Cieslak Matthew, Ingham Roger J, Ingham Janis C, Grafton Scott T
J Speech Lang Hear Res. 2015 Apr;58(2):268-77. doi: 10.1044/2015_JSLHR-S-14-0193.
Developmental stuttering is now generally considered to arise from genetic determinants interacting with neurologic function. Changes within speech-motor white matter (WM) connections may also be implicated. These connections can now be studied in great detail by high-angular-resolution diffusion magnetic resonance imaging. Therefore, diffusion spectrum imaging was used to reconstruct streamlines to examine white matter connections in people who stutter (PWS) and in people who do not stutter (PWNS).
WM morphology of the entire brain was assayed in 8 right-handed male PWS and 8 similarly aged right-handed male PWNS. WM was exhaustively searched using a deterministic algorithm that identifies missing or largely misshapen tracts. To be abnormal, a tract (defined as all streamlines connecting a pair of gray matter regions) was required to be at least one 3rd missing, in 7 out of 8 subjects in one group and not in the other group.
Large portions of bilateral arcuate fasciculi, a heavily researched speech pathway, were abnormal in PWS. Conversely, all PWS had a prominent connection in the left temporo-striatal tract connecting frontal and temporal cortex that was not observed in PWNS.
These previously unseen structural differences of WM morphology in classical speech-language circuits may underlie developmental stuttering.
发育性口吃目前通常被认为是由与神经功能相互作用的遗传决定因素引起的。言语运动白质(WM)连接的变化也可能与之有关。现在可以通过高角分辨率扩散磁共振成像对这些连接进行详细研究。因此,使用扩散谱成像来重建流线,以检查口吃者(PWS)和非口吃者(PWNS)的白质连接。
对8名右利手男性PWS和8名年龄相仿的右利手男性PWNS的全脑WM形态进行了检测。使用确定性算法对WM进行全面搜索,该算法可识别缺失或严重畸形的束。若一条束(定义为连接一对灰质区域的所有流线)在一组8名受试者中的7名中至少缺失三分之一,而在另一组中未缺失,则该束被判定为异常。
在PWS中,大量经过深入研究的言语通路——双侧弓状束出现异常。相反,所有PWS在连接额叶和颞叶皮质的左颞-纹状体束中有一个明显的连接,而在PWNS中未观察到。
经典言语语言回路中这些以前未被发现的WM形态结构差异可能是发育性口吃的基础。