Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Pediatric Community Rehabilitation, Alberta Health Services, Calgary, Alberta, Canada.
J Fluency Disord. 2023 Sep;77:105992. doi: 10.1016/j.jfludis.2023.105992. Epub 2023 Jun 23.
Developmental stuttering and Tourette syndrome (TS) are common neurodevelopmental disorders. Although disfluencies may co-occur in TS, their type and frequency do not always represent pure stuttering. Conversely, core symptoms of stuttering may be accompanied by physical concomitants (PCs) that can be confused for tics. This scoping review aimed to explore the similarities and differences between stuttering and tics in terms of epidemiology, comorbidities, phenomenology, evolution, physiopathology, and treatment. We also described the nature of PCs in stuttering and disfluencies in TS.
A literature search on Medline, Embase and PsycInfo was executed in March 2022. From 426 studies screened, 122 were included in the review (a majority being narrative reviews and case reports).
TS and stuttering have several epidemiological, phenomenological, comorbidity, and management similarities suggesting shared risk factors and physiopathology (involving the basal ganglia and their connections with speech and motor control cortical regions). PCs in stuttering commonly involve the face (eyelids, jaw/mouth/lip movements) and sometimes the head, trunk and limbs. PCs can be present from early stages of stuttering and vary over time and within individuals. The function of PCs is unknown. Some individuals with TS have a distinct disfluency pattern, composed of a majority of typical disfluencies (mostly between-word disfluencies), and a mix of cluttering-like behaviors, complex phonic tics (e.g. speech-blocking tics, echolalia, palilalia), and rarely, atypical disfluencies.
Future investigations are warranted to better understand the complex relationships between tics and stuttering and address the management of disfluencies in TS and PCs in stuttering.
发育性口吃和妥瑞氏症(TS)是常见的神经发育障碍。尽管口吃中可能会出现不流畅,但它们的类型和频率并不总是代表纯粹的口吃。相反,口吃的核心症状可能伴有身体伴随症状(PCs),这些症状可能会被误诊为抽动。本范围综述旨在探讨口吃和抽动在流行病学、共病、现象学、演变、病理生理学和治疗方面的异同。我们还描述了口吃中的 PCs 和 TS 中的不流畅的性质。
2022 年 3 月在 Medline、Embase 和 PsycInfo 上进行了文献检索。在筛选出的 426 项研究中,有 122 项研究被纳入综述(其中大部分为叙述性综述和病例报告)。
TS 和口吃在流行病学、现象学、共病和管理方面有许多相似之处,这表明它们存在共同的风险因素和病理生理学(涉及基底节及其与言语和运动控制皮质区域的联系)。口吃中的 PCs 通常涉及面部(眼睑、下巴/嘴/唇运动),有时还涉及头部、躯干和四肢。PCs 可从口吃的早期阶段出现,并且在个体之间和时间上有所变化。PCs 的功能尚不清楚。一些 TS 患者有明显的不流畅模式,由大多数典型的不流畅(主要是词间不流畅)组成,以及夹杂着类似口吃的行为、复杂的语音抽动(例如言语阻断性抽动、模仿言语、复语),以及很少见的非典型不流畅。
需要进一步研究以更好地理解抽动和口吃之间的复杂关系,并解决 TS 中的不流畅和口吃中的 PCs 的管理问题。