Honors Theses

Date of Award

Spring 5-12-2024

Document Type

Undergraduate Thesis

Department

Communication Sciences and Disorders

First Advisor

Gregory Snyder

Second Advisor

Toshikazu Ikuta

Third Advisor

Myriam Kornisch

Relational Format

Dissertation/Thesis

Abstract

Stuttering is a neurodevelopmental disorder demonstrating hallmark characteristics in all expressive linguistic modalities. Conventional behavioral stuttering treatments are largely ineffective and prone to relapse, thereby leaving the person who stutters with a potentially significant negative impact on their social, academic, and occupational opportunities and quality of life. The critical need for an effective treatment may ultimately be found in a recently proposed novel underlying mechanism of stuttering, which is low neuronal energy, potentially resulting from the synergy of reduced aerobic energy production, cellular hypoxia, reduced cerebral blood flow, reduced lysosomal and mitochondrial efficacy, increased glycolysis associated with the ARNT2 mutation, elevated dopamine levels, and lowered glucose metabolism. One novel treatment approach is to utilize a thiamine protocol featuring Benfotiamine (BFT) addressing glial and astrocytic health within the motor control neural circuits, potentially resulting in improved cellular respiration/energy functioning, ultimately resulting in improved motor control over speech and stuttering.

This proposal researches the effects of the BFT protocol via a randomized double-blind placebo control study design in adults who stutter with no other known neurophysiological diagnoses. Participants will complete three experimental conditions using BFT supplementation [placebo (0mg), low (100mg), high (250mg)], with each experimental segment lasting three weeks. At the conclusion of each experimental segment, there will be a one-week washout period such that BFT levels can return to baseline. Data collection for each segment will use a pre/post study design and measure overt stuttering severity (SSI-4th Edition), quality of life (OASES), and biological markers (Organic Acid Testing – OAT) for each participant.

Repeated Measure Analysis of Variance will be used to detect significant changes from pre- and post-measures in overt stuttering severity (SSI-4), quality-of-life (OASES), and biological markers from the OAT analysis for each participant and experimental segment. A regression analysis will measure predictive indicators from each segment’s pre-OAT analysis correlating with treatment responsiveness.

Data suggests that the use of BFT will outperform existing thiamine HCL protocols as it provides greater bioavailability, neuroprotective effects, facilitation of energy production, and is able to cross the blood brain barrier. The genetic diversity underlying stuttering suggests that the BFT protocol will not yield similar effects on all participants, suggesting multiple genetic subpopulations within the stuttering community. It is anticipated that predictive biological markers will correlate with BFT treatment responsiveness, suggesting the need for targeted treatment strategies relative to specific genetic stuttering subpopulations. Given the genetic and neurological etiology of stuttering, there is a pressing need to initiate interventions that target the cellular mechanisms underlying stuttering.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Available for download on Friday, April 30, 2027

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