Summarized from messages posted to Stutt-L November 1998, and January 20, 1999, by Peter Ramig
In my view, the impact on stuttering is not near as favorable as it has been for those suffering from spasmodic dysphonia.
Peter R. Ramig, PhD
Professor, Dept. of Speech, Language and Hearing Sciences
University of Colorado at Boulder
Campus Box 409, Boulder, CO 80309-0409
Phone: (303) 492-3049 FAX: (303) 492-3274
There were no significant differences from grouped Placebo injections to Botox injections on the number of syllables stuttered.
Two of the six subjects did show significant reductions in stuttering with the Botox compared to the Placebo , however they had to cope with significant breathiness for several weeks. It's worth studying again for those individuals who stutter with predominant laryngospasms ( hard vocal onsets), those with substantial secondary physical features that accompany the stuttering blocks do less well.
Richard M. Merson, Ph.D.
Speech-Language Pathologist CCC
William Beaumont Hospital
3535 West Thirteen Mile Rd., MOB101
Royal Oak, Michigan 48073-6769
There was also a question posted on the neurology-forum web awhile ago - I don't know if the email addresses below are still correct, but the information is interesting. JAK
My intrigue stems from the fact that I am a stutterer. I understand that the physical phenomena of stuttering is related to poorly controlled. over-stimulated, or spastic vocal cords.
My question is whether anyone out there is aware of applying Botox injections as a method of treating stuttering?
I know of two articles which talk about the NIH's research. "Treatment of Speech and Voice Disorders With Botulinum Toxin," by Christy L. Ludlow, Ph.D., appeared in The Journal of the American Medical Assocation, November 28, 1990, Volume 264, pages 2671 - 2675. Here is some of what it says about botox & stuttering:
"Seven stutterers (six men) between the ages of 24 and 56 years who had not received long-term benefit from speech therapy participated . . . Significant reductions in speech disruptions occurred following administration of botulinum toxin . . . on three measures: the speech rate increased, the percent time fluent increased, and the mean number of word or phrase repetitions and interjections decreased. . . . The reduction in these behaviors suggests that a reduction in muscle activation reduced the level of anticipation of stuttering. Possibly muscle activation levels before speech movement play a role in the expectation of stuttering.
"Although significant changes occurred in the stuttering of all seven patients, only four elected to return for reinjection 4 months later . . . Although at least two of three nonreturning patients had improved, they complained about the transient breathiness and did not want a second injection for that reason.
"These results do not seem to be due to suggestion, . . . " (pages 2674,2675)
There is another article I know of, titled "Responses of Stutterers and Vocal Tremor Patients to Treatment with Botulinum Toxin," by Sheila V. Stager and Christy L. Ludlow. I think it appeared in a book called Therapy with Botulinum Toxin, edited by Jankovic & Hallett. It's chapter 37, pages 481 - 490.
Regarding botox & stuttering, the article describes its research & results on 19 people who stutter. Its conclusion section states: "Stutterers [as compared with other groups tested] reported fewer days of benefit and did not always return for multiple injections. This patient population seemed disturbed by the side effects, which minimized their perception of any benefit." The article noted that the severity of blocks was reduced and that the injection had no effect on the fear of speaking. The article noted that people who stutter "have been stuttering all their life, and have learned, with varying degrees of success, to continue to communicate. Thus, improvement to them may mean how closely their speech approximates normalcy." (pages 487, 488)
According to my records, Dr. Ludlow can be reached at:
Christy L. Ludlow, Ph.D.
Head, Speech and Voice Unit
Intramural Research Program
National Institute on Deafness and Other Communication Disorders and Stroke
National Institutes of Health
Building 10, Room 5N226
Bethesda, MD 20892
Also, a few years ago (early 90's?) an article in Parade magazine mentioned similar research involving botox and I believe it also mentioned its use with stuttering. The article referred to the work of Mitchell Brin, M.D. I believe it also stated that research was being performed at approximately six centers throughout the country.
Dr. Brin's address was listed as:
Movement Disorders Research Center
The Neurologic Institute
710 W 168th St
New York, NY 10032
(note from J Kuster - I found the Brin reference in Medline - Brin MF, et al. Laryngeal botulinum toxin injections for disabling stuttering in adults. Neurology. 1994 Dec;44(12):2262-6. PMID: 7991110; UI: 95083104. Tony Troiano adds that he believes Dr. Brin is now affiliated with Mount Sinai Medical Center also in NYC)
For more information about methods other than speech- or psychotherapy, (both of which, particularly when they are combined, claim a degree of success), for managing adult stuttering and its aftermath, you might want to consult an article called "The Pharmacology of Stuttering: A Critical Review" by John Paul Brady, M.D. of The University of Pennsylvania's Med School. I haven't read it, but from some of what I've heard it discusses includes calcium channel blockers and cholinergic drugs, in addition to reviewing the available literature.
The article appeared in The American Journal of Psychiatry, October 1991, volume 148, issue 10, pages 1309 - 1316.
For other avenues, there are also quite a few self-help groups in existence, both in the US & throughout the world.
Please note that the information given here may be out-of date or inaccurate. I am not a neurologist, but I do stutter and I am very interested in the disorder's neurology.