EEG responses to auditory cues predict fluency variability and stuttering intervention outcome

Stuttering is a variable speech disorder whose brain mechanisms remain unknown. Sensorimotor brain circuits, critical for motor-speech control, including auditory processing necessary for speech prediction and monitoring, have been linked to the disorder. Despite considerable advances, it remains unclear whether auditory circuits relate to stuttering variability, and whether the panoply of interventions for persons who stutter can lead to brain changes within these circuits. We employed electroencephalography (EEG), in a group of persons who stutter, in combination with auditory probes to tap onto the importance of auditory cortical regions in stuttering variability. Participantsproduced flexible speech (i.e., describing visual scenes) and non-flexible speech (i.e., reading syllables), following an auditory cue. More pronounced P200 auditory evoked potentials were observed in participants with higher dysfluency rates, mainly in the spontaneous speech task. Interestingly, speech therapy intervention led to a reduction of the P200 potential, which was in turn significantly related to fluency improvements. Furthermore, EEG response patterns discriminative of cue frequency (400 or 800 Hz tones) were also predictive of dysfluency scores. Our study highlights the involvement of auditory cortical processing and that of auditory attention in stuttering variability. We support that a higher state of auditory alertness may be implicated in the sensorimotor mechanisms of stuttering, and that speech therapy interventions promoting more self-confident communication can restraint auditory alertness, and potentially reduce speech dysfluencies.