Watson B C, Pool K D, Devous M D, Freeman F J, Finitzo T
Callier Center for Communication Disorders, University of Texas, Dallas.
J Speech Hear Res. 1992 Jun;35(3):555-61. doi: 10.1044/jshr.3503.555.
The 1980s witnessed renewed interest in the relation between developmental stuttering and central nervous system (CNS) abnormalities. We have reported differences between nonstutterers and developmental stutterers on electrophysiologic (QTE) and metabolic (rCBF) measures of brain function. A critical step in the interpretation of results of functional brain imaging studies is to determine the relation, if any, of identified CNS abnormalities to speech motor control in persons who stutter. In this study we addressed the interpretation of rCBF findings by asking whether we could identify patterns of impaired acoustic laryngeal reaction time (LRT) as a function of response complexity parallel to rCBF findings. Stutterer subgroups determined by clinical severity ratings were not differentiated by LRT values as a function of response complexity. Stutterers with relative blood flow asymmetry below the normal median value involving both left superior and middle temporal regions of interest (ROIs) showed significantly longer LRT for the complex response than did normal speakers and stutterers with above-normal median relative flow values to at least one of these temporal ROIs. Stutterer subgroups based on reduced cingulate flow alone were not differentiated by LRT values. Findings are consistent with Goldberg's (1985) model of CNS premotor processing. Findings also suggest that stutterer subgroups might be distinguished by the presence, loci, and relative magnitude of cortical and/or subcortical rCBF abnormality in regions that subserve a fluency-generating system.
20世纪80年代，人们对发育性口吃与中枢神经系统（CNS）异常之间的关系重新产生了兴趣。我们已经报道了非口吃者和发育性口吃者在脑功能的电生理（QTE）和代谢（rCBF）测量方面的差异。功能性脑成像研究结果解释中的一个关键步骤是确定所识别的中枢神经系统异常与口吃者言语运动控制之间的关系（如果有的话）。在本研究中，我们通过询问是否能够识别出声学喉反应时间（LRT）受损模式，作为与rCBF结果平行的反应复杂性的函数，来解决rCBF研究结果的解释问题。根据临床严重程度评分确定的口吃者亚组，并未因作为反应复杂性函数的LRT值而有所区分。在涉及左颞上回和颞中回两个感兴趣区域（ROIs）的相对血流不对称低于正常中值的口吃者，与正常说话者以及至少一个这些颞叶ROIs的相对血流值高于正常中值的口吃者相比，在复杂反应中表现出明显更长的LRT。仅基于扣带回血流减少的口吃者亚组，并未因LRT值而有所区分。研究结果与戈德堡（1985年）的中枢神经系统运动前处理模型一致。研究结果还表明，口吃者亚组可能通过在服务于流畅性产生系统的区域中皮质和/或皮质下rCBF异常的存在、位置和相对大小来区分。
