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Andreas Weiser hat geschrieben:
Und noch mehr englischer Text >>>>>>>>>>>>>>>><!

Wer hier so viel Englisch reinkopiert sollte auch eine Übersetzung ins Deutsche nicht scheuen.

Gruß Andreas W.


Lieber Andreas,
dann mach Dich doch mal nützlich und biete den interessierten Lesern eine deutschsprachige Zusammenfassung.

Ich bin ja gelernter DDR-Bürger. Da waren die Möglichkeiten Englisch zu praktizieren nicht so zahlreich. Dennoch habe ich hier in der Vergangenheit schon einige schwierige Themen mit technischer und personeller Unterstützung übersetzt und versucht in allgemeinverständliche Texte zu fassen. Macht ne ganze Menge Mühe. Teamwork wäre also nicht schlecht.

Holger


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Holger Stenzel hat geschrieben:

Lieber Andreas,
dann mach Dich doch mal nützlich und biete den interessierten Lesern eine deutschsprachige Zusammenfassung.


Yep, darüber würde ich mich auch freuen, viel Spaß dabei! :D


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BeitragVerfasst: Fr Aug 04, 2006 3:54 pm 
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Wohnort: Westervoort [Niederlande]
conny hat geschrieben:

Von babelfish halte ich persönlich ehrlich gesagt....... nada.......niente....... nothing. Aber jedem Tierchen sein Plaisirchen. Adrie, übersetzt du dir die Forumsbeiträge damit ins Niederländische? Versuchs mal, was kommt denn dabei so raus?


Hoi Conny,

Die Deutsche Forumtekste zur lesen is für mir kein Problem.
Englische tekste - übersetzt in Niederlandisch mit Babel Fisch - ist mir ein gute hife es zu verstehen.


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BeitragVerfasst: Fr Aug 04, 2006 4:02 pm 
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Indevus Pharmaceuticals hat jetzt die Wirtschaftsdaten des dritten Quartals vorgelegt. Dort wird auch Bezug auf den Stand der Pagoclone Studie zur Behandlung des Stotterns genommen. Es wird vermerkt, dass vielversprechende erste Ergebnisse der bisher grössten Pharmastudie zum Stottern bekanntgegeben werden konnten und Pagoclone gegenüber dem Placebo nach verschiedenen primären und sekundären Bewertungsscalen positive Signifikanz gezeigt hat. Gespräche mit der FDA und die Planung der weiteren Entwicklung sollen noch in diesem Sommer erfolgen:

"The Company announced promising results from its Phase II trial of pagoclone for persistent developmental stuttering. The results of the trial, believed to be the largest pharmaceutical trial ever conducted for stuttering, show that pagoclone produces a statistically significant benefit in multiple primary and secondary endpoints compared to placebo. The Company plans to meet with the FDA to discuss the findings and its plans for further clinical development later this summer."

http://home.businesswire.com/portal/sit ... ewsLang=en

Für detailliertere Studienergebnisse gibt es nach Angaben von Prof. Maguire auf dem IFA-Kongress in Dublin zur Zeit noch eine Informationssperre.

Holger Stenzel


Zuletzt geändert von Holger Stenzel am Fr Aug 04, 2006 5:13 pm, insgesamt 1-mal geändert.

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Adrie van der Horst hat geschrieben:

Hoi Conny,

Die Deutsche Forumtekste zur lesen is für mir kein Problem.
Englische tekste - übersetzt in Niederlandisch mit Babel Fisch - ist mir ein gute hife es zu verstehen.


Das habe ich auch gar nicht bezweifelt, dass du die deutschen Texte lesen kannst. :D Ich übersetz mit babelfish manchmal zum Spaß ein bisschen hin und her. Kann sein, dass man den Sinn grob erfasst, naja, für unsere Zwecke hier sollte es reichen, hast schon recht.


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Aktuelle Infos:

Vom 15.09. bis 17.09. findet in Telford die 11. Nationale Konferenz der British Stammering Association (BSA) statt.
Der Titel lautet Time to talk. Das Forschungsgremium der BSA konnte als Keynote Speakers ( Hauptredner) Autoritäten der aktuellen Forschung binden. So wird Dennis Drayna zu den genetischen Forschungen sprechen, Per Alm zur Hirnforschung und Gerald Maguire zu den Pharmastudien. Tom Weidig erläutert zu diesen Themen auf The Stuttering Brain.

Auch auf dem 33. Bundeskongress der Stotterer-Selbsthilfe e.V vom 28.09. bis 01.10.2006 in Münster gibt es Beiträge zur aktuellen Hirnforschung: 29.09., 15:30 - 17:30 Uhr, Stottern im Gehirn - Prof. Dr. Katrin Neumann, Leiterin der Abteilung Pädaudiologie an der Klinik für Phoniatrie und Pädaudiologie der Universität Frankfurt. Sie hat sich zur Stotter-Hirnforschung habilitiert und vertritt die deutschsprachigen Länder (als einzige Vertreterin) im Fluency Committee der IALP (International Association of Logopedics and Phoniatrics).

Zur Zeit prüft der deutsch-französischen Konzern Sanofi-Aventis ein Engagement bei der medikamentösen Behandlung des Stotterns. Sanofi-Aventis ist der drittgrößte Pharmakonzern der Welt mit einem Umsatz von circa 27 Milliarden Euro und mehr als 97.000 Beschäftigten. In dieser Gesellschaft ist u.a. auch die französische Firma Rhône-Poulenc aufgegangen, wo 1993 das Cyclopyrrolonderivat Pagoclone entdeckt wurde.


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Aktuelle Top-Themen der Forschung zum Stottern werden beim BSA Kongress in Telford vorgetragen und diskutiert:



The new sciences of stammering
------------------------------

Over the last decade, advances in brain imaging, genetics, and pharmacology
have provoked a revolution in the scientific understanding of the human
brain. Scientists are now using this knowledge combined with the new
research tools to tackle an age-long mystery: the mechanism and causes of
stammering, and how best to treat stammering. The BSA has invited to its
annual conference in Telford leading researchers in the fields of
neuroscience, genetics, and pharmacology to share with us the new sciences
of stammering and answer the question: How are neuroscience, pharmacology
and genetics changing our understanding and treatment of stammering?
The main session of the program is the research plenary where leading
researchers give conceptually clear and simple reviews of the progress made
in their research area. After a tea break, the audience has the opportunity
to ask probing questions to the panel or comment on any issues related to
understanding or treating stuttering. The general sessions are followed by a
research symposium where the experts will present and discuss
cross-disciplinary topics.
For further information, please contact tom.weidig@physics.org or visit the
BSA website: www.stammering.org/conf.html.


PLENARY
(Chair: Velda Osborne, Sat Sep 16th Sep 9:00-10:30)

Introducing the new sciences of stammering
(Tom Weidig)

The genetics of stuttering: a review
(Dennis Drayna, National Institute of Health, US)

The pharmacology of stuttering: a review
(Gerald Maguire, University of California at Irvine, US)

The brain and stuttering: a review
(Per Alm, University of Oxford)

Q&A SESSION
(Chair: Tom Weidig, Sat Sep 16th 11:00-12:00)
Panel consists of speakers plus Kate Watkins, and LouiseWright.


SYMPOSIUM (Chair: Tom Weidig, Sat Sep 16th 14:00-17:30)

Given a gene, what is its function? Given a function, what is its gene? What
if gene combinations make up a function? (Dennis Drayna)

Similarities and differences in the functional brain abnormalities
associated with developmental stuttering and with a mutation in the FOXP2
gene. (Kate Watkins)

What does a medication-induced reduction in stuttering tell us about
physiology and genetics of stuttering? (Gerald Maguire)

Is the dopamine D2 receptor important for genetic childhood stuttering?
Neurological incidents and subgrouping. (Per Alm)

The measurement problem in stammering: a cross-disciplinary Pandora's box.
(additional workshop on Sunday morning)


Main speakers of plenary

Dr. Gerald Maguire is Associate Professor at the Department of Psychiatry at
the University of California, Irvine. He is a member of the US national
stuttering association (NSA) and currently serves on its research advisory
board. As a person who stutters himself, he has been interested in
investigating novel treatments for stuttering since early in his medical
training. His research group was the first to investigate brain differences
in stutterers using the PET brain imaging method. He was the lead
investigator on many studies investigating medications for the treatment of
stuttering. At the Telford BSA conference, he will also talk about the
latest trial on Pagoclone. Dr Maguire has spoken at a wide range of
conferences like NSA, World Congress of Stuttering and ASHA. His research
appeared at news outlets like the LA Times, NPR, ABC News, and the Boston
Globe.

Dr. Dennis Drayna is a senior researcher in genetics at the National
Institutes of Health in Bethesda, Maryland, where he currently serves as a
Section Chief in the National Institute on Deafness and Other Communication
Disorders. His primary research interests are the genetics of human
communication disorders, work that has taken him to eight different
countries on four continents in pursuit of families with these disorders.
For example, he collected blood samples from an extended Pakistani family
where many of its members stutter. At the Telford BSA conference, Dr. Drayna
will discuss his latest research, and also collect blood samples from
volunteers for his research work. He did a PhD at Harvard University, worked
as a postdoctoral fellowship in the Howard Hughes Medical Institute at the
University of Utah, and then spent 14 years in the biotechnology industry in
the San Francisco Bay area.

Dr. Per Alm is a researcher at the University of Oxford, and works together
with Dr. Kate Watkins on a project to understand the relationship between
stuttering and brain functions. As a person who stutters he got involved in
work on stuttering through the Swedish Stuttering Association. Having worked
as an engineer in his previous life, he decided to take on stuttering, and
go back to university to study neurosciences. He recently finished his PhD
thesis on the causal mechanisms of stuttering at Lund University, Sweden.
His attempts to combine a wide range of findings to a neurological model of
stuttering have been well-received. He has especially emphasized the role of
the brain structures called the basal ganglia. At the Telford BSA
conference, Dr. Alm will discuss how the current understanding of the brain
may help us understand stuttering.

Quelle: TheStutteringBrain


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Na dann hoffen wir mal, dass "the stuttering brain" auch brav die wichtigsten Ergebnisse der Konferenz präsentiert. :)


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@djub

Ich denke Tom Weidig wird das schon machen.
Apropos machen - warum machst du nicht auch mal was? Zum Beispiel ein allgemeinverständlicher deutschsprachiger Beitrag zum Stand der internationalen Forschung zum Stottern. :idea:

Holger Stenzel


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BeitragVerfasst: Sa Sep 02, 2006 2:32 pm 
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Ich studiere, arbeite gerade daran mich selbstständig zu machen, bin gerade mit meiner (noch neuen) Freundin zusammengezogen, bin (Leistungs-)Sportler und habe auch sonst gerade viel am Laufen.
Ich bin froh, wenn ich es schaffe, meine Bücher über Stottern etc. zu lesen und das Forum hier zwischendurch aufzusuchen.

Wenn ich Zeit und Muße habe, werde ich beginnen, mich in der "Szene" zu engagieren. :)

djub


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BeitragVerfasst: So Sep 03, 2006 9:48 am 
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@djub

Engagement ist gefragt. Wenn Du Dich weiter für Forschung zum Stottern interessierst, kann ich die Seiten der Stuttering Foundation of America empfehlen. Unter Basic Research gibt es hier regelmässig aktuelle Beiträge von Fachautoren.

http://www.stutteringhelp.org/

Gleiches gilt für die Seiten der Kasseler Stottertherapie.

http://www.kasseler-stottertherapie.de/

Direkt seine Fragen an die Professionals richten kann man zur ISAD Online Konferenz der Minnesota State University alljährlich vom 1. bis 22. Oktober.

ISAD2006 Online Conference - Don't Talk ABOUT us. . . . Talk WITH us

http://www.mnsu.edu/comdis/kuster/stutter.html

Aktuell: Der Vortrag von Prof. Dr. Katrin Neumann "Stottern im Gehirn" am 29.09. auf dem BUKO in Münster.

Hierzu auch folgender Beitrag: http://www.kasseler-stottertherapie.de/ ... G_0501.pdf

Holger Stenzel


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Danke, einen der Links hatte ich noch nicht in meinen Lesezeichen. Wie gesagt, engagieren kann ich mich erst wieder, wenn ich etwas mehr Zeit hab.

Meine wenige Freizeit möchte ich dann doch eher mit meiner Freundin, meiner Familie und meinen Freunden verbringen als irgendwelche Texte zu verfassen.
Aber es werden Zeiten kommen, in denen ich die Zeit haben werden.

Um eine Zusammenfassung und Verknüpfung der aktuellsten Studien zu schreiben wäre aber wohl ohnehin eher ein Fachmann geeignet und kein Laie wie ich. Aber sein Bestes geben kann man ja trotzdem.


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Speaking Out
One step closer to drug treatment of stammering
Would you take a drug to reduce stammering if you could? In June 2006, tests of a new drug showed positive results, but how close is it to being available? Martin Sommer reports on the study led by professor Gerald Maguire (a keynote speaker at the BSA Conference 2006), and on the background to drug research.

The 1950s not only heard Marilyn Monroe's beautifully whispering voice, but also saw the first wave of drug trials for the treatment of stuttering. Haloperidol, a then rather new drug for psychiatric disorders, was studied in various trials and claimed to be successful (1). However, its side effects and the rise of behavioural rather than biological theories of stuttering were key factors to prevent a widespread application of haloperidol in stuttering people, at least in the western world.

Today, new psychiatric drugs with fewer side effects exist, and modern brain imaging provides new and fascinating insights into the stuttering brain. It is therefore not surprising, that a second wave of drug trials in stuttering has just started and is likely to go on for some time. Fortunately, the quality of clinical pharmaceutical trials is much higher now than it was in the 1950s.

How drugs are tested

A key new element in current tests are placebo (or control) groups: a part of the patients on the trial do not receive the pharmacological compound but a placebo (or the sugar pill). The random control trial studies are double blind (patients and doctors do not know who gets the active compound or the sugar pill) and randomised (the dice decides which patients get the active compound). This set-up serves to rule out unspecific benefits of expectation, which can be surprisingly huge.

In addition, regulatory authorities require a solid, four-step licensing procedure to avoid catastrophic side effects (2). After pre-clinical trials on animals, phase I clinical trials are safety trials on healthy subjects which can go terribly wrong, as recently seen at Northwick Park Hospital in London (3). Phase II trials are the first time when a group of usually less than hundred patients suffering from a particular condition take the drug or the placebo to measure its clinical effect, its side effects and the appropriate dose range. About 80 % of the drug developments fail due to too strong side effects or lack of effectiveness. Phase III trials encompass several hundred patients. If these trials are positive and the compound is accepted for a disease by regulatory authorities such as the European Agency for the Evaluation of Medicinal Products (EMEA) and the Food and Drug Administration (FDA) in the USA, phase IV trials continue during the marketing of the drug to detect rare side effects. Phase IV trials can abruptly terminate a drug's career, as seen for the anti-inflammatory drug rofecoxib (Vioxx®).

Drugs to reduce stammering

Professor Maguire from the University of California at Irvine and his team were the first to undertake double-blind placebo controlled studies for risperidone (4) and olanzapine (5) on small groups of 16 and 22 adults with stuttering, respectively. These investigator-initiated trials are similar to phase II trials. Half of the subjects received placebo, the other half the active compound. They measured the percent of syllables stuttered in either trial, and took additional subjective scores like patient's perception of speech fluency in the olanzapine trial. They found the active drug of either trial to be superior to placebo in reducing the percent of syllables stuttered. Side effects of these drugs included sedation and lack of menstrual periods for risperidone, and sedation and weight gain for olanzapine. Risperidone and olanzapine have been commercially available for several years now and many patients for psychiatric indications take them. Unexpected side effects are therefore less likely.

The latest tests

This June, Indevus Pharmaceuticals, Inc. announced results from a phase II trial of pagoclone in 132 adults with persistent developmental stuttering, with 44 receiving the active compound at low doses, 44 at high doses, and 44 receiving a placebo (6). Objective fluency improved (videotaped and scored by independent raters blinded) and so did subjective assessment scores (made by the participants in the trial). They were measured twice before the start of the trial, after 4 weeks and again after 8 weeks of treatment. 55% of the pagoclone treated patients had improved at week 8 compared to 36% of placebo treated patients.

Further details such as the effective dose are missing in this company statement (6), as is a peer-reviewed article on this report in a scientific journal. Pagoclone is said to have been well-tolerated with headache and fatigue as the most frequent side effects. The eight-week blinded study period has been followed by an ongoing open-label extension study in which most original patients are said to participate (6).

Why pagoclone?

As far as the author is aware, pagoclone was never commercially available, nor has it ever succeeded in a phase III trial, and knowledge about side effects from phase IV trials is non-existent. Though pagoclone was initially studied for anxiety disorders in larger trials by Pfizer, Inc., Pfizer is said to have "discontinued development of the compound in June 2002" (7). The only phase III trial initiated by Pfizer, Inc., in August 2000 for panic disorder (7) was not available on the Medline (8) as of July 16, 2006, which suggests that it has been stopped. However, these larger trials led to two unexpected observations, one of which was reduced stuttering in patients enrolled for their anxiety who happened to stutter. These potentially interesting findings are now being further studied as primary outcome measures in specifically designed clinical trials, this time by Indevus, which seems to have taken over the rights of the compound from Pfizer (9).

The next stage

To establish a clear efficacy in alleviating stuttering and to obtain EMEA and FDA regulatory approval, larger phase III trials are necessary for both compounds, where hundreds of patients would be studied. These are very expensive and less likely to be financed for risperidone or olanzapine than for pagoclone, because the patent protection for the former drugs will cease soon.

Pharmacologically both drugs have very different properties. Risperidone and olanzapine block the receptors of the neurotransmitter dopamine in the brain, thereby modulating the balance of excitation and inhibition, as excellently reviewed by Alm (10). Pagoclone has a completely different target, binds to so-called GABA receptors and enhances inhibition in the brain (11). These very different mechanisms suggest that different subgroups of stuttering patients may profit from different drugs (10), or that the pagoclone effect is a side effect of its anxiousness-reducing properties.

Taken together, there is a new wave of pharmacological trials in stuttering, with three pivotal trials likely to qualify as phase II trials. All claim positive results, the risperidone and the olanzapine trials are published in peer-reviewed journals, for the pagoclone trial we are so far left with company statements (6) and patent applications (12) primarily addressing shareholders rather than the scientific public.

In conclusion, should we take any of these drugs? Marilyn Monroe's life (and that of many other stutterers) tells us of great success even with a prominent stammer, but also that swallowing too many ill-defined pills does not necessarily make you happy. However, stuttering does severely impair social abilities and their pursuit of happiness for some of us. Good drugs may help, and the currently available data on risperidone, olanzapine and pagoclone raises hopes that need to be validated by large phase III studies.

References
1 Brady JP. The pharmacology of stuttering: A critical review. Am J Psychiatry 1991;148:1309-1316.
2 http://en.wikipedia.org/wiki/Clinical_trial; retrieved July 16, 2006
3 http://news.bbc.co.uk/2/hi/uk_news/engl ... 11626.stm;
retrieved July 15, 2006
4 Maguire G.A et al. Risperidone for the treatment of stuttering. J Clin Psychopharmacol 2000;20:479-482.
5 Maguire GA et al. Olanzapine in the treatment of developmental stuttering: A double-blind, placebo-controlled trial. Ann Clin Psychiat 2004;16:63-67
6 http://thestutteringbrain.blogspot.com/ ... hive.html;
retrieved July 16, 2006
7 Bateson A. Pagoclone Indevus. Curr Opin Investig Drugs 2003;4:91-5.
8 www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed;
9 www.indevus.com/product/pagaclone.asp?page=pagaclone ; retrieved July 16,
2006
10 Alm PA. Stuttering and the basal ganglia circuits: a critical review of possible relations. J Communic Disord 2004;37:325-369
11 Atack JR. The benzodiazepine binding site of GABA(A) receptors as a target for the development of novel anxiolytics. Expert Opin Investig Drugs 2005 May;14:601-18.
12 www.patentstorm.us/patents/6855721.html; retrieved July 17, 2006

About the author: Dr Martin Sommer is based at the department of Clinical Neurophysiology, University of Göttingen, Germany. His research areas cover movement disorders, with a focus on Parkinson's disease and stuttering.

Acknowledgements: Thanks to Tom Weidig for assistance with this article and for providing feedback. www.thestutteringbrain.blogspot.com

From the Autumn 2006 edition of Speaking Out, pages 6-7


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To Fight Stuttering, Doctors Look at the Brain


By ANDREW POLLACK
Published: September 12, 2006, New York Times



As a child who stuttered badly, Gerald Maguire learned the tricks of coping. When called upon in class, he would sometimes answer in the voice of Elmer Fudd or Donald Duck because he didn’t stutter when imitating someone. He found easier-to-say synonyms for words that stymied him. And he almost never made phone calls because he stumbled over a phrase for which there was no substitute: his own name.

Now Dr. Maguire, a psychiatrist at the University of California, Irvine, wants to cure the ailment that afflicts him and an estimated three million Americans. He is searching for a drug to treat stuttering, organizing clinical trials and even testing treatments on himself.

He could be getting closer. In May, Indevus Pharmaceuticals announced what it called encouraging results from the largest clinical trial ever of a drug for stuttering. Even larger trials are still needed, which could take two or three years. But if they succeed, the drug, pagoclone, could become the first medical treatment approved for stuttering.

That is just part of a transformation of stuttering — in the medical view — from what was once widely considered a nervous or emotional condition to a neurological one that is at least partly genetic. Using brain scans, DNA studies and other modern techniques, scientists — many of whom stutter themselves — are slowly shedding light on a condition that has flustered its victims as far back as Moses, who some scholars believe was a stutterer because he told the Lord that he was “slow of speech and of a slow tongue” and had his brother Aaron speak for him.

“This is a total paradigm shift in the last 10 years,” said Dr. Maguire, who helped design the Indevus trial and was an investigator in it. “When I was in medical school, I learned nothing about stuttering.”

Still, much remains to be learned about the causes of stuttering and how to treat it. It is estimated that about 1 percent of the population worldwide stutters, though that figure may be high. Men who stutter outnumber women by a ratio of about 4 to 1, for reasons not known.

In most cases, stuttering begins between ages 2 and 6, when a child is just learning to speak. But three quarters of such children will stop stuttering within a few years without any intervention, said Ehud Yairi, emeritus professor of speech and hearing science at the University of Illinois, who stutters himself. Other children benefit from speech therapy.

Those who stutter say the condition — marked by repetitions of syllables, long silences and the contortion of the face as a person seems to try to force the words out — can exact a terrible emotional toll. Many talk of jobs or promotions not received, of relationships broken or not pursued. Some structure their entire lives to avoid having to speak unnecessarily or to avoid being teased.

“Stuttering is one of the last diseases it’s still O.K. to make fun of,” said Ernie Canadeo, an advertising executive from Oyster Bay, N.Y., who stutters.

Alan Rabinowitz, a noted wildlife conservationist, has told of how when called upon by a teacher in elementary school, he once avoided answering by stabbing his hand with a pencil so he would be taken to the hospital.

Still, many people overcome — if not totally cure — their stuttering, either through therapy or just the passage of time. Winston Churchill stuttered. So did Marilyn Monroe. Others who have coped with the problem include the author John Updike, Senator Joseph R. Biden Jr. of Delaware, the actor James Earl Jones, the newsman John Stossel, the singer Carly Simon and the sportscaster Bill Walton. Throughout history, various theories have been advanced for stuttering, including sexual fixations, emotional disorders, nervousness, and persistence into adult life of infantile nursing activities, according to the book “Knotted Tongues: Stuttering in History and the Quest for a Cure” by Benson Bobrick (Simon & Schuster, 1995).

One of the more popular theories from a few decades ago was that parents caused stuttering by reacting negatively to the repetitions that normally occur when children first learn to talk.

But a consensus is growing that stuttering is a neurological condition, though its exact nature is not clear. Emotional stress can make stuttering worse, however.

Brain imaging studies have shown that the brains of people who stammer behave differently from those of people who don’t when it comes to processing speech.

Luc De Nil, chairman of the department of speech and language pathology at the University of Toronto, said that in people who don’t stutter, speech processing is largely handled in the brain’s left hemisphere. With stutterers, there is an unusually large amount of activity in the right hemisphere.

Dr. Maguire said studies that he and others had done also suggest there is an excess of the neurotransmitter dopamine in the brains of those who stutter.

Stuttering also appears to be at least partly genetic. About half of the people who get treatment for stuttering have an immediate family member who also stutters, said Dennis Drayna, a geneticist at the National Institute on Deafness and Other Communication Disorders.

Scientists believe there are many genes that can contribute to stuttering, each one perhaps having a small effect. That has made it more difficult to find the genes.

But Dr. Drayna and his colleagues got a big break when a man from Cameroon wrote to an online forum on stuttering a few years ago. The man was part of a prominent family in which 48 of 106 adults stuttered, suggesting that the gene responsible for the family’s stuttering was inherited by changes in one gene.

Studying the DNA from that family, Dr. Drayna and his colleagues have narrowed the search to a stretch of Chromosome 1 containing 50 to 60 genes. Another study using families from Pakistan with large numbers of stutterers found a region on Chromosome 12, and that specific gene is close to being identified, Dr. Drayna said. Other studies have found other chromosomal regions.

If the cause of stuttering has baffled scientists, so has its treatment. A 16th-century Italian physician prescribed nosedrops to “dehumidify” the brain, according to Mr. Bobrick’s book. An American Indian tribe made stutterers spit through a hole in a board to drive the devil from their throats.

Most people who are treated for stuttering nowadays undergo various types of speech therapy. Some therapies teach speech techniques, like elongating vowels or speaking slowly. Others emphasize reducing the anxiety and fear of speaking.

“Adults can be significantly helped,” said Peter Ramig, a professor of speech language pathology at the University of Colorado, who stutters. “But it would be very unusual to see documented cases of adults who stutter being cured.”

Some stutterers have been helped by devices. The best known is the SpeechEasy, which fits in the ear like a hearing aid and feeds the voice back to the speaker with a tiny delay and at a slightly different pitch. This is said to simulate the choral effect, in which people don’t stutter when speaking or singing in unison with others. The device costs about $5,000, and 6,000 have been sold since 2001, according to the manufacturer, the Janus Development Group of Greenville, N.C.

Specialists say that the device helps some people but not others and that the effects can wear off.

As for drugs, there have been some studies over the years using medications developed to treat other conditions. Dr. Maguire ran small trials of two schizophrenia drugs, Risperdal, from Johnson & Johnson, and Zyprexa, from Eli Lilly. Both drugs showed some effectiveness, but neither company took the drug into larger trials.

That has frustrated Dr. Maguire, who said pharmaceutical companies could be missing a big market. In the past, some critics have accused pharmaceutical companies of taking conditions like anxiety or inattentiveness, which the critics say are not clearly illnesses, and turning them into medical problems so they could sell drugs. But stuttering, Dr. Maguire said, is clear cut.

One obstacle is that stuttering has been primarily treated by speech therapists, who can’t prescribe drugs and might object to the condition being treated as a medical one. “There are many people who simply have a bias against it and don’t think it’s a good idea,’’ said J. Scott Yaruss, a speech therapist at the University of Pittsburgh.

Another is that side effects might be worth risking for a serious disease like schizophrenia but not for stuttering.

Zyprexa has been linked to weight gain and diabetes. Dr. Maguire himself has taken Zyprexa for seven years and says it has greatly helped his fluency. He has gained 20 pounds in that time but believes he would have gained some of it anyway because he was approaching middle age.

Pagoclone, the newest candidate, was initially tested as a treatment for panic disorder and anxiety. Results were mixed, and Pfizer, which had the rights to the drug, returned them to Indevus.

But in those trials a few people who stuttered said their speech improved during the trial. So Indevus got a patent covering the use of the drug for stuttering and began the clinical trial, in which 88 patients got the drug and 44 a placebo.

The participants were videotaped in conversation and reading, both before starting on the drug or a placebo and four and eight weeks afterward. Evaluators, blinded to whether the patient was on the drug or the placebo when the video was made, counted the proportion of syllables stuttered and the duration of the three longest stutters. In a separate measure, clinicians evaluated the speech of their patients.

In most cases, those who got the drug did better than those who got the placebo by a statistically significant amount. As evaluated by the clinicians, 55 percent of those who got the drug improved after eight weeks, compared with 36 percent on the placebo. The most common side effects were headache and fatigue.

Still, until the results are published in a journal the company will not reveal how big the improvement was for people, or whether it was enough to make a real difference in their lives.

It’s also not quite clear how the drug is working, whether it is merely reducing anxiety or has some other effect on speech. The drug activates a receptor in the brain called GABA that is associated with a calming effect.

Indevus has not said whether it will continue to pursue pagoclone for stuttering because it is outside its focus of urology and gynecology. It is also testing pagoclone as a treatment for premature ejaculation. The company, under a previous name, Interneuron Pharmaceuticals, developed Redux, a diet drug that became part of the fen-phen combination. Wyeth, which sold the drug, withdrew it from the market after it was linked to heart valve problems.

Claire Byrne of Fountain Valley, Calif., who is taking pagoclone as part of an extension of the clinical trial, said, “I definitely think it’s helping me.” Another woman taking it said, “It’s left me feeling a little bit more free, and I engaged in more speaking situations.”

Dr. Maguire is more enthusiastic. On a conference call for securities analysts held by Indevus, he said some patients taking the drug had finally gotten jobs they wanted or were able to approach others and go out on a date. “It’s almost an awakening, people coming out of their shells, so to speak.”


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BeitragVerfasst: Mo Sep 25, 2006 9:20 am 
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Danke für all die netten Informationen, Holger.


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