-
Systematic Reviews Jul 2023We systematically reviewed the literature and performed a meta-analysis on the effects of speech therapy and phonosurgery, for transgender women, in relation to the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
We systematically reviewed the literature and performed a meta-analysis on the effects of speech therapy and phonosurgery, for transgender women, in relation to the fundamental frequency gain of the voice, regarding the type of vocal sample collected, and we compared the effectiveness of the treatments. In addition, the study design, year, country, types of techniques used, total therapy time, and vocal assessment protocols were analyzed.
METHODS
We searched the PubMed, Lilacs, and SciELO databases for observational studies and clinical trials, published in English, Portuguese, or Spanish, between January 2010 and January 2023. The selection of studies was carried out according to Prisma 2020. The quality of selected studies was assessed using the Newcastle-Ottawa scale.
RESULTS
Of 493 studies, 31 were deemed potentially eligible and retrieved for full-text review and 16 were included in the systematic review and meta-analysis. Six studies performed speech therapy and ten studies phonosurgery. The speech therapy time did not influence the post-treatment gain in voice fundamental frequency (p = 0.6254). The type of sample collected significantly influenced the post-treatment voice frequency gain (p < 0.01). When the vocal sample was collected through vowel (p < 0.01) and reading (p < 0.01), the gain was significantly more heterogeneous between the different types of treatment. Phonosurgery is significantly more effective in terms of fundamental frequency gain compared to speech therapy alone, regardless of the type of sample collected (p < 0.01). The average gain of fundamental frequency after speech therapy, in the /a/ vowel sample, was 27 Hz, 39.05 Hz in reading, and 25.42 Hz in spontaneous speech. In phonosurgery, there was a gain of 71.68 Hz for the vowel /a/, 41.07 Hz in reading, and 39.09 Hz in spontaneous speech. The study with the highest gain (110 Hz) collected vowels, and the study with the lowest gain (15 Hz), spontaneous speech. The major of the included studies received a score between 4 and 8 on the Newcastle-Ottawa Scale.
CONCLUSION
The type of vocal sample collected influences the gain result of the fundamental frequency after treatment. Speech therapy and phonosurgery increased the fundamental frequency and improved female voice perception and vocal satisfaction. However, phonosurgery yielded a greater fundamental frequency gain in the different samples collected. The study protocol was registered at Prospero (CRD42017078446).
Topics: Female; Humans; Speech Therapy; Transgender Persons; Speech; Voice; Databases, Factual
PubMed: 37481572
DOI: 10.1186/s13643-023-02267-5 -
Neuromodulation : Journal of the... Apr 2024Deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) has an ambiguous relation to speech. Speech impairment can be a... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) has an ambiguous relation to speech. Speech impairment can be a stimulation-induced side effect, and parkinsonian dysarthria can improve with STN-DBS. Owing to the lack of an up-to-date and evidence-based approach, DBS reprogramming for speech impairment is largely blind and greatly relies on the physician's experience. In this study, we aimed to establish an evidence- and experience-based algorithm for managing speech impairment in patients with PD treated with STN-DBS.
MATERIALS AND METHODS
We performed a single-center retrospective study to identify patients with STN-DBS and speech impairment. Onset of speech impairment, lead localization, and assessment of DBS-induced nature of speech impairment were collected. When DBS settings were adjusted for improving speech, the magnitude and duration of effect were collected. We also performed a systematic literature review to identify studies describing the effects of parameter adjustments aimed at improving speech impairment in patients with PD receiving STN-DBS.
RESULTS
In the retrospective study, 245 of 631 patients (38.8%) with STN-DBS had significant speech impairment. The probability of sustained marked improvement upon reprogramming was generally low (27.9%). In the systematic review, 23 of 662 identified studies were included. Only two randomized controlled trials have been performed, providing evidence for interleaving-interlink stimulation only. Considerable methodologic heterogeneity precluded the conduction of a meta-analysis.
CONCLUSIONS
Speech impairment in STN-DBS for PD is frequent, but high-quality evidence regarding DBS parameter adjustments is scarce, and the probability of sustained improvement is low. To improve this outcome, we propose an evidence- and experience-based approach to address speech impairment in STN-DBS that can be used in clinical practice.
Topics: Humans; Speech; Parkinson Disease; Subthalamic Nucleus; Deep Brain Stimulation; Retrospective Studies; Speech Disorders
PubMed: 37452799
DOI: 10.1016/j.neurom.2023.05.002 -
Trauma, Violence & Abuse Oct 2023Little is known about the current state of research on the involvement of young people in hate speech. Thus, this systematic review presents findings on a) the...
Little is known about the current state of research on the involvement of young people in hate speech. Thus, this systematic review presents findings on a) the prevalence of hate speech among children and adolescents and on hate speech definitions that guide prevalence assessments for this population; and b) the theoretical and empirical overlap of hate speech with related concepts. This review was guided by the Cochrane approach. To be included, publications were required to deal with real-life experiences of hate speech, to provide empirical data on prevalence for samples aged 5 to 21 years and they had to be published in academic formats. Included publications were full-text coded using two raters (κ = .80) and their quality was assessed. The string-guided electronic search (ERIC, SocInfo, Psycinfo, Psyndex) yielded 1,850 publications. Eighteen publications based on 10 studies met the inclusion criteria and their findings were systematized. Twelve publications were of medium quality due to minor deficiencies in their theoretical or methodological foundations. All studies used samples of adolescents and none of younger children. Nine out of 10 studies applied quantitative methodologies. Eighteen publications based on 10 studies were included. Results showed that frequencies for hate speech exposure were higher than those related to victimization and perpetration. Definitions of hate speech and assessment instruments were heterogeneous. Empirical evidence for an often theorized overlap between hate speech and bullying was found. The paper concludes by presenting a definition of hate speech, including implications for practice, policy, and research.
Topics: Humans; Child; Adolescent; Hate; Speech; Prevalence; Bullying; Crime Victims
PubMed: 35731198
DOI: 10.1177/15248380221108070