Friday, February 13, 2009

Sensorimotor part of internal globus pallidus involved?

Not sure what to make out of this but it looks interesting. Maybe a reader with more expertise on neuroanatomy knows what this may mean.

1: J Neural Transm. 2009 Feb;116(2):167-9. Epub 2009 Jan 10.Click here to read Links

Acquired stuttering after pallidal deep brain stimulation for dystonia.

Department of Neurology, Christian-Albrechts-Universität Kiel, Schittenhelmstr. 10, 24105, Kiel, Germany.
We report two patients, in whom stuttering evolved as an adverse effect of pallidal deep brain stimulation for treating dystonia. Speech dysfluency was observed under conditions that optimally suppressed dystonic symptoms without inducing other extrinsic stimulation effects. This emphasizes a role of the sensorimotor part of the internal globus pallidus in regulating speech fluency.
PMID: 19137234 [PubMed - in process]


Greg said...

Well, since the Globus pallidus is a part of the basal ganglia, it shouldn't come as too much of a shock.

It's pretty obvious that the innervation for speech-motor output uses a neuropathway (or neuro-circuit) through this structure--and if we start tinkering around w/ it via electrical stimulation--then the pathway or circuit gets broken.

Anonymous said...

Focal dystonia commonly afflicts elite musicians, and it's more common than most people think. For example, in the case of a pianist, a couple of the fingers of his left hand might seize up when playing the piano, but not when he's doing other tasks. Or a trumpet player's mouth may seize up only when playing the trumpet, but he has no problem eating or speaking.

A good pianist uses very fast, complicated sequences of precise finger movements, so you can imagine what might be going on his brain when he's playing the piano ... different parts of the brain need to work in a coordinated fashion - i.e. the basal ganglia, the sensory and motor cortex, the cerebellum, and the thalamic nuclei. So dystonia probably results when something goes wrong with the coordination (the cause is unknown). When the musician notices the first symptoms of dystonia, he may try to work through it by trying harder, causing the fingers to seize up more ... a bit like what might happen in the early stages of developmental stuttering, which causes the secondary behaviours to develop.

I hadn't heard of basal ganglia stimulation for treatment of dystonia, although it shouldn't come as too much of a surprise that it would cause a side-effect like stuttering. The usual treatment of dystonia (for example, in the case of a pianist) is a small injection of botox into the fingers. This works in some cases, but not all. Interestingly, injection of small doses of botox to the throat seems to cure stuttering in some cases, but its effect wears off after a few months, so periodic injections are necessary.


Anonymous said...

For some odd reason, I just don't take to the idea of sticking a needle into a part of my throat and injecting botox. It just...well... is kinda a desperate freakster move. I guess if you got to go back and keep doing it, I wouldn't think of it as a cure. The more I think of it, the more messed up it sounds. I just can't wrap my mind around it.

For whatever reason, I'd rather stutter...