title: The nature and treatment of stuttering as revealed by fMRI A within- and between-group comparison.
abstract: This article reviews some of our recent functional magnetic resonance imaging (fMRI) studies of stuttering. Using event-related fMRI experiments, we investigated brain activation during speech production. Results of three studies comparing persons who stutter (PWS) and persons who do not stutter (PWNS) are outlined. Their findings point to a region in the right frontal operculum (RFO) that was consistently implicated in stuttering. During overt reading and before fluency shaping therapy, PWS showed higher and more distributed neuronal activation than PWNS. Immediately after therapy differential activations were even more distributed and left sided. They extended to frontal, temporal, and parietal regions, anterior cingulate, insula, and putamen. These over-activations were slightly reduced and again more right sided two years after therapy. Left frontal deactivations remained stable over two years of observation, and therefore possibly indicate a dysfunction. After therapy, we noted higher activations in persons who stutter moderately than in those who stutter severely. These activations might reflect patterns of compensation. We discuss why these findings suggest that fluency-inducing techniques might synchronize a disturbed signal transmission between auditory, speech motor planning, and motor areas.
  
  
  OBJECTIVE
  The reader will learn about and be able to: (1) identify regions of brain activations and deactivations specific for PWS; (2) describe brain activation changes induced by fluency shaping therapy; and (3) discuss the correlation between stuttering severity and brain activation.
authors.affiliation: University of Frankfurt/Main, Klinik für Phoniatrie und Paedaudiologie, Theodor-Stern-Kai 7, Frankfurt/Main, Germany. Katrin.Neumann@em.uni-frankfurt.de
authors.forename: Katrin
authors.initials: K
authors.lastname: Neumann
authors.forename: Harald A
authors.initials: HA
authors.lastname: Euler
authors.forename: Alexander Wolff
authors.initials: AW
authors.lastname: von Gudenberg
authors.forename: Anne-Lise
authors.initials: AL
authors.lastname: Giraud
authors.forename: Heinrich
authors.initials: H
authors.lastname: Lanfermann
authors.forename: Volker
authors.initials: V
authors.lastname: Gall
authors.forename: Christine
authors.initials: C
authors.lastname: Preibisch
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012044:Regression Analysis; D012107:Research Design; D013070:Speech Therapy; D013342:Stuttering / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome