A longitudinal study of neural network development in children who stutter

Significant gaps remain in our understanding of the neurobiological, mechanistic bases of stuttering.
Accumulating evidence points to the possible role of basal ganglia-thalamocortical (BGTC) and cerebellar (CE)
networks in stuttering persistence and recovery. To date there have been few attempts to examine how BGTC
and CE network structure and function relate to behavioral differences in intrinsic timing of speech and
nonspeech gestures, and how these processes link to stuttering persistence and recovery. The long-term goal
is to leverage and significantly expand our current large-scale investigation of childhood stuttering to more fully
characterize the neural network-based brain mechanisms that underlie developmental stuttering. The overall
objective of this application is to examine connectivity of BG and CE networks in children and adolescents who
stutter relevant to auditory, motor, and sensorimotor timing. The central hypothesis is that deficient intrinsic timing
ability underlies persistent stuttering, which is reflected in BGTC and CE network connectivity patterns. The
rationale for the proposed project is that a better understanding of how maturational patterns of cortical-
subcortical networks supporting temporal processing differ in children who stutter should lead to a clearer
account of the mechanisms underlying persistence and recovery of stuttering. We plan to test our central
hypothesis and, thereby, accomplish our overall objective for this project by pursuing the following specific aims:
1. Examine detailed brain functional and structural connectivity differences along the BGTC and CE networks
associated with stuttering persistence and recovery; 2. Examine performance differences on rhythm perception
and production tasks as they relate to stuttering persistence and recovery; 3. Establish a comprehensive,
developmental dataset up to adolescence that elucidates BG and CE network connectivity and multifactorial
influences associated with stuttering persistence and recovery. Under aim 1, we will apply advanced fMRI and
DTI acquisition protocols used by a multi-site developmental neuroimaging consortium (i.e., ABCD) to compare
functional and structural connectivity changes in the BGTC and CE networks in children and adolescents who
stutter. Under aim 2, we will examine the links between cortical-subcortical network connectivity and performance
on temporal processing tasks that tax intrinsic timing abilities. Under aim 3, we will significantly expand our
investigations of childhood stuttering into the understudied and dynamic period of adolescence by leveraging a
large developmental dataset through the ABCD consortium. This approach is innovative, because it will be the
first to provide a detailed account of subcortical connectivities relevant to aberrant temporal processing function
in stuttering. The proposed research is significant, because it will lead to mechanistic insights into trait versus
compensatory neural network development associated with persistence and recovery of stuttering. Ultimately,
such knowledge has the potential to inform the development of better prognostic tools and interventions for
stuttering during childhood.

Grant Number: 5R01DC011277-16
NIH Institute/Center: NIH
Principal Investigator: Soo-Eun Chang