The neural substrates for atypical planning and execution of word production in stuttering

Using an fMRI-based classification approach and the structural equation modeling (SEM) method, this study examined the neural bases of atypical planning and execution processes involved in stuttering. Twelve stuttering speakers and 12 controls were asked to name pictures under different conditions (single-syllable, multi-syllable, or repeated-syllable) in the scanner. The contrasts between conditions provided information about planning and execution processes. The classification analysis showed that, as compared to non-stuttering controls, stuttering speakers' atypical planning of speech was evident in their neural activities in the bilateral inferior frontal gyrus (IFG) and right putamen and their atypical execution of speech was evident in their activations in the right cerebellum and insula, left premotor area (PMA), and angular gyrus (AG). SEM results further revealed two parallel neural circuits-the basal ganglia-IFG/PMA circuit and the cerebellum-PMA circuit-that were involved in atypical planning and execution processes of stuttering, respectively. The AG appeared to be involved in the interface of atypical planning and execution in stuttering. These results are discussed in terms of their implications to the theories about stuttering and to clinical applications.