The relationship between prenatal testosterone and developmental stuttering in boys.

Dönmez YE, Özcan Ö, Bilgiç A, Miniksar DY. The relationship between prenatal testosterone and developmental stuttering in boys. Turk J Pediatr 2019; 61: 193-199. Stuttering is a multi-factorial speech disorder characterized by various dysfluencies in the beginning and/or smooth flow of speech. Its incidence is about 1% in the general population, with 80% of stuttering cases seen in children aged three to eight years. The etiology of developmental stuttering has not been precisely explained. Several researchers report that neurological factors, especially atypical lateralization of the speech and language processes, play an important role in the etiology of stuttering. Various hypotheses suggest that prenatal testosterone causes atypical hemispheric lateralization. The aim of this study was to investigate the role of prenatal testosterone in the etiology of developmental stuttering by the use of the ratio of secondand fourth-digit lengths (2D:4D). Totally 133 boys (49 boys who stutter and 84 boys who do not stutter) were included in the study. The age range of children participating in the study was determined as 2-12 years. In the comparative evaluation conducted between the stuttering group and the control group in terms of their right 2D:4D and left 2D:4D ratios, it was found that the left 2D:4D ratio of the patients was significantly higher than that of the control group. We are of the opinion that prenatal testosterone may play a role in the etiology of developmental stuttering. The present study is the first study in the literature to reveal a relationship between prenatal testosterone and developmental stuttering.

An evaluation of G-protein coupled membrane estrogen receptor-1 level in stuttering.

OBJECTIVE: Stuttering is a widespread but little understood disease. There has been a recent increase in neuropathophysiological, genetic, and biochemical studies related to the etiopathogenesis. As developmental stuttering continues in adult males, hormonal factors are thought to have an effect. In this study, an evaluation was made for the first time of serum GPER-1 level in patients with a stutter. STUDY DESIGN: Prospective case control. MATERIALS AND METHODS: The study included 30 patients with a stutter, aged < 18 years, and 35 age-matched children as the control group. The Stuttering Severity Instrument-3 form was administered to the patients. Evaluations were made of serum GPER-1, TSH, estradiol, prolactin, and progesterone and testosterone levels. RESULTS: GPER-1 level was determined as 0.51 (0.42-0.67) ng/mL in the patients and as 0.19 (0.13-0.25) ng/mL in the control group, and the difference was statistically significant (p < 0.001). A statistically significant difference was determined between genders with GPER-1 level of 0.56 (0.44-0.68) ng/mL in the male stuttering patient group and 0.44 (0.35-0.49) ng/mL in the female patient group (p = 0.026). Differential diagnosis with ROC analysis for the serum GPER-1 levels was statistically significant [Area under the ROC curve (AUC): 0.998, confidence interval, CI 0.992-1.000, p < 0.001]. CONCLUSION: The GPER-1 levels of the stuttering patients were found to be higher than those of the control group and GPER-1 levels of male patients were higher than those of females. As GPER-1 has high sensitivity and sensitivity, it could be considered important in the diagnosis and treatment of stuttering.

Prenatal testosterone and stuttering.

BACKGROUND: The prevalence of stuttering is much higher in males compared to females. The biological underpinnings of this skewed sex-ratio is poorly understood, but it has often been speculated that sex hormones could play an important role. AIMS: The present study investigated a potential link between prenatal testosterone and stuttering. Here, an indirect indicator of prenatal testosterone levels, the Digit Ratio (2D:4D) of the hand, was used. As numerous studies have shown, hands with more "male" characteristics (putatively representing greater prenatal testosterone levels) are characterized by a longer ring finger compared to the index finger (represented as a lower 2D:4D ratio) in the general population. STUDY DESIGN, SUBJECTS, OUTCOME MEASURES: We searched for differences in the 2D:4D ratios between 38 persons who stutter and 36 persons who do not stutter. In a second step, we investigated potential links between the 2D:4D ratio and the multifaceted symptomatology of stuttering, as measured by the Overall Assessment of the Speaker's Experience of Stuttering (OASES), in a larger sample of 44 adults who stutter. RESULTS: In the first step, no significant differences in the 2D:4D were observed between individuals who stutter and individuals who do not stutter. In the second step, 2D:4D correlated negatively with higher scores of the OASES (representing higher negative experiences due to stuttering), and this effect was more pronounced for female persons who stutter. CONCLUSIONS: The findings indicate for the first time that prenatal testosterone may influence individual differences in psychosocial impact of this speech disorder.

Stuttering in adults: the acoustic startle response, temperamental traits, and biological factors.

UNLABELLED: The purpose of this study was to investigate the relation between stuttering and a range of variables of possible relevance, with the main focus on neuromuscular reactivity, and anxiety. The explorative analysis also included temperament, biochemical variables, heredity, preonset lesions, and altered auditory feedback (AAF). An increased level of neuromuscular reactivity in stuttering adults has previously been reported by [Guitar, B. (2003). Acoustic startle responses and temperament in individuals who stutter. Journal of Speech Language and Hearing Research, 46, 233-240], also indicating a link to anxiety and temperament. The present study included a large number of variables in order to enable analysis of subgroups and relations between variables. Totally 32 stuttering adults were compared with nonstuttering controls. The acoustic startle eyeblink response was used as a measure of neuromuscular reactivity. No significant group difference was found regarding startle, and startle was not significantly correlated with trait anxiety, stuttering severity, or AAF. Startle was mainly related to calcium and prolactin. The stuttering group had significantly higher scores for anxiety and childhood ADHD. Two subgroups of stuttering were found, with high versus low traits of childhood ADHD, characterized by indications of preonset lesions versus heredity for stuttering. The study does not support the view that excessive reactivity is a typical characteristic of stuttering. The increased anxiety is suggested to mainly be an effect of experiences of stuttering. LEARNING OUTCOMES: As a result of reading this article, the reader will be able to: (a) critically discuss the literature regarding stuttering in relation to acoustic startle, anxiety, and temperament; (b) describe the effect of calcium on neuromuscular reactivity; (c) discuss findings supporting the importance of early neurological incidents in some cases of stuttering, and the relation between such incidents and traits of ADHD or ADD; and (d) discuss the role of genetics in stuttering.

Decreased copper level in the blood serum of male stutterers and the occurrence of the vibratio brevis phenomenon.

The blood serum copper level and the phonation start were investigated in sixteen male subjects with developmental stuttering (mean age = 25.8 years). A statistically significant decrease in blood serum copper level was revealed in the stutterers under study. The differences between their mode and mean values and that of the control group were 4.6 mumol/l and 3.1 mumol/l, respectively. The negative linear regression between the copper level in serum and the vibratio brevis phenomenon was registered in the stutterers under study. A decreased copper level can be involved in the biochemical abnormalities of male developmental stutterers and it can be included among the factors participating in pathophysiology of an uncertain phonation start.

[Speech apraxia in dialysis-associated aluminum encephalopathy]. / Sprechapraxie bei dialyseassoziierter Aluminiumenzephalopathie.

A 57-year-old man on long-term renal dialysis presented with speech dyspraxia, a symptom characteristic of early aluminium encephalopathy. Once fully developed, this condition has a poor prognosis despite deferoxamine (DFO) treatment.

[Biochemical studies in stuttering in children]. / Badania biochemiczne w jakaniu dzieciecym.

Selected biochemical investigations were performed in 53 stuttering children aged 5-12, and in control group of 22 clinically healthy, non-stuttering children aged 6-16. Sodium, potassium, calcium and magnesium ions in the serum were determined according to the pharmacopoeia++ "Zweites Arztneimittelbuch++ der DDR (1983)". A special anamnestic questionnaire helped to exclude metabolic diseases and/or gastro-intestinal disorders. As a result of the study, significant differences between the Mg-ion concentrations in both groups could be demonstrated. In 47% of the stuttering children studied, hypomagnesaemia was found. This result provides interesting aspects for further investigations concerning medicamentous therapeutic concepts.

[Haloperidol. Plasma monitoring and hormonal effects of treatment]. / Halopéridol. Surveillance plasmatique et incidence hormonale du traitement.

Therapeutic plasma monitoring of haloperidol, a major neuroleptic, measured by radioimmunoassay, has shown a rather good correlation between plasma level and dosage but with large interindividual variation in children as in adults; age seems not to have any effect on haloperidol metabolism. 80% of subjects present a concomitant prolactin levels variation, whereas in 20% no prolactin response is found. During acute kinetics of either a 10 mg oral haloperidol administration or a 250 mg intramuscular haloperidol decanoate injection, a parallel elevation of prolactin, cortisol, immunoreactive bêta-endorphin and bêta-lipotropin plasma levels occur, at the same time as haloperidol plasma levels. Those rise with a good equivalence between the two doses of the two forms.