Exploring Photobiomodulation as a Potential Novel Intervention for Developmental Stuttering: A Review and Hypothesis

Developmental stuttering (DS) is a complex neurodevelopmental disorder affecting approximately 5% of children, characterized by involuntary disruptions in speech fluency. Despite its prevalence, the precise pathophysiology remains elusive, and current behavioral and pharmacological interventions often yield variable long-term efficacy. This scoping review evaluates the therapeutic potential of transcranial photobiomodulation (t-PBM), a non-invasive neuromodulation technique, by summarizing its mechanisms of action with the known neurophysiological deficits of DS. Evidence indicates that DS is associated with reduced regional cerebral blood flow (rCBF) in Broca's area, mitochondrial dysfunction, and impaired neural connectivity. t-PBM may address these deficits by stimulating cytochrome c oxidase, thereby increasing ATP production and triggering nitric oxide-mediated vasodilation to enhance rCBF. Furthermore, t-PBM promotes neuroplasticity, modulates astrocyte function-potentially counteracting GNPTAB-related deficits-and exhibits anxiolytic effects that may alleviate the secondary psychological burden of DS. By targeting these multifactorial underpinnings, t-PBM may represent a promising, low-risk adjunct or primary intervention for DS, though this remains to be tested empirically. While the theoretical framework is robust, clinical trials are needed to determine whether t-PBM has therapeutic utility, to optimize treatment parameters, establish longitudinal efficacy, and explore synergistic effects with established speech-language therapies.