Using Transcranial Magnetic Stimulation to Treat Stuttering

Modulating Bilateral Cortical Activation In Adults Who Stutter: A Pilot Study

The goal of this clinical trial is to learn if repeated transcranial magnetic stimuli (rTMS) can treat stuttering in adults. The main questions it aims to answer are:

• Will there be changes in the brains of people who stutter because of the treatment?
• Will any changes in the brain result in less stuttering?

Participants will:

• Visit the lab 3 times before treatment for tests
• Complete 10 rTMS sessions
• Visit the lab 2 times after treatment for tests

Measures must be obtained to in preparation for TMS treatment. Structural MRI and resting-state functional MRI (rsfMRI) recordings will be obtained from the participant, and they will undergo a neuronavigational session to determine best placement for the electrodes.

MRI/rsfMRI recordings: The structural MRIs will be obtained and used for TMS neuronavigation. Resting-state functional MRI will be recorded for 8 min with the eyes open. rTMS will be delivered at 10 Hz for 10 min with a stimulation intensity of 120% of the resting motor threshold (rMT).

Neuronavigation: The TMS coil will be navigated with a neuronavigation system using the individual MRIs. rTMS targets: rTMS will be delivered to the left inferior frontal gyrus (IFG). We will use the neuronavigation system to identify the IFG.

Three pre-treatment and 2 post-treatment sessions will each obtain data from the following measurements:

• rs-EEG: rs-EEG responses will be recorded with eyes open for 5 minutes using a 64-channel EEG system.
• Eye tracker: eye gaze fixations, dwell time, saccades, and gaze durations will be recorded while the participant completes several behavioral phonological memory tasks.
• Spontaneous speech sample will be obtained to determine percent syllables stuttered.

Inclusion Criteria:

• Age from 18 to 65 years
• Self-identifies as a person who currently stutters
• Right-handed or left-handed
• Normal hearing and (corrected) vision
• Able to understand and give informed consent
• Monolingual English speaker

Exclusion Criteria:

• Cardiac pacemaker or pacemaker wires; neurostimulators; implanted pumps
• Metal in the body (rods, plates, screws, shrapnel, dentures, IUD) or metallic particles in the eye
• Facial tattoos
• Not having medical insurance
• Surgical clips in the head or previous neurosurgery
• Any magnetic particles in the body
• Cochlear implants
• Prosthetic heart valves
• Epilepsy or any other type of seizure history
• History of significant head trauma (i.e., extended loss of consciousness, neurological sequelae)
• Known structural brain lesions
• Pre-existing speech, language, or neurological disorder (except for stuttering)
• Significant other disease (heart disease, malignant tumors, mental disorders)
• Significant claustrophobia; Ménière's disease
• Women who are trying to get pregnant and sexually active women (of reproductive age) not on a reliable contraceptive
• Pregnancy, breastfeeding
• Medications increasing the risk for seizures
• Non-prescribed drug use
• Use of recreational drugs such as medical marijuana
• Failure to perform the behavioral tasks or neuropsychological evaluation tests
• Prisoners