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Neurophysiologic markers of primary motor cortex for laryngeal muscles and premotor cortex in caudal opercular part of inferior frontal gyrus investigated in motor speech disorder: a navigated transcranial magnetic stimulation (TMS) study

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Abstract

Transcranial magnetic stimulation studies have so far reported the results of mapping the primary motor cortex (M1) for hand and tongue muscles in stuttering disorder. This study was designed to evaluate the feasibility of repetitive navigated transcranial magnetic stimulation (rTMS) for locating the M1 for laryngeal muscle and premotor cortical area in the caudal opercular part of inferior frontal gyrus, corresponding to Broca’s area in stuttering subjects by applying new methodology for mapping these motor speech areas. Sixteen stuttering and eleven control subjects underwent rTMS motor speech mapping using modified patterned rTMS. The subjects performed visual object naming task during rTMS applied to the (a) left M1 for laryngeal muscles for recording corticobulbar motor-evoked potentials (CoMEP) from cricothyroid muscle and (b) left premotor cortical area in the caudal opercular part of inferior frontal gyrus while recording long latency responses (LLR) from cricothyroid muscle. The latency of CoMEP in control subjects was 11.75 ± 2.07 ms and CoMEP amplitude was 294.47 ± 208.87 µV, and in stuttering subjects CoMEP latency was 12.13 ± 0.75 ms and 504.64 ± 487.93 µV CoMEP amplitude. The latency of LLR in control subjects was 52.8 ± 8.6 ms and 54.95 ± 4.86 in stuttering subjects. No significant differences were found in CoMEP latency, CoMEP amplitude, and LLR latency between stuttering and control-fluent speakers. These results indicate there are probably no differences in stuttering compared to controls in functional anatomy of the pathway used for transmission of information from premotor cortex to the M1 cortices for laryngeal muscle representation and from there via corticobulbar tract to laryngeal muscles.

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Acknowledgments

We would like to thank speech and language pathologists Milica Medić and Manuela Vuković for the recruitment of several stuttering volunteers. We thank Dalibora Behmen for the English language corrections. We are especially grateful to medical (Lucijana Krželj, Petar Medaković) and technical (Nada Težački) support team from the Polyclinic Sunce, Split, Croatia. Part of this work was previously presented (abstract) at the 1st International Brain Stimulation Conference, March 2–4, 2015, Singapore. This work was funded by the Croatian Academy of Science and Arts. Classification code of the project at the School of Medicine University of Split Croatia: 406-7/14-02/0042.

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    1. School of Medicine, Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, University of Split, Šoltanska 2, 21000, Split, Croatia

      Maja Rogić Vidaković, Dragan Gabelica & Zoran Đogaš

    2. Faculty of Philosophy, University of Zagreb, Ivana Lučića 3, 10000, Zagreb, Croatia

      Ana Jerković

    3. Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, Department of Electronics, University of Split, R. Boškovića 32, Split, Croatia

      Tomislav Jurić

    4. Faculty of Maritime Studies, Signal Processing, Analysis and Advanced Diagnostics Research and Education Laboratory (SPAADREL), University of Split, Ruđera-Boškovića 37, Split, Croatia

      Igor Vujović & Joško Šoda

    5. Faculty of Humanities and Social Sciences, University of Split, Put iza nove bolnice 10 C, Split, Croatia

      Nikola Erceg & Andreja Bubić

    6. Clinical Medical Centre “Sisters of Mercy”, Department of Neurosurgery, Clinical Unit for Intraoperative Neurophysiologic Monitoring, Vinogradska 29 A, Zagreb, Croatia

      Marina Zmajević Schönwald

    7. Bio Mag Laboratory HUS Medical Imaging center, Helsinki University Hospital, P.O. Box 340, 00029, HUS, Helsinki, Finland

      Pantelis Lioumis

    8. SGM Medical Monitoring, Grge Novaka 22A, 21000, Split, Croatia

      Dragan Gabelica

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    Maja Rogić Vidaković and Ana Jerković have contributed equally to this work.

    Handling editor: Brendan Weekes, University of Hong Kong.

    Reviewers: Mehdi Bakhtiar, University of Hong Kong; Ivy Cheng, University of Hong Kong; Chan Karen, University of Hong Kong.

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    Rogić Vidaković, M., Jerković, A., Jurić, T. et al. Neurophysiologic markers of primary motor cortex for laryngeal muscles and premotor cortex in caudal opercular part of inferior frontal gyrus investigated in motor speech disorder: a navigated transcranial magnetic stimulation (TMS) study. Cogn Process 17, 429–442 (2016). https://doi.org/10.1007/s10339-016-0766-5

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