Re-emergence of childhood stuttering in Parkinson's disease: A hypothesis

OBJECTIVE: To characterize speech patterns in patients with Parkinson's dis ease (PD) who have a history of childhood stuttering. BACKGROUND: Childhood stuttering usually resolves, but it re-emerges in som e patients after stroke or other brain disorders. This phenomenon of recurr ent stuttering has not been characterized in childhood stutterers who later develop PD. METHODS/PATIENTS: Twelve patients with a history of childhood stuttering th at remitted and subsequently recurred were included in the study. A structu red interview was administered to seven patients, and six were able to answ er questions about childhood stuttering. The Johnson Severity Scale (JSS) ( range 0-7) and a Situation Avoidance Scale (SAS) were used to rate stutteri ng severity (range 0-15) and avoidance (range 0-15). RESULTS: The mean age at onset of childhood stuttering was 6.2 years (range 5-10); the mean latency from the onset of childhood stuttering to adult st uttering was 46.1 years; and the stuttering recurred on average 5.9 years ( range 0-21) after the onset of PD. The stuttering characteristics in childh ood and adulthood included repetitions of sounds and syllables at the begin nings of words, blocks and interjections, physical tension, and a worsening of symptoms with stress. The patients rated themselves as having mild-to-m oderate childhood stuttering by the JSS (mean 3.0, range 2-4) and mild-to-m oderate stuttering and avoidance by the SAS (mean stuttering score 5.3, ran ge 3-7; mean avoidance score 4.2, range 3-6). There was no apparent associa tion between the severity of childhood stuttering and the severity of PD, b ut those patients who had higher Unified Parkinson's Disease Rating Scale s cores tended to have more and worse symptoms of stuttering. CONCLUSION: Our patients provide evidence for the hypothesis that childhood stuttering may re-emerge in adulthood with the onset of PD.