Chow Ho Ming, Chang Soo-Eun
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan.
Hum Brain Mapp. 2017 Jul;38(7):3345-3359. doi: 10.1002/hbm.23590. Epub 2017 Apr 8.
Stuttering affects the fundamental human ability of fluent speech production, and can have a significant negative impact on an individual's psychosocial development. While the disorder affects about 5% of all preschool children, approximately 80% of them recover naturally within a few years of stuttering onset. The pathophysiology and neuroanatomical development trajectories associated with persistence and recovery of stuttering are still largely unknown. Here, the first mixed longitudinal diffusion tensor imaging (DTI) study of childhood stuttering has been reported. A total of 195 high quality DTI scans from 35 children who stutter (CWS) and 43 controls between 3 and 12 years of age were acquired, with an average of three scans per child, each collected approximately a year apart. Fractional anisotropy (FA), a measure reflecting white matter structural coherence, was analyzed voxel-wise to examine group and age-related differences using a linear mixed-effects (LME) model. Results showed that CWS exhibited decreased FA relative to controls in the left arcuate fasciculus, underlying the inferior parietal and posterior temporal areas, and the mid body of corpus callosum. Further, white matter developmental trajectories reflecting growth rate of these tract regions differentiated children with persistent stuttering from those who recovered from stuttering. Specifically, a reduction in FA growth rate (i.e., slower FA growth with age) in persistent children relative to fluent controls in the left arcuate fasciculus and corpus callosum was found, which was not evident in recovered children. These findings provide first glimpses into the possible neural mechanisms of onset, persistence, and recovery of childhood stuttering. Hum Brain Mapp 38:3345-3359, 2017. © 2017 Wiley Periodicals, Inc.
口吃会影响人类流畅言语产生的基本能力,并可能对个体的心理社会发展产生重大负面影响。虽然这种障碍影响了约5%的学龄前儿童,但其中约80%的儿童在口吃开始后的几年内自然恢复。与口吃持续和恢复相关的病理生理学和神经解剖学发展轨迹在很大程度上仍然未知。在此,首次报道了一项关于儿童口吃的混合纵向扩散张量成像(DTI)研究。共采集了35名口吃儿童(CWS)和43名3至12岁对照儿童的195份高质量DTI扫描图像,每个儿童平均扫描三次,每次扫描间隔约一年。采用线性混合效应(LME)模型,对反映白质结构连贯性的分数各向异性(FA)进行体素分析,以检查组间差异和与年龄相关的差异。结果显示,与对照组相比,CWS在左侧弓状束、顶下叶和颞叶后部下方以及胼胝体中部的FA值降低。此外,反映这些脑区生长速度的白质发育轨迹将持续性口吃儿童与口吃恢复儿童区分开来。具体而言,发现持续性口吃儿童相对于流利对照组,左侧弓状束和胼胝体的FA生长速度降低(即随着年龄增长FA生长较慢),而在恢复儿童中并不明显。这些发现首次揭示了儿童口吃发病、持续和恢复的可能神经机制。《人类大脑图谱》38:3345 - 3359,2017年。© 2017威利期刊公司。