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Human Brain Mapping May 2022This study compared acoustic and neural changes accompanying two treatments matched for intensive dosage but having two different treatment targets (voice or... (Randomized Controlled Trial)
Randomized Controlled Trial
Immediate and long-term effects of speech treatment targets and intensive dosage on Parkinson's disease dysphonia and the speech motor network: Randomized controlled trial.
This study compared acoustic and neural changes accompanying two treatments matched for intensive dosage but having two different treatment targets (voice or articulation) to dissociate the effects of treatment target and intensive dosage in speech therapies. Nineteen participants with Parkinsonian dysphonia (11 F) were randomized to three groups: intensive treatment targeting voice (voice group, n = 6), targeting articulation (articulation group, n = 7), or an untreated group (no treatment, n = 6). The severity of dysphonia was assessed by the smoothed cepstral peak prominence (CPPS) and neuronal changes were evaluated by cerebral blood flow (CBF) recorded at baseline, posttreatment, and 7-month follow-up. Only the voice treatment resulted in significant posttreatment improvement in CPPS, which was maintained at 7 months. Following voice treatment, increased activity in left premotor and bilateral auditory cortices was observed at posttreatment, and in the left motor and auditory cortices at 7-month follow-up. Articulation treatment resulted in increased activity in bilateral premotor and left insular cortices that were sustained at a 7-month follow-up. Activation in the auditory cortices and a significant correlation between the CPPS and CBF in motor and auditory cortices was observed only in the voice group. The intensive dosage resulted in long-lasting behavioral and neural effects as the no-treatment group showed a progressive decrease in activity in areas of the speech motor network out to a 7-month follow-up. These results indicate that dysphonia and the speech motor network can be differentially modified by treatment targets, while intensive dosage contributes to long-lasting effects of speech treatments.
Topics: Dysphonia; Humans; Parkinson Disease; Speech; Speech Acoustics; Voice Quality
PubMed: 35141971
DOI: 10.1002/hbm.25790 -
International Journal of Pediatric... Sep 2021Paediatric inflammatory multisystem syndrome, temporally associated with SARS-CoV-2 (PIMS-TS) is a novel disease first identified in 2020. Recent cohort studies have...
IMPORTANCE
Paediatric inflammatory multisystem syndrome, temporally associated with SARS-CoV-2 (PIMS-TS) is a novel disease first identified in 2020. Recent cohort studies have described the complex presentation and symptomatology. This paper provides detailed description of the dysphagia and dysphonia symptoms, management, and outcome.
OBJECTIVE
To describe dysphagia and dysphonia in PIMS-TS.
DESIGN
Retrospective cohort study.
SETTING
Single tertiary and quaternary children's hospital.
PARTICIPANTS
All 50 children treated for paediatric multisystem inflammatory disease between April and June 2020 were included in this study.
MAIN OUTCOME(S) AND MEASURE(S)
Dysphonia: GRBAS Perceptual Severity Scores, Vocal Handicap Index scores and the Vocal Tract Discomfort Scale. Dysphagia: Functional Oral Intake Scale.
RESULTS
Fifty children met the diagnostic criteria for PIMS-TS. 33 (66%) were male. Median age was 10 years (range: 1-17). 36 (72%) were of Black, Asian or minority ethnic background. Nine (18%) required specialist assessment and management of dysphagia and/or dysphonia. Five (55%) were male with a median age of 9 years 7 months (range: 1-15 years). Symptoms typically resolved within three months. Two children presented with persisting dysphonia three months post-presentation. Neurological, inflammatory, and iatrogenic causes of dysphagia and dysphonia were identified.
CONCLUSIONS AND RELEVANCE
Dysphonia and dysphagia are present in children with PIMS-TS. Further data is required to understand pathophysiology, estimate incidence, and determine prognostic factors. This preliminary data highlights the need for dysphagia and dysphonia screening and timely referral for specialist, multidisciplinary assessment and treatment to ensure short-term aspiration risk is managed and long-term, functional outcomes are optimised.
Topics: COVID-19; Child; Deglutition Disorders; Dysphonia; Humans; Infant; Male; Retrospective Studies; SARS-CoV-2; Systemic Inflammatory Response Syndrome
PubMed: 34237522
DOI: 10.1016/j.ijporl.2021.110823 -
CoDAS 2014Integrative review of the scientific literature about the behavioral characteristics of dysphonic children discussing profiled and their etiologic relationship with the... (Review)
Review
PURPOSE
Integrative review of the scientific literature about the behavioral characteristics of dysphonic children discussing profiled and their etiologic relationship with the voice disorder, seeking to define recommendations on the importance of analyzing the behavior of children in voice assessment.
RESEARCH STRATEGY
Integrative review of articles published in the last 12 years, the Virtual Health Library.
SELECTION CRITERIA
Set up the theme of "behavioral characteristics of dysphonic children" was selected the databases LILACS, IBECS, MEDLINE, Cochrane Library, SciELO and ISI Web of Science and the following inclusion criteria: original articles, publication year from 2000 and 2012, Portuguese, English and Spanish.
DATA ANALYSIS
Among the 528 articles published childish voice and dysphonia, seven covered the topic researched and were included in the results.
RESULTS
Observed that four papers studied the behavior of children with vocal nodules, one addressed the behavioral characteristics of children with various types of dysphonic vocal fold lesion and three correlated Attention Deficit Disorder / Hyperactivity and dysphonia.
CONCLUSION
Not established a behavioral profile of children with vocal disorders, but the results were consistent recommendation for the importance of this analysis in the evaluation of dysphonia in children.
Topics: Attention Deficit Disorder with Hyperactivity; Child; Child Behavior; Dysphonia; Humans
PubMed: 24918510
DOI: 10.1590/2317-1782/2014408in -
European Annals of Otorhinolaryngology,... Nov 2014Chronic childhood dysphonia is a common condition in the school-age period. Perceived functional disorder is subjective and the alert is usually given by a person not... (Review)
Review
Chronic childhood dysphonia is a common condition in the school-age period. Perceived functional disorder is subjective and the alert is usually given by a person not belonging to the child's immediate environment. History-taking often suggests a malformation or acquired lesion. Functional assessment helps measure and diagnose the vocal impairment. Physical and endoscopic assessment in consultation is the key examination: it is only rarely impossible in children and can often found diagnosis. Additional examinations are sometimes necessary.
Topics: Child; Chronic Disease; Diagnostic Imaging; Dysphonia; Endoscopy; Humans; Medical History Taking; Physical Examination; Voice Quality
PubMed: 24986259
DOI: 10.1016/j.anorl.2013.02.001 -
Journal of Speech, Language, and... May 2022Despite the high prevalence of primary muscle tension dysphonia (MTD-1), its underlying mechanisms and their interrelationships have yet to be fully identified. The... (Review)
Review
PURPOSE
Despite the high prevalence of primary muscle tension dysphonia (MTD-1), its underlying mechanisms and their interrelationships have yet to be fully identified. The objectives of this integrative review were (a) to describe and classify the suggested underlying mechanisms for MTD-1, (b) to appraise the empirical evidence supporting each of the proposed mechanisms, and (c) to summarize the information in an integrative model.
METHOD
PubMed, Scopus, and CINAHL were searched for all publications pertaining to muscle tension dysphonia. Papers were retained if they included theoretical or empirical data pertaining to underlying mechanisms of MTD-1. A total of 921 papers initially qualified for screening, of which 100 remained for consideration in this review. Underlying mechanisms of MTD-1 were extracted using a consensus approach.
RESULTS
Seven broad categories of putative mechanisms involved in MTD-1 were identified: psychosocial, autonomic, sensorimotor, respiratory, postural, inflammatory, and neuromuscular. These categories were further divided into 19 subcategories detailed in the body of this review article. Based on the reviewed evidence, our proposed integrative model presents MTD-1 as an idiosyncratic motor adaptation to physiological perturbation or perceived threat. Under this model, physiologically or psychologically aversive stimuli can instigate a series of motor adaptations at multiple levels of the nervous system, ultimately disturbing muscle activation patterns and their biomechanical outcomes. Importantly, these adaptations appear to have the potential to become chronic even after threatening stimuli are withdrawn.
CONCLUSIONS
The proposed model highlights the importance of personalized rehabilitation in MTD-1 treatment. Limitations of the literature are discussed to provide guidance for future research aimed at improving our understanding of MTD-1.
SUPPLEMENTAL MATERIAL
https://doi.org/10.23641/asha.19586065.
Topics: Dysphonia; Hoarseness; Humans; Muscle Tonus
PubMed: 35446683
DOI: 10.1044/2022_JSLHR-21-00575 -
CoDAS 2023To investigate whether there are differences in cepstral and spectral acoustic measures between women with behavioral dysphonia with and without laryngeal lesions and...
PURPOSE
To investigate whether there are differences in cepstral and spectral acoustic measures between women with behavioral dysphonia with and without laryngeal lesions and verify whether there is a correlation between such measures and the auditory-perceptual evaluation of voice quality.
METHODS
The sample comprised 78 women with behavioral dysphonia without laryngeal lesions (BDWOL) and 68 with behavioral dysphonia with laryngeal lesions (vocal nodules) (BDWL). Cepstral peak prominence (CPP), cepstral peak prominence-smoothed (CPPS), spectral decrease, and H1-H2 (difference between the amplitude of the first and second harmonics) were extracted. They were submitted to the auditory-perceptual evaluation (APE) of the grade of hoarseness (GH), roughness (RO), breathiness (BR), and strain (ST).
RESULTS
BDWL women had higher H1-H2 values and lower CPP and CPPS values than BDWOL women. More deviant voices had lower CPP and CPPS values. Breathy voices had lower CPP and CPPS values and higher H1-H2 values than rough ones. There was a weak negative correlation between CPP and RO, a moderate negative correlation with GH, and a strong negative correlation with BR. CPPS had a moderate negative correlation with GH, RO, and BR. H1-H2 had a weak positive correlation with BR. There was a weak positive correlation between spectral decrease and ST.
CONCLUSION
H1-H2, CPP, and CPPS were different between BDWOL and BDWL women. Furthermore, cepstral and spectral measures were correlated with the different APE parameters.
Topics: Humans; Female; Animals; Dysphonia; Speech Acoustics; Voice Quality; Acoustics; Hominidae; Speech Production Measurement
PubMed: 37970895
DOI: 10.1590/2317-1782/20232022327pt -
Journal of Voice : Official Journal of... Mar 2022To explore the prevalence of dysphonia in European patients with mild-to-moderate COVID-19 and the clinical features of dysphonic patients.
INTRODUCTION
To explore the prevalence of dysphonia in European patients with mild-to-moderate COVID-19 and the clinical features of dysphonic patients.
METHODS
The clinical and epidemiological data of 702 patients with mild-to-moderate COVID-19 were collected from 19 European Hospitals. The following data were extracted: age, sex, ethnicity, tobacco consumption, comorbidities, general, and otolaryngological symptoms. Dysphonia and otolaryngological symptoms were self-assessed through a 4-point scale. The prevalence of dysphonia, as part of the COVID-19 symptoms, was assessed. The outcomes were compared between dysphonic and nondysphonic patients. The association between dysphonia severity and outcomes was studied through Bayesian analysis.
RESULTS
A total of 188 patients were dysphonic, accounting for 26.8% of cases. Females developed more frequently dysphonia than males (P = 0.022). The proportion of smokers was significantly higher in the dysphonic group (P = 0.042). The prevalence of the following symptoms was higher in dysphonic patients compared with nondysphonic patients: cough, chest pain, sticky sputum, arthralgia, diarrhea, headache, fatigue, nausea, and vomiting. The severity of dyspnea, dysphagia, ear pain, face pain, throat pain, and nasal obstruction was higher in dysphonic group compared with nondysphonic group. There were significant associations between the severity of dysphonia, dysphagia, and cough.
CONCLUSION
Dysphonia may be encountered in a quarter of patients with mild-to-moderate COVID-19 and should be considered as a symptom list of the infection. Dysphonic COVID-19 patients are more symptomatic than nondysphonic individuals. Future studies are needed to investigate the relevance of dysphonia in the COVID-19 clinical presentation.
Topics: Bayes Theorem; COVID-19; Dysphonia; Female; Hoarseness; Humans; Male; Prevalence
PubMed: 32600873
DOI: 10.1016/j.jvoice.2020.05.012 -
Journal of Medicine and Life 2021We carried out a prospective case series study in order to evaluate the laryngeal complications of the endotracheal tube. Two hundred patients aged 15 years and above...
We carried out a prospective case series study in order to evaluate the laryngeal complications of the endotracheal tube. Two hundred patients aged 15 years and above who were subjected to endotracheal intubation for less than 5 hours were enrolled in the study. The data were collected from the Al-Salam Teaching Hospital in Mosul, Iraq. A preoperative assessment was accomplished clinically using 70º and/or 90º Hopkins rods or fiber optic laryngoscopy. As part of the assessment, the patients' voices were recorded as well. Five to seven days after the procedure, the same assessment was repeated and compared to the preoperative data. If the postoperative examination and the voices were similar to the preoperative data, no follow-up was performed. If any abnormality was found in the larynx, the examination was repeated once weekly for one month or until the voice was recovered. In our study, five patients (2.5%) had intubation-related laryngeal injuries. The intubation period, changes in the position of the head or body of the patient during anesthesia, and the difficulty of intubation raised the possibility of laryngeal injuries. In general, intubation is a safe procedure; however, a laryngeal injury may appear as a rare complication. We found that there is a relation between the intubation period, changing the position of the patient during intubation, and difficulty of intubation with the occurrence of laryngeal injury.
Topics: Dysphonia; Humans; Intubation, Intratracheal; Laryngeal Diseases; Larynx; Prospective Studies
PubMed: 34377201
DOI: 10.25122/jml-2020-0148 -
Journal of Voice : Official Journal of... Nov 2023The main objective of this study is to estimate the prevalence of persistent dysphonia in hospitalised COVID-19 patients.
INTRODUCTION
The main objective of this study is to estimate the prevalence of persistent dysphonia in hospitalised COVID-19 patients.
METHODS
Data were collected from those COVID-19 patients who, during the months of March to April 2020, were hospitalised in ward or intensive care unit at the University Hospital of Fuenlabrada. Patients with dysphonia prior to SARS-CoV-2 were excluded. Informed consent was obtained orally by a telephone call, as well as clinical and epidemiological data. Patients who reported persistent dysphonia were assessed using the Voice Handicap Index 10, the maximum phonation time, the s/z ratio and a fibrolaryngoscope examination. Patients who reported persistent dysphagia were assessed with the Eating Assessment Tool 10.
RESULTS
A total of 79 patients were included in the study (48 men and 31 women). 10 ICU patients (25%) and 4 ward patients (10,3%) had dysphonia at least 3 months after hospital discharge, but no association was found between ICU admission and the presence of persistent dysphonia (P = 0.139). Persistent dysphonia in patients admitted to the ICU is associated with persistent dysphagia (P = 0.002), also the age of patients with persistent dysphonia is significantly higher than the age of non-dysphonic patients (P = 0.046). The most frequent exploratory finding was vocal cord paresis/paralysis (60.4%).
CONCLUSION
This is one of the first studies to show that persistence of dysphonia may be a consequence of COVID-19, so further studies are needed to assess the evolution and prognosis of these patients and the possible association of dysphonia with the severity of the disease.
Topics: Male; Humans; Female; Dysphonia; COVID-19; Deglutition Disorders; SARS-CoV-2; Vocal Cord Paralysis
PubMed: 34384660
DOI: 10.1016/j.jvoice.2021.07.001 -
Otolaryngologia Polska = the Polish... Apr 2019Psychogenic dysphonia is defined as disturbances in voice and speech quality with emotional background with lack of organic changes in the larynx. Mental condition has...
Psychogenic dysphonia is defined as disturbances in voice and speech quality with emotional background with lack of organic changes in the larynx. Mental condition has significant impact on the process of producing voice, functioning of respiratoryphonatory- articulation mechanism and speech prosody. The aim of the study was visual, acoustic, perceptual assessment as well as self-assessment of voice and speech quality using subjective and objective methods in patients with psychogenic dysphonia. The study included 50 patients with psychogenic dysphonia diagnosed in the Department of Clinical Fonoaudiology and Logopedics, Medical University of Białystok and treated at the Foniatric Outpatient Clinic, University Hospital in Białystok in 2017-2018. The control group consisted of 30 subjects with euphonic voice. All patients underwent subjective and objective assessment of voice and speech quality. The GRBAS scale, breathing pathway assessment, respiratory-phonatory-articulation analysis, voice and speech intensity evaluation have been performed. Speech prosody has also been examined. Patient selfassessment of voice has been conducted using Voice Handicap Index (VHI). Objective evaluation of larynx included vibrations of vocal folds visualization using High Speed Digital Imaging (HSDI). Acoustic analysis of voice quality has been performed using DiagNova Technologies. The maximum phonation time (MPT) has been determined. Hyperfunctional dysphonia is the most common clinical form of psychogenic dysphonia. Abnormal breathing pathway influence the reduction of MPT and disturbance of respiratory-phonatory-articulation coordination in patients with psychogenic dysphonia. In psychogenic dysphonia intonation and speech rate disorders are observed. Results of voice self-assessment in the majority of examined patients indicates a mild voice disability.
Topics: Adult; Communication; Disability Evaluation; Dysphonia; Female; Humans; Interdisciplinary Communication; Male; Middle Aged; Nonverbal Communication; Psychophysiologic Disorders; Recovery of Function; Vocal Cords; Voice Quality; Young Adult
PubMed: 31474620
DOI: 10.5604/01.3001.0013.0999