Stopping the stuttering

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 didn8217;t stutter when imitating someone.

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 didn8217;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 millions of others. He is searching for a drug, organising clinical trials and even testing treatments on himself.

He could be getting closer. In May, Indevus Pharmaceuticals announced 8220;encouraging results8221; from the largest clinical trial ever of a drug for stuttering. Even larger trials are needed, which could take two or three years. But if they succeed, the drug, pagoclone, could become the first medical treatment approved for stuttering.

Using brain scans, DNA studies and other techniques, scientists8212;many of whom stutter themselves8212;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 he was 8220;slow of speech and of a slow tongue8221;.

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. Men who stutter outnumber women 4 to 1, for reasons not known.

Brain imaging studies have shown the brains of people who stammer behave differently from those of people who don8217;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 don8217;t stutter, speech processing is largely handled in the brain8217;s left hemisphere. With stutterers, there is an unusually large amount of activity in the right hemisphere.

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.

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Pagoclone 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 improvedl. 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 counted the proportion of syllables stuttered and the duration of the three longest stutters. In a separate measure, clinicians evaluated the patients8217; speech.

In most cases, those who got the drug did better than those who got the placebo by a statistically significant amount8212;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.

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Claire Byrne of Fountain Valley, California, who is taking pagoclone as part of an extension of the clinical trial, said, 8220;I definitely think it8217;s helping me.8221; Another woman taking it said, 8220;It8217;s left me feeling a little bit more free, and I engaged in more speaking situations.8221;

Maguire is more enthusiastic. On a conference call for 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. 8220;It8217;s almost an awakening, people coming out of their shells, so to speak.8221;

8212;NY TIMES / ANDREW POLLACK