively unable to selectively direct attention left or right. In contrast, left-handed men who stutter were able to shift attention to the left and right ear better than any other group. For the fluent control group, there were no significant relationships among degree of handedness and dichotic-listening variables. For the stutter group, degree of handedness was significantly related to percentage left and right ear response and to the lateralization shift magnitude.
Left-handed men who stutter and right-handed women who stutter have atypical auditory processing but differ in important ways. The left-ear bias found in left-handed men who stutter in the nondirected attention condition suggests that their right temporal lobe may be important in perceiving speech, and, therefore, they have mixed dominance. These subjects were also better at shifting attention in both directions in comparison to all other groups; thus, the right hemisphere, which is dominant for shifting attention to both right and left space, may be activated. In contrast, the right-handed women who stutter had no ear bias in the nondirected attention condition, made more perceptual errors, and had difficulty shifting attention to the left and right. Although these results suggest that right-handed women who stutter have attentional deficits, the relationship between attentional disorders and stuttering remains to be elucidated. Because right-handed men who stutter were not different from controls, aberrant hemispheric dominance cannot fully account for stuttering. Unfortunately, left-handed women were not examined in this study. Therefore, these interesting sex-handedness effects found in left-handed men and right-handed women who stutter must be interpreted with caution.
本研究的主要目的是确定患有持续性发育性口吃的成年人是否存在非典型听觉处理。
口吃被归因于半球优势异常,并且在一些口吃的成年人中发现了听觉处理缺陷。双耳分听,一种听觉处理的间接测量方法,尚未被用于研究口吃的右利手和左利手者的听觉偏侧性。由于左利手者和口吃者可能存在半球优势异常,因此检查口吃和不口吃的右利手和左利手者的听觉神经系统很重要。
对患有持续性发育性口吃的成年人(n = 18)和匹配的对照组(n = 28)进行研究,在三种注意力条件下同时双耳(双耳分听)呈现辅音 - 元音刺激:非定向注意力、注意力指向右侧和注意力指向左侧。性别 - 利手组(口吃组和对照组)包括右利手男性和女性以及左利手男性,但不包括左利手女性,因为无法招募到这个口吃亚组。为了研究耳优势和听觉偏侧性,检查了两个因变量:左右耳反应百分比和偏侧化偏移幅度。还检查了利手程度与双耳分听测量之间的潜在关系。
匹配的对照组和口吃的右利手男性在非定向注意力条件下具有预期的右耳优势(REA)。相比之下,口吃的左利手男性具有左耳优势(LEA),口吃的右利手女性在非定向注意力条件下没有侧向耳偏好。口吃的右利手女性最容易听到未呈现给任何一只耳朵的声音,并且相对无法选择性地将注意力向左或向右引导。相比之下,口吃的左利手男性比其他任何组都能更好地将注意力转移到左耳和右耳。对于流利对照组,利手程度与双耳分听变量之间没有显著关系。对于口吃组,利手程度与左右耳反应百分比和偏侧化偏移幅度显著相关。
口吃的左利手男性和口吃的右利手女性存在非典型听觉处理,但在重要方面存在差异。在非定向注意力条件下口吃的左利手男性中发现的左耳偏好表明,他们的右颞叶在感知言语中可能很重要,因此,他们具有混合优势。与所有其他组相比,这些受试者在双向转移注意力方面也表现得更好;因此,在将注意力转移到左右空间方面占主导地位的右半球可能被激活。相比之下,口吃的右利手女性在非定向注意力条件下没有耳偏好,产生更多的感知错误,并且在将注意力向左和向右转移方面存在困难。尽管这些结果表明口吃的右利手女性存在注意力缺陷,但注意力障碍与口吃之间的关系仍有待阐明。由于口吃的右利手男性与对照组没有差异,半球优势异常不能完全解释口吃。不幸的是,本研究未检查左利手女性。因此,在口吃的左利手男性和右利手女性中发现的这些有趣的性别 - 利手效应必须谨慎解释。