Re-emergence of childhood stuttering in Parkinson's disease: A hypothesis

Abstract

OBJECTIVE To characterize speech patterns in patients with Parkinson's disease (PD) who have a history of childhood stuttering. BACKGROUND Childhood stuttering usually resolves, but it re‐emerges in some patients after stroke or other brain disorders. This phenomenon of recurrent stuttering has not been characterized in childhood stutterers who later develop PD. METHODS/PATIENTS Twelve patients with a history of childhood stuttering that remitted and subsequently recurred were included in the study. A structured interview was administered to seven patients, and six were able to answer questions about childhood stuttering. The Johnson Severity Scale (JSS) (range 0–7) and a Situation Avoidance Scale (SAS) were used to rate stuttering severity (range 0–15) and avoidance (range 0–15). RESULTS The mean age at onset of childhood stuttering was 6.2 years (range 5–10); the mean latency from the onset of childhood stuttering to adult stuttering was 46.1 years; and the stuttering recurred on average 5.9 years (range 0–21) after the onset of PD. The stuttering characteristics in childhood and adulthood included repetitions of sounds and syllables at the beginnings of words, blocks and interjections, physical tension, and a worsening of symptoms with stress. The patients rated themselves as having mild‐to‐moderate childhood stuttering by the JSS (mean 3.0, range 2–4) and mild‐to‐moderate stuttering and avoidance by the SAS (mean stuttering score 5.3, range 3–7; mean avoidance score 4.2, range 3–6). There was no apparent association between the severity of childhood stuttering and the severity of PD, but those patients who had higher Unified Parkinson's Disease Rating Scale scores tended to have more and worse symptoms of stuttering. CONCLUSION Our patients provide evidence for the hypothesis that childhood stuttering may re‐emerge in adulthood with the onset of PD. Mov. Disord. 16:114–118, 2001. © 2001 Movement Disorder Society.

Effect of dopaminergic medication on speech dysfluency in Parkinson’s disease: a longitudinal study

“…Yet, not the actual dose, but only the cumulative dopaminergic dose over the whole period of dopaminergic treatment correlated with the severity of dysfluency, this may reflect more complex factors related to individual severity of PD symptoms, need of therapy and response to treatment. Notably, in their seminal observation of recurrent childhood stuttering in patients with PD, Shahed and Jankovic noted that patients with higher UPDRS motor scores tended to have more and worse symptoms of stuttering (Shahed and Jankovic 2001). From a different perspective, in PD patients without history of childhood stuttering, a significant negative correlation has been found between self-ratings of medication effectiveness and dysfluency levels (Goberman et al 2010).…”

“…For instance, in a group of 53 patients in moderate and advanced stages of PD, acquired speech dysfluencies were pronounced in 15 patients (28 %), 13 of whom belonged to the advanced disease group (Benke et al 2000). Furthermore, Shahed and Jankovic (2001) reported 12 PD patients with a history of developmental stuttering who remitted and subsequently re-emerged stuttering on average 6 years after the onset of PD symptoms.…”

Characteristics of speech disfluency in Parkinson disease

“…Within-word disfluencies may also be viewed as more motoric-based compared to between-word disfluencies, and between-word disfluencies may be influenced by language factors such as slow word retrieval or poor semantic and syntactic planning. Previous studies have also found motoric-based disfluencies in parkinsonian speech (Goberman & Blomgren, 2003;Shahed & Jankovic, 2001). Further, in Canter's (1971) description of neurogenic stuttering, he described neurogenic stuttering as dysarthric (based on faulty motor execution), apraxic (based on cerebral motor programming problems), or dysnomic (based on language -word retrieval problems).…”

Dysfluencies in pure akinesia with gait freezing: Two case reports

“…Notably, the first patient had a recurrence of speech dysfluencies, since he had suffered from developmental stuttering. The recurrence of stuttering has already been reported in cases of Parkinson's disease (Shahed & Jankovic, 2001) which might suggest a common underlying mechanism for dysfluencies in acquired and developmental stuttering.…”