scholarly journals Transcranial direct current stimulation over left inferior frontal cortex improves speech fluency in adults who stutter

Brain ◽  
2018 ◽  
Vol 141 (4) ◽  
pp. 1161-1171 ◽  
Author(s):  
Jennifer Chesters ◽  
Riikka Möttönen ◽  
Kate E Watkins
Keyword(s):  
Frontal Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Inferior Frontal Cortex ◽  
Adults Who Stutter

scholarly journals Transcranial direct current stimulation over left inferior frontal cortex improves speech fluency in adults who stutter

2018 ◽  
Author(s):  
Jennifer Chesters ◽  
Riikka Möttönen ◽  
Kate E. Watkins
Keyword(s):  
Frontal Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Neurodevelopmental Disorder ◽  
Anodal Tdcs ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Fluency Intervention ◽  
Inferior Frontal Cortex ◽  
Adults Who Stutter

Stuttering is a neurodevelopmental disorder affecting 5% of children, and persisting in 1% of adults. Promoting lasting fluency improvement in adults who stutter is a particular challenge. Novel interventions to improve outcomes are required, therefore. Previous work in patients with acquired motor and language disorders reported enhanced benefits of behavioural therapies when paired with transcranial direct current stimulation (tDCS). Here, we report the results of the first trial investigating whether tDCS can improve speech fluency in adults who stutter. Thirty adult men who stutter completed a randomized, double-blind, controlled trial of anodal tDCS over left inferior frontal cortex. Fifteen men received 20 minutes of 1-mA tDCS on five consecutive days while speech fluency was temporarily induced using choral and metronome-timed speech. The other 15 men received the same speech fluency intervention with sham stimulation. We predicted that applying anodal tDCS to the left inferior frontal cortex during speech production with temporary fluency inducers would result in longer-lasting fluency improvements. Speech fluency during reading and conversation was assessed at baseline, before and after the stimulation on each day of the five-day intervention, and at 1 and 6 weeks after the end of the intervention. TDCS combined with speech fluency training significantly reduced the percentage of disfluent speech measured 1 week after the intervention compared with fluency intervention alone. At 6 weeks after the intervention, this improvement was maintained during reading but not during conversation. Outcome scores at both post-intervention time points on a clinical assessment tool (the Stuttering Severity Instrument – version 4) also showed significant improvement in the group receiving tDCS compared with the sham group, in whom fluency was unchanged from baseline. We conclude that tDCS combined with behavioural fluency intervention has the capacity to improve fluency in adults who stutter. tDCS thereby offers a potentially useful adjunct to future speech therapy interventions for this population, for whom therapy outcomes are currently limited.

scholarly journals Neural changes after training with transcranial direct current stimulation to increase speech fluency in adults who stutter

2021 ◽  
Author(s):  
Jennifer Chesters ◽  
Riikka Möttönen ◽  
Kate E Watkins
Keyword(s):  
Frontal Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Inter Quartile Range ◽  
Sham Stimulation ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adult Men ◽  
Sentence Reading ◽  
Inferior Frontal Cortex

In a randomised controlled trial, we showed that a five-day intervention combining anodal transcranial direct current stimulation over the left inferior frontal cortex with temporary speech fluency enhancing techniques reduces stuttering. Speech fluency was unchanged by the fluency training alone, as predicted. Here, we report the neural changes associated with the intervention, measured using functional MRI during sentence reading before the training and one-week later. We obtained imaging data in 25 adult men who stutter (median age = 32 y, inter-quartile range = 11) at the pre-intervention baseline and again one-week post-intervention. A control group of 15 adult men who do not stutter (median age = 30 y, inter-quartile range = 10) and did not complete the intervention were scanned on one occasion. In a whole-brain analysis of perceptibly fluent sentence reading, we compared the change in task-evoked neural activity in the sub-group of men who stutter who had received active stimulation during the intervention (N=13) with those who had sham stimulation (N=12). We hypothesised that the combination of anodal stimulation over the left inferior frontal cortex and fluency-enhancing training would result in lasting change to the brain networks supporting fluent speech production. An additional region-of-interest analysis explored effects on basal ganglia nuclei, which are thought to have a key role in the casual mechanism of stuttering, and which we hypothesised would be engaged by the behavioural approach used during training (choral and metronome-timed speaking). One week after the intervention, the group who had received active transcranial stimulation showed increased activity in speech-related brain regions, relative to the group who had received sham stimulation. Cortically, these changes were evident in left inferior frontal cortex (pars opercularis and orbitalis), anterior insula, anterior superior temporal gyrus, anterior cingulate cortex, and supplementary motor area. Subcortically, activation increased in the caudate nuclei and putamen bilaterally, and in right globus pallidus and thalamus. Together these regions form cortico-striatal-thalamo-cortical loops involved in the planning and initiation and control of speech movements.Our findings reveal that the mechanism of action of the tDCS intervention involved increasing activity across the network involved in the production of fluent speech, indicating that tDCS can be used to promote neural plasticity to strengthen networks supporting natural fluency. This study advances the potential of using non-invasive brain stimulation to improve therapy efficacy for those people who stutter who choose to work on increasing fluency.

scholarly journals Investigation of the effect of Delayed Auditory Feedback and transcranial Direct Current Stimulation (DAF-tDCS) treatment for the enhancement of speech fluency in adults who stutter: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Narges Moein ◽  
Reyhane Mohamadi ◽  
Reza Rostami ◽  
Michael Nitsche ◽  
Reza Zomorrodi ◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Feedback ◽  
Intervention Group ◽  
Control Group ◽  
Anodal Tdcs ◽  
Delayed Auditory Feedback ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adults Who Stutter

Abstract Background: With a population prevalence of one percent, stuttering is among the main speech pathology-related topics of research. Adults who stutter may benefit from transcranial direct current stimulation (tDCS) as an adjunctive intervention for enhancing speech fluency. In this study, Delayed Auditory Feedback (DAF) was combined with tDCS applied over the superior temporal gyrus. It was anticipated that intervention caused improvements of speech fluency become more stable.Methods: A randomized, double-blind, sham-controlled clinical trial was conducted to investigate the effectiveness of intervention in enhancing speech fluency. Fifty participants were randomly allocated the intervention or control group. In the intervention group, participants received DAF combined with anodal tDCS, while the control group was exposed to sham tDCS simultaneously with DAF. Each subject participated in six intervention sessions. Speech fluency was assessed before intervention as baseline, as well as immediately, one week and six weeks after intervention.Results: In the intervention group, the percentage of stuttered syllables was significantly reduced immediately, one week and six weeks after the intervention, as compared with the control group. The scores of the Stuttering Severity Instrument, also showed a significant reduction in the intervention group compared with the control group. No significant difference was found in the Overall Assessment of the Speaker’s Experience of Stuttering questionnaire scores between the two patient two groups after intervention.Conclusion: The results of this study propose anodal tDCS as an adjunctive method to increase speech fluency in stuttering for a prolonged time course after intervention, when combined with fluency therapy.Trial registration: This trial was registered in ClinicalTrial.gov before recruiting the subjects. The registration number is NCT03990168 and the date of registration is June 18, 2019. https://clinicaltrials.gov/ct2/show/NCT03990168

scholarly journals Investigation of the effect of Delayed Auditory Feedback and transcranial Direct Current Stimulation (DAF-tDCS) treatment for the enhancement of speech fluency in adults who stutter: a Randomized Controlled Trial

2020 ◽  
Author(s):  
Narges Moein ◽  
Reyhane Mohamadi ◽  
Reza Rostami ◽  
Michael Nitsche ◽  
Reza Zomorrodi ◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Feedback ◽  
Intervention Group ◽  
Control Group ◽  
Anodal Tdcs ◽  
Delayed Auditory Feedback ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adults Who Stutter

Abstract Background: With a population prevalence of one percent, stuttering is among the main speech pathology-related topics of research. Adults who stutter may benefit from transcranial direct current stimulation (tDCS) as an adjunctive intervention for enhancing speech fluency. In this study, Delayed Auditory Feedback (DAF) was combined with tDCS applied over the superior temporal gyrus. It was anticipated that the combined intervention cause improvements in speech fluency.Methods: A randomized, double-blind, sham-controlled clinical trial was conducted to investigate the effectiveness of intervention in enhancing speech fluency. Fifty participants were randomly allocated to the intervention or control group. In the intervention group, participants received DAF combined with anodal tDCS, while the control group was exposed to sham tDCS simultaneously with DAF. Each subject participated in six intervention sessions. Speech fluency was assessed as the baseline, before intervention as well as immediately, one week and six weeks after intervention. Results: In the intervention group, the percentage of stuttered syllables was significantly reduced immediately, one week and six weeks after the intervention, as compared with the control group. The scores of the Stuttering Severity Instrument, also showed a significant reduction in the intervention group compared with the control group. No significant difference was found in the Overall Assessment of the Speaker’s Experience of Stuttering questionnaire scores between the two groups after intervention. Conclusion: The results of this study propose anodal tDCS as an adjunctive method to increase speech fluency in stuttering for a prolonged time course after intervention, when combined with fluency therapy.Trial registration: This trial was registered in ClinicalTrial.gov before recruiting the subjects. The registration number is NCT03990168 and the date of registration is June 18, 2019. https://clinicaltrials.gov/ct2/show/NCT03990168

Modulation of sustained fear by transcranial direct current stimulation (tDCS) of the right inferior frontal cortex (rIFC)

2018 ◽  
Vol 139 ◽  
pp. 173-177 ◽  
Author(s):  
Martin J. Herrmann ◽  
Bibiane S.E. Simons ◽  
Anna K. Horst ◽  
Stephanie Boehme ◽  
Thomas Straube ◽  
...  
Keyword(s):  
Frontal Cortex ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Direct Current Stimulation ◽  
Inferior Frontal Cortex ◽  
The Right

scholarly journals Delayed Auditory Feedback and Transcranial Direct Current Stimulation Treatment for the Enhancement of Speech Fluency in Adults Who Stutter: Protocol for a Randomized Controlled Trial

10.2196/16646 ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. e16646
Author(s):  
Narges Moein ◽  
Reyhane Mohamadi ◽  
Reza Rostami ◽  
Michael Nitsche ◽  
Reza Zomorrodi ◽  
...  
Keyword(s):  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Auditory Feedback ◽  
Intervention Group ◽  
Control Group ◽  
Delayed Auditory Feedback ◽  
Direct Current Stimulation ◽  
Speech Fluency ◽  
Adults Who Stutter

Background Stuttering is a complex speech disorder that affects speech fluency. Recently, it has been shown that noninvasive brain stimulation may be useful to enhance the results of fluency interventions in adults who stutter. Delayed auditory feedback (DAF) is a method to enhance speech fluency in individuals who stutter. Adjunctive interventions are warranted to enhance the efficacy of this intervention. Objective Individuals who stutter have pathological activation patterns in the primary and secondary auditory areas. Consequently, in this study, we hypothesize that stimulation of these areas might be promising as an adjunctive method to fluency training via DAF to enhance speech therapy success in individuals with a stutter. We will systematically test this hypothesis in this study. Methods This study is designed as a randomized, double-blind, sham-controlled clinical trial. All participants will receive DAF. The intervention group will additionally receive real transcranial direct current stimulation, while the control group will be exposed to sham stimulation. The assignment of the participants to one of these groups will be randomized. Before starting the treatment program, 2 preintervention assessments will be conducted to determine the severity of stuttering. Once these assessments are completed, each subject will participate in 6 intervention sessions. Postintervention assessments will be carried out immediately and 1 week after the last intervention session. Subsequently, to explore the long-term stability of the treatment results, the outcome parameters will be obtained in follow-up assessments 6 weeks after the treatment. The primary outcome measurement—the percentage of stuttered syllables—will be calculated in pre-, post-, and follow-up assessments; the secondary outcomes will be the scores of the following questionnaires: the Stuttering Severity Instrument–Fourth Edition and the Overall Assessment of the Speaker’s Experience of Stuttering. Results This protocol was funded in 2019 and approved by the Research Ethics Committee of the Iran University of Medical Sciences in June 2019. Data collection started in October 2019. As of February 2020, we have enrolled 30 participants. We expect data analysis to be completed in April 2020, and results will be published in summer 2020. Conclusions We anticipate that this study will show an adjunctive effect of transcranial direct current stimulation, when combined with DAF, on stuttering. This should include not only a reduction in the percentage of stuttered syllables but also improved physical behavior and quality of life in adults who stutter. Trial Registration ClinicalTrial.gov NCT03990168; https://clinicaltrials.gov/ct2/show/NCT03990168 International Registered Report Identifier (IRRID) DERR1-10.2196/16646

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