Development of a short Japanese version of the Self-Stigma of Stuttering Scale (4S-J-16): Translation and evaluation of validity and reliability.

PURPOSE: This study aims to develop a short Japanese version of the Self-Stigma of Stuttering Scale (4S), which assesses the self-stigma of adults who stutter (AWS) in a self-completed form, and evaluate its psychometric properties and reliability and validity. METHODS: After translating the original 4S scale into Japanese (4S-J) through a forward-backward translation process, it was administered to 123 Japanese adults who stutter. A short version of the 4S-J was developed through factor analysis and eliminating items with low loadings to original factors. Reliability was verified by calculating internal consistency and test-retest reliability. Participants also completed the Japanese-translated version of the Rosenberg Self Esteem Scale, General Self-Efficacy Scale, and Subjective Happiness Scale to verify construct validity. As a secondary analysis, our results regarding psychological properties of the short version of the 4S were then compared to those of studies from other countries. RESULTS: Sixteen items were selected for the short version of the scale (4S-J-16), and confirmatory factor analysis verified the original structure of the 4S. We obtained good internal consistency and test-retest reliability. Regarding construct validity, our results showed similar correlation with the other selected scales. The value of all scores on the stigma scale in the Japanese cohort was significantly higher than that in the foreign cohort. CONCLUSIONS: Overall, the 4S-J-16 has good internal consistency, test-retest reliability, and construct validity with a three-factor structure of self-stigma in Japanese AWS. The findings suggest that Japanese cultural background increases the stigma scores, thereby enabling us to briefly assess the psychosocial issues of AWS.

Processing time affects sequential memory performance beginning at the level of visual encoding.

Electrophysiological studies have demonstrated that theta-band activity is useful for investigating neural mechanisms of memory. However, mechanisms specifically driving memory performance remain poorly understood. In sequential memory, performance can be artificially attenuated by shortening the inter-stimulus interval (ISI) between memory item presentations. Therefore, we sought to clarify the mechanisms of sequential memory performance by analyzing theta-band (4-8 Hz) activity recorded via magnetoencephalogram in 33 participants during performance of a sequential memory task where memory items were presented at either slow or fast rates in accordance with longer or shorter ISIs, respectively. Particularly in the slow task, theta activity clearly modulated in accordance with the presentation of memory items. Common cortical target regions in the occipital and frontal cortex were identified in both tasks and related to visual encoding and memory maintenance, respectively. Compared to the slow task, occipital-theta activity was significantly lower in the fast task from the midterm until the ending of encoding, in correspondence with significantly lower recall for memory items in this same period. Meanwhile, despite a loss of clarity in responsiveness to individual memory items in the fast task, frontal-theta activity was not different between tasks and exhibited particularly strong responses in both tasks during the holding period prior to recall. Our results indicate that shorter processing time erodes sequential memory performance beginning at the level of visual encoding.

Performance of Bimanual Finger Coordination Tasks in Speakers Who Stutter.

Stuttering is a neurodevelopmental speech disorder characterized by the symptoms of speech repetition, prolongation, and blocking. Stuttering-related dysfluency can be transiently alleviated by providing an external timing signal such as a metronome or the voice of another person. Therefore, the existence of a core motor timing deficit in stuttering has been speculated. If this is the case, then motoric behaviors other than speech should be disrupted in stuttering. This study examined motoric performance on four complex bimanual tasks in 37 adults who stutter and 31 fluent controls. Two tasks utilized bimanual rotation to examine motor dexterity, and two tasks used the bimanual mirror and parallel tapping movements to examine timing control ability. Video-based analyses were conducted to determine performance accuracy and speed. The results showed that individuals who stutter performed worse than fluent speakers on tapping tasks but not on bimanual rotation tasks. These results suggest stuttering is associated with timing control for general motor behavior.

Speech-Induced Suppression for Delayed Auditory Feedback in Adults Who Do and Do Not Stutter.

Speech-induced suppression is the normal, relative amplitude reduction of the auditory evoked potential for self-, compared to externally-generated, auditory stimulation. It remains controversial as to whether adults who stutter exhibit expected auditory modulation during speech; some studies have reported a significant difference between stuttering and fluent groups in speech-induced suppression during speech movement planning, while others have not. We compared auditory evoked potentials (N1 component) for auditory feedback arising from one's own voice (Speaking condition) with passive listening to a recording of one's own voice (Listening condition) in 24 normally-fluent speakers and 16 adults who stutter under various delayed auditory feedback (DAF) time conditions (100 ms, 200 ms, 500 ms, and 1,000 ms). We presented the participant's own voice with a delay, immediately after presenting it without a delay. Our working hypothesis was that the shorter the delay time, the more likely the delayed sound is perceived as self-generated. Therefore, shorter delay time conditions are proposed to result in relatively enhanced suppression of the auditory system. Results showed that in fluent speakers, the shorter the delay time, the more the auditory evoked potential in the Speaking condition tended to be suppressed. In the Listening condition, there was a larger evoked potential with shorter delay times. As a result, speech-induced suppression was only significant at the short delay time conditions of 100 and 200 ms. Adults who stutter did not show the opposing changes in the Speaking and Listening conditions seen in the fluent group. Although the evoked potential in the Listening condition tended to decrease as the delay time increased, that in the Speaking condition did not show a distinct trend, and there was a significant suppression only at 200 ms delay. For the 200 ms delay condition, speakers with more severe stuttering showed significantly greater speech-induced suppression than those with less severe stuttering. This preliminary study suggests our methods for investigating evoked potentials by presenting own voice with a delay may provide a clue as to the nature of auditory modulation in stuttering.

Altered auditory feedback perception following an 8-week mindfulness meditation practice.

Our own ongoing motor actions are perceived through sensory feedback pathways, and are integrated with neural processes to modulate further actions. This sensory feedback mechanism is known to contribute to the rehabilitation of impaired motor functions. Recent evidence also suggests that mindfulness meditation improves our awareness to sensation; therefore, enhancement of awareness to sensory feedback through mindfulness meditation training may have potential clinical applications. This study investigated an effect of eight-week practice of mindfulness meditation on speech perception/production processes. Among the thirty healthy participants, half of them engaged in regular meditation practice of 10 min per day for eight weeks, and the other half were not given any instructions for their daily life. The change of speech performance in sentence reading under 200 ms delayed auditory feedback (DAF) condition were assessed compared to without delay condition. Also, event-related potential response to the short sound of /a/, were measured. The result showed that, after the eight-week practice, the meditation group showed significantly improved speech fluency in the DAF condition, when 16-min meditation was introduced before the experiments. Furthermore, significantly increased auditory evoked potentials were observed in the central-parietal region when the participants listened to the delayed auditory feedback sound of their own voice. These findings provide the first glimpses into the possible relationship between mindfulness meditation and auditory feedback. Different instructions for daily activity between the meditation and control groups should be considered in further studies.

Turning a cylindrical treadmill with feet: An MR-compatible device for assessment of the neural correlates of lower-limb movement.

BACKGROUND: Locomotion, which is one of the most basic motor functions, is critical for performing various daily-life activities. Despite its essential function, assessment of brain activity during lower-limb movement is still limited because of the constraints of existing brain imaging methods. NEW METHOD: Here, we describe an MR-compatible, cylindrical treadmill device that allows participants to perform stepping movements on an MRI scanner table. The device was constructed from wood and all of the parts were handmade by the authors. RESULTS: We confirmed the MR-compatibility of the device by evaluating the temporal signal-to-noise ratio of 64 voxels of a phantom during scanning. Brain activity was measured while twenty participants turned the treadmill with feet in sync with metronome sounds. The rotary speed of the cylinder was encoded by optical fibers. The post/pre-central gyrus and cerebellum showed significant activity during the movements, which was comparable to the activity patterns reported in previous studies. Head movement on the y- and z-axes was influenced more by lower-limb movement than was head movement on the x-axis. Among the 60 runs (3 runs × 20 participants), head movement during two of the runs (3.3%) was excessive due to the lower-limb movement. COMPARISON WITH EXISTING METHODS: Compared to MR-compatible devices proposed in the previous studies, the advantage of this device may be simple structure and replicability to realize stepping movement with a supine position. CONCLUSIONS: Collectively, our results suggest that the treadmill device is useful for evaluating lower-limb-related neural activity.

Children who stutter at 3 years of age: A community-based study.

PURPOSE: Lack of social resources to support children who stutter may be due, in part, to the absence of epidemiological data regarding stuttering. This study investigated the proportion of three-year-old children who stutter in a city located in Hokkaido, a northern island of Japan. METHODS: The speech of individual children was assessed as part of a routine, government-conducted health care examination for 3-year-old children. The number of children screened was 2274, or 94.4% of all children in the city. The first author participated in the health care examination, and followed up all of the children who were found to stutter. RESULTS: At 3 years of age, 1.41% of the children exhibited stuttering; 82.8% of these children subsequently did not exhibit stuttering six months later. Boys were 1.57 times more likely to stutter than girls, but they had only 86% of the probability of reported or observed fluency seen in girls six months later. Significantly higher probability of later fluency was observed in children who exhibited normal, rather than delayed, language development at the 1.5-year health checkup preceding the 3-year health checkup. CONCLUSION: The proportion of three-year-old children who stutter and fluency status 6 months later are reported for a large cohort of Japanese children in Hokkaido. Language skills at 1;6 year may potentially be a factor in natural recovery or persistence; because of limitations in our study design, this assumption requires additional study. This is the first preliminary study to determine the proportion of three-year-old children who stutter in a Japanese community.

Speech Disfluency-dependent Amygdala Activity in Adults Who Stutter: Neuroimaging of Interpersonal Communication in MRI Scanner Environment.

Affective states, such as anticipatory anxiety, critically influence speech communication behavior in adults who stutter. However, there is currently little evidence regarding the involvement of the limbic system in speech disfluency during interpersonal communication. We designed this neuroimaging study and experimental procedure to sample neural activity during interpersonal communication between human participants, and to investigate the relationship between the amygdala activity and speech disfluency. Participants were required to engage in live communication with a stranger of the opposite sex in the MRI scanner environment. In the gaze condition, the stranger gazed at the participant without speaking, while in the live conversation condition, the stranger asked questions that the participant was required to answer. The stranger continued to gaze silently at the participant while the participant answered. Adults who stutter reported significantly higher discomfort than fluent controls during the experiment. Activity in the right amygdala, a key anatomical region in the limbic system involved in emotion, was significantly correlated with stuttering occurrences in adults who stutter. Right amygdala activity from pooled data of all participants also showed a significant correlation with discomfort level during the experiment. Activity in the prefrontal cortex, which forms emotion regulation neural circuitry with the amygdala, was decreased in adults who stutter than in fluent controls. This is the first study to demonstrate that amygdala activity during interpersonal communication is involved in disfluent speech in adults who stutter.

Effect of an 8-week practice of externally triggered speech on basal ganglia activity of stuttering and fluent speakers.

The neural mechanisms underlying stuttering are not well understood. It is known that stuttering appears when persons who stutter speak in a self-paced manner, but speech fluency is temporarily increased when they speak in unison with external trigger such as a metronome. This phenomenon is very similar to the behavioral improvement by external pacing in patients with Parkinson's disease. Recent imaging studies have also suggested that the basal ganglia are involved in the etiology of stuttering. In addition, previous studies have shown that the basal ganglia are involved in self-paced movement. Then, the present study focused on the basal ganglia and explored whether long-term speech-practice using external triggers can induce modification of the basal ganglia activity of stuttering speakers. Our study of functional magnetic resonance imaging revealed that stuttering speakers possessed significantly lower activity in the basal ganglia than fluent speakers before practice, especially when their speech was self-paced. After an 8-week speech practice of externally triggered speech using a metronome, the significant difference in activity between the two groups disappeared. The cerebellar vermis of stuttering speakers showed significantly decreased activity during the self-paced speech in the second compared to the first experiment. The speech fluency and naturalness of the stuttering speakers were also improved. These results suggest that stuttering is associated with defective motor control during self-paced speech, and that the basal ganglia and the cerebellum are involved in an improvement of speech fluency of stuttering by the use of external trigger.

Self-paced and externally triggered rhythmical lower limb movements: a functional MRI study.

Self-paced rhythmical lower limb movement is an important component of locomotive motion in humans. External stimuli are known to facilitate the generation of rhythmical motion. The importance of such self-paced and externally triggered movements is widely recognized, and these movements of the upper limbs have been studied in detail. However, the difference in neural mechanisms between the self-paced and externally triggered movements of the lower limbs is not clear even in healthy subjects. The present study investigated the neural regions involved in the lower limb movements by using functional magnetic resonance imaging (fMRI). The subjects were fixed face-up to an MRI bed and performed lower limb movements that mimicked walking under self-paced and externally triggered conditions. The results showed that the supplementary motor area, sensorimotor cortex and cerebellum were involved in both types of movement, but the basal ganglia and the thalamus were selectively recruited for the self-paced lower limb movement. These results are compatible with those of previous studies on the control of the lower limbs, and on upper limb movement under self-paced and externally triggered conditions.

Does simile comprehension differ from metaphor comprehension? A functional MRI study.

Since Aristotle, people have believed that metaphors and similes express the same type of figurative meaning, despite the fact that they are expressed with different sentence patterns. In contrast, recent psycholinguistic models have suggested that metaphors and similes may promote different comprehension processes. In this study, we investigated the neural substrates involved in the comprehension of metaphor and simile using functional magnetic resonance imaging (fMRI) to evaluate whether simile comprehension differs from metaphor comprehension or not. In the metaphor and simile sentence conditions, higher activation was seen in the left inferior frontal gyrus. This result suggests that the activation in both metaphor and simile conditions indicates similar patterns in the left frontal region. The results also suggest that similes elicit higher levels of activation in the medial frontal region which might be related to inference processes, whereas metaphors elicit more right-sided prefrontal activation which might be related to figurative language comprehension.

Comparison of cerebral activation involved in oral and manual stereognosis.

Brain activity associated with manual stereognosis has been the focus of increasing recent research effort. However, although oral stereognosis, defined as the ability to recognize and discriminate the food bolus in the mouth, is important for mastication and swallowing, there is little information available about the neural network relating to this function. In the present study, cerebral activation associated with oral stereognosis was evaluated as compared with manual stereognosis. Brain imaging data were acquired by functional MRI (fMRI). fMRI experiments were performed on 16 healthy right-handed young adults without any history of neurological or psychiatric disorders. All subjects had all teeth without malocclusion. Ten stereognosis test shape pieces sized approximately 20 mm × 20 mm × 10 mm were fabricated for this experiment. All test pieces had a complicated form that made them difficult to recognize with ease. Subjects were instructed to assess the shape of the test piece in the mouth or hand. The ten test pieces were randomly assigned to each subject and each run. Stereognosis-specific activation was found in the primary somatosensory area, primary motor area, supramarginal gyrus, premotor area, supplementary motor area, fusiform gyrus, frontopolar area and dorsolateral prefrontal cortex. Differences in cerebral activation between oral and manual stereognosis were found in the insular cortex and visual association cortex.

Effect of external auditory pacing on the neural activity of stuttering speakers.

External auditory pacing, such as metronome sound and speaking in unison with others, has a fluency-enhancing effect in stuttering speakers. The present study investigated the neural mechanism of the fluency-enhancing effect by using functional magnetic resonance imaging (fMRI). 12 stuttering speakers and 12 nonstuttering controls were scanned while performing metronome-timed speech, choral speech, and normal speech. Compared to nonstuttering controls, stuttering speakers showed a significantly greater increase in activation in the superior temporal gyrus under both metronome-timed and choral speech conditions relative to a normal speech condition. The caudate, globus pallidus, and putamen of the basal ganglia showed clearly different patterns of signal change from rest among the different conditions and between stuttering and nonstuttering speakers. The signal change of stuttering speakers was significantly lower than that of nonstuttering controls under the normal speech condition but was raised to the level of the controls, with no intergroup difference, in metronome-timed speech. In contrast, under the chorus condition the signal change of stuttering speakers remained lower than that of the controls. Correlation analysis further showed that the signal change of the basal ganglia and motor areas was negatively correlated with stuttering severity, but it was not significantly correlated with the stuttering rate during MRI scanning. These findings shed light on the specific neural processing of stuttering speakers when they time their speech to auditory stimuli, and provide additional evidence of the efficacy of external auditory pacing.

Neural substrates of irony comprehension: A functional MRI study.

In daily communication, we sometimes use ironic expressions to convey the opposite meaning. To understand these contradictory statements, we have to infer contextual implications and the speaker's mental state. However, little is known about how our brains carry out these complex processes. In this study, we investigated the neural substrates involved in irony comprehension using echoic utterance (Sperber and Wilson, 1986, 1995). Participants read a short scenario that consisted of five sentences. The first four sentences explained the situation of the protagonists. The fifth connoted either an ironic, literal, or unconnected meaning. The participants had to press a button to indicate whether or not the final sentence expressed irony. In the ironic sentence condition, the bilateral superior frontal gyrus, middle frontal gyrus, inferior frontal gyrus, medial prefrontal cortex, superior temporal gyrus, inferior parietal lobule, caudate, thalamus, the left insula, and amygdala were activated. In the literal sentence condition, the right superior frontal gyrus, the bilateral middle frontal gyrus, inferior frontal gyrus, medial prefrontal cortex, superior temporal gyrus, inferior parietal lobule, caudate, the left insula, the right thalamus, and the left amygdala were activated. However, in the ironic sentence condition minus the literal sentence condition, we observed higher activation in the right medial prefrontal cortex (BA 10), the right precentral (BA 6), and the left superior temporal sulcus (BA 21). Our results suggest that irony comprehension is strongly related to mentalizing processes and that activation in these regions might be affected by higher-order cognitive operations.

Neural correlates of the rejection of unfair offers in the impunity game.

OBJECTIVES: This study examined the roles of the insula and the anterior cingulate activations in the rejection of unfair offers in the impunity game. METHODS: Fifteen participants played the impunity game in ten trials as responders during neuroimaging. RESULTS: About 45% of the unfair offers were rejected by the responders even when responders could not restore a fair outcome, which cannot be accounted for by social preference of inequity aversion. Imaging data showed that the right anterior insula was activated when participants faced and rejected unfair offers. CONCLUSIONS: The insula activation during a rejection of the unfair offers is the reflection of an emotional response, rather than social preference of inequity aversion. The role of emotion in the neuroeconomics of fairness was demonstrated.