The Neural Circuitry Underlying the "Rhythm Effect" in Stuttering

• Published in: Journal of speech, language, and hearing research Vol. 64; no. 6; pp. 2325 - 2346
• Main Authors: Frankford, Saul A, Murray, Elizabeth S. Heller, Masapollo, Matthew, Cai, Shanqing, Tourville, Jason A, Nieto-Castañón, Alfonso, Guenther, Frank H
• Format: Journal Article
• Language: English
• Published: United States American Speech-Language-Hearing Association 15.06.2021
• Subjects: Adult; Adults; Auditory Perception; Brain; Brain Hemisphere Functions; Brain research; Causes of; Computational linguistics; English; Feedback; Fluency; Functional magnetic resonance imaging; Humans; Language; Language Patterns; Language Processing; Literature Reviews; Magnetic resonance imaging; Native Speakers; Natural language interfaces; Neural circuitry; North American English; Pacing; Phonemes; Planning; Reading; Research Committees; Research Methodology; Rhythm; Speaking; Special Issue: Selected Papers From the 2020 Conference on Motor Speech—Basic Science and Clinical Innovation; Speech; Speech perception; Speech Production Measurement; Speech rate; Stimuli; Stuttering; Massachusetts (Boston); United States
• ISSN: 1092-4388; 1558-9102
• DOI: 10.1044/2021_JSLHR-20-00328

Purpose: Stuttering is characterized by intermittent speech disfluencies, which are dramatically reduced when speakers synchronize their speech with a steady beat. The goal of this study was to characterize the neural underpinnings of this phenomenon using functional magnetic resonance imaging. Method: Data were collected from 16 adults who stutter and 17 adults who do not stutter while they read sentences aloud either in a normal, self-paced fashion or paced by the beat of a series of isochronous tones ("rhythmic"). Task activation and task-based functional connectivity analyses were carried out to compare neural responses between speaking conditions and groups after controlling for speaking rate. Results: Adults who stutter produced fewer disfluent trials in the rhythmic condition than in the normal condition. Adults who stutter did not have any significant changes in activation between the rhythmic condition and the normal condition, but when groups were collapsed, participants had greater activation in the rhythmic condition in regions associated with speech sequencing, sensory feedback control, and timing perception. Adults who stutter also demonstrated increased functional connectivity among cerebellar regions during rhythmic speech as compared to normal speech and decreased connectivity between the left inferior cerebellum and the left prefrontal cortex. Conclusions: Modulation of connectivity in the cerebellum and prefrontal cortex during rhythmic speech suggests that this fluency-inducing technique activates a compensatory timing system in the cerebellum and potentially modulates top-down motor control and attentional systems. These findings corroborate previous work associating the cerebellum with fluency in adults who stutter and indicate that the cerebellum may be targeted to enhance future therapeutic interventions.