An investigation of cerebellar morphology in childhood stuttering

While many studies have connected structural and functional cerebellar differences to developmental stuttering, there are limited studies of cerebellar gray matter morphology in young children who stutter. These examinations include small sample sizes of children and use morphometry methods that might not be best suited for examining the cerebellum (e.g., Chang et al., 2008). This dissertation examines how the structure of specific cerebellar lobules differs in a larger cohort of children who stutter and children who do not stutter as well as in persistent and recovered children who stutter. These data will provide evidence to better inform predictions of how the morphology of cerebellar areas are likely involved in aspects of speech motor control in developmental stuttering. In this study, gray matter morphology of the cerebellum was examined in children who do and do not stutter using voxel-based morphometry and a specialized toolbox and atlas for the cerebellum (Diedrichsen, 2006). Here we examined cerebellar gray matter volume (GMV) based on structural MRI data from children who stutter and children who do not stutter, 116 preschool-age children (stuttering N = 57) between the ages of 3-5 years, and a school-age cohort of 72 children (stuttering N = 37) six years of age and up. This dissertation is the first study to examine cerebellar GMV in a large group of children who stutter using a specialized toolbox and atlas for the cerebellum. Results from this study showed that there were no overall significant group differences of lobular GMV between the stuttering and non-stuttering groups in any of the groups of children. There were significant age-related associations, however, that differentiated children who do and do not stutter in specific age ranges. In particular, the following cerebellar lobules differed significantly in GMV between children who do and do not stutter with age: 1) cerebellar lobule VII, which may correspond with cerebellar functions that support speech planning, 2) lobule VIII, which has been linked to various functions including corrections during perturbation studies, and 3) lobule IV which has been reported to be involved in feedforward control speech motor control processes. Notably, GMV of cerebellar lobule VI was associated negatively with Stuttering Severity Instrument (SSI) score in preschool-age persistent children who stutter. Associations between SSI score and GMV in cerebellar lobule VI may mean that feedforward control mechanisms are associated with the frequency of stuttering in children who stutter. In summary, significant findings of this investigation indicate that 1) children who do and do not stutter do not show an overall difference in cerebellar GMV, 2) GMV of the cerebellum is associated with SSI score, 3) age-related differences in GMV in the cerebellum differentiate children who do and do not stutter. The results from this study indicate that feedforward control is associated with disfluencies while age-related variations of cerebellar areas that may support both the feedback and feedforward control pathways are connected to aspects of stuttering, such as age.