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From: Nathan Lavid
Date: 10/13/02
Time: 6:22:23 PM
Remote Name: 66.171.53.92
Hello Darrell,
I am sorry I have not been able to respond to your questions until now. You’ve presented quite a bit of material – all of it stimulating, and I’ll try to address what I’m able.
I did not intend to minimize the emotional aspects of stuttering in the article. I delineated the two components of stuttering, the dysfluency and anticipatory anxiety, to highlight a two-pronged approach to treatment. Research, for example the work of Miller and Watson I cited in the article, shows that the two are not directly related. In some patients, the emotional aspects are worse than the dysfluency, and hence the need to address this aspect head-on.
The neuroscience aspect of conditioning, or typically referred to as memory in the psychiatric literature, undoubtedly involves the amygdala, which is generally thought of as a key area of the brain for conducting impulses that give rise to emotional memory.
Obviously, for those who stutter and have much anxiety, the amygdala must be involved. I did not address any specific neuroimaging observations in my article, but you’re right in your conclusion that the amygdala has not been consistently shown to have more or less activity via neuroimaging studies. There are many different explanations for this. Being that the amygdala is in deep within the brain, its activity is not well detected with functional neuroimaging techniques that use sensors on the scalp, such as EEG and MEG. Moreover, since the amygdala functions, simply, as a relay station within the limbic system, it is difficult to devise experimental paradigms that are directed at monitoring its activity. Thankfully, as I can see from Dr. Ingham’s post, she would welcome your queries concerning neuroimaging and will be able to address this subject with more sophistication that I am able to provide.
Thanks again for the questions, and please do not apologize for offering criticism. The road to integrity passes through criticism, which is the goal of my participation in this conference. Nathan