Press Release

Real-time MRI reveals the movement dynamics of stuttering

Researchers at the University Medical Center Göttingen (UMG) and the Max Planck Institute for Multidisciplinary Sciences (MPI-NAT) have succeeded in visualizing the movement patterns of the internal speech muscles of a stuttering patient using real-time magnetic resonance imaging (MRI). The method helps to improve our understanding of the mechanical aspects of stuttering, to identify muscle malfunctions in speech disorders, and to aid in the acquisition and reinforcement of new speech patterns. The results have been published in the Clinical Pictures section of the renowned journal The Lancet.

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Interdisciplinary Working Group on Speech Fluency Disorders

Aim and methods

The aim of our working group is to understand better the pathophysiology of speech fluency disorders, especially stuttering that develops in childhood.

To succeed in this endeavour, we use neuro-radiological (structural and functional MRI) and neurophysiological methods, in particular transcranial magnetic stimulation and electroencephalography, depending on the research question.

Stuttering

Stuttering is a widely recognised speech fluency disorder of unexplained cause. It is characterized by involuntary repetitions and prolongations of sounds and syllables, and speech blocks.1 Verbal or situational avoidance behaviour and involuntary movements may develop over time.2

Approximately 7 million people in Europe stutter. Stuttering affects at least 5% of all children and has an astonishing rate of early recovery. After puberty, recoveries are extremely rare and about 1% of all adults stutter.3, 4 Stuttering that persists into adulthood can lead to significant restrictions in quality of life and social and professional development.5

For centuries,6 it was not clear why stuttering develops, nor why it disappears more or less spontaneously in many affected children. In the last 20 years, our group has contributed to generating evidence from neuroscience that stuttering is associated with both morphological and functional changes in the brain.7 Neuroscientific studies have provided insights into the brain structure and pathophysiology of stuttering, and its interaction with speech therapy.8, 9 New real-time MRI technologies allow a better understanding of aberrant movements during stuttering events. Ultrasound examination of the midbrain allows quantification of iron deposits in the substantia nigra.10 Testing whether this has any prognostic value is an endeavour currently getting underway. External neurostimulation reveals disturbed interactions of inhibitory and facilitatory control circuits in the motor cortex of adults who stutter.11

In recent years, large epidemiological data sets show atopic diseases as previously unrecognised comorbidities.12 Coping strategies and social anxiety receive more attention and may be independent treatment goals.13

The aim of our working group is to uncover further neurobiological processes of stuttering and its development. From the perspective of neurological movement disorders, we are interested in the temporary loss of motor control in stuttering, and how this changes through therapy or spontaneously. We investigate neurological correlates and causes of this loss of control using neurophysiological and imaging methods.

1.         American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th edition ed. Washington, D.C.: American Psychiatric Association, 2013.

2.         Mulligan HF, Anderson TJ, Jones RD, Williams MJ, Donaldson IM. Dysfluency and involuntary movements: a new look at developmental stuttering. Int J Neurosci 2001;109(1-2):23-46.

3.         Yairi E, Ambrose NG. Early childhood stuttering I: persistency and recovery rates. J Speech Lang Hear Res 1999;42(5):1097-1112.

4.         Sommer M, Waltersbacher A, Schlotmann A, Schröder H, Strzelczyk A. Prevalence and Therapy Rates for Stuttering, Cluttering, and Developmental Disorders of Speech and Language: Evaluation of German Health Insurance Data. Front Hum Neurosci 2021;15:645292.

5.         McAllister J, Collier J, Shepstone L. The impact of adolescent stuttering on educational and employment outcomes: evidence from a birth cohort study. J Fluency Disord 2012;37(2):106-121.

6.         Leon-Sarmiento FE, Paez E, Hallett M. Nature and nurture in stuttering: a systematic review on the case of Moses. Neurol Sci 2012;2012.

7.         Sommer M, Koch MA, Paulus W, Weiller C, Buchel C. Disconnection of speech-relevant brain areas in persistent developmental stuttering. Lancet 2002;360(9330):380-383.

8.         Korzeczek A, Primaßin A, Wolff von Gudenberg A, et al. Fluency shaping increases integration of the command-to-execution and the auditory-to-motor pathways in persistent developmental stuttering. Neuroimage 2021;245:118736.

9.         Neef NE, Korzeczek A, Primaßin A, et al. White matter tract strength correlates with therapy outcome in persistent developmental stuttering. Hum Brain Mapp 2022;43(11):3357-3374.

10.       Liman J, Wolff von Gudenberg A, Baehr M, Paulus W, Neef NE, Sommer M. Enlarged Area of Mesencephalic Iron Deposits in Adults Who Stutter. Front Hum Neurosci 2021;15:639269.

11.       Elfers A, Hommel S, Neef N, Wolff von Gudenberg A, Paulus W, Sommer M. 1207 Motor intracortical excitability before speech onset in adults who stutter. Movement Disorders 2019;34(Suppl. S2):S500.

12.       Ajdacic-Gross V, Rodgers S, Müller M, et al. Hay Fever is Associated with Prevalence, Age of Onset and Persistence of Stuttering. Advances in Neurodevelopmental Disorders 2020;4:67–73.

13.       Menzies RG, Packman A, Onslow M, O'Brian S, Jones M, Helgadóttir FD. In-Clinic and Standalone Internet Cognitive Behavior Therapy Treatment for Social Anxiety in Stuttering: A Randomized Trial of iGlebe. J Speech Lang Hear Res 2019;62(6):1614-1624.

For patients & parents of children who stutter

If you stutter and would like to participate in our research for a better understanding of stuttering, write an email to Prof. Sommer msommer(at)gwdg.de

People who stutter with questions about therapy and therapy satisfaction please contact the independent counselling centre of the Bundesvereinigung Stottern & Selbsthilfe e.V., Zülpicher Straße 58, 50674 Köln, phone: 0221 139-1106, fax: 0221 139-1370, email: info(at)bvss.de This association maintains a very informative website (www.bvss.de) with a variety of information about stuttering. This association is not a public institution, but an association supported by people who stutter and other committed people. It depends on your support and can make good use of donations.

Team

Oberarzt

Prof. Dr. Martin Sommer

Prof. Dr. Martin Sommer

Kontaktinformationen

  • Neurologe und Spezialist für Schmerz bei Hochbetagten

    Prof. Dr. med. Martin Sommer studierte Medizin an der Universität in Aachen und ist seit 2003 Facharzt für Neurologie, 2010 wurde er zum Professor ernannt und seit 2019 ist er spezialisiert auf neurologische Schmerzbehandlung. Mit der Eröffnung der Geriatrie-Station wurde Prof. Sommer als Oberarzt in der Geriatrie tätig. Prof. Sommer hat eine eigene Ambulanzsprechstunde, die sich auf die Schmerztherapie für Hochbetagte bezieht.

Neurowissenschaftlerin

PD Dr. rer. nat. Nicole Neef

Kontaktinformationen

Leitung Phoniatrie/Pädaudiologie

Prof. Dr. med. Arno Olthoff

Prof. Dr. med. Arno Olthoff

Kontaktinformationen

Outpatient Consultation

In cooperation with the Department of Phoniatrics/Paediatric Audiology, we offer outpatient consultations. The aim is to confirm the diagnosis of chronic idiopathic stuttering, to assess comorbidities, and to provide advice on quality life and therapy options.

The outpatient presentation serves to make an assessment of the symptoms that is as precise as possible and to plan the further procedure and, if necessary, suitable treatment options. Within the framework of the outpatient clinic, family examinations may also be possible after prior registration.

We would like to point out that we do not offer our own stuttering therapy.

Projects for doctoral or bachelor's/master's theses

Cooperation partners

  • Prof. Dr. Christine von Arnim, Abteilung Geriatrie, UMG
  • Prof. Dr. Frank Petzke, Anästhesiologie, UMG

Medical doctoral theses

MD theses in preparation:

  • Anna Elfers, Thema: „Speech-related balance of inhibition and facilitation in the tongue motor cortex in persistent developmental stuttering“, (in Vorbereitung), Universität Göttingen
  • Daniela Ponssen; „Darstellung von Artikulationsbewegungen stotternder Erwachsener in der Hochgeschwindigkeits-Magnetresonanztomographie“, (in Vorbereitung),
  • Susanne Dickhut
  • Lea Ufermann: Appendix C of current submssion
  • Marius Hergt
  • Nikolai Tabakov

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