Brain Imaging Center, Department of Neurology, Theodor Stern Kai 7, Frankfurt, Germany.
Brain. 2009 Oct;132(Pt 10):2747-60. doi: 10.1093/brain/awp185. Epub 2009 Aug 26.
Stuttering is a neurodevelopmental disorder associated with left inferior frontal structural anomalies. While children often recover, stuttering may also spontaneously disappear much later after years of dysfluency. These rare cases of unassisted recovery in adulthood provide a model of optimal brain repair outside the classical windows of developmental plasticity. Here we explore what distinguishes this type of recovery from less optimal repair modes, i.e. therapy-induced assisted recovery and attempted compensation in subjects who are still affected. We show that persistent stuttering is associated with mobilization of brain regions contralateral to the structural anomalies for compensation attempt. In contrast, the only neural landmark of optimal repair is activation of the left BA 47/12 in the orbitofrontal cortex, adjacent to a region where a white matter anomaly is observed in persistent stutterers, but normalized in recovered subjects. These findings show that late repair of neurodevelopmental stuttering follows the principles of contralateral and perianomalous reorganization.
口吃是一种与左额下回结构异常相关的神经发育障碍。虽然儿童通常会康复，但口吃也可能在多年不流畅之后自然消失。这些罕见的成人自发性康复病例为发育可塑性经典窗口期之外的最佳大脑修复提供了模型。在这里，我们探讨了区分这种类型的恢复与不太理想的修复模式的特征，即治疗诱导的辅助恢复和仍然受影响的受试者的尝试性补偿。我们发现，持续口吃与为补偿尝试而调动结构异常对侧的大脑区域有关。相比之下，最佳修复的唯一神经标志是眶额皮质左 BA47/12 的激活，该区域与持续口吃者中观察到的白质异常相邻，但在恢复者中正常化。这些发现表明，神经发育性口吃的晚期修复遵循对侧和异常周围重组的原则。
