G Deepa, B H Shrikrishna, Gajbe Ujwal, Singh Brij Raj, Sawal Anupama, Balwir Trupti
Anatomy, Datta Meghe Medical College, Datta Meghe Institute of Medical Sciences, Nagpur, IND.
Otolaryngology-Head and Neck Surgery, All India Institute of Medical Sciences, Nagpur, Nagpur, IND.
Cureus. 2022 Aug 31;14(8):e28653. doi: 10.7759/cureus.28653. eCollection 2022 Aug.
Dysfluent speech has the potential to lower one's standard of living drastically. Although there is a lot of theoretical support for basal ganglia dysfunction in developmental stuttering, there isn't any imaging data to back it up. According to several studies, there is a difference in gray matter volume between people who stammer and those who don't. According to studies, the right inferior longitudinal fasciculus and the uncinate fasciculus have higher fractional anisotropy (FA) than fluent controls. A high fractional anisotropy means good white matter integrity in these areas. In children who stutter, grey matter volume was higher in the Rolandic operculum, middle frontal gyrus, superior temporal gyrus, and inferior parietal lobule. These regions are found to be more active in adults who stammer as their speech fluency improves. Stuttering is previously linked to structural deficiencies in the corpus callosum. However, there are differences in the directionality of the findings between studies, which are unknown. According to current theories, stuttering is caused by a breakdown in the integration of auditory data in speech motor planning, which affects behavior tasks that rely on basal ganglia structures. According to some studies, connectivity in the left inferior frontal gyrus (IFG) and basal ganglia of persons with stuttering (PWS) was significantly reduced. Still, it was more robust in the left supplementary motor cortex (SMC) and premotor cortex (PMC) (primary motor cortex). In the Broca's region, there was also decreased perfusion and spectroscopic indicators of neuronal density. Spontaneous speech is more affected by stuttering than conversation, reading, sentence repetition, or singing. As per the dual process theory of language formation, the basal ganglia are essential for formulaic phrases, but the left hemisphere is important for innovative, freshly constructed sentences. According to current theories on their functional traits and connections to cortical areas of control, the basal ganglia are the complex networks in charge of organizing, initiating, carrying out, and controlling motor behaviors. Given the distinct neuroanatomical characteristics of people who stutter, more research into this cohort is required to further our understanding of the illness. The primary goal of this review article is to fill in any knowledge voids between the neuroanatomical structure of the basal ganglia and the onset of stuttering.
言语不流畅有可能大幅降低一个人的生活水平。尽管发育性口吃中基底神经节功能障碍有很多理论支持，但尚无影像学数据予以佐证。多项研究表明，口吃者与非口吃者之间灰质体积存在差异。研究显示，与言语流畅的对照组相比，口吃者的右侧下纵束和钩束具有更高的分数各向异性（FA）。高分 数各向异性意味着这些区域的白质完整性良好。在口吃儿童中，中央前回盖部、额中回、颞上回和顶下小叶的灰质体积更大。研究发现，随着言语流畅度的提高，这些区域在成年口吃者中更为活跃。口吃以前与胼胝体的结构缺陷有关。然而，不同研究结果的方向性存在差异，原因不明。根据目前的理论，口吃是由于言语运动计划中听觉数据整合出现故障，从而影响依赖基底神经节结构的行为任务。一些研究表明，口吃者（PWS）左额下回（IFG）与基底神经节之间的连接显著减少。不过，在左辅助运动皮层（SMC）和运动前皮层（PMC）（初级运动皮层）中这种连接更为稳固。在布罗卡区，灌注减少且神经元密度的光谱指标也降低。与对话、阅读、句子重复或唱歌相比，口吃对自发言语的影响更大。根据语言形成的双过程理论，基底神经节对公式化短语至关重要，而左半球对创新的、新构建的句子很重要。根据目前关于其功能特征以及与控制皮层区域连接的理论，基底神经节是负责组织、启动、执行和控制运动行为的复杂网络。鉴于口吃者独特的神经解剖学特征，需要对这一群体进行更多研究，以加深我们对该疾病的理解。这篇综述文章的主要目的是填补基底神经节神经解剖结构与口吃发病之间的任何知识空白。
