Vocal aging and adductor spasmodic dysphonia: response to botulinum toxin injection.

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Cannito, Michael P; Kahane, Joel C; Chorna, Lesya

2008-01-01

Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botulinum toxin injection and our expectations for its success. Adductor spasmodic dysphonia, a type of laryngeal dystonia, is typically treated using botulinum toxin injections of the vocal folds in order to suppress adductory muscle spasms which are disruptive to production of speech and voice. A few studies have suggested diminished response to treatment in older patients with adductor spasmodic dysphonia. This retrospective study provides a reanalysis of existing pre-to-post treatment data as function of age. Perceptual judgments of speech produced by 42 patients with ADSD were made by two panels of professional listeners with expertise in voice or fluency of speech. Results demonstrate a markedly reduced positive response to botulinum toxin treatment in the older patients. Perceptual findings are further elucidated by means of acoustic spectrography. Literature on vocal aging is reviewed to provide a specific set of biological mechanisms that best account for the observed interaction of botulinum toxin treatment with advancing age.

Parry-Romberg syndrome (progressive hemifacial atrophy) with spasmodic dysphonia--a rare association.

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Mugundhan, K; Selvakumar, C J; Gunasekaran, K; Thiruvarutchelvan, K; Sivakumar, S; Anguraj, M; Arun, S

2014-04-01

Parry-Romberg syndrome is a rare clinical entity characterised by progressive hemifacial atrophy with appearance of 'saber'. Various neurological and otorhinolaryngological disorders are associated with this syndrome. The association of Parry -Romberg syndrome with Spasmodic dysphonia has rarely been reported. A 37 year old female presented with progressive atrophy of tissues of left side of face for 10 years and change in voice for 1 year. On examination, wasting and atrophy of tissues including tongue was noted on left side of the face. ENT examination revealed adductor spasmodic dysphonia. We report the rare association of Parry -Romberg syndrome with spasmodic dysphonia.

Abnormal striatal dopaminergic neurotransmission during rest and task production in spasmodic dysphonia.

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Simonyan, Kristina; Berman, Brian D; Herscovitch, Peter; Hallett, Mark

2013-09-11

Spasmodic dysphonia is a primary focal dystonia characterized by involuntary spasms in the laryngeal muscles during speech production. The pathophysiology of spasmodic dysphonia is thought to involve structural and functional abnormalities in the basal ganglia-thalamo-cortical circuitry; however, neurochemical correlates underpinning these abnormalities as well as their relations to spasmodic dysphonia symptoms remain unknown. We used positron emission tomography with the radioligand [(11)C]raclopride (RAC) to study striatal dopaminergic neurotransmission at the resting state and during production of symptomatic sentences and asymptomatic finger tapping in spasmodic dysphonia patients. We found that patients, compared to healthy controls, had bilaterally decreased RAC binding potential (BP) to striatal dopamine D2/D3 receptors on average by 29.2%, which was associated with decreased RAC displacement (RAC ΔBP) in the left striatum during symptomatic speaking (group average difference 10.2%), but increased RAC ΔBP in the bilateral striatum during asymptomatic tapping (group average difference 10.1%). Patients with more severe voice symptoms and subclinically longer reaction time to initiate the tapping sequence had greater RAC ΔBP measures, while longer duration of spasmodic dysphonia was associated with a decrease in task-induced RAC ΔBP. Decreased dopaminergic transmission during symptomatic speech production may represent a disorder-specific pathophysiological trait involved in symptom generation, whereas increased dopaminergic function during unaffected task performance may be explained by a compensatory adaptation of the nigrostriatal dopaminergic system possibly due to decreased striatal D2/D3 receptor availability. These changes can be linked to the clinical and subclinical features of spasmodic dysphonia and may represent the neurochemical basis of basal ganglia alterations in this disorder.

Brain structural changes in spasmodic dysphonia: A multimodal magnetic resonance imaging study.

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Kostic, Vladimir S; Agosta, Federica; Sarro, Lidia; Tomić, Aleksandra; Kresojević, Nikola; Galantucci, Sebastiano; Svetel, Marina; Valsasina, Paola; Filippi, Massimo

2016-04-01

The pathophysiology of spasmodic dysphonia is poorly understood. This study evaluated patterns of cortical morphology, basal ganglia, and white matter microstructural alterations in patients with spasmodic dysphonia relative to healthy controls. T1-weighted and diffusion tensor magnetic resonance imaging (MRI) scans were obtained from 13 spasmodic dysphonia patients and 30 controls. Tract-based spatial statistics was applied to compare diffusion tensor MRI indices (i.e., mean, radial and axial diffusivities, and fractional anisotropy) between groups on a voxel-by-voxel basis. Cortical measures were analyzed using surface-based morphometry. Basal ganglia were segmented on T1-weighted images, and volumes and diffusion tensor MRI metrics of nuclei were measured. Relative to controls, patients with spasmodic dysphonia showed increased cortical surface area of the primary somatosensory cortex bilaterally in a region consistent with the buccal sensory representation, as well as right primary motor cortex, left superior temporal, supramarginal and superior frontal gyri. A decreased cortical area was found in the rolandic operculum bilaterally, left superior/inferior parietal and lingual gyri, as well as in the right angular gyrus. Compared to controls, spasmodic dysphonia patients showed increased diffusivities and decreased fractional anisotropy of the corpus callosum and major white matter tracts, in the right hemisphere. Altered diffusion tensor MRI measures were found in the right caudate and putamen nuclei with no volumetric changes. Multi-level alterations in voice-controlling networks, that included regions devoted not only to sensorimotor integration, motor preparation and motor execution, but also processing of auditory and visual information during speech, might have a role in the pathophysiology of spasmodic dysphonia. Copyright © 2016 Elsevier Ltd. All rights reserved.

Pharyngeal Dystonia Mimicking Spasmodic Dysphonia.

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Shi, Lucy L; Simpson, C Blake; Hapner, Edie R; Jinnah, Hyder A; Johns, Michael M

2018-03-01

The aim of this study was to describe the presentation of pharyngeal dystonia (PD), which can occur as a focal or segmental dystonia with a primarily pharyngeal involvement for the discussion of treatment methods for controlling consequent symptoms. PD is specific to speech-related tasks. A retrospective medical record review of four patients with PD was performed. All patients were initially misdiagnosed with adductor spasmodic dysphonia and failed standard treatment with botulinum toxin type A (BTX). On laryngoscopy, the patients were discovered to have segmental or focal dystonia primarily affecting the pharyngeal musculature contributing to their vocal manifestations. A novel treatment regimen was designed, which involved directing BTX injections into the muscles involved in spasmodic valving at the oropharyngeal level. After titrating to an optimal dose, all patients showed improvement in their voice and speech with only mild dysphagia. These patients have maintained favorable results with repeat injections at 6- to 12-week intervals. PD, or dystonia with predominant pharyngeal involvement, is a rare entity with vocal manifestations that are not well described. It can be easily mistaken for spasmodic dysphonia. PD is specific to speech-related tasks. A novel method of BTX injections into the involved muscles results in a significant improvement in voice without significant dysphagia. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Comparing health locus of control in patients with Spasmodic Dysphonia, Functional Dysphonia and Nonlaryngeal Dystonia.

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Haselden, Karen; Powell, Theresa; Drinnan, Mike; Carding, Paul

2009-11-01

Locus of Control (LoC) refers to an individuals' perception of whether they are in control of life events. Health Locus of Control refers to whether someone feels they have influence over their health. Health Locus of Control has not been studied in any depth in voice-disordered patients. The objective of this study was to examine Health Locus of Control in three patient groups: (1) Spasmodic Dysphonia, (2) Functional Dysphonia and (3) a nondysphonic group with Nonlaryngeal Dystonia. LoC was measured and compared in a total of 57 patients using the Multidimensional Health Locus of Control Scales (diagnostic specific) Form C. Internal, Chance, and Powerful others LoC were measured and comparisons were made using one-way analysis of variance. Contrary to expectations Internal LoC was found to be significantly higher in the Functional Dysphonia group when compared to the other two groups. There was no significant difference between the groups in Chance or Powerful others LoC. The two organic groups, Spasmodic Dysphonia and Nonlaryngeal Dystonia, were more alike in Internal Health Locus of Control than the Functional Dysphonia group. The diagnostic nature of the groups was reflected in their LoC scores rather than their voice loss. These results contribute to the debate about the etiology of Spasmodic Dysphonia and will be of interest to those involved in the psychology of voice and those managing voice-disordered patients.

Spasmodic dysphonia: let's look at that again.

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Murry, Thomas

2014-11-01

G. Paul Moore influenced the study of spasmodic dysphonia (SD) with his 1960 publication that examined the neurological, medical, and vocal fold behavior in a group of patients with adductor spasmodic dysphonia (ADSD). This review of advances in the diagnosis and treatment of SD follows a time line of research that can be traced in part to the early work of Moore et al. This article reviews the research in ADSD over the past 50 plus years. The capstone events that brought SD to its present day level of management by laryngologists and speech-language pathologists are highlighted. A look to the future to understand more of the disorder is offered for this debilitating disorder. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Selective lateral laser thyroarytenoid myotomy for adductor spasmodic dysphonia.

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Hussain, A; Shakeel, M

2010-08-01

Selective lateral laser thyroarytenoid myotomy is a conceptually sound, simple, minimally invasive, repeatable and predictable new surgical procedure for treating adductor spasmodic dysphonia. This paper aims to introduce and describe the surgical technique, and to present a clinical case series and its outcomes. A prospective, clinical case series treated with selective lateral laser thyroarytenoid myotomy, with follow up of 2.5 years. Pre- and post-operative data were collected prospectively for patients undergoing selective lateral laser thyroarytenoid myotomy. These data included patient demographics, previous interventions for adductor spasmodic dysphonia, technical aspects of surgery and clinical outcome. Outcome data included clinical assessment, voice handicap index, need for further intervention, and patient satisfaction assessed by subjective improvement (detailed subjectively by the patients themselves and objectively using the Glasgow benefit inventory). Four patients (two men and two women; mean age 65 years; age range 41-80 years) were included. The mean duration of adductor spasmodic dysphonia was 11 years. All patients had previously been treated with botulinum toxin A. All patients reported improvement in voice quality, fluency, sustainability and elimination of voice breaks over 2.5 years' follow up. Clinical assessment revealed no alteration in mucosal wave, and complete relief of hyperadduction was observed on phonation. No patients required supplementary botulinum toxin treatment during follow up. Selective lateral laser thyroarytenoid myotomy seems to represent a curative procedure for adductor spasmodic dysphonia, a chronic, debilitating condition. This procedure is conceptually simple, minimally invasive and repeatable. It also seems to offer a safe and lasting alternative to botulinum toxin therapy.

Psychological aspects of adductor spasmodic dysphonia: a prospective population controlled questionnaire study.

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Kaptein, A A; Hughes, B M; Scharloo, M; Hondebrink, N; Langeveld, T P M

2010-02-01

To examine psychosocial concomitants, illness perceptions, and treatment perceptions in patients with adductor spasmodic dysphonia. Prospective controlled cohort study. A tertiary care facility. Forty-nine out-patients (38 women, 11 men; average age of 52 years) with adductor spasmodic dysphonia completed a battery of reliable and validated psychometric assessment instruments. Control patients' data were derived from scores in questionnaires by samples in the formal Manuals of the questionnaires used. Psychosocial functioning, illness perceptions, and treatment perceptions. Scores on psychosocial measures were elevated in male patients especially, indicating levels of psychological morbidity significantly above those seen in the general population. Assessments of illness perceptions and treatment perceptions indicated that patients perceive that they have a very low degree of control over the disorder, and experience a high emotional impact from it. Voice Handicap Index scores illustrated substantial degrees of perceived handicap. Adductor spasmodic dysphonia is associated with significant negative psychosocial concomitants, coupled with low perceived control over the condition. Future research should elucidate the implications of illness perceptions and treatment perceptions for the biopsychosocial care of persons with adductor spasmodic dysphonia in order to improve self-management and enhance quality of life.

Spasmodic dysphonia: description of the disease and associated neurologic disorders

Directory of Open Access Journals (Sweden)

Coelho, Marina Serrato

2010-06-01

Full Text Available Introduction: Spasmodic dysphonia (SD is a problem that affects speech and vocalization, one of the most devastating disorders of oral communication. It is characterized by vocal quality tensaestrangulada, harshly and / or interspersed with abrupt vocal attack and a great tension in the vocal tract. The etiology of spasmodic dysphonia is unclear. Some authors point to psychogenic causes, neurological or even unknown. Objective: To assess the prevalence of muscular dystonias and other neurological symptoms in patients with ED. Method: A retrospective study of 10 cases with diagnosis of ED for symptoms and neurological disorders associated. Results: There was a significant predominance of the disease in females (9:1. The average age of onset of symptoms was 32 years, ranging between 14 and 60 years. The mean disease duration was 10 years. Among the patients, 87.5% had a diagnosis of disorders of movement made by a neurologist, including orofacial dystonias (50%, essential tremor (50% and spastic paraparesis (12%. Conclusion: The presence of movement disorders followed almost all cases of spasmodic dysphonia. More studies are needed to clarify the pathophysiological basis of disease.

Speech Intelligibility in Severe Adductor Spasmodic Dysphonia

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Bender, Brenda K.; Cannito, Michael P.; Murry, Thomas; Woodson, Gayle E.

2004-01-01

This study compared speech intelligibility in nondisabled speakers and speakers with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (Botox) injection. Standard speech samples were obtained from 10 speakers diagnosed with severe ADSD prior to and 1 month following Botox injection, as well as from 10 age- and gender-matched…

Disfluency in Spasmodic Dysphonia: A Multivariate Analysis.

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Cannito, Michael P.; Burch, Annette Renee; Watts, Christopher; Rappold, Patrick W.; Hood, Stephen B.; Sherrard, Kyla

1997-01-01

This study examined visual analog scaling judgments of disfluency by normal listeners in response to oral reading by 20 adults with spasmodic dysphonia (SD) and nondysphonic controls. Findings suggest that although dysfluency is not a defining feature of SD, it does contribute significantly to the overall clinical impression of severity of the…

Factors Associated With Patient-perceived Hoarseness in Spasmodic Dysphonia Patients.

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Hu, Amanda; Hillel, Al; Meyer, Tanya

2016-11-01

The American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guidelines on Hoarseness distinguishes between hoarseness, which is a symptom perceived by the patient, and dysphonia, which is a diagnosis made by the clinician. Our objective was to determine factors that are associated with patient-perceived hoarseness in spasmodic dysphonia (SD) patients. Retrospective study. Adductor SD patients who presented for botulinum toxin injections from September 2011 to June 2012 were recruited. The main outcome variable, Voice Handicap Index-10 (VHI-10), was used to quantify patient-perceived hoarseness. Clinical data, Hospital Anxiety and Depression Scale (HADS), and VHI-10 were collected. Clinician-perceived dysphonia was measured by a speech-language pathologist with Consensus Auditory Perceptual Evaluation of Voice (CAPE-V). Statistical analysis included univariate analyses and multiple linear regression. One hundred thirty-nine SD patients had VHI-10 score of 26.0 ± 7.2 (mean ± standard deviation), disease duration of 10.5 + 7.0 years, CAPE-V overall score of 43.2 ± 21.8, HADS anxiety score of 6.7 ± 3.8, and HADS depression score of 3.6 ± 2.8. In univariate analyses, there were positive correlations (P dysphonia are associated with higher levels of patient-perceived hoarseness in SD patients. Hoarseness is a very personal symptom. Multiple factors determine its self-perception. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Long-Term Follow-Up of Patients with Spasmodic Dysphonia and Improved Voice despite Discontinuation of Treatment.

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Geneid, Ahmed; Lindestad, Per-Åke; Granqvist, Svante; Möller, Riitta; Södersten, Maria

2016-01-01

To evaluate voice function in patients with adductor spasmodic dysphonia (AdSD) who discontinued botulinum toxin (BTX) treatment because they felt that their voice had improved sufficiently. Twenty-eight patients quit treatment in 2004, of whom 20 fulfilled the inclusion criteria for the study, with 3 subsequently excluded because of return of symptoms, leaving 17 patients (11 males, 6 females) included in this follow-up study. A questionnaire concerning current voice function and the Voice Handicap Index were completed. Audio-perceptual voice assessments were done by 3 listeners. The inter- and intrarater reliabilities were r > 0.80. All patients had a subjectively good stable voice, but with differences in their audio-perceptual voice assessment scores. Based on the pre-/posttreatment auditory scores on the overall degree of AdSD, patients were divided into 2 subgroups showing more and less improvement, with 10 and 7 patients, respectively. The subgroup with more improvement had shorter duration from the onset of symptoms until the start of BTX treatment, and included 7 males compared to only 4 males in the subgroup with less improvement. It seems plausible that the symptoms of spasmodic dysphonia may decrease over time. Early intervention and male gender seem to be important factors for long-term reduction of the voice symptoms of AdSD. © 2016 S. Karger AG, Basel.

Assessing the effectiveness of botulinum toxin injections for adductor spasmodic dysphonia: clinician and patient perception.

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Braden, Maia N; Johns, Michael M; Klein, Adam M; Delgaudio, John M; Gilman, Marina; Hapner, Edie R

2010-03-01

To determine the effectiveness of Botox treatment for adductor spasmodic dysphonia (ADSD), the clinician and patient judge changes in voice symptoms and the effect on quality of life. Currently, there is no standard protocol for determining the effectiveness of Botox injections in treating ADSD. Therefore, clinicians use a variety of perceptual scales and patient-based self-assessments to determine patients' impressions of severity and changes after treatments. The purpose of this study was to assess clinician-patient agreement of the effects of Botox on voice quality and quality of life in ADSD. Retrospective chart review of 199 randomly selected patients since 2004. Results indicated a weak correlation between the patient's assessment of voice impairment (EIS) and patient's quality of life impairment (Voice-Related Quality of Life [V-RQOL]) in the mild-moderate dysphonia severity group and the moderate-to-severe dysphonia group. There was a weak correlation between the patient's assessment of voice impairment EIS and the clinician's perceptual judgment of voice impairment (Consensus Auditory Perceptual Evaluation of Voice [CAPE-V]) only in the moderate to severe dysphonia group. There was a weak correlation between the patient's quality of life impairment (V-RQOL) and the clinician's perceptual judgment of voice impairment (CAPE-V) only in the severe to profound dysphonia group. The poor relationship among commonly used outcome measures leads us to question how best to assess the effectiveness of Botox in ADSD. Clinicians are required to document treatment outcomes, making it important to use scales that are valid, reliable, and sensitive to change. Future research directions include examining relationships between measures both before and after Botox injections, examining the specific factors that determine quality of life changes, and further research on specific parameters of the CAPE-V as well as comparing perceptual and quality of life scales with acoustic

Treatment for spasmodic dysphonia: limitations of current approaches

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Ludlow, Christy L.

2009-01-01

Purpose of review Although botulinum toxin injection is the gold standard for treatment of spasmodic dysphonia, surgical approaches aimed at providing long-term symptom control have been advancing over recent years. Recent findings When surgical approaches provide greater long-term benefits to symptom control, they also increase the initial period of side effects of breathiness and swallowing difficulties. However, recent analyses of quality-of-life questionnaires in patients undergoing regular injections of botulinum toxin demonstrate that a large proportion of patients have limited relief for relatively short periods due to early breathiness and loss-of-benefit before reinjection. Summary Most medical and surgical approaches to the treatment of spasmodic dysphonia have been aimed at denervation of the laryngeal muscles to block symptom expression in the voice, and have both adverse effects as well as treatment benefits. Research is needed to identify the central neuropathophysiology responsible for the laryngeal muscle spasms in order target treatment towards the central neurological abnormality responsible for producing symptoms. PMID:19337127

Cortical Silent Period Reveals Differences Between Adductor Spasmodic Dysphonia and Muscle Tension Dysphonia.

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Samargia, Sharyl; Schmidt, Rebekah; Kimberley, Teresa Jacobson

2016-03-01

The pathophysiology of adductor spasmodic dysphonia (AdSD), like other focal dystonias, is largely unknown. The purposes of this study were to determine (a) cortical excitability differences between AdSD, muscle tension dysphonia (MTD), and healthy controls; (b) distribution of potential differences in cranial or skeletal muscle; and (c) if cortical excitability measures assist in the differential diagnosis of AdSD and MTD. Ten participants with adductor spasmodic dysphonia, 8 with muscle tension dysphonia, and 10 healthy controls received single and paired pulse transcranial magnetic stimulation (TMS) to the primary motor cortex contralateral to tested muscles, first dorsal interosseus (FDI), and masseter. We tested the hypothesis that cortical excitability measures in AdSD would be significantly different from those in MTD and healthy controls. In addition, we hypothesized that there would be a correlation between cortical excitability measures and clinical voice severity in AdSD. Cortical silent period duration in masseter and FDI was significantly shorter in AdSD than MTD and healthy controls. Other measures failed to demonstrate differences. There are differences in cortical excitability between AdSD, MTD, and healthy controls. These differences in the cortical measure of both the FDI and masseter muscles in AdSD suggest widespread dysfunction of the GABAB mechanism may be a pathophysiologic feature of AdSD, similar to other forms of focal dystonia. Further exploration of the use of TMS to assist in the differential diagnosis of AdSD and MTD is warranted. © The Author(s) 2015.

Gender differences in onabotulinum toxin A dosing for adductor spasmodic dysphonia.

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Lerner, Michael Z; Lerner, Benjamin A; Patel, Amit A; Blitzer, Andrew

2017-05-01

The objective of this study was to determine the influence of gender on onabotulinum toxin A dosing for the treatment of adductor spasmodic dysphonia symptoms. Retrospective review. A chart review of the senior author's database of botulinum toxin injections was performed. Patients diagnosed with adductor spasmodic dysphonia who received onabotulinum toxin A (BoNTA) injections to the thyroarytenoid muscle for at least 5 years were included for study. Patients who received alternate formulations of botulinum toxin (Myobloc, Dysport, or Xeomin) and patients with alternate diagnoses, such as abductor spasmodic dysphonia, tremor, and oromandibular dystonia, were excluded. The average BoNTA dose was calculated for each patient and statistical analysis was performed comparing the male and female groups. A total of 201 patients (52 males and 149 females) met inclusion criteria. The average follow-up times for the male and female groups were 10.2 ± 3.6 and 11.1 ± 4 years, respectively. The average BoNTA doses for the male and female groups were 0.6 ± 0.42 U and 1.3 ± 1.1 U, respectively. Statistical analysis was performed using an independent samples two-tailed t test yielding a P value of .0000000002. A large effect size was noted with Cohen's d = 0.85. The data from this retrospective chart review reveal a statistically and clinically significant correlation between female gender and higher average BoNTA dose for symptom control in adductor spasmodic dysphonia. Explanations for this observation are speculative and include a possible inverse relationship between optimal BoNTA dose and vocal fold mass and possibly greater neutralizing antibody formation among female patients. 4. Laryngoscope, 127:1131-1134, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Botulinum toxin efficacy in the treatment of patients with spasmodic dysphonia

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Svetel Marina

2007-01-01

Full Text Available Background/Aim. Spasmodic dysphonia (DS is a disabling speech disturbance appearing as the consequence of dystonic vocal folds contraction. Its intermittent appearance in the laryngeal muscles causes vocal function discontinuation. The quality of life of these patients is significantly disturbed. Surgical and a medical therapy appear to be inadequate and unsuccessful ones of no steady improvement. It is the botulinum toxin therapy that proved to be highly efficacious one, with the established improvement in 80−100% of patients. The aim of our study was to evaluate the efficacy of botulinum toxin therapy in patients with SD and to show our preliminary results. Methods. The study included 10 patients with adductor spasmodic dysphonia. After diagnostic procedures, botulinum toxin was applied either in one or both vocal folds, in doses of 12−16 units each. In our study we applied indirect technique originally developed by Hočevar and Pirtošek. Perceptive voice and speech analysis was performed prior to and after the instillation of botuline toxin as per structured Scale of pathological characteristics of voice and speech appearing in the spasmodic dysphonia. Results. The majority of our patients experienced both subjective improvement and the improvement in the terms of the quality of life, Voice Henolicap Index − (VHI that was rated as rather significant one (t = 3.562; p = 0.006. Conclusion. Regardless unquestionable improvement of definite phonation, further function restitution requires individual vocal therapy and psychotherapy. Vocal therapy includes structural vocal techniques which reduce degree of vocal tension and rapid changes in the power and the height of voice. Further investigations are necessary for the scope of the definition of a standardized therapeutically procedure for spasmodic dysphonia treatment which comprises multidisciplinary approach in diagnosis, therapy and treatment efficacy evaluation.

Brainstem pathology in spasmodic dysphonia

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Simonyan, Kristina; Ludlow, Christy L.; Vortmeyer, Alexander O.

2009-01-01

Spasmodic dysphonia (SD) is a primary focal dystonia of unknown pathophysiology, characterized by involuntary spasms in the laryngeal muscles during speech production. We examined two rare cases of postmortem brainstem tissue from SD patients compared to four controls. In SD patients, small clusters of inflammation were found in the reticular formation surrounding solitary tract, spinal trigeminal and ambigual nuclei, inferior olive and pyramids. Mild neuronal degeneration and depigmentation were observed in the substantia nigra and locus coeruleus. No abnormal protein accumulations and no demyelination or axonal degeneration were found. These neuropathological findings may provide insights into the pathophysiology of SD. PMID:19795469

Spasmodic dysphonia may respond to bilateral thalamic deep brain ...

African Journals Online (AJOL)

Background Spasmodic dysphonia is a primary focal dystonia manifested by loss of control of the vocal muscles during speech secondary to laryngeal muscle spasms. The pathophysiology is not well understood. Deep brain stimulation surgery (DBS) for other focal dystonias has been well reported. Methods We report the ...

Dystonia-Causing Mutations as a Contribution to the Etiology of Spasmodic Dysphonia.

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de Gusmão, Claudio M; Fuchs, Tania; Moses, Andrew; Multhaupt-Buell, Trisha; Song, Phillip C; Ozelius, Laurie J; Franco, Ramon A; Sharma, Nutan

2016-10-01

Spasmodic dysphonia is a focal dystonia of the larynx with heterogeneous manifestations and association with familial risk factors. There are scarce data to allow precise understanding of etiology and pathophysiology. Screening for dystonia-causing genetic mutations has the potential to allow accurate diagnosis, inform about genotype-phenotype correlations, and allow a better understanding of mechanisms of disease. Cross-sectional study. Tertiary academic medical center. We enrolled patients presenting with spasmodic dysphonia to the voice clinic of our academic medical center. Data included demographics, clinical features, family history, and treatments administered. The following genes with disease-causing mutations previously associated with spasmodic dysphonia were screened: TOR1A (DYT1), TUBB4 (DYT4), and THAP1 (DYT6). Eighty-six patients were recruited, comprising 77% females and 23% males. A definite family history of neurologic disorder was present in 15% (13 of 86). Average age (± standard deviation) of symptom onset was 42.1 ± 15.7 years. Most (99%; 85 of 86) were treated with botulinum toxin, and 12% (11 of 86) received oral medications. Genetic screening was negative in all patients for the GAG deletion in TOR1A (DYT1) and in the 5 exons currently associated with disease-causing mutations in TUBB4 (DYT4). Two patients tested positive for novel/rare variants in THAP1 (DYT6). Genetic screening targeted at currently known disease-causing mutations in TOR1A, THAP1, and TUBB4 appears to have low diagnostic yield in sporadic spasmodic dysphonia. In our cohort, only 2 patients tested positive for novel/rare variants in THAP1. Clinicians should make use of genetic testing judiciously and in cost-effective ways. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Multidimensional assessment of strongly irregular voices such as in substitution voicing and spasmodic dysphonia: a compilation of own research.

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Moerman, Mieke; Martens, Jean-Pierre; Dejonckere, Philippe

2015-04-01

This article is a compilation of own research performed during the European COoperation in Science and Technology (COST) action 2103: 'Advance Voice Function Assessment', an initiative of voice and speech processing teams consisting of physicists, engineers, and clinicians. This manuscript concerns analyzing largely irregular voicing types, namely substitution voicing (SV) and adductor spasmodic dysphonia (AdSD). A specific perceptual rating scale (IINFVo) was developed, and the Auditory Model Based Pitch Extractor (AMPEX), a piece of software that automatically analyses running speech and generates pitch values in background noise, was applied. The IINFVo perceptual rating scale has been shown to be useful in evaluating SV. The analysis of strongly irregular voices stimulated a modification of the European Laryngological Society's assessment protocol which was originally designed for the common types of (less severe) dysphonia. Acoustic analysis with AMPEX demonstrates that the most informative features are, for SV, the voicing-related acoustic features and, for AdSD, the perturbation measures. Poor correlations between self-assessment and acoustic and perceptual dimensions in the assessment of highly irregular voices argue for a multidimensional approach.

Vocal outcome after endoscopic thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia.

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Gandhi, Sachin; Remacle, Marc; Mishra, Prasun; Desai, Vrushali

2014-12-01

Spasmodic dysphonia (SD) remains one of the most difficult of laryngeal pathologies to treat. With limited role for speech therapy, various surgical modalities have been tried with various success rates. The objective of the study is to report the results of vocal outcome after thyroarytenoid myoneurectomy in patients of adductor spasmodic dysphonia (ASD). 15 patients of ASD were selected. GRBAS, and voice handicap index (VHI) were used for perceptual evaluation of voice. Thyroarytenoid myoneurectomy was performed by vaporizing the muscular layer of the vocal fold with CO2 laser, at an intensity of 6 W with 1.2 mm diameter in scanner mode. Voice analysis was repeated at 12, 24 and 48 months follow-up. Preoperative GRBAS scores and VHI score of all the patients were poor. At 12 months 12/15 (80 %) patients having strain score of 0. There was marked improvement in VHI scores at 6 months. 10/15 (67 %) patients have been followed up for 24 months. 5/10 (50 %) patients have strain (S) value of 0. VHI scoring of 5/10 (50 %) patients was <30. Two of the four patients completed 48 months follow-up had a strain (S) value of 0, one patient has strain value of 1 and one patient had strain value of 2. 2/4 patients had VHI score of <30; one patient had that of 40. Trans-oral CO2 laser thyroarytenoid myoneurectomy shows significant long-term improvement in voice quality in terms of reduced speech brakes, effort and strain in voice.

The point-touch technique for botulinum toxin injection in adductor spasmodic dysphonia: quality of life assessment.

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Morzaria, S; Damrose, E J

2011-07-01

Botulinum toxin injection under electromyographic guidance is the 'gold standard' for adductor spasmodic dysphonia treatment. The point-touch technique, an alternative injection method which relies on anatomical landmarks, is cheaper, quicker and more accessible, but has not yet gained widespread acceptance due to concerns about patient satisfaction. To assess swallowing and voice-related quality of life following point-touch botulinum toxin injection in adductor spasmodic dysphonia patients. Stanford University Voice and Swallowing Center. Prospective case series (evidence level four). Consecutive adductor spasmodic dysphonia patients with a stable botulinum toxin dose-response relationship were recruited prospectively. The Eating Assessment Tool and Voice-Related Quality of Life questionnaires were completed pre-treatment and at 10 and 30 per cent completion of the injection cycle, respectively. Thirty-seven patients completed follow up. The mean total botulinum toxin dose was 0.88 units. Pre-treatment Voice-Related Quality of Life questionnaire results reflected the burden of disease. Post-treatment Eating Assessment Tool and Voice-Related Quality of Life questionnaire results were collected at 2.53 and 7.84 weeks, respectively; the former showed an increase in dysphagia, albeit statistically insignificant, while the latter showed significantly improved scores (both domain and total). The point-touch technique is a viable alternative for botulinum toxin injection in the treatment of adductor spasmodic dysphonia.

Interarytenoid muscle botox injection for treatment of adductor spasmodic dysphonia with vocal tremor.

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Kendall, Katherine A; Leonard, Rebecca J

2011-01-01

Up to one-third of patients presenting with adductor spasmodic dysphonia will have an associated vocal tremor. These patients may not respond fully to treatment using thyroarytenoid (TA) muscle botulinum toxin (Botox) injection. Treatment failures are attributed to the involvement of multiple muscle groups in the tremor. This study evaluates the results of combined interarytenoid (IA) and TA muscle Botox injection in a group of 27 patients with adductor spasmodic dysphonia and vocal tremor and in four patients with severe vocal tremor alone. Patient-satisfaction data were reviewed retrospectively. Pre- and postinjection acoustic data were collected prospectively. Acoustic measures of fundamental frequency and cycle-by-cycle variability in frequency (jitter) and intensity (shimmer) were obtained from 15 patients' sustained vowel productions. Measures were collected after TA muscle injection, alone, and after combined TA and IA (TA+IA) muscle injections. In addition, two experienced voice clinicians blindly assessed tremor severity from recordings made for each patient in the two conditions. Patients were also queried regarding their satisfaction with the results of the injections and whether they desired to continue receiving TA+IA treatment. Significant improvement in all acoustic measures except for % jitter was observed after the TA+IA muscle injections. Listeners identified voice samples after TA+IA muscle injections as demonstrating less tremor in 73% of the paired comparisons. Sixty-seven percent of the patients with spasmodic dysphonia and vocal tremor wished to continue to receive IA muscle injections. Only one patient with severe vocal tremor wished to continue with injections. The addition of an IA muscle Botox injection to the treatment of patients with a combination adductor spasmodic dysphonia and vocal tremor may improve voice outcomes. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Review of differential diagnosis and management of spasmodic dysphonia.

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Whurr, Renata; Lorch, Marjorie

2016-06-01

The recent literature on spasmodic dysphonia is reviewed with regard to pathogenesis, differential diagnosis, treatment options, audits, and current methods of management. Advances in technology have enabled clinicians to better understand the connection between brain and laryngeal function and dysfunction. Refinements in imaging and genetic investigation techniques have led to advances in the understanding of the underlying mechanism of this neurolaryngeal disorder. Development of diagnostic assessment tools and measures of quality of life hold the potential to improve treatment and care. Fifty articles published between 2014 and 2015 were selected for this review. The sources were drawn from several clinical specialties: 54% come under the scope of laryngology, 32% from neurology, and 14% from other areas. It remains poorly understood, misdiagnosed, and underdiagnosed. Its identification, diagnosis, treatment selection, and coordination of care require an expert specialist multidisciplinary team. More training is required to help people who have this chronic and psychosocially disabling voice disorder, which impinges on all aspects of their lives. Spasmodic dysphonia is now classified as a 'rare' disease in the United States. This designation will assist in international standards of diagnosis, assessment, treatment, and management.

Abnormal activation of the primary somatosensory cortex in spasmodic dysphonia: an fMRI study.

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Simonyan, Kristina; Ludlow, Christy L

2010-11-01

Spasmodic dysphonia (SD) is a task-specific focal dystonia of unknown pathophysiology, characterized by involuntary spasms in the laryngeal muscles during speaking. Our aim was to identify symptom-specific functional brain activation abnormalities in adductor spasmodic dysphonia (ADSD) and abductor spasmodic dysphonia (ABSD). Both SD groups showed increased activation extent in the primary sensorimotor cortex, insula, and superior temporal gyrus during symptomatic and asymptomatic tasks and decreased activation extent in the basal ganglia, thalamus, and cerebellum during asymptomatic tasks. Increased activation intensity in SD patients was found only in the primary somatosensory cortex during symptomatic voice production, which showed a tendency for correlation with ADSD symptoms. Both SD groups had lower correlation of activation intensities between the primary motor and sensory cortices and additional correlations between the basal ganglia, thalamus, and cerebellum during symptomatic and asymptomatic tasks. Compared with ADSD patients, ABSD patients had larger activation extent in the primary sensorimotor cortex and ventral thalamus during symptomatic task and in the inferior temporal cortex and cerebellum during symptomatic and asymptomatic voice production. The primary somatosensory cortex shows consistent abnormalities in activation extent, intensity, correlation with other brain regions, and symptom severity in SD patients and, therefore, may be involved in the pathophysiology of SD.

Adductor spasmodic dysphonia and botulinum toxin treatment : The effect on well-being

NARCIS (Netherlands)

Langeveld, TPM; Luteijn, F; van Rossum, M; Drost, HA; De Jong, RJB

2001-01-01

Adductor spasmodic dysphonia (AdSD) is a controversial and enigmatic voice disorder. It is generally accepted that it has a neurologic, although undetermined, cause, and it is accompanied by much psychological and physical distress. In this prospective study, standardized psychometric tests were

Automated acoustic analysis of task dependency in adductor spasmodic dysphonia versus muscle tension dysphonia.

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Roy, Nelson; Mazin, Alqhazo; Awan, Shaheen N

2014-03-01

Distinguishing muscle tension dysphonia (MTD) from adductor spasmodic dysphonia (ADSD) can be difficult. Unlike MTD, ADSD is described as "task-dependent," implying that dysphonia severity varies depending upon the demands of the vocal task, with connected speech thought to be more symptomatic than sustained vowels. This study used an acoustic index of dysphonia severity (i.e., the Cepstral Spectral Index of Dysphonia [CSID]) to: 1) assess the value of "task dependency" to distinguish ADSD from MTD, and to 2) examine associations between the CSID and listener ratings. Case-Control Study. CSID estimates of dysphonia severity for connected speech and sustained vowels of patients with ADSD (n = 36) and MTD (n = 45) were compared. The diagnostic precision of task dependency (as evidenced by differences in CSID-estimated dysphonia severity between connected speech and sustained vowels) was examined. In ADSD, CSID-estimated severity for connected speech (M = 39. 2, SD = 22.0) was significantly worse than for sustained vowels (M = 29.3, SD = 21.9), [P = .020]. Whereas in MTD, no significant difference in CSID-estimated severity was observed between connected speech (M = 55.1, SD = 23.8) and sustained vowels (M = 50.0, SD = 27.4), [P = .177]. CSID evidence of task dependency correctly identified 66.7% of ADSD cases (sensitivity) and 64.4% of MTD cases (specificity). CSID and listener ratings were significantly correlated. Task dependency in ADSD, as revealed by differences in acoustically-derived estimates of dysphonia severity between connected speech and sustained vowel production, is a potentially valuable diagnostic marker. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Effect of Botulinum Toxin and Surgery among Spasmodic Dysphonia Patients : A Systematic Review

NARCIS (Netherlands)

van Esch, Babette F; Wegner, Inge; Stegeman, Inge; Grolman, Wilko

2017-01-01

OBJECTIVE: The effect of botulinum toxin among patients with adductor spasmodic dysphonia (AdSD) is temporary. To optimize long-term treatment outcome, other therapy options should be evaluated. Alternative treatment options for AdSD comprise several surgical treatments, such as thyroarytenoid

Acoustic Variations in Adductor Spasmodic Dysphonia as a Function of Speech Task.

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Sapienza, Christine M.; Walton, Suzanne; Murry, Thomas

1999-01-01

Acoustic phonatory events were identified in 14 women diagnosed with adductor spasmodic dysphonia (ADSD), a focal laryngeal dystonia that disturbs phonatory function, and compared with those of 14 age-matched women with no vocal dysfunction. Findings indicated ADSD subjects produced more aberrant acoustic events than controls during tasks of…

A Measure of the Auditory-perceptual Quality of Strain from Electroglottographic Analysis of Continuous Dysphonic Speech: Application to Adductor Spasmodic Dysphonia.

Science.gov (United States)

Somanath, Keerthan; Mau, Ted

2016-11-01

(1) To develop an automated algorithm to analyze electroglottographic (EGG) signal in continuous dysphonic speech, and (2) to identify EGG waveform parameters that correlate with the auditory-perceptual quality of strain in the speech of patients with adductor spasmodic dysphonia (ADSD). Software development with application in a prospective controlled study. EGG was recorded from 12 normal speakers and 12 subjects with ADSD reading excerpts from the Rainbow Passage. Data were processed by a new algorithm developed with the specific goal of analyzing continuous dysphonic speech. The contact quotient, pulse width, a new parameter peak skew, and various contact closing slope quotient and contact opening slope quotient measures were extracted. EGG parameters were compared between normal and ADSD speech. Within the ADSD group, intra-subject comparison was also made between perceptually strained syllables and unstrained syllables. The opening slope quotient SO7525 distinguished strained syllables from unstrained syllables in continuous speech within individual subjects with ADSD. The standard deviations, but not the means, of contact quotient, EGGW50, peak skew, and SO7525 were different between normal and ADSD speakers. The strain-stress pattern in continuous speech can be visualized as color gradients based on the variation of EGG parameter values. EGG parameters may provide a within-subject measure of vocal strain and serve as a marker for treatment response. The addition of EGG to multidimensional assessment may lead to improved characterization of the voice disturbance in ADSD. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Voice Onset Time for the Word-Initial Voiceless Consonant /t/ in Japanese Spasmodic Dysphonia-A Comparison With Normal Controls.

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Yanagida, Saori; Nishizawa, Noriko; Mizoguchi, Kenji; Hatakeyama, Hiromitsu; Fukuda, Satoshi

2015-07-01

Voice onset time (VOT) for word-initial voiceless consonants in adductor spasmodic dysphonia (ADSD) and abductor spasmodic dysphonia (ABSD) patients were measured to determine (1) which acoustic measures differed from the controls and (2) whether acoustic measures were related to the pause or silence between the test word and the preceding word. Forty-eight patients with ADSD and nine patients with ABSD, as well as 20 matched normal controls read a story in which the word "taiyo" (the sun) was repeated three times, each differentiated by the position of the word in the sentence. The target of measurement was the VOT for the word-initial voiceless consonant /t/. When the target syllable appeared in a sentence following a comma, or at the beginning of a sentence following a period, the ABSD patients' VOTs were significantly longer than those of the ADSD patients and controls. Abnormal prolongation of the VOTs was related to the pause or silence between the test word and the preceding word. VOTs in spasmodic dysphonia (SD) may vary according to the SD subtype or speaking conditions. VOT measurement was suggested to be a useful method for quantifying voice symptoms in SD. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Spasmodic dysphonia: a laryngeal control disorder specific to speech.

Science.gov (United States)

Ludlow, Christy L

2011-01-19

Spasmodic dysphonia (SD) is a rare neurological disorder that emerges in middle age, is usually sporadic, and affects intrinsic laryngeal muscle control only during speech. Spasmodic bursts in particular laryngeal muscles disrupt voluntary control during vowel sounds in adductor SD and interfere with voice onset after voiceless consonants in abductor SD. Little is known about its origins; it is classified as a focal dystonia secondary to an unknown neurobiological mechanism that produces a chronic abnormality of laryngeal motor neuron regulation during speech. It develops primarily in females and does not interfere with breathing, crying, laughter, and shouting. Recent postmortem studies have implicated the accumulation of clusters in the parenchyma and perivascular regions with inflammatory changes in the brainstem in one to two cases. A few cases with single mutations in THAP1, a gene involved in transcription regulation, suggest that a weak genetic predisposition may contribute to mechanisms causing a nonprogressive abnormality in laryngeal motor neuron control for speech but not for vocal emotional expression. Research is needed to address the basic cellular and proteomic mechanisms that produce this disorder to provide intervention that could target the pathogenesis of the disorder rather than only providing temporary symptom relief.

Longitudinal variations of laryngeal overpressure and voice-related quality of life in spasmodic dysphonia.

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Yeung, Jeffrey C; Fung, Kevin; Davis, Eric; Rai, Sunita K; Day, Adam M B; Dzioba, Agnieszka; Bornbaum, Catherine; Doyle, Philip C

2015-03-01

Adductor spasmodic dysphonia (AdSD) is a voice disorder characterized by variable symptom severity and voice disability. Those with the disorder experience a wide spectrum of symptom severity over time, resulting in varied degrees of perceived voice disability. This study investigated the longitudinal variability of AdSD, with a focus on auditory-perceptual judgments of a dimension termed laryngeal overpressure (LO) and patient self-assessments of voice-related quality of life (V-RQOL). Longitudinal, correlational study. Ten adults with AdSD were followed over three time periods. At each, both voice samples and self-ratings of V-RQOL were gathered prior to their scheduled Botox injection. Voice recordings subsequently were perceptually evaluated by eight listeners for LO using a visual analog scale. LO ratings for all-voiced and Rainbow Passage sentence stimuli were found to be highly correlated. However, only the LO ratings obtained from judgments of AV stimuli were found to correlate moderately with self-ratings of voice disability for both the physical functioning and social-emotional subscores, as well as the total V-RQOL score. Based on perceptual judgments, LO appears to provide a reliable means of quantifying the severity of voice abnormalities in AdSD. Variability in self-ratings of the V-RQOL suggest that perceived disability related to AdSD should be actively monitored. Further, auditory-perceptual judgments may provide an accurate index of the potential impact of the disorder on the speaker. Similarly, LO was supported as a simple clinical measure that serves as a reliable index of voice change over time. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

[Stimuli phrases of adductor spasmodic dysphonia phonatory break in mandarin Chinese].

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Ge, Pingjiang; Ren, Qingyi; Chen, Zhipeng; Cheng, Qiuhui; Sheng, Xiaoli; Wang, Ling; Chen, Shaohua; Zhang, Siyi

2015-12-01

To investigate the characteristics of adductor spasmodic dysphonia phonatory break in mandarin Chinese and select the stimuli phrases. Thirty-eight patients with adductor spasmodic dysphonia were involved in this study. Standard phrase " fù mŭ xīn" and a speech corpus in mandarin Chinese with 229 syllables covering all vowel and constant of mandarin Chinese were selected. Every patient read the phrases above twice in normal speed and comfortable voice. Two auditory perpetual speech pathologists marked phonatory break syllables respectively. The frequency of phonatory break syllables and their located phrases were calculated, rated and described. The phrases including the most phonatory break syllables were selected as stimuli phrases, the phonatory break frequency of which was also higher than that of standard phrase "fù mŭ xīn". Phonatory break happened in the reading of all patients. The average number of phonatory break syllables was 14 (3-33). Phonatroy break occurred when saying 177 (77.3%) syllables in the speech corpus. The syllables "guŏ, rén, zāng, diàn, chē, gè, guăn, a, bā, ne, de" broke in 23.1%-41.0% patients. These syllables belonged to the phrases "pĭng guŏ, huŏ chē, shì de, nĭ shì gè hăo rén, wŏ mén shì yŏu zŏng shì bă qĭn shì nong dé hĕn zāng, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a,wŏ yīng gāi zài xìn lĭ xiĕ yī xiē shén mē ne?". Thirty-seven patients (97.3%) had phonatory break in above mentioned words. Ratios of these words phonatory break also were more than "fù mŭ xīn". Adductor spasmodic dysphonic patients exhibited different degrees of phonatory break in mandarine Chinese. The phrases" shì de, pĭng guŏ, huŏ chē, nĭ shì gè hăo rén, wŏ mén nà biān yŏu wăng qiú yùn dong chăng, cān gŭan, jiŭ bā hé yī gè miàn bāo dìan, tā shì duō me kāng kăi a" were recommended as stimuli

Spasmodic Dysphonia: a Laryngeal Control Disorder Specific to Speech

Science.gov (United States)

Ludlow, Christy L.

2016-01-01

Spasmodic dysphonia (SD) is a rare neurological disorder that emerges in middle age, is usually sporadic, and affects intrinsic laryngeal muscle control only during speech. Spasmodic bursts in particular laryngeal muscles disrupt voluntary control during vowel sounds in adductor SD and interfere with voice onset after voiceless consonants in abductor SD. Little is known about its origins; it is classified as a focal dystonia secondary to an unknown neurobiological mechanism that produces a chronic abnormality of laryngeal motor neuron regulation during speech. It develops primarily in females and does not interfere with breathing, crying, laughter, and shouting. Recent postmortem studies have implicated the accumulation of clusters in the parenchyma and perivascular regions with inflammatory changes in the brainstem in one to two cases. A few cases with single mutations in THAP1, a gene involved in transcription regulation, suggest that a weak genetic predisposition may contribute to mechanisms causing a nonprogressive abnormality in laryngeal motor neuron control for speech but not for vocal emotional expression. Research is needed to address the basic cellular and proteomic mechanisms that produce this disorder to provide intervention that could target the pathogenesis of the disorder rather than only providing temporary symptom relief. PMID:21248101

Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study

Science.gov (United States)

Upile, Tahwinder; Elmiyeh, Behrad; Jerjes, Waseem; Prasad, Vyas; Kafas, Panagiotis; Abiola, Jesuloba; Youl, Bryan; Epstein, Ruth; Hopper, Colin; Sudhoff, Holger; Rubin, John

2009-01-01

Objectives In this preliminary prospective study, we compared unilateral and bilateral thyroarytenoid muscle injections of Botulinum toxin (Dysport) in 31 patients with adductor spasmodic dysphonia, who had undergone more than 5 consecutive Dysport injections (either unilateral or bilateral) and had completed 5 concomitant self-rated efficacy and complication scores questionnaires related to the previous injections. We also developed a Neurophysiological Scoring (NPS) system which has utility in the treatment administration. Method and materials Data were gathered prospectively on voice improvement (self-rated 6 point scale), length of response and duration of complications (breathiness, cough, dysphagia and total voice loss). Injections were performed under electromyography (EMG) guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven. Results Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS) and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections. Conclusion Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia. PMID:19852852

Unilateral versus bilateral thyroarytenoid Botulinum toxin injections in adductor spasmodic dysphonia: a prospective study

Directory of Open Access Journals (Sweden)

Abiola Jesuloba

2009-10-01

Full Text Available Abstract Objectives In this preliminary prospective study, we compared unilateral and bilateral thyroarytenoid muscle injections of Botulinum toxin (Dysport in 31 patients with adductor spasmodic dysphonia, who had undergone more than 5 consecutive Dysport injections (either unilateral or bilateral and had completed 5 concomitant self-rated efficacy and complication scores questionnaires related to the previous injections. We also developed a Neurophysiological Scoring (NPS system which has utility in the treatment administration. Method and materials Data were gathered prospectively on voice improvement (self-rated 6 point scale, length of response and duration of complications (breathiness, cough, dysphagia and total voice loss. Injections were performed under electromyography (EMG guidance. NPS scale was used to describe the EMG response. Dose and unilateral/bilateral injections were determined by clinical judgment based on previous response. Time intervals between injections were patient driven. Results Low dose unilateral Dysport injection was associated with no significant difference in the patient's outcome in terms of duration of action, voice score (VS and complication rate when compared to bilateral injections. Unilateral injections were not associated with any post treatment total voice loss unlike the bilateral injections. Conclusion Unilateral low dose Dysport injections are recommended in the treatment of adductor spasmodic dysphonia.

Differentiating between adductor and abductor spasmodic dysphonia using airflow interruption

Science.gov (United States)

Hoffman, Matthew R.; Jiang, Jack J.; Rieves, Adam L.; McElveen, Kelsey A.B.; Ford, Charles N.

2009-01-01

Objective To measure the laryngeal resistance (RL), subglottal pressure (Ps), and mean flow rate (MFR) of adductor (ADSD) and abductor (ABSD) spasmodic dysphonia patients using the airflow interrupter. Methods The RL of six ABSD and seven ADSD patients was measured using the airflow interrupter, a noninvasive device designed to measure MFR and Ps via mechanical balloon valve interruption. Subjects performed ten trials at each of two intensity levels, with each trial consisting of a sustained /a/ during which phonation was interrupted for 500 ms. Laryngeal resistance was calculated as subglottal pressure divided by airflow. Results Mean RL for the ADSD and ABSD subtypes at 65 dB were 24.78 cmH2O/l/s and 14.51 cmH2O/l/s, respectively (p = 0.04). Mean RL at 70 dB were 40.02 cmH2O/l/s and 15.84 cmH2O/l/s (p = 0.014). Ps for the ADSD and ABSD subtypes at 65 dB were 10.23 cmH2O and 8.32 cmH2O, respectively (p = 0.582). At the 70 dB level, Ps were 12.39 cmH2O and 11.78 cmH2O (p = 0.886). MFR for the ADSD and ABSD subtypes at 65 dB were 435 ml/s and 746 ml/s (p = 0.205). Mean MFR at 70 dB were 518 ml/s and 848 ml/s (p = 0.198). Conclusion Noninvasive measurements of RL may be useful for differentiating between ADSD and ABSD. This simple objective test which produces a quantitative output could be used to evaluate laryngeal function in patients with spasmodic dysphonia. PMID:19554636

Mutations in THAP1 (DYT6) and generalised dystonia with prominent spasmodic dysphonia: a genetic screening study

DEFF Research Database (Denmark)

Djarmati, Ana; Schneider, Susanne A; Lohmann, Katja

2009-01-01

-onset generalised dystonia with spasmodic dysphonia. This combination of symptoms might be a characteristic feature of DYT6 dystonia and could be useful in the differential diagnosis of DYT1, DYT4, DYT12, and DYT17 dystonia. In addition to the identified mutations, a rare non-coding substitution in THAP1 might...

Liquid-type Botulinum Toxin Type A in Adductor Spasmodic Dysphonia: A Prospective Pilot Study.

Science.gov (United States)

Cha, Wonjae; Jang, Jeon Yeob; Wang, Soo-Geun; Kang, Ji-Heon; Jo, Min-Gyu

2017-05-01

Botulinum toxin (BTX) has been widely used to treat adductor spasmodic dysphonia (ADSD). Most commercially available forms of BTX require reconstitution before use, which may increase the risk of contamination and requires careful titration. Recently, a liquid-type BTX type A (BTX-A) has been developed, which should simplify the procedure and enhance its efficacy. Herein, we present a prospective pilot study to investigate the efficacy and safety of liquid-type BTX-A in the treatment of ADSD. Twenty-six consecutive liquid-type BTX-A injections were performed in 12 patients with ADSD. We included as a control group 34 consecutive patients with ADSD who had previously undergone 52 vocal fold injection procedures with freeze-dried-type BTX-A. All patients in both groups had improvement of symptoms related to ADSD and period of normal voice. Most patients experienced breathiness, and the onset time, the peak response time, and the duration of breathiness were similar in both groups. The duration of effect (days) was 96.96 ± 18.91 and 77.38 ± 18.97 in the freeze-dried-type and the liquid-type groups, and the duration of benefit (days) was 80.02 ± 18.24 and 62.69 ± 19.73 in the freeze-dried-type and the liquid-type groups. To compare the efficacy between the freeze-dried-type and the liquid-type BTX-A, the sessions of the unilateral vocal fold injection were included and were categorized as group A (1 ~ 2 units BTX-A) and group B (2 ~ 3 units BTX-A), according to the dose per vocal fold. There was no significant difference of effect time between freeze-dried-type and liquid-type BTX-A groups. No adverse events related to BTX or vocal fold injection were reported. Liquid-type BTX-A is safe and effective for the treatment of spasmodic dysphonia. With the advantages of simple preparation, storage, and reuse and animal protein-free constituents, liquid-type BTX-A may be a good option in the treatment of spasmodic dysphonia. Copyright © 2017 The

Disease-specific self-efficacy in spasmodic dysphonia patients.

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Hu, Amanda; Isetti, Derek; Hillel, Allen D; Waugh, Patricia; Comstock, Bryan; Meyer, Tanya K

2013-03-01

Self-efficacy (SE) is an optimistic self-belief that one can perform a novel task. This concept involves empowerment, self-esteem, and adaptation to a stressful situation. SE is a strong predictor of health behaviors. Our objectives were to study SE in spasmodic dysphonia (SD) and to develop a disease-specific SE-SD scale. Prospective study. Academic hospital. Disease-specific SE-SD items were developed with laryngologists, speech pathologists, and SD patients. These items, General SE Scale, Voice Handicap Index-10 (VHI-10), Consensus Auditory Perceptual Evaluation of Voice (CAPE-V), and Hospital Anxiety and Depression Scale (HADS), were administered to SD patients who presented for botulinum toxin injections. One hundred forty-five SD patients (mean age 59.5 ± 13.6 years) had a general SE score (Cronbach's α = 0.894) of 33.4 ± 5.2 out of 40. This was negatively correlated with HADS-A (r = -0.42, P < 0.001) and HADS-D (r = -0.42, P < .001), but not correlated with VHI-10 (r = -0.098, P = .243) and CAPE-V (r = -0.047, P = .57). Factor analysis selected 8 items from the general SE scale and 5 disease-specific SE-SD items to generate a 13-item disease-specific SE-SD scale (Cronbach's α = 0.907). Disease-specific SE-SD score was 42.1 ± 6.9 out of 52 and was negatively correlated with VHI-10 (r = -0.19, P = .005), HADS-A (r = -0.43, P < .001), and HADS-D (r = -0.57, P < .001), but not correlated with CAPE-V (r = -0.024, P = .60). SD patients established on botulinum toxin injections have high degrees of general and disease-specific SE. Patients with higher SE-SD demonstrate lower vocal handicap and lower levels of anxiety and depression. A 13-item disease-specific SE-SD scale has been developed.

The Mayo Clinic Arizona Spasmodic Dysphonia Experience: A Demographic Analysis of 718 Patients.

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Patel, Alpen B; Bansberg, Stephen F; Adler, Charles H; Lott, David G; Crujido, Lisa

2015-11-01

Analyze demographic data collected over a 25-year experience of 718 patients with spasmodic dysphonia (SD) who have been treated with botulinum toxin-A (BoNT-A) and compare our data with previously published studies. Seven hundred eighteen patients with SD were treated with 6621 BoNT-A injections at Mayo Clinic Arizona between 1989 and 2014. All patients were treated by the same physician team. Background demographic data for each patient were recorded. Of 718 patients, 557 patients were female (77.6%). Six hundred sixty of 718 (91.8%) patients had adductor SD (AdSD), and 58 of 718 (8.1%) patients had abductor SD (AbSD). Average age of onset was 51 years. Of 718 patients, 378 (52.6%) had vocal tremor (VT); VT was present in 54.4% of AdSD patients and 32.1% of AbSD patients. Thirty-seven of 718 (5.2%) patients had other dystonias, including cervical dystonia (2.3%), blepharospasm (1.4%), limb dystonia (1.1%), and oromandibular dystonia (0.3%). A positive family history of SD was present in only 6 of 718 patients (0.8%) and of other dystonias in 11 of 718 patients (1.5%). Spasmodic dysphonia is a chronic and potentially disabling focal laryngeal dystonia. The Mayo Clinic Arizona SD experience compares to prior reports and reveals a female preponderance, onset in middle age, infrequent hereditary pattern, high co-occurrence of VT, and low co-occurrence of other dystonias. © The Author(s) 2015.

The Consequences of Spasmodic Dysphonia on Communication-Related Quality of Life: A Qualitative Study of the Insider's Experiences

Science.gov (United States)

Baylor, C.R.; Yorkston, K.M.; Eadie, T.L.

2005-01-01

The purpose of this study was to explore the biopsychosocial consequences of spasmodic dysphonia (SD) as experienced by people with SD. Qualitative research methods were used to investigate the insider's perspective of living with SD. Six adults with SD participated in face-to-face phenomenological interviews. The results are summarized in a model…

Botulinum Toxin Dosing Trends in Spasmodic Dysphonia Over a 20-year Period.

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Namin, Arya W; Christopher, Kara M; Eisenbeis, John F

2017-01-01

The study aims to (1) identify the botulinum toxin (BTX) dosing trend in a cohort of patients who received at least 20 injections for the treatment of adductor spasmodic dysphonia (ADSD), (2) describe two distinct BTX dosing trends in treating ADSD (a "classic" dosing trend that initially decreases before stabilizing, and a "fluctuating" dosing trend), and (3) determine if patients with the "classic" dosing trend differed in age or in dosing intervals from those with the "fluctuating" dosing trend. This is a retrospective case series. Of 149 patients who received a total of 2484 BTX injections for the treatment of spasmodic dysphonia in 1993-2013, 49 patients received at least 20 injections. The BTX dose and the interval between doses were recorded. The mean dose of injections 1-20 was determined. The age at initial injection, initial dose, and interval in days between treatments were compared for the "fluctuating" and "classic" groups. The cohort exhibits a significant decrease in dose during the first 10-15 injections. The "fluctuating" group had a significantly shorter interval between injections (mean interval = 97.09 days, SD = 29.41; mean interval = 136.90 days, SD = 43.76, P = 0.002). The mean age at initial dose was not significantly different between the "classic" and "fluctuating" groups. The average BTX dose of patients with ADSD who receive long-term injections significantly decreases during the initial 10-15 injections before stabilizing. Patients who exhibit the "fluctuating" dosing pattern have a significantly shorter interval between injections than those with the "classic" dosing pattern. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Communication‐related affective, behavioral, and cognitive reactions in speakers with spasmodic dysphonia

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Vanryckeghem, Martine

2017-01-01

Objectives To investigate the self‐perceived affective, behavioral, and cognitive reactions associated with communication of speakers with spasmodic dysphonia as a function of employment status. Study Design Prospective cross‐sectional investigation Methods 148 Participants with spasmodic dysphonia (SD) completed an adapted version of the Behavior Assessment Battery (BAB‐Voice), a multidimensional assessment of self‐perceived reactions to communication. The BAB‐Voice consisted of four subtests: the Speech Situation Checklist for A) Emotional Reaction (SSC‐ER) and B) Speech Disruption (SSC‐SD), C) the Behavior Checklist (BCL), and D) the Communication Attitude Test for Adults (BigCAT). Participants were assigned to groups based on employment status (working versus retired). Results Descriptive comparison of the BAB‐Voice in speakers with SD to previously published non‐dysphonic speaker data revealed substantially higher scores associated with SD across all four subtests. Multivariate Analysis of Variance (MANOVA) revealed no significantly different BAB‐Voice subtest scores as a function of SD group status (working vs. retired). Conclusions BAB‐Voice scores revealed that speakers with SD experienced substantial impact of their voice disorder on communication attitude, coping behaviors, and affective reactions in speaking situations as reflected in their high BAB scores. These impacts do not appear to be influenced by work status, as speakers with SD who were employed or retired experienced similar levels of affective and behavioral reactions in various speaking situations and cognitive responses. These findings are consistent with previously published pilot data. The specificity of items assessed by means of the BAB‐Voice may inform the clinician of valid patient‐centered treatment goals which target the impairment extended beyond the physiological dimension. Level of Evidence 2b PMID:29299525

Communication-related affective, behavioral, and cognitive reactions in speakers with spasmodic dysphonia.

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Watts, Christopher R; Vanryckeghem, Martine

2017-12-01

To investigate the self-perceived affective, behavioral, and cognitive reactions associated with communication of speakers with spasmodic dysphonia as a function of employment status. Prospective cross-sectional investigation. 148 Participants with spasmodic dysphonia (SD) completed an adapted version of the Behavior Assessment Battery (BAB-Voice), a multidimensional assessment of self-perceived reactions to communication. The BAB-Voice consisted of four subtests: the Speech Situation Checklist for A) Emotional Reaction (SSC-ER) and B) Speech Disruption (SSC-SD), C) the Behavior Checklist (BCL), and D) the Communication Attitude Test for Adults (BigCAT). Participants were assigned to groups based on employment status (working versus retired). Descriptive comparison of the BAB-Voice in speakers with SD to previously published non-dysphonic speaker data revealed substantially higher scores associated with SD across all four subtests. Multivariate Analysis of Variance (MANOVA) revealed no significantly different BAB-Voice subtest scores as a function of SD group status (working vs. retired). BAB-Voice scores revealed that speakers with SD experienced substantial impact of their voice disorder on communication attitude, coping behaviors, and affective reactions in speaking situations as reflected in their high BAB scores. These impacts do not appear to be influenced by work status, as speakers with SD who were employed or retired experienced similar levels of affective and behavioral reactions in various speaking situations and cognitive responses. These findings are consistent with previously published pilot data. The specificity of items assessed by means of the BAB-Voice may inform the clinician of valid patient-centered treatment goals which target the impairment extended beyond the physiological dimension. 2b.

Botulinum Toxin in Secondarily Nonresponsive Patients with Spasmodic Dysphonia.

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Mor, Niv; Tang, Christopher; Blitzer, Andrew

2016-09-01

Chemodenervation with botulinum toxin (BoNT) has been effective and well tolerated for all types of dystonia for >30 years. We reviewed outcomes of our patients treated with BoNT serotype A (BoNT-A) for spasmodic dysphonia (SD) who became secondarily nonresponsive. We found that 8 of 1400 patients became nonresponsive to BoNT-A (0.57%), which is lower than the secondary nonresponse rate in other dystonias. After a cessation period, 4 of our patients resumed BoNT-A injections, and recurrence of immunoresistance was not seen in any of them. When compared with patients with other dystonias, patients with SD receive extremely low doses of BoNT. Small antigen challenge may explain the lower rate of immunoresistance and long-lasting efficacy after BoNT-A is restarted among secondary nonresponsive patients with SD. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

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Kim, Jae Wook; Park, Jae Hong; Park, Ki Nam; Lee, Seung Won

2014-01-01

Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group). Methods. Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI) before injection and at 1, 3, and 6 months after injection. Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P > 0.05). There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable. PMID:25383369

Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

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Jae Wook Kim

2014-01-01

Full Text Available Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group. Methods. Thirty patients with adductor spasmodic dysphonia (ADSD, who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI before injection and at 1, 3, and 6 months after injection. Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P>0.05. There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

Treatment efficacy of electromyography versus fiberscopy-guided botulinum toxin injection in adductor spasmodic dysphonia patients: a prospective comparative study.

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Kim, Jae Wook; Park, Jae Hong; Park, Ki Nam; Lee, Seung Won

2014-01-01

This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group) and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group). Thirty patients with adductor spasmodic dysphonia (ADSD), who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI) before injection and at 1, 3, and 6 months after injection. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P > 0.05). There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

Long-term voice handicap index after type II thyroplasty using titanium bridges for adductor spasmodic dysphonia.

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Sanuki, Tetsuji; Yumoto, Eiji; Kodama, Narihiro; Minoda, Ryosei; Kumai, Yoshihiko

2014-06-01

To determine the long-term functional outcomes of type II thyroplasty using titanium bridges for adductor spasmodic dysphonia (AdSD) by perceptual analysis using the Voice Handicap Index-10 (VHI-10) and by acoustic analysis. Fifteen patients with AdSD underwent type II thyroplasty using titanium brides between August 2006 and February 2011. VHI-10 scores, a patient-based survey that quantifies a patient's perception of his or her vocal handicap, were determined before and at least 2 years after surgery. Concurrent with the VHI-10 evaluation, acoustic parameters were assessed, including jitter, shimmer, harmonic-to-noise ratio (HNR), standard deviation of F0 (SDF0), and degree of voice breaks (DVB). The average follow-up interval was 30.1 months. No patient had strangulation of the voice, and all were satisfied with the voice postoperatively. In the perceptual analysis, the mean VHI-10 score improved significantly, from 26.7 to 4.1 two years after surgery. All patients had significantly improved each score of three different aspects of VHI-10, representing improved functional, physical, and emotional well-being. All acoustic parameters improved significantly 2 years after surgery. The treatment of AdSD with type II thyroplasty significantly improved the voice-related quality of life and acoustic parameters 2 years after surgery. The results of the study suggest that type II thyroplasty using titanium bridges provides long-term relief of vocal symptoms in patients with AdSD. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Long-term Effect of Sodium Oxybate (Xyrem®) in Spasmodic Dysphonia with Vocal Tremor

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Simonyan, Kristina; Frucht, Steven J.

2013-01-01

Background Symptoms of spasmodic dysphonia (SD) are usually managed successfully with botulinum toxin injections. Vocal tremor (VT), which accompanies SD, has a poor response to this treatment. Case Report We report a case of a female with SD and VT who became symptom-free for 10 months after the intake of a single dose of sodium oxybate (Xyrem®). The long-term treatment effect correlated with attenuated brain activity in the key regions of dystonic brain network. Discussion Our case demonstrates that the novel treatment of sodium oxybate may hold promise for SD patients, especially those who have associated VT. PMID:24386608

Long-Term Effect of Sodium Oxybate (Xyrem® in Spasmodic Dysphonia with Vocal Tremor

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Kristina Simonyan

2013-12-01

Full Text Available Background: Symptoms of spasmodic dysphonia (SD are usually managed successfully with botulinum toxin injections. Vocal tremor (VT, which accompanies SD, has a poor response to this treatment.Case Report: We report a case of a female with SD and VT who became symptom‐free for 10 months after the intake of a single dose of sodium oxybate (Xyrem®. The long‐term treatment effect correlated with attenuated brain activity in the key regions of dystonic brain network. Discussion: Our case demonstrates that the novel treatment of sodium oxybate may hold promise for SD patients, especially those who have associated VT.

Abnormal Structure–Function Relationship in Spasmodic Dysphonia

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Ludlow, Christy L.

2012-01-01

Spasmodic dysphonia (SD) is a primary focal dystonia characterized by involuntary spasms in the laryngeal muscles during speech production. Although recent studies have found abnormal brain function and white matter organization in SD, the extent of gray matter alterations, their structure–function relationships, and correlations with symptoms remain unknown. We compared gray matter volume (GMV) and cortical thickness (CT) in 40 SD patients and 40 controls using voxel-based morphometry and cortical distance estimates. These measures were examined for relationships with blood oxygen level–dependent signal change during symptomatic syllable production in 15 of the same patients. SD patients had increased GMV, CT, and brain activation in key structures of the speech control system, including the laryngeal sensorimotor cortex, inferior frontal gyrus (IFG), superior/middle temporal and supramarginal gyri, and in a structure commonly abnormal in other primary dystonias, the cerebellum. Among these regions, GMV, CT and activation of the IFG and cerebellum showed positive relationships with SD severity, while CT of the IFG correlated with SD duration. The left anterior insula was the only region with decreased CT, which also correlated with SD symptom severity. These findings provide evidence for coupling between structural and functional abnormalities at different levels within the speech production system in SD. PMID:21666131

Alterations in CNS Activity Induced by Botulinum Toxin Treatment in Spasmodic Dysphonia: An H[subscript 2][superscript 15]O PET Study

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Ali, S. Omar; Thomassen, Michael; Schulz, Geralyn M.; Hosey, Lara A.; Varga, Mary; Ludlow, Christy L.; Braun, Allen R.

2006-01-01

Speech-related changes in regional cerebral blood flow (rCBF) were measured using H[subscript 2][superscript 15]O positron-emission tomography in 9 adults with adductor spasmodic dysphonia (ADSD) before and after botulinum toxin (BTX) injection and 10 age- and gender-matched volunteers without neurological disorders. Scans were acquired at rest…

Behavior Assessment Battery: A Pilot Study of the Affective, Behavioral, and Cognitive Correlates Surrounding Spasmodic Dysphonia.

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Vanryckeghem, Martine; Hoffman Ruddy, Bari; Lehman, Jeffrey

2016-01-01

This study investigates if adults with adductor spasmodic dysphonia (ADSD) report to experience anxiety and voice problems in particular situations, indicate the presence of negative speech-associated attitude, and/or the use of coping behaviors, by means of the Behavior Assessment Battery (BAB) modified for voice. Thirty-two participants with ADSD and 32 adults without a voice disorder participated in this study. Each person completed four different BAB-Voice subtests. These standardized self-report tests are adaptations of the original BAB for people who stutter and explore an individual's speech-related belief, negative emotional reaction to and speech problems in particular speech situations, and the use of concomitant behaviors. Individuals with spasmodic dysphonia (SD) scored statistically significantly higher compared to typical speakers on all BAB subtests, indicating that individuals with SD report being significantly more anxious and experiencing significantly more voice problems in particular speech circumstances. They also reported a significant amount of negative speech-associated attitude and the use of a significant number of coping behaviors. Internal reliability was good for three of the four BAB subtests. The BAB is capable of reflecting the dimensions that surround the disorder of SD. The self-report measures have the potential to augment the observations made by the clinician and may lead to a more diverse and all-encompassing therapy for the person suffering from SD. Future research with a revised version of the BAB-Voice will continue to explore the validity, reliability, and replicability of the initial data. Published by Elsevier Inc.

Voice disorders in the workplace: productivity in spasmodic dysphonia and the impact of botulinum toxin.

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Meyer, Tanya K; Hu, Amanda; Hillel, Allen D

2013-11-01

The impact of the disordered voice on standard work productivity measures and employment trends is difficult to quantify; this is in large part due to the heterogeneity of the disease processes. Spasmodic dysphonia (SD), a chronic voice disorder, may be a useful model to study this impact. Self-reported work measures (worked missed, work impairment, overall work productivity, and activity impairment) were studied among patients receiving botulinum toxin (BTX) treatments for SD. It was hypothesized that there would be a substantial difference in work-related measures between the best and worst voicing periods. In addition, job types, employment shifts, and vocal requirements during the course of vocal disability from SD were investigated for each individual, and the impact of SD on these patterns was studied. A total of 145 patients with SD, either adductor or abductor, who were established in routine therapeutic BTX injections agreed to participate in a self-administered questionnaire study. Seventy-two participants were currently working and provided highly detailed information on work-related measures. Their answers characterized the effect of SD on their employment status, productivity at work, activity impairment outside of work, employment retention or change, and whether the individual perceived that BTX therapy affected these measures. Patients were asked to complete the Work Productivity and Activity Impairment (WPAI) instrument to determine these measures for their best and worst voicing weeks over the duration since their previous BTX injection. Voice-specific quality of life instruments (Voice Handicap Index-10) and perceptual assessments (Consensus Auditory Perceptual Evaluation of Voice) were elicited to provide correlations of work measures with patient-perceived voice handicap and clinician-perceived voice quality. Cross-sectional analysis using self-administered questionnaire. A total of 108 patients reported ever working during their diagnosis and

Tracing Spasmodic Dysphonia: The Source of Ludwig Traube's Priority.

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Lorch, Marjorie Perlman; Whurr, Renata

2016-08-01

Since the mid-20th century, one citation is given historical priority as the first description of spasmodic dysphonia (SD): Ludwig Traube's 1871 case of the "spastic form of nervous hoarseness." Our objective is to understand how this case serves as the foundation of understanding laryngeal movement disorders. The original German paper was located and translated. Bibliographical and bibliometric methods are used to determine the citation history of this original source over the past 140 years. Although secondary citations in contemporary publications typically credit Traube for establishing the clinical entity SD, his case does not conform to currently accepted diagnostic features. Citation patterns indicate the source of Traube's priority is publications by Arnold and Luchsinger, mid-20th-century ENT clinicians, particularly their influential 1965 textbook used to train US and UK clinicians on voice disorders for several generations. Sometimes secondary citations in medical literature lead to the inadvertent perpetuation of factual misrepresentation. The clinical picture of Traube's original case does not represent what clinicians would recognize as SD today. The rich 19th-century literature on voice disorders is a valuable resource for present day clinicians. © The Author(s) 2016.

Spasmodic dysphonia follow-up with videolaryngoscopy and voice spectrography during treatment with botulinum toxin.

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Esposito, Marcello; Dubbioso, R; Apisa, P; Allocca, R; Santoro, L; Cesari, U

2015-09-01

Spasmodic dysphonia (SD) is a focal dystonia of laryngeal muscles seriously impairing quality of voice. Adductor SD (ADSD) is the most common presentation of this disorder that can be identified by specialized phoniatricians and neurologists firstly on a clinical evaluation and then confirmed by videolaryngoscopy (VL). Botulinum toxin (BTX) injection with electromyographic guidance in muscles around vocal cords is the most effective treatment. Voice Handicap Index (VHI) questionnaire is the main tool to assess dysphonia and response to treatment. Objective of this study is to perform VL and voice spectrography (VS) to confirm the efficacy of BTX injections over time. 13 patients with ADSD were studied with VHI, VL and VS before and after 4 consecutive treatment with onobotulinumtoxin-A. For each treatment vocal improvement was proved by a significant reduction of VHI score and increase of maximum time phonation and harmonic-to-noise ratio while VL showed the absence of spasm in most of patients. No change of the response to BTX was found between injections. This study supports the efficacy of the treatment of SD with BTX with objective measurements and suggests that the efficacy of recurring treatments is stable over time.

Psychiatric comorbidity in patients with spasmodic dysphonia: a controlled study

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Gündel, H; Busch, R; Ceballos‐Baumann, A; Seifert, E

2007-01-01

Objectives To study the prevalence of psychiatric comorbidity assessed by a structured clinical interview in patients with spasmodic dysphonia (SD) compared with patients suffering from vocal fold paralysis (VFP). Methods In 48 patients with SD and 27 patients with VFP, overall psychiatric comorbidity was studied prospectively using the Structured Clinical Interview for DSM‐IV Axis I disorders. Physical disability and psychometric variables were assessed with standardised self‐rating questionnaires. Results 41.7% of SD subjects and 19.5% of the control group met DSM‐IV clinical criteria for current psychiatric comorbidity (p<0.05). Significant predictors of psychiatric comorbidity in SD were severity of voice impairment and subjective assessment of “satisfaction with health”. As a limitation, the severity of voice impairment in patients with SD was nearly twice as high, and their illness had lasted nearly twice as long. Conclusions We found a high prevalence of psychiatric comorbidity in patients with SD. The significant correlation between current psychiatric comorbidity and the extent of voice pathology may point to an especially strong interaction between somatic and psychiatric complaints in SD. PMID:17615166

Spasmodic Dysphonia in Multiple Sclerosis Treatment With Botulin Toxin A: A Pilot Study.

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Di Stadio, Arianna; Bernitsas, Evanthia; Restivo, Domenico Antonio; Alfonsi, Enrico; Marchese-Ragona, Rosario

2018-04-09

This study aims to evaluate the effect of botulin toxin A in patients with multiple sclerosis (MS) affected by spasmodic dysphonia (SD) and to show the safety and effectiveness of this treatment in long-term observation. This is a pilot study on three relapsing-remitting MS patients with SD and their response to botulin toxin A. None of the patients reported dysphagia or other adverse events. Significant improvement was observed in terms of both voice quality and laryngostroboscopy results. The treatment effect was durable for 6-8 months. Botulin toxin A is a safe treatment that can be successfully used to treat SD in patients with MS. Larger studies are necessary to confirm our results. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

A comparison of the VHI, VHI-10, and V-RQOL for measuring the effect of botox therapy in adductor spasmodic dysphonia.

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Morzaria, Sanjay; Damrose, Edward J

2012-05-01

Although disease-specific quality-of-life (QOL) instruments are an invaluable outcome measure in spasmodic dysphonia, there is no consensus on which QOL instrument should be used. To determine the responsiveness of the Voice Handicap Index (VHI), Voice Handicap Index-10 (VHI-10), and Voice-Related Quality of Life (V-RQOL) to the treatment effect of botulinum toxin (Botox) in adductor spasmodic dysphonia (ADSD). Stanford University Voice and Swallowing Center. Prospective case series (level of evidence=4). Consecutive ADSD patients with a stable Botox dose-response relationship were recruited prospectively. VHI, VHI-10, and V-RQOL scores were obtained pretreatment and during the middle third of the posttreatment injection cycle. Thrity-seven patients completed the follow-up. The average total Botox dose was 0.88 units. The average follow-up time after injection was 7.84 weeks. The pretreatment QOL scores reflected the burden of the disease. All the three instruments were highly correlated in subscale and total scores. After treatment, all three instruments showed significant improvement. The VHI, VHI-10, and V-RQOL all reflected the morbidity associated with ADSD and were significantly responsive to the effect of Botox therapy. The choice of instrument should be based on physician preference. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Spasmodic dysphonia: onset, course, socioemotional effects, and treatment response.

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Tanner, Kristine; Roy, Nelson; Merrill, Ray M; Sauder, Cara; Houtz, Daniel R; Smith, Marshall E

2011-07-01

This investigation explored the onset, progression, socioemotional effects, and treatment outcomes of spasmodic dysphonia (SD). A cross-sectional epidemiological approach was used to examine questionnaire responses from 150 individuals with SD. Symptoms of SD (mean age at onset, 46 years) began gradually in 76% of cases and were progressive (ie, failed to plateau) in 34% of cases. Botulinum toxin A (Botox) helped to attenuate voice symptoms in 91% of cases; however, the scores on the Voice-Related Quality of Life questionnaire (V-RQOL) were not associated with this effect. The V-RQOL scores improved with time since symptom onset, independent of age and treatment. The patients with only SD experienced onset, course, and progression of symptoms similar to those of the patients with SD and coexisting vocal tremor. The symptoms of SD begin gradually and worsen over time. New evidence indicates that SD symptoms may continue to progress without plateau in at least a subset of patients. Individuals with SD and coexisting vocal tremor experience symptom trajectories similar to those of patients with SD only. Although Botox may attenuate voice symptoms, these effects do not appear to be strongly related to the V-RQOL scores. These results provide new and valuable insights regarding the onset, course, progression, and treatment of SD.

Morell Mackenzie's Contribution to the Description of Spasmodic Dysphonia.

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Lorch, Marjorie Perlman; Whurr, Renata

2016-12-01

Since the middle of the 20th century, most discussions of spasmodic dysphonia (SD) reference a paper by Ludwig Traube published in1871 as the first historical citation, crediting him with priority for this clinical syndrome. However, our recent research has determined that the original observation by Traube was published in 1864 and does not in fact describe what is currently recognized as SD. It appears that many clinics throughout Europe and North America were investigating and publishing observations on a range of voice disorders. The wider context of work on laryngeal disorders in the 1860s-1870s is considered. One of Traube's contemporaries, Morell Mackenzie, made significant contributions to the understanding of laryngeal movement disorder and its consequences for the voice. These will be examined to gain a clearer focus on the characterization of this disorder. The clinical descriptions published by Morrell Mackenzie in the 1860s provide details that conform quite closely to our current-day understanding of SD. The citation of Traube's "hysterical" patient links to mid 20th-century views of the functional nature of SD and the utility of psychiatric treatment. The description presented by Mackenzie is consistent with current views of SD as a movement disorder. © The Author(s) 2016.

Laryngeal dystonia gravidarum: sudden onset of adductor spasmodic dysphonia in pregnancy.

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Ankola, Ashish; Sulica, Lucian; Murry, Thomas

2013-12-01

The purpose of this study was to identify the presence or absence of known factors related to onset of adductor spasmodic dysphonia (ADSD) in a population with sudden onset during or after pregnancy. Retrospective review. A review of 350 patient records identified five patients with sudden onset of ADSD related to pregnancy. An age-matched group with sudden onset of ADSD not related to pregnancy served as controls. All subjects completed a 20-question survey of risk factors relevant to ADSD. The average age of onset in both groups was 31 years. Three had onset of ADSD in the postpartum period, the other two during pregnancy. Significantly increased avocational voice use was found in the pregnant group compared to the control group. There was a significant difference in the two groups regarding cumulative risk factors traditionally associated with ADSD. Sudden onset of ADSD can occur in pregnancy in women with clinical profiles that differ from traditional ADSD patients. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Co-Prevalence of Tremor with Spasmodic Dysphonia: A Case-Control Study

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White, Laura; Klein, Adam; Hapner, Edie; Delgaudio, John; Hanfelt, John; Jinnah, H. A.; Johns, Michael

2011-01-01

OBJECTIVES/HYPOTHESIS The aim of this study was to define the co-prevalence of tremor with spasmodic dysphonia (SD). STUDY DESIGN A single institution prospective, case-control study was performed from May 2010 to July 2010. METHODS Consecutive patients with SD (cases) and other voice disorders (controls) were enrolled prospectively. Each participant underwent a voice evaluation and an evaluation for tremor. RESULTS 146 voice disorder controls and 128 patients with SD were enrolled. 26% of patients with SD had vocal tremor, 21% had non-vocal tremor. Patients with SD were 2.8 times more likely to have co-prevalent tremor than the control group (OR = 2.81; 95% CI, 1.55 to 5.08) and only 35% of patients with SD had been seen by a neurologist for the evaluation of dystonia and tremor. CONCLUSIONS Tremor is highly prevalent in patients with SD. It is important for each patient diagnosed with SD to undergo an evaluation for tremor, this is especially important in patients diagnosed with vocal tremor. Level of evidence 3b. PMID:21792965

Central voice production and pathophysiology of spasmodic dysphonia.

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Mor, Niv; Simonyan, Kristina; Blitzer, Andrew

2018-01-01

Our ability to speak is complex, and the role of the central nervous system in controlling speech production is often overlooked in the field of otolaryngology. In this brief review, we present an integrated overview of speech production with a focus on the role of central nervous system. The role of central control of voice production is then further discussed in relation to the potential pathophysiology of spasmodic dysphonia (SD). Peer-review articles on central laryngeal control and SD were identified from PUBMED search. Selected articles were augmented with designated relevant publications. Publications that discussed central and peripheral nervous system control of voice production and the central pathophysiology of laryngeal dystonia were chosen. Our ability to speak is regulated by specialized complex mechanisms coordinated by high-level cortical signaling, brainstem reflexes, peripheral nerves, muscles, and mucosal actions. Recent studies suggest that SD results from a primary central disturbance associated with dysfunction at our highest levels of central voice control. The efficacy of botulinum toxin in treating SD may not be limited solely to its local effect on laryngeal muscles and also may modulate the disorder at the level of the central nervous system. Future therapeutic options that target the central nervous system may help modulate the underlying disorder in SD and allow clinicians to better understand the principal pathophysiology. NA.Laryngoscope, 128:177-183, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Chiropractic Care for a Patient with Spasmodic Dysphonia Associated with Cervical Spine Trauma

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Waddell, Roger K.

2005-01-01

Abstract Objective To discuss the diagnosis and response to treatment of spasmodic dysphonia in a 25-year-old female vocalist following an auto accident. Clinical Features The voice disorder and neck pain appeared after the traumatic incident. Examination of the cervical spine revealed moderate pain, muscle spasm and restricted joint motion at C-1 and C-5 on the left side. Cervical range of motion was reduced on left rotation. Bilateral manual muscle testing of the trapezius and sternocleidomastoid muscles, which share innervation with the laryngeal muscles by way of the spinal accessory nerve, were weak on the left side. Pre and post accident voice range profiles (phonetograms) that measure singing voice quality were examined. The pre- and post-accident phonetograms revealed significant reduction in voice intensity and fundamental frequency as measured in decibels and hertz. Intervention and Outcome Low-force chiropractic spinal manipulative therapy to C-1 and C-5 was employed. Following a course of care, the patient's singing voice returned to normal, as well as a resolution of her musculo- skeletal complaints. Conclusion It appears that in certain cases, the singing voice can be adversely affected if neck or head trauma is severe enough. This case proposes that trauma with irritation to the cervical spine nerve roots as they communicate with the spinal accessory, and in turn the laryngeal nerves, may be contributory in some functional voice disorders or muscle tension dysphonia. PMID:19674642

Treatment of spasmodic dysphonia with a neuromodulating electrical implant.

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Pitman, Michael J

2014-11-01

To investigate the feasibility of an implantable electrical stimulation device to treat spasmodic dysphonia (SD) by neuromodulation of the muscle spindle gamma loop. Prospective case series. Five subjects underwent daily stimulation of the left thyroarytenoid muscle (TA) below the level of α-motor neuron activation (AMNA) for 5 consecutive days. Professional and patient voice evaluations were performed. Transcartilagenous placement of an implantable stimulation device lead was investigated in anesthetized porcine and cadaveric human models. Three of 5 subjects improved in all categories of evaluation. One subject improved in three of four categories. These four subjects described significant carryover of effect after treatment. The fifth subject evidenced improvement until contracting an upper respiratory infection on day 3. Transcartilagenous electrode placement into the porcine TA with muscle stimulation was successful. The electrode lead was passed from the cadaveric larynx to the mastoid tip in the subplatysma layer with an absence of tension. The symptoms of SD improve after electrical stimulation of the TA at levels below AMNA. This is likely through neuromodulation of the muscle spindle gamma loop. Implantation of an electrode into the TA with a postauricular implanted stimulator is feasible with modifications of an already existing device. With further investigation, such a device has the potential to deliver an alternative treatment for SD. 4. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Qualidade de Vida em Voz: estudo na doença de Parkinson idiopática e na Disfonia Espasmódica Adutora Quality of life in voice: a study in Parkinson's disease and in adductor spasmodic dysphonia

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Bárbara Pereira Lopes

2012-01-01

Full Text Available OBJETIVO: avaliar o impacto causado pela alteração vocal na qualidade de vida (QV dos pacientes com doença de Parkinson (DP idiopática e com disfonia espasmódica adutora (DEA. MÉTODO: o estudo foi realizado com 56 indivíduos do sexo feminino, dos quais 28 compunham o grupo controle; 14, o grupo de DEA, no período anterior ao tratamento com toxina botulínica; e 14, o grupo de DP idiopática. Os participantes preencheram o questionário de Qualidade de Vida em Voz (QVV validado para o português brasileiro. Para verificar a diferença entre as médias dos grupos foi utilizado o método de análise de variância por postos de Kruskal-Wallis e o teste de Tamhane para comparações múltiplas, com significância PURPOSE: to evaluate the impact of voice disorders on quality of life of patients with idiopathic Parkinson's disease and with adductor spasmodic dysphonia. METHOD: the study consisted of 56 females, 28 in the control group; 14, the adductor spasmodic dysphonia group in the period prior to treatment with botulinum toxin; and 14, the group of idiopathic Parkinson's disease. The participants filled in the Voice-Related Quality of life (V-RQOL questionnaire validated for Brazilian Portuguese. To check the difference between averages of the groups it was used the method of analysis of variance by Kruskal-Wallis and Tamhane test for multiple comparisons, with significance <0.05. RESULTS: the average age of the groups were 66.18 for the control group, 67.21 for the Parkinson's disease group and 59.7 for the adductor spasmodic dysphonia group, with no statistical difference between the groups. In the V-RQOL protocol the mean domain social-emotional, physical functioning and total score were higher in the control group, followed by group of Parkinson's disease and, finally, the group of adductor spasmodic dysphonia with statistically significant difference between them. In addition, there was statistical difference for each pair of groups

Qualidade de Vida em Voz: estudo na doença de Parkinson idiopática e na disfonia espasmódica adutora Quality of life in voice: a study in Parkinson's disease and in adductor spasmodic dysphonia

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Bárbara Pereira Lopes

2013-04-01

Full Text Available OBJETIVO: avaliar o impacto causado pela alteração vocal na qualidade de vida (QV dos pacientes com doença de Parkinson (DP idiopática e com disfonia espasmódica adutora (DEA. MÉTODO: o estudo foi realizado com 56 indivíduos do sexo feminino, dos quais 28 compunham o grupo controle; 14, o grupo de DEA, no período anterior ao tratamento com toxina botulínica; e 14, o grupo de DP idiopática. Os participantes preencheram o questionário de Qualidade de Vida em Voz (QVV validado para o português brasileiro. Para verificar a diferença entre as médias dos grupos foi utilizado o método de análise de variância por postos de Kruskal-Wallis e o teste de Tamhane para comparações múltiplas, com significância PURPOSE: to evaluate the impact of voice disorders on quality of life of patients with idiopathic Parkinson's disease and with adductor spasmodic dysphonia. METHOD: the study consisted of 56 females, 28 in the control group; 14, the adductor spasmodic dysphonia group in the period prior to treatment with botulinum toxin; and 14, the group of idiopathic Parkinson's disease. The participants filled in the Voice-Related Quality of life (V-RQOL questionnaire validated for Brazilian Portuguese. To check the difference between averages of the groups it was used the method of analysis of variance by Kruskal-Wallis and Tamhane test for multiple comparisons, with significance <0.05. RESULTS: the average age of the groups were 66.18 for the control group, 67.21 for the Parkinson's disease group and 59.7 for the adductor spasmodic dysphonia group, with no statistical difference between the groups. In the V-RQOL protocol the mean domain social-emotional, physical functioning and total score were higher in the control group, followed by group of Parkinson's disease and, finally, the group of adductor spasmodic dysphonia with statistically significant difference between them. In addition, there was statistical difference for each pair of groups

The role of laryngoscopy in the diagnosis of spasmodic dysphonia.

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Daraei, Pedram; Villari, Craig R; Rubin, Adam D; Hillel, Alexander T; Hapner, Edie R; Klein, Adam M; Johns, Michael M

2014-03-01

Spasmodic dysphonia (SD) can be difficult to diagnose, and patients often see multiple physicians for many years before diagnosis. Improving the speed of diagnosis for individuals with SD may decrease the time to treatment and improve patient quality of life more quickly. To assess whether the diagnosis of SD can be accurately predicted through auditory cues alone without the assistance of visual cues offered by laryngoscopic examination. Single-masked, case-control study at a specialized referral center that included patients who underwent laryngoscopic examination as part of a multidisciplinary workup for dysphonia. Twenty-two patients were selected in total: 10 with SD, 5 with vocal tremor, and 7 controls without SD or vocal tremor. The laryngoscopic examination was recorded, deidentified, and edited to make 3 media clips for each patient: video alone, audio alone, and combined video and audio. These clips were randomized and presented to 3 fellowship-trained laryngologist raters (A.D.R., A.T.H., and A.M.K.), who established the most probable diagnosis for each clip. Intrarater and interrater reliability were evaluated using repeat clips incorporated in the presentations. We measured diagnostic accuracy for video-only, audio-only, and combined multimedia clips. These measures were established before data collection. Data analysis was accomplished with analysis of variance and Tukey honestly significant differences. Of patients with SD, diagnostic accuracy was 10%, 73%, and 73% for video-only, audio-only, and combined, respectively (P < .001, df = 2). Of patients with vocal tremor, diagnostic accuracy was 93%, 73%, and 100% for video-only, audio-only, and combined, respectively (P = .05, df = 2). Of the controls, diagnostic accuracy was 81%, 19%, and 62% for video-only, audio-only, and combined, respectively (P < .001, df = 2). The diagnosis of SD during examination is based primarily on auditory cues. Viewing combined audio and video

Comparison of Perceptual Signs of Voice before and after Vocal Hygiene Program in Adults with Dysphonia

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Seyyedeh Maryam khoddami

2011-12-01

Full Text Available Background and Aim: Vocal abuse and misuse are the most frequent causes of voice disorders. Consequently some therapy is needed to stop or modify such behaviors. This research was performed to study the effectiveness of vocal hygiene program on perceptual signs of voice in people with dysphonia.Methods: A Vocal hygiene program was performed to 8 adults with dysphonia for 6 weeks. At first, Consensus Auditory- Perceptual Evaluation of Voice was used to assess perceptual signs. Then the program was delivered, Individuals were followed in second and forth weeks visits. In the last session, perceptual assessment was performed and individuals’ opinions were collected. Perceptual findings were compared before and after the therapy.Results: After the program, mean score of perceptual assessment decreased. Mean score of every perceptual sign revealed significant difference before and after the therapy (p≤0.0001. «Loudness» had maximum score and coordination between speech and respiration indicated minimum score. All participants confirmed efficiency of the therapy.Conclusion: The vocal hygiene program improves all perceptual signs of voice although not equally. This deduction is confirmed by both clinician-based and patient-based assessments. As a result, vocal hygiene program is necessary for a comprehensive voice therapy but is not solely effective to resolve all voice problems.

Value of Laryngeal Electromyography in Spasmodic Dysphonia Diagnosis and Therapy.

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Yang, Qingwen; Xu, Wen; Li, Yun; Cheng, Liyu

2015-07-01

To investigate the role of laryngeal electromyography (LEMG) in the diagnosis and treatment of spasmodic dysphonia (SD). The clinical manifestations, characteristics of motor unit potentials (MUPs), recruitment potentials, and laryngeal nerve evoked potentials (EPs) in LEMG, as well as the changes after botulinum toxin (BTX) treatment, were analyzed in 39 patients with adductor SD. The main clinical manifestations were a strained voice and phonation interruptions; in addition, the patients displayed hyper-adducted vocal folds during phonation. LEMG revealed significantly increased amplitudes of the thyroarytenoid muscle MUPs. The recruitment potentials were in a dense bunch, discharging full interference patterns with significantly increased amplitudes; the mean and maximum amplitude of recruitment potentials were 3090 μV and 5000 μV, respectively. The amplitude of EPs of thyroarytenoid muscle increased significantly; the mean and maximum amplitudes were 10.3 mV and 26.3 mV, respectively. After BTX was injected, the LEMG revealed denervation changes, and the EPs weakened or disappeared in the injected muscle. SD could be diagnosed, and the therapeutic efficacy of SD treatments could be evaluated based on clinical characteristics combined with LEMG characteristics. The increased amplitudes of the recruitment potentials and EPs of the thyroarytenoid muscle were the characteristic indexes. After BTX was injected, denervated potential characteristics appeared in the muscles. © The Author(s) 2015.

Diagnostic Delays in Spasmodic Dysphonia: A Call for Clinician Education.

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Creighton, Francis X; Hapner, Edie; Klein, Adam; Rosen, Ami; Jinnah, Hyder A; Johns, Michael M

2015-09-01

Spasmodic dysphonia (SD) is a rare but often debilitating disease. Due to lack of awareness among practitioners and lack of well-defined diagnostic criteria, it can be difficult for patients with SD to receive a diagnosis and subsequent treatment. There is currently no literature documenting the efficacy of the medical community in recognizing and diagnosing this disorder. We aimed to quantify the patients' experiences with obtaining a diagnosis of SD. One hundred seven consecutive patients with SD completed questionnaires about their experiences with SD. Patients were recruited either during outpatient laryngology visits or during participation in a National Institutes of Health funded study investigating SD. It took patients an average of 4.43 years (53.21 months) to be diagnosed with SD after first going to a physician with vocal symptoms. Patients had to see an average of 3.95 physicians to receive a diagnosis of SD. Patients (31.4%) had been prescribed medications other than botulinum toxin to treat their symptoms. Patients (30%) attempted alternative therapies for treatment of SD, such as chiropractor or dietary modification. Despite advances in diagnostic modalities in medicine, the diagnosis of SD still remains elusive. Objective criteria for the diagnosis of SD and increased clinician education are warranted to address this diagnostic delay. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Análise vocal em pacientes com disfonia espasmódica nos momentos pré e pós tratamento com toxina Botulínica A Vocal analysis in patients with spasmodic dysphonia before and after treatment with Botulinum toxin A

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Ana Cristina Côrtes Gama

2012-10-01

Full Text Available OBJETIVO: avaliar de forma objetiva e subjetiva a voz de pacientes com disfonia espasmódica nos momentos pré e pós aplicação de toxina botulínica A. MÉTODO: as emissões vocais de onze pacientes do sexo feminino foram registradas antes e após (15 dias o tratamento. As amostras vocais foram analisadas por duas fonoaudiólogas com experiência em voz por meio da análise perceptivo-auditiva (escala GRBASI e da análise espectrográfica. RESULTADOS: na análise perceptivo-auditiva com vogal sustentada os parâmetros que alteraram após o tratamento foram o grau de severidade, tensão e instabilidade, enquanto na fala encadeada foram o grau de severidade e a tensão. Na análise espectrográfica ocorreu melhora do traçado após o tratamento sem significância estatística entre os parâmetros. CONCLUSÃO: ocorreu melhora significante dos aspectos perceptivo-auditivos após o tratamento e, portanto, as injeções de toxina botulínica A mostraram-se eficazes no tratamento da disfonia espasmódica no grupo estudado.PURPOSE: to analyze in an objective and subjective manner the voice of patients with spasmodic dysphonia in the moments before and after botulinum toxin A. METHOD: the vocal emissions of eleven women patients were recorded before and after (15 days treatment. The vocal samples were analyzed by two experienced speech therapists through the perceptual analysis (GRBASI scale and spectrographic analysis. RESULTS: in the perceptual analysis with subtended vowel, the altered parameters were degree of severity, strain and instability, while in connected speech only degree of severity and strain changed after treatment. In the perceptual analysis with sustained vowel, the parameters that have changed, were the degree of severity, strain and instability, while in connected speech only degree of severity and strain changed after treatment. The spectrographic analysis was improved after treatment with no statistical significance found among

Risk and protective factors for spasmodic dysphonia: a case-control investigation.

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Tanner, Kristine; Roy, Nelson; Merrill, Ray M; Kimber, Kamille; Sauder, Cara; Houtz, Daniel R; Doman, Darrin; Smith, Marshall E

2011-01-01

Spasmodic dysphonia (SD) is a chronic, incurable, and often disabling voice disorder of unknown pathogenesis. The purpose of this study was to identify possible endogenous and exogenous risk and protective factors uniquely associated with SD. Prospective, exploratory, case-control investigation. One hundred fifty patients with SD and 150 medical controls (MCs) were interviewed regarding their personal and family histories, environmental exposures, illnesses, injuries, voice use patterns, and general health using a previously vetted and validated epidemiologic questionnaire. Odds ratios and multiple logistic regression analyses (α<0.15) identified several factors that significantly increased the likelihood of having SD. These factors included (1) a personal history of mumps, blepharospasm, tremor, intense occupational and avocational voice use, and a family history of voice disorders; (2) an immediate family history of meningitis, tremor, tics, cancer, and compulsive behaviors; and (3) an extended family history of tremor and cancer. SD is likely multifactorial in etiology, involving both genetic and environmental factors. Viral infections/exposures, along with intense voice use, may trigger the onset of SD in genetically predisposed individuals. Future studies should examine the interaction among genetic and environmental factors to determine the pathogenesis of SD. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Inferring speaker attributes in adductor spasmodic dysphonia: ratings from unfamiliar listeners.

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Isetti, Derek; Xuereb, Linnea; Eadie, Tanya L

2014-05-01

To determine whether unfamiliar listeners' perceptions of speakers with adductor spasmodic dysphonia (ADSD) differ from control speakers on the parameters of relative age, confidence, tearfulness, and vocal effort and are related to speaker-rated vocal effort or voice-specific quality of life. Twenty speakers with ADSD (including 6 speakers with ADSD plus tremor) and 20 age- and sex-matched controls provided speech recordings, completed a voice-specific quality-of-life instrument (Voice Handicap Index; Jacobson et al., 1997), and rated their own vocal effort. Twenty listeners evaluated speech samples for relative age, confidence, tearfulness, and vocal effort using rating scales. Listeners judged speakers with ADSD as sounding significantly older, less confident, more tearful, and more effortful than control speakers (p < .01). Increased vocal effort was strongly associated with decreased speaker confidence (rs = .88-.89) and sounding more tearful (rs = .83-.85). Self-rated speaker effort was moderately related (rs = .45-.52) to listener impressions. Listeners' perceptions of confidence and tearfulness were also moderately associated with higher Voice Handicap Index scores (rs = .65-.70). Unfamiliar listeners judge speakers with ADSD more negatively than control speakers, with judgments extending beyond typical clinical measures. The results have implications for counseling and understanding the psychosocial effects of ADSD.

Differences in botulinum toxin dosing between patients with adductor spasmodic dysphonia and essential voice tremor.

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Orbelo, Diana M; Duffy, Joseph R; Hughes Borst, Becky J; Ekbom, Dale; Maragos, Nicolas E

2014-01-01

To explore possible dose differences in average botulinum toxin (BTX) given to patients with adductor spasmodic dysphonia (ADSD) compared with patients with essential voice tremor (EVT). A retrospective study compared the average BTX dose injected in equal doses to the thyroarytenoid (TA) muscles of 51 patients with ADSD with 52 patients with EVT. Those with ADSD received significantly higher total doses (6.80 ± 2.79 units) compared with those with EVT (5.02 ± 1.65 units). Dose at time of first injection, age at time of first injection, gender, year of first injection, and average time between injections were included in multivariate analysis but did not interact with total average dose findings. Patients with ADSD may need relatively higher doses of BTX injections to bilateral TA muscles compared with patients with EVT. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Functional reinnervation of vocal folds after selective laryngeal adductor denervation-reinnervation surgery for spasmodic dysphonia.

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DeConde, Adam S; Long, Jennifer L; Armin, Bob B; Berke, Gerald S

2012-09-01

Selective laryngeal adductor denervation-reinnervation surgery (SLAD-R) offers a viable surgical alternative for patients with adductor spasmodic dysphonia refractory to botulinum toxin injections. SLAD-R selectively denervates the symptomatic thyroarytenoid muscle by dividing the distal adductor branch of the recurrent laryngeal nerve (RLN), and preventing reinnervation, by the proximal RLN and maintaining vocal fold bulk and tone by reinnervating the distal RLN with the ansa cervicalis. We present a patient who had previously undergone successful SLAD-R but presented 10 years postoperatively with a new regional dystonia involving his strap muscles translocated to his reinnervated larynx by his previous ansa-RLN neurorraphy. The patient's symptomatic vocal fold adduction resolved completely on division of the ansa-RLN neurorraphy confirming successful selective functional reinnervation of vocal fold adductors by the ansa cervicalis. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Everyday listeners' impressions of speech produced by individuals with adductor spasmodic dysphonia.

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Nagle, Kathleen F; Eadie, Tanya L; Yorkston, Kathryn M

2015-01-01

Individuals with adductor spasmodic dysphonia (ADSD) have reported that unfamiliar communication partners appear to judge them as sneaky, nervous or not intelligent, apparently based on the quality of their speech; however, there is minimal research into the actual everyday perspective of listening to ADSD speech. The purpose of this study was to investigate the impressions of listeners hearing ADSD speech for the first time using a mixed-methods design. Everyday listeners were interviewed following sessions in which they made ratings of ADSD speech. A semi-structured interview approach was used and data were analyzed using thematic content analysis. Three major themes emerged: (1) everyday listeners make judgments about speakers with ADSD; (2) ADSD speech does not sound normal to everyday listeners; and (3) rating overall severity is difficult for everyday listeners. Participants described ADSD speech similarly to existing literature; however, some listeners inaccurately extrapolated speaker attributes based solely on speech samples. Listeners may draw erroneous conclusions about individuals with ADSD and these biases may affect the communicative success of these individuals. Results have implications for counseling individuals with ADSD, as well as the need for education and awareness about ADSD. Copyright © 2015 Elsevier Inc. All rights reserved.

Effects of type II thyroplasty on adductor spasmodic dysphonia.

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Sanuki, Tetsuji; Yumoto, Eiji; Minoda, Ryosei; Kodama, Narihiro

2010-04-01

Type II thyroplasty, or laryngeal framework surgery, is based on the hypothesis that the effect of adductor spasmodic dysphonia (AdSD) on the voice is due to excessively tight closure of the glottis, hampering phonation. Most of the previous, partially effective treatments have aimed to relieve this tight closure, including recurrent laryngeal nerve section or avulsion, extirpation of the adductor muscle, and botulinum toxin injection, which is currently the most popular. The aim of this study was to assess the effects of type II thyroplasty on aerodynamic and acoustic findings in patients with AdSD. Case series. University hospital. Ten patients with AdSD underwent type II thyroplasty between August 2006 and December 2008. Aerodynamic and acoustic analyses were performed prior to and six months after surgery. Mean flow rates (MFRs) and voice efficiency were evaluated with a phonation analyzer. Jitter, shimmer, the harmonics-to-noise ratio (HNR), standard deviation of the fundamental frequency (SDF0), and degree of voice breaks (DVB) were measured from each subject's longest sustained phonation sample of the vowel /a/. Voice efficiency improved significantly after surgery. No significant difference was found in the MFRs between before and after surgery. Jitter, shimmer, HNR, SDF0, and DVB improved significantly after surgery. Treatment of AdSD with type II thyroplasty significantly improved aerodynamic and acoustic findings. The results of this study suggest that type II thyroplasty provides relief from voice strangulation in patients with AdSD. Copyright 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

Emotional Considerations in Spasmodic Dysphonia: Psychometric Quantification.

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Cannito, Michael P.

1991-01-01

This study examined emotional characteristics of 18 female spasmodic dysphonic subjects in comparison to matched normal controls across psychometric measures of depression, anxiety, and somatic complaints. Statistically significant differences were noted between groups for all measures and over half of the dysphonic subjects exhibited clinically…

Auditory-Perceptual and Acoustic Methods in Measuring Dysphonia Severity of Korean Speech.

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Maryn, Youri; Kim, Hyung-Tae; Kim, Jaeock

2016-09-01

The purpose of this study was to explore the criterion-related concurrent validity of two standardized auditory-perceptual rating protocols and the Acoustic Voice Quality Index (AVQI) for measuring dysphonia severity in Korean speech. Sixty native Korean subjects with various voice disorders were asked to sustain the vowel [a:] and to read aloud the Korean text "Walk." A 3-second midvowel portion of the sustained vowel and two sentences (with 25 syllables) were edited, concatenated, and analyzed according to methods described elsewhere. From 56 participants, both continuous speech and sustained vowel recordings had sufficiently high signal-to-noise ratios (35.5 dB and 37 dB on average, respectively) and were therefore subjected to further dysphonia severity analysis with (1) "G" or Grade from the GRBAS protocol, (2) "OS" or Overall Severity from the Consensus Auditory-Perceptual Evaluation of Voice protocol, and (3) AVQI. First, high correlations were found between G and OS (rS = 0.955 for sustained vowels; rS = 0.965 for continuous speech). Second, the AVQI showed a strong correlation with G (rS = 0.911) as well as OS (rP = 0.924). These findings are in agreement with similar studies dealing with continuous speech in other languages. The present study highlights the criterion-related concurrent validity of these methods in Korean speech. Furthermore, it supports the cross-linguistic robustness of the AVQI as a valid and objective marker of overall dysphonia severity. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Impaired limb proprioception in adults with spasmodic dysphonia

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Konczak, Jürgen; Aman, Joshua E.; Chen, Yu-Wen; Li, Kuan-yi; Watson, Peter J.

2015-01-01

Objectives Focal dystonia of the head, neck are associated with a loss of kinaesthetic acuity at muscles distant from the dystonic sites. That is, while the motor deficits in focal dystonia are confined, the associated somatosensory deficits are generalized. This is the first systematic study to examine, if patients diagnosed with spasmodic dystonia (SD) show somatosensory impairments similar in scope to other forms of focal dystonia. Methods Proprioceptive acuity (ability to discriminate between two stimuli) for forearm position and motion sense was assessed in 14 spasmodic dystonia subjects and 28 age-matched controls using a passive motion apparatus. Psychophysical thresholds, uncertainty area and a proprioceptive acuity index were computed based on the subjects’ verbal responses. Results The main findings are: First, the SD group showed significantly elevated thresholds and uncertainty areas for forearm position sense when compared to the control group. Second, 9 out of 14 dystonia subjects (64%) exhibited an acuity index for position sense above the control group maximum. Three SD subjects had a motion sense acuity index above the control group maximum. Conclusion The results indicate that impaired limb proprioception is a common feature of SD. Like other forms of focal dystonia, spasmodic dystonia does affect the somatosensation of non-dystonic muscle systems. That is, SD is associated with a generalized somatosensory deficit. PMID:25737471

Impaired Limb Proprioception in Adults With Spasmodic Dysphonia.

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Konczak, Jürgen; Aman, Joshua E; Chen, Yu-Wen; Li, Kuan-yi; Watson, Peter J

2015-11-01

Focal dystonia of the head and neck are associated with a loss of kinesthetic acuity at muscles distant from the dystonic sites. That is, while the motor deficits in focal dystonia are confined, the associated somatosensory deficits are generalized. This is the first systematic study to examine, if patients diagnosed with spasmodic dystonia (SD) show somatosensory impairments similar in scope to other forms of focal dystonia. Proprioceptive acuity (ability to discriminate between two stimuli) for forearm position and motion sense was assessed in 14 spasmodic dystonia subjects and 28 age-matched controls using a passive motion apparatus. Psychophysical thresholds, uncertainty area (UA), and a proprioceptive acuity index (AI) were computed based on the subjects' verbal responses. The main findings are as follows: first, the SD group showed significantly elevated thresholds and UAs for forearm position sense compared with the control group. Second, 9 of 14 dystonia subjects (64%) exhibited an AI for position sense above the control group maximum. Three SD subjects had a motion sense AI above the control group maximum. The results indicate that impaired limb proprioception is a common feature of SD. Like other forms of focal dystonia, spasmodic dystonia does affect the somatosensation of nondystonic muscle systems. That is, SD is associated with a generalized somatosensory deficit. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Botulinum Toxin-A Dosing Trends for Adductor Spasmodic Dysphonia at a Single Institution Over 10 Years.

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Bradley, Joseph P; Barrow, Emily M; Hapner, Edie R; Klein, Adam M; Johns, Michael M

2017-05-01

This study aimed to identify the changes in dosing of botulinum toxin-A for adductor spasmodic dysphonia (ADSD) over a prolonged period. This is a retrospective chart review. One hundred thirteen subjects treated for ADSD from 2003 to 2013 were identified from a clinical database. Subject age, gender, and total injection dose amount were all recorded for all subjects who had at least 10 injections. Fifty-four subjects met criteria for inclusion. There were no age or gender differences in the starting dose for subjects. Dosing decreased significantly compared with the second dose (5.05 ± 1.623 Units), by the sixth dose (4.26 ± 1.698 Units), and continued through the 10th dose (4.08 ± 2.019 Units) (P < 0.005 for all). Botulinum toxin-A dosing for ADSD decreases consistently over subsequent injections after the initial two dose titrations. Copyright © 2017. Published by Elsevier Inc.

An open-label study of sodium oxybate in Spasmodic dysphonia.

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Rumbach, Anna F; Blitzer, Andrew; Frucht, Steven J; Simonyan, Kristina

2017-06-01

Spasmodic dysphonia (SD) is a task-specific laryngeal dystonia that affects speech production. Co-occurring voice tremor (VT) often complicates the diagnosis and clinical management of SD. Treatment of SD and VT is largely limited to botulinum toxin injections into laryngeal musculature; other pharmacological options are not sufficiently developed. Open-label study. We conducted an open-label study in 23 SD and 22 SD/VT patients to examine the effects of sodium oxybate (Xyrem), an oral agent with therapeutic effects similar to those of alcohol in these patients. Blinded randomized analysis of voice and speech samples assessed symptom improvement before and after drug administration. Sodium oxybate significantly improved voice symptoms (P = .001) primarily by reducing the number of SD-characteristic voice breaks and severity of VT. Sodium oxybate further showed a trend for improving VT symptoms (P = .03) in a subset of patients who received successful botulinum toxin injections for the management of their SD symptoms. The drug's effects were observed approximately 30 to 40 minutes after its intake and lasted about 3.5 to 4 hours. Our study demonstrated that sodium oxybate reduced voice symptoms in 82.2% of alcohol-responsive SD patients both with and without co-occurring VT. Our findings suggest that the therapeutic mechanism of sodium oxybate in SD and SD/VT may be linked to that of alcohol, and as such, sodium oxybate might be beneficial for alcohol-responsive SD and SD/VT patients. 4 Laryngoscope, 127:1402-1407, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Effect of Botulinum Toxin and Surgery among Spasmodic Dysphonia Patients.

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van Esch, Babette F; Wegner, Inge; Stegeman, Inge; Grolman, Wilko

2017-02-01

Objective The effect of botulinum toxin among patients with adductor spasmodic dysphonia (AdSD) is temporary. To optimize long-term treatment outcome, other therapy options should be evaluated. Alternative treatment options for AdSD comprise several surgical treatments, such as thyroarytenoid myotomy, thyroplasty, selective laryngeal adductor denervation-reinnervation, laryngeal nerve crush, and recurrent laryngeal nerve resection. Here, we present the first systematic review comparing the effect of botulinum toxin with surgical treatment among patients diagnosed with AdSD. Data Sources MEDLINE (PubMed), EMBASE, and the Cochrane Library. Methods Articles were reviewed by 2 independent authors, and data were compiled in tables for analysis of the objective outcome (voice expert evaluation after voice recording), the subjective outcome (patient self-assessment scores), and voice-related quality of life (Voice Health Index scores). Results No clinical trials comparing both treatment modalities were identified. Single-armed studies evaluated either the effect of botulinum toxin or surgical treatment. Thirteen studies reported outcomes after botulinum toxin treatment (n = 419), and 9 studies reported outcomes after surgical treatment (n = 585 patients). A positive effect of bilateral botulinum toxin injections was found for the objective voice outcome, subjective voice outcome, and quality of life. The duration of the beneficial effect ranged from 15 to 18 weeks. Surgical treatment had an overall positive effect on objective voice improvement, subjective voice improvement, and quality of live. Conclusion No preference for one treatment could be demonstrated. Prospective clinical trials comparing treatment modalities are recommended to delineate the optimal outcomes by direct comparison.

The effect of unilateral thalamic deep brain stimulation on the vocal dysfunction in a patient with spasmodic dysphonia: interrogating cerebellar and pallidal neural circuits.

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Poologaindran, Anujan; Ivanishvili, Zurab; Morrison, Murray D; Rammage, Linda A; Sandhu, Mini K; Polyhronopoulos, Nancy E; Honey, Christopher R

2018-02-01

Spasmodic dysphonia (SD) is a neurological disorder of the voice where a patient's ability to speak is compromised due to involuntary contractions of the intrinsic laryngeal muscles. Since the 1980s, SD has been treated with botulinum toxin A (BTX) injections into the throat. This therapy is limited by the delayed-onset of benefits, wearing-off effects, and repeated injections required every 3 months. In a patient with essential tremor (ET) and coincident SD, the authors set out to quantify the effects of thalamic deep brain stimulation (DBS) on vocal function while investigating the underlying motor thalamic circuitry. A 79-year-old right-handed woman with ET and coincident adductor SD was referred to our neurosurgical team. While primarily treating her limb tremor, the authors studied the effects of unilateral, thalamic DBS on vocal function using the Unified Spasmodic Dysphonia Rating Scale (USDRS) and voice-related quality of life (VRQOL). Since dystonia is increasingly being considered a multinodal network disorder, an anterior trajectory into the left thalamus was deliberately chosen such that the proximal contacts of the electrode were in the ventral oralis anterior (Voa) nucleus (pallidal outflow) and the distal contacts were in the ventral intermediate (Vim) nucleus (cerebellar outflow). In addition to assessing on/off unilateral thalamic Vim stimulation on voice, the authors experimentally assessed low-voltage unilateral Vim, Voa, or multitarget stimulation in a prospective, randomized, doubled-blinded manner. The evaluators were experienced at rating SD and were familiar with the vocal tremor of ET. A Wilcoxon signed-rank test was used to study the pre- and posttreatment effect of DBS on voice. Unilateral left thalamic Vim stimulation (DBS on) significantly improved SD vocal dysfunction compared with no stimulation (DBS off), as measured by the USDRS (p dysphonia. A Phase 1 pilot trial (DEBUSSY; clinical trial no. NCT02558634, clinicaltrials.gov) is

Type II thyroplasty changes cortical activation in patients with spasmodic dysphonia.

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Tateya, Ichiro; Omori, Koichi; Kojima, Hisayoshi; Naito, Yasushi; Hirano, Shigeru; Yamashita, Masaru; Ito, Juichi

2015-04-01

Spasmodic dysphonia (SD) is a complex neurological communication disorder characterized by a choked, strain-strangled vocal quality with voice stoppages in phonation. Its symptoms are exacerbated by situations where communication failures are anticipated, and reduced when talking with animals or small children. Symptoms are also reduced following selected forms of treatment. It is reasonable to assume that surgical alteration reducing symptoms would also alter brain activity, though demonstration of such a phenomenon has not been documented. The objective of this study is to reveal brain activity of SD patients before and after surgical treatment. We performed lateralization thyroplasties on three adductor SD patients and compared pre- and post-operative positron emission tomography recordings made during vocalization. Pre-operatively, cordal supplementary motor area (SMA), bilateral auditory association areas, and thalamus were activated while reading aloud. Such activity was not observed in normal subjects. Type II thyroplasty was performed according to Isshiki's method and the strained voice was significantly reduced or eliminated in all three patients. Post-operative PET showed normal brain activation pattern with a significant decrease in cordal SMA, bilateral auditory association areas and thalamus, and a significant increase in rostral SMA compared with pre-operative recordings. This is the first report showing that treatment to a peripheral organ, which reverses voice symptoms, also reverses dysfunctional patterns of the central nervous system in patients with SD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Brain activity related to phonation in young patients with adductor spasmodic dysphonia.

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Kiyuna, Asanori; Maeda, Hiroyuki; Higa, Asano; Shingaki, Kouta; Uehara, Takayuki; Suzuki, Mikio

2014-06-01

This study investigated the brain activities during phonation of young patients with adductor spasmodic dysphonia (ADSD) of relatively short disease duration (<10 years). Six subjects with ADSD of short duration (mean age: 24. 3 years; mean disease duration: 41 months) and six healthy controls (mean age: 30.8 years) underwent functional magnetic resonance imaging (fMRI) using a sparse sampling method to identify brain activity during vowel phonation (/i:/). Intragroup and intergroup analyses were performed using statistical parametric mapping software. Areas of activation in the ADSD and control groups were similar to those reported previously for vowel phonation. All of the activated areas were observed bilaterally and symmetrically. Intergroup analysis revealed higher brain activities in the SD group in the auditory-related areas (Brodmann's areas [BA] 40, 41), motor speech areas (BA44, 45), bilateral insula (BA13), bilateral cerebellum, and middle frontal gyrus (BA46). Areas with lower activation were in the left primary sensory area (BA1-3) and bilateral subcortical nucleus (putamen and globus pallidus). The auditory cortical responses observed may reflect that young ADSD patients control their voice by use of the motor speech area, insula, inferior parietal cortex, and cerebellum. Neural activity in the primary sensory area and basal ganglia may affect the voice symptoms of young ADSD patients with short disease duration. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Perioperative complications and safety of type II thyroplasty (TPII) for adductor spasmodic dysphonia.

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Mizoguchi, Kenji; Hatakeyama, Hiromitsu; Yanagida, Saori; Nishizawa, Noriko; Oridate, Nobuhiko; Fukuda, Satoshi; Homma, Akihiro

2017-05-01

Type II thyroplasty (TPII) is one of the surgical options offered in the management of adductor spasmodic dysphonia (AdSD); however, there have been no detailed reports of its safety and associated complications during the perioperative period. Our aim was to assess the complications and safety of TPII. TPII was performed for consecutive 15 patients with AdSD from April 2012 through May 2014. We examined retrospectively the perioperative complications, the degree of surgical invasion, and recovery process from surgery. All patients underwent successful surgery under only local anesthesia. Vocal fold erythema was observed in 14 patients and vocal fold edema in 10 patients; however, all of them showed complete resolution within 1 month. No patient experienced severe complications such as acute airway distress or hemorrhage. Fourteen patients were able to have oral from the 1st postoperative morning, with the remaining patient able to have oral intake from the 2nd postoperative day. In addition, no patient experienced aspiration postoperatively. In conclusion, only minor complications were observed in association with TPII in this study. No dysphagia was observed postoperatively, which is an advantage over other treatments. The results of our study suggest that TPII is a safe surgical treatment for AdSD.

Vocal Function Exercises for Muscle Tension Dysphonia: Auditory-Perceptual Evaluation and Self-Assessment Rating.

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Jafari, Narges; Salehi, Abolfazl; Izadi, Farzad; Talebian Moghadam, Saeed; Ebadi, Abbas; Dabirmoghadam, Payman; Faham, Maryam; Shahbazi, Mehdi

2017-07-01

Muscle tension dysphonia (MTD) is a functional dysphonia, which appears with an excessive tension in the intrinsic and extrinsic laryngeal musculatures. MTD can affect voice quality and quality of life. The purpose of the present study was to assess the effectiveness of vocal function exercises (VFEs) on perceptual and self-assessment ratings in a group of 15 subjects with MTD. The study comprised 15 subjects with MTD (8 men and 7 women, mean age 39.8 years, standard deviation 10.6, age range 24-62 years). All participants were native Persian speakers who underwent a 6-week course of VFEs. The Voice Handicap Index (VHI) (the self-assessment scale) and Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scale (perceptual rating of voice quality) were used to compare pre- and post-VFEs. GRBAS data of patients before and after VFEs were compared using Wilcoxon signed-rank test, and VHI data of patients pre- and post-VFEs were compared using Student paired t test. These perceptual parameters showed a statistically significant improvement in subjects with MTD after voice therapy (significant at P self-assessment ratings measurements (with the VHI). As a result, the data provide evidence regarding the efficacy of VFEs in the treatment of patients with MTD. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Factors influencing botulinum toxin dose instability in spasmodic dysphonia patients.

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Rosow, David E; Pechman, Amanda; Saint-Victor, Sandra; Lo, Kaming; Lundy, Donna S; Casiano, Roy R

2015-05-01

Many patients with spasmodic dysphonia (SD) see consistent effects from botulinum toxin (BTX) injections of the same dose, whereas others require dosage changes over time. We sought to determine whether demographics (age and gender) or environmental factors (smoking) affect the long-term stability of BTX dosing in these patients. Retrospective review. Charts of all patients undergoing BTX injection for adductor SD were reviewed. Dosage change, defined as whether there was any difference in total dosage used between two beneficial injections, was used as a measure of dosing stability. Beneficial injections were indicated by a voice rating score of at least three of four and any non-zero duration of improved voice. Logistic regression analysis was performed to determine whether age, gender, smoking status, or duration of treatment correlated with odds of having a dosage change. A total of 211 patients were ultimately included. Age, gender, and smoking status were all found to have no correlative effect on dosing stability. The only factor that was predictive of dose stability was the number of previous beneficial injections, as every additional injection led to decreased odds of a change in dosage for the next injection (odds ratio=0.964; 95% confidence interval=0.947-0.981). Dosage of BTX injections for long-term treatment of SD has a significant propensity to remain stable over time. Factors such as age, gender, and smoking status do not appear to influence the dosage stability. These findings should allow for better patient counseling regarding expectations for their long-term treatment. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Auditory-Perceptual Evaluation of Dysphonia: A Comparison Between Narrow and Broad Terminology Systems

DEFF Research Database (Denmark)

Iwarsson, Jenny

2017-01-01

of the terminology used in the multiparameter Danish Dysphonia Assessment (DDA) approach into the five-parameter GRBAS system. Methods. Voice samples illustrating type and grade of the voice qualities included in DDA were rated by five speech language pathologists using the GRBAS system with the aim of estimating...... terms and antagonists, reflecting muscular hypo- and hyperfunction. Key Words: Auditory-perceptual voice analysis–Dysphonia–GRBAS–Listening test–Voice ratings....

Case-control study of risk factors for spasmodic dysphonia: A comparison with other voice disorders.

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Tanner, Kristine; Roy, Nelson; Merrill, Ray M; Sauder, Cara; Houtz, Daniel R; Smith, Marshall E

2012-05-01

This epidemiology study examined risk factors uniquely associated with spasmodic dysphonia (SD). Case-control. A questionnaire was administered to 150 patients with SD (with and without coexisting vocal tremor) and 136 patients with other structural, neurological, and functional voice disorders (excluding SD and vocal tremor). Questions included personal and family medical histories, environmental exposures, trauma, illnesses, voice use habits, and the Short Form 36. Several factors were uniquely associated with SD (α = .05), including: 1) a personal history of cervical dystonia, sinus and throat illnesses, mumps, rubella, dust exposure, and frequent volunteer voice use, 2) a family history of voice disorders, 3) an immediate family history of vocal tremor and meningitis, and 4) an extended family history of head and neck tremor, ocular disease, and meningitis. Vocal tremor coexisted with SD in 29% of cases. Measles and mumps vaccines were protective for SD. SD is likely multifactorial and associated with several endogenous and exogenous factors. Certain viral exposures, voice use patterns, and familial neurological conditions may contribute to the onset of SD later in life. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Shortened cortical silent period in adductor spasmodic dysphonia: evidence for widespread cortical excitability.

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Samargia, Sharyl; Schmidt, Rebekah; Kimberley, Teresa Jacobson

2014-02-07

The purpose of this study was to compare cortical inhibition in the hand region of the primary motor cortex between subjects with focal hand dystonia (FHD), adductor spasmodic dysphonia (AdSD), and healthy controls. Data from 28 subjects were analyzed (FHD n=11, 53.25 ± 8.74 y; AdSD: n=8, 56.38 ± 7.5 y; and healthy controls: n=941.67 ± 10.85 y). All subjects received single pulse TMS to the left motor cortex to measure cortical silent period (CSP) in the right first dorsal interosseus (FDI) muscle. Duration of the CSP was measured and compared across groups. A one-way ANCOVA with age as a covariate revealed a significant group effect (p<0.001). Post hoc analysis revealed significantly longer CSP duration in the healthy group vs. AdSD group (p<0.001) and FHD group (p<0.001). These results suggest impaired intracortical inhibition is a neurophysiologic characteristic of FHD and AdSD. In addition, the shortened CSP in AdSD provides evidence to support a widespread decrease in cortical inhibition in areas of the motor cortex that represent an asymptomatic region of the body. These findings may inform future investigations of differential diagnosis as well as alternative treatments for focal dystonias. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

[A study on vowel duration and word length of adductor spasmodic dysphonia].

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Chen, Zhipeng; Ge, Pingjiang

2016-03-01

To understand the vowel duration and statement reading of the adductor spasmodic dysphonia (ADSD) patients compared with their normal controls, and provide ideas for clinical diagnosis and treatment. Twenty-nine ADSD patients were included in the research, with 31 normal controls. All subjects filled in form voice handicap index (VHI) by themselves. Maximum phonetic time (MPT) and maximum loudness phonetic time(MLPT) were tested on /a/ sound for all patients. Also, all the patients were required to read aloud a standard mandarin assay named , duration were measured with Praat5. 0 software after sounds were collected. A one-way t-test was performed to compare spasmodic group with control group on VHI, MPT, MLPT and duration for reading standard sentences. Pearson/Spearman correlation was tested. Result: The VHI of the 29 ADSD patients is 89±12, and their normal controls 15±16, indicating that the VHI in ADSD group is significantly higher than in the control group(P<0. 01). The MPT of the ADSD group is(16. 9±9. 8 s), and the control group is (25. 3±10.0)s, indicating that MPT in the ADSD group is significantly shorter than the control group(P<0. 01). The MLPT of the ADSD group is (15.7±7. 6)s, and the control group is (26. 5±11. 4)s, indicating that MLPT in the ADSD group is significantly shorter than the control group (P<0. 01). The duration of standard sentence reading of the ADSD group is (55.0±14. 2)s, and the control group is (37. 8±4. 8)s, indicating that the duration of standard sentence reading in the ADSD group is significantly longer than the control group (P<0. 01). Correlation analysis showed that MPT and MLPT are related within the ADSD group(r=0. 697,P< 0.01), other indexes being tested have no significant correlations. The voice disorder condition of the ADSD patients is significantly worse than normal people. Their pronunciations on continuous vowels are not lasting compared with normal people. In the meantime, their ability to read sentences

Clinical experience with patients with spasmodic dysphonia and primary Meige syndrome.

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Pedrero-Escalas, María Fernanda; García-López, Isabel; Santiago-Pérez, Susana; Vivancos, Francisco; Gavilán, Javier

2018-04-28

Meige syndrome (MS) is part of the group of segmental cranial dystonias, which affect more than two cranial muscle groups. Specifically, blepharospasm is associated with another cranial dystonia (oromandibular, cervical or laryngeal). The aim of this paper was to report our experience in patients with spasmodic dysphonia (SD) associated with primary MS. A retrospective study involving 8 patients between May 2010 and June 2015. Variables recorded were: age, sex, associated dystonia, electromyographic pattern in laryngeal muscles and treatment given. Outcomes after treatment were assessed using GRBAS(i) scale and VHI-30 questionnaire, always provided by the same examiner. Fifty-six patients with MS were treated in the Neurology Department. Eight patients of 56 were diagnosed with SD (prevalence of 14%). All of our patients had adductor SD. The median age was 71years. All the patients were treated with intralaryngeal botulinum toxin under electromyographic control. Clinically relevant improvements were found after treatment on both the GRBAS(i) scale and the VHI-30 questionnaire. In the study of SD, we should always rule out an association with MS. From the point of view of otorhinolaryngology, the joint use of the GRBAS(i) scale and the VHI-30 questionnaire are useful, reliable and efficient methods for assessing progress and response to treatment. Laryngeal infiltration under electromyographic control with botulinum toxin is the therapeutic alternative that provides better results. The management of SD associated with MS does not differ from isolated SD. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

Cortical sensorimotor alterations classify clinical phenotype and putative genotype of spasmodic dysphonia

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Battistella, Giovanni; Fuertinger, Stefan; Fleysher, Lazar; Ozelius, Laurie J.; Simonyan, Kristina

2017-01-01

Background Spasmodic dysphonia (SD), or laryngeal dystonia, is a task-specific isolated focal dystonia of unknown causes and pathophysiology. Although functional and structural abnormalities have been described in this disorder, the influence of its different clinical phenotypes and genotypes remains scant, making it difficult to explain SD pathophysiology and to identify potential biomarkers. Methods We used a combination of independent component analysis and linear discriminant analysis of resting-state functional MRI data to investigate brain organization in different SD phenotypes (abductor vs. adductor type) and putative genotypes (familial vs. sporadic cases) and to characterize neural markers for genotype/phenotype categorization. Results We found abnormal functional connectivity within sensorimotor and frontoparietal networks in SD patients compared to healthy individuals as well as phenotype- and genotype-distinct alterations of these networks, involving primary somatosensory, premotor and parietal cortices. The linear discriminant analysis achieved 71% accuracy classifying SD and healthy individuals using connectivity measures in the left inferior parietal and sensorimotor cortex. When categorizing between different forms of SD, the combination of measures from left inferior parietal, premotor and right sensorimotor cortices achieved 81% discriminatory power between familial and sporadic SD cases, whereas the combination of measures from the right superior parietal, primary somatosensory and premotor cortices led to 71% accuracy in the classification of adductor and abductor SD forms. Conclusions Our findings present the first effort to identify and categorize isolated focal dystonia based on its brain functional connectivity profile, which may have a potential impact on the future development of biomarkers for this rare disorder. PMID:27346568

An open-label study of sodium oxybate (Xyrem®) in spasmodic dysphonia

Science.gov (United States)

Rumbach, Anna F.; Blitzer, Andrew; Frucht, Steven J.; Simonyan, Kristina

2016-01-01

Objective Spasmodic dysphonia (SD) is a task-specific laryngeal dystonia that affects speech production. Co-occurring voice tremor (VT) often complicates the diagnosis and clinical management of SD. Treatment of SD and VT is largely limited to botulinum toxin injections into laryngeal musculature; other pharmacological options are not sufficiently developed. Study Design and Methods We conducted an open-label study in 23 SD and 22 SD/VT patients to examine the effects of sodium oxybate (Xyrem®), an oral agent with therapeutic effects similar to those of alcohol in these patients. Blinded randomized analysis of voice and speech samples assessed symptom improvement before and after drug administration. Results Sodium oxybate significantly improved voice symptoms (p = 0.001) primarily by reducing the number of SD-characteristic voice breaks and severity of VT. Sodium oxybate further showed a trend for improving VT symptoms (p = 0.03) in a subset of patients who received successful botulinum toxin injections for the management of their SD symptoms. The drug’s effects were observed approximately 30–40 min after its intake and lasted about 3.5–4 hours. Conclusion Our study demonstrated that sodium oxybate reduced voice symptoms in 82.2% of alcohol-responsive SD patients both with and without co-occurring VT. Our findings suggest that the therapeutic mechanism of sodium oxybate in SD and SD/VT may be linked to that of alcohol and as such sodium oxybate might be beneficial for alcohol-responsive SD and SD/VT patients. PMID:27808415

Cortical sensorimotor alterations classify clinical phenotype and putative genotype of spasmodic dysphonia.

Science.gov (United States)

Battistella, G; Fuertinger, S; Fleysher, L; Ozelius, L J; Simonyan, K

2016-10-01

Spasmodic dysphonia (SD), or laryngeal dystonia, is a task-specific isolated focal dystonia of unknown causes and pathophysiology. Although functional and structural abnormalities have been described in this disorder, the influence of its different clinical phenotypes and genotypes remains scant, making it difficult to explain SD pathophysiology and to identify potential biomarkers. We used a combination of independent component analysis and linear discriminant analysis of resting-state functional magnetic resonance imaging data to investigate brain organization in different SD phenotypes (abductor versus adductor type) and putative genotypes (familial versus sporadic cases) and to characterize neural markers for genotype/phenotype categorization. We found abnormal functional connectivity within sensorimotor and frontoparietal networks in patients with SD compared with healthy individuals as well as phenotype- and genotype-distinct alterations of these networks, involving primary somatosensory, premotor and parietal cortices. The linear discriminant analysis achieved 71% accuracy classifying SD and healthy individuals using connectivity measures in the left inferior parietal and sensorimotor cortices. When categorizing between different forms of SD, the combination of measures from the left inferior parietal, premotor and right sensorimotor cortices achieved 81% discriminatory power between familial and sporadic SD cases, whereas the combination of measures from the right superior parietal, primary somatosensory and premotor cortices led to 71% accuracy in the classification of adductor and abductor SD forms. Our findings present the first effort to identify and categorize isolated focal dystonia based on its brain functional connectivity profile, which may have a potential impact on the future development of biomarkers for this rare disorder. © 2016 EAN.

Long term results of childhood dysphonia treatment.

Science.gov (United States)

Mackiewicz-Nartowicz, Hanna; Sinkiewicz, Anna; Bielecka, Arleta; Owczarzak, Hanna; Mackiewicz-Milewska, Magdalena; Winiarski, Piotr

2014-05-01

The aim of this study was to assess the long term results of treatment and rehabilitation of childhood dysphonia. This study included a group of adolescents (n=29) aged from 15 to 20 who were treated due to pediatric hyperfunctional dysphonia and soft vocal fold nodules during their pre-mutational period (i.e. between 5 and 12 years of age). The pre-mutational therapy was comprised of proper breathing pattern training, voice exercises and psychological counseling. Laryngostroboscopic examination and perceptual analysis of voice were performed in each patient before treatment and one to four years after mutation was complete. The laryngostroboscopic findings, i.e. symmetry, amplitude, mucosal wave and vocal fold closure, were graded with NAPZ scale, and the GRBAS scale was used for the perceptual voice analysis. Complete regression of the childhood dysphonia was observed in all male patients (n=14). Voice disorders regressed completely also in 8 out of 15 girls, but symptoms of dysphonia documented on perceptual scale persisted in the remaining seven patients. Complex voice therapy implemented in adolescence should be considered as either the treatment or preventive measure of persistent voice strain, especially in girls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Coprevalence of Anxiety and Depression With Spasmodic Dysphonia: A Case-Control Study

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White, Laura J.; Hapner, Edie R.; Klein, Adam M.; Delgaudio, John M.; Hanfelt, John J.; Jinnah, H. A.; Johns, Michael M.

2012-01-01

Summary Introduction There is evidence supporting an association between depression and anxiety in patients with chronic disease. Spasmodic dysphonia (SD) is a chronic, incurable, and disabling voice disorder. Reported rates of depression and anxiety in SD range from 7.1% to 72%, with a maximum number of 18 patients. The goal of this study was to define the coprevalence of depression and anxiety with SD. Materials and Methods A single-institution case-control study was performed from May to July 2010. Consecutive patients with SD and benign voice disorders were enrolled prospectively. On enrollment, patients were asked to fill out a questionnaire that reviewed the duration of the voice disorder and personal history of anxiety and depression, including current and lifetime diagnosis. Results One hundred forty-six controls with benign voice disorders and 128 patients with SD were enrolled. Patients with SD were no more likely to be diagnosed with depression or anxiety than those of the control group (odds ratio [OR] = 0.985, 95% confidence interval [CI] = 0.59–1.63; and OR = 1.314; 95% CI 0.75–2.3, respectively). Additionally, duration of disease was a risk factor for depression in both the SD group and the control group, and the association was not significantly different between groups. Conclusion Patients with SD were no more likely to have depression or anxiety than those with other voice disorders. It is important for otolaryngologists to be aware of the increased rates of depression in patients diagnosed with chronic diseases, including voice disorders, and to refer to a psychiatrist when appropriate. PMID:22209056

Coprevalence of anxiety and depression with spasmodic dysphonia: a case-control study.

Science.gov (United States)

White, Laura J; Hapner, Edie R; Klein, Adam M; Delgaudio, John M; Hanfelt, John J; Jinnah, H A; Johns, Michael M

2012-09-01

There is evidence supporting an association between depression and anxiety in patients with chronic disease. Spasmodic dysphonia (SD) is a chronic, incurable, and disabling voice disorder. Reported rates of depression and anxiety in SD range from 7.1% to 72%, with a maximum number of 18 patients. The goal of this study was to define the coprevalence of depression and anxiety with SD. A single-institution case-control study was performed from May to July 2010. Consecutive patients with SD and benign voice disorders were enrolled prospectively. On enrollment, patients were asked to fill out a questionnaire that reviewed the duration of the voice disorder and personal history of anxiety and depression, including current and lifetime diagnosis. One hundred forty-six controls with benign voice disorders and 128 patients with SD were enrolled. Patients with SD were no more likely to be diagnosed with depression or anxiety than those of the control group (odds ratio [OR]=0.985, 95% confidence interval [CI]=0.59-1.63; and OR=1.314; 95% CI=0.75-2.3, respectively). Additionally, duration of disease was a risk factor for depression in both the SD group and the control group, and the association was not significantly different between groups. Patients with SD were no more likely to have depression or anxiety than those with other voice disorders. It is important for otolaryngologists to be aware of the increased rates of depression in patients diagnosed with chronic diseases, including voice disorders, and to refer to a psychiatrist when appropriate. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Minithyrotomy with radiofrequency-induced thermotherapy for the treatment of adductor spasmodic dysphonia.

Science.gov (United States)

Desai, Shaun C; Park, Andrea M; Chernock, Rebecca D; Paniello, Randal C

2016-10-01

A simple, safe and effective surgical alternative for treating adductor spasmodic dysphonia (ADSD) would appeal to many patients. This study evaluates a new option, using radiofrequency-induced thermotherapy (RFITT) of the thyroarytenoid muscle (TA) via the minithyrotomy approach to reduce the force of adduction. Fifteen dogs were used. In part 1, the optimal RFITT power settings, exposure time, probe location, and number of passes were determined. Part 2 compared laryngeal adductor pressures (LAPs) at baseline; immediately postintervention; and at 1, 3, or 6 months postintervention. Interventions included RFITT via the transcervical minithyrotomy approach (n = 15), transoral RFITT (n = 3), botulinum toxin (Botox) injection (n = 3), or no-intervention controls (n = 3). Postintervention induced phonation and histologic analyses were performed as well. In the minithyrotomy RFITT group, the mean LAP was 30.3% of baseline immediately posttreatment. At 1, 3, and 6 months postoperatively, the mean LAPs were 24.9%, 44.8%, and 43.5%, respectively. Transoral RFITT reduced LAP to 56.6% of baseline immediately posttreatment, but returned to normal in the 1 and 3 month animals. The Botox injections dropped the LAP to 57% of baseline at 1 month, but returned to normal at 3 months. Mucosal waves, based on induced phonation stroboscopy, were present at the terminal date in all animals. Thirteen of 15 transcervical RFITT preparations (87%) showed no injury to the lamina propria, whereas 80% showed evidence of TA muscle atrophy and fibrosis. Minithyrotomy RFITT is a feasible technique that shows encouraging long-term results for the potential treatment of patients with ADSD. N/A. Laryngoscope, 126:2325-2329, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

The Comparison of Thyroarytenoid Muscle Myectomy and Type II Thyroplasty for Spasmodic Dysphonia.

Science.gov (United States)

Nomoto, Masaki; Tokashiki, Ryoji; Hiramatsu, Hiroyuki; Konomi, Ujimoto; Motohashi, Rei; Sakurai, Eriko; Toyomura, Fumimasa; Ueda, Yuri; Inoue, Shun; Tsukahara, Kiyoaki; Suzuki, Mamoru

2015-07-01

Surgical treatments for adductor spasmodic dysphonia include bilateral thyroarytenoid muscle myectomy (TAM) and type II thyroplasty (TPII), both of which are commonly performed. The present study aimed to compare the effects of TAM and TPII. Retrospective study. Subjects were 30 and 35 patients who underwent TAM and TPII, between March 2008 and November 2012. Voice quality was evaluated based on "voice handicap index 10 (VHI10)" and auditory impressions before and 6 months after surgery using five parameters: "strangulation," "interruption," "tremor," "grade," and "breathiness." Comparison of the two procedures revealed significant improvements in VHI10, strangulation, interruption, and tremor, and a significant decline in breathiness after surgery. In particular, VHI10 was improved by more than six points in 90% of patients with TAM, and 96% with TPII. No significant difference was observed between the severities of two procedures preoperatively. Comparison of each postoperative score between the two procedures revealed that TAM significantly improved strangulation, interruption, and tremor, and significantly worsened breathiness, with no significant difference in VHI10. Scatter plots (x: preoperative scores; y: postoperative scores) and regression lines of evaluation items demonstrated that TAM is more effective than TPII in severe cases. Compared with TPII, TAM tends to improve strangulation, interruption, and tremor; however, it tends to worsen breathiness postoperatively. Postoperative VHI10 scores did not differ significantly between the two procedures. Given favorable improvement rates, both surgical procedures were considered effective. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Botulinum toxin treatment of false vocal folds in adductor spasmodic dysphonia: Functional outcomes.

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Simpson, C Blake; Lee, Christopher T; Hatcher, Jeanne L; Michalek, Joel

2016-01-01

Supraglottic injection of botulinum toxin (Botox) has been described as an effective treatment for adductor spasmodic dysphonia (ADSD). Anecdotal evidence suggests that the patients have little to no breathiness after injection, but no formal longitudinal studies have been carried out to date. The purpose of this study was to examine the voice outcomes in patients with ADSD after supraglottic Botox injection. Retrospective case series. Patients with ADSD who were treated with supraglottic Botox injections completed a qualitative self-evaluation of voice function after injection using the percentage of normal function (PNF) scale, a validated, quantitative scale from 0% (no function) to 100% (normal function). Posttreatment voice improvement after injection was determined using a Voice Handicap Index-10 (VHI-10) questionnaire. A total of 198 supraglottic injections were performed between July 2011 and October 2014. Twenty-five questionnaires were completed. Mean postinjection PNF was 95.0% ± 8.4% and was significantly increased from the preinjection mean PNF (62.5%) ± 22.6% (P < 0.001). The mean best VHI-10 for all injections was 7.23. In 19 of 25 patients (76%), there was no reduction in PNF in the early postinjection period. In the remaining six patients (24%), the decline in mean vocal function was 9.2%. Supraglottic Botox injection is an effective treatment for ADSD. Postinjection voice is significantly improved, and the majority of patients do not experience breathy voice/decline in vocal function after injection. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Patient perceptions of factors leading to spasmodic dysphonia: a combined clinical experience of 350 patients.

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Childs, Lesley; Rickert, Scott; Murry, Thomas; Blitzer, Andrew; Sulica, Lucian

2011-10-01

Spasmodic dysphonia (SD) is an idiopathic voice disorder that is characterized by either a strained, strangled voice quality or a breathy voice with aphonic segments of connected speech. It has been suggested that environmental factors play a role in triggering the onset. Clinical observation suggests that some patients associate onset with specific events or factors while others do not. The purpose of this study was to examine a large database of SD patients to determine if specific triggers are associated with the onset of SD. Retrospective chart review. A total of 350 charts of patients with SD were identified and were categorized as either "sudden onset" or "gradual onset." One hundred sixty-nine recalled their circumstances surrounding onset. Forty-five percent of these patients described the onset as sudden. Patient perceptions of inciting events in the sudden onset group were identified 77% of the time and 2% of the time in the gradual onset group. The most common factors identified were stress (42%), upper respiratory infection (33%), and pregnancy and parturition (10%). Thirty-five percent of SD patients perceive their disorder to have a sudden onset with identified inciting events. This prevalence raises questions regarding possible behavioral and environmental factors surrounding the onset of this disorder. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

Abnormal motor cortex excitability during linguistic tasks in adductor-type spasmodic dysphonia.

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Suppa, A; Marsili, L; Giovannelli, F; Di Stasio, F; Rocchi, L; Upadhyay, N; Ruoppolo, G; Cincotta, M; Berardelli, A

2015-08-01

In healthy subjects (HS), transcranial magnetic stimulation (TMS) applied during 'linguistic' tasks discloses excitability changes in the dominant hemisphere primary motor cortex (M1). We investigated 'linguistic' task-related cortical excitability modulation in patients with adductor-type spasmodic dysphonia (ASD), a speech-related focal dystonia. We studied 10 ASD patients and 10 HS. Speech examination included voice cepstral analysis. We investigated the dominant/non-dominant M1 excitability at baseline, during 'linguistic' (reading aloud/silent reading/producing simple phonation) and 'non-linguistic' tasks (looking at non-letter strings/producing oral movements). Motor evoked potentials (MEPs) were recorded from the contralateral hand muscles. We measured the cortical silent period (CSP) length and tested MEPs in HS and patients performing the 'linguistic' tasks with different voice intensities. We also examined MEPs in HS and ASD during hand-related 'action-verb' observation. Patients were studied under and not-under botulinum neurotoxin-type A (BoNT-A). In HS, TMS over the dominant M1 elicited larger MEPs during 'reading aloud' than during the other 'linguistic'/'non-linguistic' tasks. Conversely, in ASD, TMS over the dominant M1 elicited increased-amplitude MEPs during 'reading aloud' and 'syllabic phonation' tasks. CSP length was shorter in ASD than in HS and remained unchanged in both groups performing 'linguistic'/'non-linguistic' tasks. In HS and ASD, 'linguistic' task-related excitability changes were present regardless of the different voice intensities. During hand-related 'action-verb' observation, MEPs decreased in HS, whereas in ASD they increased. In ASD, BoNT-A improved speech, as demonstrated by cepstral analysis and restored the TMS abnormalities. ASD reflects dominant hemisphere excitability changes related to 'linguistic' tasks; BoNT-A returns these excitability changes to normal. © 2015 Federation of European Neuroscience Societies and John

Whispering dysphonia (DYT4 dystonia) is caused by a mutation in the TUBB4 gene

NARCIS (Netherlands)

Lohmann, Katja; Wilcox, Robert A.; Winkler, Susen; Ramirez, Alfredo; Rakovic, Aleksandar; Park, Jin-Sung; Arns, Björn; Lohnau, Thora; Groen, Justus; Kasten, Meike; Brüggemann, Norbert; Hagenah, Johann; Schmidt, Alexander; Kaiser, Frank J.; Kumar, Kishore R.; Zschiedrich, Katja; Alvarez-Fischer, Daniel; Altenmüller, Eckart; Ferbert, Andreas; Lang, Anthony E.; Münchau, Alexander; Kostic, Vladimir; Simonyan, Kristina; Agzarian, Marc; Ozelius, Laurie J.; Langeveld, Antonius P. M.; Sue, Carolyn M.; Tijssen, Marina A. J.; Klein, Christine

2013-01-01

OBJECTIVE: A study was undertaken to identify the gene underlying DYT4 dystonia, a dominantly inherited form of spasmodic dysphonia combined with other focal or generalized dystonia and a characteristic facies and body habitus, in an Australian family. METHODS: Genome-wide linkage analysis was

Whispering dysphonia (DYT4 dystonia) is caused by a mutation in the TUBB4 gene

NARCIS (Netherlands)

Lohmann, Katja; Wilcox, Robert A.; Winkler, Susen; Ramirez, Alfredo; Rakovic, Aleksandar; Park, Jin-Sung; Arns, Bjoern; Lohnau, Thora; Kasten, Meike; Brueggemann, Norbert; Hagenah, Johann; Schmidt, Alexander; Kaiser, Frank J.; Kumar, Kishore R.; Zschiedrich, Katja; Alvarez-Fischer, Daniel; Altenmueller, Eckart; Ferbert, Andreas; Lang, Anthony E.; Muenchau, Alexander; Kostic, Vladimir; Simonyan, Kristina; Agzarian, Marc; Ozelius, Laurie J.; Langeveld, Antonius P. M.; Sue, Carolyn M.; Tijssen, Marina A. J.; Klein, Christine; Groen, Justus

Objective A study was undertaken to identify the gene underlying DYT4 dystonia, a dominantly inherited form of spasmodic dysphonia combined with other focal or generalized dystonia and a characteristic facies and body habitus, in an Australian family. Methods Genome-wide linkage analysis was carried

Validation of a telephone screening tool for spasmodic dysphonia and vocal fold tremor.

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Johnson, David M; Hapner, Edie R; Klein, Adam M; Pethan, Madeleine; Johns, Michael M

2014-11-01

The objective of this study was to ascertain whether clinicians can reliably distinguish between spasmodic dysphonia (SD)/vocal tremor and other voice disorders by telephone, despite this modality's limited frequency response. Randomized, single-blinded, and prospective study. Voice-disordered patients with (n = 22) and without (n = 17) SD and/or vocal tremor recorded standardized utterances via landline telephone. A laryngologist and two speech-language pathologists blinded to the diagnoses rated each recording as "yes" or "no" to "SD or tremor present?," and if "yes" categorized into adductor, abductor, tremor only, or adductor with tremor subtypes. Twenty-one recordings were presented twice at random so intrarater reliability could be assessed. All ratings were compared with gold standard diagnosis by a second laryngologist who performed a full examination, including videostroboscopy, on each patient. For the comparison "SD or tremor" yes versus no, sensitivity, specificity, positive predictive value, and negative predictive value are 90%, 95%, 96%, and 89%, respectively. Interrater reliability (Cohen kappa) compared with the gold standard ranged from 0.70 to 0.93 (substantial to almost perfect agreement). Cronbach alpha among three raters was 0.90 for this comparison. Intrarater reliability (number matched/number inspected) was very high, ranging from 0.97 to 1.0. Comparing gold standard and telephone rating of SD/tremor subtypes, kappa ranged from 0.48 to 0.60 (moderate agreement). Cronbach alpha among three raters was 0.88 for this comparison. Intrarater reliability ranged from 0.84 to 0.97. SD and tremor can be reliably distinguished from other voice disorders over the telephone. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Considerations for initial dosing of botulinum toxin in treatment of adductor spasmodic dysphonia.

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Rosow, David E; Parikh, Punam; Vivero, Richard J; Casiano, Roy R; Lundy, Donna S

2013-06-01

To assess the effect on voice improvement and duration of breathiness based on initial dose of onabotulinum toxin A (BTX-A) in the management of adductor spasmodic dysphonia (SD) and to compare voice outcomes for initial bilaterally injected doses of 1.25 units (group A) vs 2.5 units (group B) of BTX-A. Case series with chart review of patients with adductor SD treated at a tertiary care facility from 1990 to 2011. Academic subspecialty laryngology practice. Demographic data (age and sex), voice rating, duration of voice improvement, and breathiness were evaluated and compared between groups A and B using the Student t test and χ(2) analysis. Of 478 patients identified, 305 (223 in group A, 82 in group B) patients met inclusion criteria. The average age was 56.2 years in group A and 57.4 years in group B (P = .5). The female to male ratio was 2.91 for group A vs 3.56 for group B (P = .61). Good voice outcomes (grade 3 or 4) were reported by 91% of group A patients vs 94% of group B (P = .75). The average duration of voice improvement was 99.7 days for group A and 108.3 days for group B (P = .54). The average duration of breathiness was 10.88 days for group A vs 15.42 days for group B (P = .02). Patients injected with 1.25 units bilaterally had a statistically significant shorter duration of breathiness without a statistically significant difference in clinical effectiveness or voice outcome. It is therefore recommended that a relatively low initial BTX-A dose be used with subsequent titration to achieve improved voice outcomes.

Neural correlates of dystonic tremor: A multimodal study of voice tremor in spasmodic dysphonia

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Kirke, Diana N.; Battistella, Giovanni; Kumar, Veena; Rubien-Thomas, Estee; Choy, Melissa; Rumbach, Anna; Simonyan, Kristina

2016-01-01

Tremor, affecting a dystonic body part, is a frequent feature of adult-onset dystonia. However, our understanding of dystonic tremor pathophysiology remains ambiguous, as its interplay with the main co-occurring disorder, dystonia, is largely unknown. We used a combination of functional MRI, voxel-based morphometry and diffusion-weighted imaging to investigate similar and distinct patterns of brain functional and structural alterations in patients with dystonic tremor of voice (DTv) and isolated spasmodic dysphonia (SD). We found that, compared to controls, SD patients with and without DTv showed similarly increased activation in the sensorimotor cortex, inferior frontal (IFG) and superior temporal gyri, putamen and ventral thalamus, as well as deficient activation in the inferior parietal cortex and middle frontal gyrus (MFG). Common structural alterations were observed in the IFG and putamen, which were further coupled with functional abnormalities in both patient groups. Abnormal activation in left putamen was correlated with SD onset; SD/DTv onset was associated with right putaminal volumetric changes. DTv severity established a significant relationship with abnormal volume of the left IFG. Direct patient group comparisons showed that SD/DTv patients had additional abnormalities in MFG and cerebellar function and white matter integrity in the posterior limb of the internal capsule. Our findings suggest that dystonia and dystonic tremor, at least in the case of SD and SD/DTv, are heterogeneous disorders at different ends of the same pathophysiological spectrum, with each disorder carrying a characteristic neural signature, which may potentially help development of differential markers for these two conditions. PMID:26843004

Outcome Measurement in the Treatment of Spasmodic Dysphonia: A Systematic Review of the Literature.

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Rumbach, Anna; Aiken, Patrick; Novakovic, Daniel

2018-04-11

The aim of this review was to systematically identify all available studies reporting outcomes measures to assess treatment outcomes for people with spasmodic dysphonia (SD). Full-text journal articles were identified through searches of PubMed, Embase, CINAHL, and Cochrane databases and hand searching of journals. A total of 4,714 articles were retrieved from searching databases; 1,165 were duplicates. Titles and abstracts of 3,549 were screened, with 171 being selected for full-text review. During full-text review, 101 articles were deemed suitable for inclusion. An additional 24 articles were identified as suitable for inclusion through a hand search of reference lists. Data were extracted from 125 studies. A total of 220 outcome measures were identified. Considered in reference to the World Health Organization International Classification of Functioning, Disability and Health (ICF), the majority of outcomes were measured at a Body Function level (n = 212, 96%). Outcomes that explored communication and participation in everyday life and attitudes toward communication (ie, activity and participation domains) were infrequent (n = 8; 4%). Quality of life, a construct not measured within the ICF, was also captured by four outcome measures. No instruments evaluating communication partners' perspectives or burden/disability were identified. The outcome measures used in SD treatment studies are many and varied. The outcome measures identified predominately measure constructs within the Body Functions component of the ICF. In order to facilitate data synthesis across trials, the development of a core outcome set is recommended. Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

Neural correlates of dystonic tremor: a multimodal study of voice tremor in spasmodic dysphonia.

Science.gov (United States)

Kirke, Diana N; Battistella, Giovanni; Kumar, Veena; Rubien-Thomas, Estee; Choy, Melissa; Rumbach, Anna; Simonyan, Kristina

2017-02-01

Tremor, affecting a dystonic body part, is a frequent feature of adult-onset dystonia. However, our understanding of dystonic tremor pathophysiology remains ambiguous as its interplay with the main co-occurring disorder, dystonia, is largely unknown. We used a combination of functional MRI, voxel-based morphometry and diffusion-weighted imaging to investigate similar and distinct patterns of brain functional and structural alterations in patients with dystonic tremor of voice (DTv) and isolated spasmodic dysphonia (SD). We found that, compared to controls, SD patients with and without DTv showed similarly increased activation in the sensorimotor cortex, inferior frontal (IFG) and superior temporal gyri, putamen and ventral thalamus, as well as deficient activation in the inferior parietal cortex and middle frontal gyrus (MFG). Common structural alterations were observed in the IFG and putamen, which were further coupled with functional abnormalities in both patient groups. Abnormal activation in left putamen was correlated with SD onset; SD/DTv onset was associated with right putaminal volumetric changes. DTv severity established a significant relationship with abnormal volume of the left IFG. Direct patient group comparisons showed that SD/DTv patients had additional abnormalities in MFG and cerebellar function and white matter integrity in the posterior limb of the internal capsule. Our findings suggest that dystonia and dystonic tremor, at least in the case of SD and SD/DTv, are heterogeneous disorders at different ends of the same pathophysiological spectrum, with each disorder carrying a characteristic neural signature, which may potentially help development of differential markers for these two conditions.

Long-term Evaluation of Type 2 Thyroplasty with Titanium Bridges for Adductor Spasmodic Dysphonia.

Science.gov (United States)

Sanuki, Tetsuji; Yumoto, Eiji

2017-07-01

Objectives Standard treatments of adductor spasmodic dysphonia (AdSD) provide temporary relief of symptoms. Type 2 thyroplasty offers a long-term solution; however, long-term voice outcome data are lacking. The objective of this study was to assess the long-term voice outcomes of type 2 thyroplasty with titanium bridges through use of a validated voice questionnaire. Study Design Case series with chart review. Setting University hospital. Subjects and Methods Forty-seven consecutively enrolled patients with AdSD underwent type 2 thyroplasty with titanium bridges between August 2006 and November 2014. Questionnaires were completed during regularly scheduled follow-ups and, in some cases, were sent to patients who missed follow-up appointments. In 2015, questionnaires were mailed to all 47 patients and included a Voice Handicap Index-10 evaluation, as well as questions on postoperative vocal symptoms, surgical site, and status of the implanted titanium bridges. Results Of 47 patients with AdSD, 31 (66%) completed the questionnaires. The average follow-up interval was 41.3 months. No patient reported experiencing an adverse event around the surgical site, and almost all were satisfied with their voices postoperatively. The mean postoperative (>3 years) Voice Handicap Index-10 score improved significantly, from 26.3 to 9.4 (n = 17, P = .0009). Conclusions Type 2 thyroplasty for AdSD significantly improved patient quality of life and voice symptoms and continued to do so long after the surgery. The results of this study suggest that type 2 thyroplasty provides relief from vocal symptoms in patients with AdSD for >3 years.

Brain Activity in Patients With Adductor Spasmodic Dysphonia Detected by Functional Magnetic Resonance Imaging.

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Kiyuna, Asanori; Kise, Norimoto; Hiratsuka, Munehisa; Kondo, Shunsuke; Uehara, Takayuki; Maeda, Hiroyuki; Ganaha, Akira; Suzuki, Mikio

2017-05-01

Spasmodic dysphonia (SD) is considered a focal dystonia. However, the detailed pathophysiology of SD remains unclear, despite the detection of abnormal activity in several brain regions. The aim of this study was to clarify the pathophysiological background of SD. This is a case-control study. Both task-related brain activity measured by functional magnetic resonance imaging by reading the five-digit numbers and resting-state functional connectivity (FC) measured by 150 T2-weighted echo planar images acquired without any task were investigated in 12 patients with adductor SD and in 16 healthy controls. The patients with SD showed significantly higher task-related brain activation in the left middle temporal gyrus, left thalamus, bilateral primary motor area, bilateral premotor area, bilateral cerebellum, bilateral somatosensory area, right insula, and right putamen compared with the controls. Region of interest voxel FC analysis revealed many FC changes within the cerebellum-basal ganglia-thalamus-cortex loop in the patients with SD. Of the significant connectivity changes between the patients with SD and the controls, the FC between the left thalamus and the left caudate nucleus was significantly correlated with clinical parameters in SD. The higher task-related brain activity in the insula and cerebellum was consistent with previous neuroimaging studies, suggesting that these areas are one of the unique characteristics of phonation-induced brain activity in SD. Based on FC analysis and their significant correlations with clinical parameters, the basal ganglia network plays an important role in the pathogenesis of SD. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Influence of consonant voicing characteristics on sentence production in abductor versus adductor spasmodic dysphonia.

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Cannito, Michael P; Chorna, Lesya B; Kahane, Joel C; Dworkin, James P

2014-05-01

This study evaluated the hypotheses that sentence production by speakers with adductor (AD) and abductor (AB) spasmodic dysphonia (SD) may be differentially influenced by consonant voicing and manner features, in comparison with healthy, matched, nondysphonic controls. This was a prospective, single blind study, using a between-groups, repeated measures design for the independent variables of perceived voice quality and sentence duration. Sixteen subjects with ADSD and 10 subjects with ABSD, as well as 26 matched healthy controls produced four short, simple sentences that were systematically loaded with voiced or voiceless consonants of either obstruant or continuant manner categories. Experienced voice clinicians, who were "blind" as to speakers' group affixations, used visual analog scaling to judge the overall voice quality of each sentence. Acoustic sentence durations were also measured. Speakers with ABSD or ADSD demonstrated significantly poorer than normal voice quality on all sentences. Speakers with ABSD exhibited longer than normal duration for voiceless consonant sentences. Speakers with ADSD had poorer voice quality for voiced than for voiceless consonant sentences. Speakers with ABSD had longer durations for voiceless than for voiced consonant sentences. The two subtypes of SD exhibit differential performance on the basis of consonant voicing in short, simple sentences; however, each subgroup manifested voicing-related differences on a different variable (voice quality vs sentence duration). Findings suggest different underlying pathophysiological mechanisms for ABSD and ADSD. Findings also support inclusion of short, simple sentences containing voiced or voiceless consonants as part of the diagnostic protocol for SD, with measurement of sentence duration in addition to judments of voice quality severity. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Onabotulinum toxin A dosage trends over time for adductor spasmodic dysphonia: A 15-year experience.

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Tang, Christopher G; Novakovic, Daniel; Mor, Niv; Blitzer, Andrew

2016-03-01

Although onabotulinum neurotoxin A (BoNTA) has been used for over three decades for the treatment of adductor spasmodic dysphonia, no study has been performed to look at the trend of BoNTA dosages across time. The goal of this study is to evaluate the dosage trends to determine if the dosage necessary for voice improvement in patients increases over time. Charts were reviewed for patients with 15 years or more of experience. Linear regression analysis was performed to determine correlation coefficients and trends. Fifty-five patients receiving BoNTA injections by the senior author (a.b.) for over 15 years were evaluated. Thirty-nine patients (82% female) met inclusion criteria. Patients received injections over an average of 18.6 years ± 1.36 years, with the longest follow-up of 21.5 years. Of 39 patients, 16 (41%) had a negative correlation coefficient (Pearson's r) suggesting a decrease over time, whereas 23 (59%) had a positive correlation coefficient suggesting an increase over time. The mean correlation coefficient was 0.139 ± 0.534 and P  0.05 in 20 patients. R(2) for all patients were less than 0.75. Onabotulinum neurotoxin A injection dosage trends vary depending on the individual over time. Overall, the dose range appears to be stable in the majority of patients, suggesting that tolerance does not play a significant part in dose variation over time. 4. Laryngoscope, 126:678-681, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Voice tuning with new instruments for type II thyroplasty in the treatment of adductor spasmodic dysphonia.

Science.gov (United States)

Sanuki, Tetsuji; Yumoto, Eiji; Toya, Yutaka; Kumai, Yoshihiko

2016-10-01

Adductor spasmodic dysphonia is a rare voice disorder characterized by strained and strangled voice quality with intermittent phonatory breaks and adductory vocal fold spasms. Type II thyroplasty differs from previous treatments in that this surgery does not involve any surgical intervention into the laryngeal muscle, nerve or vocal folds. Type II thyroplasty intervenes in the thyroid cartilage, which is unrelated to the lesion. This procedure, conducted with the aim of achieving lateralization of the vocal folds, requires utmost surgical caution due to the extreme delicacy of the surgical site, critically sensitive adjustment, and difficult procedures to maintain the incised cartilages at a correct position. During surgery, the correct separation of the incised cartilage edges with voice monitoring is the most important factor determining surgical success and patient satisfaction. We designed new surgical instruments: a thyroid cartilage elevator for undermining the thyroid cartilage, and spacer devices to gauge width while performing voice monitoring. These devices were designed to prevent surgical complications, and to aid in selecting the optimal size of titanium bridges while temporally maintaining a separation during voice monitoring. We designed new surgical instruments, including a thyroid cartilage elevator and spacer devices. Precise surgical procedures and performing voice tuning during surgery with the optimal separation width of the thyroid cartilage are key points for surgical success. We introduce the technique of voice tuning using these surgical tools in order to achieve a better outcome with minimal surgical complications. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Correlation of the Dysphonia Severity Index (DSI), Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), and Gender in Brazilians With and Without Voice Disorders.

Science.gov (United States)

Nemr, Katia; Simões-Zenari, Marcia; de Souza, Glaucia S; Hachiya, Adriana; Tsuji, Domingos H

2016-11-01

This study aims to analyze the Dysphonia Severity Index (DSI) in Brazilians with or without voice disorders and investigate DSI's correlation with gender and auditory-perceptual evaluation data obtained via the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) protocol. A total of 66 Brazilian adults from both genders participated in the study, including 24 patients with dysphonia confirmed on laryngeal examination (dysphonic group [DG]) and 42 volunteers without voice or hearing complaints and without auditory-perceptual voice disorders (nondysphonic group [NDG]). The vocal tasks included in CAPE-V and DSI were performed and recorded. Data were analyzed by means of the independent t test, the Mann-Whitney U test, and Pearson correlation at the 5% significance level. Differences were found in the mean DSI values between the DG and the NDG. Differences were also found in all DSI items between the groups, except for the highest frequency parameter. In the DG, a moderate negative correlation was detected between overall dysphonia severity (CAPE-V) and DSI value, and between breathiness and DSI value, and a weak negative correlation was detected between DSI value and roughness. In the NDG, the maximum phonation time was higher among males. In both groups, the highest frequency parameter was higher among females. The DSI discriminated among Brazilians with or without voice disorders. A correlation was found between some aspects of the DSI and the CAPE-V but not between DSI and gender. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Lateral Cricoarytenoid Release: Development of a Novel Surgical Treatment Option for Adductor Spasmodic Dysphonia in a Canine Laryngeal Model.

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Park, Andrea M; Paniello, Randal C

2016-09-01

To investigate the efficacy of a novel adductor muscle-releasing technique designed to decrease the force of vocal fold adduction, as a potential surgical therapy for patients with adductor spasmodic dysphonia (ADSD). Experimental animal study. A canine laryngeal model was used to assess the acute and sustained efficacy of a lateral cricoarytenoid (LCA) muscle release. A total of 34 canine hemilaryngeal preparations were divided among 7 experimental groups. The LCA muscle was separated from its cricoid cartilage origin via an open, anterior, submucosal approach. The laryngeal adductory pressures (LAP) were assessed pre- and post-muscle release via direct recurrent laryngeal nerve stimulation. Measurements were repeated at 1.5, 3, or 6 months postoperatively. Another study evaluated release of the thyroarytenoid (TA) muscle from its thyroid cartilage origin. Releasing the LCA muscle demonstrated a significant decrease in LAP acutely and was maintained at all 3 time points with the aid of a barrier (P < .05). Without the barrier, the LCA muscle reattached to the cricoid. Acute release of the TA muscle did not significantly decrease the LAP. The proposed LCA release procedure may provide patients with a permanent treatment option for ADSD. However, longer-term studies and human trials are needed. © The Author(s) 2016.

Impacto na qualidade vocal da miectomia parcial e neurectomia endoscópica do músculo tireoaritenóideo em paciente com disfonia espasmódica de adução Impact in vocal quality in partial myectomy and neurectomy endoscopic of thyroarytenoid muscle in patients with adductor spasmodic dysphonia

Directory of Open Access Journals (Sweden)

Domingos Hiroshi Tsuji

2006-04-01

Full Text Available A disfonia espasmódica de adução é um distúrbio vocal grave, caracterizado por espasmos dos músculos laríngeos durante a fonação, produzindo voz quebrada, tensa, forçada e estrangulada. Seus sintomas decorrem da contração intermitente e involuntária dos músculos tireoaritenóideos durante a fonação, o que resulta em pregas vocais tensas, pressionadas uma contra a outra, e no aumento da resistência glótica. OBJETIVO: Apresentar os resultados preliminares do impacto na qualidade vocal da cirurgia de Neurectomia do ramo tireoaritenóideo do laríngeo inferior, via endoscópica, associada à miectomia parcial do músculo tireoaritenóideo com laser de CO2. MATERIAL E MÉTODO: A cirurgia foi realizada em 7 pacientes (6 mulheres e 1 homem, com idades variando entre 22 e 75 anos, com diagnóstico de disfonia espasmódica de adução. Os pacientes foram submetidos ao VHI (Voice Handicap Index no pré e pós-operatório. RESULTEDOS E CONCLUSÃO: A melhora vocal foi conseguida em todos os pacientes estudados não ocorrendo deterioração da qualidade vocal ao longo do período pós-operatório. Houve uma diferença evidente no VHI antes e após a cirurgia. Essa técnica cirúrgica mostrou-se eficaz e inovadora no tratamento da disfonia espasmódica de adução.Impact in vocal quality in partial myectomy and neurectomy endoscopic of thyroarytenoid muscle in patients with adductor spasmodic dysphonia the adductor spasmodic dysphonia is a severe vocal disorder characterized by muscle laryngeal spasms during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms come from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold strain, pressed one against another and increased glottic resistance. AIM: report the results in the impact in vocal quality in neurectomy of the thyroarytenoid branch of the inferior laryngeal nerve by endoscopic route associated with

Quantifying the cepstral peak prominence, a measure of dysphonia.

Science.gov (United States)

Heman-Ackah, Yolanda D; Sataloff, Robert T; Laureyns, Griet; Lurie, Deborah; Michael, Deirdre D; Heuer, Reinhardt; Rubin, Adam; Eller, Robert; Chandran, Swapna; Abaza, Mona; Lyons, Karen; Divi, Venu; Lott, Joanna; Johnson, Jennifer; Hillenbrand, James

2014-11-01

The purpose of this study is to establish normative values for the smoothed cepstral peak prominence (CPPS) and its sensitivity and specificity as a measure of dysphonia. Prospective cohort study. Voice samples of running speech were obtained from 835 patients and 50 volunteers. Eight laryngologists and four speech-language pathologists performed perceptual ratings of the voice samples on the degree of dysphonia/normality using an analog scale. The mean of their perceptual ratings was used as the gold standard for the detection of the presence or absence of dysphonia. CPPS was measured using the CPPS algorithm of Hillenbrand, and the cut-off value for positivity that has the highest sensitivity and specificity for discriminating between normal and severely dysphonia voices was determined based on ROC-curve analysis. The cut-off value for normal for CPPS was set at 4.0 or higher, which gave a sensitivity of 92.4%, a specificity of 79%, a positive predictive value of 82.5%, and a negative predictive value of 90.8%. The area under the receiver operating characteristic (ROC) curve was 0.937 (P dysphonia, with the normal value of CPPS (Hillenbrand algorithm) of a running speech sample being defined as a value of 4.0 or higher. Copyright © 2014 The Voice Foundation. All rights reserved.

Long-term Dose Stability of OnabotulinumtoxinA Injection for Adductor Spasmodic Dysphonia: A 19-Year Single Institution Experience

Directory of Open Access Journals (Sweden)

Paul Paddle

2017-11-01

Full Text Available ObjectivesAdductor spasmodic dysphonia (AdSD is a focal dystonia predominantly involving the laryngeal adductor muscles. AdSD is reported to be a largely non-progressive neurological disorder, though fluctuations in symptom severity do occur. Repeated laryngeal onabotulinumtoxinA (BTX-A injections are the primary management for AdSD. A number of studies have demonstrated long-term dose stability as evidence of this long-term disease stability.MethodsA retrospective review was performed on all patients undergoing BTX-A injections for AdSD from April 1994 to September 2013 by a single laryngologist at a tertiary referral laryngology center. Patient demographics, injection doses, use of diazepam and/or lidocaine, and self-reported vocal function were recorded. Multiple linear regression analyses were performed.Results83 patients underwent a total of 1,168 injections over 19 years. The mean starting dose was 2.35 MU (0.79 SD. The mean long-term dose was 2.36 MU (0.79 SD. After adjusting for confounders, the change in the relative dose of BTX-A, with every year elapsed since initial dose was 0.13% (95% confidence interval −0.31 to 0.57%, p = 0.568.ConclusionBTX-A dose is stable over time in our large cohort of patients treated with bilateral thyroarytenoid injections for AdSD.

Workplace productivity and voice disorders: a cognitive interviewing study on presenteeism in individuals with spasmodic dysphonia.

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Isetti, Derek; Meyer, Tanya

2014-11-01

The objective of this study was to obtain initial reactions and suggested modifications to two existing presenteeism scales: the Stanford Presenteeism Scale 6 (SPS-6) and the Work Productivity and Activity Impairment Questionnaire-Specific Health Problem (WPAI-SHP) among a cohort of employed individuals with a focal laryngeal dystonia, spasmodic dysphonia (SD). The study design is a qualitative study. Nine speakers with SD underwent cognitive interviews, during which they were asked to evaluate the relevance of statements and clarity of wording on the SPS-6, the WPAI-SHP, and an additional set of voice-related statements designed by the researchers. Participants were asked to complete the scales, rank order statements in terms of perceived importance, and suggest additional statements of relevance. Although all participants noted that their SD did have an effect on their jobs, there were suggestions for modifying both the WPAI-SHP and the SPS-6. Participants regarded specific voice-related statements that were generated by the researchers to be of greater importance than the majority of the statements on the SPS-6. Minor changes in the wording of the instructions on the WPAI-SHP were recommended. Presenteeism is an important construct to measure in individuals with a chronic voice disorder such as SD. However, existing presenteeism scales might best be administered in conjunction with additional statements that are more voice related so that clinicians can be made aware of specific difficulties encountered in the workplace. Copyright © 2014 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Toward validation of the cepstral spectral index of dysphonia (CSID) as an objective treatment outcomes measure.

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Peterson, Elizabeth A; Roy, Nelson; Awan, Shaheen N; Merrill, Ray M; Banks, Russell; Tanner, Kristine

2013-07-01

To examine the validity of the Cepstral Spectral Index of Dysphonia (CSID) as an objective treatment outcomes measure of dysphonia severity. Pre- and posttreatment samples of sustained vowel and connected speech productions were elicited from 112 patients across six diagnostic categories: unilateral vocal fold paralysis, adductor spasmodic dysphonia, primary muscle tension dysphonia, benign vocal fold lesions, presbylaryngis, and mutational falsetto. Listener ratings of severity in connected speech were compared with a three-factor CSID model consisting of the cepstral peak prominence (CPP), the low-to-high spectral energy ratio, and its standard deviation. Two additional variables, the CPP standard deviation and gender, were included in the five-factor CSID model to estimate severity of vowels. CSID-estimated severity for sustained vowels and connected speech was strongly associated with listener ratings pretreatment, posttreatment, and change observed pre- to posttreatment. Spectrum effects were examined, and severity of dysphonia did not influence the relationship between listener perceived severity and CSID-estimated severity. The results confirm a robust relationship between listener perceived and CSID-derived dysphonia severity estimates in sustained vowels and connected speech across diverse diagnoses and severity levels and support the clinical utility of the CSID as an objective treatment outcomes measure. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Dysphonia in performers: toward a clinical definition of laryngology of the performing voice.

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Guss, Joel; Sadoughi, Babak; Benson, Brian; Sulica, Lucian

2014-05-01

To identify causes of dysphonia in performers and compare causes and aspects of treatment of dysphonia in performers and nonperformers. Case-control study. A chart review of all new patients presenting with a chief complaint of dysphonia over a 1-year period was performed. The prevalence of laryngeal disorders was reviewed and differences between performers and nonperformers were analyzed. The odds ratio of the prevalence of each disorder was computed against performer status as a risk factor. Four hundred seventy-six new patients complaining of dysphonia presented over 12 months; 74 were vocal performers. The median duration of symptoms in performers was 90 days. Phonotraumatic lesions were significantly more prevalent in performers (63.5% vs. 28.6%, P fold swelling (4-fold increase in performers), pseudocysts (3-fold increase), and vocal fold hemorrhage/ectasia. Neurologic disorders (vocal fold paralysis and spasmodic dysphonia), neoplastic pathologies, and age-related phenomena (atrophy/presbyphonia) were significantly more common in nonperformers. Overall and diagnosis-specific rates of surgical intervention were equal between the two groups. Phonotraumatic injury is responsible for the majority of dysphonia in vocal performers, to a significantly greater extent than in nonperformers and requires the implementation of standard therapeutic strategies. Awareness of the specific risks and management needs of the performer is of paramount importance to the practice of laryngology of the performing voice. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Dysphonia in adults with developmental stuttering: A descriptive study

Directory of Open Access Journals (Sweden)

Anél Botha

2017-06-01

Objectives: This study aimed to describe the vocal characteristics of PWS. Method: Acoustic and perceptual data were collected during a comprehensive voice assessment. The severity of stuttering was also determined. Correlations between the stuttering severity instrument (SSI and the acoustic measurements were evaluated to determine the significance. Twenty participants were tested for this study. Result: Only two participants (10% obtained a positive Dysphonia Severity Index (DSI score of 1.6 or higher, indicating that no dysphonia was present, while 90% of participants (n = 18 scored lower than 1.6, indicating that those participants presented with dysphonia. Some participants presented with weakness (asthenia of voice (35%, while 65% presented with a slightly strained voice quality. Moderately positive correlations between breathiness and SSI (r = 0.40, p = 0.08 have been reported. In addition, participants with high SSI scores also scored a poor DSI of below 1.6, as observed by a moderate positive correlation between SSI and DSI (r = 0.41. Conclusion: The majority of PWS presented with dysphonia, evident in the perceptual or acoustic parameters of their voices. These results can be used for further investigation to create awareness and to establish intervention strategies for voice disorders among PWS.

Prevalence and Severity of Dysphonia in Patients with Cystic Fibrosis: A Pilot Study.

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Willis, John; Michael, Deirdre D; Boyer, Holly; Misono, Stephanie

2015-07-01

To assess the prevalence and severity of dysphonia in patients with cystic fibrosis sinusitis. We hypothesized that patients with CF sinusitis, compared with 2 control groups, would have higher self-reported prevalence of dysphonia and greater severity of dysphonia, according to patient-reported outcome measures as well as auditory-perceptual evaluation by expert listeners. Cross-sectional comparative pilot study. Academic tertiary care clinic. Analysis included 37 study participants: 17 patients with CF sinusitis, 10 healthy individuals, and 10 patients with non-CF sinusitis. All participants completed the 10-item Voice Handicap Index (VHI-10) questionnaire and provided voice samples. On all samples, 6 blinded speech-language pathologists independently performed auditory-perceptual evaluation, using Consensus Auditory-Perceptual Evaluation of Voice. To assess severity of sinonasal symptoms, we used the 20-item Sinonasal Outcome Test (SNOT-20). Standard parametric and nonparametric statistical analysis was performed. The differences between the 3 groups in prevalence of abnormal VHI-10 scores were not statistically significant. SNOT-20 scores were similar in the 2 sinusitis patient groups. VHI-10 scores were highest in patients with CF sinusitis, intermediate in patients with non-CF sinusitis, and lowest in healthy individuals (P = .005). Auditory-perceptual evaluation demonstrated greater overall severity of dysphonia in patients with CF sinusitis compared with the 2 control groups (P = .0005). Cystic fibrosis sinusitis appeared to be associated with worse vocal function as measured by patient self-report as well as auditory-perceptual evaluation of voice compared with patients with non-CF sinusitis and healthy controls. Further investigation in this area is warranted. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Correlation among the dysphonia severity index (DSI), the RBH voice perceptual evaluation, and minimum glottal area in female patients with vocal fold nodules.

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Hussein Gaber, Ammar Gaber; Liang, Fa-Ya; Yang, Jin-Shan; Wang, Ya-Jing; Zheng, Yi-Qing

2014-01-01

To investigate the clinical significance and correlation of the dysphonia severity index (DSI), the RBH (roughness [R]; breathiness [B]; hoarseness [H]) perceptual voice quality evaluation, and minimum glottal area (MGA) in patients with vocal fold nodules and validate the practicality of the DSI further. The DSI evaluation, the voice RBH perceptual evaluation, and the MGA were performed on 30 female patients with vocal fold nodules (the patient group) and 30 female volunteers with normal voices (the control group). The DSI determination was calculated using the following formula: DSI = 0.13 × MPT + 0.0053 × F(0)-High - 0.26 × I-Low - 1.18 × Jitter(%) + 12.4. The RBH evaluation was graded according to four scales. The MGA was measured by KayPENTAX Kips (7105) software. The differences among the DSI, the RBH grade, and MGA of the patients were compared. The median DSI values of the patient group and the control group were -0.81 and 3.79, respectively, and the difference was statistically significant (P dysphonia in female patients with vocal nodules has significant clinical application and good correlation with MGA measurement. Copyright © 2014 The Voice Foundation. All rights reserved.

Toward the Development of an Objective Index of Dysphonia Severity: A Four-Factor Acoustic Model

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Awan, Shaheen N.; Roy, Nelson

2006-01-01

During assessment and management of individuals with voice disorders, clinicians routinely attempt to describe or quantify the severity of a patient's dysphonia. This investigation used acoustic measures derived from sustained vowel samples to predict dysphonia severity (as determined by auditory-perceptual ratings), for a diverse set of voice…

Endoscopic laser thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia: a pilot study on long-term outcome on voice quality.

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Tsuji, Domingos Hiroshi; Takahashi, Marystella Tomoe; Imamura, Rui; Hachiya, Adriana; Sennes, Luiz Ubirajara

2012-09-01

Adductor spasmodic dysphonia (ADSD) is a focal laryngeal dystonia, which compromises greatly the quality of life of the patients involved. It is a severe vocal disorder characterized by spasms of laryngeal muscles during speech, producing phonatory breaks, forced, strained and strangled voice. Its symptoms result from involuntary and intermittent contractions of thyroarytenoid muscle during speech, which causes vocal fold to strain, pressing each vocal fold against the other and increasing glottic resistance. Botulinum toxin injection remains the gold-standard treatment. However, as injections should be repeated periodically leading to voice quality instability, a more definitive procedure would be desirable. In this pilot study we report the long-term vocal quality results of endoscopic laser thyroarytenoid myoneurectomy. Prospective study. Surgery was performed in 15 patients (11 females and four males), aged between 29 and 73 years, diagnosed with ADSD. Voice Handicap Index (VHI) was obtained before and after surgery (median 31 months postoperatively). A significant improvement in VHI was observed after surgery, as compared with baseline values (P=0.001). The median and interquartile range for preoperative VHI was 99 and 13, respectively and 24 and 42, for postoperative VHI. Subjective improvement of voice as assessed by the patients showed median improvement of 80%. Because long-term follow-up showed significant improvement of voice quality, this innovative surgical technique seems a satisfactory alternative treatment of ADSD patients who seek a definite improvement of their condition. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Clinical Practice Guideline: Hoarseness (Dysphonia) (Update).

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Stachler, Robert J; Francis, David O; Schwartz, Seth R; Damask, Cecelia C; Digoy, German P; Krouse, Helene J; McCoy, Scott J; Ouellette, Daniel R; Patel, Rita R; Reavis, Charles Charlie W; Smith, Libby J; Smith, Marshall; Strode, Steven W; Woo, Peak; Nnacheta, Lorraine C

2018-03-01

cause amenable to voice therapy. The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. (6) Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. (7) Clinicians should inform patients with dysphonia about control/preventive measures. (8) Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in QOL of patients with dysphonia after treatment or observation. The guideline update group made a strong recommendation against 1 action: (1) Clinicians should not routinely prescribe antibiotics to treat dysphonia. The guideline update group made recommendations against other actions: (1) Clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) for patients with a primary voice complaint

Dysphonia in adults with developmental stuttering: A descriptive study.

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Botha, Anél; Ras, Elizbé; Abdoola, Shabnam; Van der Linde, Jeannie

2017-06-26

Persons with stuttering (PWS) often present with other co-occurring conditions. The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) proposes that it is important to understand the full burden of a health condition. A few studies have explored voice problems among PWS, and the characteristics of voices of PWS are relatively unknown. The importance of conducting future research has been emphasised. This study aimed to describe the vocal characteristics of PWS. Acoustic and perceptual data were collected during a comprehensive voice assessment. The severity of stuttering was also determined. Correlations between the stuttering severity instrument (SSI) and the acoustic measurements were evaluated to determine the significance. Twenty participants were tested for this study. Only two participants (10%) obtained a positive Dysphonia Severity Index (DSI) score of 1.6 or higher, indicating that no dysphonia was present, while 90% of participants (n = 18) scored lower than 1.6, indicating that those participants presented with dysphonia. Some participants presented with weakness (asthenia) of voice (35%), while 65% presented with a slightly strained voice quality. Moderately positive correlations between breathiness and SSI (r = 0.40, p = 0.08) have been reported. In addition, participants with high SSI scores also scored a poor DSI of below 1.6, as observed by a moderate positive correlation between SSI and DSI (r = 0.41). The majority of PWS presented with dysphonia, evident in the perceptual or acoustic parameters of their voices. These results can be used for further investigation to create awareness and to establish intervention strategies for voice disorders among PWS.

Clinical Practice Guideline: Hoarseness (Dysphonia) (Update) Executive Summary.

Science.gov (United States)

Stachler, Robert J; Francis, David O; Schwartz, Seth R; Damask, Cecelia C; Digoy, German P; Krouse, Helene J; McCoy, Scott J; Ouellette, Daniel R; Patel, Rita R; Reavis, Charles Charlie W; Smith, Libby J; Smith, Marshall; Strode, Steven W; Woo, Peak; Nnacheta, Lorraine C

2018-03-01

cause amenable to voice therapy. The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. (6) Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. (7) Clinicians should inform patients with dysphonia about control/preventive measures. (8) Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in QOL of patients with dysphonia after treatment or observation. The guideline update group made a strong recommendation against 1 action: (1) Clinicians should not routinely prescribe antibiotics to treat dysphonia. The guideline update group made recommendations against other actions: (1) Clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) for patients with a primary voice complaint

Immediate effects of the Finnish resonance tube method on behavioral dysphonia.

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Paes, Sabrina Mazzer; Zambon, Fabiana; Yamasaki, Rosiane; Simberg, Susanna; Behlau, Mara

2013-11-01

To investigate the immediate effects of the Finnish resonance tube method for teachers with behavioral dysphonia. Twenty-five female teachers (m=39.9 years of age) with at least a 5-year history of dysphonia were included. Additional inclusion criteria were the diagnosis of chronic behavioral dysphonia with an indication for speech therapy and the absence of any prior speech therapy. Subjects produced three sets of 10 tokens of sustained phonation with a 1-minute rest interval between tokens into a 27-cm glass tube immersed in at least 2 cm of water. Voice samples were recorded before and after these sets. The effects of these exercises were evaluated by self-assessment, auditory perceptual analysis, and acoustic evaluation involving extraction of fundamental frequency and visual spectrographic analysis. Sixty-eight percent of the teachers reported increased phonatory comfort and 52% reported improved voice quality after performing the exercises. Perceptual analysis indicated improved voice quality in the samples of counting numbers, confirmed by decreased instability, subharmonics, noise in high frequencies, and the tendency for reduced low frequency noise on spectrographic evaluation. Additionally, mean fundamental frequency decreased. The Finnish resonance tube method increased phonatory comfort and vocal changes suggestive diminished hyperfunction. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Effects of muscle tension dysphonia on tone phonation: acoustic and perceptual studies in Vietnamese female teachers.

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Nguyen, Duong Duy; Kenny, Dianna T

2009-07-01

Muscle tension dysphonia (MTD) is a hyperfunctional voice disorder commonly seen in professional voice users. To date, published acoustic studies of this disorder have mainly focused on nontonal language speakers, and no publication has documented its impact on lexical tone characteristics. In this study, we examined whether and how this voice disorder affected acoustically and perceptually the characteristics of tones in Vietnamese teachers. Voice data were obtained from 42 Vietnamese female primary school teachers diagnosed with MTD and 30 vocally healthy teachers. Tonal data were analyzed using Computerized Speech Lab (CSL-4300B) and Speech Analyzer. Parameters analyzed included the two most important acoustic cues in Vietnamese tones, that is, tonal fundamental frequency (F(0)) and laryngealization. Tonal F(0) was assessed using a factorial analysis of variance with group and career durations as independent variables. Tonal samples were also perceptually assessed by a panel of native speakers of the same dialect. The results showed that MTD lowered tonal F(0) in high tones and tones with extensive fundamental frequency variation. There was also a significant main effect for career duration; in MTD group, tonal F(0) was lower in teachers with longer career duration. The teachers with MTD showed different patterns of laryngealization compared with the control group. Tone perception was poorer for tones with extensive fundamental frequency variation and without a typical phonation type. The results in this group of teachers supported our hypothesis that MTD impairs lexical tone phonation.

Reduction of Parkinson's-related dysphonia by thyroplasty.

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Roubeau, B; Bruel, M; de Crouy Chanel, O; Périé, S

2016-12-01

Parkinson's-related dysphonia has a negative impact on the quality of speech by increasing the effects of the associated dysarthria. When this dysphonia is related to vocal fold adduction defect, constituting a real glottic insufficiency, vocal fold medialization can be proposed after failure of intensive voice and speech therapy. Acoustic and aerodynamic voice and speech analysis techniques, perceptual evaluation and estimation of vocal handicap, associated with fiberoptic laryngoscopy were performed to determine the indication for vocal fold medialization in these patients with glottic insufficiency. Vocal fold medialization by Montgomery thyroplasty implant was performed under local anesthesia and neuroanalgesia in two patients with Parkinson's disease presenting a dysphonia refractory to speech therapy. Postoperative evaluation showed improvement of voice quality with an increased number of harmonics and improvement of aerodynamic parameters. Vocal fold medialization by Montgomery thyroplasty implant effectively improved voice quality in these two patients allowing a more effective vocal fold adduction. The reducing of the hypophonia has a positive effect on the quality of oral communication. The medialization thyroplasty technique, under local anesthesia, allows intraoperative control of the voice as well as removal of the implant when necessary. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Persistent dysphonia in two performers affecting the singing and projected speaking voice: a report on a collaborative approach to management.

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Baker, Janet

2002-01-01

The projected speaking voice and the singing voice are highly sensitive to external and internal influences, and teachers of spoken voice and singing are in a unique position to identify subtle and more serious vocal difficulties in their students. Persistent anomalies may herald early onset of changes in vocal fold structure, neurophysiological control, or emotional stability. Two cases are presented to illustrate the benefits of a collaborative approach to diagnosis and management. The first, a 21-year-old male drama and singing student with an abnormally high speaking voice and falsetto singing voice was found to have a psychogenic dysphonia referred to as "puberphonia" or "mutational falsetto". The second, a 34-year-old female alto with strained phonation and perceived stutter of the vocal folds was diagnosed with "adductor spasmodic dysphonia" or "focal laryngeal dystonia" of neurological origin.

Quality of life, self-perceived dysphonia, and diagnosed dysphonia through clinical tests in teachers.

Science.gov (United States)

Bassi, Iara Barreto; Assunção, Ada Ávila; de Medeiros, Adriane Mesquita; de Menezes, Letícia Neiva; Teixeira, Letícia Caldas; Côrtes Gama, Ana Cristina

2011-03-01

To examine the impact of voice on the quality of life of teachers and to assess whether the degree of dysphonia and otorhinolaryngologists' (ORL) diagnostics are correlated with the quality of life. Eighty-eight female teachers from the municipal schools of Belo Horizonte who were in speech therapy at the Speech Therapy Clinic of the Hospital das Clínicas of Minas Gerais participated in the study. The variables studied were age, ORL diagnosis, perceptual-hearing assessment of voice through GRBAS scale, and vocal activities and participation profile (VAPP) protocol. Statistical analysis was performed through the descriptive analysis of the data and the Spearman coefficient of correlation. The average age of the participants was 38 years. Vocal deviation: degree 1-56 teachers (63.6%); degree 2-27 teachers (30.6%); and without vocal deviation-five teachers (5.6%). It was found that 57.9% of the teachers presented combined ORL diagnosis. No statistically significant relationship was observed among the ORL diagnosis, the degree of dysphonia, and the parameter values of quality of life assessed by VAPP. The examined participants of this study presented light degree of vocal deviation and ORL combined diagnosis. According to the figures obtained by VAPP, there was negative impact of voice on the quality of life of female teachers, but these impacts were not correlated with ORL diagnosis and grade of dysphonia. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Comparison of voice quality in patients with GERD-related dysphonia or chronic cough.

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Domeracka-Kołodziej, Anna; Grabczak, Elżbieta M; Dąbrowska, Marta; Arcimowicz, Magdalena; Lachowska, Magdalena; Osuch-Wójcikiewicz, Ewa; Niemczyk, Kazimierz

2014-01-01

The aim was to compare a voice quality in patients with GERD-related dysphonia or chronic cough and to determine whether there is a relationship between the main symptom reported and voice quality. 249 consecutive patients diagnosed with GERD-related chronic cough or dysphonia were involved in this retrospective study and were divided into two main groups of men and women, and furthermore into groups of chronic cough and dysphonia. Laryngeal lesions were evaluated with videolaryngostroboscopy using Reflux Finding Score. Voice quality was assessed using GRBAS scale, sonograms, and multidimensional voice program (MDVP). All subjects were found to have vocal abnormalities both in subjective and objective voice analysis. Perceptual assessment of voice (GRBAS) did not reveal any differences between analyzed groups depending on the reported symptom. In MDVP analysis, the group of women with cough as the main symptom demonstrated significantly less abnormalities in VTI value. In men with cough as their main complaint, significantly less MDVP abnormalities were found in Jita, Jitt, RAP, PPQ, and sPPQ parameters. The comparison of voice perceptual assessment in patients with GERD-related dysphonia or chronic cough revealed no differences between analyzed groups. In objective voice analysis, the latter group presented lower degree of hoarseness in Yanagihara's scale. In objective MDVP analysis, the chronic cough group presented lower degree of abnormalities only in one of the noise related parameters in females and five frequency perturbation parameters in males. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

[The impact of vibratory stimulation therapy on voice quality in hyperfunctional occupational dysphonia].

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Kosztyła-Hojna, Bożena; Kuryliszyn-Moskal, Anna; Rogowski, Marek; Moskal, Diana; Dakowicz, Agnieszka; Falkowski, Dawid; Kasperuk, Joanna

2012-01-01

Hyperfunctional dysphonia is the most frequent type of occupational functional dysphonia. Pharmacotherapy, physiotherapy and psychotherapy are used in the treatment of occupational dysphonia. Vibratory massages of the regions of the larynx relax the external muscles of neck, which have an indirect impact on the tension of the vocal folds. The aim of the study is to assess the impact of vibratory stimulation therapy on voice quality in patients with hyperfunctional occupational dysphonia treated pharmacologically. Forty patients with hyperfunctional occupational dysphonia treated phoniatrically in the Phoniatric Outpatient Clinic were included in the study. Patients were divided into two groups. Group I consisted of 20 patients treated pharmacologically. In group II, including 20 patients, apart from pharmacotherapy the vibratory stimulation therapy by the device of VR type (CyberBioMed LLC) was used. In the analysis of voice quality the evaluation of the vocal folds vibration using videolaryngostroboscopy and acoustic assessment of voice were conducted. The perceptual assessment of voice, the visualization of the vocal folds vibration in stroboscopic examination of the larynx and the acoustic assessment of voice enable the appropriate diagnostics of the clinical type and voice quality in hyperfunctional dysphonia. The tension of superficial and deep muscles of neck has the impact on the phonatory function of the larynx. Pharmacological treatment improves the voice quality in hyperfunctional occupational dysphonia. Pharmacological treatment combines with the relaxation of muscles of neck using the device of VR type significantly improve voice quality in hyperfunctional occupational dysphonia. Copyright © 2012 Polish Otolaryngology Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

Chemodenervation of the Larynx

Directory of Open Access Journals (Sweden)

Rachel Kaye

2017-11-01

Full Text Available Botulinum neurotoxin (BoNT has existed for thousands of years; however, it was not medically utilized until investigations into its therapeutic use began in sincerity during the late 1970s and 1980s. This, coupled with the reclassification of spasmodic dysphonia as a focal dystonia, led to the use of chemodenervation for this disorder, which has since become a refined technique. Indeed, due to its safety and efficacy, BoNT has been investigated in multiple neurolaryngology disorders, including spasmodic dysphonia, vocal tremor, and muscle tension dysphonia. BoNT has been shown to be a useful and safe adjunct in the treatment for these disorders and may reduce or eliminate oral pharmacotherapy and/or prevent the need for a surgical intervention. We present the historical background, development, proposed mechanisms of action, uses, and techniques for administering BoNT for laryngeal disorders, with a particular focus on spasmodic dysphonia.

Chemodenervation of the Larynx

Science.gov (United States)

Kaye, Rachel; Blitzer, Andrew

2017-01-01

Botulinum neurotoxin (BoNT) has existed for thousands of years; however, it was not medically utilized until investigations into its therapeutic use began in sincerity during the late 1970s and 1980s. This, coupled with the reclassification of spasmodic dysphonia as a focal dystonia, led to the use of chemodenervation for this disorder, which has since become a refined technique. Indeed, due to its safety and efficacy, BoNT has been investigated in multiple neurolaryngology disorders, including spasmodic dysphonia, vocal tremor, and muscle tension dysphonia. BoNT has been shown to be a useful and safe adjunct in the treatment for these disorders and may reduce or eliminate oral pharmacotherapy and/or prevent the need for a surgical intervention. We present the historical background, development, proposed mechanisms of action, uses, and techniques for administering BoNT for laryngeal disorders, with a particular focus on spasmodic dysphonia. PMID:29099066

Is the perception of dysphonia severity language-dependent? A comparison of French and Italian voice assessments.

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Ghio, Alain; Cantarella, Giovanna; Weisz, Frédérique; Robert, Danièle; Woisard, Virginie; Fussi, Franco; Giovanni, Antoine; Baracca, Giovanna

2015-04-01

In this cross-language study, six Italian and six French voice experts evaluated perceptually the speech of 27 Italian and 40 French patients with dysphonia to determine if there were differences based on native language. French and Italian voice specialists agreed substantially in their evaluations of the overall grade of dysphonia and moderately concerning roughness and breathiness. No statistically significant effects were found related to the language of the speakers with the exception of breathiness, a finding that was interpreted as being due to different voice pathologies in the patient groups. It was concluded that the perception of the overall grade of dysphonia and breathiness is not language-dependent, whereas the significant difference in the perception of roughness may be related to a perception/adaption process.

Psychological effects of dysphonia in voice professionals.

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Salturk, Ziya; Kumral, Tolgar Lutfi; Aydoğdu, Imran; Arslanoğlu, Ahmet; Berkiten, Güler; Yildirim, Güven; Uyar, Yavuz

2015-08-01

To evaluate the psychological effects of dysphonia in voice professionals compared to non-voice professionals and in both genders. Cross-sectional analysis. Forty-eight 48 voice professionals and 52 non-voice professionals with dysphonia were included in this study. All participants underwent a complete ear, nose, and throat examination and an evaluation for pathologies that might affect vocal quality. Participants were asked to complete the Turkish versions of the Voice Handicap Index-30 (VHI-30), Perceived Stress Scale (PSS), and the Hospital Anxiety and Depression Scale (HADS). HADS scores were evaluated as HADS-A (anxiety) and HADS-D (depression). Dysphonia status was evaluated by grade, roughness, breathiness, asthenia, and strain (GRBAS) scale perceptually. The results were compared statistically. Significant differences between the two groups were evident when the VHI-30 and PSS data were compared (P = .00001 and P = .00001, respectively). However, neither HADS score (HADS-A and HADS-D) differed between groups. An analysis of the scores in terms of sex revealed that females had significantly higher PSS scores (P = .006). The GRBAS scale revealed no difference between groups (P = .819, .931, .803, .655, and .803, respectively). No between-sex differences in the VHI-30 or HADS scores were evident We found that voice professionals and females experienced more stress and were more dissatisfied with their voices. 4. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

[Comparison of cepstral coefficients to other voice evaluation parameters in patients with occupational dysphonia].

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Niebudek-Bogusz, Ewa; Strumiłło, Paweł; Wiktorowicz, Justyna; Sliwińska-Kowalska, Mariola

2013-01-01

BACKGROUND Special consideration has recently been given to cepstral analysis with mel-frequency cepstral coefficients (MFCCs). The aim of this study was to assess the applicability of MFCCs in acoustic analysis for diagnosing occupational dysphonia in comparison to subjective and objective parameters of voice evaluation. The study comprised 2 groups, one of 55 female teachers (mean age: 45 years) with occupational dysphonia confirmed by videostroboscopy and 40 female controls with normal voice (mean age: 43 years). The acoustic samples involving sustained vowels "a" and four standardized sentences were analyzed by computed analysis of MFCCs. The results were compared to acoustic parameters of jitter and shimmer groups, noise to harmonic ratio, Yanagihara index evaluating the grade of hoarseness, the aerodynamic parameter: maximum phonation time and also subjective parameters: GRBAS perceptual scale and Voice Handicap Index (VHI). The compared results revealed differences between the study and control groups, significant for MFCC2, MFCC3, MFCC5, MFCC6, MFCC8, MFCC10, particularly for MFCC6 (p teachers correlated with all eight objective parameters, also showed the significant relation with perceptual voice feature A (asthenity) of subjective scale GRBAS, characteristic of weak tired voice. The cepstral analysis with mel frequency cepstral coefficients is a promising tool for evaluating occupational voice disorders, capable of reflecting the perceptual voice features better than other methods of acoustic analysis.

Voice deviation, dysphonia risk screening and quality of life in individuals with various laryngeal diagnoses

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Nemr, Katia; Cota, Ariane; Tsuji, Domingos; Simões-Zenari, Marcia

2018-01-01

OBJECTIVES: To characterize the voice quality of individuals with dysphonia and to investigate possible correlations between the degree of voice deviation (D) and scores on the Dysphonia Risk Screening Protocol-General (DRSP), the Voice-Related Quality of Life (V-RQOL) measure and the Voice Handicap Index, short version (VHI-10). METHODS: The sample included 200 individuals with dysphonia. Following laryngoscopy, the participants completed the DRSP, the V-RQOL measure, and the VHI-10; subsequently, voice samples were recorded for auditory-perceptual and acoustic analyses. The correlation between the score for each questionnaire and the overall degree of vocal deviation was analyzed, as was the correlation among the scores for the three questionnaires. RESULTS: Most of the participants (62%) were female, and the mean age of the sample was 49 years. The most common laryngeal diagnosis was organic dysphonia (79.5%). The mean D was 59.54, and the predominance of roughness had a mean of 54.74. All the participants exhibited at least one abnormal acoustic aspect. The mean questionnaire scores were DRSP, 44.7; V-RQOL, 57.1; and VHI-10, 16. An inverse correlation was found between the V-RQOL score and D; however, a positive correlation was found between both the VHI-10 and DRSP scores and D. CONCLUSION: A predominance of adult women, organic dysphonia, moderate voice deviation, high dysphonia risk, and low to moderate quality of life impact characterized our sample. There were correlations between the scores of each of the three questionnaires and the degree of voice deviation. It should be noted that the DRSP monitored the degree of dysphonia severity, which reinforces its applicability for patients with different laryngeal diagnoses. PMID:29538494

Refractory Dysphonia Due to Isolated Cricothyroid Muscle Dystonia.

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Kraft, Shannon; Childes, Jana; Hillel, Allen; Schindler, Joshua

2016-07-01

To demonstrate the utility of electromyography (EMG) in the evaluation and management of treatment-resistant dysphonia. We report a case of refractory dysphonia in which EMG was used to identify and treat isolated cricothyroid (CT) dystonia. The patient, a healthy 43-year-old woman, presented with 9 months of progressive hoarseness. Her symptoms were present across vocal tasks but were particularly bothersome while dictating. On presentation, her voice was rated grade 3, roughness 3, breathiness 1, asthenia 0, and strain 3 (G3R3B1A0S3). Videostroboscopy was remarkable for hyperfunction. Voice therapy was not beneficial despite appropriate effort. Microdirect laryngoscopy revealed no evidence of structural pathology. The patient was referred for EMG because of her normal examination and failure to improve with therapy. The CT muscle demonstrated an increased latency of 750 ms in all vocal tasks. One month after CT injection with 3 units of botulinum toxin (BTX), her voice was improved. Perceptual voice evaluation was rated G1R1B0A0S1. Voice Handicap Index improved from 87 to 35. In the absence of structural pathology, EMG can be a useful adjunct in the diagnosis of dysphonia that persists despite adequate trials of voice therapy. To our knowledge, this is the only report of laryngeal dystonia due to isolated CT dysfunction successfully treated with BTX. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Nonlinear dynamic-based analysis of severe dysphonia in patients with vocal fold scar and sulcus vocalis

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Choi, Seong Hee; Zhang, Yu; Jiang, Jack J.; Bless, Diane M.; Welham, Nathan V.

2011-01-01

Objective The primary goal of this study was to evaluate a nonlinear dynamic approach to the acoustic analysis of dysphonia associated with vocal fold scar and sulcus vocalis. Study Design Case-control study. Methods Acoustic voice samples from scar/sulcus patients and age/sex-matched controls were analyzed using correlation dimension (D2) and phase plots, time-domain based perturbation indices (jitter, shimmer, signal-to-noise ratio [SNR]), and an auditory-perceptual rating scheme. Signal typing was performed to identify samples with bifurcations and aperiodicity. Results Type 2 and 3 acoustic signals were highly represented in the scar/sulcus patient group. When data were analyzed irrespective of signal type, all perceptual and acoustic indices successfully distinguished scar/sulcus patients from controls. Removal of type 2 and 3 signals eliminated the previously identified differences between experimental groups for all acoustic indices except D2. The strongest perceptual-acoustic correlation in our dataset was observed for SNR; the weakest correlation was observed for D2. Conclusions These findings suggest that D2 is inferior to time-domain based perturbation measures for the analysis of dysphonia associated with scar/sulcus; however, time-domain based algorithms are inherently susceptible to inflation under highly aperiodic (i.e., type 2 and 3) signal conditions. Auditory-perceptual analysis, unhindered by signal aperiodicity, is therefore a robust strategy for distinguishing scar/sulcus patient voices from normal voices. Future acoustic analysis research in this area should consider alternative (e.g., frequency- and quefrency-domain based) measures alongside additional nonlinear approaches. PMID:22516315

An examination of variations in the cepstral spectral index of dysphonia across a single breath group in connected speech.

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Watts, Christopher R; Awan, Shaheen N

2015-01-01

The purpose of this study was to use spectral and cepstral analyses of speech to investigate whether underlying physiological changes in voice result in changes in acoustic estimates of dysphonia severity in continuous speech contexts within a single breath group. The effect of dysphonia on acoustic estimates of dysphonia severity, frequency, relative intensity, and vocalization time across initial and terminal segments of a single breath group using a common clinical stimulus was investigated. Prospective quasi-experimental controlled design. Digitized recordings of the Consensus Auditory-Perceptual Evaluation of Voice sentence "We were away a year ago" were obtained from 20 treatment-seeking dysphonic individuals (females, mean age = 39 years) and 20 normal controls (females, mean age = 39 years). Each recorded sample was separated into the first four syllables ("We were away … ") and second four syllables ("…a year ago.") of the breath group. Cepstral and spectral measures, intensity measures, and temporal analyses were obtained and used in calculations of the Cepstral Spectral Index of Dysphonia (CSID, an acoustic estimate of dysphonia severity), fundamental frequency (F0), vocalization time, and relative vocal intensity (dB SLP). Statistical analyses were applied to calculations of change (delta [Δ]) in these measures from one breath group segment to the next. Results revealed a significant effect of group on measures of CSID and F0, but not relative intensity or vocalization time. Dysphonic speakers exhibited a significant increase in the CSID from the first to second breath group segment and limited variation in F0 compared with controls. These results may support the hypothesis that voice impairment increases in severity toward the termination of a breath group even within a short temporal frame (i.e., 2 seconds or less of connected speech), and that this portion of the breath group may be an important determinant of perceptual impressions. Further

Tratamento médico e fonoaudiológico da disfonia espasmódica: uma revisão bibliográfica Medical treatment and speech therapy for spasmodic dysphonia: a literature review

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Eliana Maria Gradim Fabron

2013-01-01

Full Text Available A disfonia espasmódica (DE é um distúrbio vocal caracterizado por voz tensa-estrangulada, com quebras de sonoridade e que compromete a comunicação do indivíduo. O objetivo deste estudo é apresentar uma revisão bibliográfica dos tratamentos médico e fonoaudiológico proposto para a DE no período entre 2006 e 2010. Os tratamentos descritos foram: injeção de toxina botulínica (TB, miectomia, neurectomia, denervação e reinervação laríngea seletiva adutora, tireoplastia, miotermia tiroaritenóidea com radiofrequência, injeção de lidocaína, homeopatia e tratamento fonoaudiológico (fonoterapia. O uso de injeção de TB mostrou resultados que indicaram a satisfação dos pacientes tratados, embora alguns dos artigos apontassem a necessidade de reaplicação da toxina frequentemente, como desvantagem. Os procedimentos cirúrgicos foram considerados duradouros e indicados para os pacientes que não quiseram se submeter às aplicações de TB. Tais estudos, no entanto, apresentaram contingência de pacientes restrita e os resultados foram baseados, na maioria das investigações, no julgamento dos próprios pacientes sobre a sua qualidade vocal. Os tratamentos, com uso de lidocaína e homeopatia, mostraram resultados positivos em relação à qualidade vocal dos pacientes e foram sugeridos como uma opção, também, para aqueles que não gostariam de ser submetidos ao tratamento cirúrgico ou à aplicação de TB. Os poucos estudos que reportam fonoterapia assinalaram bons resultados quando a mesma foi associada à injeção de TB, mostrando a escassez de informações nesta área. Futuras pesquisas envolvendo a fonoterapia no tratamento da DE são necessárias.Spasmodic dysphonia (SD is a voice disorder characterized by a strained-strangled voice, with sound breaks and has implications in one's communication. The purpose of this study is to present a bibliographic review of the speech therapy and medical treatment suggested for SD

Vocal therapy of hyperkinetic dysphonia

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Mumović Gordana

2014-01-01

Full Text Available Introduction. Hyperkinetic (hyperfunctional dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. Objective. The objective of this study was to evaluate the effects of vocal therapy on voice condition characterized by hyperkinetic dysphonia with prenodular lesions and soft nodules. Methods. The study included 100 adult patients and 27 children aged 4-16 years with prenodular lesions and soft nodules. A subjective acoustic analysis using the GIRBAS scale was performed prior to and after vocal therapy. Twenty adult patients and 10 children underwent objective acoustic analysis including several acoustic parameters. Pathological vocal qualities (hoarse, harsh and breathy voice were also obtained by computer analysis. Results. The subjective acoustic analysis revealed a significant (p<0.01 reduction in all dysphonia parameters after vocal treatment in adults and children. After treatment, all levels of dysphonia were lowered in 85% (85/100 of adult patients and 29% (29/100 had a normal voice. Before vocal therapy 9 children had severe, 13 had moderate and 8 slight dysphonia. After vocal therapy only 1 child had severe dysphonia, 7 had moderate, 10 had slight levels of dysphonia and 9 were without voice disorder. The objective acoustic analysis in adults revealed a significant improvement (p≤0.025 in all dysphonia parameters except SD F0 and jitter %. In children, the acoustic parameters SD F0, jitter % and NNE (normal noise energy were significantly improved (p=0.003-0.03. Pathological voice qualities were also improved in adults and children (p<0.05. Conclusion. Vocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affecting diverse acoustic parameters.

Vocal therapy of hyperkinetic dysphonia.

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Mumović, Gordana; Veselinović, Mila; Arbutina, Tanja; Škrbić, Renata

2014-01-01

Hyperkinetic (hyperfunctional) dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. The objective of this study was to evaluate the effects of vocal therapy on voice condition characterized by hyperkinetic dysphonia with prenodular lesions and soft nodules. The study included 100 adult patients and 27 children aged 4-16 years with prenodular lesions and soft nodules. A subjective acoustic analysis using the GIRBAS scale was performed prior to and after vocal therapy. Twenty adult patients and 10 children underwent objective acoustic analysis including several acoustic parameters. Pathological vocal qualities (hoarse, harsh and breathy voice) were also obtained by computer analysis. The subjective acoustic analysis revealed a significant (pvocal treatment in adults and children. After treatment, all levels of dysphonia were lowered in 85% (85/100) of adult patients and 29% (29/100) had a normal voice. Before vocal therapy 9 children had severe, 13 had moderate and 8 slight dysphonia. After vocal therapy only 1 child had severe dysphonia, 7 had moderate, 10 had slight levels of dysphonia and 9 were without voice disorder. The objective acoustic analysis in adults revealed a significant improvement (p≤0.025) in all dysphonia parameters except SD FO and jitter %. In children, the acoustic parameters SD FO, jitter % and NNE (normal noise energy) were significantly improved (p=0.003-0.03). Pathological voice qualities were also improved in adults and children (pVocal therapy effectively improves the voice in hyperkinetic dysphonia with prenodular lesions and soft nodules in both adults and children, affectinq diverse acoustic parameters.

Laryngeal myofascial pain syndrome as a new diagnostic entity of dysphonia.

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Jung, Soo Yeon; Park, Hae Sang; Bae, Hasuk; Yoo, Jeong Hyun; Park, Hyung Jun; Park, Kee Duk; Kim, Han Su; Chung, Sung Min

2017-04-01

To consider the feasibility of diagnosing intrinsic laryngeal muscle myofascial pain syndrome (MPS) in dysphonic patients who demonstrated immediate symptom and stroboscopic finding improvement after laryngeal electromyography (LEMG) without further treatment. A chart review of patients who showed subtle vocal fold movement abnormalities on a stroboscopic examination and underwent ultrasonography (US)-guided LEMG was performed. Patients with vocal fold paralysis, mucosal lesions, spasmodic dysphonia, and vocal tremor on stroboscopic examination were excluded. Among them, patients with normal EMG findings were included in this study. The patients who reported voice symptom improvement after LEMG without further treatment were placed in laryngeal MPS (LMPS) group and the other patients were placed in non-laryngeal MPS (non-MPS) group. Predisposing factors, voice symptom, symptom-duration, and stroboscopic findings of these patients were reviewed. Among the 16 patients, LEMG findings were normal, five (31%) were included in the LMPS group and the other 11 patients (69%) were included in the non-MPS group. All LMPS group patients had a history of voice abuse and reported odynophonia. The Korean Voice Handicap Index-10 score decreased significantly after US-guided LEMG without additional treatment in the LMPS group. The stroboscopic findings revealed that vocal fold hypomobility was the most common finding in the LMPS group, and two patients showed a muscle tension dysphonia pattern. The LMPS groups showed improvement of vocal fold mobility on 1-week stroboscopic evaluation. LMPS is a potential diagnosis for patients with vocal fold hypomobility finding on stroboscopic findings but with normal EMG results. Diagnosis of LMPS could be considered in patients who showed symptom and vocal fold movement improvement after LEMG. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Validation of the Cepstral Spectral Index of Dysphonia (CSID) as a Screening Tool for Voice Disorders: Development of Clinical Cutoff Scores.

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Awan, Shaheen N; Roy, Nelson; Zhang, Dong; Cohen, Seth M

2016-03-01

The purposes of this study were to (1) evaluate the performance of the Cepstral Spectral Index of Dysphonia (CSID--a multivariate estimate of dysphonia severity) as a potential screening tool for voice disorder identification and (2) identify potential clinical cutoff scores to classify voice-disordered cases versus controls. Subjects were 332 men and women (116 men, 216 women) comprised of subjects who presented to a physician with a voice-related complaint and a group of non-voice-related control subjects. Voice-disordered cases versus controls were initially defined via three reference standards: (1) auditory-perceptual judgment (dysphonia +/-); (2) Voice Handicap Index (VHI) score (VHI +/-); and (3) laryngoscopic description (laryngoscopic +/-). Speech samples were analyzed using the Analysis of Dysphonia in Speech and Voice program. Cepstral and spectral measures were combined into a CSID multivariate formula which estimated dysphonia severity for Rainbow Passage samples (i.e., the CSIDR). The ability of the CSIDR to accurately classify cases versus controls in relation to each reference standard was evaluated via a combination of logistic regression and receiver operating characteristic (ROC) analyses. The ability of the CSIDR to discriminate between cases and controls was represented by the "area under the ROC curve" (AUC). ROC classification of dysphonia-positive cases versus controls resulted in a strong AUC = 0.85. A CSIDR cutoff of ≈24 achieved the best balance between sensitivity and specificity, whereas a more liberal cutoff score of ≈19 resulted in higher sensitivity while maintaining respectable specificity which may be preferred for screening purposes. Weaker but adequate AUCs = 0.75 and 0.73 were observed for the classification of VHI-positive and laryngoscopic-positive cases versus controls, respectively. Logistic regression analyses indicated that subject age may be a significant covariate in the discrimination of dysphonia-positive and VHI

A Randomized, Controlled Trial of Behavioral Voice Therapy for Dysphonia Related to Prematurity of Birth.

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Reynolds, Victoria; Meldrum, Suzanne; Simmer, Karen; Vijayasekaran, Shyan; French, Noel

2017-03-01

Dysphonia is a potential complication of prematurity. Preterm children may sustain iatrogenic laryngeal damage from medical intervention in the neonatal period, and further, adopt compensatory, maladaptive voicing behaviors. This pilot study aimed to evaluate the effects of a voice therapy protocol on voice quality in school-aged, very preterm (VP) children. Twenty-seven VP children with dysphonia were randomized to an immediate intervention group (n = 7) or a delayed-intervention, waiting list control group (n = 14). Following analysis of these data, a secondary analysis was conducted on the pooled intervention data (n = 21). Six participants did not complete the trial. Change to voice quality was measured via pre- and posttreatment assessments using the Consensus Auditory Perceptual Evaluation of Voice. The intervention group did not demonstrate statistically significant improvements in voice quality, whereas this was observed in the control group (P = 0.026). However, when intervention data were pooled including both the immediate and delayed groups following intervention, dysphonia severity was significantly lower (P = 0.026) in the treatment group. Dysphonia in most VP children in this cohort was persistent. These pilot data indicate that some participants experienced acceptable voice outcomes on spontaneous recovery, whereas others demonstrated a response to behavioral intervention. Further research is needed to identify the facilitators of and barriers to intervention success, and to predict those who may experience spontaneous recovery. Copyright © 2017 The Voice Foundation. All rights reserved.

Spasmodic torticollis: the dental connection.

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Sims, Anthony B; Stack, Brendan C; Demerjian, G Gary

2012-07-01

Spasmodic torticollis or cervical dystonia (CD) is the most common form of focal dystonia and is characterized by sustained abnormal muscle contractions in the head and neck area resulting in abnormal positioning or posturing of the head. The dystonic muscle spasms associated with spasmodic torticollis may affect any combination of neck muscles. Three cases are reported of spasmodic torticollis that were treated by a dental appliance with individual varying occlusal heights to open the maxillomandibular vertical dimension. Upon increasing the vertical dimension of occlusion, there was a slowing and/or discontinuance of the symptoms of cervical dystonia. The proposed hypothesis for this reversal is that there may be neuritis of the auriculotemporal branch of the trigeminal nerve, which has direct input into the reticular formation (RF), and it may activate the cells of the pontine region of the RF known for the control and deviation of head posture. There is growing clinical evidence that temporomandibular joint (TMJ) dysfunction may be a factor in this neurological and painful disorder when it coexists.

Theoretical Analyses of the Functional Regions of the Heavy Chain of Botulinum Neurotoxin

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1994-01-01

SE. Schulz GM. liallctt M. Effects of hb)tulinum toxin injections on speech in adductor spasmodic dysphonia . Neurology 1988,38:1220-1225. 3. Jankovic...hemifacial spasm. Mov Disord 1987:4:237-254. 5. Brin MF. Blitzer A, Fahn S, Gould W. Lovelace RE. Adductor laryngeal dystonia (spastic dysphonia ): treatment

Comparison of cepstral coefficients to other voice evaluation parameters in patients with occupational dysphonia

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Ewa Niebudek-Bogusz

2013-12-01

Full Text Available Background: Special consideration has recently been given to cepstral analysis with mel-frequency cepstral coefficients (MFCCs. The aim of this study was to assess the applicability of MFCCs in acoustic analysis for diagnosing occupational dysphonia in comparison to subjective and objective parameters of voice evaluation. Materials and Methods: The study comprised 2 groups, one of 55 female teachers (mean age: 45 years with occupational dysphonia confirmed by videostroboscopy and 40 female controls with normal voice (mean age: 43 years. The acoustic samples involving sustained vowels "a" and four standardized sentences were analyzed by computed analysis of MFCCs. The results were compared to acoustic parameters of jitter and shimmer groups, noise to harmonic ratio, Yanagihara index evaluating the grade of hoarseness, the aerodynamic parameter: maximum phonation time and also subjective parameters: GRBAS perceptual scale and Voice Handicap Index (VHI. Results: The compared results revealed differences between the study and control groups, significant for MFCC2, MFCC3, MFCC5, MFCC6, MFCC8, MFCC10, particularly for MFCC6 (p < 0.001 and MFCC8 (p < 0.009, which may suggest their clinical applicability. In the study group, MFCC4, MFCC8 and MFCC10 correlated significantly with the major objective parameters of voice assessment. Moreover, MFCC8 coefficient, which in the female teachers correlated with all eight objective parameters, also showed the significant relation with perceptual voice feature A (asthenity of subjective scale GRBAS, characteristic of weak tired voice. Conclusions: The cepstral analysis with mel frequency cepstral coefficients is a promising tool for evaluating occupational voice disorders, capable of reflecting the perceptual voice features better than other methods of acoustic analysis. Med Pr 2013;64(6:805–816

Surgical management of spasmodic torticollis

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Wael Fouad

2011-12-01

Full Text Available Introduction: Spasmodic torticollis (ST is a neuromuscular disorder characterized by uncontrolled clonic and intermittently tonic spasm of the neck muscles. Objective: This retrospective study was done to study clinical picture and to evaluate the surgical results of different surgical procedures in 11 patients who had spasmodic torticollis. Methods: The male to female ratio was 1–2 (4 males and 7 females and their ages ranged from 18 to 65 years. The X-ray of the cervical spine was performed before the operation to exclude cervical disorders that can cause symptoms similar to spasmodic torticollis. MRI of the head and neck was performed in all patients, without finding significant brain lesions. Electromyography of the cervical muscles was performed preoperatively and postoperatively. All cases underwent surgery in the form of variable combinations of ventral rhizotomy of C1, C2+ selective peripheral denervation of neck muscles involved according to the type of torticollis. Mean postoperative follow up period was 24 months. Results: There was no operative mortality. As regards the morbidity, one patient had deficiency of shoulder elevation that was transient and improved after 3 months; one patient had wound infection that responded well to antibiotics after culture and sensitivity. Postoperative dysphagia was found in two cases that improved in one of them after two months. At the last follow up examination period, excellent results were obtained in 55% of patients, good results in 18% of patients, fair results in 18% of patients, and poor results in 9% of cases. Conclusion: There is no standard surgical procedure for treatment of ST; this is adapted to each patient according to type of torticollis. Better results were obtained in simple torticollis (excellent results in 100%, than in complex type (excellent and good results in 33.3%. Keywords: Focal dystonia, Spasmodic torticollis, Anterior rhizotomy, Selective denervation

Laryngeal manual therapy palpatory evaluation scale: A preliminary study to examine its usefulness in diagnosis of occupational dysphonia

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Ewelina Woźnicka

2017-04-01

Full Text Available Background: The aim of this study has been to assess the larynx and soft tissue around the vocal tract in a group of people with healthy voice, and in a group of patients with occupational dysphonia using the new laryngeal manual therapy palpatory evaluation scale (LMTPE. Material and Methods: The examinations were performed in a study (dysphonic group of professional voice users who had developed voice disorders (N = 51 and in the control group of normophonic subjects (N = 50. All the participants underwent perceptual voice assessment and examination by means of the LMTPE scale. Additionally, phoniatric examination including VHI (Voice Handicap Index questionnaire, GRBAS (the Grade of hoarseness, Roughness, Breathiness, Asthenic, Strained perceptual evaluation, maximum phonation time (MPT measurement and videostroboscopy was performed in the study group. Results: The comparison of the LMTPE total score showed that the results of the study group were significantly poorer than those of controls (p < 0.001. In the study group, correlations were found between the LMTPE results and the VHI scores (p < 0.05, perceptual evaluation by the GRBAS (p < 0.05 and the objective parameter MPT (p < 0.05. Conclusions: The study has proven that the LMTPE scale is characterized by the high score of Cronbach’s α ratio estimating the reliability of the test. The results have confirmed that the LMTPE scale seems to be a valuable tool, useful in diagnostics of occupational dysphonia, particularly of hyperfunction origin. Med Pr 2017;68(2:179–188

[How to render an expert opinion on dysphonia].

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Nawka, T; Rosanowski, F; Gross, M

2014-09-01

In Germany, parameters for medicolegal evaluation of dysphonia have to be revised against the background of communication disorders getting more important in a modern communication society. In this work, up-to-date diagnostic tools are reviewed and evaluated for medicolegal purposes. Parametrization is -performed according to the International Classification of Functioning, Disability and Health ICF. Following this schema, -dysphonia is graded as follows: 1) No dysphonia (no problem, percentile 0-4) impairment of the whole person 0%, 2) Slight, strain-induced dysphonia (slight problem, percentile 5-24) -impairment of the whole person 0-10%, 3) Moderate dysphonia (moderate problem, percentile 25-49) impairment of the whole person 20-30%, 4) Severe dysphonia (severe problem, percentile 50-95) impairment of the whole person 40-50%, 5) Complete loss of voice (extreme problem, percentile 96-100%) impairment of the whole person 50%. © Georg Thieme Verlag KG Stuttgart · New York.

Botulinum toxin injection - larynx

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Injection laryngoplasty; Botox - larynx: spasmodic dysphonia-BTX; Essential voice tremor (EVT)-btx; Glottic insufficiency; Percutaneous electromyography - guided botulinum toxin treatment; Percutaneous indirect laryngoscopy - guided botulinum toxin treatment; ...

Voice symptoms and vocal deviation self-assessment in different types of dysphonia.

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Moreti, Felipe; Zambon, Fabiana; Behlau, Mara

2014-01-01

To identify the relationship among the type of dysphonia, vocal deviation self-assessed and the presence of voice symptoms in adults. One hundred sixty-four subjects of both genders (58 males and 106 females, mean age 42.89 years) diagnosis of dysphonia, divided into three groups according to the type of dysphonia: 87 individuals with functional dysphonia, 35 individuals with organofunctional dysphonia and 42 individuals with organic dysphonia, answered the Brazilian validated version of Voice Symptom Scale (VoiSS) (Escala de Sintomas Vocais - ESV), that consists of 30 questions with four scores: Impairment, Emotional, Physical and Total, and self-assessed their voices as excellent, very good, good, fair or poor. According to the dysphonia type, there were differences in ESV Impairment, Emotional and Total mean scores, which was not found in the Physical score. The Impairment, Emotional and Total mean scores were higher in organic dysphonia, followed by organofunctional dysphonia and finally functional dysphonia. When the vocal self-assessment is poor, the higher are the deviations in the Impairment, Emotional and Total ESV scores. Individuals with organic dysphonia reported higher perception of voice symptoms, followed by subjects with organofunctional dysphonia and finally individuals with functional dysphonia. In general, individuals with dysphonia presented physical voice symptoms, regardless of the type of the dysphonia. Finally, there are direct correlations between Impairment, Emotional and Total ESV scores and the vocal self-assessment.

Quantifying Dysphonia Severity Using a Spectralcepstral-Based Acoustic Index: Comparisons with Auditory-Perceptual Judgements from the CAPE-V

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Awan, Shaheen N.; Roy, Nelson; JettE, Marie E.; Meltzner, Geoffrey S.; Hillman, Robert E.

2010-01-01

This study investigated the relationship between acoustic spectral/cepstral measures and listener severity ratings in normal and disordered voice samples. CAPE-V sentence samples and the vowel /[script]/were elicited from eight normal speakers and 24 patients with varying degrees of dysphonia severity. Samples were analysed for measures of the…

The Effectiveness of the Comprehensive Voice Rehabilitation Program Compared With the Vocal Function Exercises Method in Behavioral Dysphonia: A Randomized Clinical Trial.

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Pedrosa, Vanessa; Pontes, Antônio; Pontes, Paulo; Behlau, Mara; Peccin, Stella Maria

2016-05-01

To evaluate the effectiveness of the Comprehensive Voice Rehabilitation Program (CVRP) compared with Vocal Function Exercises (VFEs) to treat functional dysphonia. This is a randomized blinded clinical trial. Eighty voice professionals presented with voice complaints for more than 6 months with a functional dysphonia diagnosis. Subjects were randomized into two voice treatment groups: CVRP and VFE. The rehabilitation program consisted of six voice treatment sessions and three assessment sessions performed before, immediately after, and 1 month after treatment. The outcome measures were self-assessment protocols (Voice-Related Quality of Life [V-RQOL] and Voice Handicap Index [VHI]), perceptual evaluation of vocal quality, and a visual examination of the larynx, both blinded. The randomization process produced comparable groups in terms of age, gender, signs, and symptoms. Both groups had positive outcome measures. The CVRP effect size was 1.09 for the V-RQOL, 1.17 for the VHI, 0.79 for vocal perceptual evaluation, and 1.01 for larynx visual examination. The VFE effect size was 0.86 for the V-RQOL, 0.62 for the VHI, 0.48 for the vocal perceptual evaluation, and 0.51 for larynx visual examination. Only 10% of the patients were lost over the study. Both treatment programs were effective. The probability of a patient improving because of the CVRP treatment was similar to that of the VFE treatment. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Is perceived dysphonia related to perceived healthiness?

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Maryn, Youri; Debo, Kim

2015-10-01

Literature has shown that voice-disordered persons are at higher risk for negative attitudes on several personality and physical appearance traits than vocally normal persons. This study investigated general perceptions of health in subjects with various degrees of dysphonia. Recordings from 100 normophonic and dysphonic subjects were auditorily rated on dysphonia severity by five experienced clinicians and on degree of healthiness/unhealthiness by seven unexperienced listeners. Results revealed strong correlation between auditory ratings of dysphonia severity and unhealthiness severity. Dysphonic subjects are rated significantly unhealthier than normophonic subjects, and the receiver-operating characteristics curve showed that even slight dysphonia induces negative attributions of unhealthiness. This study provides additional evidence for the negative attitudes with which dysphonic speakers are confronted, especially in terms of health.

Vocal therapy of hyperkinetic dysphonia

OpenAIRE

Mumović Gordana; Veselinović Mila; Arbutina Tanja; Škrbić Renata

2014-01-01

Introduction. Hyperkinetic (hyperfunctional) dysphonia is a common pathology. The disorder is often found in vocal professionals faced with high vocal requirements. Objective. The objective of this study was to evaluate the effects of vocal therapy on voice condition characterized by hyperkinetic dysphonia with prenodular lesions and soft nodules. Methods. The study included 100 adult patients and 27 children aged 4-16 years with prenodular lesions and soft...

Efficacy of Water Resistance Therapy in Subjects Diagnosed With Behavioral Dysphonia: A Randomized Controlled Trial.

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Guzman, Marco; Jara, Rodrigo; Olavarria, Christian; Caceres, Paloma; Escuti, Geordette; Medina, Fernanda; Medina, Laura; Madrid, Sofia; Muñoz, Daniel; Laukkanen, Anne-Maria

2017-05-01

The purpose of the present study was to determine the efficacy of water resistance therapy (WRT) in a long-term period of voice treatment in subjects diagnosed with voice disorders. Twenty participants, with behavioral dysphonia, were randomly assigned to one of two treatment groups: (1) voice treatment with WRT, and (2) voice treatment with tube phonation with the distal end in air (TPA). Before and after voice therapy, participants underwent aerodynamic, electroglottographic, acoustic, and auditory-perceptual assessments. The Voice Handicap Index and self-assessment of resonant voice quality were also performed. The treatment included eight voice therapy sessions. For the WRT group, the exercises consisted of a sequence of five phonatory tasks performed with a drinking straw submerged 5 cm into water. For the TPA, the exercises consisted of the same phonatory tasks, and all of them were performed into the same straw but the distal end was in air. Wilcoxon test showed significant improvements for both groups for Voice Handicap Index (decrease), subglottic pressure (decrease), phonation threshold pressure (decrease), and self-perception of resonant voice quality (increase). Improvement in auditory-perceptual assessment was found only for the TPA group. No significant differences were found for any acoustic or electroglottographic variables. No significant differences were found between WRT and TPA groups for any variable. WRT and TPA may improve voice function and self-perceived voice quality in individuals with behavioral dysphonia. No differences between these therapy protocols should be expected. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Voice symptoms and vocal deviation self-assessment in different types of dysphonia

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Moreti,Felipe; Zambon,Fabiana; Behlau,Mara

2014-01-01

PURPOSE: To identify the relationship among the type of dysphonia, vocal deviation self-assessed and the presence of voice symptoms in adults.METHODS: One hundred sixty-four subjects of both genders (58 males and 106 females, mean age 42.89 years) diagnosis of dysphonia, divided into three groups according to the type of dysphonia: 87 individuals with functional dysphonia, 35 individuals with organofunctional dysphonia and 42 individuals with organic dysphonia, answered the Brazilian validate...

Association between asthma and dysphonia: A population-based study.

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Park, Bumjung; Choi, Hyo Geun

2016-09-01

We investigated whether asthma predisposes patients to organic laryngeal lesions or increases dysphonia in those without organic laryngeal lesions. We performed a cross-sectional study with data from the Korea National Health and Nutrition Examination Survey; 19,330 subjects from 2008 through 2011 were included. The associations of asthma with organic laryngeal lesions and dysphonia were analyzed using a simple/multiple logistic regression analysis with complex sampling while adjusting for confounding factors (age, sex, smoking status, stress level, and body mass index) that could contribute to dysphonia. Compared with non-asthma participants, the asthma patients tended to be older and female and to have higher stress levels. These factors were associated with dysphonia (Age, AOR = 1.20, 95% CI = 1.14 = 1.23, P dysphonia. Compared with non-asthma participants, asthma patients who had not taken asthma medication recently showed a higher AOR (1.62; 95% CI = 1.0-2.42) for dysphonia, and asthma patients who had taken asthma medication recently showed the highest adjusted odds ratio for dysphonia (AOR = 1.97; 95% confidence interval, CI = 1.28-3.02, P = 0.001). On multiple logistic regression analysis, vocal nodules, laryngeal polyps, and laryngitis were not associated with asthma (all P > 0.05). Asthma patients are predisposed to subjective dysphonia due to demographic and clinical characteristics (older age, female, and higher stress level) as well as to asthma itself. However, asthma was not associated with organic laryngeal lesions in this study.

Dysphonia in very preterm children: a review of the evidence.

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Reynolds, Victoria; Meldrum, Suzanne; Simmer, Karen; Vijayasekaran, Shyan; French, Noel

2014-01-01

Intubation is a known risk factor for dysphonia yet is essential in the perinatal care of many very preterm infants. Children born preterm, who are frequently resuscitated with endotracheal intubation, may be at risk of dysphonia at school age and beyond. To identify and describe the evidence pertaining to long-term voice outcomes and risk factors for developing dysphonia in preterm children. In addition to case studies and series, three larger-scale studies have reported on dysphonia and voice outcomes in preterm children. Studies reporting treatment outcomes were not available. Factors associated with poor voice outcomes included female gender, birth weight Dysphonia is a newly reported, long-term complication of preterm birth, yet the number of relevant studies remains limited. Further research is required to confirm the risk factors for developing dysphonia, which will inform future voice treatment studies.

Behavioral Dysphonia and Depression in Elementary School Teachers.

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Marques da Rocha, Luise; Behlau, Mara; Dias de Mattos Souza, Luciano

2015-11-01

To verify the relationship between behavioral dysphonia and current depressive episodes in municipal elementary school teachers. We hypothesize that teachers with behavioral dysphonia will be more susceptible to psychiatric disorders. Cross-sectional study, quantitative, conducted across municipal schools in both rural and urban regions of Pelotas. Five-hundred seventy-five teachers from urban and rural areas of the same Brazilian state were included. The full version of the Voice Handicap Index validated into Brazilian Portuguese was used to determine the presence of behavioral dysphonia. A profile of vocal behaviors was also used to quantify the number of phonotraumatic events. In addition, the Mini-International Neuropsychiatric Interview was used to determine current episodes of depression. Data were analyzed via correlative studies using chi-square and Poisson regression analyses. Across all teachers, the prevalence of dysphonia was 33.9% and 55% reported that they had already taken a leave because of their voice. Those teachers with a current depressive episode had a higher rate of dysphonia compared with those without depression (prevalence ratio [PR] 1.66; P Teachers who presented with a risk of serious vocal problems had a prevalence ratio of 2.58, indicating a greater proportion of dysphonia, whereas teachers classified as champions of abuse were five times more likely compared with those teachers with behaved or candidates for voice problems. There is an association between behavioral dysphonia and current depressive episodes in elementary school teachers. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

An apparatus for a complimentary treatment of spasmodic torticollis.

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Saito, I; Weiss, T

1988-07-01

We have developed an apparatus for treating spasmodic torticollis that can be used at home both during intensive therapy and follow-up. The refractoriness of spasmodic torticollis requires patients to practice biofeedback training partly on a home basis. However, it is usually difficult for spasmodic torticollis patients to provide and handle electromyographic (EMG) biofeedback training instruments. The present apparatus has 2 parts: first, a harness with a light source which is fixed on both shoulders; second, a photoreceptor, operant system for rewarding effect, and a digital recorder. The light is adjusted to strike the photoreceptor on the forehead when headposition is normal. Subjects are asked to keep the operant system--e.g. a radio--activated. They are trained in various postures as sitting, standing and walking. This apparatus provides a chance of home training to augment and maintain the effect during therapeutic sessions and the follow-up period.

Vocal dose in teachers: correlation with dysphonia.

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Gama, Ana Cristina Côrtes; Santos, Juliana Nunes; Pedra, Elisângela de Fátima Pereira; Rabelo, Alessandra Terra Vasconcelos; Magalhães, Max de Castro; Casas, Estevam Barbosa de Las

2016-04-01

Teachers are professionals with high prevalence of dysphonia, whose main risk factors are the large work hours in classrooms with the presence of background noise. The purpose of the study was to calculate the phonation time and the cycle dose of teachers with dysphonia and teachers without voice disorders during the class. There were two groups analyzed: five teachers with functional dysphonia were the first group and five teachers without voice disorders were the second group. For the data was used the VoxLog® dosimeter and the parameters were: intensity; fundamental frequency; phonation time and cycle dose. The statistical analysis used ANOVA, Student's T-test, and Kruskal-Wallis test. Dysphonic teachers showed major values of phonation time and cycle dose compared with teachers without voice disorders. The dysphonia is related to extended period of speech time and greater exposure of the tissue of the vocal fold to phonotrauma.

Back-and-Forth Methodology for Objective Voice Quality Assessment: From/to Expert Knowledge to/from Automatic Classification of Dysphonia

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Fredouille, Corinne; Pouchoulin, Gilles; Ghio, Alain; Revis, Joana; Bonastre, Jean-François; Giovanni, Antoine

2009-12-01

This paper addresses voice disorder assessment. It proposes an original back-and-forth methodology involving an automatic classification system as well as knowledge of the human experts (machine learning experts, phoneticians, and pathologists). The goal of this methodology is to bring a better understanding of acoustic phenomena related to dysphonia. The automatic system was validated on a dysphonic corpus (80 female voices), rated according to the GRBAS perceptual scale by an expert jury. Firstly, focused on the frequency domain, the classification system showed the interest of 0-3000 Hz frequency band for the classification task based on the GRBAS scale. Later, an automatic phonemic analysis underlined the significance of consonants and more surprisingly of unvoiced consonants for the same classification task. Submitted to the human experts, these observations led to a manual analysis of unvoiced plosives, which highlighted a lengthening of VOT according to the dysphonia severity validated by a preliminary statistical analysis.

Back-and-Forth Methodology for Objective Voice Quality Assessment: From/to Expert Knowledge to/from Automatic Classification of Dysphonia

Directory of Open Access Journals (Sweden)

Corinne Fredouille

2009-01-01

Full Text Available This paper addresses voice disorder assessment. It proposes an original back-and-forth methodology involving an automatic classification system as well as knowledge of the human experts (machine learning experts, phoneticians, and pathologists. The goal of this methodology is to bring a better understanding of acoustic phenomena related to dysphonia. The automatic system was validated on a dysphonic corpus (80 female voices, rated according to the GRBAS perceptual scale by an expert jury. Firstly, focused on the frequency domain, the classification system showed the interest of 0–3000 Hz frequency band for the classification task based on the GRBAS scale. Later, an automatic phonemic analysis underlined the significance of consonants and more surprisingly of unvoiced consonants for the same classification task. Submitted to the human experts, these observations led to a manual analysis of unvoiced plosives, which highlighted a lengthening of VOT according to the dysphonia severity validated by a preliminary statistical analysis.

Use of Botulinum Neurotoxin for the Treatment of Movement Disorders

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... spasmodic dysphonia, or ABSD). Does BoNT control motor tics? Tics associated with Tourette syndrome are relatively brief, intermittent movements (also known as motor tics) or sounds (also known as vocal or phonic ...

The epidemiology of dysphonia in the aging population.

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Marino, Jeffrey P; Johns, Michael M

2014-12-01

The expanding elderly population continues to exert profound effects on the United States healthcare delivery system. This review summarizes the epidemiology of dysphonia in the aging population as well as its impact on quality of life and the emerging challenges of managing elderly patients with voice disorders. Although often underreported, dysphonia is present in as many as one in three elderly patients. The differential diagnosis for dysphonia in an aging patient is broad, and multifactorial causes are common. In the elderly, dysphonia exerts significant adverse effects on quality of life and often occurs against a background of multiple chronic medical conditions, polypharmacy, hearing loss, dysphagia, and neurologic disease. Recent data have demonstrated that elderly patients respond well to both surgical and nonsurgical treatments for voice disorders. Elderly patients and medical providers, as well as families and caregivers, must be educated about the prevalence of dysphonia in the aging population, its psychosocial impact, and available treatment options. Optimizing the care of voice disorders is essential to maximizing quality of life in aging patients.

Practical Considerations for Dysphonia Caused by Inhaled Corticosteroids

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Galván, César A.; Guarderas, Juan Carlos

2012-01-01

Inhaled corticosteroid (ICS) therapy has become standard in the treatment of asthma. A common local adverse effect of ICS therapy is dysphonia, which has been reported to affect 5% to 58% of patients. Although causes of dysphonia associated with ICS therapy have been underinvestigated, it may result from deposition of an active ICS in the oropharynx during administration, which then causes myopathy or a mucosal effect in the laryngopharynx. Use of ICS should be considered during any evaluation of dysphonia. We recommend using the lowest effective dosage of ICS, administering medication with a spacer, gargling, rinsing the mouth and washing the face after inhalation, and washing the spacer. If dysphonia develops despite these interventions, ICS use should be suspended until symptoms resolve, provided that asthma control is not compromised. PMID:22958993

Psychosis improved dysphonia

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Murphy, Ruth Ann; Hallahan, Brian

2013-01-01

We present the case of a 40-year-old single man with a diagnosis of Schizoaffective Disorder since 1989 and a comorbid diagnosis of functional (dissociative) dysphonia since 2011. Although receiving ongoing treatment from a Speech and Language Therapist, the patient's symptoms of dysphonia have remained prominent from the time of diagnosis in 2011 and have been particularly apparent during times of psychosocial and interpersonal stress. He had a dramatic and complete resolution of all dysphonic symptoms during an acute relapse of the psychosis in February 2013 and experienced a gradual re-emergence of dysphonic symptoms when his episode of psychosis resolved. This is the first case report to demonstrate such an association and we discuss potential mechanisms for the resolution of dysphonic symptoms during this psychotic relapse. PMID:24323380

Combined Functional Voice Therapy in Singers With Muscle Tension Dysphonia in Singing.

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Sielska-Badurek, Ewelina; Osuch-Wójcikiewicz, Ewa; Sobol, Maria; Kazanecka, Ewa; Rzepakowska, Anna; Niemczyk, Kazimierz

2017-07-01

The purpose of this study was to evaluate vocal tract function and the voice quality in singers with muscle tension dysphonia (MTD) after undergoing combined functional voice therapy of the singing voice. This is a prospective, randomized study. Forty singers (29 females and 11 males, mean age: 24.6 ± 8.8 years) with MTD were enrolled in the study. The study group consisted of 20 singers who underwent combined functional voice therapy (10-15 individual sessions, 30-40 minutes each). Singers who did not opt for vocal rehabilitation consisted of the control group. Effects of rehabilitation were assessed with videolaryngostroboscopy, palpation of the vocal tract structures, flexible fiberoptic evaluation of the pharynx and the larynx, perceptual speaking and singing voice assessment, acoustic analysis, maximal phonation time, and the Voice Handicap Index. After combined functional voice therapy in the study group, great improvement was noticed in palpation of the vocal tract structures (P singing range obtained from acoustic analysis of glissando (P singing. Development of palpation and perceptual singing voice examination protocols enables one to compare results before and after rehabilitation in clinics. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

DYSPHONIA AS AN UNCOMMON PRESENTATION OF PONTOCEREBELLAR CHOROID PLEXUS PAPILLOMA.

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Rotim, Krešimir; Sajko, Tomislav; Zmajević, Marina; Šumonja, Ilijana; Grgić, Marko

2015-06-01

A case is presented of a patient with dysphonia, hearing loss and ataxia due to vestibulocochlear and vagal nerve compression by choroid plexus papilloma in the cerebellopontine angle. Choroid plexus papillomas are rare tumors usually arising in the lateral and fourth ventricle, and rarely found in the cerebellopontine angle, making the neuroimaging characteristics usually not sufficient for diagnosis. Patients usually present with headache and hydrocephalus but tumors in the cerebellopontine angle can cause vestibulocochlear dysfunction and cerebellar symptoms. Dysphonia along with hearing loss was a dominant symptom in the case presented. After complete surgical removal of the tumor, deterioration of dysphonia was noticed; it could be explained as peripheral vagal nerve neuropathy due to tumor compression and intraoperative manipulation. In this case report, we describe dysphonia as an uncommon presentation of a rare posterior fossa tumor. To our knowledge, a case of choroid plexus papilloma presenting with dysphonia has not been described before. Our case extends the differential diagnosis of dysphonia from the otorhinolaryngological to the neurosurgical field.

Parkinson's disease detection based on dysphonia measurements

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Lahmiri, Salim

2017-04-01

Assessing dysphonic symptoms is a noninvasive and effective approach to detect Parkinson's disease (PD) in patients. The main purpose of this study is to investigate the effect of different dysphonia measurements on PD detection by support vector machine (SVM). Seven categories of dysphonia measurements are considered. Experimental results from ten-fold cross-validation technique demonstrate that vocal fundamental frequency statistics yield the highest accuracy of 88 % ± 0.04. When all dysphonia measurements are employed, the SVM classifier achieves 94 % ± 0.03 accuracy. A refinement of the original patterns space by removing dysphonia measurements with similar variation across healthy and PD subjects allows achieving 97.03 % ± 0.03 accuracy. The latter performance is larger than what is reported in the literature on the same dataset with ten-fold cross-validation technique. Finally, it was found that measures of ratio of noise to tonal components in the voice are the most suitable dysphonic symptoms to detect PD subjects as they achieve 99.64 % ± 0.01 specificity. This finding is highly promising for understanding PD symptoms.

Pediatrician approach to dysphonia.

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Sajisevi, Mirabelle; Cohen, Seth; Raynor, Eileen

2014-08-01

The prevalence of voice disorders reaches up to 23.4% in the pediatric population and has a negative impact on quality of life. The objective of this study is to examine how pediatricians assess and manage patients with voice disorders and barriers they face when evaluating patients with dysphonia. The study was designed as a cross-sectional survey. Pediatricians who are members of the North Carolina Pediatric Society or Duke University affiliated physicians were selected to participate in the study. They were emailed a description of the study with a link to a questionnaire regarding comfort level in recognizing an abnormal voice, how often they assess for dysphonia, barriers to evaluation of voice problems, reasons for referral, and common treatments employed. A total of 1125 physicians were sent a questionnaire and 72 replied for a response rate of 6.4%. Of those who responded, only 16.7% routinely assess patients for voice problems. The most common reasons for not assessing patients for dysphonia include patients not complaining of voice problems or parents not concerned, and being unsure of the best method or available treatment options. Referrals were most commonly made when speech could not be understood or when the voice problem coincided with other neurological symptoms. Allergy and reflux medications were often trialed prior to referral. The majority of responders felt that voice problems impacted quality of life and 84.7% were interested in more information regarding pediatric voice problems. Pediatricians encounter barriers in the assessment of voice problems in their patients. There is evidence from our study that they have interest in learning more about dysphonia. Otolaryngologists must continue to provide outreach to pediatricians to enhance the screening and management of patients with voice disorders. Copyright © 2014. Published by Elsevier Ireland Ltd.

Occupational and individual risk factors for dysphonia in teachers.

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Assunção, A Á; Bassi, I B; de Medeiros, A M; Rodrigues, C de Souza; Gama, A C C

2012-10-01

In recent decades several groups of researchers have been interested in describing and understanding vocal morbidity in teachers in order to explain the large number of teachers diagnosed with dysphonia and account for the absenteeism attributed to vocal disability. To determine the proportion of teachers who reported a diagnosis of dysphonia and measure associations between individual and contextual factors and the event of interest. Teachers were recruited from the city of Belo Horizonte and invited to complete a web-based institutional intranet questionnaire. In total, 649 teachers responded; 32% (CI 28.5-35.5) reported that they had received a physician diagnosis of dysphonia. This prevalence was significantly higher among female teachers (prevalence ratio (PR) 2.33; CI 1.41-3.85), and groups who reported limited technical resources and equipment (PR 1.56; CI 1.14-2.15), a diagnosis of gastritis (PR 1.59; CI 1.28-1.98), not being summoned for an annual physician examination (PR 0.47; CI 0.32-0.68), or absenteeism (PR 1.39; CI 1.06-1.81). The high prevalence of dysphonia in teachers was not associated with any individual variables, except for sex and comorbidity (diagnosis of gastritis). Limited technical resources and equipment were associated with dysphonia and suggests policy change is important in preventing dysphonia.

Dysphonia and dysphagia after anterior cervical decompression.

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Tervonen, Hanna; Niemelä, Mika; Lauri, Eija-Riitta; Back, Leif; Juvas, Anja; Räsänen, Pirjo; Roine, Risto P; Sintonen, Harri; Salmi, Tapani; Vilkman, S Erkki; Aaltonen, Leena-Maija

2007-08-01

In this paper, the authors investigate the effects of anterior cervical decompression (ACD) on swallowing and vocal function. The study comprised 114 patients who underwent ACD. The early group (50 patients) was examined immediately pre- and postoperatively, and the late group (64 patients) was examined at only 3 to 9 months postoperatively. Fifty age- and sex-matched patients from the Department of Otorhinolaryngology-Head and Neck Surgery who had not been intubated in the previous 5 years were used as a control group. All patients in the early and control groups were examined by a laryngologist; patients in the late group were examined by a laryngologist and a neurosurgeon. Videolaryngostroboscopy was performed in all members of the patient and control groups, and the function of the ninth through 12th cranial nerves were clinically evaluated. Data were collected concerning swallowing, voice quality, surgery results, and health-related quality of life. Patients with persistent dysphonia were referred for phoniatric evaluation and laryngeal electromyography (EMG). Those with persistent dysphagia underwent transoral endoscopic evaluation of swallowing function and videofluorography. Sixty percent of patients in the early group reported dysphonia and 69% reported dysphagia at the immediate postoperative visit. Unilateral vocal fold paresis occurred in 12%. The prevalence of both dysphonia and dysphagia decreased in both groups 3 to 9 months postoperatively. All six patients with vocal fold paresis in the early group recovered, and in the late group there were two cases of vocal fold paresis. The results of laryngeal EMG were abnormal in 14 of 16 patients with persistent dysphonia. Neither intraoperative factors nor age or sex had any effect on the occurrence of dysphonia, dysphagia, or vocal fold paresis. Most patients were satisfied with the surgical outcome. Dysphonia, dysphagia, and vocal fold paresis are common but usually transient complications of ACD

A Qualitative Study of Interference with Communicative Participation across Communication Disorders in Adults

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Baylor, Carolyn; Burns, Michael; Eadie, Tanya; Britton, Deanna; Yorkston, Kathryn

2011-01-01

Purpose: To explore the similarities and differences in self-reported restrictions in communicative participation across different communication disorders in community-dwelling adults. Method: Interviews were conducted with 44 adults representing 7 different medical conditions: spasmodic dysphonia, multiple sclerosis, stroke, stuttering,…

Epidemiological association of olfactory dysfunction with hearing loss and dysphonia in the Korean population

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Park, Jae Hong; Byeon, Hyung Kwon; Park, Ki Nam; Kim, Jae Wook; Lee, Seung Won; Han, Kyung-do; Chang, Jae Won; Kim, Won Shik; Koh, Yoon Woo; Ban, Myung Jin

2017-01-01

Abstract The aim of the study is to investigate the association between olfactory dysfunction (OD), hearing loss, and dysphonia. The cross-sectional data for 17,984 adults who completed the Korea National Health and Nutrition Examination Surveys (2010−12) were analyzed. OD, hearing loss, and dysphonia were assessed using self-reporting questionnaires. The association of OD with hearing loss and dysphonia was evaluated. Hearing loss and dysphonia were significantly more prevalent in patients with OD than in those without OD (hearing loss, 28.1% vs 11.3%; dysphonia, 11.1% vs 5.9%; both P dysphonia, and was greater in those with combined hearing loss and dysphonia than in both patients without these dysfunctions and in those with a single dysfunction (odds ratio 3.115, 95% confidence interval 1.973–4.917). OD was significantly associated with hearing loss and dysphonia. PMID:29382018

Dysphonia in preterm children: assessing incidence and response to treatment.

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Reynolds, Victoria; Meldrum, Suzanne; Simmer, Karen; Vijayasekaran, Shyan; French, Noel P

2014-03-01

Mild dysphonia in childhood is surprisingly common, yet moderate to severe dysphonia is rare. The latter has been associated with complex medical conditions and congenital abnormalities. Intubation injury has also been documented as a cause of childhood dysphonia. Children born very preterm may be intubated as part of the intensive care administered in the perinatal and neonatal periods, yet there are few studies investigating dysphonia in this population. This study will be the first to: use an objective acoustic voice assessment in a paediatric study, document the incidence of dysphonia in very preterm children at school age, and conduct a controlled trial of behavioural voice therapy in this population. This study will consist of three phases: assessment of voice quality and its impact on quality of life in up to 200 children born at less than 32 weeks' gestation: assessment of the nature and extent of laryngeal pathology in children with moderate to severe dysphonia; and a non-blinded, randomised controlled trial of behavioural voice therapy in children with moderate to severe dysphonia. This study will be the first to use clinical assessment to examine the voice quality of very preterm children, and to use fibre optic endoscopic evaluation of laryngeal function to determine the nature and extent of any laryngeal pathology in such children. Those participants with significant voice difficulties will be randomised to receive treatment immediately or after the eight week assessment. This study is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12613001015730/ACTRN12613001012763). Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Transcutaneous Electrical Nerve Stimulation (TENS) and Laryngeal Manual Therapy (LMT): Immediate Effects in Women With Dysphonia.

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Conde, Mariana de Cásisa Macedo; Siqueira, Larissa Thaís Donalonso; Vendramini, José Eduardo; Brasolotto, Alcione Ghedini; Guirro, Rinaldo Roberto de Jesus; Silverio, Kelly Cristina Alves

2018-05-01

This study aimed to verify the immediate effect of low-frequency transcutaneous electrical nerve stimulation (TENS) and laryngeal manual therapy (LMT) in musculoskeletal pain, voice quality, and self-reported signs in women with dysphonia. Thirty women with behavioral dysphonia were randomly divided into the TENS group and the LMT group. All participants fulfilled the pain survey and had their voices recorded to posterior perceptual and acoustic analysis before and after intervention. The TENS group received a unique low-frequency TENS session (20 minutes). The LMT group received LMT (20 minutes) with soft and superficial massage in the sternocleidomastoid muscle, suprahyoid muscles, and larynx. Afterward, the volunteers reported their voice, larynx, breathing, and articulatory signs. Pre and post data were compared by parametric and nonparametric tests. After TENS, a decrease in pain intensity in the posterior or anterior region of the neck, shoulders, upper or lower back, and masseter was observed. After LMT, a decrease in pain intensity in the neck anterior region, shoulders, lower back, and temporal region was observed. Also, after TENS, there was an improvement in vowel /a/ instability; after LMT, there was a general improvement in voice quality, decrease in tension, and decrease in breathiness in speech. Positive voice and laryngeal signs were reported after TENS, and positive laryngeal signs and articulation were reported after LMT. TENS and LMT may be used in voice treatment of women with behavioral dysphonia, and both may be considered important therapy resources that reduce musculoskeletal pain and cause positive laryngeal signs. Both TENS and LMT are able to partially improve voice quality, but TENS presented better results. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Dysphonia in extremely preterm children: A longitudinal observation.

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Reynolds, Victoria; Meldrum, Suzanne; Simmer, Karen; Vijayasekaran, Shyan; French, Noel

2016-12-01

Dysphonia is a potential long-term complication of preterm birth. Childhood voice disorders caused by vocal hyperfunction resolve with pubertal changes to the vocal mechanism in many cases. In extremely preterm children, whose voice quality is affected by supraglottic hyperfunction adapted secondary to underlying structural laryngeal pathology sustained during neonatal intubation, the prognosis is unknown. A pilot study was conducted to assess the incidence and severity of dysphonia in children born at dysphonia severity scores were significantly lower on repeat assessment, but no differences were observed in objective or quality of life scores. Individual variation was observed: the difference in CAPE-V scores ranged from -36 to + 1. No participant presented with normal voice quality on repeat assessment. Analysis of group data masked individual variability in this series. Mechanisms underlying such individual variation are currently unknown. These data suggest that dysphonia is persistent in extremely preterm children. Further investigation is warranted to elucidate the progression of voice disorders in extremely preterm children, to inform prognostic predictors and treatment decisions.

[Incidence of dysphonia in teaching staff of schools].

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Bellia, S; Serafino, L; Luca, N; Farruggia, E; Bellia, M

2007-01-01

Some categories of workers (actors, teachers, singers) use a particular working tool: their voice. In order to assess the spread of dysphonia and its possible causes across a specific class of workers--the teachers of some schools in the city of Catania--we have set up a ad hoc questionnaire. A special database has been subsequently arranged, aimed at the statistical analysis of the responses obtained. The analysis of the responses shows that the phenomenon is more present in female than male teachers, 48% versus 30%. The dysphonia occurs mainly at the end of the working day, lasts throughout the school year and improves in summer, demonstrating the importance of teaching activity in its pathogenesis. One aspect especially stands out: dysphonia occurs exclusively in those individuals suffering from diseases with possible alterations of the voice, such as allergopathies, tireopathies and gastropathies. Therefore, work activity alone does not seem able to cause a chronic dysphonia, whereas the presence of diseases causing disability of vocal cords appears to play an important role.

Assessment of Grade of Dysphonia and Correlation With Quality of Life Protocol.

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Spina, Ana Lúcia; Crespo, Agrício Nubiato

2017-03-01

The main objective of this study is to check the correlation between vocal self-assessment and results of the Voice-Related Quality of Life (V-RQOL) protocol, and whether there is a correlation between perceptual vocal assessment made by voice therapists and the results from the V-RQOL protocol. The study included 245 subjects with vocal complaints. This was a prospective analytical clinical study. Vocal perceptual assessment of each subject with dysphonia was made by three voice therapists, followed by self-assessment made by the subjects themselves, and the application of the V-RQOL protocol. The results have shown poor level of agreement between vocal assessment made by the voice therapists and self-assessment made by the subjects. The statistical analysis indicated that the results of V-RQOL protocol showed significant correlation with the vocal assessment made by the voice therapists and the self-assessment by the subjects. The agreement between the assessments was low and variable; age, gender, professional voice use, and clinical laryngoscopic diagnosis did not influence the agreement level. Protocol V-RQOL is sensitive to vocal assessment made by the voice therapists and self-assessment made by the patient. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Dysphonia risk screening protocol

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Nemr, Katia; Simões-Zenari, Marcia; da Trindade Duarte, João Marcos; Lobrigate, Karen Elena; Bagatini, Flavia Alves

2016-01-01

OBJECTIVE: To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia. METHOD: This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors) divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis. RESULTS: The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children), 29.25 (adult women), 22.75 (adult men), and 27.10 (seniors). CONCLUSION: The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics. PMID:27074171

Dysphonia risk screening protocol

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Katia Nemr

2016-03-01

Full Text Available OBJECTIVE: To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia. METHOD: This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis. RESULTS: The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children, 29.25 (adult women, 22.75 (adult men, and 27.10 (seniors. CONCLUSION: The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics.

[Clinical-psychological components in the consideration of functional dysphonia--a review].

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Kiese-Himmel, C

2015-03-01

The etiopathogenesis of functional dysphonia is complex; it is not sufficient to look solely at vocal behavior aspects. The predisposing basis for functional dysphonia can lie in the constitution of an individual, his/her professional speaking and speech behavior and/or may be personality-based. (Prolonged) psychosocial stress, vocal overstressing, unfavorable speaking habits, infection of the upper respiratory tract, inflammatory processes in the larynx, emotional life events and COSO events are considered as possible triggers. The interaction of predisposed and causal factors is unknown. Stress, overall fatigue, anxiety, depression and/or certain personality traits (which complicate or hamper coping) are considered as perpetuating factors. In any case, overlaps between voice symptoms and reactive psychic as well as social problems have to be kept in mind (e. g. the burden of suffering, depressive processing, speaking anxiety, socially withdrawal). Because the association of multiple psychosocial factors with functional dysphonia is not distinct--such are always existent in organ medically unexplained symptoms--functional dysphonia has to be diagnostically differentiated. For the purpose of the article, a psycho-diagnostic path following the ICD-10 chapter V along general lines is presented. Until now, it is unknown which psychosocial factors discriminate a psychogenic dysphonia from muscle tension dysphonia. © Georg Thieme Verlag KG Stuttgart · New York.

Dysphonia in nursing home and assisted living residents: prevalence and association with frailty.

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G Nichols, Brent; Varadarajan, Varun; Bock, Jonathan M; Blumin, Joel H

2015-01-01

Previous studies of geriatric dysphonia prevalence have been limited to ambulatory outpatient and senior communities. Our goal was to identify prevalence of dysphonia in nursing home residents and assisted living residents and search for correlations between indices of dysphonia and indices of frailty. Prospective epidemiological survey. Residents of a vertically integrated senior care organization who were 65 or older and able to understand and complete the questionnaire were recruited to complete the voice handicap index 10 (VHI-10) to assess for dysphonia (VHI-10 > 10 = dysphonia) and Vulnerable Elders Survey 13 (VES-13), a validated instrument to assess for frailty (VES > 3 = frailty). A total of 119 residents were surveyed. Thirty-three percent of nursing home residents, and 25% of assisted living residents reported dysphonia with 29% of all respondents reporting dysphonia. The mean VHI-10 was 7.4, the median was 5, and the interquartile range was 2-12.5. There was a significant relationship between VHI-10 and VES-13 score (P = 0.029). There were no statistically significant relationships between frailty, age, or type of living and dysphonia or VHI-10. There is a high prevalence of voice dysfunction in assisted living and nursing home residents. The correlation between VHI-10 and VES-13 suggests that voice declines as frailty increases. Copyright © 2015 The Voice Foundation. All rights reserved.

Randomized controlled trial of vocal function exercises on muscle tension dysphonia in Vietnamese female teachers.

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Nguyen, Duong Duy; Kenny, Dianna T

2009-04-01

This study evaluated the treatment effects of vocal function exercises on muscle tension dysphonia (MTD) in tonal language speakers. Single-blinded, randomized, controlled, clinical trial. Forty female primary school teachers from Northern Vietnam, diagnosed with MTD, were randomly allocated into a treatment group (n = 22), which used a full vocal exercise protocol (FE) (modified for use with Vietnamese speakers), and a control group (n = 18) which was treated with a partial vocal exercise protocol (PE). The treatment duration was 4 weeks for both groups. Acoustic and perceptual data were used as primary outcome measures. Acoustic parameters included frequency and amplitude perturbation, harmonics-to-noise ratio (HNR), mean fundamental frequency of the broken and rising tones, and parameters representing pitch movement in the rising tone. Perceptual analyses were performed on pre- and posttreatment samples of the sustained /a/ sound using anchor vocal samples. Self-report data, collected via a posttreatment questionnaire, comprised the secondary outcome measure. Significant changes in perturbation, HNR, and perceptual data were observed in the FE group but not in the PE group. The FE group showed increased size and speed of pitch change. Participants from both groups showed positive changes in some tonal parameters after treatment. However, the magnitude of change and the number of participants with positive changes were larger in the FE group. The data showed that vocal function exercises may be a cost-effective treatment for MTD.

Assessment of dysphonia due to benign vocal fold lesions by acoustic and aerodynamic indices: a multivariate analysis.

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Cantarella, Giovanna; Baracca, Giovanna; Pignataro, Lorenzo; Forti, Stella

2011-04-01

The goal was to identify acoustic and aerodynamic indices that allow the discrimination of a benign organic dysphonic voice from a normal voice. Fifty-three patients affected by dysphonia caused by vocal folds benign lesions, and a control group were subjected to maximum phonation time (MPT) measurements, GRB perceptual evaluations and acoustic/aerodynamic tests. All analyzed variables except the airflow variation coefficient were significantly different between the two groups. The unique significant factors in the discrimination between healthy and dysphonic subjects were the aerodynamic indices of MPT and Glottal efficiency index, and the acoustic index Shimmer. These results show that a combination of three parameters can discriminate a voice deviance and highlight the importance of a multidimensional assessment for objective voice evaluation.

Longitudinal Phonatory Characteristics after Botulinum Toxin Type A Injection.

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Fisher, Kimberly V.; And Others

1996-01-01

A study investigated the long-term effects of a Botulinum Toxin Type A injection on the glottal competency of a man with adductor spasmodic dysphonia. Results suggest that change in degree of glottal adduction over time can be observed even when vocal instability is present within each recording session. (CR)

African Journal of Neurological Sciences - 2009 Vol. 28 No 1

African Journals Online (AJOL)

Keywords: Deep brain stimulation, Essential tremor, Spasmodic dysphonia, Thalamus ... stimulators ON versus stimulators OFF. ... at 6 months post-DBS were as follows: for the right IPG, settings were contact 3(+), contact 0(-), 2.3 volts amplitude, 90 microseconds pulse width, and 130 Hz frequency; for the left IPG, settings ...

Diagnosis of dysphonia among municipal employees: individual and work factors.

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Bassi, Iara Barreto; Assunção, Ada Ávila

2015-05-01

To investigate the association between occupational status and the distribution of dysphonia. In 2009, a sample of 5646 (14%) of the population of 38,304 municipal employees of Belo Horizonte was obtained. A questionnaire was made available on an Internet Web site that could be entered only after the respondent had given consent. The response variable was drawn up with reference to the question: "Has a doctor ever told you that you have dysphonia?," for which the possible responses were yes or no. The following variables were included in the logistic regression model: sociodemographic data, work characteristics, and lifestyle habits. The associations relating to dysphonia were found to be different between men and women. Differing from men, occupational factors influenced the outcome among women. Among men, there were significant associations between dysphonia and sociodemographic characteristics, health-related factors, and lifestyle factors. Gender differentials should be taken into consideration in health promotion actions among this group of municipal employees. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Vocal nodules in a colombian teachers group with dysphonia

OpenAIRE

Andrés Felipe Alvarado Díaz; Carlos Eduardo Pinzón; José Rafael Tovar Cuevas; Adriana Fajardo Hoyos

2013-01-01

Objectives: This study determined the prevalence of vocal nodules associated with dysphonia in teachers aged from 35 to 65 years, taking into consideration both individual and occupational variables. Methodology: Descriptive study that included the information contained in 262 medical records of teachers diagnosed with dysphonia in occupational health consultations at the institutions that provide health services in Bogotá, Colombia from March 2009 to March 2012. The presence of laryngeal nod...

Does regular practice of physical activity reduce the risk of dysphonia?

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Assunção, Ada Avila; de Medeiros, Adriane Mesquita; Barreto, Sandhi Maria; Gama, Ana Cristina Cortes

2009-12-01

The purpose of this study was to investigate the association between regular physical activity and the prevalence of dysphonia. A cross-sectional study was conducted with 3142 teachers from 129 municipal public schools in the city of Belo Horizonte, Brazil. The dependent variable, dysphonia, was classified (absent or present) according to reported symptoms (fatigue when speaking and loss of voice quality), their frequency (occasionally and daily), and duration (past 15 days). The independent variable was regular physical activity. The degree of association was estimated based on the prevalence ratio and a 95% confidence interval obtained by the Poisson regression adapted for cross-sectional studies. In the study sample, the prevalence of dysphonia in teachers was 15.63%. Nearly half (47.52%) of the teachers reported no regular practice of physical exercises. The remaining teachers (52.48%) walked and did physical exercises, sports, and other activities; 31.25% undertook these activities once or twice a week, and 21.23% exercised three or more times a week. Teachers who did not practice physical activity were more likely to present dysphonia compared to those that exercised three or more times a week. Regular physical activity was associated positively with the prevalence of dysphonia.

Queixas vocais e grau de disfonia em professoras do ensino fundamental Vocal complaints and degree of dysphonia in elementary school teachers

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Luciana Lemos de Azevedo

2009-01-01

GRAM 5.7 acoustic analysis program. After acoustic analysis, the voices were perceptually analyzed and classified by three speech therapists with at least five years of clinical experience in the area. RESULTS: From the selected teachers, 30.77% showed normal voice quality, while 23.08% were considered to have mild dysphonia and 46.15% moderate dysphonia. None of the subjects showed severe dysphonia. Confidence intervals of 95% provided estimations of a minimum of 6.6% of teachers with discrete dysphonia and 22.39% with moderate dysphonia in the population of reference. Regardless of the type of vocal complaint, the total number of complaints among teachers with moderate dysphonia was significantly higher than among teachers with normal voice quality. Nevertheless, there were no differences between groups in the distribution of specific complaints, when these were individually analyzed. CONCLUSION: The majority of the teachers in this study had altered vocal quality, mostly being classified with moderated degree dysphonia. Specific vocal complaints appear to be equally distributed among teachers with normal voice and with dysphonia. Results point out the importance of vocal health projects directed to this population.

Dysphonia as a sign of HPV laryngeal infection: a case report.

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Longubuco, Carlos Eduardo Gama; dos Reis, Helena Lucia Barroso; Cavalcante, Fernanda Sampaio; de Pinho, Carla Renata Petillo; Oliveira, Nathalia Silva; Nicol, Alcina Frederica; Zamolyi, Renata Quintella; Ferreira, Dennis de Carvalho

2014-12-11

Voice dysfunction or dysphonia may be associated with several clinical conditions. Among these, laryngeal human papillomavirus (HPV)-induced lesions should be considered as a possible causative factor. We report a case of dysphonia in a patient presenting with an HPV laryngeal lesion. We also discuss the clinical features of the disease, its histopathological findings, and treatment and rigorous follow-up. We report a case of laryngeal papilloma in a 29-year-old, Afro-descendant, male patient with dysphonia. He was a non-smoker and was not a drug user. Videolaryngostroboscopy revealed signs suggestive of pharyngolaryngeal reflux. The right vocal fold presented with a papillomatous aspect in the posterior third, which underwent excision. Histopathological examination showed a nodular lesion of the right vocal fold, conclusive of squamous papilloma with absence of malignancy. Patients presenting with persistent voice dysfunction or dysphonia should be investigated for possible laryngeal HPV infection. Diagnostic confirmation by HPV genotyping is important for follow-up of potential recurrence.

Describing pediatric dysphonia with nonlinear dynamic parameters

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Meredith, Morgan L.; Theis, Shannon M.; McMurray, J. Scott; Zhang, Yu; Jiang, Jack J.

2008-01-01

Objective Nonlinear dynamic analysis has emerged as a reliable and objective tool for assessing voice disorders. However, it has only been tested on adult populations. In the present study, nonlinear dynamic analysis was applied to normal and dysphonic pediatric populations with the goal of collecting normative data. Jitter analysis was also applied in order to compare nonlinear dynamic and perturbation measures. This study’s findings will be useful in creating standards for the use of nonlinear dynamic analysis as a tool to describe dysphonia in the pediatric population. Methods The study included 38 pediatric subjects (23 children with dysphonia and 15 without). Recordings of sustained vowels were obtained from each subject and underwent nonlinear dynamic analysis and percent jitter analysis. The resulting correlation dimension (D2) and percent jitter values were compared across the two groups using t-tests set at a significance level of p = 0.05. Results It was shown that D2 values covary with the presence of pathology in children. D2 values were significantly higher in dysphonic children than in normal children (p = 0.002). Standard deviations indicated a higher level of variation in normal children’s D2 values than in dysphonic children’s D2 values. Jitter analysis showed markedly higher percent jitter in dysphonic children than in normal children (p = 0.025) and large standard deviations for both groups. Conclusion This study indicates that nonlinear dynamic analysis could be a viable tool for the detection and assessment of dysphonia in children. Further investigations and more normative data are needed to create standards for using nonlinear dynamic parameters for the clinical evaluation of pediatric dysphonia. PMID:18947887

Author Details

African Journals Online (AJOL)

Bansberg, S. Vol 28, No 1 (2009) - Articles Spasmodic dysphonia may respond to bilateral thalamic deep brain stimulation. Abstract PDF. ISSN: 1015-8618. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions ...

Muscle tension dysphonia in Vietnamese female teachers.

Science.gov (United States)

Nguyen, Duong Duy; Kenny, Dianna T; Tran, Ninh Duy; Livesey, Jonathan R

2009-03-01

There has been no published research on muscle tension dysphonia (MTD) in speakers who use a tonal language. Using a sample of 47 Northern Vietnamese female primary school teachers with MTD, we aimed to discover whether professional voice users of tonal languages presented with the same symptoms of MTD as speakers of nontonal languages and whether they presented with additional symptoms as a result of speaking a tonal language. The vocal characteristics were assessed by use of a questionnaire and expert perceptual evaluation. Laryngeal features were assessed by photolaryngoscopy. The results showed that MTD was associated with a larger number of vocal symptoms than previously reported. However, the participants did not have the same vocal symptoms reported in English speakers, for example, hard glottal attack, pitch breaks, unusual speech rate, and glottal fry. Factor analysis of the vocal symptoms revealed three factors: "vocal fatigue/hyperfunction," "physical discomfort," and "voice quality," all of which demonstrated high reliability. The major laryngeal characteristic was a glottal gap. The glottal shapes observed included: 44.7% had an incomplete closure, 29.8% a posterior gap, 12.8% an hourglass-shaped gap, 8.5% a spindle-shaped gap, and 4.3% had complete glottal closure. The findings implied a potential contribution of linguistic-specific factors and teaching-related factors to the presentation of this voice disorder in this group of teachers.

The Effect of Listener Experience and Anchors on Judgments of Dysphonia

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Eadie, Tanya L.; Kapsner-Smith, Mara

2011-01-01

Purpose: To determine the effect of auditory anchors on judgments of overall severity (OS) and vocal effort (VE) in dysphonic speech when judgments are made by experienced and inexperienced listeners, and when self-rated by individuals with dysphonia (speaker-listeners). Method: Twenty individuals with dysphonia and 4 normal controls provided…

Epidemiological association of olfactory dysfunction with hearing loss and dysphonia in the Korean population: A cross-sectional study.

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Park, Jae Hong; Byeon, Hyung Kwon; Park, Ki Nam; Kim, Jae Wook; Lee, Seung Won; Han, Kyung-do; Chang, Jae Won; Kim, Won Shik; Koh, Yoon Woo; Ban, Myung Jin

2017-11-01

The aim of the study is to investigate the association between olfactory dysfunction (OD), hearing loss, and dysphonia.The cross-sectional data for 17,984 adults who completed the Korea National Health and Nutrition Examination Surveys (2010-12) were analyzed. OD, hearing loss, and dysphonia were assessed using self-reporting questionnaires. The association of OD with hearing loss and dysphonia was evaluated.Hearing loss and dysphonia were significantly more prevalent in patients with OD than in those without OD (hearing loss, 28.1% vs 11.3%; dysphonia, 11.1% vs 5.9%; both P dysphonia, and was greater in those with combined hearing loss and dysphonia than in both patients without these dysfunctions and in those with a single dysfunction (odds ratio 3.115, 95% confidence interval 1.973-4.917).OD was significantly associated with hearing loss and dysphonia. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

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African Journals Online (AJOL)

Lyons, M. Vol 28, No 1 (2009) - Articles Spasmodic dysphonia may respond to bilateral thalamic deep brain stimulation. Abstract PDF. ISSN: 1015-8618. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of ...

[Functional dysphonia and vocal cord nodules in teachers in Navarra, Spain].

Science.gov (United States)

Palomino Moreno, María Prado; Hoyo Rodríguez, Asier; García López, Vega; Losantos Martínez, Juan Tomás

2013-01-01

To describe teachers treated for dysphonia and vocal cord nodules by the public health system in Navarra (Spain), to describe associated factors and to identify the proportion of these cases registered as occupational diseases. Cases of dysphonia occurring in persons between the age of 18 and 65 years, registered between May 2010 and June 2011, and treated in a specific unit (Speech Unit) of Otorhinolaryngology Services were identified. Information on occupation, sex and clinical diagnosis was collected. For teachers, additional information was obtained on smoking habits, teaching level and prior training in speech disorders and their prevention. Cases declared as occupational diseases were identified from the official Register of Occupational Diseases of Navarra. 135 teachers (18% of all dysphonia patients in the sample) were treated for dysphonia in the Speech Unit (87% women). Being female was 3-fold higher among teachers than other occupations (crude prevalence odds ratio = 3.5; 95% confidence interval, 95%CI, 2.1-5.9). Female teachers were also 6.5 years (95%CI, 1.7-11.4) younger than male teachers. No association was found between smoking and risk of vocal cord nodules or dysphonia. Only 20% of teachers treated had received training on speech disorders and their prevention. Nine out of 83 cases of vocal cord nodules diagnosed in professional voice users were officially declared as occupational diseases; in all cases, these were teachers. Dysphonia in teachers is a frequent reason for visiting a specialty clinic. Among these professionals, women showed a higher risk of suffering from vocal cord nodules. Most cases of vocal cord nodules in our sample were not reported as occupational diseases. Copyright belongs to the Societat Catalana de Seguretat i Medicina del Treball.

Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series

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Regina Helena Garcia Martins

2014-12-01

Full Text Available Introduction: Psychogenic dysphonia is a functional disorder with variable clinical manifestations. Objective: To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. Methods: The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. Results: 28 patients (26 women and 2 men were assessed. Their occupations included: housekeeper (n = 17, teacher (n = 4, salesclerk (n = 4, nurse (n = 1, retired (n = 1, and psychologist (n = 1. Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. Conclusions: In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed.

Dysphonia Severity Index in Typically Developing Indian Children.

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Pebbili, Gopi Kishore; Kidwai, Juhi; Shabnam, Srushti

2017-01-01

Dysphonia is a variation in an individual's quality, pitch, or loudness from the voice characteristics typical of a speaker of similar age, gender, cultural background, and geographic location. Dysphonia Severity Index (DSI) is a recognized assessment tool based on a weighted combination of maximum phonation time, highest frequency, lowest intensity, and jitter (%) of an individual. Although dysphonia in adults is accurately evaluated using DSI, standard reference values for school-age children have not been studied. This study aims to document the DSI scores in typically developing children (8-12 years). A total of 42 typically developing children (8-12 years) without complaint of voice problem on the day of testing participated in the study. DSI was computed by substituting the raw scores of substituent parameters: maximum phonation time, highest frequency, lowest intensity, and jitter% using various modules of CSL 4500 software. The average DSI values obtained in children were 2.9 (1.23) and 3.8 (1.29) for males and females, respectively. DSI values are found to be significantly higher (P = 0.027) for females than those for males in Indian children. This could be attributed to the anatomical and behavioral differences among females and males. Further, pubertal changes set in earlier for females approximating an adult-like physiology, thereby leading to higher DSI values in them. The mean DSI value obtained for male and female Indian children can be used as a preliminary reference data against which the DSI values of school-age children with dysphonia can be compared. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series.

Science.gov (United States)

Martins, Regina Helena Garcia; Tavares, Elaine Lara Mendes; Ranalli, Paula Ferreira; Branco, Anete; Pessin, Adriana Bueno Benito

2014-01-01

Psychogenic dysphonia is a functional disorder with variable clinical manifestations. To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series. The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings. 28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n=17), teacher (n=4), salesclerk (n=4), nurse (n=1), retired (n=1), and psychologist (n=1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms. In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Visual assessment of voice disorders in patients with occupational dysphonia

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Bożena Kosztyła-Hojna

2014-11-01

Full Text Available [b]introduction[/b]. In a group of persons using the voice occupationally, the frequent symptoms are hoarseness, voice fatigability and aphonia. Pathological changes in the larynx may have organic or functional character which require different methods of treatment and rehabilitation. Visualization of vibrations of the vocal folds is an essential condition for an appropriate assessment of the causes of dysphonia. [b]objective[/b]. The purpose of the study is assessment of the usefulness of a high-speed imaging (HSI system in the diagnosis of functional and organic dysphonia of occupational character, compared with digital kymography (DKG and digital stroboscopy (DS with a high resolution module. [b]material and methods[/b]. The study group consisted of 64 patients with voice quality disorders with features of occupational dysphonia. The control group consisted of 15 patients with euphonic voice. Analysis of the voice quality parameters during phonation of the ‘e’ vowel was performed using HSI, DKG and stroboscopy of high resolution, by means of a digital HS camera (HRES Endocam, Richard Wolf GmbH, Knittlingen, Germany. Vocal folds vibrations were registered at the rate of 4,000 frames per second. [b]results[/b]. HSI is the most reliable diagnostic tool giving the possibility of an analysis of the true vibrations of the vocal folds. It also enables an observation of the aperiodicity of vibrations of the vocal folds, while DS with high resolution allows diagnosis of the periodicity of the vibrations. [b]conclusions[/b]. HSI is particularly useful in the diagnosis of neurologically-based pathology of the voice (paralytic dysphonia and organic dysphonia. The quickest method of diagnosing the phonatory paresis of the glottis is DKG. The advantage of both HSI and DKG is the non-invasiveness of examinations; however, their limitations are time-consuming and the high cost of equipment.

O uso da toxina botulínica no tratamento da distonia laríngea (disfonia espasmódica: estudo preliminar com doze pacientes Use of botulinum toxin in the treatment of laryngeal dystonia (spasmodic dysphonia: preliminary study of twelve patients

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Hélio A. G. Teive

2001-03-01

Full Text Available A distonia laríngea (disfonia espasmódica é distúrbio do movimento caracterizado por contrações involuntárias da musculatura laríngea envolvida no processo de vocalização. A utilização da toxina botulínica no tratamento da distonia laríngea trouxe consideráveis benefícios clínicos. Descrevemos os resultados preliminares do uso terapêutico da toxina botulínica no tratamento da distonia laríngea em 12 pacientes. Após investigação clínica, os pacientes foram submetidos a videolaringoestroboscopia para confirmação diagnóstica e as injeções de toxina botulínica foram realizadas através de punção da membrana cricotireóidea em direção ao músculo tireoaritenóideo, com uso de eletromiografia. A maioria dos pacientes submetidos ao tratamento com toxina botulínica apresentou melhora significativa da distonia laríngea (83% dos casos, com duração média do efeito de quatro meses, sem efeitos colaterais significativos.Laryngeal dystonia (spasmodic dysphonia is a movement disorder characterized by involuntary contractions of laryngeal muscles involved with vocalization. The introduction of botulinum toxin in the treatment of laryngeal dystonia had a major clinical impact due to the striking improvement of symptoms. We report the preliminary results of therapeutical use of botulinum toxin in the treatment of twelve patients with laryngeal dystonia. After an extensive clinical evaluation, the patients underwent a videostroboscopic exam for diagnostic confirmation. Botulinum toxin was injected in the cricothyreoid membrane, directed towards the thyreoaritenoid muscle, with the aid of eletromyography needles. Most of patients who underwent botulinum toxin injection had a significant improvement of their symptoms (83%, with effects lasting for four months in average and without important side effects.

Cross-system effects of dysphagia treatment on dysphonia: a case report

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LaGorio, Lisa A; Carnaby-Mann, Giselle D; Crary, Michael A

2008-01-01

Traditionally, treatment of dysphagia and dysphonia has followed a specificity approach whereby treatment plans have focused on each dysfunction individually. Recently however, a therapeutic cross-system effect has been proposed between these two dysfunctions. At least one study has demonstrated swallowing improvement in subjects who completed a dysphonia treatment program. However, we are unaware of any evidence demonstrating the converse effect. In this paper, we present a case-report of a ...

Current and emerging concepts in muscle tension dysphonia: a 30-month review.

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Altman, Kenneth W; Atkinson, Cory; Lazarus, Cathy

2005-06-01

The modern theory of hoarseness is that there are multifactorial etiologies contributing to the voice problem. The hypothesis of this study is that muscle tension dysphonia is multifactorial with various contributing etiologies. This project is a retrospective chart review of all patients seen in the Voice Speech and Language Service and Swallowing Center at our institution with a diagnosis of muscle tension (functional hypertensive) dysphonia over a 30-month period. A literature search and review is also performed regarding current and emerging concepts of muscle tension dysphonia. One hundred fifty subjects were identified (60% female, 40% male, with a mean age of 42.3 years). Significant factors in patient history believed to contribute to abnormal voice production were gastroesophageal reflux in 49%, high stress levels in 18%, excessive amounts of voice use in 63%, and excessive loudness demands on voice use in 23%. Otolaryngologic evaluation was performed in 82% of patients, in whom lesions, significant vocal fold edema, or paralysis/paresis was identified in 52.3%. Speech pathology assessment revealed poor breath support, inappropriately low pitch, and visible cervical neck tension in the majority of patients. Inappropriate intensity was observed in 23.3% of patients. This set of multiple contributing factors is discussed in the context of current and emerging understanding of muscle tension dysphonia. Results confirm multifactorial etiologies contributing to hoarseness in the patients identified with muscle tension dysphonia. An interdisciplinary approach to treating all contributing factors portends the best prognosis.

Dysphonia and vocal fold telangiectasia in hereditary hemorrhagic telangiectasia.

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Chang, Joseph; Yung, Katherine C

2014-11-01

This case report is the first documentation of dysphonia and vocal fold telangiectasia as a complication of hereditary hemorrhagic telangiectasia (HHT). Case report of a 40-year-old man with HHT presenting with 2 years of worsening hoarseness. Hoarseness corresponded with a period of anticoagulation. Endoscopy revealed vocal fold scarring, vocal fold telangiectasias, and plica ventricular is suggestive of previous submucosal vocal fold hemorrhage and subsequent counterproductive compensation with ventricular phonation. Hereditary hemorrhagic telangiectasia may present as dysphonia with vocal fold telangiectasias and place patients at risk of vocal fold hemorrhage. © The Author(s) 2014.

Lower cervical levels: Increased risk of early dysphonia following anterior cervical spine surgery.

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Zeng, Ji-Huan; Li, Xiao-Dan; Deng, Liang; Xiao, Qiang

2016-10-01

The present study aimed to re-evaluate the incidence of early dysphonia after anterior cervical spine surgery (ACSS) and to determine the related risk factors. Patients underwent ACSS between January 2011 and December 2013 at two sites were identified retrospectively from hospital's patient databases. A total of 233 cases were included in this study. Dysphonia developed 1 month postoperatively was recorded. Follow-up was conducted in all positive-response patients. Those reporting severe or persistent voice symptoms were referred to otolaryngologists for further assessments and (or) treatments. Pre and intraoperative factors were collected to determine their relationships with dysphonia one month postoperatively. 45 patients developed dysphonia at one month, including 23 males and 22 females, yielding to an incidence of 19.3%. 34 cases resolved themselves in 3 months, leaving the remaining 11 patients considered to be severe or persistent cases. However, 10 of them recovered spontaneously in the next 9 months, while the last case received vocal cord medialization and returned to almost normal speech function at 18 months. In univariate analysis, only approaching level involving C6-C7 or (and) C7-T1 was significantly associated with postoperative dysphonia (Pdysphonia following ACSS was relatively high and approaching at lower cervical levels was an independent predictive factor. Copyright © 2016 Elsevier B.V. All rights reserved.

An analysis of occupational dysphonia diagnosed in the North-East of Poland.

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Kosztyła-Hojna, Bozena; Rogowski, Marek; Ruczaj, Jerzy; Pepiński, Witold; Lobaczuk-Sitnik, Anna

2004-01-01

The objective of the study was to evaluate factors predisposing to occupational dysphonia in a group of professional voice users. The study involved 374 patients treated in the Clinic of Otolaryngology and the Phoniatric Outpatient Clinic, Department of Otolaryngology, Medical University of Białystok in 1999--2001. Group I consisted of 309 patients qualified as professional voice users. The obtained results were compared with those yielded in a group of 65 persons of other occupations (group II). All the diagnosed patients neither smoked nor abused alcohol. Tobacco smokers, patients with chronic diseases of the respiratory system or individuals exposed to irritating vapors were excluded from the study. The clinical evaluation included phoniatric examinations with use of videoendoscopy (VIS) and videolaryngostroboscopy (VLSS) of the larynx. Based on the larynx endoscopic image the voice organ pathology was diagnosed in the patients as functional and/or organic dysphonia. The former comprised hyperfunctional or hypofunctional dysphonia and insufficiency of the glottis and the latter other laryngeal disturbances. In the statistical analysis chi2 parametric test of independence for two averages was used. Female teachers of primary and lower secondary schools, mean age 43 years, prevailed in the group of professional voice users, in which functional dysphonia was more common. In this group, the onset of organic changes was earlier than that of functional changes and was manifested by soft vocal nodules, edematous and inflammatory changes in the vocal fold mucosa. Functional dysphonia of 3 degrees, 4 degrees and even 5 degrees predominated in the group of professional voice users in the course of their employment.

Lingual thyroid causing dysphonia: case report

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Alfio José Tincani

Full Text Available CONTEXT: Lingual thyroid gland is a rare clinical entity that is caused by the failure of the thyroid gland to descend to a normal cervical location during embryogenesis. The occurrence of an ectopic thyroid gland located at the base of the tongue may cause problems for the patient, with symptoms of dysphagia, dysphonia, upper airway obstruction or even hemorrhage at any time from infancy through adulthood. CASE REPORT: We report on a case of lingual thyroid gland in a 41-year-old female patient. The embryology and diagnosis of ectopic thyroid are discussed and its management is outlined. Features of the diagnostic and therapeutic evaluation are described with attention to the clinical findings, laboratory tests, thyroid scan and computed tomography imaging studies employed in the confirmation of diagnosis and planning of appropriate treatment. The history of the condition is reviewed and a treatment strategy is outlined. Surgical excision of the gland is reserved for cases of gland enlargement that result in compromised airways (dysphagia or dysphonia or recurrent hemorrhage.

Is insufficient pulmonary air support the cause of dysphonia in chronic obstructive pulmonary disease?

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Hassan, Megahed M; Hussein, Mona T; Emam, Ahmed Mamdouh; Rashad, Usama M; Rezk, Ibrahim; Awad, Al Hussein

2018-08-01

Optimal pulmonary air support is essential pre-requisite for efficient phonation. The objective is to correlate pulmonary and vocal functions in chronic obstructive pulmonary disease (COPD) to find out whether the reduced pulmonary function per se could induce dysphonia. In this prospective case-control study, sixty subjects with stable COPD underwent evaluation of pulmonary and vocal functions. The pulmonary functions measured include {Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF)}. The vocal functions were {jitter, shimmer, noise-to-harmonic ratio, pitch perturbation quotient, amplitude perturbation quotient, maximum phonation time (MPT), sound pressure level, phonatory efficiency, resistance and power. A control group (n=35) underwent the same measurements. These functions were compared between subjects and controls. Also, correlation of the vocal and pulmonary functions was conducted. Thirty five (58.3%) of COPD subjects have dysphonia. The pulmonary functions were lower in all COPD group than in the control group (P<0.001 for all parameters). Also, the FVC, FEV1, PEF and MMEF % of predicted values were significantly lower in subjects with dysphonia (n=35) than those without dysphonia (n=25) with P values 0.0018, <0.001, 0.0011 and 0.0026 respectively. In addition, the MPT in all subjects showed positive correlations to the 5 pulmonary functions (P=0.004 for FEV1/FVC ratio and P<0.001 for the rest). Also, the phonatory efficiency showed significant positive correlations with the pulmonary functions FVC, FEV1, PEF and MMEF (P=0.001, 0.001, 0.002 and 0.001 respectively). Unlike efficiency, the phonatory resistance revealed significant negative correlations with these pulmonary functions in the same order (P=0.001, 0.003, 0.002, 0.001 respectively). Dysphonia is a common comorbidity with COPD which attributed to multifactorial etiologies. The lower

The prevalence of laryngeal pathology in a treatment-seeking population with dysphonia.

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Van Houtte, Evelyne; Van Lierde, Kristiane; D'Haeseleer, Evelien; Claeys, Sofie

2010-02-01

This article describes the prevalence of laryngeal pathology in a treatment-seeking population with dysphonia in the Flemish part of Belgium. Retrospective investigation. During a period of 5 years (2004-2008), data were collected from 882 patients who consulted with dysphonia at the ear, nose, and throat department of the University Hospital in Ghent (Belgium). Laryngeal pathology was diagnosed using videostroboscopy. Ages ranged from 4 years to 90 years. Functional voice disorders were most frequently diagnosed (30%), followed by vocal fold nodule (15%), and pharyngolaryngeal reflux (9%). The role of age, gender, and occupation was investigated. Pathologies were significantly more common in females than in males, representing 63.8% and 36.2% of the population, respectively. Professional voice users accounted for 41% of the workforce population, with teachers as main subgroup. In professional voice users, functional dysphonia occurred in 41%, vocal fold nodules in 15%, and pharyngolaryngeal reflux in 11%. Our data were compared with data from other countries. Functional voice disorders were overall the most common cause of voice disorders (except in childhood), followed by vocal fold nodules and pharyngolaryngeal reflux. Professional voice users accounted for almost one half of the active population, with functional voice disorders as the main cause of dysphonia.

Voice disorders (dysphonia) in public school female teachers working in Belo Horizonte: prevalence and associated factors.

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de Medeiros, Adriane Mesquita; Barreto, Sandhi Maria; Assunção, Ada Avila

2008-11-01

The objective of this study is to establish the prevalence of dysphonia and associated factors in public school female teachers working in Belo Horizonte. This cross-sectional study was conducted on a random sample of schools between May 2004 and July 2005. There were 2103 elementary education daytime teachers from 83 schools included in the study. Self-applied questionnaires were used for data collection. These included questions on social and demographic matters, general health and mental health (General Health Questionnaire-12 [GHQ-12]), the environment and organization of work, and voice-related aspects. The variable dysphonia was classified as absent, possible, or probable based on the association between frequency of fatigue when speaking and worsened voice quality during the past 15 days. Multinomial logistic regression was used to analyze factors independently associated with dysphonia in each response subgroup and in total. One third of the female teachers did not report voice symptoms during the past 15 days (33%). The prevalence of probable dysphonia was 15%, and the prevalence for possible dysphonia was 52%. Factors associated with probable dysphonia were presence of recent upper airway problems (odds ratio [OR]=5.95, 95% confidence interval [CI]=4.06-8.71), problems at work because of voice (OR=65.30, 95% CI=19.33-220.59), other activities with intense voice use (OR=1.71, 95% CI=1.08-2.71), high noise levels (OR=2.55, 95% CI=1.72-3.76), poor ventilation in the classroom (OR=2.00, 95% CI=1.24-3.22), current mental disorder (OR=3.20, 95% CI=2.18-4.70), sedentary life style (OR=1.94, 95% CI=1.21-3.09), and marriage (OR=1.70, 95% CI=1.16-2.47). Associations between probable dysphonia, poor working conditions, health-related aspects, and professional jeopardy indicate the complexity of dysphonia in female teachers and the need for collective intervention strategies.

Vocal nodules in a colombian teachers group with dysphonia

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Andrés Felipe Alvarado Díaz

2013-12-01

Full Text Available Objectives: This study determined the prevalence of vocal nodules associated with dysphonia in teachers aged from 35 to 65 years, taking into consideration both individual and occupational variables. Methodology: Descriptive study that included the information contained in 262 medical records of teachers diagnosed with dysphonia in occupational health consultations at the institutions that provide health services in Bogotá, Colombia from March 2009 to March 2012. The presence of laryngeal nodules was based on the findings of a nasofibrolaryngoscopy procedure. Results: Nodules were found in 67 teachers, which corresponded to a rate of 25.5%, being apparently (highest observed rates associated primarily with the following variables: females, ages from 45 to 54 years, bilateral nodules, and teaching position (preschool and physical education. Of the teachers with nodules, 76.1% had fewer than five doctor's appointments, and 75% had more than 90 days of sick leave. Conclusion: A high percentage of teachers have vocal nodules associated with dysphonia. This may be apparently related to different variables such as sex, type of nodule, area and teaching position. Was observed only a statistically significant association among presence of nodules and age (p=0.018. In addition this disorder generates a large number of incapacities and employee absenteeism.

Factors Associated with Dysphonia in High School Cheerleaders.

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Campbell, Shari L.; And Others

1988-01-01

Questionnaire responses from 146 high school cheerleaders indicated that acute, cheering-related dysphonia may be preceded or accompanied by a set of clinical signs that could be incorporated easily into a screening protocol for prospective cheerleaders. (Author/DB)

Dysphonia – the single symptom of rifampicin resistant laryngeal tuberculosis

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Paulauskienė Iveta

2016-01-01

Full Text Available Tuberculosis is still the most frequent granulomatous laryngeal disease. Absence of pathognomonic symptoms and change in clinical pattern frequently leads to misdiagnosis and delayed treatment. Hoarseness is the commonest symptom of laryngeal tuberculosis and constitutional symptoms are usually rare. However dysphonia can be caused by many other more common conditions. Hoarseness can be a symptom of organic (nodules and polyps of vocal folds, tumors, vocal fold paresis or functional (functional dysphonia, laryngeal conversion disorder, paradoxical vocal folds motion conditions. Rarely systemic diseases as amyloidosis, sarcoidosis, Wegener’s granulomatosis or tuberculosis can cause vocal dysfunction too. That is why laryngeal tuberculosis is often forgotten in case of persistent hoarseness. In this article, we present a case of a young previously healthy woman, complaining of persistent hoarseness with no other leading symptoms. Though endoscopic image suggested a malignancy, histology showed granulomatous lesion. Detailed examination revealed laryngeal and pulmonary tuberculosis resistant to rifampicin. Conclusion: Dysphonia can be the only one symptom of laryngeal tuberculosis. The disease should be taken into consideration when a patient complains of persistent hoarseness in order to avoid delays in treatment and spread of infection.

Laryngeal electromyography in movement disorders: preliminary data

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Kimaid Paulo A.T.

2004-01-01

Full Text Available This study describes preliminary laryngeal electromyography (LEMG data and botulinum toxin treatment in patients with dysphonia due to movement disorders. Twenty-five patients who had been clinically selected for botulinum toxin administration were examined, 19 with suspected laryngeal dystonia or spasmodic dysphonia (SD, 5 with vocal tremor, and 1 with Gilles de la Tourette syndrome (GTS. LEMG evaluations were performed before botulinum toxin administration using monopolar electrodes. Electromyography was consistent with dystonia in 14 patients and normal in 5, and differences in frequency suggesting essential tremor in 3 and Parkinson tremors in 2. The different LEMG patterns and significant improvement in our patients from botulinum toxin therapy has led us to perform laryngeal electromyography as a routine in UNICAMP movement disorders ambulatory.

Managing dysphonia in paediatric patients with complex airway conditions.

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Ojha, S; Setlur, J; Bunting, G; Hartnick, C J

2015-08-01

To suggest a phonosurgical management strategy that can be used for children who have previously undergone laryngotracheal reconstruction. This cases series describes three children who presented with complex, multi-level airway stenosis and marked dysphonia. Phonosurgical intervention involved endoscopic and open approaches, and was combined with voice therapy. A phonosurgical reconstruction management algorithm is suggested for evaluating and treating these complex conditions. Pre-operative assessment is critical, and should involve voice analysis and glottal anatomy assessment using office laryngoscopy and stroboscopy. The risks must be weighed up against the benefit of vocal improvement. Surgical intervention should involve combined endoscopic and open approaches. Voice restoration after paediatric airway reconstruction is a complex challenge. Surgical intervention should be conducted in a step-by-step manner to reduce the risk of worsening dysphonia and airway compromise. The risks and benefits must be carefully explored and discussed.

Comprehensive Management of Psychogenic Dysphonia: A Case Illustration

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Sudhir, Paulomi M.; Chandra, Prabha S.; Shivashankar, N.; Yamini, B. K.

2009-01-01

Psychogenic dysphonia refers to the loss of voice, in the absence of apparent structural or neurological pathology. It is a disorder seen more often in women and is usually associated with significant life events and emotional difficulties that may lead to conflict over speaking. Therapeutic interventions in voice disorders recommend the adoption…

Dysphonia Detected by Pattern Recognition of Spectral Composition.

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Leinonen, Lea; And Others

1992-01-01

This study analyzed production of a long vowel sound within Finnish words by normal or dysphonic voices, using the Self-Organizing Map, the artificial neural network algorithm of T. Kohonen which produces two-dimensional representations of speech. The method was found to be both sensitive and specific in the detection of dysphonia. (Author/JDD)

Etiologies of Dysphonia in Patients Referred to ENT Clinics Based on videolaryngoscopy

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Keyvan Kiakojury

2014-07-01

Full Text Available Introduction: Laryngeal dysfunction may be divided into three categories; organic, neurologic and functional disorders. Dysphonia and hoarseness are the most common symptoms and, in some cases, the only signs of laryngeal dysfunction. In differential diagnosis of any type of chronic hoarseness, a neoplastic process must be considered and, thus continuous light video laryngoscopy can provide important information on the presence of neoplastic lesions in order to prevent disease progression via early detection and action.   Materials and Methods: This cross-sectional, descriptive-analytical study was carried out on 197 patients with voice disorders admitted to Ayatollah Rouhani Hospital for video laryngoscopy. Available sampling was used and the results achieved were analyzed using SPSS17 statistical software.   Results: A total of 197 patients (mean age, 40.72 ±15.17 years participated in this study, 56.9% of whom were male. From analysis of video laryngoscopy, organic dysphonia was found to be the most common cause of voice disorders, while functional and neurologic dysphonia were observed in 8.6% and 5.6% of patients, respectively. Vocal nodules and Reinke's edema were among the most common causes of organic dysphonia, with a frequency of 24.4% and 23.4%, respectively; while laryngeal carcinoma accounted for 2.5% of all diagnosed cases with organic causes.   Conclusion:  Since the presence of voice disorders for more than 3 weeks can be a sign of laryngeal dysfunction, early diagnosis using noninvasive methods such as video laryngoscopy and appropriate medical measures can help prevent the disease progression and eliminate the need for actions such as laryngectomy.

Body Concept, Disability, and Depression in Patients with Spasmodic Torticollis

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M. Jahanshahi

1990-01-01

Full Text Available Eighty-five patients with idiopathic spasmodic torticollis were compared with an equally chronic group of 49 cervical spondylosis sufferers in terms of body concept, depression, and disability. The torticollis patients were significantly more depressed and disabled and had a more negative body concept. Depression had different determinants in the two groups. Extent of disfigurement was a major predictor of depression in torticollis. Neuroticism accounted for the greatest proportion of the variance of depression in cervical spondylosis.

Tardive Dystonia: Clinical Spectrum and Novel Manifestations

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R. Jeffrey Davis

1988-01-01

Full Text Available Tardive dystonia was identified in 25 patients: involvement of the face and neck was most common; truncal and limb dystonia were also observed. There were 3 cases of laryngospasm and 2 of spasmodic dysphonia. The latter has not been previously reported as a manifestation of tardive dystonia. In all cases, movements typical of classic tardive dyskinesia could be demonstrated. This group illustrates the variety of dystonic disorders that may occur in conjunction with tardive dyskinesia.

Reduction of Risk Factors in Patients with Behavioral Dysphonia After Vocal Group Therapy.

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Silva, Wégina Jordâna Nascimento da; Lopes, Leonardo Wanderley; Macedo, Anny Elizabety Ramalho de; Costa, Denise Batista da; Almeida, Anna Alice Figueiredo de

2017-01-01

The origin and development of dysphonia, particularly behavioral dysphonia, is associated with several risk factors. Here, we verified the effectiveness of group therapy in reducing the risk factors, and established the association between risk factors and sex, age, profession, and diagnosis of laryngeal disorders in patients with behavioral dysphonia. This is a descriptive, quantitative, field intervention study. Participants (n = 26, adult patients of both sexes), with a diagnosis of behavioral dysphonia, received group therapy intervention. Data for risk factors were collected pre- and posttherapy using the Vocal Screening Protocol. The data were analyzed using descriptive and inferential statistics (Student t test, chi-squared test or Spearman correlation test). The majority (80.8%, n = 21) of patients were female, 65.4% (n = 17) were not in a vocal profession, and 42.3% (n = 11) presented with a lesion in the membranous portion of the vocal fold. The number of personal risk factors decreased after group therapy (P = 0.04). In addition, age was correlated with total (P = 0.001), environmental (P = 0.002), and personal (P = 0.003) vocal risk factors posttherapy. This study revealed an association between the reduction of personal risk factors and vocal group therapy, and a correlation between age and total, environmental, and personal vocal risk factors posttherapy. Thus, maintenance and origins of the behaviors that modify the behavioral aspects of the participants directly influence the production of individual vocal habits. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Systematic review of the treatment of functional dysphonia and prevention of voice disorders.

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Ruotsalainen, Jani; Sellman, Jaana; Lehto, Laura; Verbeek, Jos

2008-05-01

To evaluate the effectiveness of interventions for treating functional dysphonia or preventing voice disorders in adults. We searched MEDLINE (1950 to 2006), EMBASE (1974 to 2006), CENTRAL (Issue 2 2006), CINAHL (1983 to 2006), PsychINFO (1967 to 2006), Science Citation Index (1986 to 2006), and the Occupational Health databases OSH-ROM (February 2006). Systematic review and meta-analysis of randomized controlled trials. Included studies evaluated the effectiveness of interventions for 1) treating functional/nonorganic dysphonia or 2) preventing voice disorders. We identified six randomized controlled trials about treatment and two about prevention. Two authors independently extracted data and assessed trial quality. A combination of direct and indirect voice therapy, compared with no intervention, improves self-reported (standardized mean difference -1.07; 95% CI -1.94 to -0.19), observer-rated (weighted mean difference [WMD] -13.00; 95% CI -17.92 to -8.08), and instrumentally assessed vocal functioning (WMD -1.20; 95% CI -2.37 to -0.03) in adults with functional dysphonia. Effects are reported to remain for at least 14 weeks. Effects are similar in patients and in teachers and student teachers screened for voice problems. We found two studies that did not show voice training, compared with no intervention, to have a preventive effective in improving self-reported vocal functioning. Assessment of publication bias showed that the real effect sizes are probably smaller. Comprehensive voice therapy is effective in improving vocal performance in adults with functional dysphonia. There is no evidence of effectiveness of voice training in preventing voice disorders.

Psychosocial Aspects of Adolescent Dysphonia: An Approach to Treatment.

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Beery, Quinter C.

1991-01-01

This paper presents an approach to voice therapy with adolescents, emphasizing the importance of psychosocial and family influences as they relate to vocal behavior. The goals of therapy for the adolescent with dysphonia usually follow an orderly sequence, first dealing with individual behavior and later with family and peer group influences. (JDD)

Aerodynamic Profiles of Women with Muscle Tension Dysphonia/Aphonia

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Gillespie, Amanda I.; Gartner-Schmidt, Jackie; Rubinstein, Elaine N.; Abbott, Katherine Verdolini

2013-01-01

Purpose: In this study, the authors aimed to (a) determine whether phonatory airflows and estimated subglottal pressures (est-P[subscript sub]) for women with primary muscle tension dysphonia/aphonia (MTD/A) differ from those for healthy speakers; (b) identify different aerodynamic profile patterns within the MTD/A subject group; and (c) determine…

Oromandibular Dystonia—Meige′s Syndrome: Report of a Rare Case with Review

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Siddharth Gupta

2010-01-01

Full Text Available Meige′s syndrome is a combination of two forma of dystonia; blepharospasm and oromandibular dystonia (OMD. Oromandibular dystonia (OMD is a form of focal dystonia affecting head and neck region, including the lower face, jaw, tongue and larynx. It may be a factor contributing to muscle stiffness, degenerative changes in temporomandibular joint, mucosal lesions, damage to teeth, and dental prosthesis. We take this opportunity to present a patient with oromandibular dystonia associated with blepharospasm and spasmodic dysphonia.

[Dysphonia in children: Retrospective and comparative study between the late 1980s and today].

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Ruiz, Y; Orive, D; Coulombeau, B; Perouse, R

Child dysphonia is a frequent pathological situation which concerns 6 to 38 percent of a school attending population. Thus it demands a specific and adapted treatment. Because of its direct consequences on social, family and school lives, parents often seek advice from a speech specialist. This study focuses on the specificities of those individuals having diagnosed child dysphonia, as well as the treatment which can be given to them. Our work covers a period of twenty years of comparative studies. We have read through dr Coulombeau's files, from 2005 to 2011, and we have made up a series of questions addressed to the speech therapists having speech impaired children in their practice. We have cross-examined these data with those of Dr Cornut's, covering a period of seven years (1985-1991). The qualitative and quantitative studies which have been carried out enabled us to highlight the fact there has been a constant background of child dysphonia and an evolution in the offered treatments. Indeed, we have realised that the number of individuals having diagnosed child dysphonia are less and less operated on. In the same time people tend to ignore the offered treatments. Though the follow-ups to a prior visit at a speech therapist have decreased for twenty years, it still remains the most common treatment. Our analysis does not focus on the effects of the given treatments on a long term basis. It thus appears that a study consisting in analysing the development of these children through adulthood would be greatly accurate.

Perceptual learning.

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Seitz, Aaron R

2017-07-10

Perceptual learning refers to how experience can change the way we perceive sights, sounds, smells, tastes, and touch. Examples abound: music training improves our ability to discern tones; experience with food and wines can refine our pallet (and unfortunately more quickly empty our wallet), and with years of training radiologists learn to save lives by discerning subtle details of images that escape the notice of untrained viewers. We often take perceptual learning for granted, but it has a profound impact on how we perceive the world. In this Primer, I will explain how perceptual learning is transformative in guiding our perceptual processes, how research into perceptual learning provides insight into fundamental mechanisms of learning and brain processes, and how knowledge of perceptual learning can be used to develop more effective training approaches for those requiring expert perceptual skills or those in need of perceptual rehabilitation (such as individuals with poor vision). I will make a case that perceptual learning is ubiquitous, scientifically interesting, and has substantial practical utility to us all. Copyright © 2017. Published by Elsevier Ltd.

[Persistent dysphonia showing a laryngeal foreign body in a child].

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Hammoudi, K; Bakhos, D; Bakhos-Merieau, E; Pondaven, S; Lescanne, E

2011-07-01

Inhalation of a laryngotracheobronchial foreign body is a common pediatric emergency situation. It is a source of morbidity and even mortality, especially among children under 3 years of age. A 14-month-old child presented suddenly combining bitonal dysphonia and dyspnea. Given the persistence of symptoms after 1.5 months and the normality of examinations requested by his doctor (pH, cervical ultrasonography, cervical and thoracic radiography), an ENT opinion was sought. An aerodigestive tract endoscopy was carried out in the emergency setting, finding a glottic foreign body associated with subglottic granulomas. The foreign body extraction led to the immediate disappearance of dyspnea. Dysphonia gradually improved under Budesonide aerosols. The lack of penetration syndrome in the interrogation and non specific symptoms may lead to an important diagnosis and treatment delay with dramatic consequences in case of airway foreign body. Endoscopy under general anesthesia must be practiced if there is any doubt for a thorough examination of the airways. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Proton MR spectroscopy in idiopathic spasmodic torticollis

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Federico, F.; Lucivero, V.; Simone, I.L.; Defazio, G.; De Salvia, R.; Mezzapesa, D.M.; Petruzzellis, M.; Tortorella, C.; Livrea, P. [Dept. of Neurology and Psychiatry, Bari (Italy)

2001-07-01

Single-voxel proton magnetic resonance spectroscopy ({sup 1}H-MRS), localised to the basal ganglia, was used to determine changes in metabolite levels in idiopathic spasmodic torticollis (IST). We examined nine patients and 13 healthy subjects. The mean values ({+-} SD) of peak area ratios were: IST: N-acetyl-aspartate (NAA)/choline-containing compounds (Cho) 1.79 {+-} 0.39, NAA/creatine and phosphocreatine compounds (Cr) 1.61 {+-} 0.38, Cho/Cr 0.91 {+-} 0.19; controls: NAA/Cho 2.07 {+-} 0.35, NAA/Cr 1.82 {+-} 0.31, Cho/Cr 0.89 {+-} 0.12. Statistical analysis showed that NAA/Cho and NAA/Cr were significantly lower in patients than in controls (P = 0.0304 and 0.0431, respectively). These results indicate a reduction in NAA, and suggest striatal involvement in the pathogenesis IST. (orig.)

Laryngeal involvement causing dysphonia in a 29 year old nursing ...

African Journals Online (AJOL)

In most instances, diagnosis of leprosy can easily be made based on the clinical signs and symptoms. However, when patients present with atypical features, clinical diagnosis can be a challenge. We report a case of a nursing mother with lepromatous leprosy who presented with dysphonia and skin lesions initially thought ...

Exploring Genetic and Environmental Effects in Dysphonia: A Twin Study

Science.gov (United States)

Simberg, Susanna; Santtila, Pekka; Soveri, Anna; Varjonen, Markus; Sala, Eeva; Sandnabba, N. Kenneth

2009-01-01

Purpose: To explore the existence of genetic effects as well as the interaction between potential genetic effects and a voice-demanding occupation on dysphonia. Method: One thousand seven hundred and twenty-eight Finnish twins (555 male; 1,173 female) born between 1961 and 1989 completed a questionnaire concerning vocal symptoms and occupation.…

A possible association between dysphonia and sleep duration: A cross-sectional study based on the Korean National Health and nutrition examination surveys from 2010 to 2012.

Science.gov (United States)

Cho, Jung-Hae; Guilminault, Christian; Joo, Young-Hoon; Jin, Sang-Kyun; Han, Kyung-Do; Park, Chan-Soon

2017-01-01

Sleep is important in terms of good general health and appropriate sleep duration has been linked to quality-of-life. Dysphonia may impair communication and social relationships, and is thus also closely related to quality-of-life. No large-scale, cross-sectional epidemiological study of a sample representative of the population of an entire country has yet assessed the possible existence of a relationship between sleep duration and dysphonia. We investigated a possible association between subjective voice problems and self-reported sleep duration in South Korean subjects using 2010-2012 data from the Korean National Health and Nutrition Examination Survey (KNHANES). Cross-sectional data on 17,806 adults (7,578 males and 10,228 females) over the age of 19 years who completed the KNHANES were analyzed. All participants reported voice problems (if present) and their daily average sleep duration using a self-reporting questionnaire. Sleep duration was classified into five categories as follows: ≤5, 6, 7, 8, and ≥9 h/day. The overall prevalence of dysphonia was 6.8%; 5.7% in males and 7.7% in females. The prevalence for dysphonia by sleep duration exhibited a U-shape, with the lowest point being at sleep duration of 7-8h. After adjustment for covariates (age, sex, smoking status, alcohol consumption, regular exercise, low income, high-level education), a sleep duration of ≤5 h (OR = 1.454; 95% CI, 1.153-1.832) and a sleep duration of ≥9 h (OR = 1.365; 95% CI, 1.017-1.832) were significantly associated with dysphonia, compared to a sleep duration of 7 h. In terms of gender, males who slept for ≥9 h were at a 2-fold (OR = 2.028; 95% CI, 1.22-3.35) higher odds for dysphonia (pdysphonia ≥3 weeks in duration (long-term dysphonia). This is the first study to show that both short and long sleep duration were significantly associated with the development of dysphonia. The association between sleep duration and dysphonia was more marked in males than females. A

The role of voice therapy in the treatment of dyspnea and dysphonia in a patient with a vagal nerve stimulation device.

Science.gov (United States)

Gillespie, Amanda I; Helou, Leah B; Ingle, John W; Baldwin, Maria; Rosen, Clark A

2014-01-01

Vagal nerve stimulators (VNS) are implanted to treat medically refractory epilepsy and depression. The VNS stimulates the vagus nerve in the left neck. Laryngeal side effects are common and include dysphagia, dysphonia, and dyspnea. The current case study represents a patient with severe dyspnea and dysphonia, persisting even with VNS deactivation. The case demonstrates the use of voice and respiratory retraining therapy for the treatment of VNS-induced dysphonia and dyspnea. It also highlights the importance of a multidisciplinary approach, including laryngology, neurology, and speech-language pathology, in the treatment of these challenging patients. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Articulatory Changes Following Treatment of Muscle Tension Dysphonia: Preliminary Acoustic Evidence

Science.gov (United States)

Dromey, Christopher; Nissen, Shawn L.; Roy, Nelson; Merrill, Ray M.

2008-01-01

Purpose: Primary muscle tension dysphonia (MTD), a voice disturbance that occurs in the absence of structural or neurological pathology, may respond to manual circumlaryngeal techniques, which ostensibly alter the posture of the larynx and/or the configuration of the vocal folds without directly targeting supralaryngeal articulatory structures.…

Analysis of possible factors of vocal interference during the teaching activity.

Science.gov (United States)

Silva, Bárbara Gabriela; Chammas, Tiago Visacre; Zenari, Marcia Simões; Moreira, Renata Rodrigues; Samelli, Alessandra Giannella; Nemr, Kátia

2017-12-11

To measure the risk of dysphonia in teachers, as well as investigate whether the perceptual-auditory and acoustic aspects of the voice of teachers in situations of silence and noise, the signal-to-noise ratio, and the noise levels in the classroom are associated with the presence of dysphonia. This is an observational cross-sectional research with 23 primary and secondary school teachers from a private school in the municipality of São Paulo, Brazil, divided into the groups without dysphonia and with dysphonia. We performed the following procedures: general Dysphonia Risk Screening Protocol (General-DRSP) and complementary to speaking voice - teacher (Specific-DRSP), voice recording during class and in an individual situation in a silent room, and measurement of the signal-to-noise ratio and noise levels of classrooms. We have found differences between groups regarding physical activity (General-DRSP) and particularities of the profession (Specific-DRSP), as well as in all aspects of the perceptual-auditory vocal analysis. We have found signs of voice wear in the group without dysphonia. Regarding the vocal resources in the situations of noise and silence, we have identified a difference for the production of abrupt vocal attack and the tendency of a more precise speech in the situation of noise. Both the signal-to-noise ratio and the room noise levels during class were high in both groups. Teachers in both groups are at high risk for developing dysphonia and have negative vocal signals to a greater or lesser extent. Signal-to-noise ratio was inadequate in most classrooms, considering the standards for both children with normal hearing and with hearing loss, as well as equivalent noise levels.

Mutation in TWINKLE in a Large Iranian Family with Progressive External Ophthalmoplegia, Myopathy, Dysphagia and Dysphonia, and Behavior Change.

Science.gov (United States)

Tafakhori, Abbas; Yu Jin Ng, Alvin; Tohari, Sumanty; Venkatesh, Byrappa; Lee, Hane; Eskin, Ascia; Nelson, Stanley F; Bonnard, Carine; Reversade, Bruno; Kariminejad, Ariana

2016-02-01

TWINKLE (c10orf2) gene is responsible for autosomal dominant progressive external ophthalmoplegia (PEO). In rare cases, additional features such as muscle weakness, peripheral neuropathy, ataxia, cardiomyopathy, dysphagia, dysphonia, cataracts, depression, dementia, parkinsonism, and hearing loss have been reported in association with heterozygous mutations of the TWINKLE gene. We have studied a large Iranian family with myopathy, dysphonia, dysphagia, and behavior change in addition to PEO in affected members. We identified a missense mutation c.1121G > A in the c10orf2 gene in all affected members. Early death is a novel feature seen in affected members of this family that has not been reported to date. The association of PEO, myopathy, dysphonia, dysphagia, behavior change and early death has not been previously reported in the literature or other patients with this mutation.

The effectiveness of voice therapy for teachers with dysphonia.

Science.gov (United States)

Niebudek-Bogusz, E; Sznurowska-Przygocka, B; Fiszer, M; Kotyło, P; Sinkiewicz, A; Modrzewska, M; Sliwinska-Kowalska, M

2008-01-01

An incorrect voice emission is a risk factor for developing occupational voice disorders. The study aimed at assessing the effectiveness of voice therapy in female teachers with dysphonia. The study comprised 133 subjects with voice disorders, taking part in a vocal training programme. A reference group for the present study included 53 teachers with dysphonia. Questionnaire surveys, phoniatric examination and videostroboscopic evaluation were conducted at initial and control examination. In the study group, an improvement after the vocal training was noted in most of the reported symptoms and also in some quantitative parameters of phoniatric examinations compared to the findings for the reference group. The number of patients who assessed their voice as normal increased significantly after the vocal training (2.3 vs. 46.6%). A significant increase in the mean maximum phonation time, from 13.3 to 16.6 s, was observed. The same applied to voice frequency range (increase from 171 to 226.8 Hz). The outcomes of vocal training, such as a subjective improvement of voice quality and an increase in the quantitative parameters (prolonged maximum phonation time, extended voice range) seem to be important parameters for monitoring the effectiveness of training in correct voice emission. 2008 S. Karger AG, Basel.

Comparison Between Vocal Function Exercises and Voice Amplification.

Science.gov (United States)

Teixeira, Letícia Caldas; Behlau, Mara

2015-11-01

To compare the effectiveness of vocal function exercises (VFEs) versus voice amplification (VA) after a 6-week therapy for teachers diagnosed with behavioral dysphonia. A total of 162 teachers with behavioral dysphonia were randomly allocated into two intervention groups and one control group (CG). Outcomes were assessed using auditory-perceptual evaluation of voice, laryngeal status assessment, self-ratings of the impact of dysphonia, and acoustic analysis. The VFE group showed effective changes across treatment outcome measures: overall severity of dysphonia relative to the CG, laryngeal evaluation, and self-perceived dysphonia. The VA group showed positive outcomes in some measures of self-rated dysphonia. The CG had poorer outcomes across self-assessment dimensions. The VFE method is effective in treating the behavioral dysphonia of teachers, can change the overall severity and the self-perception of the impact of dysphonia, and the laryngeal evaluation outcomes. The use of a voice amplifier is effective as a preventive measure because it results in an improved self-perception of dysphonia, especially in the work-related dimension. One case of dysphonia aggravation can be prevented in every three patients with behavioral dysphonia engaged in VFE, and one case in every five patients using VA. The lack of a therapeutic intervention worsens teachers' behavioral dysphonia in a period of 6 weeks. Copyright © 2015 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

[Clinical study of post-stroke upper limb spasmodic hemiplegia treated with jingou diaoyu needling technique and Bobath therapy].

Science.gov (United States)

Sun, Runjie; Tian, Liang; Fang, Xiaoli; Du, Xiaozheng; Zhu, Bowen; Song, Zhongyang; Xu, Xuan; Qin, Xiaoguang

2017-04-12

To compare the difference in the clinical efficacy on post-stroke upper limb spasmodic hemiplegia between the combined therapy of jingou diaoyu needling technique and Bobath technology and simple Bobath technology. Sixty patients were randomized into an observation group and a control group, 30 cases in each one. The usual medication of neurological internal medicine was used in the two groups. In the control group, Bobath facilitation technology was applied to the rehabilitation training. In the observation group, on the basis of the treatment as the control group, jingou diaoyu needling technique was used to stimulate Zhongfu (LU 1), Tianfu (LU 3), Chize (LU 5), Quchi (LI 11), Jianshi (PC 5) and Daling (PC 7). The treatment was given once a day; 5 treatments made one session and totally 4-week treatment was required in the two groups. The modified Ashworth scale, the modified Fugle-Meyer assessment (FMA) and the Barthel index (BI) were adopted to evaluate the muscular tension, the upper limb motor function and the activities of daily living (ADL) before and after treatment in the two groups. The clinical efficacy was compared between the two groups. Compared with those before treatment, the modified Ashworth scale, Fugl-Meyer score and BI score were all improved after treatment in the two groups (all P Bobath therapy achieve the superior efficacy on post-stroke upper limb spasmodic hemiplegia as compared with the simple application Bobath therapy. This combined treatment effectively relieve spasmodic state and improve the upper limb motor function and the activities of daily living.

[Description of dysphonia cases assisted in a mutua in 2013].

Science.gov (United States)

Rodríguez Bayarri, M Jesús; Oliveres Verges, Joan; Linares Salas, Carlos; Martínez Llorente, Enrique; Puget Bosch, Dulce

2015-01-01

To describe a case series of patients with dysphonia evaluated in a national Spanish mutua. Computerized medical records of 2013 were reviewed and 129 patients with diagnoses compatible with dysphonia were identified. Eighty-six (67%) of the 129 cases were recognized as occupational diseases, three cases were considered as occupational injuries (two with a diagnosis of Reinke's edema) and the remaining 40 cases were considered to not be work-related. Most of the cases (90%) occurred in women between the ages of 30 and 49 years. Ninety-three percent of the cases diagnosed as occupational diseases underwent speech therapy and, of these, 72% were cured. The majority of the cases (61%) occurred in teachers. Average duration of sickness absence, among those patients who took it, was 113.5 days. All cases reported as occupational disease met the criteria set by the Spanish legislation (RD 1299/2006). Non-occupational diseases were referred to the national health service. Customized speech therapy was effective for most of the patients. The average duration of sick leave in our series was high. Copyright belongs to the Societat Catalana de Salut Laboral.

Evaluation of voice acoustic parameters related to the vocal-loading test in professionally active teachers with dysphonia.

Science.gov (United States)

Niebudek-Bogusz, Ewa; Kotyło, Piotr; Sliwińska-Kowalska, Mariola

2007-01-01

Teachers are at risk of developing voice disorders. A clinical battery of vocal function tests should include non-invasive and accurate measurements. The quantitative methods (e.g., voice acoustic analysis) make it possible to objectively evaluate voice efficiency and outcomes of dysphonia treatment. To identify possible signs of vocal fatigue, acoustic waveform perturbations during sustained phonation were measured before and after the vocal-loading test in 51 professionally active female teachers with functional voice disorders, using IRIS software. All the participants were also subjected to laryngological/phoniatric examination involving videostroboscopy combined with self-estimation by voice handicap index (VHI)-based scale. The phoniatric examination revealed glottal insufficiency with bowed vocal folds in 35.2%, soft vocal nodules in 31.4%, and hyperfunctional dysphonia with a tendency towards vestibular phonation in 19.6% of the patients. In the VHI scale, 66% of the female teachers estimated their own voice problems as moderate disability. An acoustic analysis performed after the vocal-loading test showed an increased rate of abnormal frequency perturbation parameters (pitch perturbation quotient (Jitter), relative average perturbation (RAP), and pitch period perturbation quotient (PPQ)) compared to the pre-test outcomes. The same was true of pitch-intensity contour of vowel /a:/, an indication of voice instability during sustained phonation. The recorded impairments of voice acoustic parameters related to vocal loading provide further evidence of dysphonia. The voice acoustic analysis performed before and after the vocal-loading test can significantly contribute to objective voice examinations useful in diagnosis of dysphonia among teachers.

Functional Dysphonia during Mental Imagery: Testing the Trait Theory of Voice Disorders

Science.gov (United States)

van Mersbergen, Miriam; Patrick, Christopher; Glaze, Leslie

2008-01-01

Purpose: Previous research has proposed that persons with functional dysphonia (FD) present with temperamental traits that predispose them to their voice disorder. We investigated this theory in a controlled experiment and compared them with social anxiety (SA) and healthy control (HC) groups. Method: Twelve participants with FD, 19 participants…

Analysis of possible factors of vocal interference during the teaching activity

Directory of Open Access Journals (Sweden)

Bárbara Gabriela Silva

2017-12-01

Full Text Available ABSTRACT OBJECTIVE To measure the risk of dysphonia in teachers, as well as investigate whether the perceptual-auditory and acoustic aspects of the voice of teachers in situations of silence and noise, the signal-to-noise ratio, and the noise levels in the classroom are associated with the presence of dysphonia. METHODS This is an observational cross-sectional research with 23 primary and secondary school teachers from a private school in the municipality of São Paulo, Brazil, divided into the groups without dysphonia and with dysphonia. We performed the following procedures: general Dysphonia Risk Screening Protocol (General-DRSP and complementary to speaking voice - teacher (Specific-DRSP, voice recording during class and in an individual situation in a silent room, and measurement of the signal-to-noise ratio and noise levels of classrooms. RESULTS We have found differences between groups regarding physical activity (General-DRSP and particularities of the profession (Specific-DRSP, as well as in all aspects of the perceptual-auditory vocal analysis. We have found signs of voice wear in the group without dysphonia. Regarding the vocal resources in the situations of noise and silence, we have identified a difference for the production of abrupt vocal attack and the tendency of a more precise speech in the situation of noise. Both the signal-to-noise ratio and the room noise levels during class were high in both groups. CONCLUSIONS Teachers in both groups are at high risk for developing dysphonia and have negative vocal signals to a greater or lesser extent. Signal-to-noise ratio was inadequate in most classrooms, considering the standards for both children with normal hearing and with hearing loss, as well as equivalent noise levels.

Perceptual load in sport and the heuristic value of the perceptual load paradigm in examining expertise-related perceptual-cognitive adaptations.

Science.gov (United States)

Furley, Philip; Memmert, Daniel; Schmid, Simone

2013-03-01

In two experiments, we transferred perceptual load theory to the dynamic field of team sports and tested the predictions derived from the theory using a novel task and stimuli. We tested a group of college students (N = 33) and a group of expert team sport players (N = 32) on a general perceptual load task and a complex, soccer-specific perceptual load task in order to extend the understanding of the applicability of perceptual load theory and further investigate whether distractor interference may differ between the groups, as the sport-specific processing task may not exhaust the processing capacity of the expert participants. In both, the general and the specific task, the pattern of results supported perceptual load theory and demonstrates that the predictions of the theory also transfer to more complex, unstructured situations. Further, perceptual load was the only determinant of distractor processing, as we neither found expertise effects in the general perceptual load task nor the sport-specific task. We discuss the heuristic utility of using response-competition paradigms for studying both general and domain-specific perceptual-cognitive adaptations.

Relationship between adherence to speech therapy in patients with dysphonia and quality of life.

Science.gov (United States)

Duarte de Almeida, Letícia; Santos, Lívia Rodrigues; Bassi, Iara Barreto; Teixeira, Letícia Caldas; Côrtes Gama, Ana Cristina

2013-09-01

The present study analyzed if aspects of voice-related quality of life (VRQOL) were associated with adherence to voice therapy in teachers. Retrospective survey in which the medical records of 179 dysphonic teachers (62, abandonment group and 114, discharge group) who underwent speech therapy at the Speech Therapy Clinic at the Hospital das Clínicas of the Universidade Federal de Minas Gerais (AV-HCUFMG) were analyzed. Female teachers with dysphonia referred by Gerência de Saúde e Perícia Médica (Department of Health and Medical Analysis) of Belo Horizonte City Hall were included. The variables of interest were: age, number of voice therapy sessions attended (attendance), number of sessions missed (absence), type of dysphonia, and Vocal Activity and Protocol Profile (VAPP) scores administered during the first therapy session as a component of voice assessment. The chi-square test was used to assess categorical variables. For continuous variables, the Mann-Whitney test, a nonparametric test for independent samples, was used. The groups differed with regard to the type of dysphonia as well as the several parameters of the VAPP: vocal self-perception, effects at work, effects on daily communication, effects on emotion, and the total VAPP score. Individuals with less favorable VRQOL scores were less adherent to voice therapy compared with subjects with more favorable VRQOL. Copyright © 2013 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Interventions for treating functional dysphonia in adults.

Science.gov (United States)

Ruotsalainen, J H; Sellman, J; Lehto, L; Jauhiainen, M; Verbeek, J H

2007-07-18

Poor voice quality due to functional dysphonia can lead to a reduced quality of life. In occupations where voice use is substantial it can lead to a loss of employment. To evaluate the effectiveness of interventions to treat functional dysphonia in adults. We searched MEDLINE (PubMed, 1950 to 2006), EMBASE (1974 to 2006), CENTRAL (The Cochrane Library, Issue 2 2006), CINAHL (1983 to 2006), PsychINFO (1967 to 2006), Science Citation Index (1986 to 2006) and the Occupational Health databases OSH-ROM (to 2006). The date of the last search was 5(th) April 2006. Randomised controlled trials (RCTs) of interventions evaluating the effectiveness of treatments targeted at adults with functional dysphonia. For work-directed interventions interrupted time series and prospective cohort studies were also eligible. Two authors independently extracted data and assessed trial quality. Meta-analysis was performed where appropriate. We identified six randomised controlled trials including a total of 163 participants in intervention groups and 141 controls. One trial was high quality. Interventions were grouped into 1) Direct voice therapy 2) Indirect voice therapy 3) Combination of direct and indirect voice therapy and 4) Other treatments: pharmacological treatment and vocal hygiene instructions given by phoniatrist. No studies were found evaluating direct voice therapy on its own. One study did not show indirect voice therapy on its own to be effective when compared to no intervention. There is evidence from three studies for the effectiveness of a combination of direct and indirect voice therapy on self-reported vocal functioning (SMD -1.07; 95% CI -1.94 to -0.19), on observer-rated vocal functioning (WMD -13.00; 95% CI -17.92 to -8.08) and on instrumental assessment of vocal functioning (WMD -1.20; 95% CI -2.37 to -0.03) when compared to no intervention. The results of one study also show that the remedial effect remains significant for at least 14 weeks on self-reported vocal

MUSCLE TENSION DYSPHONIA

Directory of Open Access Journals (Sweden)

Irena Hočevar Boltežar

2004-07-01

Full Text Available Background. Muscle tension dysphonia (MTD is the cause of hoarseness in almost one half of the patients with voice disorders. The otorhinolaryngologic examination discovers no evident organic lesions in the larynx at least in the beginning of the voice problems. The reason for the hoarse voice is a disordered and maladjusted activity of the muscles taking part in phonation and/or articulation. In some patients, the irregular function of the larynx results in mucosal lesions on vocal folds. The factors participating in the development of MTD, directly or indirectly influence the quality of laryngeal mucosa, the activity of the phonatory muscles and/or increase of the vocal load. In the diagnostics and treatment of the MTD a phoniatrician, a speech and language therapist and a psychologist closely cooperate with the patient who must take an active role. The treatment is a long-lasting one but resulted in a high percentage of clinical success.Conclusions. Most likely, MTD is not a special disease but only a reflection of any disorder in the complicated system of regulation and realization of phonation. The prognosis of treatment is good when all unfavourable factors participating in development of MTD are eliminated and a proper professional voice- and psychotherapy started.

Section four: laryngitis and dysphonia.

Science.gov (United States)

Hueston, William J; Kaur, Dipinpreet

2013-12-01

Acute laryngitis is most often caused by viral illnesses through direct inflammation of the vocal cords or from irritation due to postnasal drainage. Bacterial infections, such as acute epiglottitis, also can cause dysphonia but typically have other systemic symptoms as well as respiratory distress. Chronic laryngitis is characterized by symptoms lasting more than 3 weeks. Chronic vocal cord issues can be related to overuse or stress on the vocal cords resulting in nodules or polyps. Individuals in certain occupations, such as singers, school teachers, and chemical workers, are at greater risk of chronic laryngitis. The diagnostic approach to chronic laryngitis should include visualization of the vocal cords to rule out potential malignant lesions. For acute and chronic overuse symptoms, the best treatment is vocal rest. The use of antibiotics or decongestants should be discouraged. Written permission from the American Academy of Family Physicians is required for reproduction of this material in whole or in part in any form or medium.

Early Motor Unit Disease Masquerading as Psychogenic Breathy Dysphonia: A Clinical Case Presentation

Science.gov (United States)

Aronson, Arnold E.

1971-01-01

Presented is a study of a 20-year-old girl with mild, breathy dysphonia, previously diagnosed as psychogenic. In actuality, her voice change was a sign of early myasthenia gravis. It is pointed out that voice changes can be a first and only sign of early neurologic disease. (Author/KW)

Perceptual Robust Design

DEFF Research Database (Denmark)

Pedersen, Søren Nygaard

The research presented in this PhD thesis has focused on a perceptual approach to robust design. The results of the research and the original contribution to knowledge is a preliminary framework for understanding, positioning, and applying perceptual robust design. Product quality is a topic...... been presented. Therefore, this study set out to contribute to the understanding and application of perceptual robust design. To achieve this, a state-of-the-art and current practice review was performed. From the review two main research problems were identified. Firstly, a lack of tools...... for perceptual robustness was found to overlap with the optimum for functional robustness and at most approximately 2.2% out of the 14.74% could be ascribed solely to the perceptual robustness optimisation. In conclusion, the thesis have offered a new perspective on robust design by merging robust design...

Perceptually-Inspired Computing

Directory of Open Access Journals (Sweden)

Ming Lin

2015-08-01

Full Text Available Human sensory systems allow individuals to see, hear, touch, and interact with the surrounding physical environment. Understanding human perception and its limit enables us to better exploit the psychophysics of human perceptual systems to design more efficient, adaptive algorithms and develop perceptually-inspired computational models. In this talk, I will survey some of recent efforts on perceptually-inspired computing with applications to crowd simulation and multimodal interaction. In particular, I will present data-driven personality modeling based on the results of user studies, example-guided physics-based sound synthesis using auditory perception, as well as perceptually-inspired simplification for multimodal interaction. These perceptually guided principles can be used to accelerating multi-modal interaction and visual computing, thereby creating more natural human-computer interaction and providing more immersive experiences. I will also present their use in interactive applications for entertainment, such as video games, computer animation, and shared social experience. I will conclude by discussing possible future research directions.

Temporal discrimination thresholds in adult-onset primary torsion dystonia: an analysis by task type and by dystonia phenotype.

LENUS (Irish Health Repository)

Bradley, D

2012-01-01

Adult-onset primary torsion dystonia (AOPTD) is an autosomal dominant disorder with markedly reduced penetrance. Sensory abnormalities are present in AOPTD and also in unaffected relatives, possibly indicating non-manifesting gene carriage (acting as an endophenotype). The temporal discrimination threshold (TDT) is the shortest time interval at which two stimuli are detected to be asynchronous. We aimed to compare the sensitivity and specificity of three different TDT tasks (visual, tactile and mixed\\/visual-tactile). We also aimed to examine the sensitivity of TDTs in different AOPTD phenotypes. To examine tasks, we tested TDT in 41 patients and 51 controls using visual (2 lights), tactile (non-painful electrical stimulation) and mixed (1 light, 1 electrical) stimuli. To investigate phenotypes, we examined 71 AOPTD patients (37 cervical dystonia, 14 writer\\'s cramp, 9 blepharospasm, 11 spasmodic dysphonia) and 8 musician\\'s dystonia patients. The upper limit of normal was defined as control mean +2.5 SD. In dystonia patients, the visual task detected abnormalities in 35\\/41 (85%), the tactile task in 35\\/41 (85%) and the mixed task in 26\\/41 (63%); the mixed task was less sensitive than the other two (p = 0.04). Specificity was 100% for the visual and tactile tasks. Abnormal TDTs were found in 36 of 37 (97.3%) cervical dystonia, 12 of 14 (85.7%) writer\\'s cramp, 8 of 9 (88.8%) blepharospasm, 10 of 11 (90.1%) spasmodic dysphonia patients and 5 of 8 (62.5%) musicians. The visual and tactile tasks were found to be more sensitive than the mixed task. Temporal discrimination threshold results were comparable across common adult-onset primary torsion dystonia phenotypes, with lower sensitivity in the musicians.

Analysis of possible factors of vocal interference during the teaching activity

OpenAIRE

Silva, Bárbara Gabriela; Chammas, Tiago Visacre; Zenari, Marcia Simões; Moreira, Renata Rodrigues; Samelli, Alessandra Giannella; Nemr, Kátia

2017-01-01

ABSTRACT OBJECTIVE To measure the risk of dysphonia in teachers, as well as investigate whether the perceptual-auditory and acoustic aspects of the voice of teachers in situations of silence and noise, the signal-to-noise ratio, and the noise levels in the classroom are associated with the presence of dysphonia. METHODS This is an observational cross-sectional research with 23 primary and secondary school teachers from a private school in the municipality of São Paulo, Brazil, divided into ...

Visual Perceptual Learning and Models.

Science.gov (United States)

Dosher, Barbara; Lu, Zhong-Lin

2017-09-15

Visual perceptual learning through practice or training can significantly improve performance on visual tasks. Originally seen as a manifestation of plasticity in the primary visual cortex, perceptual learning is more readily understood as improvements in the function of brain networks that integrate processes, including sensory representations, decision, attention, and reward, and balance plasticity with system stability. This review considers the primary phenomena of perceptual learning, theories of perceptual learning, and perceptual learning's effect on signal and noise in visual processing and decision. Models, especially computational models, play a key role in behavioral and physiological investigations of the mechanisms of perceptual learning and for understanding, predicting, and optimizing human perceptual processes, learning, and performance. Performance improvements resulting from reweighting or readout of sensory inputs to decision provide a strong theoretical framework for interpreting perceptual learning and transfer that may prove useful in optimizing learning in real-world applications.

Perceptual learning and human expertise.

Science.gov (United States)

Kellman, Philip J; Garrigan, Patrick

2009-06-01

We consider perceptual learning: experience-induced changes in the way perceivers extract information. Often neglected in scientific accounts of learning and in instruction, perceptual learning is a fundamental contributor to human expertise and is crucial in domains where humans show remarkable levels of attainment, such as language, chess, music, and mathematics. In Section 2, we give a brief history and discuss the relation of perceptual learning to other forms of learning. We consider in Section 3 several specific phenomena, illustrating the scope and characteristics of perceptual learning, including both discovery and fluency effects. We describe abstract perceptual learning, in which structural relationships are discovered and recognized in novel instances that do not share constituent elements or basic features. In Section 4, we consider primary concepts that have been used to explain and model perceptual learning, including receptive field change, selection, and relational recoding. In Section 5, we consider the scope of perceptual learning, contrasting recent research, focused on simple sensory discriminations, with earlier work that emphasized extraction of invariance from varied instances in more complex tasks. Contrary to some recent views, we argue that perceptual learning should not be confined to changes in early sensory analyzers. Phenomena at various levels, we suggest, can be unified by models that emphasize discovery and selection of relevant information. In a final section, we consider the potential role of perceptual learning in educational settings. Most instruction emphasizes facts and procedures that can be verbalized, whereas expertise depends heavily on implicit pattern recognition and selective extraction skills acquired through perceptual learning. We consider reasons why perceptual learning has not been systematically addressed in traditional instruction, and we describe recent successful efforts to create a technology of perceptual

Perceptual learning and human expertise

Science.gov (United States)

Kellman, Philip J.; Garrigan, Patrick

2009-06-01

We consider perceptual learning: experience-induced changes in the way perceivers extract information. Often neglected in scientific accounts of learning and in instruction, perceptual learning is a fundamental contributor to human expertise and is crucial in domains where humans show remarkable levels of attainment, such as language, chess, music, and mathematics. In Section 2, we give a brief history and discuss the relation of perceptual learning to other forms of learning. We consider in Section 3 several specific phenomena, illustrating the scope and characteristics of perceptual learning, including both discovery and fluency effects. We describe abstract perceptual learning, in which structural relationships are discovered and recognized in novel instances that do not share constituent elements or basic features. In Section 4, we consider primary concepts that have been used to explain and model perceptual learning, including receptive field change, selection, and relational recoding. In Section 5, we consider the scope of perceptual learning, contrasting recent research, focused on simple sensory discriminations, with earlier work that emphasized extraction of invariance from varied instances in more complex tasks. Contrary to some recent views, we argue that perceptual learning should not be confined to changes in early sensory analyzers. Phenomena at various levels, we suggest, can be unified by models that emphasize discovery and selection of relevant information. In a final section, we consider the potential role of perceptual learning in educational settings. Most instruction emphasizes facts and procedures that can be verbalized, whereas expertise depends heavily on implicit pattern recognition and selective extraction skills acquired through perceptual learning. We consider reasons why perceptual learning has not been systematically addressed in traditional instruction, and we describe recent successful efforts to create a technology of perceptual

[Spasmodic hemiplegia after stroke treated with scalp acupuncture, music therapy and rehabilitation: a randomized controlled trial].

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Jia, Chengjie; Zhang, Hongru; Ni, Guangxia; Zhang, Yinan; Su, Bin; Xu, Xinlei

2017-12-12

To evaluate the differences in the clinical therapeutic effects on spasmodic hemiplegia after stroke among the alliance therapy of scalp acupuncture, music therapy combined with rehabilitation, the simple rehabilitation therapy and the combination of music therapy and rehabilitation. A total of 76 patients of post-stroke spasmodic hemiplegia were randomized into a rehabilitation group (25 cases), a combination group with music therapy and rehabilitation (25 cases) and an alliance therapy group with scalp acupuncture, music therapy and rehabilitation (26 cases). In the rehabilitation group, the routine rehabilitation therapy was applied, including the removal of various incentives that cause spasm, the correction of body position and the physical therapy. In the combination group, the music therapy was added on the basis of the treatment as the rehabilitation group. The music physician used the rhythmic auditory stimulation, the patterned sensory enhancement and the therapeutic instrumental music playing to set up the task in the treatment. In the alliance therapy group, scalp acupuncture was added on the basis of the treatment as the combination group. The anterior oblique line of vertex-tempora (MS 6) and the posterior oblique line of vertex-tempora (MS 7) on the contralateral side were selected and stimulated with penetrating needling technique. The needles were retained. During the needling retaining, the needles were rotated once every 10 min, for 2 min each time. The treatment was given one session a day, totally for 5 sessions a week, continuously for 4 weeks. The Fugl-Meyer assessment (FMA), Barthel index (BI) and the modified Ashworth scale (MAS) of the affected elbow and the passive knee movement at static condition were observed in the patients before and after treatment. The results of FMA, BI and MAS were not different before treatment in the patients among the three groups (all P >0.05), indicating the comparability among groups. After treatment, FMA

Articulatory Changes in Muscle Tension Dysphonia: Evidence of Vowel Space Expansion Following Manual Circumlaryngeal Therapy

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Roy, Nelson; Nissen, Shawn L.; Dromey, Christopher; Sapir, Shimon

2009-01-01

In a preliminary study, we documented significant changes in formant transitions associated with successful manual circumlaryngeal treatment (MCT) of muscle tension dysphonia (MTD), suggesting improvement in speech articulation. The present study explores further the effects of MTD on vowel articulation by means of additional vowel acoustic…

Laryngeal manifestations of relapsing polychondritis and a novel treatment option.

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Childs, Lesley F; Rickert, Scott; Wengerman, Oscar C; Lebovics, Robert; Blitzer, Andrew

2012-09-01

Laryngotracheal involvement in relapsing polychondritis (RP) is rare. However, it is one of the most common causes of death in this patient population. We present three patients who primarily presented with laryngeal manifestations of RP and a novel treatment option for bamboo nodules. Retrospective chart review and comprehensive review of the literature. Two patients first presented to an otolaryngologist because of hoarseness and chronic cough that eventually progressed to dyspnea upon exertion. Laryngeal examination revealed subglottic stenoses. Upon rheumatologic workup both were diagnosed with RP. After treatment with steroids and immunosuppressive drugs, one of the patient's laryngeal symptoms improved, whereas the other required dilation procedures. Neither patient had classic auricular or nasal symptoms upon initial presentation. The third patient was being treated for spasmodic dysphonia and was noted to have bamboo nodules with accompanying dysphonia. Rheumatologic workup revealed RP and systemic treatment ensued. Unfortunately, her symptoms of hoarseness persisted despite systemic treatment. A pulsed-potassium-titanyl-phosphate (KTP) laser was applied to the bilateral bamboo nodules, which eventually caused resolution of her vocal fold lesions and dysphonia. We present three patients with RP, all of whom sought health care by an otolaryngologist primarily. Awareness of this disease entity and the possibility for early laryngeal involvement is crucial for proper care of those with this life-threatening disease. Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Intensified Voice Therapy: A New Model for the Rehabilitation of Patients Suffering from Functional Dysphonias

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Fischer, Michael J.; Gutenbrunner, Christoph; Ptok, Martin

2009-01-01

The objective of this study was to evaluate a new intervention for chronic dysphonias, consisting of a 2-week outpatient treatment period using intensified voice therapy combined with elements of physical medicine, including physiotherapy (orthotherapy, detonisation and training of the trunk muscles, respiratory therapy and others), manual therapy…

Effects of Voice Therapy on Laryngeal Motor Units During Phonation in Chronic Superior Laryngeal Nerve Paresis Dysphonia.

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Kaneko, Mami; Hitomi, Takefumi; Takekawa, Takashi; Tsuji, Takuya; Kishimoto, Yo; Hirano, Shigeru

2017-09-26

Injury to the superior laryngeal nerve can result in dysphonia, and in particular, loss of vocal range. It can be an especially difficult problem to address with either voice therapy or surgical intervention. Some clinicians and scientists suggest that combining vocal exercises with adjunctive neuromuscular electrical stimulation may enhance the positive effects of voice therapy for superior laryngeal nerve paresis (SLNP). However, the effects of voice therapy without neuromuscular electrical stimulation are unknown. The purpose of this retrospective study was to demonstrate the clinical effectiveness of voice therapy for rehabilitating chronic SLNP dysphonia in two subjects, using interspike interval (ISI) variability of laryngeal motor units by laryngeal electromyography (LEMG). Both patients underwent LEMG and were diagnosed with having 70% recruitment of the cricothyroid muscle, and 70% recruitment of the cricothyroid and thyroarytenoid muscles, respectively. Both patients received voice therapy for 3 months. Grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, stroboscopic examination, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 were performed before and after voice therapy. Mean ISI variability during steady phonation was also assessed. After voice therapy, both patients showed improvement in vocal assessments by acoustic, aerodynamic, GRBAS, and Voice Handicap Index-10 analysis. LEMG indicated shortened ISIs in both cases. This study suggests that voice therapy for chronic SLNP dysphonia can be useful for improving SLNP and voice quality. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Cerebellar tDCS dissociates the timing of perceptual decisions from perceptual change in speech

NARCIS (Netherlands)

Lametti, D.R.; Oostwoud Wijdenes, L.; Bonaiuto, J.; Bestmann, S.; Rothwell, J.C.

2016-01-01

Neuroimaging studies suggest that the cerebellum might play a role in both speech perception and speech perceptual learning. However, it remains unclear what this role is: does the cerebellum directly contribute to the perceptual decision? Or does it contribute to the timing of perceptual decisions?

Perceptual organization and visual attention.

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Kimchi, Ruth

2009-01-01

Perceptual organization--the processes structuring visual information into coherent units--and visual attention--the processes by which some visual information in a scene is selected--are crucial for the perception of our visual environment and to visuomotor behavior. Recent research points to important relations between attentional and organizational processes. Several studies demonstrated that perceptual organization constrains attentional selectivity, and other studies suggest that attention can also constrain perceptual organization. In this chapter I focus on two aspects of the relationship between perceptual organization and attention. The first addresses the question of whether or not perceptual organization can take place without attention. I present findings demonstrating that some forms of grouping and figure-ground segmentation can occur without attention, whereas others require controlled attentional processing, depending on the processes involved and the conditions prevailing for each process. These findings challenge the traditional view, which assumes that perceptual organization is a unitary entity that operates preattentively. The second issue addresses the question of whether perceptual organization can affect the automatic deployment of attention. I present findings showing that the mere organization of some elements in the visual field by Gestalt factors into a coherent perceptual unit (an "object"), with no abrupt onset or any other unique transient, can capture attention automatically in a stimulus-driven manner. Taken together, the findings discussed in this chapter demonstrate the multifaceted, interactive relations between perceptual organization and visual attention.

Aplicação da técnica de emissão em tempo máximo de fonação em paciente com disfonia espasmódica adutora: relato de caso Applying the technique of sustained maximum phonation time in a female patient with adductor spasmodic dysphonia: case report

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Luiz Alberto Alves Mota

2012-01-01

Full Text Available A Disfonia Espasmódica Adutora é uma desordem neurológica do processamento motor central, caracterizada por contrações involuntárias e inapropriadas da musculatura fonatória, produzindo uma hiperadução das pregas vocais, o que promove uma voz trêmula, entrecortada e tensa-estrangulada. O objetivo deste estudo foi descrever os parâmetros vocais, acústicos e laríngeos pré e pós-tratamento fonoaudiológico realizado por meio da aplicação da Técnica de Emissão em Tempo Máximo de Fonação (TETMF em paciente com Disfonia Espasmódica de Adução. Esta técnica tem como objetivo promover o aumento da resistência glótica, melhorar a estabilidade fonatória e adequar a coaptação glótica. Participou deste estudo de caso uma paciente de 66 anos de idade, gênero feminino, com Disfonia Espasmódica Adutora. A paciente foi submetida à avaliação otorrinolaringológica e fonoaudiológica pré e pós-aplicação da TETMF. Foi verificada modificação de parâmetros vocais, acústicos e laríngeos, tais como a classificação da disfonia de G3R1B1A0S3I3 para G2R1B1A0S2I2, pitch de grave a adequado, traçado espectrográfico instável para mais estável e expressivo aumento da frequência fundamental média e da intensidade vocal média, além da melhora da eficiência glótica com o fechamento da fenda glótica anteroposterior. A terapia fonoaudiológica com a aplicação da TETMF foi considerada uma adequada opção de tratamento para o caso, tendo em vista os resultados alcançados, com destaque para a qualidade vocal e estabilidade fonatória. Ressalta-se a importância de novos estudos para comprovação da eficácia da técnica no tratamento da Disfonia Espasmódica Adutora.Adductor Spasmodic Dysphonia (ASD is a neurological disorder of central motor processing, characterized by involuntary and inappropriate contractions of the phonatory muscles, producing hyperadduction of the vocal folds, which causes a tremulous, faltering

Influence of phonetic context on the dysphonic event: contribution of new methodologies for the analysis of pathological voice.

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Revis, J; Galant, C; Fredouille, C; Ghio, A; Giovanni, A

2012-01-01

Widely studied in terms of perception, acoustics or aerodynamics, dysphonia stays nevertheless a speech phenomenon, closely related to the phonetic composition of the message conveyed by the voice. In this paper, we present a series of three works with the aim to understand the implications of the phonetic manifestation of dysphonia. Our first study proposes a new approach to the perceptual analysis of dysphonia (the phonetic labeling), which principle is to listen and evaluate each phoneme in a sentence separately. This study confirms the hypothesis of Laver that the dysphonia is not a constant noise added to the speech signal, but a discontinuous phenomenon, occurring on certain phonemes, based on the phonetic context. However, the burden of executing the task has led us to look to the techniques of automatic speaker recognition (ASR) to automate the procedure. With the collaboration of the LIA, we have developed a system for automatic classification of dysphonia from the techniques of ASR. This is the subject of our second study. The first results obtained with this system suggest that the unvoiced consonants show predominant performance in the task of automatic classification of dysphonia. This result is surprising since it is often assumed that dysphonia occurs only on laryngeal vibration. We started looking for explanations of this phenomenon and we present our assumptions and experiences in the third work we present.

Vocal aging and adductor spasmodic dysphonia: Response to botulinum toxin injection

OpenAIRE

Cannito, Michael P; Kahane, Joel C; Chorna, Lesya

2008-01-01

Michael P Cannito, Joel C Kahane, Lesya ChornaSchool of Audiology and Speech-Language Pathology, The University of Memphis, Memphis, TN, USAAbstract: Aging of the larynx is characterized by involutional changes which alter its biomechanical and neural properties and create a biological environment that is different from younger counterparts. Illustrative anatomical examples are presented. This natural, non-disease process appears to set conditions which may influence the effectiveness of botu...

High-throughput mutational analysis of TOR1A in primary dystonia

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Truong Daniel D

2009-03-01

Full Text Available Abstract Background Although the c.904_906delGAG mutation in Exon 5 of TOR1A typically manifests as early-onset generalized dystonia, DYT1 dystonia is genetically and clinically heterogeneous. Recently, another Exon 5 mutation (c.863G>A has been associated with early-onset generalized dystonia and some ΔGAG mutation carriers present with late-onset focal dystonia. The aim of this study was to identify TOR1A Exon 5 mutations in a large cohort of subjects with mainly non-generalized primary dystonia. Methods High resolution melting (HRM was used to examine the entire TOR1A Exon 5 coding sequence in 1014 subjects with primary dystonia (422 spasmodic dysphonia, 285 cervical dystonia, 67 blepharospasm, 41 writer's cramp, 16 oromandibular dystonia, 38 other primary focal dystonia, 112 segmental dystonia, 16 multifocal dystonia, and 17 generalized dystonia and 250 controls (150 neurologically normal and 100 with other movement disorders. Diagnostic sensitivity and specificity were evaluated in an additional 8 subjects with known ΔGAG DYT1 dystonia and 88 subjects with ΔGAG-negative dystonia. Results HRM of TOR1A Exon 5 showed high (100% diagnostic sensitivity and specificity. HRM was rapid and economical. HRM reliably differentiated the TOR1A ΔGAG and c.863G>A mutations. Melting curves were normal in 250/250 controls and 1012/1014 subjects with primary dystonia. The two subjects with shifted melting curves were found to harbor the classic ΔGAG deletion: 1 a non-Jewish Caucasian female with childhood-onset multifocal dystonia and 2 an Ashkenazi Jewish female with adolescent-onset spasmodic dysphonia. Conclusion First, HRM is an inexpensive, diagnostically sensitive and specific, high-throughput method for mutation discovery. Second, Exon 5 mutations in TOR1A are rarely associated with non-generalized primary dystonia.

Prevalence of Perceived Dysphonia and Its Correlation With the Prevalence of Clinically Diagnosed Laryngeal Disorders: The Korea National Health and Nutrition Examination Surveys 2010-2012.

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Byeon, Haewon

2015-10-01

This study investigated the prevalence of perceived dysphonia and its correlation with the prevalence of clinically diagnosed laryngeal disorders. Subjects were 8713 non-institutionalized civilian adults over the age of 19 (3810 men and 4912 women) who completed the laryngeal examination of the fifth Korea National Health and Nutrition Examination Survey. A Poisson regression was used to examine the association between perceived dysphonia and laryngeal disorders. Adjusting for covariates (age, sex, education level, income, occupation, alcohol drinking, and self-reported health status), those with perceived voice problems were 4.8 times (OR=4.75, 95% CI, 3.77-5.99) more likely to have laryngeal disorders than those without voice problems. In particular, the vocal fold pathology correlated with perceived dysphonia was: vocal fold nodules (OR=5.32, 95% CI, 3.43-8.26), vocal polyps (OR=3.73, 95% CI, 1.57-8.86), vocal cysts (OR=11.97, 95% CI, 1.97-72.72), Reinke's edema (OR=9.27, 95% CI, 4.77-18.00), laryngeal paralysis (OR=3.58, 95% CI, 1.56-8.26), laryngeal granulomas (OR=4.31, 95% CI, 1.01-18.80), epiglottic cyst (OR=2.94, 95% CI, 1.21-7.13), and laryngitis (OR=4.07, 95% CI, 2.91-5.69). People with self-perceived dysphonia had a high risk of laryngeal disorders. © The Author(s) 2015.

Perceptual Processing Affects Conceptual Processing

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van Dantzig, Saskia; Pecher, Diane; Zeelenberg, Rene; Barsalou, Lawrence W.

2008-01-01

According to the Perceptual Symbols Theory of cognition (Barsalou, 1999), modality-specific simulations underlie the representation of concepts. A strong prediction of this view is that perceptual processing affects conceptual processing. In this study, participants performed a perceptual detection task and a conceptual property-verification task…

Acetylcholine and Olfactory Perceptual Learning

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Wilson, Donald A.; Fletcher, Max L.; Sullivan, Regina M.

2004-01-01

Olfactory perceptual learning is a relatively long-term, learned increase in perceptual acuity, and has been described in both humans and animals. Data from recent electrophysiological studies have indicated that olfactory perceptual learning may be correlated with changes in odorant receptive fields of neurons in the olfactory bulb and piriform…

Perceptual dimensions differentiate emotions.

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Cavanaugh, Lisa A; MacInnis, Deborah J; Weiss, Allen M

2015-08-26

Individuals often describe objects in their world in terms of perceptual dimensions that span a variety of modalities; the visual (e.g., brightness: dark-bright), the auditory (e.g., loudness: quiet-loud), the gustatory (e.g., taste: sour-sweet), the tactile (e.g., hardness: soft vs. hard) and the kinaesthetic (e.g., speed: slow-fast). We ask whether individuals use perceptual dimensions to differentiate emotions from one another. Participants in two studies (one where respondents reported on abstract emotion concepts and a second where they reported on specific emotion episodes) rated the extent to which features anchoring 29 perceptual dimensions (e.g., temperature, texture and taste) are associated with 8 emotions (anger, fear, sadness, guilt, contentment, gratitude, pride and excitement). Results revealed that in both studies perceptual dimensions differentiate positive from negative emotions and high arousal from low arousal emotions. They also differentiate among emotions that are similar in arousal and valence (e.g., high arousal negative emotions such as anger and fear). Specific features that anchor particular perceptual dimensions (e.g., hot vs. cold) are also differentially associated with emotions.

Integrated approaches to perceptual learning.

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Jacobs, Robert A

2010-04-01

New technologies and new ways of thinking have recently led to rapid expansions in the study of perceptual learning. We describe three themes shared by many of the nine articles included in this topic on Integrated Approaches to Perceptual Learning. First, perceptual learning cannot be studied on its own because it is closely linked to other aspects of cognition, such as attention, working memory, decision making, and conceptual knowledge. Second, perceptual learning is sensitive to both the stimulus properties of the environment in which an observer exists and to the properties of the tasks that the observer needs to perform. Moreover, the environmental and task properties can be characterized through their statistical regularities. Finally, the study of perceptual learning has important implications for society, including implications for science education and medical rehabilitation. Contributed articles relevant to each theme are summarized. Copyright © 2010 Cognitive Science Society, Inc.

Studying Real-World Perceptual Expertise

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Jianhong eShen

2014-08-01

Full Text Available Significant insights into visual cognition have come from studying real-world perceptual expertise. Many have previously reviewed empirical findings and theoretical developments from this work. Here we instead provide a brief perspective on approaches, considerations, and challenges to studying real-world perceptual expertise. We discuss factors like choosing to use real-world versus artificial object domains of expertise, selecting a target domain of real-world perceptual expertise, recruiting experts, evaluating their level of expertise, and experimentally testing experts in the lab and online. Throughout our perspective, we highlight expert birding (also called birdwatching as an example, as it has been used as a target domain for over two decades in the perceptual expertise literature.

Evaluative pressure overcomes perceptual load effects.

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Normand, Alice; Autin, Frédérique; Croizet, Jean-Claude

2015-06-01

Perceptual load has been found to be a powerful bottom-up determinant of distractibility, with high perceptual load preventing distraction by any irrelevant information. However, when under evaluative pressure, individuals exert top-down attentional control by giving greater weight to task-relevant features, making them more distractible from task-relevant distractors. One study tested whether the top-down modulation of attention under evaluative pressure overcomes the beneficial bottom-up effect of high perceptual load on distraction. Using a response-competition task, we replicated previous findings that high levels of perceptual load suppress task-relevant distractor response interference, but only for participants in a control condition. Participants under evaluative pressure (i.e., who believed their intelligence was assessed) showed interference from task-relevant distractor at all levels of perceptual load. This research challenges the assumptions of the perceptual load theory and sheds light on a neglected determinant of distractibility: the self-relevance of the performance situation in which attentional control is solicited.

Perceptual learning modifies untrained pursuit eye movements.

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Szpiro, Sarit F A; Spering, Miriam; Carrasco, Marisa

2014-07-07

Perceptual learning improves detection and discrimination of relevant visual information in mature humans, revealing sensory plasticity. Whether visual perceptual learning affects motor responses is unknown. Here we implemented a protocol that enabled us to address this question. We tested a perceptual response (motion direction estimation, in which observers overestimate motion direction away from a reference) and a motor response (voluntary smooth pursuit eye movements). Perceptual training led to greater overestimation and, remarkably, it modified untrained smooth pursuit. In contrast, pursuit training did not affect overestimation in either pursuit or perception, even though observers in both training groups were exposed to the same stimuli for the same time period. A second experiment revealed that estimation training also improved discrimination, indicating that overestimation may optimize perceptual sensitivity. Hence, active perceptual training is necessary to alter perceptual responses, and an acquired change in perception suffices to modify pursuit, a motor response. © 2014 ARVO.

The Effects of Amplification on Vocal Dose in Teachers with Dysphonia.

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Assad, Joana Perpetuo; Gama, Ana Cristina Côrtes; Santos, Juliana Nunes; de Castro Magalhães, Max

2017-11-06

The purpose of this study was to determine if voice amplification influenced vocal dose in female teachers with dysphonia. This was an experimental study with comparative intrasubjects in which 15 individuals were compared in two different moments: condition 1 (C1) without voice amplification and condition 2 (C2) with voice amplification. All of them were female, kindergarten and elementary school teachers who presented organic or functional dysphonia. The search was carried out at the school where the teachers work. The professional voice use was considered the teachers' activity for a continuous period of two classes (average recording time of 96 minutes, with no difference in time between C1 and C2). To measure the dose we used the vocal dosimeter composed of a microphone, an accelerometer fixed to the neck, and a portable unit that stores the vocal data. The phonation data (intensity, fundamental frequency, phonation percentage, cycle dose, and distance dose) were analyzed by the equipment software (VoxLog). The use of vocal amplification in teachers promotes a reduction of the fundamental frequency (295.6-267.7 Hz), the voice intensity (96.2-93.3 dB sound pressure level), the cycle doses (489.4-345.2 thousand cycles per second), and distance doses (3,800-2,300 m). The vocal amplification allows the teacher to maintain the same phonation time (phonation percentage) but decreases the number of vocal fold oscillations (cycle dose) and the total distance traveled by the vocal fold tissue during phonation (distance dose), reducing the exposure of the vocal folds to voice trauma. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Attentional capture under high perceptual load.

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Cosman, Joshua D; Vecera, Shaun P

2010-12-01

Attentional capture by abrupt onsets can be modulated by several factors, including the complexity, or perceptual load, of a scene. We have recently demonstrated that observers are less likely to be captured by abruptly appearing, task-irrelevant stimuli when they perform a search that is high, as opposed to low, in perceptual load (Cosman & Vecera, 2009), consistent with perceptual load theory. However, recent results indicate that onset frequency can influence stimulus-driven capture, with infrequent onsets capturing attention more often than did frequent onsets. Importantly, in our previous task, an abrupt onset was present on every trial, and consequently, attentional capture might have been affected by both onset frequency and perceptual load. In the present experiment, we examined whether onset frequency influences attentional capture under conditions of high perceptual load. When onsets were presented frequently, we replicated our earlier results; attentional capture by onsets was modulated under conditions of high perceptual load. Importantly, however, when onsets were presented infrequently, we observed robust capture effects. These results conflict with a strong form of load theory and, instead, suggest that exposure to the elements of a task (e.g., abrupt onsets) combines with high perceptual load to modulate attentional capture by task-irrelevant information.

The Impact of a Teaching or Singing Career on the Female Vocal Quality at the Mean Age of 67 Years: A Pilot Study.

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D'haeseleer, Evelien; Claeys, Sofie; Bettens, Kim; Leemans, Laura; Van Calster, Ann-Sophie; Van Damme, Nina; Thijs, Zoë; Daelman, Julie; Leyns, Clara; Van Lierde, Kristiane

2017-07-01

The purpose of this study was to measure the objective and subjective vocal quality in women aged between 60 and 75 years. Secondly, the impact of a teaching or singing career on the vocal quality was investigated by comparing the vocal quality of retired women with different careers. This is a case-control study. Seventy-three retired women between 60 and 75 years (mean age: 67 years, standard deviation: 4.49) participated in the study and were divided into three groups: women with a teaching career (n = 21), choir singers with a singing career (n = 12), and women with a non-vocal career (n = 40). All subjects underwent the same assessment protocol consisting of objective (aerodynamic, maximum performance, vocal range, acoustic measurements, and the Dysphonia Severity Index) and subjective (the Voice Handicap Index, auditory-perceptual evaluations by three listeners) voice measurements. In all three groups, objective and perceptual voice analysis showed a mild dysphonia. No differences in the Dysphonia Severity Index were found between the three groups. The voices of choir singers with a singing career were perceived significantly less rough than voices of the women with a non-vocal career. Additionally, the lowest frequency of the frequency range was significantly lower in the retired teachers and choir singers than in the controls. The results of this study prudently suggest that a singing or a teaching career compared with a non-vocal career has a positive impact on the vocal frequency range, and that singing has a positive impact on the perceptual vocal quality of the older female voice. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Perceptual learning modifies untrained pursuit eye movements

OpenAIRE

Szpiro, Sarit F. A.; Spering, Miriam; Carrasco, Marisa

2014-01-01

Perceptual learning improves detection and discrimination of relevant visual information in mature humans, revealing sensory plasticity. Whether visual perceptual learning affects motor responses is unknown. Here we implemented a protocol that enabled us to address this question. We tested a perceptual response (motion direction estimation, in which observers overestimate motion direction away from a reference) and a motor response (voluntary smooth pursuit eye movements). Perceptual training...

Semantic Representations in 3D Perceptual Space

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Suncica Zdravkovic

2011-05-01

Full Text Available Barsalou's (1999 perceptual theory of knowledge echoes the pre-20th century tradition of conceptualizing all knowledge as inherently perceptual. Hence conceptual space has an infinite number of dimensions and heavily relies on perceptual experience. Osgood's (1952 semantic differential technique was developed as a bridge between perception and semantics. We updated Osgood's methodology in order to investigate current issues in visual cognition by: (1 using a 2D rather than a 1D space to place the concepts, (2 having dimensions that were perceptual while the targets were conceptual, (3 coupling visual experience with another two perceptual domains (audition and touch, (4 analyzing the data using MDS (not factor analysis. In three experiments, subjects (N = 57 judged five concrete and five abstract words on seven bipolar scales in three perceptual modalities. The 2D space led to different patterns of response compared to the classic 1D space. MDS revealed that perceptual modalities are not equally informative for mapping word-meaning distances (Mantel min = −.23; Mantel max = .88. There was no reliable differences due to test administration modality (paper vs. computer, nor scale orientation. The present findings are consistent with multidimensionality of conceptual space, a perceptual basis for knowledge, and dynamic characteristics of concepts discussed in contemporary theories.

The Assessment Methods of Laryngeal Muscle Activity in Muscle Tension Dysphonia: A Review

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Khoddami, Seyyedeh Maryam; Nakhostin Ansari, Noureddin; Izadi, Farzad; Talebian Moghadam, Saeed

2013-01-01

The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD). The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG) are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD. PMID:24319372

Referenceless Prediction of Perceptual Fog Density and Perceptual Image Defogging.

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Choi, Lark Kwon; You, Jaehee; Bovik, Alan Conrad

2015-11-01

We propose a referenceless perceptual fog density prediction model based on natural scene statistics (NSS) and fog aware statistical features. The proposed model, called Fog Aware Density Evaluator (FADE), predicts the visibility of a foggy scene from a single image without reference to a corresponding fog-free image, without dependence on salient objects in a scene, without side geographical camera information, without estimating a depth-dependent transmission map, and without training on human-rated judgments. FADE only makes use of measurable deviations from statistical regularities observed in natural foggy and fog-free images. Fog aware statistical features that define the perceptual fog density index derive from a space domain NSS model and the observed characteristics of foggy images. FADE not only predicts perceptual fog density for the entire image, but also provides a local fog density index for each patch. The predicted fog density using FADE correlates well with human judgments of fog density taken in a subjective study on a large foggy image database. As applications, FADE not only accurately assesses the performance of defogging algorithms designed to enhance the visibility of foggy images, but also is well suited for image defogging. A new FADE-based referenceless perceptual image defogging, dubbed DEnsity of Fog Assessment-based DEfogger (DEFADE) achieves better results for darker, denser foggy images as well as on standard foggy images than the state of the art defogging methods. A software release of FADE and DEFADE is available online for public use: http://live.ece.utexas.edu/research/fog/index.html.

Generation and Perceptual Implicit Memory: Different Generation Tasks Produce Different Effects on Perceptual Priming

Science.gov (United States)

Mulligan, Neil W.; Dew, Ilana T. Z.

2009-01-01

The generation manipulation has been critical in delineating differences between implicit and explicit memory. In contrast to past research, the present experiments indicate that generating from a rhyme cue produces as much perceptual priming as does reading. This is demonstrated for 3 visual priming tasks: perceptual identification, word-fragment…

Acoustic and capacity analysis of voice academic teachers with diagnosed hyperfunctional dysphonia by using DiagnoScope Specialist software.

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Zielińska-Bliźniewska, Hanna; Pietkiewicz, Piotr; Miłoński, Jarosław; Urbaniak, Joanna; Olszewski, Jurek

2013-01-01

The aim of the study was to assess the acoustic and capacity analyses of voice in academic teachers with hyperfunctional dysphonia using DiagnoScope Specialist software. The study covered 46 female academic teachers aged 34-48 years. The women were diagnosed with hyperfunctional dysphonia (with absence of organic pathologies). Having obtained the informed consent, a primary medical history was taken, videolaryngoscopic and stroboscopic examinations were performed and diagnostic voice acoustic and capacity analyses were carried out using DiagnoScope Specialist software. The acoustic analysis carried out of academic teachers with diagnosed hyperfunctional dysphonia showed enhancement in the following parameters: fundamental frequency (FO) by 1.2%; relative average perturbation (Jitter by 100.0% and RAP by 81.8%); relative amplitude perturbation quotient (APQ) by 2.9%; non-harmonic to harmonic ratio (U2H) by 16.0%; and noise to harmonic ratio (NHR) by 13.4%. A decrease of 2.5% from normal values was noted in relative amplitude perturbation (Shimmer). Formant frequencies also showed reduction (F1 by 10.7%, F2 by 5.1%, F3 by 2.2%, and F4 by 3.5%). The harmonic perturbation quotient (HPQ) was 0.8% lower and the residual harmonic perturbation quotient (RHPQ) 16.8% lower, with the residual to harmonic (R2H) decreasing by 35.1 per cent; the sub-harmonic to harmonic (S2H) by 2.4%; and the Yanagihara coefficient by 20.2%. The capacity analysis with the DiagnoScope Specialist software showed figures significantly lower than normal values of the following parameters: phonation time, true phonation time, phonation break coefficients, vocal capacity coefficient and mean vocal capacity. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

Reactive agents and perceptual ambiguity

NARCIS (Netherlands)

Dartel, M. van; Sprinkhuizen-Kuyper, I.G.; Postma, E.O.; Herik, H.J. van den

2005-01-01

Reactive agents are generally believed to be incapable of coping with perceptual ambiguity (i.e., identical sensory states that require different responses). However, a recent finding suggests that reactive agents can cope with perceptual ambiguity in a simple model (Nolfi, 2002). This paper

High-speed Imaging of Vocal Fold Vibration Onset Delay: Normal Versus Abnormal.

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Woo, Peak

2017-05-01

Vocal fold vibration onset delay (VFVOD) is heard frequently in spasmodic dysphonia and in muscle tension dysphonia. VFVOD changes due to other vocal pathologies have not been investigated. VFVOD during sustained vowel production was estimated with high-speed video in 10 normal and 40 pathologic subjects (scars, vocal fold paralysis, vocal fold nodules, and polyps). Analysis of high-speed video was done using digital kymography. VFVOD can be divided into two portions. Pre-phonation delay (PPD) is the duration when the vocal folds are nearly approximated to the time of first observed oscillation. Steady state delay (SSD) is the time when vocal folds are observed to come into oscillation until steady state of oscillation is observed. Normal subjects have almost zero PPD with vocal fold oscillation observed before full vocal fold adduction. Pathologic cases showed prolonged PPD because of (1) false cord adduction, (2) prolonged true vocal fold adduction, and (3) delay to onset of vocal fold vibration. Normal subjects have SSD of three to five cycles before steady state. Pathologic states result in increased SSD. Causes for increased SSD include (1) slow ramping up to steady state, (2) partial vibration of vocal folds, and (3) diplophonia with alternating beats before achieving steady state. There are significant differences between normal and pathology groups in both PPD and SSD. VFVOD is elevated in pathologic states. This can be due to increase in PPD or SSD. VFVOD is an under-recognized phenomenon that may contribute to complaints of vocal fatigue and dysphonia. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Perceptual integration without conscious access.

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Fahrenfort, Johannes J; van Leeuwen, Jonathan; Olivers, Christian N L; Hogendoorn, Hinze

2017-04-04

The visual system has the remarkable ability to integrate fragmentary visual input into a perceptually organized collection of surfaces and objects, a process we refer to as perceptual integration. Despite a long tradition of perception research, it is not known whether access to consciousness is required to complete perceptual integration. To investigate this question, we manipulated access to consciousness using the attentional blink. We show that, behaviorally, the attentional blink impairs conscious decisions about the presence of integrated surface structure from fragmented input. However, despite conscious access being impaired, the ability to decode the presence of integrated percepts remains intact, as shown through multivariate classification analyses of electroencephalogram (EEG) data. In contrast, when disrupting perception through masking, decisions about integrated percepts and decoding of integrated percepts are impaired in tandem, while leaving feedforward representations intact. Together, these data show that access consciousness and perceptual integration can be dissociated.

Perceptual integration without conscious access

NARCIS (Netherlands)

Fahrenfort, Johannes J.; Van Leeuwen, Jonathan; Olivers, Christian N.L.; Hogendoorn, Hinze

2017-01-01

The visual system has the remarkable ability to integrate fragmentary visual input into a perceptually organized collection of surfaces and objects, a process we refer to as perceptual integration. Despite a long tradition of perception research, it is not known whether access to consciousness is

Perceptual learning: top to bottom.

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Amitay, Sygal; Zhang, Yu-Xuan; Jones, Pete R; Moore, David R

2014-06-01

Perceptual learning has traditionally been portrayed as a bottom-up phenomenon that improves encoding or decoding of the trained stimulus. Cognitive skills such as attention and memory are thought to drive, guide and modulate learning but are, with notable exceptions, not generally considered to undergo changes themselves as a result of training with simple perceptual tasks. Moreover, shifts in threshold are interpreted as shifts in perceptual sensitivity, with no consideration for non-sensory factors (such as response bias) that may contribute to these changes. Accumulating evidence from our own research and others shows that perceptual learning is a conglomeration of effects, with training-induced changes ranging from the lowest (noise reduction in the phase locking of auditory signals) to the highest (working memory capacity) level of processing, and includes contributions from non-sensory factors that affect decision making even on a "simple" auditory task such as frequency discrimination. We discuss our emerging view of learning as a process that increases the signal-to-noise ratio associated with perceptual tasks by tackling noise sources and inefficiencies that cause performance bottlenecks, and present some implications for training populations other than young, smart, attentive and highly-motivated college students. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Perceptual learning and adult cortical plasticity.

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Gilbert, Charles D; Li, Wu; Piech, Valentin

2009-06-15

The visual cortex retains the capacity for experience-dependent changes, or plasticity, of cortical function and cortical circuitry, throughout life. These changes constitute the mechanism of perceptual learning in normal visual experience and in recovery of function after CNS damage. Such plasticity can be seen at multiple stages in the visual pathway, including primary visual cortex. The manifestation of the functional changes associated with perceptual learning involve both long term modification of cortical circuits during the course of learning, and short term dynamics in the functional properties of cortical neurons. These dynamics are subject to top-down influences of attention, expectation and perceptual task. As a consequence, each cortical area is an adaptive processor, altering its function in accordance to immediate perceptual demands.

Perceptual inference.

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Aggelopoulos, Nikolaos C

2015-08-01

Perceptual inference refers to the ability to infer sensory stimuli from predictions that result from internal neural representations built through prior experience. Methods of Bayesian statistical inference and decision theory model cognition adequately by using error sensing either in guiding action or in "generative" models that predict the sensory information. In this framework, perception can be seen as a process qualitatively distinct from sensation, a process of information evaluation using previously acquired and stored representations (memories) that is guided by sensory feedback. The stored representations can be utilised as internal models of sensory stimuli enabling long term associations, for example in operant conditioning. Evidence for perceptual inference is contributed by such phenomena as the cortical co-localisation of object perception with object memory, the response invariance in the responses of some neurons to variations in the stimulus, as well as from situations in which perception can be dissociated from sensation. In the context of perceptual inference, sensory areas of the cerebral cortex that have been facilitated by a priming signal may be regarded as comparators in a closed feedback loop, similar to the better known motor reflexes in the sensorimotor system. The adult cerebral cortex can be regarded as similar to a servomechanism, in using sensory feedback to correct internal models, producing predictions of the outside world on the basis of past experience. Copyright © 2015 Elsevier Ltd. All rights reserved.

Adaptation and perceptual norms

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Webster, Michael A.; Yasuda, Maiko; Haber, Sara; Leonard, Deanne; Ballardini, Nicole

2007-02-01

We used adaptation to examine the relationship between perceptual norms--the stimuli observers describe as psychologically neutral, and response norms--the stimulus levels that leave visual sensitivity in a neutral or balanced state. Adapting to stimuli on opposite sides of a neutral point (e.g. redder or greener than white) biases appearance in opposite ways. Thus the adapting stimulus can be titrated to find the unique adapting level that does not bias appearance. We compared these response norms to subjectively defined neutral points both within the same observer (at different retinal eccentricities) and between observers. These comparisons were made for visual judgments of color, image focus, and human faces, stimuli that are very different and may depend on very different levels of processing, yet which share the property that for each there is a well defined and perceptually salient norm. In each case the adaptation aftereffects were consistent with an underlying sensitivity basis for the perceptual norm. Specifically, response norms were similar to and thus covaried with the perceptual norm, and under common adaptation differences between subjectively defined norms were reduced. These results are consistent with models of norm-based codes and suggest that these codes underlie an important link between visual coding and visual experience.

Reliability and validity of the Korean version of Pediatric Voice Handicap Index: in school age children.

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Park, Sung Shin; Kwon, Tack-Kyun; Choi, Seong Hee; Lee, Won Yong; Hong, Young Hye; Jeong, Nyun Gi; Sung, Myung-Whun; Kim, Kwang Hyun

2013-01-01

The aim of this study was to assess the reliability and validity of the Pediatric Voice Handicap Index (pVHI) for cross-cultural adaptation of the Korean version with school age children. The questionnaire was translated into Korean and was completed by 101 Korean parents who have children with or without disordered voice. The Korean version-pVHI scores were obtained with 60 parents of normal children and 41 parents who have children with voice problems. Content validity was verified by five experienced speech-language pathologists with clinical specialization in voice disorders. Internal consistency was calculated through Cronbach's α coefficient and test-retest reliability of the Korean version-pVHI score was determined using Pearson product-moment correlation coefficients. Mann-Whitney U test was used to compare GRBAS with the Korean version-pVHI scores between normal and dysphonia group. The relationship between the parent-reported the Korean version-pVHI total scores and perceptual ratings of voice quality from experts was investigated using Spearman correlation coefficients. The results showed that the Korean version-pVHI provided a high internal consistency (α=0.92) and test-retest reliability of its subscales: total (T) 0.97, functional (F) 0.90, physical (P) 0.95, emotional (E) 0.92. The Korean version-pVHI mean scores in normal group were 1.28 (T), 0.62 (F), 0.35 (P) and 0.32 (E), respectively whereas those of the Korean version-pVHI in children group with dysphonia were 23.13 (T), 8.90 (F), 9.54 (P) and 4.93 (E). Significant differences in the Korean version-pVHI (T, F, P, E) and perceptual evaluation (grade, rough, breathy) between normal and dysphonia group were revealed (PKorean version-pVHI parameters (T) and perceptual measures (G) was exhibited in children with dysphonia. The subjective Korean version-pVHI can be applicable and useful supplementary tool for evaluating parents' perception of their children's voice dysfunction, identifying

[Occupational dysphonia management in different countries of the European Union and throughout the world].

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Niebudek-Bogusz, Ewa

2009-01-01

Teachers are significantly more likely to develop multiple voice problems than non-teachers. The article presents methods for the diagnoses and treatment of occupational dysphonia in different countries of the European Union and throughout the world. Conclusions comprise the implications concerning the model of dysphonic teachers management in Poland, putting strong emphasis on the necessity for multidimensional therapy in collaboration with otolaryngologist/phoniatrician, logopedist/speech therapist and also psychologist/physiotherapist. The importance of training professional voice users in vocal hygiene and healthy voice habits has also been emphasized.

Perceptual Training Strongly Improves Visual Motion Perception in Schizophrenia

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Norton, Daniel J.; McBain, Ryan K.; Ongur, Dost; Chen, Yue

2011-01-01

Schizophrenia patients exhibit perceptual and cognitive deficits, including in visual motion processing. Given that cognitive systems depend upon perceptual inputs, improving patients' perceptual abilities may be an effective means of cognitive intervention. In healthy people, motion perception can be enhanced through perceptual learning, but it…

A Neural Signature Encoding Decisions under Perceptual Ambiguity.

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Sun, Sai; Yu, Rongjun; Wang, Shuo

2017-01-01

People often make perceptual decisions with ambiguous information, but it remains unclear whether the brain has a common neural substrate that encodes various forms of perceptual ambiguity. Here, we used three types of perceptually ambiguous stimuli as well as task instructions to examine the neural basis for both stimulus-driven and task-driven perceptual ambiguity. We identified a neural signature, the late positive potential (LPP), that encoded a general form of stimulus-driven perceptual ambiguity. In addition to stimulus-driven ambiguity, the LPP was also modulated by ambiguity in task instructions. To further specify the functional role of the LPP and elucidate the relationship between stimulus ambiguity, behavioral response, and the LPP, we employed regression models and found that the LPP was specifically associated with response latency and confidence rating, suggesting that the LPP encoded decisions under perceptual ambiguity. Finally, direct behavioral ratings of stimulus and task ambiguity confirmed our neurophysiological findings, which could not be attributed to differences in eye movements either. Together, our findings argue for a common neural signature that encodes decisions under perceptual ambiguity but is subject to the modulation of task ambiguity. Our results represent an essential first step toward a complete neural understanding of human perceptual decision making.

Is sequence awareness mandatory for perceptual sequence learning: An assessment using a pure perceptual sequence learning design.

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Deroost, Natacha; Coomans, Daphné

2018-02-01

We examined the role of sequence awareness in a pure perceptual sequence learning design. Participants had to react to the target's colour that changed according to a perceptual sequence. By varying the mapping of the target's colour onto the response keys, motor responses changed randomly. The effect of sequence awareness on perceptual sequence learning was determined by manipulating the learning instructions (explicit versus implicit) and assessing the amount of sequence awareness after the experiment. In the explicit instruction condition (n = 15), participants were instructed to intentionally search for the colour sequence, whereas in the implicit instruction condition (n = 15), they were left uninformed about the sequenced nature of the task. Sequence awareness after the sequence learning task was tested by means of a questionnaire and the process-dissociation-procedure. The results showed that the instruction manipulation had no effect on the amount of perceptual sequence learning. Based on their report to have actively applied their sequence knowledge during the experiment, participants were subsequently regrouped in a sequence strategy group (n = 14, of which 4 participants from the implicit instruction condition and 10 participants from the explicit instruction condition) and a no-sequence strategy group (n = 16, of which 11 participants from the implicit instruction condition and 5 participants from the explicit instruction condition). Only participants of the sequence strategy group showed reliable perceptual sequence learning and sequence awareness. These results indicate that perceptual sequence learning depends upon the continuous employment of strategic cognitive control processes on sequence knowledge. Sequence awareness is suggested to be a necessary but not sufficient condition for perceptual learning to take place. Copyright © 2018 Elsevier B.V. All rights reserved.

Prediction of kindergarteners' behavior on Metropolitan Readiness Tests from preschool perceptual and perceptual-motor performances: a validation study.

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Belka, D E

1981-06-01

Multiple regression equations were generated to predict cognitive achievement for 40 children (ages 57 to 68 mo.) 1 yr. after administration of a battery of 6 perceptual and perceptual-motor tests to determine if previous results from Toledo could be replicated. Regression equations generated from maximum R2 improvement techniques indicated that performance at prekindergarten is useful for prediction of cognitive performance (total score and total score without the copying subtest on the Metropolitan Readiness Tests) 1 yr. later at the end of kindergarten. The optimal battery included scores on auditory perception, fine perceptual-motor, and gross perceptual-motor tasks. The moderate predictive power of the equations obtained was compared with high predictive power generated in the Toledo study.

Animacy, perceptual load, and inattentional blindness.

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Calvillo, Dustin P; Jackson, Russell E

2014-06-01

Inattentional blindness is the failure to notice unexpected objects in a visual scene while engaging in an attention-demanding task. We examined the effects of animacy and perceptual load on inattentional blindness. Participants searched for a category exemplar under low or high perceptual load. On the last trial, the participants were exposed to an unexpected object that was either animate or inanimate. Unexpected objects were detected more frequently when they were animate rather than inanimate, and more frequently with low than with high perceptual loads. We also measured working memory capacity and found that it predicted the detection of unexpected objects, but only with high perceptual loads. The results are consistent with the animate-monitoring hypothesis, which suggests that animate objects capture attention because of the importance of the detection of animate objects in ancestral hunter-gatherer environments.

Grey scale, the 'crispening effect', and perceptual linearization

NARCIS (Netherlands)

Belaïd, N.; Martens, J.B.

1998-01-01

One way of optimizing a display is to maximize the number of distinguishable grey levels, which in turn is equivalent to perceptually linearizing the display. Perceptual linearization implies that equal steps in grey value evoke equal steps in brightness sensation. The key to perceptual

Perceptual Fusion in Humans and Machines

NARCIS (Netherlands)

A.A. Salah (Albert Ali); O. Tanrı dağ

2008-01-01

htmlabstractHumans perceive the world through different perceptual modalities, which are processed in the brain by modality-specific areas and structures. However, there also exist multimodal neurons and areas, specialized in integrating perceptual information to enhance or suppress brain response.

A Novel Perceptual Hash Algorithm for Multispectral Image Authentication

Directory of Open Access Journals (Sweden)

Kaimeng Ding

2018-01-01

Full Text Available The perceptual hash algorithm is a technique to authenticate the integrity of images. While a few scholars have worked on mono-spectral image perceptual hashing, there is limited research on multispectral image perceptual hashing. In this paper, we propose a perceptual hash algorithm for the content authentication of a multispectral remote sensing image based on the synthetic characteristics of each band: firstly, the multispectral remote sensing image is preprocessed with band clustering and grid partition; secondly, the edge feature of the band subsets is extracted by band fusion-based edge feature extraction; thirdly, the perceptual feature of the same region of the band subsets is compressed and normalized to generate the perceptual hash value. The authentication procedure is achieved via the normalized Hamming distance between the perceptual hash value of the recomputed perceptual hash value and the original hash value. The experiments indicated that our proposed algorithm is robust compared to content-preserved operations and it efficiently authenticates the integrity of multispectral remote sensing images.

Natural texture retrieval based on perceptual similarity measurement

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Gao, Ying; Dong, Junyu; Lou, Jianwen; Qi, Lin; Liu, Jun

2018-04-01

A typical texture retrieval system performs feature comparison and might not be able to make human-like judgments of image similarity. Meanwhile, it is commonly known that perceptual texture similarity is difficult to be described by traditional image features. In this paper, we propose a new texture retrieval scheme based on texture perceptual similarity. The key of the proposed scheme is that prediction of perceptual similarity is performed by learning a non-linear mapping from image features space to perceptual texture space by using Random Forest. We test the method on natural texture dataset and apply it on a new wallpapers dataset. Experimental results demonstrate that the proposed texture retrieval scheme with perceptual similarity improves the retrieval performance over traditional image features.

A Computerized Tomography Study of Vocal Tract Setting in Hyperfunctional Dysphonia and in Belting.

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Saldias, Marcelo; Guzman, Marco; Miranda, Gonzalo; Laukkanen, Anne-Maria

2018-04-03

Vocal tract setting in hyperfunctional patients is characterized by a high larynx and narrowing of the epilaryngeal and pharyngeal region. Similar observations have been made for various singing styles, eg, belting. The voice quality in belting has been described to be loud, speech like, and high pitched. It is also often described as sounding "pressed" or "tense". The above mentioned has led to the hypothesis that belting may be strenuous to the vocal folds. However, singers and teachers of belting do not regard belting as particularly strenuous. This study investigates possible similarities and differences between hyperfunctional voice production and belting. This study concerns vocal tract setting. Four male patients with hyperfunctional dysphonia and one male contemporary commercial music singer were registered with computerized tomography while phonating on [a:] in their habitual speaking pitch. Additionally, the singer used the pitch G4 in belting. The scannings were studied in sagittal and transversal dimensions by measuring lengths, widths, and areas. Various similarities were found between belting and hyperfunction: high vertical larynx position, small hypopharyngeal width, and epilaryngeal outlet. On the other hand, belting differed from dysphonia (in addition to higher pitch) by a wider lip and jaw opening, and larger volumes of the oral cavity. Belting takes advantage of "megaphone shape" of the vocal tract. Future studies should focus on modeling and simulation to address sound energy transfer. Also, they should consider aerodynamic variables and vocal fold vibration to evaluate the "price of decibels" in these phonation types. Copyright © 2018. Published by Elsevier Inc.

Perceptually specific and perceptually non-specific influences on rereading benefits for spatially transformed text: evidence from eye movements.

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Sheridan, Heather; Reingold, Eyal M

2012-12-01

The present study used eye tracking methodology to examine rereading benefits for spatially transformed text. Eye movements were monitored while participants read the same target word twice, in two different low-constraint sentence frames. The congruency of perceptual processing was manipulated by either applying the same type of transformation to the word during the first and second presentations (i.e., the congruent condition), or employing two different types of transformations across the two presentations of the word (i.e., the incongruent condition). Perceptual specificity effects were demonstrated such that fixation times for the second presentation of the target word were shorter for the congruent condition compared to the incongruent condition. Moreover, we demonstrated an additional perceptually non-specific effect such that second reading fixation times were shorter for the incongruent condition relative to a baseline condition that employed a normal typography (i.e., non-transformed) during the first presentation and a transformation during the second presentation. Both of these effects (i.e., perceptually specific and perceptually non-specific) were similar in magnitude for high and low frequency words, and both effects persisted across a 1 week lag between the first and second readings. We discuss the present findings in the context of the distinction between conscious and unconscious memory, and the distinction between perceptually versus conceptually driven processing. Copyright © 2012 Elsevier Inc. All rights reserved.

Reproducibility of somatosensory spatial perceptual maps.

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Steenbergen, Peter; Buitenweg, Jan R; Trojan, Jörg; Veltink, Peter H

2013-02-01

Various studies have shown subjects to mislocalize cutaneous stimuli in an idiosyncratic manner. Spatial properties of individual localization behavior can be represented in the form of perceptual maps. Individual differences in these maps may reflect properties of internal body representations, and perceptual maps may therefore be a useful method for studying these representations. For this to be the case, individual perceptual maps need to be reproducible, which has not yet been demonstrated. We assessed the reproducibility of localizations measured twice on subsequent days. Ten subjects participated in the experiments. Non-painful electrocutaneous stimuli were applied at seven sites on the lower arm. Subjects localized the stimuli on a photograph of their own arm, which was presented on a tablet screen overlaying the real arm. Reproducibility was assessed by calculating intraclass correlation coefficients (ICC) for the mean localizations of each electrode site and the slope and offset of regression models of the localizations, which represent scaling and displacement of perceptual maps relative to the stimulated sites. The ICCs of the mean localizations ranged from 0.68 to 0.93; the ICCs of the regression parameters were 0.88 for the intercept and 0.92 for the slope. These results indicate a high degree of reproducibility. We conclude that localization patterns of non-painful electrocutaneous stimuli on the arm are reproducible on subsequent days. Reproducibility is a necessary property of perceptual maps for these to reflect properties of a subject's internal body representations. Perceptual maps are therefore a promising method for studying body representations.

Topographic generalization of tactile perceptual learning.

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Harrar, Vanessa; Spence, Charles; Makin, Tamar R

2014-02-01

Perceptual learning can improve our sensory abilities. Understanding its underlying mechanisms, in particular, when perceptual learning generalizes, has become a focus of research and controversy. Specifically, there is little consensus regarding the extent to which tactile perceptual learning generalizes across fingers. We measured tactile orientation discrimination abilities on 4 fingers (index and middle fingers of both hands), using psychophysical measures, before and after 4 training sessions on 1 finger. Given the somatotopic organization of the hand representation in the somatosensory cortex, the topography of the cortical areas underlying tactile perceptual learning can be inferred from the pattern of generalization across fingers; only fingers sharing cortical representation with the trained finger ought to improve with it. Following training, performance improved not only for the trained finger but also for its adjacent and homologous fingers. Although these fingers were not exposed to training, they nevertheless demonstrated similar levels of learning as the trained finger. Conversely, the performance of the finger that was neither adjacent nor homologous to the trained finger was unaffected by training, despite the fact that our procedure was designed to enhance generalization, as described in recent visual perceptual learning research. This pattern of improved performance is compatible with previous reports of neuronal receptive fields (RFs) in the primary somatosensory cortex (SI) spanning adjacent and homologous digits. We conclude that perceptual learning rooted in low-level cortex can still generalize, and suggest potential applications for the neurorehabilitation of syndromes associated with maladaptive plasticity in SI. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Stage of readiness of patients with behavioral dysphonia in pre and post-group voice therapy assessments.

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Costa, Bianca Oliveira Ismael da; Silva, Priscila Oliveira Costa; Pinheiro, Renata Serrano de Andrade; Silva, Hêmmylly Farias da; Almeida, Anna Alice Figueirêdo de

2017-08-10

To verify the efficacy of group voice therapy in the stage of readiness and identify which items of the URICA-Voice range are more sensitive to post-therapy change in patients with behavioral dysphonia. An intervention study was conducted on 49 patients with behavioral dysphonia. An eclectic approach to group therapy was implemented over eight sessions, the first and last sessions consisting of assessments. The URICA-Voice range was used to evaluate the stage of readiness at pre- and post-therapy assessments. A descriptive and inferential statistical analysis was implemented for the results. Most participants were female, did not make professional use of voice, and had membranous vocal fold lesions. Most of them were in the Contemplation stage at in both moments, pre- and post-therapy. There was no significant change in the comparison of pre- and post-therapy scores. The majority of patients showed a reduction in the stage of readiness and some advanced to a higher stage. In the comparison of URICA-V range items, seven questions had equal or inferior responses in the post-therapy assessment. There was no statistical difference when comparing the pre- and post-therapy total average score of the URICA-Voice range. There were significant changes in the stage of readiness of patients in pre- and post-group speech therapy assessments.

ViA: a perceptual visualization assistant

Science.gov (United States)

Healey, Chris G.; St. Amant, Robert; Elhaddad, Mahmoud S.

2000-05-01

This paper describes an automated visualized assistant called ViA. ViA is designed to help users construct perceptually optical visualizations to represent, explore, and analyze large, complex, multidimensional datasets. We have approached this problem by studying what is known about the control of human visual attention. By harnessing the low-level human visual system, we can support our dual goals of rapid and accurate visualization. Perceptual guidelines that we have built using psychophysical experiments form the basis for ViA. ViA uses modified mixed-initiative planning algorithms from artificial intelligence to search of perceptually optical data attribute to visual feature mappings. Our perceptual guidelines are integrated into evaluation engines that provide evaluation weights for a given data-feature mapping, and hints on how that mapping might be improved. ViA begins by asking users a set of simple questions about their dataset and the analysis tasks they want to perform. Answers to these questions are used in combination with the evaluation engines to identify and intelligently pursue promising data-feature mappings. The result is an automatically-generated set of mappings that are perceptually salient, but that also respect the context of the dataset and users' preferences about how they want to visualize their data.

Comparing perceptual and preferential decision making.

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Dutilh, Gilles; Rieskamp, Jörg

2016-06-01

Perceptual and preferential decision making have been studied largely in isolation. Perceptual decisions are considered to be at a non-deliberative cognitive level and have an outside criterion that defines the quality of decisions. Preferential decisions are considered to be at a higher cognitive level and the quality of decisions depend on the decision maker's subjective goals. Besides these crucial differences, both types of decisions also have in common that uncertain information about the choice situation has to be processed before a decision can be made. The present work aims to acknowledge the commonalities of both types of decision making to lay bare the crucial differences. For this aim we examine perceptual and preferential decisions with a novel choice paradigm that uses the identical stimulus material for both types of decisions. This paradigm allows us to model the decisions and response times of both types of decisions with the same sequential sampling model, the drift diffusion model. The results illustrate that the different incentive structure in both types of tasks changes people's behavior so that they process information more efficiently and respond more cautiously in the perceptual as compared to the preferential task. These findings set out a perspective for further integration of perceptual and preferential decision making in a single ramework.

Pupil size tracks perceptual content and surprise.

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Kloosterman, Niels A; Meindertsma, Thomas; van Loon, Anouk M; Lamme, Victor A F; Bonneh, Yoram S; Donner, Tobias H

2015-04-01

Changes in pupil size at constant light levels reflect the activity of neuromodulatory brainstem centers that control global brain state. These endogenously driven pupil dynamics can be synchronized with cognitive acts. For example, the pupil dilates during the spontaneous switches of perception of a constant sensory input in bistable perceptual illusions. It is unknown whether this pupil dilation only indicates the occurrence of perceptual switches, or also their content. Here, we measured pupil diameter in human subjects reporting the subjective disappearance and re-appearance of a physically constant visual target surrounded by a moving pattern ('motion-induced blindness' illusion). We show that the pupil dilates during the perceptual switches in the illusion and a stimulus-evoked 'replay' of that illusion. Critically, the switch-related pupil dilation encodes perceptual content, with larger amplitude for disappearance than re-appearance. This difference in pupil response amplitude enables prediction of the type of report (disappearance vs. re-appearance) on individual switches (receiver-operating characteristic: 61%). The amplitude difference is independent of the relative durations of target-visible and target-invisible intervals and subjects' overt behavioral report of the perceptual switches. Further, we show that pupil dilation during the replay also scales with the level of surprise about the timing of switches, but there is no evidence for an interaction between the effects of surprise and perceptual content on the pupil response. Taken together, our results suggest that pupil-linked brain systems track both the content of, and surprise about, perceptual events. © 2015 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

Frequent video game players resist perceptual interference.

Directory of Open Access Journals (Sweden)

Aaron V Berard

Full Text Available Playing certain types of video games for a long time can improve a wide range of mental processes, from visual acuity to cognitive control. Frequent gamers have also displayed generalized improvements in perceptual learning. In the Texture Discrimination Task (TDT, a widely used perceptual learning paradigm, participants report the orientation of a target embedded in a field of lines and demonstrate robust over-night improvement. However, changing the orientation of the background lines midway through TDT training interferes with overnight improvements in overall performance on TDT. Interestingly, prior research has suggested that this effect will not occur if a one-hour break is allowed in between the changes. These results have suggested that after training is over, it may take some time for learning to become stabilized and resilient against interference. Here, we tested whether frequent gamers have faster stabilization of perceptual learning compared to non-gamers and examined the effect of daily video game playing on interference of training of TDT with one background orientation on perceptual learning of TDT with a different background orientation. As a result, we found that non-gamers showed overnight performance improvement only on one background orientation, replicating previous results with the interference in TDT. In contrast, frequent gamers demonstrated overnight improvements in performance with both background orientations, suggesting that they are better able to overcome interference in perceptual learning. This resistance to interference suggests that video game playing not only enhances the amplitude and speed of perceptual learning but also leads to faster and/or more robust stabilization of perceptual learning.

Frequent video game players resist perceptual interference.

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Berard, Aaron V; Cain, Matthew S; Watanabe, Takeo; Sasaki, Yuka

2015-01-01

Playing certain types of video games for a long time can improve a wide range of mental processes, from visual acuity to cognitive control. Frequent gamers have also displayed generalized improvements in perceptual learning. In the Texture Discrimination Task (TDT), a widely used perceptual learning paradigm, participants report the orientation of a target embedded in a field of lines and demonstrate robust over-night improvement. However, changing the orientation of the background lines midway through TDT training interferes with overnight improvements in overall performance on TDT. Interestingly, prior research has suggested that this effect will not occur if a one-hour break is allowed in between the changes. These results have suggested that after training is over, it may take some time for learning to become stabilized and resilient against interference. Here, we tested whether frequent gamers have faster stabilization of perceptual learning compared to non-gamers and examined the effect of daily video game playing on interference of training of TDT with one background orientation on perceptual learning of TDT with a different background orientation. As a result, we found that non-gamers showed overnight performance improvement only on one background orientation, replicating previous results with the interference in TDT. In contrast, frequent gamers demonstrated overnight improvements in performance with both background orientations, suggesting that they are better able to overcome interference in perceptual learning. This resistance to interference suggests that video game playing not only enhances the amplitude and speed of perceptual learning but also leads to faster and/or more robust stabilization of perceptual learning.

Greater perceptual sensitivity to happy facial expression.

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Maher, Stephen; Ekstrom, Tor; Chen, Yue

2014-01-01

Perception of subtle facial expressions is essential for social functioning; yet it is unclear if human perceptual sensitivities differ in detecting varying types of facial emotions. Evidence diverges as to whether salient negative versus positive emotions (such as sadness versus happiness) are preferentially processed. Here, we measured perceptual thresholds for the detection of four types of emotion in faces--happiness, fear, anger, and sadness--using psychophysical methods. We also evaluated the association of the perceptual performances with facial morphological changes between neutral and respective emotion types. Human observers were highly sensitive to happiness compared with the other emotional expressions. Further, this heightened perceptual sensitivity to happy expressions can be attributed largely to the emotion-induced morphological change of a particular facial feature (end-lip raise).

Perceptual tools for quality-aware video networks

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Bovik, A. C.

2014-01-01

Monitoring and controlling the quality of the viewing experience of videos transmitted over increasingly congested networks (especially wireless networks) is a pressing problem owing to rapid advances in video-centric mobile communication and display devices that are straining the capacity of the network infrastructure. New developments in automatic perceptual video quality models offer tools that have the potential to be used to perceptually optimize wireless video, leading to more efficient video data delivery and better received quality. In this talk I will review key perceptual principles that are, or could be used to create effective video quality prediction models, and leading quality prediction models that utilize these principles. The goal is to be able to monitor and perceptually optimize video networks by making them "quality-aware."

Audiovisual speech perception development at varying levels of perceptual processing.

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Lalonde, Kaylah; Holt, Rachael Frush

2016-04-01

This study used the auditory evaluation framework [Erber (1982). Auditory Training (Alexander Graham Bell Association, Washington, DC)] to characterize the influence of visual speech on audiovisual (AV) speech perception in adults and children at multiple levels of perceptual processing. Six- to eight-year-old children and adults completed auditory and AV speech perception tasks at three levels of perceptual processing (detection, discrimination, and recognition). The tasks differed in the level of perceptual processing required to complete them. Adults and children demonstrated visual speech influence at all levels of perceptual processing. Whereas children demonstrated the same visual speech influence at each level of perceptual processing, adults demonstrated greater visual speech influence on tasks requiring higher levels of perceptual processing. These results support previous research demonstrating multiple mechanisms of AV speech processing (general perceptual and speech-specific mechanisms) with independent maturational time courses. The results suggest that adults rely on both general perceptual mechanisms that apply to all levels of perceptual processing and speech-specific mechanisms that apply when making phonetic decisions and/or accessing the lexicon. Six- to eight-year-old children seem to rely only on general perceptual mechanisms across levels. As expected, developmental differences in AV benefit on this and other recognition tasks likely reflect immature speech-specific mechanisms and phonetic processing in children.

The perceptual effects of learning object categories that predict perceptual goals

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Van Gulick, Ana E.; Gauthier, Isabel

2014-01-01

In classic category learning studies, subjects typically learn to assign items to one of two categories, with no further distinction between how items on each side of the category boundary should be treated. In real life, however, we often learn categories that dictate further processing goals, for instance with objects in only one category requiring further individuation. Using methods from category learning and perceptual expertise, we studied the perceptual consequences of experience with objects in tasks that rely on attention to different dimensions in different parts of the space. In two experiments, subjects first learned to categorize complex objects from a single morphspace into two categories based on one morph dimension, and then learned to perform a different task, either naming or a local feature judgment, for each of the two categories. A same-different discrimination test before and after each training measured sensitivity to feature dimensions of the space. After initial categorization, sensitivity increased along the category-diagnostic dimension. After task association, sensitivity increased more for the category that was named, especially along the non-diagnostic dimension. The results demonstrate that local attentional weights, associated with individual exemplars as a function of task requirements, can have lasting effects on perceptual representations. PMID:24820671

Low level perceptual, not attentional, processes modulate distractor interference in high perceptual load displays: evidence from neglect/extinction.

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Mevorach, Carmel; Tsal, Yehoshua; Humphreys, Glyn W

2014-01-10

According to perceptual load theory (Lavie, 2005) distractor interference is determined by the availability of attentional resources. If target processing does not exhaust resources (with low perceptual load) distractor processing will take place resulting in interference with a primary task; however, when target processing uses-up attentional capacity (with high perceptual load) interference can be avoided. An alternative account (Tsal and Benoni, 2010a) suggests that perceptual load effects can be based on distractor dilution by the mere presence of additional neutral items in high-load displays so that the effect is not driven by the amount of attention resources required for target processing. Here we tested whether patients with unilateral neglect or extinction would show dilution effects from neutral items in their contralesional (neglected/extinguished) field, even though these items do not impose increased perceptual load on the target and at the same time attract reduced attentional resources compared to stimuli in the ipsilesional field. Thus, such items do not affect the amount of attention resources available for distractor processing. We found that contralesional neutral elements can eliminate distractor interference as strongly as centrally presented ones in neglect/extinction patients, despite contralesional items being less well attended. The data are consistent with an account in terms of perceptual dilution of distracters rather than available resources for distractor processing. We conclude that distractor dilution can underlie the elimination of distractor interference in visual displays.

Low level perceptual, not attentional, processes modulate distractor interference in high perceptual Load displays: evidence from neglect/extinction

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Carmel eMevorach

2014-01-01

Full Text Available According to perceptual load theory (Lavie, 2005 distractor interference is determined by the availability of attentional resources. If target processing does not exhaust resources (with low perceptual load distractor processing will take place resulting in interference with a primary task; however when target processing uses-up attentional capacity (with high perceptual load interference can be avoided. An alternative account (Tsal & Benoni, 2010 suggests that perceptual load effects can be based on distractor dilution by the mere presence of additional neutral items in high load displays so that the effect is not driven by the amount of attention resources required for target processing. Here we tested whether patients with unilateral neglect or extinction would show dilution effects from neutral items in their contralesional (neglected/extinguished field, even though these items do not impose increased perceptual load on the target and at the same time attract reduced attentional resources compared to stimuli in the ipsilesional field. Thus, such items do not affect the amount of attention resources available for distractor processing. We found that contralesional neutral elements can eliminate distractor interference as strongly as centrally presented ones in neglect/extinction patients, despite contralesional items being less well attended. The data are consistent with an account in terms of perceptual dilution of distracters rather than available resources for distractor processing. We conclude that distractor dilution can underlie the elimination of distractor interference in visual displays.

Neural plasticity underlying visual perceptual learning in aging.

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Mishra, Jyoti; Rolle, Camarin; Gazzaley, Adam

2015-07-01

Healthy aging is associated with a decline in basic perceptual abilities, as well as higher-level cognitive functions such as working memory. In a recent perceptual training study using moving sweeps of Gabor stimuli, Berry et al. (2010) observed that older adults significantly improved discrimination abilities on the most challenging perceptual tasks that presented paired sweeps at rapid rates of 5 and 10 Hz. Berry et al. further showed that this perceptual training engendered transfer-of-benefit to an untrained working memory task. Here, we investigated the neural underpinnings of the improvements in these perceptual tasks, as assessed by event-related potential (ERP) recordings. Early visual ERP components time-locked to stimulus onset were compared pre- and post-training, as well as relative to a no-contact control group. The visual N1 and N2 components were significantly enhanced after training, and the N1 change correlated with improvements in perceptual discrimination on the task. Further, the change observed for the N1 and N2 was associated with the rapidity of the perceptual challenge; the visual N1 (120-150 ms) was enhanced post-training for 10 Hz sweep pairs, while the N2 (240-280 ms) was enhanced for the 5 Hz sweep pairs. We speculate that these observed post-training neural enhancements reflect improvements by older adults in the allocation of attention that is required to accurately dissociate perceptually overlapping stimuli when presented in rapid sequence. This article is part of a Special Issue entitled SI: Memory Å. Copyright © 2014 Elsevier B.V. All rights reserved.

Competition explains limited attention and perceptual resources: implications for perceptual load and dilution theories.

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Scalf, Paige E; Torralbo, Ana; Tapia, Evelina; Beck, Diane M

2013-01-01

Both perceptual load theory and dilution theory purport to explain when and why task-irrelevant information, or so-called distractors are processed. Central to both explanations is the notion of limited resources, although the theories differ in the precise way in which those limitations affect distractor processing. We have recently proposed a neurally plausible explanation of limited resources in which neural competition among stimuli hinders their representation in the brain. This view of limited capacity can also explain distractor processing, whereby the competitive interactions and bias imposed to resolve the competition determine the extent to which a distractor is processed. This idea is compatible with aspects of both perceptual load and dilution models of distractor processing, but also serves to highlight their differences. Here we review the evidence in favor of a biased competition view of limited resources and relate these ideas to both classic perceptual load theory and dilution theory.

Shared mechanisms of perceptual learning and decision making.

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Law, Chi-Tat; Gold, Joshua I

2010-04-01

Perceptual decisions require the brain to weigh noisy evidence from sensory neurons to form categorical judgments that guide behavior. Here we review behavioral and neurophysiological findings suggesting that at least some forms of perceptual learning do not appear to affect the response properties of neurons that represent the sensory evidence. Instead, improved perceptual performance results from changes in how the sensory evidence is selected and weighed to form the decision. We discuss the implications of this idea for possible sites and mechanisms of training-induced improvements in perceptual processing in the brain. Copyright © 2009 Cognitive Science Society, Inc.

Competition explains limited attention and perceptual resources: implications for perceptual load and dilution theories

Directory of Open Access Journals (Sweden)

Paige E. Scalf

2013-05-01

Full Text Available Both perceptual load theory and dilution theory purport to explain when and why task-irrelevant information, or so-called distractors are processed. Central to both explanations is the notion of limited resources, although the theories differ in the precise way in which those limitations affect distractor processing. We have recently proposed a neurally plausible explanation of limited resources in which neural competition among stimuli hinders their representation in the brain. This view of limited capacity can also explain distractor processing, whereby the competitive interactions and bias imposed to resolve the competition determine the extent to which a distractor is processed. This idea is compatible with aspects of both perceptual load and dilution models of distractor processing, but also serves to highlight their differences. Here we review the evidence in favor of a biased competition view of limited resources and relate these ideas to both classic perceptual load theory and dilution theory.

The effects of attention on perceptual implicit memory.

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Rajaram, S; Srinivas, K; Travers, S

2001-10-01

Reports on the effects of dividing attention at study on subsequent perceptual priming suggest that perceptual priming is generally unaffected by attentional manipulations as long as word identity is processed. We tested this hypothesis in three experiments by using the implicit word fragment completion and word stem completion tasks. Division of attention was instantiated with the Stroop task in order to ensure the processing of word identity even when the participant's attention was directed to a stimulus attribute other than the word itself. Under these conditions, we found that even though perceptual priming was significant, it was significantly reduced in magnitude. A stem cued recall test in Experiment 2 confirmed a more deleterious effect of divided attention on explicit memory. Taken together, our findings delineate the relative contributions of perceptual analysis and attentional processes in mediating perceptual priming on two ubiquitously used tasks of word fragment completion and word stem completion.

Perceptual Space of Superimposed Dual-Frequency Vibrations in the Hands.

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Hwang, Inwook; Seo, Jeongil; Choi, Seungmoon

2017-01-01

The use of distinguishable complex vibrations that have multiple spectral components can improve the transfer of information by vibrotactile interfaces. We investigated the qualitative characteristics of dual-frequency vibrations as the simplest complex vibrations compared to single-frequency vibrations. Two psychophysical experiments were conducted to elucidate the perceptual characteristics of these vibrations by measuring the perceptual distances among single-frequency and dual-frequency vibrations. The perceptual distances of dual-frequency vibrations between their two frequency components along their relative intensity ratio were measured in Experiment I. The estimated perceptual spaces for three frequency conditions showed non-linear perceptual differences between the dual-frequency and single-frequency vibrations. A perceptual space was estimated from the measured perceptual distances among ten dual-frequency compositions and five single-frequency vibrations in Experiment II. The effect of the component frequency and the frequency ratio was revealed in the perceptual space. In a percept of dual-frequency vibration, the lower frequency component showed a dominant effect. Additionally, the perceptual difference among single-frequency and dual-frequency vibrations were increased with a low relative difference between two frequencies of a dual-frequency vibration. These results are expected to provide a fundamental understanding about the perception of complex vibrations to enrich the transfer of information using vibrotactile stimuli.

Iterative perceptual learning for social behavior synthesis

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de Kok, I.A.; Poppe, Ronald Walter; Heylen, Dirk K.J.

We introduce Iterative Perceptual Learning (IPL), a novel approach to learn computational models for social behavior synthesis from corpora of human–human interactions. IPL combines perceptual evaluation with iterative model refinement. Human observers rate the appropriateness of synthesized

Perceptual load interacts with stimulus processing across sensory modalities.

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Klemen, J; Büchel, C; Rose, M

2009-06-01

According to perceptual load theory, processing of task-irrelevant stimuli is limited by the perceptual load of a parallel attended task if both the task and the irrelevant stimuli are presented to the same sensory modality. However, it remains a matter of debate whether the same principles apply to cross-sensory perceptual load and, more generally, what form cross-sensory attentional modulation in early perceptual areas takes in humans. Here we addressed these questions using functional magnetic resonance imaging. Participants undertook an auditory one-back working memory task of low or high perceptual load, while concurrently viewing task-irrelevant images at one of three object visibility levels. The processing of the visual and auditory stimuli was measured in the lateral occipital cortex (LOC) and auditory cortex (AC), respectively. Cross-sensory interference with sensory processing was observed in both the LOC and AC, in accordance with previous results of unisensory perceptual load studies. The present neuroimaging results therefore warrant the extension of perceptual load theory from a unisensory to a cross-sensory context: a validation of this cross-sensory interference effect through behavioural measures would consolidate the findings.

Nonlinear dynamic mechanism of vocal tremor from voice analysis and model simulations

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Zhang, Yu; Jiang, Jack J.

2008-09-01

Nonlinear dynamic analysis and model simulations are used to study the nonlinear dynamic characteristics of vocal folds with vocal tremor, which can typically be characterized by low-frequency modulation and aperiodicity. Tremor voices from patients with disorders such as paresis, Parkinson's disease, hyperfunction, and adductor spasmodic dysphonia show low-dimensional characteristics, differing from random noise. Correlation dimension analysis statistically distinguishes tremor voices from normal voices. Furthermore, a nonlinear tremor model is proposed to study the vibrations of the vocal folds with vocal tremor. Fractal dimensions and positive Lyapunov exponents demonstrate the evidence of chaos in the tremor model, where amplitude and frequency play important roles in governing vocal fold dynamics. Nonlinear dynamic voice analysis and vocal fold modeling may provide a useful set of tools for understanding the dynamic mechanism of vocal tremor in patients with laryngeal diseases.

"King archie, who was quite grouchy" - a vocal dysphonia health education project O rei Sebastião que era muito resmungão

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Maria Rosário Dias

2013-02-01

Full Text Available PURPOSE: one major cause of dysphonia can be linked to the presence of vocal folds nodules - a condition commonly seen in children due to vocal misuse and/or vocal abuse. The present health education project, also directed to parents and educators, aims at making children (the project's chief target-population aware of how to make a correct use of their voice. METHOD: the target population includes parents, educators and children from both sexes and aged between five and eight years old. RESULT: a health education initiative was developed, which main instrument consists in a children's literature book, supplemented by an interactive CD. The instrument relies on a simple and easy-to-follow story where the issue of child dysphonia is addressed. CONCLUSIONS: the developed health education instrument is substantial for its chief target-population; it works as a suitable vehicle for promoting, in children, access, sensibility and awareness regarding aspects of one's voice one should be attentive to.

"King archie, who was quite grouchy" - a vocal dysphonia health education project O rei Sebastião que era muito resmungão

Directory of Open Access Journals (Sweden)

Maria Rosário Dias

2012-01-01

Full Text Available PURPOSE: one major cause of dysphonia can be linked to the presence of vocal folds nodules - a condition commonly seen in children due to vocal misuse and/or vocal abuse. The present health education project, also directed to parents and educators, aims at making children (the project's chief target-population aware of how to make a correct use of their voice. METHOD: the target population includes parents, educators and children from both sexes and aged between five and eight years old. RESULT: a health education initiative was developed, which main instrument consists in a children's literature book, supplemented by an interactive CD. The instrument relies on a simple and easy-to-follow story where the issue of child dysphonia is addressed. CONCLUSIONS: the developed health education instrument is substantial for its chief target-population; it works as a suitable vehicle for promoting, in children, access, sensibility and awareness regarding aspects of one's voice one should be attentive to.

Accurate expectancies diminish perceptual distraction during visual search

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Sy, Jocelyn L.; Guerin, Scott A.; Stegman, Anna; Giesbrecht, Barry

2014-01-01

The load theory of visual attention proposes that efficient selective perceptual processing of task-relevant information during search is determined automatically by the perceptual demands of the display. If the perceptual demands required to process task-relevant information are not enough to consume all available capacity, then the remaining capacity automatically and exhaustively “spills-over” to task-irrelevant information. The spill-over of perceptual processing capacity increases the likelihood that task-irrelevant information will impair performance. In two visual search experiments, we tested the automaticity of the allocation of perceptual processing resources by measuring the extent to which the processing of task-irrelevant distracting stimuli was modulated by both perceptual load and top-down expectations using behavior, functional magnetic resonance imaging, and electrophysiology. Expectations were generated using a trial-by-trial cue that provided information about the likely load of the upcoming visual search task. When the cues were valid, behavioral interference was eliminated and the influence of load on frontoparietal and visual cortical responses was attenuated relative to when the cues were invalid. In conditions in which task-irrelevant information interfered with performance and modulated visual activity, individual differences in mean blood oxygenation level dependent responses measured from the left intraparietal sulcus were negatively correlated with individual differences in the severity of distraction. These results are consistent with the interpretation that a top-down biasing mechanism interacts with perceptual load to support filtering of task-irrelevant information. PMID:24904374

Accurate expectancies diminish perceptual distraction during visual search

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Jocelyn L Sy

2014-05-01

Full Text Available The load theory of visual attention proposes that efficient selective perceptual processing of task-relevant information during search is determined automatically by the perceptual demands of the display. If the perceptual demands required to process task-relevant information are not enough to consume all available capacity, then the remaining capacity automatically and exhaustively spills-over to task-irrelevant information. The spill-over of perceptual processing capacity increases the likelihood that task-irrelevant information will impair performance. In two visual search experiments, we tested the automaticity of the allocation of perceptual processing resources by measuring the extent to which the processing of task-irrelevant distracting stimuli was modulated by both perceptual load and top-down expectations using behavior, fMRI, and electrophysiology. Expectations were generated by a trial-by-trial cue that provided information about the likely load of the upcoming visual search task. When the cues were valid, behavioral interference was eliminated and the influence of load on frontoparietal and visual cortical responses was attenuated relative to when the cues were invalid. In conditions in which task-irrelevant information interfered with performance and modulated visual activity, individual differences in mean BOLD responses measured from the left intraparietal sulcus were negatively correlated with individual differences in the severity of distraction. These results are consistent with the interpretation that a top-down biasing mechanism interacts with perceptual load to support filtering of task-irrelevant information.

Perceptual incongruence influences bistability and cortical activation

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Brouwer, G.J.; Tong, F.; Hagoort, P.; van Ee, R.

2009-01-01

We employed a parametric psychophysical design in combination with functional imaging to examine the influence of metric changes in perceptual incongruence on perceptual alternation rates and cortical responses. Subjects viewed a bistable stimulus defined by incongruent depth cues; bistability

Iterative Perceptual Learning for Social Behavior Synthesis

NARCIS (Netherlands)

de Kok, I.A.; Poppe, Ronald Walter; Heylen, Dirk K.J.

We introduce Iterative Perceptual Learning (IPL), a novel approach for learning computational models for social behavior synthesis from corpora of human-human interactions. The IPL approach combines perceptual evaluation with iterative model refinement. Human observers rate the appropriateness of

The vocal quality in female student teachers during the 3 years of study.

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Van Lierde, K M; Claeys, S; Dhaeseleer, E; Deley, S; Derde, K; Herregods, I; Strybol, I; Wuyts, F

2010-09-01

The purpose of the present cross-sectional study was to determine the objective vocal quality and the vocal characteristics (vocal risk factors, vocal and corporal complaints) in 143 female student teachers during the 3 years of study. The objective vocal quality was measured by means of the Dysphonia Severity Index (DSI). Perceptual voice assessment, the Voice Handicap Index, questionnaires addressing vocal risks, and vocal and corporal complaints during and/or after voice usage were performed. Student teachers have a normal perceptual and objective vocal quality corresponding with a DSI% of 76. The analysis of variance revealed a significant improvement of the vocal quality between the first and the third year of study. No psychosocial handicapping effect of the voice was observed, though there are some vocal complaints and almost all student teachers reported the presence of corporal pain during and/or after speaking. Especially sore throat and headache were mentioned as the most present corporal pain symptoms. Due to the decreased awareness and the multifactorial genesis of the potential vocal risk factors, the student teachers are at risk for developing an occupational dysphonia during their teaching career. Because teaching is a high-risk profession for the development of voice problems, the incorporation of a direct vocal training technique to increase vocal endurance during teaching together with a vocal hygiene program, dietetics, and a stress management training program during the 3 years of study is needed to prevent occupational dysphonia. 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Effective dysphonia detection using feature dimension reduction and kernel density estimation for patients with Parkinson's disease.

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Shanshan Yang

Full Text Available Detection of dysphonia is useful for monitoring the progression of phonatory impairment for patients with Parkinson's disease (PD, and also helps assess the disease severity. This paper describes the statistical pattern analysis methods to study different vocal measurements of sustained phonations. The feature dimension reduction procedure was implemented by using the sequential forward selection (SFS and kernel principal component analysis (KPCA methods. Four selected vocal measures were projected by the KPCA onto the bivariate feature space, in which the class-conditional feature densities can be approximated with the nonparametric kernel density estimation technique. In the vocal pattern classification experiments, Fisher's linear discriminant analysis (FLDA was applied to perform the linear classification of voice records for healthy control subjects and PD patients, and the maximum a posteriori (MAP decision rule and support vector machine (SVM with radial basis function kernels were employed for the nonlinear classification tasks. Based on the KPCA-mapped feature densities, the MAP classifier successfully distinguished 91.8% voice records, with a sensitivity rate of 0.986, a specificity rate of 0.708, and an area value of 0.94 under the receiver operating characteristic (ROC curve. The diagnostic performance provided by the MAP classifier was superior to those of the FLDA and SVM classifiers. In addition, the classification results indicated that gender is insensitive to dysphonia detection, and the sustained phonations of PD patients with minimal functional disability are more difficult to be correctly identified.

Protective Strategies Against Dysphonia in Teachers: Preliminary Results Comparing Voice Amplification and 0.9% NaCl Nebulization.

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Masson, Maria Lúcia Vaz; de Araújo, Tânia Maria

2018-03-01

This study aimed to compare the effects of two protective strategies, voice amplification (VA) and 0.9% NaCl nebulization (NEB), on teachers' voice in the work setting. An interventional evaluator-blind study was conducted, assigning 53 teachers from two public high schools to one of the two protective strategy groups (VA or NEB). Vocal function was assessed in a sound-treated booth before and after a 4-week period. Assessment included the severity of voice impairment (Consensus Auditory-Perceptual Evaluation of Voice [CAPE-V]), acoustic analysis of fundamental frequency (f0), sound pressure level (SPL), jitter, shimmer, glottal-to-noise excitation ratio (GNE), noise (VoxMetria), and the self-rated Screening Index for Voice Disorder (SIVD). Data were statistically analyzed using SPSS Statistics (version 22) with a significance level of P ≤ 0.05. Effect size was calculated using Cohen's d coefficient. There were no statistical differences between groups at baseline in terms of age, sex, time of teaching, teaching workload, and voice outcomes, except for SPL. During postintervention between groups, NEB displayed lower SIVD scores (VA = 3; NEB = 0; P = 0.018) and VA had lower acoustic irregularity (VA = 3.19; NEB = 3.69; P = 0.027), with moderate to large effect size. Postintervention within-groups decreased CAPE-V for VA (pretest = 31.97; posttest = 28.24; P = 0.021) and SIVD for NEB (pretest = 3; posttest = 0; P = 0.001). SPL decreased in both groups, NEB decreased in men only, and VA decreased in both men and women. NEB increased f0 for female participants (P ≤ 0.001). Both VA and NEB may help mitigate dysphonia in different pathways, being potential interventions for protecting teachers' voices in the work setting. An ongoing study with a control group will further support these preliminary results. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Perceptual load-dependent neural correlates of distractor interference inhibition.

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Jiansong Xu

2011-01-01

Full Text Available The load theory of selective attention hypothesizes that distractor interference is suppressed after perceptual processing (i.e., in the later stage of central processing at low perceptual load of the central task, but in the early stage of perceptual processing at high perceptual load. Consistently, studies on the neural correlates of attention have found a smaller distractor-related activation in the sensory cortex at high relative to low perceptual load. However, it is not clear whether the distractor-related activation in brain regions linked to later stages of central processing (e.g., in the frontostriatal circuits is also smaller at high rather than low perceptual load, as might be predicted based on the load theory.We studied 24 healthy participants using functional magnetic resonance imaging (fMRI during a visual target identification task with two perceptual loads (low vs. high. Participants showed distractor-related increases in activation in the midbrain, striatum, occipital and medial and lateral prefrontal cortices at low load, but distractor-related decreases in activation in the midbrain ventral tegmental area and substantia nigra (VTA/SN, striatum, thalamus, and extensive sensory cortices at high load.Multiple levels of central processing involving midbrain and frontostriatal circuits participate in suppressing distractor interference at either low or high perceptual load. For suppressing distractor interference, the processing of sensory inputs in both early and late stages of central processing are enhanced at low load but inhibited at high load.

Perceptual load-dependent neural correlates of distractor interference inhibition.

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Xu, Jiansong; Monterosso, John; Kober, Hedy; Balodis, Iris M; Potenza, Marc N

2011-01-18

The load theory of selective attention hypothesizes that distractor interference is suppressed after perceptual processing (i.e., in the later stage of central processing) at low perceptual load of the central task, but in the early stage of perceptual processing at high perceptual load. Consistently, studies on the neural correlates of attention have found a smaller distractor-related activation in the sensory cortex at high relative to low perceptual load. However, it is not clear whether the distractor-related activation in brain regions linked to later stages of central processing (e.g., in the frontostriatal circuits) is also smaller at high rather than low perceptual load, as might be predicted based on the load theory. We studied 24 healthy participants using functional magnetic resonance imaging (fMRI) during a visual target identification task with two perceptual loads (low vs. high). Participants showed distractor-related increases in activation in the midbrain, striatum, occipital and medial and lateral prefrontal cortices at low load, but distractor-related decreases in activation in the midbrain ventral tegmental area and substantia nigra (VTA/SN), striatum, thalamus, and extensive sensory cortices at high load. Multiple levels of central processing involving midbrain and frontostriatal circuits participate in suppressing distractor interference at either low or high perceptual load. For suppressing distractor interference, the processing of sensory inputs in both early and late stages of central processing are enhanced at low load but inhibited at high load.

Perceptual load corresponds with factors known to influence visual search.

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Roper, Zachary J J; Cosman, Joshua D; Vecera, Shaun P

2013-10-01

One account of the early versus late selection debate in attention proposes that perceptual load determines the locus of selection. Attention selects stimuli at a late processing level under low-load conditions but selects stimuli at an early level under high-load conditions. Despite the successes of perceptual load theory, a noncircular definition of perceptual load remains elusive. We investigated the factors that influence perceptual load by using manipulations that have been studied extensively in visual search, namely target-distractor similarity and distractor-distractor similarity. Consistent with previous work, search was most efficient when targets and distractors were dissimilar and the displays contained homogeneous distractors; search became less efficient when target-distractor similarity increased irrespective of display heterogeneity. Importantly, we used these same stimuli in a typical perceptual load task that measured attentional spillover to a task-irrelevant flanker. We found a strong correspondence between search efficiency and perceptual load; stimuli that generated efficient searches produced flanker interference effects, suggesting that such displays involved low perceptual load. Flanker interference effects were reduced in displays that produced less efficient searches. Furthermore, our results demonstrate that search difficulty, as measured by search intercept, has little bearing on perceptual load. We conclude that rather than be arbitrarily defined, perceptual load might be defined by well-characterized, continuous factors that influence visual search. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Chromatic Perceptual Learning but No Category Effects without Linguistic Input.

Science.gov (United States)

Grandison, Alexandra; Sowden, Paul T; Drivonikou, Vicky G; Notman, Leslie A; Alexander, Iona; Davies, Ian R L

2016-01-01

Perceptual learning involves an improvement in perceptual judgment with practice, which is often specific to stimulus or task factors. Perceptual learning has been shown on a range of visual tasks but very little research has explored chromatic perceptual learning. Here, we use two low level perceptual threshold tasks and a supra-threshold target detection task to assess chromatic perceptual learning and category effects. Experiment 1 investigates whether chromatic thresholds reduce as a result of training and at what level of analysis learning effects occur. Experiment 2 explores the effect of category training on chromatic thresholds, whether training of this nature is category specific and whether it can induce categorical responding. Experiment 3 investigates the effect of category training on a higher level, lateralized target detection task, previously found to be sensitive to category effects. The findings indicate that performance on a perceptual threshold task improves following training but improvements do not transfer across retinal location or hue. Therefore, chromatic perceptual learning is category specific and can occur at relatively early stages of visual analysis. Additionally, category training does not induce category effects on a low level perceptual threshold task, as indicated by comparable discrimination thresholds at the newly learned hue boundary and adjacent test points. However, category training does induce emerging category effects on a supra-threshold target detection task. Whilst chromatic perceptual learning is possible, learnt category effects appear to be a product of left hemisphere processing, and may require the input of higher level linguistic coding processes in order to manifest.

Perceptual Grouping via Untangling Gestalt Principles

DEFF Research Database (Denmark)

Qi, Yonggang; Guo, Jun; Li, Yi

2013-01-01

the importance of Gestalt rules by solving a learning to rank problem, and formulate a multi-label graph-cuts algo- rithm to group image primitives while taking into account the learned Gestalt confliction. Our experiment results confirm the existence of Gestalt confliction in perceptual grouping and demonstrate...... confliction, i.e., the relative importance of each rule compared with another, remains unsolved. In this paper, we investigate the problem of perceptual grouping by quantifying the confliction among three commonly used rules: similarity, continuity and proximity. More specifically, we propose to quantify...... an improved performance when such a conflic- tion is accounted for via the proposed grouping algorithm. Finally, a novel cross domain image classification method is proposed by exploiting perceptual grouping as representation....

Distonia laríngea: relato de caso e tratamento com toxina botulínica Laryngeal dystonia: case report and treatment with botulinum toxin

Directory of Open Access Journals (Sweden)

Victor José Barbosa Santos

2006-06-01

Full Text Available Distonia laríngea, ou disfonia espasmódica, é caracterizada por contrações involuntárias e inapropriadas da musculatura responsável pela fonação, sendo a do tipo adutora a mais comum. Caracteriza-se por quebras fonatórias, sendo seu diagnóstico confirmado por videolaringoestroboscopia. O tratamento de escolha é feito com a aplicação direta de toxina botulínica nos músculos responsáveis pelo movimento incoordenado. O objetivo desse trabalho é relatar o caso de uma paciente com diagnóstico de distonia laríngea do tipo adutora, tratada com toxina botulínica e discutir as vantagens e observações descritas na literatura a respeito desse tratamento.Laryngeal dystonia or spasmodic dysphonia is characterized by involuntary and innapropiate spasms of vocal muscles, having the adductor type as the most common one. It is chacterized by strain-strangled voice with pitch breaks. Diagnosis is made by means of videolaryngostroboscopic exam. The treatment of choice is done with botulinum toxin directly injected in the muscles responsible for the mismatched movement. The aim of this study is to report on an adductor- type dysphonia patient and to discuss the advantages and observations about this treatment reported in the literature.

Auditory perceptual load: A review.

Science.gov (United States)

Murphy, Sandra; Spence, Charles; Dalton, Polly

2017-09-01

Selective attention is a crucial mechanism in everyday life, allowing us to focus on a portion of incoming sensory information at the expense of other less relevant stimuli. The circumstances under which irrelevant stimuli are successfully ignored have been a topic of scientific interest for several decades now. Over the last 20 years, the perceptual load theory (e.g. Lavie, 1995) has provided one robust framework for understanding these effects within the visual modality. The suggestion is that successful selection depends on the perceptual demands imposed by the task-relevant information. However, less research has addressed the question of whether the same principles hold in audition and, to date, the existing literature provides a mixed picture. Here, we review the evidence for and against the applicability of perceptual load theory in hearing, concluding that this question still awaits resolution. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Gaze-contingent training enhances perceptual skill acquisition

NARCIS (Netherlands)

Mann, D.L.; Ryu, D.; Abernethy, B.A.; Poolton, J.M.

2016-01-01

The purpose of this study was to determine whether decision-making skill in perceptual-cognitive tasks could be enhanced using a training technique that impaired selective areas of the visual field. Recreational basketball players performed perceptual training over 3 days while viewing with a

The treatment of muscle tension dysphonia: a comparison of two treatment techniques by means of an objective multiparameter approach.

Science.gov (United States)

Van Lierde, Kristiane M; De Bodt, Marc; Dhaeseleer, Evelien; Wuyts, Floris; Claeys, Sofie

2010-05-01

The purpose of the present study is to measure the effectiveness of two treatment techniques--vocalization with abdominal breath support and manual circumlaryngeal therapy (MCT)--in patients with muscle tension dysphonia (MTD). The vocal quality before and after the two treatment techniques was measured by means of the dysphonia severity index (DSI), which is designed to establish an objective and quantitative correlate of the perceived vocal quality. The DSI is based on the weighted combination of the following set of voice measurements: maximum phonation time (MPT), highest frequency, lowest intensity, and jitter. The repeated-measures analysis of variance (ANOVA) revealed a significant difference between the objective overall vocal quality before and after MCT. No significant differences were measured between the objective overall vocal quality before and after vocalization with abdominal breath support. This study showed evidence that MCT is an effective treatment technique for patients with elevated laryngeal position, increased laryngeal muscle tension, and MTD. The precise way in which MCT has an effect on vocal quality has not been addressed in this experiment, but merits study. Further research into this topic could focus on electromyography (EMG) recordings in relation to vocal improvements with larger sample of subjects. (c) 2010 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Modelling the Perceptual Components of Loudspeaker Distortion

DEFF Research Database (Denmark)

Olsen, Sune L.; Agerkvist, Finn T.; MacDonald, Ewen

2016-01-01

While non-linear distortion in loudspeakers decreases audio quality, the perceptual consequences can vary substantially. This paper investigates the metric Rnonlin [1] which was developed to predict subjective measurements of sound quality in nonlinear systems. The generalisability of the metric...... the perceptual consequences of non-linear distortion....

A perceptual study of Scottish dialects

OpenAIRE

Tichenor, Sydney

2012-01-01

Perceptual dialectology is dedicated to the formal study of folk linguistic perceptions. Through an amalgamation of social psychology, ethnography, dialectology, sociolinguistics, cultural geography and myriad other fields, perceptual dialectology provides a methodology to gain insight to overt folk language attitudes, knowledge of regional distribution, and the importance of language variation and change (Preston 1989, 1999a). This study conducts the first investigation of folk percept...

Perceptual incongruence influences bistability and cortical activation.

Directory of Open Access Journals (Sweden)

Gijs Joost Brouwer

Full Text Available We employed a parametric psychophysical design in combination with functional imaging to examine the influence of metric changes in perceptual incongruence on perceptual alternation rates and cortical responses. Subjects viewed a bistable stimulus defined by incongruent depth cues; bistability resulted from incongruence between binocular disparity and monocular perspective cues that specify different slants (slant rivalry. Psychophysical results revealed that perceptual alternation rates were positively correlated with the degree of perceived incongruence. Functional imaging revealed systematic increases in activity that paralleled the psychophysical results within anterior intraparietal sulcus, prior to the onset of perceptual alternations. We suggest that this cortical activity predicts the frequency of subsequent alternations, implying a putative causal role for these areas in initiating bistable perception. In contrast, areas implicated in form and depth processing (LOC and V3A were sensitive to the degree of slant, but failed to show increases in activity when these cues were in conflict.

Prior expectations facilitate metacognition for perceptual decision.

Science.gov (United States)

Sherman, M T; Seth, A K; Barrett, A B; Kanai, R

2015-09-01

The influential framework of 'predictive processing' suggests that prior probabilistic expectations influence, or even constitute, perceptual contents. This notion is evidenced by the facilitation of low-level perceptual processing by expectations. However, whether expectations can facilitate high-level components of perception remains unclear. We addressed this question by considering the influence of expectations on perceptual metacognition. To isolate the effects of expectation from those of attention we used a novel factorial design: expectation was manipulated by changing the probability that a Gabor target would be presented; attention was manipulated by instructing participants to perform or ignore a concurrent visual search task. We found that, independently of attention, metacognition improved when yes/no responses were congruent with expectations of target presence/absence. Results were modeled under a novel Bayesian signal detection theoretic framework which integrates bottom-up signal propagation with top-down influences, to provide a unified description of the mechanisms underlying perceptual decision and metacognition. Copyright © 2015 Elsevier Inc. All rights reserved.

Neurological evidence linguistic processes precede perceptual simulation in conceptual processing.

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Louwerse, Max; Hutchinson, Sterling

2012-01-01

There is increasing evidence from response time experiments that language statistics and perceptual simulations both play a role in conceptual processing. In an EEG experiment we compared neural activity in cortical regions commonly associated with linguistic processing and visual perceptual processing to determine to what extent symbolic and embodied accounts of cognition applied. Participants were asked to determine the semantic relationship of word pairs (e.g., sky - ground) or to determine their iconic relationship (i.e., if the presentation of the pair matched their expected physical relationship). A linguistic bias was found toward the semantic judgment task and a perceptual bias was found toward the iconicity judgment task. More importantly, conceptual processing involved activation in brain regions associated with both linguistic and perceptual processes. When comparing the relative activation of linguistic cortical regions with perceptual cortical regions, the effect sizes for linguistic cortical regions were larger than those for the perceptual cortical regions early in a trial with the reverse being true later in a trial. These results map upon findings from other experimental literature and provide further evidence that processing of concept words relies both on language statistics and on perceptual simulations, whereby linguistic processes precede perceptual simulation processes.

Load theory behind the wheel; perceptual and cognitive load effects.

Science.gov (United States)

Murphy, Gillian; Greene, Ciara M

2017-09-01

Perceptual Load Theory has been proposed as a resolution to the longstanding early versus late selection debate in cognitive psychology. There is much evidence in support of Load Theory but very few applied studies, despite the potential for the model to shed light on everyday attention and distraction. Using a driving simulator, the effect of perceptual and cognitive load on drivers' visual search was assessed. The findings were largely in line with Load Theory, with reduced distractor processing under high perceptual load, but increased distractor processing under high cognitive load. The effect of load on driving behaviour was also analysed, with significant differences in driving behaviour under perceptual and cognitive load. In addition, the effect of perceptual load on drivers' levels of awareness was investigated. High perceptual load significantly increased inattentional blindness and deafness, for stimuli that were both relevant and irrelevant to driving. High perceptual load also increased RTs to hazards. The current study helps to advance Load Theory by illustrating its usefulness outside of traditional paradigms. There are also applied implications for driver safety and roadway design, as the current study suggests that perceptual and cognitive load are important factors in driver attention. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

[Professional dysphonia and its risk factors in the material of the outpatient clinic of the Department of Otolaryngology, Medical Academy of Białystok].

Science.gov (United States)

Kosztyła-Hojna, Bozena; Rogowski, Marek; Ruczaj, Jan; Pepiński, Witold

2004-01-01

Occurrence of professional dysphonia was analysed in a group of 309 patients treated in the Phoniatric Outpatient Clinic, Department of Otolaryngology, Medical Academy in Białystok through the period of 1999-2001. In a group of professional voice users female teachers of primary schools and lower secondary schools predominated. Obtained results were compared with those from a group of 65 persons of other occupations. In the both groups other harmful factors affecting the voice organ were excluded. The clinical assessment included subjective and objective laryngological examination using videolaryngostroboscopy. The clinical material was evaluated in a view of functional and organic disorders of the voice organ. Early occurrence and aggravation of functional changes in the larynx was recorded in non professional voice users in the course of their seniority. In professional patients organic changes were more common and occurred earlier than functional disorders. Severity of dysphonia was related to the larynx pathology, especially of a functional character.

Constraints on Perceptual Learning: Objects and Dimensions.

Science.gov (United States)

Bedford, Felice L.

1995-01-01

Addresses two questions that may be unique to perceptual learning: What are the circumstances that produce learning? and What is the content of learning? Suggests a critical principle for each question. Provides a discussion of perceptual learning theory, how learning occurs, and what gets learned. Includes a 121-item bibliography. (DR)

Effective Dysphonia Detection Using Feature Dimension Reduction and Kernel Density Estimation for Patients with Parkinson’s Disease

Science.gov (United States)

Yang, Shanshan; Zheng, Fang; Luo, Xin; Cai, Suxian; Wu, Yunfeng; Liu, Kaizhi; Wu, Meihong; Chen, Jian; Krishnan, Sridhar

2014-01-01

Detection of dysphonia is useful for monitoring the progression of phonatory impairment for patients with Parkinson’s disease (PD), and also helps assess the disease severity. This paper describes the statistical pattern analysis methods to study different vocal measurements of sustained phonations. The feature dimension reduction procedure was implemented by using the sequential forward selection (SFS) and kernel principal component analysis (KPCA) methods. Four selected vocal measures were projected by the KPCA onto the bivariate feature space, in which the class-conditional feature densities can be approximated with the nonparametric kernel density estimation technique. In the vocal pattern classification experiments, Fisher’s linear discriminant analysis (FLDA) was applied to perform the linear classification of voice records for healthy control subjects and PD patients, and the maximum a posteriori (MAP) decision rule and support vector machine (SVM) with radial basis function kernels were employed for the nonlinear classification tasks. Based on the KPCA-mapped feature densities, the MAP classifier successfully distinguished 91.8% voice records, with a sensitivity rate of 0.986, a specificity rate of 0.708, and an area value of 0.94 under the receiver operating characteristic (ROC) curve. The diagnostic performance provided by the MAP classifier was superior to those of the FLDA and SVM classifiers. In addition, the classification results indicated that gender is insensitive to dysphonia detection, and the sustained phonations of PD patients with minimal functional disability are more difficult to be correctly identified. PMID:24586406

The classification of idiopathic spasmodic torticollis: three types based on social adaptation and frustration tolerance.

Science.gov (United States)

Kashiwase, H; Kato, M

1997-12-01

In this study, idiopathic spasmodic torticollis (ST) has been classfied into three types from the opinion of social adaptation and the differences of frustration tolerance. The three types were as follows: type I (overadaptive type), type II (maladaptive type), and type III (compatible type). Type I is a typical psychosomatic with high frustration tolerance. Type II is personality disorder with low frustration tolerance. In type III, frustration tolerance varies depending on social circumstances (i.e., different at home and at the office). In type I, the prognosis of ST is generally unfavorable, since it is associated with recurrence and prolongation of the symptoms. In type II, the prognosis of ST is generally favorable. However, type II patients experience relationship or social difficulties. One characteristic of type III is that the onset of symptoms is usually found in an older person because of proper use of frustration tolerance at home and at the office.

On Perceptual Distortion Minimization and Nonlinear Least-Squares Frequency Estimation

DEFF Research Database (Denmark)

Christensen, Mads Græsbøll; Jensen, Søren Holdt

2006-01-01

In this paper, we present a framework for perceptual error minimization and sinusoidal frequency estimation based on a new perceptual distortion measure, and we state its optimal solution. Using this framework, we relate a number of well-known practical methods for perceptual sinusoidal parameter...

Attention without awareness: Attentional modulation of perceptual grouping without awareness.

Science.gov (United States)

Lo, Shih-Yu

2018-04-01

Perceptual grouping is the process through which the perceptual system combines local stimuli into a more global perceptual unit. Previous studies have shown attention to be a modulatory factor for perceptual grouping. However, these studies mainly used explicit measurements, and, thus, whether attention can modulate perceptual grouping without awareness is still relatively unexplored. To clarify the relationship between attention and perceptual grouping, the present study aims to explore how attention interacts with perceptual grouping without awareness. The task was to judge the relative lengths of two centrally presented horizontal bars while a railway-shaped pattern defined by color similarity was presented in the background. Although the observers were unaware of the railway-shaped pattern, their line-length judgment was biased by that pattern, which induced a Ponzo illusion, indicating grouping without awareness. More importantly, an attentional modulatory effect without awareness was manifested as evident by the observer's performance being more often biased when the railway-shaped pattern was formed by an attended color than when it was formed by an unattended one. Also, the attentional modulation effect was shown to be dynamic, being more pronounced with a short presentation time than a longer one. The results of the present study not only clarify the relationship between attention and perceptual grouping but also further contribute to our understanding of attention and awareness by corroborating the dissociation between attention and awareness.

Beta oscillations define discrete perceptual cycles in the somatosensory domain.

Science.gov (United States)

Baumgarten, Thomas J; Schnitzler, Alfons; Lange, Joachim

2015-09-29

Whether seeing a movie, listening to a song, or feeling a breeze on the skin, we coherently experience these stimuli as continuous, seamless percepts. However, there are rare perceptual phenomena that argue against continuous perception but, instead, suggest discrete processing of sensory input. Empirical evidence supporting such a discrete mechanism, however, remains scarce and comes entirely from the visual domain. Here, we demonstrate compelling evidence for discrete perceptual sampling in the somatosensory domain. Using magnetoencephalography (MEG) and a tactile temporal discrimination task in humans, we find that oscillatory alpha- and low beta-band (8-20 Hz) cycles in primary somatosensory cortex represent neurophysiological correlates of discrete perceptual cycles. Our results agree with several theoretical concepts of discrete perceptual sampling and empirical evidence of perceptual cycles in the visual domain. Critically, these results show that discrete perceptual cycles are not domain-specific, and thus restricted to the visual domain, but extend to the somatosensory domain.

Effect of practice on perceptual load

OpenAIRE

Mejia-Ramirez, Manuel

2013-01-01

Within attention studies, Lavie's load theory (Lavie & Tsal, 1994; Lavie, Hirst, de Fockert, & Viding, 2004) presented an account that could settle the question whether attention selects stimuli to be processed at an early or late stage of cognitive processing. This theory relied on the concepts of "perceptual load" and "attentional capacity", proposing that attentional resources are automatically allocated to stimuli, but when the perceptual load of the stimuli exceeds person's capacity, tas...

Frontoparietal cortex mediates perceptual transitions in bistable perception.

Science.gov (United States)

Weilnhammer, Veith A; Ludwig, Karin; Hesselmann, Guido; Sterzer, Philipp

2013-10-02

During bistable vision, perception oscillates between two mutually exclusive percepts despite constant sensory input. Greater BOLD responses in frontoparietal cortex have been shown to be associated with endogenous perceptual transitions compared with "replay" transitions designed to closely match bistability in both perceptual quality and timing. It has remained controversial, however, whether this enhanced activity reflects causal influences of these regions on processing at the sensory level or, alternatively, an effect of stimulus differences that result in, for example, longer durations of perceptual transitions in bistable perception compared with replay conditions. Using a rotating Lissajous figure in an fMRI experiment on 15 human participants, we controlled for potential confounds of differences in transition duration and confirmed previous findings of greater activity in frontoparietal areas for transitions during bistable perception. In addition, we applied dynamic causal modeling to identify the neural model that best explains the observed BOLD signals in terms of effective connectivity. We found that enhanced activity for perceptual transitions is associated with a modulation of top-down connectivity from frontal to visual cortex, thus arguing for a crucial role of frontoparietal cortex in perceptual transitions during bistable perception.

Triggers of fear: perceptual cues versus conceptual information in spider phobia.

Science.gov (United States)

Peperkorn, Henrik M; Alpers, Georg W; Mühlberger, Andreas

2014-07-01

Fear reactions in spider-phobic patients can be activated by specific perceptual cues or by conceptual fear-related information. Matching perceptual fear cues and fear-related information were expected to result in maximal fear responses, perceptual fear cues alone in less fear, and information alone in the weakest responses. We used virtual reality to manipulate the available cues and information. Forty-eight phobic patients and 48 healthy participants were repeatedly exposed to either a perceptual cue, information, or a combination of both. In conditions with a fear-relevant perceptual cue, phobic patients reported increased fear compared to the condition with information only. Across exposures trials, these reactions diminished. Skin conductance in phobic patients was significantly higher in the combined than in the cue or the information condition. Perceptual cues are essential for phobic fear reactions in spider phobia. In combination with fear-relevant information, perceptual cues activate an intense and persistent fear reaction. © 2013 Wiley Periodicals, Inc.

Reliability in perceptual analysis of voice quality.

Science.gov (United States)

Bele, Irene Velsvik

2005-12-01

This study focuses on speaking voice quality in male teachers (n = 35) and male actors (n = 36), who represent untrained and trained voice users, because we wanted to investigate normal and supranormal voices. In this study, both substantial and methodologic aspects were considered. It includes a method for perceptual voice evaluation, and a basic issue was rater reliability. A listening group of 10 listeners, 7 experienced speech-language therapists, and 3 speech-language therapist students evaluated the voices by 15 vocal characteristics using VA scales. Two sets of voice signals were investigated: text reading (2 loudness levels) and sustained vowel (3 levels). The results indicated a high interrater reliability for most perceptual characteristics. Connected speech was evaluated more reliably, especially at the normal level, but both types of voice signals were evaluated reliably, although the reliability for connected speech was somewhat higher than for vowels. Experienced listeners tended to be more consistent in their ratings than did the student raters. Some vocal characteristics achieved acceptable reliability even with a smaller panel of listeners. The perceptual characteristics grouped in 4 factors reflected perceptual dimensions.

Perceptual transparency from image deformation.

Science.gov (United States)

Kawabe, Takahiro; Maruya, Kazushi; Nishida, Shin'ya

2015-08-18

Human vision has a remarkable ability to perceive two layers at the same retinal locations, a transparent layer in front of a background surface. Critical image cues to perceptual transparency, studied extensively in the past, are changes in luminance or color that could be caused by light absorptions and reflections by the front layer, but such image changes may not be clearly visible when the front layer consists of a pure transparent material such as water. Our daily experiences with transparent materials of this kind suggest that an alternative potential cue of visual transparency is image deformations of a background pattern caused by light refraction. Although previous studies have indicated that these image deformations, at least static ones, play little role in perceptual transparency, here we show that dynamic image deformations of the background pattern, which could be produced by light refraction on a moving liquid's surface, can produce a vivid impression of a transparent liquid layer without the aid of any other visual cues as to the presence of a transparent layer. Furthermore, a transparent liquid layer perceptually emerges even from a randomly generated dynamic image deformation as long as it is similar to real liquid deformations in its spatiotemporal frequency profile. Our findings indicate that the brain can perceptually infer the presence of "invisible" transparent liquids by analyzing the spatiotemporal structure of dynamic image deformation, for which it uses a relatively simple computation that does not require high-level knowledge about the detailed physics of liquid deformation.

Inharmonicity Analysis: A Novel Physical Method for Acoustic Screening of Dysphonia

Science.gov (United States)

Matteson, Sam; Lu, Fang-Ling

2008-10-01

In the United States 6.8% of men, women, and children report current voice problems and approximately 29% will report some problems during their lifetime. Often this dysphonia is due to pathologies of the vocal folds. The authors (a physicist and a speech pathologist) describe an interdisciplinary approach that shows promise of detecting physiological abnormalities of the vocal folds from an analysis of the Fourier spectrum of spoken ``tokens.'' The underlying principle maintains that the normal human vocal fold is a linear oscillator that emits overtones that are very nearly precise integral values of the fundamental. Physiological problems of the vocal folds, however, introduce mechanical non-linearities that manifest themselves as frequency deviations from the ideal harmonic (that is, integral) values. The authors quantify this inharmonicity, describing and illustrating how one can obtain and analyze such data. They outline, as well, a proposed program to assess the clinical sensitivity and significance of the analysis discussed in this work.

The influence of schizotypal traits on attention under high perceptual load.

Science.gov (United States)

Stotesbury, Hanne; Gaigg, Sebastian B; Kirhan, Saim; Haenschel, Corinna

2018-03-01

Schizophrenia Spectrum Disorders (SSD) are known to be characterised by abnormalities in attentional processes, but there are inconsistencies in the literature that remain unresolved. This article considers whether perceptual resource limitations play a role in moderating attentional abnormalities in SSD. According to perceptual load theory, perceptual resource limitations can lead to attenuated or superior performance on dual-task paradigms depending on whether participants are required to process, or attempt to ignore, secondary stimuli. If SSD is associated with perceptual resource limitations, and if it represents the extreme end of an otherwise normally distributed neuropsychological phenotype, schizotypal traits in the general population should lead to disproportionate performance costs on dual-task paradigms as a function of the perceptual task demands. To test this prediction, schizotypal traits were quantified via the Schizotypal Personality Questionnaire (SPQ) in 74 healthy volunteers, who also completed a dual-task signal detection paradigm that required participants to detect central and peripheral stimuli across conditions that varied in the overall number of stimuli presented. The results confirmed decreasing performance as the perceptual load of the task increased. More importantly, significant correlations between SPQ scores and task performance confirmed that increased schizotypal traits, particularly in the cognitive-perceptual domain, are associated with greater performance decrements under increasing perceptual load. These results confirm that attentional difficulties associated with SSD extend sub-clinically into the general population and suggest that cognitive-perceptual schizotypal traits may represent a risk factor for difficulties in the regulation of attention under increasing perceptual load.

The influence of schizotypal traits on attention under high perceptual load

Directory of Open Access Journals (Sweden)

Hanne Stotesbury

2018-03-01

Full Text Available Schizophrenia Spectrum Disorders (SSD are known to be characterised by abnormalities in attentional processes, but there are inconsistencies in the literature that remain unresolved. This article considers whether perceptual resource limitations play a role in moderating attentional abnormalities in SSD. According to perceptual load theory, perceptual resource limitations can lead to attenuated or superior performance on dual-task paradigms depending on whether participants are required to process, or attempt to ignore, secondary stimuli. If SSD is associated with perceptual resource limitations, and if it represents the extreme end of an otherwise normally distributed neuropsychological phenotype, schizotypal traits in the general population should lead to disproportionate performance costs on dual-task paradigms as a function of the perceptual task demands. To test this prediction, schizotypal traits were quantified via the Schizotypal Personality Questionnaire (SPQ in 74 healthy volunteers, who also completed a dual-task signal detection paradigm that required participants to detect central and peripheral stimuli across conditions that varied in the overall number of stimuli presented. The results confirmed decreasing performance as the perceptual load of the task increased. More importantly, significant correlations between SPQ scores and task performance confirmed that increased schizotypal traits, particularly in the cognitive-perceptual domain, are associated with greater performance decrements under increasing perceptual load. These results confirm that attentional difficulties associated with SSD extend sub-clinically into the general population and suggest that cognitive-perceptual schizotypal traits may represent a risk factor for difficulties in the regulation of attention under increasing perceptual load.

Perceptual Experience and Seeing-as

Directory of Open Access Journals (Sweden)

Daniel Enrique Kalpokas

2015-07-01

Full Text Available According to Rorty, Davidson and Brandom, to have an experience is to be caused by our senses to hold a perceptual belief. This article argues that the phenomenon of seeing-as cannot be explained by such a conception of perceptual experience. First, the notion of experience defended by the aforementioned authors is reconstructed. Second, the main features of what Wittgenstein called “seeing aspects” are briefly presented. Finally, several arguments are developed in order to support the main thesis of the article: seeing-as cannot be explained by the conception of experience defended by Rorty, Davidson and Brandom.

Brain studies may alter long-held concepts about likely causes of some voice disorders

International Nuclear Information System (INIS)

Anon.

1989-01-01

Two voice disorders long considered to be psychological problems, stuttering and spasmodic dysphonia, have been shown in many persons to have a neurophysiological basis. Investigators at the 155th national meeting of the American Association for the Advancement of Science, in San Francisco, described their findings, which are based on new analytic techniques. The research is being done at the Dallas Center for Vocal Motor Control, Callier Center for Communication Disorders, University of Texas at Dallas Health Science Center. The technology employed to learn what's wrong with the brains, rather than the psyches, of persons with certain speech disorders includes magnetic resonance imaging (MRI), brain electrical activity mapping (BEAM), and single photon emission computerized tomography (SPECT). The results of applying these techniques are combined with quantitative behavioral measures of vocal and nonvocal motor control, language performance, and cognition to arrive at a better understanding of the problem

Brain studies may alter long-held concepts about likely causes of some voice disorders

Energy Technology Data Exchange (ETDEWEB)

1989-02-17

Two voice disorders long considered to be psychological problems, stuttering and spasmodic dysphonia, have been shown in many persons to have a neurophysiological basis. Investigators at the 155th national meeting of the American Association for the Advancement of Science, in San Francisco, described their findings, which are based on new analytic techniques. The research is being done at the Dallas Center for Vocal Motor Control, Callier Center for Communication Disorders, University of Texas at Dallas Health Science Center. The technology employed to learn what's wrong with the brains, rather than the psyches, of persons with certain speech disorders includes magnetic resonance imaging (MRI), brain electrical activity mapping (BEAM), and single photon emission computerized tomography (SPECT). The results of applying these techniques are combined with quantitative behavioral measures of vocal and nonvocal motor control, language performance, and cognition to arrive at a better understanding of the problem.

Visual perceptual abilities of Chinese-speaking and English-speaking children.

Science.gov (United States)

Lai, Mun Yee; Leung, Frederick Koon Shing

2012-04-01

This paper reports an investigation of Chinese-speaking and English-speaking children's general visual perceptual abilities. The Developmental Test of Visual Perception was administered to 41 native Chinese-speaking children of mean age 5 yr. 4 mo. in Hong Kong and 35 English-speaking children of mean age 5 yr. 2 mo. in Melbourne. Of interest were the two interrelated components of visual perceptual abilities, namely, motor-reduced visual perceptual and visual-motor integration perceptual abilities, which require either verbal or motoric responses in completing visual tasks. Chinese-speaking children significantly outperformed the English-speaking children on general visual perceptual abilities. When comparing the results of each of the two different components, the Chinese-speaking students' performance on visual-motor integration was far better than that of their counterparts (ES = 2.70), while the two groups of students performed similarly on motor-reduced visual perceptual abilities. Cultural factors such as written language format may be contributing to the enhanced performance of Chinese-speaking children's visual-motor integration abilities, but there may be validity questions in the Chinese version.

Understanding perceptual boundaries in laparoscopic surgery.

Science.gov (United States)

Lamata, Pablo; Gomez, Enrique J; Hernández, Félix Lamata; Oltra Pastor, Alfonso; Sanchez-Margallo, Francisco Miquel; Del Pozo Guerrero, Francisco

2008-03-01

Human perceptual capabilities related to the laparoscopic interaction paradigm are not well known. Its study is important for the design of virtual reality simulators, and for the specification of augmented reality applications that overcome current limitations and provide a supersensing to the surgeon. As part of this work, this article addresses the study of laparoscopic pulling forces. Two definitions are proposed to focalize the problem: the perceptual fidelity boundary, limit of human perceptual capabilities, and the Utile fidelity boundary, that encapsulates the perceived aspects actually used by surgeons to guide an operation. The study is then aimed to define the perceptual fidelity boundary of laparoscopic pulling forces. This is approached with an experimental design in which surgeons assess the resistance against pulling of four different tissues, which are characterized with both in vivo interaction forces and ex vivo tissue biomechanical properties. A logarithmic law of tissue consistency perception is found comparing subjective valorizations with objective parameters. A model of this perception is developed identifying what the main parameters are: the grade of fixation of the organ, the tissue stiffness, the amount of tissue bitten, and the organ mass being pulled. These results are a clear requirement analysis for the force feedback algorithm of a virtual reality laparoscopic simulator. Finally, some discussion is raised about the suitability of augmented reality applications around this surgical gesture.

Developing the Communicative Participation Item Bank: Rasch Analysis Results from a Spasmodic Dysphonia Sample

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Baylor, Carolyn R.; Yorkston, Kathryn M.; Eadie, Tanya L.; Miller, Robert M.; Amtmann, Dagmar

2009-01-01

Purpose: The purpose of this study was to conduct the initial psychometric analyses of the Communicative Participation Item Bank--a new self-report instrument designed to measure the extent to which communication disorders interfere with communicative participation. This item bank is intended for community-dwelling adults across a range of…

Conceptual and methodological concerns in the theory of perceptual load.

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Benoni, Hanna; Tsal, Yehoshua

2013-01-01

The present paper provides a short critical review of the theory of perceptual load. It closely examines the basic tenets and assumptions of the theory and identifies major conceptual and methodological problems that have been largely ignored in the literature. The discussion focuses on problems in the definition of the concept of perceptual load, on the circularity in the characterization and manipulation of perceptual load and the confusion between the concept of perceptual load and its operationalization. The paper also selectively reviews evidence supporting the theory as well as inconsistent evidence which proposed alternative dominant factors influencing the efficacy of attentional selection.

Visual perception of procedural textures: identifying perceptual dimensions and predicting generation models.

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Liu, Jun; Dong, Junyu; Cai, Xiaoxu; Qi, Lin; Chantler, Mike

2015-01-01

Procedural models are widely used in computer graphics for generating realistic, natural-looking textures. However, these mathematical models are not perceptually meaningful, whereas the users, such as artists and designers, would prefer to make descriptions using intuitive and perceptual characteristics like "repetitive," "directional," "structured," and so on. To make up for this gap, we investigated the perceptual dimensions of textures generated by a collection of procedural models. Two psychophysical experiments were conducted: free-grouping and rating. We applied Hierarchical Cluster Analysis (HCA) and Singular Value Decomposition (SVD) to discover the perceptual features used by the observers in grouping similar textures. The results suggested that existing dimensions in literature cannot accommodate random textures. We therefore utilized isometric feature mapping (Isomap) to establish a three-dimensional perceptual texture space which better explains the features used by humans in texture similarity judgment. Finally, we proposed computational models to map perceptual features to the perceptual texture space, which can suggest a procedural model to produce textures according to user-defined perceptual scales.

Visual perception of procedural textures: identifying perceptual dimensions and predicting generation models.

Directory of Open Access Journals (Sweden)

Jun Liu

Full Text Available Procedural models are widely used in computer graphics for generating realistic, natural-looking textures. However, these mathematical models are not perceptually meaningful, whereas the users, such as artists and designers, would prefer to make descriptions using intuitive and perceptual characteristics like "repetitive," "directional," "structured," and so on. To make up for this gap, we investigated the perceptual dimensions of textures generated by a collection of procedural models. Two psychophysical experiments were conducted: free-grouping and rating. We applied Hierarchical Cluster Analysis (HCA and Singular Value Decomposition (SVD to discover the perceptual features used by the observers in grouping similar textures. The results suggested that existing dimensions in literature cannot accommodate random textures. We therefore utilized isometric feature mapping (Isomap to establish a three-dimensional perceptual texture space which better explains the features used by humans in texture similarity judgment. Finally, we proposed computational models to map perceptual features to the perceptual texture space, which can suggest a procedural model to produce textures according to user-defined perceptual scales.

Memory: Enduring Traces of Perceptual and Reflective Attention

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Chun, Marvin M.; Johnson, Marcia K.

2011-01-01

Attention and memory are typically studied as separate topics, but they are highly intertwined. Here we discuss the relation between memory and two fundamental types of attention: perceptual and reflective. Memory is the persisting consequence of cognitive activities initiated by and/or focused on external information from the environment (perceptual attention) and initiated by and/or focused on internal mental representations (reflective attention). We consider three key questions for advancing a cognitive neuroscience of attention and memory: To what extent do perception and reflection share representational areas? To what extent are the control processes that select, maintain, and manipulate perceptual and reflective information subserved by common areas and networks? During perception and reflection, to what extent are common areas responsible for binding features together to create complex, episodic memories and for reviving them later? Considering similarities and differences in perceptual and reflective attention helps integrate a broad range of findings and raises important unresolved issues. PMID:22099456

Memory: enduring traces of perceptual and reflective attention.

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Chun, Marvin M; Johnson, Marcia K

2011-11-17

Attention and memory are typically studied as separate topics, but they are highly intertwined. Here we discuss the relation between memory and two fundamental types of attention: perceptual and reflective. Memory is the persisting consequence of cognitive activities initiated by and/or focused on external information from the environment (perceptual attention) and initiated by and/or focused on internal mental representations (reflective attention). We consider three key questions for advancing a cognitive neuroscience of attention and memory: to what extent do perception and reflection share representational areas? To what extent are the control processes that select, maintain, and manipulate perceptual and reflective information subserved by common areas and networks? During perception and reflection, to what extent are common areas responsible for binding features together to create complex, episodic memories and for reviving them later? Considering similarities and differences in perceptual and reflective attention helps integrate a broad range of findings and raises important unresolved issues. Copyright © 2011 Elsevier Inc. All rights reserved.

Perceptual Load Affects Eyewitness Accuracy & Susceptibility to Leading Questions

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Gillian Murphy

2016-08-01

Full Text Available Load Theory (Lavie, 1995; 2005 states that the level of perceptual load in a task (i.e. the amount of information involved in processing task-relevant stimuli determines the efficiency of selective attention. There is evidence that perceptual load affects distractor processing, with increased inattentional blindness under high load. Given that high load can result in individuals failing to report seeing obvious objects, it is conceivable that load may also impair memory for the scene. The current study is the first to assess the effect of perceptual load on eyewitness memory. Across three experiments (two video-based and one in a driving simulator, the effect of perceptual load on eyewitness memory was assessed. The results showed that eyewitnesses were less accurate under high load, in particular for peripheral details. For example, memory for the central character in the video was not affected by load but memory for a witness who passed by the window at the edge of the scene was significantly worse under high load. High load memories were also more open to suggestion, showing increased susceptibility to leading questions. High visual perceptual load also affected recall for auditory information, illustrating a possible cross-modal perceptual load effect on memory accuracy. These results have implications for eyewitness memory researchers and forensic professionals.

Mechanism of Perceptual Attention

National Research Council Canada - National Science Library

Lu, Zhong-Lin

2000-01-01

.... Attention may affect the perceived clarity of visual displays and improve performance. In this project, a powerful external noise method was developed to identify and characterize the effect of attention on perceptual performance in visual tasks...

Mechanisms of Perceptual Attention

National Research Council Canada - National Science Library

Dosher, Barbara

2000-01-01

.... Attention may affect the perceived clarity of visual displays and improve performance. In this project, a powerful external noise method was developed to identify and characterize the effect of attention on perceptual performance in visual tasks...

Action video game play facilitates the development of better perceptual templates

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Bejjanki, Vikranth R.; Zhang, Ruyuan; Li, Renjie; Pouget, Alexandre; Green, C. Shawn; Lu, Zhong-Lin; Bavelier, Daphne

2014-01-01

The field of perceptual learning has identified changes in perceptual templates as a powerful mechanism mediating the learning of statistical regularities in our environment. By measuring threshold-vs.-contrast curves using an orientation identification task under varying levels of external noise, the perceptual template model (PTM) allows one to disentangle various sources of signal-to-noise changes that can alter performance. We use the PTM approach to elucidate the mechanism that underlies the wide range of improvements noted after action video game play. We show that action video game players make use of improved perceptual templates compared with nonvideo game players, and we confirm a causal role for action video game play in inducing such improvements through a 50-h training study. Then, by adapting a recent neural model to this task, we demonstrate how such improved perceptual templates can arise from reweighting the connectivity between visual areas. Finally, we establish that action gamers do not enter the perceptual task with improved perceptual templates. Instead, although performance in action gamers is initially indistinguishable from that of nongamers, action gamers more rapidly learn the proper template as they experience the task. Taken together, our results establish for the first time to our knowledge the development of enhanced perceptual templates following action game play. Because such an improvement can facilitate the inference of the proper generative model for the task at hand, unlike perceptual learning that is quite specific, it thus elucidates a general learning mechanism that can account for the various behavioral benefits noted after action game play. PMID:25385590

Action video game play facilitates the development of better perceptual templates.

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Bejjanki, Vikranth R; Zhang, Ruyuan; Li, Renjie; Pouget, Alexandre; Green, C Shawn; Lu, Zhong-Lin; Bavelier, Daphne

2014-11-25

The field of perceptual learning has identified changes in perceptual templates as a powerful mechanism mediating the learning of statistical regularities in our environment. By measuring threshold-vs.-contrast curves using an orientation identification task under varying levels of external noise, the perceptual template model (PTM) allows one to disentangle various sources of signal-to-noise changes that can alter performance. We use the PTM approach to elucidate the mechanism that underlies the wide range of improvements noted after action video game play. We show that action video game players make use of improved perceptual templates compared with nonvideo game players, and we confirm a causal role for action video game play in inducing such improvements through a 50-h training study. Then, by adapting a recent neural model to this task, we demonstrate how such improved perceptual templates can arise from reweighting the connectivity between visual areas. Finally, we establish that action gamers do not enter the perceptual task with improved perceptual templates. Instead, although performance in action gamers is initially indistinguishable from that of nongamers, action gamers more rapidly learn the proper template as they experience the task. Taken together, our results establish for the first time to our knowledge the development of enhanced perceptual templates following action game play. Because such an improvement can facilitate the inference of the proper generative model for the task at hand, unlike perceptual learning that is quite specific, it thus elucidates a general learning mechanism that can account for the various behavioral benefits noted after action game play.

The Role of Perceptual Load in Object Recognition

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Lavie, Nilli; Lin, Zhicheng; Zokaei, Nahid; Thoma, Volker

2009-01-01

Predictions from perceptual load theory (Lavie, 1995, 2005) regarding object recognition across the same or different viewpoints were tested. Results showed that high perceptual load reduces distracter recognition levels despite always presenting distracter objects from the same view. They also showed that the levels of distracter recognition were…

Correlation of the Voice Handicap Index-10 (VHI-10) and Voice-Related Quality of Life (V-RQOL) in patients with dysphonia.

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Romak, Jonathan J; Orbelo, Diana M; Maragos, Nicolas E; Ekbom, Dale C

2014-03-01

This study examines the correlation between two voice-specific patient-reported outcome measures: the Voice Handicap Index-10 (VHI-10) and Voice-Related Quality of Life (V-RQOL). Retrospective chart review. Eight hundred four patients presenting to our voice clinic between May 2009 and August 2011. All patients completed the VHI-10 and V-RQOL in a single sitting. Correlation between the two scales was examined using Spearman rank analysis. Calculated VHI-10 score was derived from V-RQOL score by direct conversion equation and compared with measured VHI-10 score. Receiver Operating Characteristic (ROC) curves were derived for diagnostic groups. Spearman correlation coefficient between the VHI-10 and V-RQOL was -0.91 (P dysphonia (V-RQOL AUC = 0.536 [SE ± 0.026]; VHI-10 AUC = 0.508 [SE ± 0.26]; P = 0.018) groups, with the V-RQOL showing relatively greater sensitivity. The VHI-10 and V-RQOL are highly correlated. However, VHI-10 score cannot be calculated from V-RQOL score using the tested equation. The V-RQOL may be more sensitive than the VHI-10 in detecting the impact of presbyphonia and muscle tension dysphonia. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

Conceptual and Methodological Concerns in the Theory of Perceptual Load

Directory of Open Access Journals (Sweden)

Hanna eBenoni

2013-08-01

Full Text Available The present paper provides a short critical review of the theory of perceptual load. It closely examines the basic tenets and assumptions of the theory and identifies major conceptual and methodological problems that have been largely ignored in the literature. The discussion focuses on problems in the definition of the concept of perceptual load, on the circularity in the characterization and manipulation of perceptual load and the confusion between the concept of perceptual load and its operationalization. The paper also selectively reviews evidence supporting the theory as well as inconsistent evidence which proposed alternative dominant factors influencing the efficacy of attentional selection.

The Role of Perceptual Load in Inattentional Blindness

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Cartwright-Finch, Ula; Lavie, Nilli

2007-01-01

Perceptual load theory offers a resolution to the long-standing early vs. late selection debate over whether task-irrelevant stimuli are perceived, suggesting that irrelevant perception depends upon the perceptual load of task-relevant processing. However, previous evidence for this theory has relied on RTs and neuroimaging. Here we tested the…

Attentional sets influence perceptual load effects, but not dilution effects.

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Benoni, Hanna; Zivony, Alon; Tsal, Yehoshua

2014-01-01

Perceptual load theory [Lavie, N. (1995). Perceptual load as a necessary condition for selective attention. Journal of Experimental Psychology: Human Perception and Performance, 21, 451-468.; Lavie, N., & Tsal, Y. (1994) Perceptual load as a major determinant of the locus of selection in visual attention. Perception & Psychophysics, 56, 183-197.] proposes that interference from distractors can only be avoided in situations of high perceptual load. This theory has been supported by blocked design manipulations separating low load (when the target appears alone) and high load (when the target is embedded among neutral letters). Tsal and Benoni [(2010a). Diluting the burden of load: Perceptual load effects are simply dilution effects. Journal of Experimental Psychology: Human Perception and Performance, 36, 1645-1656.; Benoni, H., & Tsal, Y. (2010). Where have we gone wrong? Perceptual load does not affect selective attention. Vision Research, 50, 1292-1298.] have recently shown that these manipulations confound perceptual load with "dilution" (the mere presence of additional heterogeneous items in high-load situations). Theeuwes, Kramer, and Belopolsky [(2004). Attentional set interacts with perceptual load in visual search. Psychonomic Bulletin & Review, 11, 697-702.] independently questioned load theory by suggesting that attentional sets might also affect distractor interference. When high load and low load were intermixed, and participants could not prepare for the presentation that followed, both the low-load and high-load trials showed distractor interference. This result may also challenge the dilution account, which proposes a stimulus-driven mechanism. In the current study, we presented subjects with both fixed and mixed blocks, including a mix of dilution trials with low-load trials and with high-load trials. We thus separated the effect of dilution from load and tested the influence of attentional sets on each component. The results revealed that whereas

Minimalist approach to perceptual interactions.

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Lenay, Charles; Stewart, John

2012-01-01

WORK AIMED AT STUDYING SOCIAL COGNITION IN AN INTERACTIONIST PERSPECTIVE OFTEN ENCOUNTERS SUBSTANTIAL THEORETICAL AND METHODOLOGICAL DIFFICULTIES: identifying the significant behavioral variables; recording them without disturbing the interaction; and distinguishing between: (a) the necessary and sufficient contributions of each individual partner for a collective dynamics to emerge; (b) features which derive from this collective dynamics and escape from the control of the individual partners; and (c) the phenomena arising from this collective dynamics which are subsequently appropriated and used by the partners. We propose a minimalist experimental paradigm as a basis for this conceptual discussion: by reducing the sensory inputs to a strict minimum, we force a spatial and temporal deployment of the perceptual activities, which makes it possible to obtain a complete recording and control of the dynamics of interaction. After presenting the principles of this minimalist approach to perception, we describe a series of experiments on two major questions in social cognition: recognizing the presence of another intentional subject; and phenomena of imitation. In both cases, we propose explanatory schema which render an interactionist approach to social cognition clear and explicit. Starting from our earlier work on perceptual crossing we present a new experiment on the mechanisms of reciprocal recognition of the perceptual intentionality of the other subject: the emergent collective dynamics of the perceptual crossing can be appropriated by each subject. We then present an experimental study of opaque imitation (when the subjects cannot see what they themselves are doing). This study makes it possible to characterize what a properly interactionist approach to imitation might be. In conclusion, we draw on these results, to show how an interactionist approach can contribute to a fully social approach to social cognition.

Aerodynamic profiles of women with muscle tension dysphonia/aphonia.

Science.gov (United States)

Gillespie, Amanda I; Gartner-Schmidt, Jackie; Rubinstein, Elaine N; Abbott, Katherine Verdolini

2013-04-01

In this study, the authors aimed to (a) determine whether phonatory airflows and estimated subglottal pressures (est-Psub) for women with primary muscle tension dysphonia/aphonia (MTD/A) differ from those for healthy speakers; (b) identify different aerodynamic profile patterns within the MTD/A subject group; and (c) determine whether results suggest new understanding of pathogenesis in MTD/A. Retrospective review of aerodynamic data collected from 90 women at the time of primary MTD/A diagnosis. Aerodynamic profiles were significantly different for women with MTD/A as compared with healthy speakers. Five distinct profiles were identified: (a) normal flow, normal est-Psub; (b) high flow, high est-Psub; (c) low flow, normal est-Psub; (d) normal flow, high est-Psub; and (e) high flow, normal est-Psub. This study is the first to identify distinct subgroups of aerodynamic profiles in women with MTD/A and to quantitatively identify a clinical phenomenon sometimes described in association with it-"breath holding"-that is shown by low airflow with normal est-Psub. Results were consistent with clinical claims that diverse respiratory and laryngeal functions may underlie phonatory patterns associated with MTD/A. One potential mechanism, based in psychobiological theory, is introduced to explain some of the variability in aerodynamic profiles of women with MTD/A.

Effects of regular aerobic exercise on visual perceptual learning.

Science.gov (United States)

Connell, Charlotte J W; Thompson, Benjamin; Green, Hayden; Sullivan, Rachel K; Gant, Nicholas

2017-12-02

This study investigated the influence of five days of moderate intensity aerobic exercise on the acquisition and consolidation of visual perceptual learning using a motion direction discrimination (MDD) task. The timing of exercise relative to learning was manipulated by administering exercise either before or after perceptual training. Within a matched-subjects design, twenty-seven healthy participants (n = 9 per group) completed five consecutive days of perceptual training on a MDD task under one of three interventions: no exercise, exercise before the MDD task, or exercise after the MDD task. MDD task accuracy improved in all groups over the five-day period, but there was a trend for impaired learning when exercise was performed before visual perceptual training. MDD task accuracy (mean ± SD) increased in exercise before by 4.5 ± 6.5%; exercise after by 11.8 ± 6.4%; and no exercise by 11.3 ± 7.2%. All intervention groups displayed similar MDD threshold reductions for the trained and untrained motion axes after training. These findings suggest that moderate daily exercise does not enhance the rate of visual perceptual learning for an MDD task or the transfer of learning to an untrained motion axis. Furthermore, exercise performed immediately prior to a visual perceptual learning task may impair learning. Further research with larger groups is required in order to better understand these effects. Copyright © 2017 Elsevier Ltd. All rights reserved.

Perceptual Biases in Relation to Paranormal and Conspiracy Beliefs.

Science.gov (United States)

van Elk, Michiel

2015-01-01

Previous studies have shown that one's prior beliefs have a strong effect on perceptual decision-making and attentional processing. The present study extends these findings by investigating how individual differences in paranormal and conspiracy beliefs are related to perceptual and attentional biases. Two field studies were conducted in which visitors of a paranormal conducted a perceptual decision making task (i.e. the face/house categorization task; Experiment 1) or a visual attention task (i.e. the global/local processing task; Experiment 2). In the first experiment it was found that skeptics compared to believers more often incorrectly categorized ambiguous face stimuli as representing a house, indicating that disbelief rather than belief in the paranormal is driving the bias observed for the categorization of ambiguous stimuli. In the second experiment, it was found that skeptics showed a classical 'global-to-local' interference effect, whereas believers in conspiracy theories were characterized by a stronger 'local-to-global interference effect'. The present study shows that individual differences in paranormal and conspiracy beliefs are associated with perceptual and attentional biases, thereby extending the growing body of work in this field indicating effects of cultural learning on basic perceptual processes.

Perceptual Biases in Relation to Paranormal and Conspiracy Beliefs.

Directory of Open Access Journals (Sweden)

Michiel van Elk

Full Text Available Previous studies have shown that one's prior beliefs have a strong effect on perceptual decision-making and attentional processing. The present study extends these findings by investigating how individual differences in paranormal and conspiracy beliefs are related to perceptual and attentional biases. Two field studies were conducted in which visitors of a paranormal conducted a perceptual decision making task (i.e. the face/house categorization task; Experiment 1 or a visual attention task (i.e. the global/local processing task; Experiment 2. In the first experiment it was found that skeptics compared to believers more often incorrectly categorized ambiguous face stimuli as representing a house, indicating that disbelief rather than belief in the paranormal is driving the bias observed for the categorization of ambiguous stimuli. In the second experiment, it was found that skeptics showed a classical 'global-to-local' interference effect, whereas believers in conspiracy theories were characterized by a stronger 'local-to-global interference effect'. The present study shows that individual differences in paranormal and conspiracy beliefs are associated with perceptual and attentional biases, thereby extending the growing body of work in this field indicating effects of cultural learning on basic perceptual processes.

Biased and unbiased perceptual decision-making on vocal emotions.

Science.gov (United States)

Dricu, Mihai; Ceravolo, Leonardo; Grandjean, Didier; Frühholz, Sascha

2017-11-24

Perceptual decision-making on emotions involves gathering sensory information about the affective state of another person and forming a decision on the likelihood of a particular state. These perceptual decisions can be of varying complexity as determined by different contexts. We used functional magnetic resonance imaging and a region of interest approach to investigate the brain activation and functional connectivity behind two forms of perceptual decision-making. More complex unbiased decisions on affective voices recruited an extended bilateral network consisting of the posterior inferior frontal cortex, the orbitofrontal cortex, the amygdala, and voice-sensitive areas in the auditory cortex. Less complex biased decisions on affective voices distinctly recruited the right mid inferior frontal cortex, pointing to a functional distinction in this region following decisional requirements. Furthermore, task-induced neural connectivity revealed stronger connections between these frontal, auditory, and limbic regions during unbiased relative to biased decision-making on affective voices. Together, the data shows that different types of perceptual decision-making on auditory emotions have distinct patterns of activations and functional coupling that follow the decisional strategies and cognitive mechanisms involved during these perceptual decisions.

Cognitive-perceptual examination of remediation approaches to hypokinetic dysarthria.

Science.gov (United States)

McAuliffe, Megan J; Kerr, Sarah E; Gibson, Elizabeth M R; Anderson, Tim; LaShell, Patrick J

2014-08-01

To determine how increased vocal loudness and reduced speech rate affect listeners' cognitive-perceptual processing of hypokinetic dysarthric speech associated with Parkinson's disease. Fifty-one healthy listener participants completed a speech perception experiment. Listeners repeated phrases produced by 5 individuals with dysarthria across habitual, loud, and slow speaking modes. Listeners were allocated to habitual ( n = 17), loud ( n = 17), or slow ( n = 17) experimental conditions. Transcripts derived from the phrase repetition task were coded for overall accuracy (i.e., intelligibility), and perceptual error analyses examined how these conditions affected listeners' phonemic mapping (i.e., syllable resemblance) and lexical segmentation (i.e., lexical boundary error analysis). Both speech conditions provided obvious perceptual benefits to listeners. Overall, transcript accuracy was highest in the slow condition. In the loud condition, however, improvement was evidenced across the experiment. An error analysis suggested that listeners in the loud condition prioritized acoustic-phonetic cues in their attempts to resolve the degraded signal, whereas those in the slow condition appeared to preferentially weight lexical stress cues. Increased loudness and reduced rate exhibited differential effects on listeners' perceptual processing of dysarthric speech. The current study highlights the insights that may be gained from a cognitive-perceptual approach.

Perceptual learning in children with visual impairment improves near visual acuity.

Science.gov (United States)

Huurneman, Bianca; Boonstra, F Nienke; Cox, Ralf F A; van Rens, Ger; Cillessen, Antonius H N

2013-09-17

This study investigated whether visual perceptual learning can improve near visual acuity and reduce foveal crowding effects in four- to nine-year-old children with visual impairment. Participants were 45 children with visual impairment and 29 children with normal vision. Children with visual impairment were divided into three groups: a magnifier group (n = 12), a crowded perceptual learning group (n = 18), and an uncrowded perceptual learning group (n = 15). Children with normal vision also were divided in three groups, but were measured only at baseline. Dependent variables were single near visual acuity (NVA), crowded NVA, LH line 50% crowding NVA, number of trials, accuracy, performance time, amount of small errors, and amount of large errors. Children with visual impairment trained during six weeks, two times per week, for 30 minutes (12 training sessions). After training, children showed significant improvement of NVA in addition to specific improvements on the training task. The crowded perceptual learning group showed the largest acuity improvements (1.7 logMAR lines on the crowded chart, P children in the crowded perceptual learning group showed improvements on all NVA charts. Children with visual impairment benefit from perceptual training. While task-specific improvements were observed in all training groups, transfer to crowded NVA was largest in the crowded perceptual learning group. To our knowledge, this is the first study to provide evidence for the improvement of NVA by perceptual learning in children with visual impairment. (http://www.trialregister.nl number, NTR2537.).

Visible digital watermarking system using perceptual models

Science.gov (United States)

Cheng, Qiang; Huang, Thomas S.

2001-03-01

This paper presents a visible watermarking system using perceptual models. %how and why A watermark image is overlaid translucently onto a primary image, for the purposes of immediate claim of copyright, instantaneous recognition of owner or creator, or deterrence to piracy of digital images or video. %perceptual The watermark is modulated by exploiting combined DCT-domain and DWT-domain perceptual models. % so that the watermark is visually uniform. The resulting watermarked image is visually pleasing and unobtrusive. The location, size and strength of the watermark vary randomly with the underlying image. The randomization makes the automatic removal of the watermark difficult even though the algorithm is known publicly but the key to the random sequence generator. The experiments demonstrate that the watermarked images have pleasant visual effect and strong robustness. The watermarking system can be used in copyright notification and protection.

A new method for mapping perceptual biases across visual space.

Science.gov (United States)

Finlayson, Nonie J; Papageorgiou, Andriani; Schwarzkopf, D Samuel

2017-08-01

How we perceive the environment is not stable and seamless. Recent studies found that how a person qualitatively experiences even simple visual stimuli varies dramatically across different locations in the visual field. Here we use a method we developed recently that we call multiple alternatives perceptual search (MAPS) for efficiently mapping such perceptual biases across several locations. This procedure reliably quantifies the spatial pattern of perceptual biases and also of uncertainty and choice. We show that these measurements are strongly correlated with those from traditional psychophysical methods and that exogenous attention can skew biases without affecting overall task performance. Taken together, MAPS is an efficient method to measure how an individual's perceptual experience varies across space.

Stimulus recognition occurs under high perceptual load: Evidence from correlated flankers.

Science.gov (United States)

Cosman, Joshua D; Mordkoff, J Toby; Vecera, Shaun P

2016-12-01

A dominant account of selective attention, perceptual load theory, proposes that when attentional resources are exhausted, task-irrelevant information receives little attention and goes unrecognized. However, the flanker effect-typically used to assay stimulus identification-requires an arbitrary mapping between a stimulus and a response. We looked for failures of flanker identification by using a more-sensitive measure that does not require arbitrary stimulus-response mappings: the correlated flankers effect. We found that flanking items that were task-irrelevant but that correlated with target identity produced a correlated flanker effect. Participants were faster on trials in which the irrelevant flanker had previously correlated with the target than when it did not. Of importance, this correlated flanker effect appeared regardless of perceptual load, occurring even in high-load displays that should have abolished flanker identification. Findings from a standard flanker task replicated the basic perceptual load effect, with flankers not affecting response times under high perceptual load. Our results indicate that task-irrelevant information can be processed to a high level (identification), even under high perceptual load. This challenges a strong account of high perceptual load effects that hypothesizes complete failures of stimulus identification under high perceptual load. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Perceptual Load Affects Eyewitness Accuracy and Susceptibility to Leading Questions.

Science.gov (United States)

Murphy, Gillian; Greene, Ciara M

2016-01-01

Load Theory (Lavie, 1995, 2005) states that the level of perceptual load in a task (i.e., the amount of information involved in processing task-relevant stimuli) determines the efficiency of selective attention. There is evidence that perceptual load affects distractor processing, with increased inattentional blindness under high load. Given that high load can result in individuals failing to report seeing obvious objects, it is conceivable that load may also impair memory for the scene. The current study is the first to assess the effect of perceptual load on eyewitness memory. Across three experiments (two video-based and one in a driving simulator), the effect of perceptual load on eyewitness memory was assessed. The results showed that eyewitnesses were less accurate under high load, in particular for peripheral details. For example, memory for the central character in the video was not affected by load but memory for a witness who passed by the window at the edge of the scene was significantly worse under high load. High load memories were also more open to suggestion, showing increased susceptibility to leading questions. High visual perceptual load also affected recall for auditory information, illustrating a possible cross-modal perceptual load effect on memory accuracy. These results have implications for eyewitness memory researchers and forensic professionals.

Dual mechanisms governing reward-driven perceptual learning [version 1; referees: 2 approved

Directory of Open Access Journals (Sweden)

Dongho Kim

2015-09-01

Full Text Available In this review, we explore how reward signals shape perceptual learning in animals and humans. Perceptual learning is the well-established phenomenon by which extensive practice elicits selective improvement in one’s perceptual discrimination of basic visual features, such as oriented lines or moving stimuli. While perceptual learning has long been thought to rely on ‘top-down’ processes, such as attention and decision-making, a wave of recent findings suggests that these higher-level processes are, in fact, not necessary.  Rather, these recent findings indicate that reward signals alone, in the absence of the contribution of higher-level cognitive processes, are sufficient to drive the benefits of perceptual learning. Here, we will review the literature tying reward signals to perceptual learning. Based on these findings, we propose dual underlying mechanisms that give rise to perceptual learning: one mechanism that operates ‘automatically’ and is tied directly to reward signals, and another mechanism that involves more ‘top-down’, goal-directed computations.

Perceptual biases in relation to paranormal and conspiracy beliefs

NARCIS (Netherlands)

van Elk, M.

2015-01-01

Previous studies have shown that one’s prior beliefs have a strong effect on perceptual decision-making and attentional processing. The present study extends these findings by investigating how individual differences in paranormal and conspiracy beliefs are related to perceptual and attentional

Is Hand Selection Modulated by Cognitive-perceptual Load?

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Liang, Jiali; Wilkinson, Krista; Sainburg, Robert L

2018-01-15

Previous studies proposed that selecting which hand to use for a reaching task appears to be modulated by a factor described as "task difficulty". However, what features of a task might contribute to greater or lesser "difficulty" in the context of hand selection decisions has yet to be determined. There has been evidence that biomechanical and kinematic factors such as movement smoothness and work can predict patterns of selection across the workspace, suggesting a role of predictive cost analysis in hand-selection. We hypothesize that this type of prediction for hand-selection should recruit substantial cognitive resources and thus should be influenced by cognitive-perceptual loading. We test this hypothesis by assessing the role of cognitive-perceptual loading on hand selection decisions, using a visual search task that presents different levels of difficulty (cognitive-perceptual load), as established in previous studies on overall response time and efficiency of visual search. Although the data are necessarily preliminary due to small sample size, our data suggested an influence of cognitive-perceptual load on hand selection, such that the dominant hand was selected more frequently as cognitive load increased. Interestingly, cognitive-perceptual loading also increased cross-midline reaches with both hands. Because crossing midline is more costly in terms of kinematic and kinetic factors, our findings suggest that cognitive processes are normally engaged to avoid costly actions, and that the choice not-to-cross midline requires cognitive resources. Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.

Adherence to Voice Therapy Recommendations Is Associated With Preserved Employment Fitness Among Teachers With Work-Related Dysphonia.

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Rinsky-Halivni, Lilah; Klebanov, Miriam; Lerman, Yehuda; Paltiel, Ora

2017-05-01

Referral to voice therapy and recommendations for voice rest and microphone use are common interventions in occupational medicine aimed at preserving the working capability of teachers with occupation-related voice problems. Research on the impact of such interventions in terms of employment is lacking. This study examined changes in fitness (ie, ability) to work of dysphonic teachers referred to an occupational clinic and evaluated employment outcomes following voice therapy, voice rest, and microphone use. A historical prospective study was carried out. Of 365 classroom teachers who were first referred to a regional occupational medicine clinic due to dysphonia between January 2007 and December 2012, 156 were sampled and 153 were followed-up for an average of 5 years (range 2-8). Data were collected from medical records and from interviews conducted in 2014 aimed at assessing employment status. Logistic regression models were used to assess associations between interventions and employment outcomes. Survival analyses were performed to evaluate the association between participating in voice therapy and length of retained employment fitness. Thirty-four (22.2%) teachers suffered declines in working capabilities due to dysphonia. Voice therapy was demonstrated as being a protective factor against such declines (odds ratio = 0.05 [0.01-0.27]). Adherence to recommendation of voice therapy was teachers occurred within 20 months after referral. Unlike voice therapy, voice rest and microphone use were not associated with retention of working capabilities. Voice therapy, especially when instituted early, is a strong predictor for retaining fitness for employment among dysphonic teachers. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Limited Cognitive Resources Explain a Trade-Off between Perceptual and Metacognitive Vigilance.

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Maniscalco, Brian; McCurdy, Li Yan; Odegaard, Brian; Lau, Hakwan

2017-02-01

Why do experimenters give subjects short breaks in long behavioral experiments? Whereas previous studies suggest it is difficult to maintain attention and vigilance over long periods of time, it is unclear precisely what mechanisms benefit from rest after short experimental blocks. Here, we evaluate decline in both perceptual performance and metacognitive sensitivity (i.e., how well confidence ratings track perceptual decision accuracy) over time and investigate whether characteristics of prefrontal cortical areas correlate with these measures. Whereas a single-process signal detection model predicts that these two forms of fatigue should be strongly positively correlated, a dual-process model predicts that rates of decline may dissociate. Here, we show that these measures consistently exhibited negative or near-zero correlations, as if engaged in a trade-off relationship, suggesting that different mechanisms contribute to perceptual and metacognitive decisions. Despite this dissociation, the two mechanisms likely depend on common resources, which could explain their trade-off relationship. Based on structural MRI brain images of individual human subjects, we assessed gray matter volume in the frontal polar area, a region that has been linked to visual metacognition. Variability of frontal polar volume correlated with individual differences in behavior, indicating the region may play a role in supplying common resources for both perceptual and metacognitive vigilance. Additional experiments revealed that reduced metacognitive demand led to superior perceptual vigilance, providing further support for this hypothesis. Overall, results indicate that during breaks between short blocks, it is the higher-level perceptual decision mechanisms, rather than lower-level sensory machinery, that benefit most from rest. Perceptual task performance declines over time (the so-called vigilance decrement), but the relationship between vigilance in perception and metacognition has

Can Attention be Divided Between Perceptual Groups?

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McCann, Robert S.; Foyle, David C.; Johnston, James C.; Hart, Sandra G. (Technical Monitor)

1994-01-01

Previous work using Head-Up Displays (HUDs) suggests that the visual system parses the HUD and the outside world into distinct perceptual groups, with attention deployed sequentially to first one group and then the other. New experiments show that both groups can be processed in parallel in a divided attention search task, even though subjects have just processed a stimulus in one perceptual group or the other. Implications for models of visual attention will be discussed.

Perceptual and Cognitive Impairments and Driving

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Korner-Bitensky, Nicol; Coopersmith, Henry; Mayo, Nancy; Leblanc, Ginette; Kaizer, Franceen

1990-01-01

Perceptual and cognitive disorders that frequently accompany stroke and head injury influence an individual's ability to drive a motor vehicle. Canadian physicians are legally responsible for identifying patients who are potentially unsafe to drive and, if they fail to do so, may be held liable in a civil action suit. The authors review the guidelines for physicians evaluating a patient's fitness to drive after brain injury. They also examine the actions a physician should take when a patient with perceptual and cognitive problems wants to drive. Ultimately, by taking these actions, physicians will help to prevent driving accidents. PMID:21234047

Perceptual-motor functioning in children with phenylketonuria.

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Koff, E; Boyle, P; Pueschel, S M

1977-10-01

Children with treated phenylketonuria (PKU) have been described as being at high risk for perceptual-motor dysfunction. In this study, the Wechsler Intelligence Scale for Children (WISC) and the Bender Gestalt test were administered to 19 school age children with treated PKU and of average intelligence who have been off diet from five months to six years four months. Perceptual-motor performance was evaluated, and school functioning was rated by classroom teachers. Substantial impairment of perceptual-motor functioning as measured by the Bender Gestalt test and lower WISC performance IQs than verbal IQs were observed in children of average intelligence. Quality of dietary control was found to be associated with performance on the Bender Gestalt test. These findings suggest the possibility of a specific deficit that could seriously interfere with academic progress, but which is not signalled by obvious impairment of overall intellectual functioning.

A visual perceptual descriptor with depth feature for image retrieval

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Wang, Tianyang; Qin, Zhengrui

2017-07-01

This paper proposes a visual perceptual descriptor (VPD) and a new approach to extract perceptual depth feature for 2D image retrieval. VPD mimics human visual system, which can easily distinguish regions that have different textures, whereas for regions which have similar textures, color features are needed for further differentiation. We apply VPD on the gradient direction map of an image, capture texture-similar regions to generate a VPD map. We then impose the VPD map on a quantized color map and extract color features only from the overlapped regions. To reflect the nature of perceptual distance in single 2D image, we propose and extract the perceptual depth feature by computing the nuclear norm of the sparse depth map of an image. Extracted color features and the perceptual depth feature are both incorporated to a feature vector, we utilize this vector to represent an image and measure similarity. We observe that the proposed VPD + depth method achieves a promising result, and extensive experiments prove that it outperforms other typical methods on 2D image retrieval.

Human visual perceptual organization beats thinking on speed.

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van der Helm, Peter A

2017-05-01

What is the degree to which knowledge influences visual perceptual processes? This question, which is central to the seeing-versus-thinking debate in cognitive science, is often discussed using examples claimed to be proof of one stance or another. It has, however, also been muddled by the usage of different and unclear definitions of perception. Here, for the well-defined process of perceptual organization, I argue that including speed (or efficiency) into the equation opens a new perspective on the limits of top-down influences of thinking on seeing. While the input of the perceptual organization process may be modifiable and its output enrichable, the process itself seems so fast (or efficient) that thinking hardly has time to intrude and is effective mostly after the fact.

Effect of perceptual load on conceptual processing: an extension of Vermeulen's theory.

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Xie, Jiushu; Wang, Ruiming; Sun, Xun; Chang, Song

2013-10-01

The effect of color and shape load on conceptual processing was studied. Perceptual load effects have been found in visual and auditory conceptual processing, supporting the theory of embodied cognition. However, whether different types of visual concepts, such as color and shape, share the same perceptual load effects is unknown. In the current experiment, 32 participants were administered simultaneous perceptual and conceptual tasks to assess the relation between perceptual load and conceptual processing. Keeping color load in mind obstructed color conceptual processing. Hence, perceptual processing and conceptual load shared the same resources, suggesting embodied cognition. Color conceptual processing was not affected by shape pictures, indicating that different types of properties within vision were separate.

First-Hand Accounts of Sensory Perceptual Experiences in Autism: A Qualitative Analysis.

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Jones, Robert S. P.; Quigney, Ciara; Huws, Jaci C.

2003-01-01

Five first-hand Web page accounts of unusual sensory perceptual experiences written by persons with high-functioning autism were selected for qualitative analysis. Four core categories emerged: turbulent sensory perceptual experiences; coping mechanisms; enjoyable sensory perceptual experiences; and awareness of being different, suggesting they…

Consensus paper: the role of the cerebellum in perceptual processes.

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Baumann, Oliver; Borra, Ronald J; Bower, James M; Cullen, Kathleen E; Habas, Christophe; Ivry, Richard B; Leggio, Maria; Mattingley, Jason B; Molinari, Marco; Moulton, Eric A; Paulin, Michael G; Pavlova, Marina A; Schmahmann, Jeremy D; Sokolov, Arseny A

2015-04-01

Various lines of evidence accumulated over the past 30 years indicate that the cerebellum, long recognized as essential for motor control, also has considerable influence on perceptual processes. In this paper, we bring together experts from psychology and neuroscience, with the aim of providing a succinct but comprehensive overview of key findings related to the involvement of the cerebellum in sensory perception. The contributions cover such topics as anatomical and functional connectivity, evolutionary and comparative perspectives, visual and auditory processing, biological motion perception, nociception, self-motion, timing, predictive processing, and perceptual sequencing. While no single explanation has yet emerged concerning the role of the cerebellum in perceptual processes, this consensus paper summarizes the impressive empirical evidence on this problem and highlights diversities as well as commonalities between existing hypotheses. In addition to work with healthy individuals and patients with cerebellar disorders, it is also apparent that several neurological conditions in which perceptual disturbances occur, including autism and schizophrenia, are associated with cerebellar pathology. A better understanding of the involvement of the cerebellum in perceptual processes will thus likely be important for identifying and treating perceptual deficits that may at present go unnoticed and untreated. This paper provides a useful framework for further debate and empirical investigations into the influence of the cerebellum on sensory perception.

Selective Attention to Perceptual Dimensions and Switching between Dimensions

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Meiran, Nachshon; Dimov, Eduard; Ganel, Tzvi

2013-01-01

In the present experiments, the question being addressed was whether switching attention between perceptual dimensions and selective attention to dimensions are processes that compete over a common resource? Attention to perceptual dimensions is usually studied by requiring participants to ignore a never-relevant dimension. Selection failure…

Multivoxel neurofeedback selectively modulates confidence without changing perceptual performance

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Cortese, Aurelio; Amano, Kaoru; Koizumi, Ai; Kawato, Mitsuo; Lau, Hakwan

2016-01-01

A central controversy in metacognition studies concerns whether subjective confidence directly reflects the reliability of perceptual or cognitive processes, as suggested by normative models based on the assumption that neural computations are generally optimal. This view enjoys popularity in the computational and animal literatures, but it has also been suggested that confidence may depend on a late-stage estimation dissociable from perceptual processes. Yet, at least in humans, experimental tools have lacked the power to resolve these issues convincingly. Here, we overcome this difficulty by using the recently developed method of decoded neurofeedback (DecNef) to systematically manipulate multivoxel correlates of confidence in a frontoparietal network. Here we report that bi-directional changes in confidence do not affect perceptual accuracy. Further psychophysical analyses rule out accounts based on simple shifts in reporting strategy. Our results provide clear neuroscientific evidence for the systematic dissociation between confidence and perceptual performance, and thereby challenge current theoretical thinking. PMID:27976739

Perceptual processing during trauma, priming and the development of intrusive memories

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Sündermann, Oliver; Hauschildt, Marit; Ehlers, Anke

2013-01-01

Background Intrusive reexperiencing in posttraumatic stress disorder (PTSD) is commonly triggered by stimuli with perceptual similarity to those present during the trauma. Information processing theories suggest that perceptual processing during the trauma and enhanced perceptual priming contribute to the easy triggering of intrusive memories by these cues. Methods Healthy volunteers (N = 51) watched neutral and trauma picture stories on a computer screen. Neutral objects that were unrelated to the content of the stories briefly appeared in the interval between the pictures. Dissociation and data-driven processing (as indicators of perceptual processing) and state anxiety during the stories were assessed with self-report questionnaires. After filler tasks, participants completed a blurred object identification task to assess priming and a recognition memory task. Intrusive memories were assessed with telephone interviews 2 weeks and 3 months later. Results Neutral objects were more strongly primed if they occurred in the context of trauma stories than if they occurred during neutral stories, although the effect size was only moderate (ηp2=.08) and only significant when trauma stories were presented first. Regardless of story order, enhanced perceptual priming predicted intrusive memories at 2-week follow-up (N = 51), but not at 3 months (n = 40). Data-driven processing, dissociation and anxiety increases during the trauma stories also predicted intrusive memories. Enhanced perceptual priming and data-driven processing were associated with lower verbal intelligence. Limitations It is unclear to what extent these findings generalize to real-life traumatic events and whether they are specific to negative emotional events. Conclusions The results provide some support for the role of perceptual processing and perceptual priming in reexperiencing symptoms. PMID:23207970

The Spatial Focus of Attention Is Controlled at Perceptual and Cognitive Levels

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Caparos, Serge; Linnell, Karina J.

2010-01-01

Selective attention has been hypothesized to reduce distractor interference at both perceptual and postperceptual levels (Lavie, 2005), respectively, by focusing perceptual resources on the attended location and by blocking at postperceptual levels distractors that survive perceptual selection. This study measured the impact of load on these…

Varieties of perceptual learning.

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Mackintosh, N J

2009-05-01

Although most studies of perceptual learning in human participants have concentrated on the changes in perception assumed to be occurring, studies of nonhuman animals necessarily measure discrimination learning and generalization and remain agnostic on the question of whether changes in behavior reflect changes in perception. On the other hand, animal studies do make it easier to draw a distinction between supervised and unsupervised learning. Differential reinforcement will surely teach animals to attend to some features of a stimulus array rather than to others. But it is an open question as to whether such changes in attention underlie the enhanced discrimination seen after unreinforced exposure to such an array. I argue that most instances of unsupervised perceptual learning observed in animals (and at least some in human animals) are better explained by appeal to well-established principles and phenomena of associative learning theory: excitatory and inhibitory associations between stimulus elements, latent inhibition, and habituation.

Perceptual Specificity Effects in Rereading: Evidence from Eye Movements

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Sheridan, Heather; Reingold, Eyal M.

2012-01-01

The present experiments examined perceptual specificity effects using a rereading paradigm. Eye movements were monitored while participants read the same target word twice, in two different low-constraint sentence frames. The congruency of perceptual processing was manipulated by either presenting the target word in the same distortion typography…

Perceptual maps: the good, the bad and the ugly

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J.C. Gower (John); P.J.F. Groenen (Patrick); M. van de Velden (Michel); K. Vines (Karen)

2010-01-01

textabstractPerceptual maps are often used in marketing to visually study relations between two or more attributes. However, in many perceptual maps published in the recent literature it remains unclear what is being shown and how the relations between the points in the map can be interpreted or

Constructing knowledge through perceptual processes in making craft-art

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Milla Ojala

2013-10-01

Full Text Available The focus of the study is on the knowledge that is constructed through perceptual processes during craft making in the context of the Finnish Basic Education in the Arts (BEA system. Craft studies in the BEA are defined as craft-art. The research method used is the grounded theory. The data consists of seven interviews and participant observations. Participants in the study are adolescents who study craft-art in the BEA system in Visual Art School, Aimo in Hämeenlinna. The aim of the article is to present, define and reflect on the concepts, properties and dimensions concerning perceptual processes that are discovered in this stage of the study following grounded theory procedures. The perceptual processes are an essential means of constructing knowledge in craft-art. Consequently, one aim of the study is to discuss how these processes are connected to various types of knowledge. The perceptual processes are described by seven concepts: imitative, anticipative, evaluative, experimental, emotional, temporal and bodily perceptions. They indicate on a conceptual level the characteristic of knowledge constructed through perceptual processes in craft-art. Further, theconcepts have several properties that can vary dimensionally between two qualities. The properties are activity, function and position. The dimensions of the properties vary from active to passive, formal to informal and internal to external. In conclusion, the concepts can describe a large range of incidents in different situations. They also seem to describe well the practice of  craft-art and there are several connections with pre-existing concepts of knowledge.Keywords: Craft, Knowledge, Perceptual process, Basic Education in the Arts, Grounded Theory 

Perceptual distortion analysis of color image VQ-based coding

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Charrier, Christophe; Knoblauch, Kenneth; Cherifi, Hocine

1997-04-01

It is generally accepted that a RGB color image can be easily encoded by using a gray-scale compression technique on each of the three color planes. Such an approach, however, fails to take into account correlations existing between color planes and perceptual factors. We evaluated several linear and non-linear color spaces, some introduced by the CIE, compressed with the vector quantization technique for minimum perceptual distortion. To study these distortions, we measured contrast and luminance of the video framebuffer, to precisely control color. We then obtained psychophysical judgements to measure how well these methods work to minimize perceptual distortion in a variety of color space.

Mid-level perceptual features distinguish objects of different real-world sizes.

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Long, Bria; Konkle, Talia; Cohen, Michael A; Alvarez, George A

2016-01-01

Understanding how perceptual and conceptual representations are connected is a fundamental goal of cognitive science. Here, we focus on a broad conceptual distinction that constrains how we interact with objects--real-world size. Although there appear to be clear perceptual correlates for basic-level categories (apples look like other apples, oranges look like other oranges), the perceptual correlates of broader categorical distinctions are largely unexplored, i.e., do small objects look like other small objects? Because there are many kinds of small objects (e.g., cups, keys), there may be no reliable perceptual features that distinguish them from big objects (e.g., cars, tables). Contrary to this intuition, we demonstrated that big and small objects have reliable perceptual differences that can be extracted by early stages of visual processing. In a series of visual search studies, participants found target objects faster when the distractor objects differed in real-world size. These results held when we broadly sampled big and small objects, when we controlled for low-level features and image statistics, and when we reduced objects to texforms--unrecognizable textures that loosely preserve an object's form. However, this effect was absent when we used more basic textures. These results demonstrate that big and small objects have reliably different mid-level perceptual features, and suggest that early perceptual information about broad-category membership may influence downstream object perception, recognition, and categorization processes. (c) 2015 APA, all rights reserved).

Perceptual Learning: 12-Month-Olds' Discrimination of Monkey Faces

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Fair, Joseph; Flom, Ross; Jones, Jacob; Martin, Justin

2012-01-01

Six-month-olds reliably discriminate different monkey and human faces whereas 9-month-olds only discriminate different human faces. It is often falsely assumed that perceptual narrowing reflects a permanent change in perceptual abilities. In 3 experiments, ninety-six 12-month-olds' discrimination of unfamiliar monkey faces was examined. Following…

Perceptual consciousness overflows cognitive access.

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Block, Ned

2011-12-01

One of the most important issues concerning the foundations of conscious perception centers on the question of whether perceptual consciousness is rich or sparse. The overflow argument uses a form of 'iconic memory' to argue that perceptual consciousness is richer (i.e., has a higher capacity) than cognitive access: when observing a complex scene we are conscious of more than we can report or think about. Recently, the overflow argument has been challenged both empirically and conceptually. This paper reviews the controversy, arguing that proponents of sparse perception are committed to the postulation of (i) a peculiar kind of generic conscious representation that has no independent rationale and (ii) an unmotivated form of unconscious representation that in some cases conflicts with what we know about unconscious representation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Out of mind, out of sight: perceptual consequences of memory suppression.

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Kim, Kyungmi; Yi, Do-Joon

2013-04-01

In the present study, the effect of memory suppression on subsequent perceptual processing of visual objects was examined within a modified think/no-think paradigm. Suppressing memories of visual objects significantly impaired subsequent perceptual identification of those objects when they were briefly encountered (Experiment 1) and when they were presented in noise (Experiment 2), relative to performance on baseline items for which participants did not undergo suppression training. However, in Experiment 3, when perceptual identification was performed on mirror-reversed images of to-be-suppressed objects, no impairment was observed. These findings, analogous to those showing forgetting of suppressed words in long-term memory, suggest that suppressing memories of visual objects might be mediated by direct inhibition of perceptual representations, which, in turn, impairs later perception of them. This study provides strong support for the role of inhibitory mechanisms in memory control and suggests a tight link between higher-order cognitive operations and perceptual processing.

Autism-specific covariation in perceptual performances: "g" or "p" factor?

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Meilleur, Andrée-Anne S; Berthiaume, Claude; Bertone, Armando; Mottron, Laurent

2014-01-01

Autistic perception is characterized by atypical and sometimes exceptional performance in several low- (e.g., discrimination) and mid-level (e.g., pattern matching) tasks in both visual and auditory domains. A factor that specifically affects perceptive abilities in autistic individuals should manifest as an autism-specific association between perceptual tasks. The first purpose of this study was to explore how perceptual performances are associated within or across processing levels and/or modalities. The second purpose was to determine if general intelligence, the major factor that accounts for covariation in task performances in non-autistic individuals, equally controls perceptual abilities in autistic individuals. We asked 46 autistic individuals and 46 typically developing controls to perform four tasks measuring low- or mid-level visual or auditory processing. Intelligence was measured with the Wechsler's Intelligence Scale (FSIQ) and Raven Progressive Matrices (RPM). We conducted linear regression models to compare task performances between groups and patterns of covariation between tasks. The addition of either Wechsler's FSIQ or RPM in the regression models controlled for the effects of intelligence. In typically developing individuals, most perceptual tasks were associated with intelligence measured either by RPM or Wechsler FSIQ. The residual covariation between unimodal tasks, i.e. covariation not explained by intelligence, could be explained by a modality-specific factor. In the autistic group, residual covariation revealed the presence of a plurimodal factor specific to autism. Autistic individuals show exceptional performance in some perceptual tasks. Here, we demonstrate the existence of specific, plurimodal covariation that does not dependent on general intelligence (or "g" factor). Instead, this residual covariation is accounted for by a common perceptual process (or "p" factor), which may drive perceptual abilities differently in autistic and

Autism-specific covariation in perceptual performances: "g" or "p" factor?

Directory of Open Access Journals (Sweden)

Andrée-Anne S Meilleur

Full Text Available Autistic perception is characterized by atypical and sometimes exceptional performance in several low- (e.g., discrimination and mid-level (e.g., pattern matching tasks in both visual and auditory domains. A factor that specifically affects perceptive abilities in autistic individuals should manifest as an autism-specific association between perceptual tasks. The first purpose of this study was to explore how perceptual performances are associated within or across processing levels and/or modalities. The second purpose was to determine if general intelligence, the major factor that accounts for covariation in task performances in non-autistic individuals, equally controls perceptual abilities in autistic individuals.We asked 46 autistic individuals and 46 typically developing controls to perform four tasks measuring low- or mid-level visual or auditory processing. Intelligence was measured with the Wechsler's Intelligence Scale (FSIQ and Raven Progressive Matrices (RPM. We conducted linear regression models to compare task performances between groups and patterns of covariation between tasks. The addition of either Wechsler's FSIQ or RPM in the regression models controlled for the effects of intelligence.In typically developing individuals, most perceptual tasks were associated with intelligence measured either by RPM or Wechsler FSIQ. The residual covariation between unimodal tasks, i.e. covariation not explained by intelligence, could be explained by a modality-specific factor. In the autistic group, residual covariation revealed the presence of a plurimodal factor specific to autism.Autistic individuals show exceptional performance in some perceptual tasks. Here, we demonstrate the existence of specific, plurimodal covariation that does not dependent on general intelligence (or "g" factor. Instead, this residual covariation is accounted for by a common perceptual process (or "p" factor, which may drive perceptual abilities differently in

Neural mechanisms underlying the induction and relief of perceptual curiosity

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Marieke eJepma

2012-02-01

Full Text Available Curiosity is one of the most basic biological drives in both animals and humans, and has been identified as a key motive for learning and discovery. Despite the importance of curiosity and related behaviors, the topic has been largely neglected in human neuroscience; hence little is known about the neurobiological mechanisms underlying curiosity. We used functional magnetic resonance imaging (fMRI to investigate what happens in our brain during the induction and subsequent relief of perceptual curiosity. Our core findings were that (i the induction of perceptual curiosity, through the presentation of ambiguous visual input, activated the anterior insula and anterior cingulate cortex, brain regions sensitive to conflict and arousal; (ii the relief of perceptual curiosity, through visual disambiguation, activated regions of the striatum that have been related to reward processing; and (iii the relief of perceptual curiosity was associated with hippocampal activation and enhanced incidental memory. These findings provide the first demonstration of the neural basis of human perceptual curiosity. Our results provide neurobiological support for a classic psychological theory of curiosity, which holds that curiosity is an aversive condition of increased arousal whose termination is rewarding and facilitates memory.

Perceptual and Cognitive Load Interact to Control the Spatial Focus of Attention

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Linnell, Karina J.; Caparos, Serge

2011-01-01

Caparos and Linnell (2009, 2010) used a variable-separation flanker paradigm to show that (a) when cognitive load is low, increasing perceptual load causes spatial attention to focus and (b) when perceptual load is high, decreasing cognitive load causes spatial attention to focus. Here, we tested whether the effects of perceptual and cognitive…

Multisensory Cues Capture Spatial Attention Regardless of Perceptual Load

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Santangelo, Valerio; Spence, Charles

2007-01-01

We compared the ability of auditory, visual, and audiovisual (bimodal) exogenous cues to capture visuo-spatial attention under conditions of no load versus high perceptual load. Participants had to discriminate the elevation (up vs. down) of visual targets preceded by either unimodal or bimodal cues under conditions of high perceptual load (in…

Bayesian Face Recognition and Perceptual Narrowing in Face-Space

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Balas, Benjamin

2012-01-01

During the first year of life, infants' face recognition abilities are subject to "perceptual narrowing", the end result of which is that observers lose the ability to distinguish previously discriminable faces (e.g. other-race faces) from one another. Perceptual narrowing has been reported for faces of different species and different races, in…

Cultural differences in perceptual reorganization in US and Pirahã adults.

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Jennifer M D Yoon

Full Text Available Visual illusions and other perceptual phenomena can be used as tools to uncover the otherwise hidden constructive processes that give rise to perception. Although many perceptual processes are assumed to be universal, variable susceptibility to certain illusions and perceptual effects across populations suggests a role for factors that vary culturally. One striking phenomenon is seen with two-tone images-photos reduced to two tones: black and white. Deficient recognition is observed in young children under conditions that trigger automatic recognition in adults. Here we show a similar lack of cue-triggered perceptual reorganization in the Pirahã, a hunter-gatherer tribe with limited exposure to modern visual media, suggesting such recognition is experience- and culture-specific.

[Evaluation of the notification of dysphonia on the voice profesionals as a sentinel event in Navarra. Period 2013-2015.

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Arrizabalaga Baigorri, Sara; García López, Vega

2017-07-07

Among the lesions produced by the professional use of the voice since 2007, the Vocal Nodules (VN) are recognized in Spain as an Occupational Disease. With the aim of promoting its notification in Navarre, the Sentinel Program was incorporated in 2013 and, with this study, we seek to verify its efficacy. The study population were voice professionals reported for dysphonia as sentinel events during the years 2013 to 2015 in Navarre. Its effectiveness was validated by the cumulative incidence of 100,000 workers for each of the years and Positive Predictive Value as an indicator of suspicion. The declaration was verified as an occupational disease. In the period April 2013 to December, 110 cases were reported, 71 nominal and 39 non-nominal. The annual incidence increased from 9.0 cases per 100,000 to 13.4. Of the cases investigated, 63 were women and 8 men. The mean age was 40.8 years (38.5-43.1 95% CI). 58 cases (81.7%) corresponded to teachers. In 22 of the 71 nodules (31%) and 9 coincidences were notified as an occupational disease. We found a greater presence of nodules in professionals with extra work use of voice (OR 4.2 IC 1.3-14.3) and better evolution of pathologies other than VN (OR = 2.5 CI 1.1-5.8 ). The suspicion was confirmed as occupational in 54 cases (positive predictive value 76.1%). The centinel program is effective in reporting dysphonia although it is important to highlight the low declaration as occupational disease of the cases detected.