Finnish researchers discover the origin of stuttering in the brain

Stuttering is extremely stressful for those who have it, especially because other people often react insultingly, aggressively, or incorrectly to this speech disorder. Involuntary repetition of syllables and sounds, prolongation of sounds, and noticeable or “silent” blockages can disturb those affected. The feeling of distress can also become physically noticeable, for example through facial flushing or sweating.

Stuttering does not allow any conclusions to be drawn about the personality or intelligence of the affected person. People who stutter know exactly what they want to say, but they can't say it fluently at the moment.

For a long time, stuttering was thought to be a psychological or emotional disorder. In fact, stuttering is a speech disorder caused by the nervous system in which the regulation of speech production in the brain is impaired.

The origin of stuttering is local

Finnish researchers now believe they have identified the area of ​​the brain where stuttering occurs. In people who stutter, they discovered structural changes in the nodes of the brain network.

According to the team led by Joho Gotsa from the University of Turku, its center is located in the Putamen region. The putamen is one of the basic regions of the brain and is part of the gray matter in the brain. It is especially important for facial motor skills, i.e. facial expressions.

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Various causes of stuttering

Speech disorder can have different causes. There is a genetic predisposition that can, but does not necessarily, lead to stuttering. In addition, neurological diseases such as Parkinson's disease or strokes can lead to stuttering. For the study, the Finnish researchers also examined patients who started stuttering after a stroke. The stroke affected only the part of the brain in which the brain network in question was located.

Test participants showed the same structural changes in the nodes of this brain network as those who developed stuttering in childhood. According to the study, this shows that stuttering always arises in this network, regardless of genetic or neurological causes.

New treatment methods?

The Finnish study impressively confirms that the left hemisphere plays a crucial role in encoding speech and in translating thoughts into speech and spoken language, says Professor Martin Sommer, chief medical officer and head of the Interdisciplinary Working Group on Speech Disorders in the Department of Neurology at the Medical Centre. University of Göttingen (UMG). The study also showed that the two forms of stuttering, neurogenic stuttering, that is, stuttering resulting from a stroke, and stuttering in early childhood, are not very different, says Sommer, who is himself affected by stuttering and is the Federal Society for Stuttering and Self-Portrait. -Help (BVSS) advises.

To date, there are no effective pharmacological or neurological treatment methods. According to the Finnish researchers, the localization of the structural change creates new treatment options, such as deep brain stimulation that targets this brain network.

Neurophysiologist Sommer welcomes the new research approach, but also has concerns: “It is certainly possible to extract a treatment from this, but it requires a few intermediate steps to understand where you should connect the electrode to what polarity,” Sommer explains. “We have not reached this stage yet.”

Stuttering is not uncommon

In Germany, with a population of about 84 million, an estimated 800,000 people permanently stutter. More than five percent of young children stutter, or about 50 out of every 1,000 children. Boys are affected more often than girls.

Stuttering often begins suddenly between the ages of 2 and 6 years. This disorder usually goes away on its own over the next two years, but about 1% of those affected still stutter into adulthood.

How is stuttering treated?

Medications, breathing or relaxation treatments, or any recovery treatments don't really work against stuttering. “There are still questionable treatment providers out there promising a miracle cure, so to speak, so you have to be careful,” Sommer says.

“Even the most severe cases of stuttering can be prevented with simple methods such as speaking as me-tro-nom, but then stuttering does not disappear, but is hidden behind a changed way of speaking. And who wants to talk like that all day? Then you have to be careful not to It gets into the wrong hands,” Sommer warns.

Changing speaking behavior

However, there are two effective stuttering treatment methods that can also be combined: fluency shaping and stuttering modification. Both methods “are based on the idea that conscious control of the muscular speech process in the larynx and mouth enables the soft voice to be used preventively or when symptoms of stuttering appear,” explains stuttering therapist Frauke Kern.

These techniques can reduce the duration and severity of actual symptoms and reduce fear of stuttering by regaining control of the speech process, Kern says. She is a member of the Federal Council of the German Federal Society for Speech Therapy.

Fluency shaping changes the way you speak, for example by using a 'soft sound' at the beginning of a word or consciously extending a syllable or sound. The goal of this method is to prevent stuttering when speaking.

Through the stuttering modification method, sufferers learn so-called obstacle-solving techniques in order to get out of the stressful situation in a controlled and somewhat manageable way. “This is an interesting approach that involves identifying stuttering events,” says neurophysiologist Sommer. This reduces stress and overcomes the moment of stuttering. Therapist Kern emphasizes above all that normal speech is preserved when stuttering is corrected.

Face the challenge

Affected people often try to avoid certain words or situations out of shame or fear of making a fool of themselves. This can lead to those affected withdrawing from daily life and becoming socially isolated.

Therefore, people who stutter also learn to face difficult situations. “The biggest danger when you stutter is keeping your mouth shut, and a lot of people do that. But that's a shame, because if you keep your mouth shut, no one will see or hear it. If you keep your mouth shut, you won't get very far. Avoidance behavior is unfortunate because it limits Great opportunities for people's development. “That's why it's important not to keep your mouth shut, but to say what you want to say,” advises neurologist Sommer.

Self-help groups can help overcome the fear of speaking. It is usually helpful to deal with stuttering openly and confidently with your family, friends, or at work.

What doesn't help people who stutter?

People who stutter can do without advice, which is often well-intentioned. You don't need to take a deep breath, concentrate or stay calm. Such advice annoys or just annoys you.

“So the best thing is to wait, watch and listen. People who stutter need more time, that's the way it is! There are always people trying to continue the word or sentence. Firstly, it is very painful to interrupt someone. Moreover, this may not be what “Then it gets complicated,” Sommer says.

Author: Alexander Freund