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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Kazan medical journal</journal-id><journal-title-group><journal-title xml:lang="en">Kazan medical journal</journal-title><trans-title-group xml:lang="ru"><trans-title>Казанский медицинский журнал</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0368-4814</issn><issn publication-format="electronic">2587-9359</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">687439</article-id><article-id pub-id-type="doi">10.17816/KMJ687439</article-id><article-id pub-id-type="edn">TJSJZS</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Morphofunctional basis of stuttering and the use of transcranial magnetic stimulation as a therapeutic approach</article-title><trans-title-group xml:lang="ru"><trans-title>Морфофункциональная основа заикания и применение транскраниальной магнитной стимуляции в качестве терапевтического метода</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title>口吃的形态功能基础及经颅磁刺激作为治疗方法的应用</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6155-1007</contrib-id><contrib-id contrib-id-type="spin">7477-9182</contrib-id><name-alternatives><name xml:lang="en"><surname>Zhilyaeva</surname><given-names>Tatiana V.</given-names></name><name xml:lang="ru"><surname>Жиляева</surname><given-names>Татьяна Владимировна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, Dr. Sci. (Medicine), Professor, Depart. of Neurology, Psychiatry and Narcology; Head, Lab. of Neurocognitive Research; leading research associate, Depart. of Translational Psychiatry</p></bio><bio xml:lang="ru"><p>д-р мед. наук, профессор, каф. неврологии, психиатрии и наркологии; руководитель, лаб. нейрокогнитивных исследований; ведущий научный сотрудник, отд. трансляционной психиатрии</p></bio><email>bizet@inbox.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-3166-4060</contrib-id><contrib-id contrib-id-type="spin">9706-3102</contrib-id><name-alternatives><name xml:lang="en"><surname>Borisova</surname><given-names>Anastasia M.</given-names></name><name xml:lang="ru"><surname>Борисова</surname><given-names>Анастасия Максимовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>doctor of functional diagnostics</p></bio><bio xml:lang="ru"><p>врач функциональной диагностики</p></bio><email>anastasia.gostenko@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Privolzhsky Research Medical University</institution></aff><aff><institution xml:lang="ru">Приволжский исследовательский медицинский университет</institution></aff></aff-alternatives><pub-date date-type="preprint" iso-8601-date="2026-03-28" publication-format="electronic"><day>28</day><month>03</month><year>2026</year></pub-date><pub-date date-type="pub" iso-8601-date="2026-04-07" publication-format="electronic"><day>07</day><month>04</month><year>2026</year></pub-date><volume>107</volume><issue>2</issue><issue-title xml:lang="en">Kazan medical journal</issue-title><issue-title xml:lang="ru">Казанский медицинский журнал</issue-title><fpage>273</fpage><lpage>283</lpage><history><date date-type="received" iso-8601-date="2025-07-13"><day>13</day><month>07</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2025-11-21"><day>21</day><month>11</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2026, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2026, Эко-Вектор</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; 2026,</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2029-04-07"/><license><ali:license_ref xmlns:ali="http://www.niso.org/schemas/ali/1.0/">https://creativecommons.org/licenses/by-nc-nd/4.0/</ali:license_ref></license></permissions><self-uri xlink:href="https://kazanmedjournal.ru/kazanmedj/article/view/687439">https://kazanmedjournal.ru/kazanmedj/article/view/687439</self-uri><abstract xml:lang="en"><p>This review presents data from contemporary studies of the neurobiological and physiological bases of stuttering. According to the International Classification of Diseases, 10th Revision, stuttering is characterized by repetitions or prolongations of sounds, syllables, or words, as well as by delays or pauses that disrupt the rhythm of speech. Stuttering affects social communication as well as family, educational, professional, and other areas of life. Behavioral modification of speech patterns (speech therapy) is mainly used in the treatment of stuttering.</p> <p>When considering the physiological bases of stuttering, abnormal cortical activation is observed (hyperactivation of speech and motor areas of the right hemisphere and the supplementary motor area), as well as dysfunction of the basal ganglia. These changes may be associated with altered activity and reduced gray matter volume in speech motor areas, white matter deficits (in the regions of the motor representation of the tongue and larynx), and abnormalities of conducting pathways (the frontal aslant tract, corticobulbar, and corticospinal pathways).</p> <p>The review also discusses methods of noninvasive neuromodulation, such as transcranial magnetic stimulation, used both to study the neurophysiology of stuttering and for therapy. During transcranial magnetic stimulation, a short magnetic field pulse passes through the scalp and induces an electrical current in the cerebral cortex. The delivered impulses can modulate neuronal activity, depolarize neurons, alter intracortical excitability, and activate distant corticosubcortical and spinal structures. Prospects for further development of transcranial magnetic stimulation protocols to optimize the correction of stuttering are presented.</p></abstract><trans-abstract xml:lang="ru"><p>В настоящем обзоре литературы представлены данные современных исследований, посвящённых нейробиологическим и физиологическим основам заикания. Заикание характеризуется повторами или удлинением звуков, слогов или слов, а также задержками или паузами, нарушающими ритм речи, согласно Международной классификации болезней 10-го пересмотра. Заикание оказывает влияние на социальную коммуникацию, а также на семейную, образовательную, профессиональную и другие сферы жизни. В терапии заикания в основном используются поведенческие модификации речевых моделей (логопедические занятия).</p> <p>При рассмотрении физиологических основ заикания отмечаются аномальная корковая активация (гиперактивация речевых и моторных областей правого полушария, области SMA), дисфункция базальных ганглиев, что может быть связано с изменённой активностью и уменьшением количества серого вещества в речевых моторных областях, дефицитом белого вещества (в области моторного представительства языка и гортани), а также нарушениями проводящих трактов (лобного косого тракта, кортикобульбарных и кортикоспинальных путей).</p> <p>В обзоре рассмотрены методы неинвазивной нейромодуляции, такие как транскраниальная магнитная стимуляция, используемая как инструмент исследования нейрофизиологии заикания и как метод терапии. При транскраниальной магнитной стимуляции кратковременное магнитное поле проходит через кожу головы и индуцирует электрический ток в коре головного мозга. Посылаемые импульсы могут модулировать нейронную активность, деполяризовать нейроны, изменять внутрикортикальную возбудимость и активировать отдалённые корково-подкорковые и спинномозговые структуры. Представлены перспективы дальнейшей разработки протоколов транскраниальной магнитной стимуляции для оптимизации коррекции заикания.</p></trans-abstract><trans-abstract xml:lang="zh"><p>本篇文献综述介绍了当前关于口吃的神经生物学及生理学基础的研究成果。根据《国际疾病分类第十次修订本》（ICD-10），口吃的特征表现为声音、音节或词语的重复或延长，以及中断言语节奏的停顿或迟滞。口吃会对社交沟通产生影响，并波及家庭、教育、职业及其他生活领域。目前，口吃的治疗主要采用对言语模式进行行为干预（言语矫正训练）。</p> <p>在探讨口吃的生理学基础时发现，患者存在异常的大脑皮层激活现象（右侧大脑半球言语与运动区域、辅助运动区（SMA）的过度激活），以及基底节功能障碍，这些可能与言语运动区域的活动改变及灰质减少有关。此外，研究还发现白质受损（主要集中在语言与喉部运动投射区），以及传导通路的功能异常（如额斜束、皮质延髓束及皮质脊髓束）。</p> <p>本综述探讨了非侵入性神经调控方法，例如经颅磁刺激，它既被用作研究口吃神经生理学的工具，也被用作一种治疗手段。在进行经颅磁刺激时，短时间的磁场会穿过头皮并在大脑皮层诱发电流。所发送的脉冲可以调节神经元活动、使神经元去极化、改变皮层内兴奋性，并激活远端的皮质-皮层下及脊髓结构。文中还展望了未来进一步开发经颅磁刺激方案，以优化口吃矫正效果的前景。</p></trans-abstract><kwd-group xml:lang="en"><kwd>stuttering</kwd><kwd>noninvasive neuromodulation</kwd><kwd>noninvasive brain stimulation</kwd><kwd>transcranial magnetic stimulation</kwd><kwd>repetitive transcranial magnetic stimulation</kwd><kwd>review</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>заикание</kwd><kwd>неинвазивная нейромодуляция</kwd><kwd>неинвазивная стимуляция мозга</kwd><kwd>транскраниальная магнитная стимуляция</kwd><kwd>повторяющаяся транскраниальная магнитная стимуляция</kwd><kwd>обзор</kwd></kwd-group><kwd-group xml:lang="zh"><kwd>口吃</kwd><kwd>非侵入性神经调控</kwd><kwd>非侵入性脑刺激</kwd><kwd>经颅磁刺激</kwd><kwd>重复经颅磁刺激</kwd><kwd>综述</kwd></kwd-group><funding-group><award-group><funding-source><institution-wrap><institution xml:lang="ru">Российский научный фонд</institution></institution-wrap><institution-wrap><institution xml:lang="en">Russian Science Foundation</institution></institution-wrap></funding-source><award-id>25-15-20007</award-id></award-group><award-group><funding-source><institution-wrap><institution xml:lang="ru">Правительство Нижегородской области</institution></institution-wrap><institution-wrap><institution xml:lang="en">Government of Nizhny Novgorod Region</institution></institution-wrap></funding-source></award-group><funding-statement xml:lang="en">The review was prepared as part of the project Development of a Technology for Correcting Stuttering in Children Using Neuronavigation-Guided Rhythmic Transcranial Magnetic Stimulation of the Brain Supplemented With Replenishment of Neurotropic Nutrient Deficiencies, supported by the Russian Science Foundation and the Nizhny Novgorod Region (grant No. 25-15-20007; regional competition Fundamental and Exploratory Research by Individual Research Groups).</funding-statement><funding-statement xml:lang="ru">Обзор выполнен в рамках проекта «Разработка технологии коррекции заикания у детей с помощью нейронавигационной ритмической транскраниальной магнитной стимуляции мозга, дополненной восполнением дефицита нутриентов с нейротропной активностью» при финансовой поддержке Российского научного фонда и Нижегородской области (грант № 25-15-20007, региональный конкурс: «Проведение фундаментальных научных исследований и поисковых научных исследований отдельными научными группами»).</funding-statement></funding-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Alegre E, Penman A, Unicomb R, Scarinci N. 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