New Research Identifies Brain Link to Stuttering

Transcript

[00:00:00] Hey, everyone. I'm here in Edgewater, New Jersey, and I am filming for our Proud Stutter documentary on Jay Jordan. Um, we're so excited to be here. We just finished, um, our second day of filming, and it's just, it's making me so excited to be able to do the thing. This work and I, I'm so, so excited to share with you all the end product when it comes out.

I have Tessa and Jotty here and we're just having the best time getting to know Jay and his family. And yeah, I We're just really excited and I, I'm really excited also to release another episode of Proud Stutter. I hope you like it.[00:01:00]

I'm Maya Chupkov and I'm a woman who stutters. Welcome to Proud Stutter, a show about stuttering and embracing verbal diversity in an effort to change how we talk about it. One conversation at a time.

Welcome back to Proud Stutter. I'm your host, Maya Chupkov. Today, we have Catherine Bays. Catherine is a speech therapist and researcher specialized in stuttering and acquired neurogenic communication disorders. Welcome, Catherine, to Proud Stutter. Thank you, Maya. And thanks for having me. Really pleased to be here today to talk about the work that we are doing.

Yes. So I always get so excited when I see new stuttering research, especially Um, any stuttering [00:02:00] research around like what's happening inside the brain. I'm always so fascinated with like what's going on inside my brain when I'm stuttering and um, I know there isn't like a definitive answer, but um, but yeah, that's, I'd love to hear, um, more about your new research that just came out.

came out even before that, like what got you interested in doing this research in the first place? Uh, I've always had an interest in stuttering because my grandfather, um, had a severe stutter and it really had a big impact on his life. Um, and then when I became a speech therapist and I just became really interested in doing research and in understanding more about speech and especially what goes on in our brains.

I [00:03:00] am very interested not only in developmental stuttering, which is what most people refer to when they talk about stuttering. So that's the thing. Type of stuttering that usually has an onset in the preschool years, and then it may persist into adulthood, but stuttering can also occur in people who have spoken fluently their whole lives, and then they can have a stroke, for example, or traumatic brain injury.

Parkinson's disease. And due to these changes in the brain, they can start to stutter, especially when you're interested in knowing what is happening in the brain, because in people who have stroke, for example, you have specific lesions. And so we know that these lesions are then associated with the onset of the stuttering.

And historically by looking at brain lesions is really how we've learned a lot about the brain and how the brain works. So you just published a paper called Localization of Stuttering Based on Causal Brain Lesions. Can you talk to us about your new research? [00:04:00] Um, so for this specific study, what we wanted to do is we wanted to look at lesions following stroke that cause stuttering to try and understand more about the brain and the different areas that can be involved in stuttering.

So when we look at acquired stuttering and when you look at the lesions, um, following stroke, we. actually see that they don't really give us a clear indication as to which brain lesion is associated with the onset of stuttering. Um, because they are really spread across different parts of the brain. And so what we have done is we've used a new technique.

Um, and that technique looks not just at where the lesions occur, But what are all of the brain networks that are influenced by these lesions? So how is the brain communicating differently? So how are brain areas communicating differently with each other due to these lesions? So instead of looking at different parts of the brain, we've really [00:05:00] looked at what are the networks that are affected by it, and is there a commonality between all of the people who start to stutter following brain lesions?

And so what we have done is we have looked at cases that have been published in the literature. So, um, people reported on lesions that cause stuttering. And so we, um, used that lesion network mapping technique there. And then, um, I have been, uh, working with people with acquired neurogenic stuttering for lots of years.

And so we looked at the people that I've worked with clinically as well. And we looked at their brain skins and then did this. that similar analysis as well. What we saw was that there is a common network of brain areas. What we were then interested in was to look if, um, that network was really, network hub was really only important for people with acquired stuttering following stroke or whether that would also be relevant for people with persistent developmental stuttering.

[00:06:00] Because in developmental stuttering, again, uh, so there have been lots of brain studies that have been done, right, but we don't really know exactly what is going on yet. So we were interested to see if the network hub that we identified in acquired stuttering was also relevant for, um, resistant developmental stuttering.

There were also gray matter changes, um, associated with impact of stuttering in developmental stuttering. So we identified a common network hub of brain areas associated with acquired stuttering and with developmental stuttering. And can you just give us like a very broad summary of what the research tells us now about stuttering?

We know that there's a genetic component to stuttering and we know that there are brain differences associated with stuttering. And what, um, it showed is that it's both areas that are responsible for speech production, but also areas that are associated with [00:07:00] emotional processing as well. What we, um, are still trying to map is exactly what happens when.

With our study, we have looked at adults, uh, with persistent developmental stuttering, uh, but we are not sure that the exact same areas are also the areas that show differences in preschoolers who stutter, uh, close to the onset of stuttering, for example. So that is really an important, uh, next step to take and to look at.

Another, uh, important step is to really link these findings to make some of our Some treatment options more effective if people are interested in treatments, uh, and that may be treatment focusing on speech fluency, but also on, um, emotional consequences, um, of stuttering as well. And why is this, why is your research study?

important, like what does it [00:08:00] contribute to, um, the existing research around stuttering? I find it really helpful because this really provides an explanation for why we found all of these different brain areas across all of these different studies. So what it shows us is really that all of these differences can be brought back to a common network of brain areas, which helps us to explain a lot of these differences.

So now that you have this Um, research study out what, what are you working on? Now, and does it have any connection to the one you just published the moment we are doing a treatment study in preschoolers who stutter so where we have the kids go in a scanner before the treatments and then we, um, Give treatment and then we look at where, whether there's any brain changes after treatment as well.

Um, and then, uh, we are also doing a [00:09:00] study at, um, people with Parkinson's disease. So to look at the development of stutter disfluencies over time and how that changes. And so we're also looking at brain changes associated with, uh, those stutter disfluencies as well. So I think it's really important if we want to.

a really good understanding of stuttering and what may be happening in the brain. We really look at the different age groups and the different sub populations really to try and understand what happens. Because I think that's important to allow us to differentiate the changes in the brain that are associated with the cause of stuttering and what makes the stuttering Disfluencies occur in the first place, but also what the consequences are or other things that are associated with stuttering that may be developed due to the stuttering itself.

Yeah, I'm particularly interested in Parkinson's because my, [00:10:00] um, my mother in law has Parkinson's and I actually know several people who have Parkinson's and stutter and they didn't stutter until they, they got Parkinson's. And so can you talk more about that? the connection between Parkinson's and stuttering?

So, yeah, so we know that in Parkinson's, one of the key areas in the brain where changes are occurring are the basal ganglia. And so one of the key areas that came out of our study now, where we did the lesion network mapping in stroke and looked at what, uh, persistent developmental stuttering was also the basal ganglia.

So yes, so there are definitely similarities between what is happening at the level of the brain in that it's similar areas that are implicated and where we see changes occurring. So obviously the trajectory of stuttering following Parkinson's is quite [00:11:00] different because a lot of people with Parkinson's did not stutter before and then there are these brain changes associated with Parkinson's that may.

Parkinson's that may lead to these disfluencies. So, uh, what we have been doing, um, here in Christchurch, uh, we have a large study where we follow people with Parkinson's over time. And so I started collecting speech samples. So we're just having a conversation and, uh, people read a passage every time they come in.

And so we, uh, follow up changes in their speech over time. And we also look. at brain changes, uh, associated brain changes over time as well. What we've done in the first instance was look at the types of discrepancies that occur and how many people with Parkinson's develop stuttering. Uh, and so in our study, um, that was 20 percent of people with Parkinson's, uh, who stuttered.

when we saw them the first [00:12:00] time. And then when we follow them up over time, we see that that definitely increases. So a lot more people, uh, Parkinson's develop stuttering over time and their stuttering also gets worse. Yeah. So that's. gives us a little bit more information around how brain changes associated with Parkinson's can lead to disfluencies, but it also allows us to find out more about, uh, other things.

So, for example, we know that different types of medication, for example, people with Parkinson's, they can also influence the stuttering. It provides another perspective to understand more about the areas of the brain and how they are associated with fluency and disfluency. Earlier in the interview, you, you, um, you mentioned your grandfather and how his story really inspired you to want to learn more about stuttering.

Um, can you talk, can you talk to us more about [00:13:00] your, your grandfather? Like what was, what was your grandfather, father like? So my grandfather was a child and a teenager, um, around the period of the Second World War, when obviously not a lot of attention was paid to stuttering and its well being and how to, um, respond to it.

And so, um, he has always really, um, pushed through his stutter, uh, developed a lot of, secondary behaviours, um, and didn't really learn to address his stuttering. So he, um, it really made him a very hard man who did not communicate a lot with people, um, and yeah, really needed to fill in for him. really comfortable with people before he started talking to them and sharing, um, stories with them.

With my grandfather, I've never, with my [00:14:00] grandfather, when I asked questions around his stuttering, I've never really received a clear answer around when his stuttering started. And, um, when I asked questions around his stuttering, stuttering. Um, everyone said that his stuttering started, uh, when he was a teenager and both of his parents died during the Second World War.

And so that stuttering started as a reaction to that. And so I've. I don't know if he stuttered before and if the stuttering, uh, just became a lot more pronounced, uh, due to all of the, um, things he was going through. Um, but at the moment I work a lot with people with acquired stuttering. So, um, and some of.

The people I work with do start to stutter following significant emotional events in their lives. And so some part of me wishes I could go back and really understand a little bit more [00:15:00] about his stuttering and what happened around the onset of the stuttering and to see if there would have been different.

How it could have helped him to address the stuttering. Um, maybe your grandfather sounds like such a fascinating man. Um, thanks for, for sharing that with us. Um, so my last question is, um, I asked like, Anytime I, like, encounter a researcher or scientist who does, like, who focuses on stuttering, I always ask them about The study, the, that 1 percent of the population stutters, cause I myself don't believe that number.

I feel like there's way more of us. So I'm just curious, like what your thoughts are about that study and, um, and like [00:16:00] if we were to do another one, like, like, I don't know, like how can we get better data about like how many of us really stutter out there? That is a really good question. And. It's interesting that you formulate the question this way because obviously I discussed that study in my lectures to my speech therapy students.

And we often have the same discussion but in another direction because when I ask people to put up their hand and share how many people they know with a stutter, it really does not. Reflect the 1 percent and then it's only when we start talking about it a little bit more that they realize actually that they do know a lot of people with a stutter.

But that may be, um, that may. not really be talked about openly. And, um, so yeah, so we, we usually have that [00:17:00] discussion around that study from a different perspective in that they go like 1%, that's a lot. Um, and then, and then when, uh, yeah, people reflect on it, they realize that there are actually a lot of people who stutter.

Uh, so I, I agree with you that maybe, uh, there may be more. People who stutter in that 1 percent how we could do that study differently. I think one of the, um, Things that I noticed over and over again with the research that I'm doing is that often people don't really have a good understanding of stuttering.

So when I started to work on the stroke ward, um, and said that I did the study on acquired stuttering, um, I noticed that I spent a lot of time explaining what stuttering is, and so I think part of the [00:18:00] difficulty is that everyone kind of seems to think that they know what stuttering is. Uh, but then there may not really be good at identifying it or really defining it as well.

So I think for any studies that we, um, do around prevalence and identifying, uh, people who stutter, we need to just really, really, really communicate. Um, what we are looking for and what the characteristics of the stuttering are. Um, so that obviously includes, uh, the different types of speech disfluency.

And even there, there's a lot of misunderstanding around what stutter disfluencies are and what aren't. And then, um, the associated, um, components of stuttering as well, because as we know, adults who have been stuttering their whole lives are really good at, um, maybe compensating for it at using different speech techniques or maybe [00:19:00] avoiding certain situations, uh, that make them stutter more.

Um, so yeah, so it's really important that stuttering is looked at holistically for those types of studies. Yeah, couldn't agree more. And I still stumble when I like try to explain what stuttering is because really like every stutter is different. And yes, there's like, yeah, like there's blocking, there's, you know, there's just a lot of like types of stuttering that I guess we, there's language for, but then I feel like there's, Types of stuttering that we don't even have language for yet.

So it's like, um, but yeah, I do think having a holistic, um, definition of stuttering or as holistic as we have the language for, is [00:20:00] super important. And, um, yeah, I really hope we can get an updated statistic soon because even when I say, Oh yeah, 1%, I'm always like, I don't, I think it's more, it's closer to 2%, but that could just be because I talk to people who stutter all the time.

Yes. Yes. Absolutely. Yeah. Um. And, and people with acquired stuttering are also not included, uh, in those statistics, right? So. Right. Yep. So that's an important, uh, another important component and another important aspect to focus on. Well, um, thank you so much, Catherine. This was such a great conversation. Um, are there any last thoughts you have before we, we end?

Uh, no, I just wanted to thank you so much for having me on the podcast. It's [00:21:00] really good to be able to share the work that we are doing, and I really hope that it can help people who stutter, um, to understand their brains a little bit more, um, and to really, um, Help us find Figure out the best ways in which we can support people who stutter, um, over time.

And that's it for this episode of Proud Stutter. This episode of Proud Stutter was produced and edited by me, Maya Chupkov. Our music was composed by Augusto Diniz. And our artwork by By Mara Ezekiel and Noah Chupkov. If you have an idea or want to be part of a future episode, visit us at www.

proudstutter. com. And if you like the show, you can leave us a review wherever you are listening to this podcast. Want to leave us a voicemail? Check out our show [00:22:00] notes for the number to call in. More importantly, tell your friends to listen too. Until we meet again, thanks for listening. Be proud and be you.