Neuroimaging Detects Chemical Disturbances in Stuttering Interview with:
Joseph O’Neill, PhD
Division of Child and Adolescent Psychiatry
University of California–Los Angeles Semel Institute for Neuroscience
Los Angeles What is the background for this study? What are the main findings?

Response: Stuttering seriously diminishes quality of life. While many children who stutter eventually grow out of it, stuttering does persist into adulthood in many others, despite treatment. Like earlier investigators, we are using neuroimaging to explore possible brain bases of stuttering, aiming, eventually, to improve prognosis. What’s novel is that our study deploy neuroimaging modalities– arterial spin labelling and, in this paper, magnetic resonance spectroscopy (MRS)– not previously employed in stuttering. MRS offers prospects of detecting possible neurochemical disturbances in stuttering.

The MRS results showed differences in neurometabolite– brain chemicals– levels between people who stutter (adults and children) and those who don’t in many brain regions where other neuroimaging has also observed effects of stuttering. In particular, MRS effects were apparent in brain circuits where our recent fMRI work detected signs of stuttering, circuits subserving self-regulation of speech production, attention and emotion. This reinforces the idea that stuttering has to do with how the brain manages its own activity along multiple dimensions: motivation, allocation of resources, and behavioral output. What should readers take away from your report?

Response: Clinically, stuttering seems rather focal, a select speech impediment that leaves most other functions intact. Yet– consistent with other neuroimaging– MRS found small but significant effects of stuttering in numerous widespread, brain regions. In hindsight, this makes sense: several muscles of respiration, of phonation, of articulation,… all have to work in coordination with each other and with multiple cognitive functions to achieve the feat of normal speech, which is impaired in stuttering. Stuttering, furthermore, can trigger powerful emotions. Hence, it’s plausible that the brain adjusts neurometabolite levels and other physiological parameters in multiple brain regions in someone with chronic stuttering. What recommendations do you have for future research as a result of this study?

Response: Our study indicated some differences in regional brain chemistry between children who stutter and adults who stutter. One great goal– still far off in the future– would be to develop neuroimaging tests to predict which children who stutter are likely to recover and which are likely to continue stuttering as adults. More intensive, or different, intervention might be indicated for the latter. A more immediate goal is another study of stuttering using alternative MRS techniques. In this paper, we examined essentially three neurometabolites. But alternative techniques used in our work on other disorders assay further metabolites, including the major brain neurotransmitters glutamate and gamma-aminobutyric acid (GABA). We would like to see if levels of glutamate and GABA in the brain differ between those who stutter and those who do not. If so, that might form some basis for rational pharmacotherapy. Is there anything else you would like to add?

Response: We’d like to thank the Millhiser Family Trust, the Suzanne Murphy Crosby endowment, NIMH, and Children’s Hospital LA for generously supporting our investigation of this highly disabling condition. Thank you for your contribution to the community.


O’Neill J, Dong Z, Bansal R, Ivanov I, Hao X, Desai J, Pozzi E, Peterson BS. Proton Chemical Shift Imaging of the Brain in Pediatric and Adult Developmental Stuttering. JAMA Psychiatry. Published online November 23, 2016. doi:10.1001/jamapsychiatry.2016.3199

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Last Updated on November 28, 2016 by Marie Benz MD FAAD