Laryngeal and Speech Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20852, USA.
Cereb Cortex. 2011 Nov;21(11):2507-18. doi: 10.1093/cercor/bhr028. Epub 2011 Apr 6.
The neurophysiological basis for stuttering may involve deficits that affect dynamic interactions among neural structures supporting fluid speech processing. Here, we examined functional and structural connectivity within corticocortical and thalamocortical loops in adults who stutter. For functional connectivity, we placed seeds in the left and right inferior frontal Brodmann area 44 (BA44) and in the ventral lateral nucleus (VLN) of the thalamus. Subject-specific seeds were based on peak activation voxels captured during speech and nonspeech tasks using functional magnetic resonance imaging. Psychophysiological interaction (PPI) was used to find brain regions with heightened functional connectivity with these cortical and subcortical seeds during speech and nonspeech tasks. Probabilistic tractography was used to track white matter tracts in each hemisphere using the same seeds. Both PPI and tractrography supported connectivity deficits between the left BA44 and the left premotor regions, while connectivity among homologous right hemisphere structures was significantly increased in the stuttering group. No functional connectivity differences between BA44 and auditory regions were found between groups. The functional connectivity results derived from the VLN seeds were less definitive and were not supported by the tractography results. Our data provide strongest support for deficient left hemisphere inferior frontal to premotor connectivity as a neural correlate of stuttering.
口吃的神经生理学基础可能涉及影响支持流畅言语处理的神经结构之间动态相互作用的缺陷。在这里,我们研究了口吃成年人的皮质-皮质和丘脑皮质环路中的功能和结构连接。对于功能连接,我们在左、右额下回 Brodmann 区 44(BA44)和丘脑腹外侧核(VLN)中放置了种子。基于使用功能磁共振成像进行言语和非言语任务期间捕获的峰值激活体素,为每个受试者特异性地放置种子。使用心理生理交互(PPI)在言语和非言语任务期间找到与这些皮质和皮质下种子具有更高功能连接的大脑区域。使用相同的种子,在每个半球中使用概率追踪技术追踪白质束。PPI 和 tractrography 都支持口吃组中左 BA44 与左运动前区之间的连接缺陷,而同源右半球结构之间的连接显著增加。两组之间在 BA44 和听觉区域之间未发现功能连接差异。从 VLN 种子得出的功能连接结果不太明确,并且不受轨迹追踪结果的支持。我们的数据为左侧额下回到运动前区连接不足作为口吃的神经相关物提供了最强有力的支持。