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1.
PLoS Comput Biol ; 20(2): e1011849, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38315733

RESUMO

Sleep deprivation has an ever-increasing impact on individuals and societies. Yet, to date, there is no quick and objective test for sleep deprivation. Here, we used automated acoustic analyses of the voice to detect sleep deprivation. Building on current machine-learning approaches, we focused on interpretability by introducing two novel ideas: the use of a fully generic auditory representation as input feature space, combined with an interpretation technique based on reverse correlation. The auditory representation consisted of a spectro-temporal modulation analysis derived from neurophysiology. The interpretation method aimed to reveal the regions of the auditory representation that supported the classifiers' decisions. Results showed that generic auditory features could be used to detect sleep deprivation successfully, with an accuracy comparable to state-of-the-art speech features. Furthermore, the interpretation revealed two distinct effects of sleep deprivation on the voice: changes in slow temporal modulations related to prosody and changes in spectral features related to voice quality. Importantly, the relative balance of the two effects varied widely across individuals, even though the amount of sleep deprivation was controlled, thus confirming the need to characterize sleep deprivation at the individual level. Moreover, while the prosody factor correlated with subjective sleepiness reports, the voice quality factor did not, consistent with the presence of both explicit and implicit consequences of sleep deprivation. Overall, the findings show that individual effects of sleep deprivation may be observed in vocal biomarkers. Future investigations correlating such markers with objective physiological measures of sleep deprivation could enable "sleep stethoscopes" for the cost-effective diagnosis of the individual effects of sleep deprivation.


Assuntos
Privação do Sono , Voz , Humanos , Sono , Qualidade da Voz , Vigília
2.
Acta Otorhinolaryngol Ital ; 44(1): 27-35, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38420719

RESUMO

Objective: The aim of this study was to compare the efficacy of voice therapy combined with standard anti-reflux therapy in reducing symptoms and signs of laryngopharyngeal reflux (LPR). Methods: A randomised clinical trial was conducted. Fifty-two patients with LPR diagnosed by 24 h multichannel intraluminal impedance-pH monitoring were randomly allocated in two groups: medical treatment (MT) and medical plus voice therapy (VT). Clinical symptoms and laryngeal signs were assessed at baseline and after 3 months of treatment with the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Voice Handicap Index (VHI) and GRBAS scales. Results: Groups had similar scores at baseline. At 3-month follow-up, a significant decrease in RSI and RFS total scores were found in both groups although it appeared to be more robust in the VT group. G and R scores of the GRBAS scale significantly improved after treatment in both groups, with better results in the VT group. The VHI total score at 3 months improved more in the VT group (VHI delta 9.54) than in the MT group (VHI delta 5.38) (p < 0.001). Conclusions: The addition of voice therapy to medications and diet appears to be more effective in improving treatment outcomes in subjects with LPR. Voice therapy warrants consideration in addition to medication and diet when treating patients with LPR.


Assuntos
Refluxo Laringofaríngeo , Voz , Humanos , Refluxo Laringofaríngeo/diagnóstico , Refluxo Laringofaríngeo/tratamento farmacológico , Projetos Piloto , Inibidores da Bomba de Prótons/uso terapêutico , Qualidade da Voz
3.
J Speech Lang Hear Res ; 67(3): 740-752, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38315579

RESUMO

PURPOSE: This study set out to investigate whether individuals with dysphonia, as determined by either self-assessment or clinician-based auditory-perceptual judgment, exhibited differences in perilaryngeal muscle activities using surface electromyography (sEMG) during various phonatory tasks. Additionally, the study aimed to assess the effectiveness of sEMG in identifying dysphonic cases. METHOD: A total of 77 adults (44 women, 33 men, Mage = 30.4 years) participated in this study, with dysphonic cases identified separately using either a 10-item Voice Handicap Index (VHI-10) or clinician-based auditory-perceptual voice quality (APVQ) evaluation. sEMG activities were measured from the areas of suprahyoid and sternocleidomastoid muscles during prolonged vowel /i/ phonations at different pitch and loudness levels. Normalized root-mean-square value against the maximal voluntary contraction (RMS %MVC) of the sEMG signals was obtained for each phonation and compared between subject groups and across phonatory tasks. Additionally, binary logistic regression analysis was performed to determine how the sEMG measures could predict the VHI-10-based or APVQ-based dysphonic cases. RESULTS: Participants who scored above the criteria on either the VHI-10 (n = 29) or APVQ judgment (n = 17) exhibited significantly higher RMS %MVC in the right suprahyoid muscles compared to the corresponding control groups. Although the RMS %MVC value from the right suprahyoid muscles alone was not a significant predictor of self-evaluated dysphonic cases, a combination of the RMS %MVC values from both the right and left suprahyoid muscles significantly predicted APVQ-based dysphonic cases with a 69.66% fair level. CONCLUSIONS: This study found that individuals with dysphonia, as determined by either self-assessment or APVQ judgment, displayed more imbalanced suprahyoid muscle activities in voice production compared to nondysphonic groups. The combination of the sEMG measures from both left and right suprahyoid muscles showed potential as a predictor of dysphonia with a fair level of confidence. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25112804.


Assuntos
Disfonia , Adulto , Masculino , Humanos , Feminino , Disfonia/diagnóstico , Músculos do Pescoço , Fonação , Qualidade da Voz , Eletromiografia
4.
J Acoust Soc Am ; 155(2): 1422-1436, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38364044

RESUMO

Auditory attribution of speaker gender has historically been assumed to operate within a binary framework. The prevalence of gender diversity and its associated sociophonetic variability motivates an examination of how listeners perceptually represent these diverse voices. Utterances from 30 transgender (1 agender individual, 15 non-binary individuals, 7 transgender men, and 7 transgender women) and 30 cisgender (15 men and 15 women) speakers were used in an auditory free classification paradigm, in which cisgender listeners classified the speakers on perceived general similarity and gender identity. Multidimensional scaling of listeners' classifications revealed two-dimensional solutions as the best fit for general similarity classifications. The first dimension was interpreted as masculinity/femininity, where listeners organized speakers from high to low fundamental frequency and first formant frequency. The second was interpreted as gender prototypicality, where listeners separated speakers with fundamental frequency and first formant frequency at upper and lower extreme values from more intermediate values. Listeners' classifications for gender identity collapsed into a one-dimensional space interpreted as masculinity/femininity. Results suggest that listeners engage in fine-grained analysis of speaker gender that cannot be adequately captured by a gender dichotomy. Further, varying terminology used in instructions may bias listeners' gender judgements.


Assuntos
Minorias Sexuais e de Gênero , Percepção da Fala , Humanos , Masculino , Feminino , Qualidade da Voz , Acústica da Fala , Masculinidade
5.
J Acoust Soc Am ; 155(2): 1264-1271, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38345424

RESUMO

The problem of characterizing voice quality has long caused debate and frustration. The richness of the available descriptive vocabulary is overwhelming, but the density and complexity of the information voices convey lead some to conclude that language can never adequately specify what we hear. Others argue that terminology lacks an empirical basis, so that language-based scales are inadequate a priori. Efforts to provide meaningful instrumental characterizations have also had limited success. Such measures may capture sound patterns but cannot at present explain what characteristics, intentions, or identity listeners attribute to the speaker based on those patterns. However, some terms continually reappear across studies. These terms align with acoustic dimensions accounting for variance across speakers and languages and correlate with size and arousal across species. This suggests that labels for quality rest on a bedrock of biology: We have evolved to perceive voices in terms of size/arousal, and these factors structure both voice acoustics and descriptive language. Such linkages could help integrate studies of signals and their meaning, producing a truly interdisciplinary approach to the study of voice.


Assuntos
Percepção da Fala , Acústica da Fala , Qualidade da Voz , Som , Audição
6.
Semin Speech Lang ; 45(2): 137-151, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38417816

RESUMO

Abductor laryngeal dystonia (ABLD) is a rare neurological voice disorder which results in sporadic opening of the vocal folds during speech. Etiology is unknown, and to date there is no identified effective behavioral treatment for it. It is hypothesized that LSVT LOUD®, which was developed to treat dysphonia secondary to Parkinson's disease, may have application to speakers with ABLD to improve outcomes beyond that with botulinum neurotoxin (BoNT) treatment alone. The participant received one injection of BoNT in each vocal fold 2 to 3 months prior to initiating intensive voice therapy via teletherapy. Objective measures of vocal loudness (dB sound pressure level), maximum phonation time, and high/low pitch frequency (Hz) were recorded in all treatment sessions and follow-up sessions. Over the course of treatment, the participant showed steady gains in phonation time, volume, pitch range, and vocal quality with a substantial reduction in aphonic voice breaks by the end of the treatment program. Perceptual symptoms of ABLD were nearly undetectable by the participant and the clinicians up to 12 months posttreatment, with no additional BoNT injections. The results suggest that LSVT LOUD® following BoNT was effective, with long-lasting improvement in vocal function, for this speaker with ABLD.


Assuntos
Toxinas Botulínicas , Disfonia , Distonia , Humanos , Disfonia/tratamento farmacológico , Disfonia/etiologia , Distonia/tratamento farmacológico , Distonia/etiologia , Qualidade da Voz , Fonação , Resultado do Tratamento
7.
Int J Occup Med Environ Health ; 37(1): 84-97, 2024 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-38375631

RESUMO

OBJECTIVES: Emotions and stress affect voice production. There are only a few reports in the literature on how changes in the autonomic nervous system affect voice production. The aim of this study was to examine emotions and measure stress reactions during a voice examination procedure, particularly changes in the muscles surrounding the larynx. MATERIAL AND METHODS: The study material included 50 healthy volunteers (26 voice workers - opera singers, 24 control subjects), all without vocal complaints. All subjects had good voice quality in a perceptual assessment. The research procedure consisted of 4 parts: an ear, nose, and throat (ENT)­phoniatric examination, surface electromyography, recording physiological indicators (heart rate and skin resistance) using a wearable wristband, and a psychological profile based on questionnaires. RESULTS: The results of the study demonstrated that there was a relationship between positive and negative emotions and stress reactions related to the voice examination procedure, as well as to the tone of the vocal tract muscles. There were significant correlations between measures describing the intensity of experienced emotions and vocal tract muscle maximum amplitude of the cricothyroid (CT) and sternocleidomastoid (SCM) muscles during phonation and non-phonation tasks. Subjects experiencing eustress (favorable stress response) had increased amplitude of submandibular and CT at rest and phonation. Subjects with high levels of negative emotions, revealed positive correlations with SCMmax during the glissando. The perception of positive and negative emotions caused different responses not only in the vocal tract but also in the vegetative system. Correlations were found between emotions and physiological parameters, most markedly in heart rate variability. A higher incidence of extreme emotions was observed in the professional group. CONCLUSIONS: The activity of the vocal tract muscles depends on the type and intensity of the emotions and stress reactions. The perception of positive and negative emotions causes different responses in the vegetative system and the vocal tract. Int J Occup Med Environ Health. 2024;37(1):84-97.


Assuntos
Canto , Humanos , Fonação/fisiologia , Qualidade da Voz/fisiologia , Eletromiografia , Eletrofisiologia
8.
PLoS One ; 19(1): e0289453, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38285654

RESUMO

Singing voice separation on robots faces the problem of interpreting ambiguous auditory signals. The acoustic signal, which the humanoid robot perceives through its onboard microphones, is a mixture of singing voice, music, and noise, with distortion, attenuation, and reverberation. In this paper, we used the 3D Inception-ResUNet structure in the U-shaped encoding and decoding network to improve the utilization of the spatial and spectral information of the spectrogram. Multiobjectives were used to train the model: magnitude consistency loss, phase consistency loss, and magnitude correlation consistency loss. We recorded the singing voice and accompaniment derived from the MIR-1K dataset with NAO robots and synthesized the 10-channel dataset for training the model. The experimental results show that the proposed model trained by multiple objectives reaches an average NSDR of 11.55 dB on the test dataset, which outperforms the comparison model.


Assuntos
Música , Canto , Qualidade da Voz , Acústica
9.
Brain Stimul ; 17(1): 112-124, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38272256

RESUMO

BACKGROUND: DBS of the subthalamic nucleus (STN) considerably ameliorates cardinal motor symptoms in PD. Reported STN-DBS effects on secondary dysarthric (speech) and dysphonic symptoms (voice), as originating from vocal tract motor dysfunctions, are however inconsistent with rather deleterious outcomes based on post-surgical assessments. OBJECTIVE: To parametrically and intra-operatively investigate the effects of deep brain stimulation (DBS) on perceptual and acoustic speech and voice quality in Parkinson's disease (PD) patients. METHODS: We performed an assessment of instantaneous intra-operative speech and voice quality changes in PD patients (n = 38) elicited by direct STN stimulations with variations of central stimulation features (depth, laterality, and intensity), separately for each hemisphere. RESULTS: First, perceptual assessments across several raters revealed that certain speech and voice symptoms could be improved with STN-DBS, but this seems largely restricted to right STN-DBS. Second, computer-based acoustic analyses of speech and voice features revealed that both left and right STN-DBS could improve dysarthric speech symptoms, but only right STN-DBS can considerably improve dysphonic symptoms, with left STN-DBS being restricted to only affect voice intensity features. Third, several subareas according to stimulation depth and laterality could be identified in the motoric STN proper and close to the associative STN with optimal (and partly suboptimal) stimulation outcomes. Fourth, low-to-medium stimulation intensities showed the most optimal and balanced effects compared to high intensities. CONCLUSIONS: STN-DBS can considerably improve both speech and voice quality based on a carefully arranged stimulation regimen along central stimulation features.


Assuntos
Estimulação Encefálica Profunda , Disfonia , Doença de Parkinson , Núcleo Subtalâmico , Humanos , Fala , Qualidade da Voz/fisiologia , Doença de Parkinson/complicações , Doença de Parkinson/terapia , Núcleo Subtalâmico/fisiologia
10.
J Acoust Soc Am ; 155(1): 18-28, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38169520

RESUMO

In an earlier study, we analyzed how audio signals obtained from three professional opera singers varied when they sang one octave wide eight-tone scales in ten different emotional colors. The results showed systematic variations in voice source and long-term-average spectrum (LTAS) parameters associated with major emotion "families". For two of the singers, subglottal pressure (PSub) also was recorded, thus allowing analysis of an additional main physiological voice control parameter, glottal resistance (defined as the ratio between PSub and glottal flow), and related to glottal adduction. In the present study, we analyze voice source and LTAS parameters derived from the audio signal and their correlation with Psub and glottal resistance. The measured parameters showed a systematic relationship with the four emotion families observed in our previous study. They also varied systematically with values of the ten emotions along the valence, power, and arousal dimensions; valence showed a significant correlation with the ratio between acoustic voice source energy and subglottal pressure, while Power varied significantly with sound level and two measures related to the spectral dominance of the lowest spectrum partial. the fundamental.


Assuntos
Canto , Voz , Humanos , Qualidade da Voz , Voz/fisiologia , Acústica , Glote/fisiologia
11.
J Acoust Soc Am ; 155(1): 381-395, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38240668

RESUMO

Auditory perceptual evaluation is considered the gold standard for assessing voice quality, but its reliability is limited due to inter-rater variability and coarse rating scales. This study investigates a continuous, objective approach to evaluate hoarseness severity combining machine learning (ML) and sustained phonation. For this purpose, 635 acoustic recordings of the sustained vowel /a/ and subjective ratings based on the roughness, breathiness, and hoarseness scale were collected from 595 subjects. A total of 50 temporal, spectral, and cepstral features were extracted from each recording and used to identify suitable ML algorithms. Using variance and correlation analysis followed by backward elimination, a subset of relevant features was selected. Recordings were classified into two levels of hoarseness, H<2 and H≥2, yielding a continuous probability score y∈[0,1]. An accuracy of 0.867 and a correlation of 0.805 between the model's predictions and subjective ratings was obtained using only five acoustic features and logistic regression (LR). Further examination of recordings pre- and post-treatment revealed high qualitative agreement with the change in subjectively determined hoarseness levels. Quantitatively, a moderate correlation of 0.567 was obtained. This quantitative approach to hoarseness severity estimation shows promising results and potential for improving the assessment of voice quality.


Assuntos
Disfonia , Rouquidão , Humanos , Rouquidão/diagnóstico , Reprodutibilidade dos Testes , Qualidade da Voz , Fonação , Acústica , Acústica da Fala , Medida da Produção da Fala
12.
J Laryngol Otol ; 138(2): 224-231, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37334556

RESUMO

OBJECTIVE: The main purpose of this study was to retrospectively evaluate the efficiency of DoctorVox voice therapy in psychogenic dysphonia or aphonia patients, and to share the mid- to long-term results of the method. METHODS: The study was carried out on patients who underwent DoctorVox voice therapy for psychogenic dysphonia or aphonia between January 2015 and September 2019. The evaluation methods used were: the Voice Handicap Index-10; the grade, roughness, breathiness, asthenia and strain ('GRBAS') scale; and videolaryngostroboscopy recordings. RESULTS: The mean Voice Handicap Index-10 values of the patients were 30.91 ± 2.97 before treatment, 8.14 ± 3.82 after treatment, and 3.36 ± 1.78 in the final follow-up examination. The grade, roughness, breathiness, asthenia and strain scale scores were: 9 ± 0.67 pre-treatment, 0.78 ± 0.80 post-treatment, and 0.57 ± 0.64 at the final follow up. CONCLUSION: DoctorVox voice therapy seems to be an efficient treatment method for psychogenic dysphonia or aphonia; it helps develop phonatory muscle functions, using multidimensional biofeedback mechanisms, and increases the patients' therapy adherence.


Assuntos
Disfonia , Humanos , Disfonia/diagnóstico , Afonia , Estudos Retrospectivos , Astenia , Qualidade da Voz
13.
Otolaryngol Head Neck Surg ; 170(1): 169-178, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37573487

RESUMO

OBJECTIVE: Early-stage glottic cancer (ESGC) is a malignancy of the head and neck. Besides disease control, preservation and improvement of voice quality are essential. To enable expectation management and well-informed decision-making, patients should be sufficiently counseled with individualized information on expected voice quality. This study aims to develop an individualized dynamic prediction model for patient-reported voice quality. This model should be able to provide individualized predictions at every time point from intake to the end of follow-up. STUDY DESIGN: Longitudinal cohort study. SETTING: Tertiary cancer center. METHODS: Patients treated for ESGC were included in this study (N = 294). The Voice Handicap Index was obtained prospectively. The framework of mixed and joint models was used. The prognostic factors used are treatment, age, gender, comorbidity, performance score, smoking, T-stage, and involvement of the anterior commissure. The overall performance of these models was assessed during an internal cross-validation procedure and presentation of absolute errors using box plots. RESULTS: The mean age in this cohort was 67 years and 81.3% are male. Patients were treated with transoral CO2 laser microsurgery (57.8%), single vocal cord irradiation up to (24.5), or local radiotherapy (17.5%). The mean follow-up was 43.4 months (SD 21.5). Including more measurements during prediction improves predictive performance. Including more clinical and demographic variables did not provide better predictions. Little differences in predictive performance between models were found. CONCLUSION: We developed a dynamic individualized prediction model for patient-reported voice quality. This model has the potential to empower patients and professionals in making well-informed decisions and enables tailor-made counseling.


Assuntos
Neoplasias Laríngeas , Terapia a Laser , Humanos , Masculino , Idoso , Feminino , Qualidade da Voz , Resultado do Tratamento , Estudos Longitudinais , Neoplasias Laríngeas/patologia , Terapia a Laser/métodos , Glote/cirurgia , Medidas de Resultados Relatados pelo Paciente , Microcirurgia/métodos , Estudos Retrospectivos
14.
Am J Speech Lang Pathol ; 33(1): 393-405, 2024 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-38060689

RESUMO

PURPOSE: Variability in auditory-perceptual ratings of voice limits their utility, with the poorest reliability often noted for vocal strain. The purpose of this study was to determine whether an experimental method, called visual sort and rate (VSR), promoted stronger rater reliability than visual analog scale (VAS), for ratings of strain in two clinical populations: adductor laryngeal dystonia (ADLD) and vocal hyperfunction (VH). METHOD: Connected speech samples from speakers with ADLD and VH as well as age- and sex-matched controls were selected from a database. Fifteen inexperienced listeners rated strain for two speaker sets (25 ADLD speakers and five controls; 25 VH speakers and five controls) across four rating blocks: VAS-ADLD, VSR-ADLD, VAS-VH, and VSR-VH. For the VAS task, listeners rated each speaker for strain using a vertically oriented 100-mm VAS. For the VSR task, stimuli were distributed into sets of samples with a range of severities in each set. Listeners sorted and ranked samples for strain within each set, and final ratings were captured on a vertically oriented 100-mm VAS. Intrarater reliability (Pearson's r) and interrater variability (mean of the squared differences between a listener's ratings and group mean ratings) were compared across rating methods and populations using two repeated-measures analyses of variance. RESULTS: Intrarater reliability of strain was significantly stronger when listeners used VSR compared to VAS; listeners also showed significantly better intrarater reliability in ADLD than VH. Listeners demonstrated significantly less interrater variability (better reliability) when using VSR compared to VAS. No significant effect of population or interactions was found between listeners for measures of interrater variability. CONCLUSIONS: VSR increases intrarater reliability for ratings of vocal strain in speakers with VH and ADLD. VSR decreases variability of auditory-perceptual judgments of strain between inexperienced listeners in these clinical populations. Future research should determine whether benefits of VSR extend to voice clinicians and/or clinical settings.


Assuntos
Disfonia , Percepção da Fala , Voz , Humanos , Qualidade da Voz , Julgamento , Reprodutibilidade dos Testes , Medida da Produção da Fala/métodos
15.
Eur Arch Otorhinolaryngol ; 281(2): 835-841, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38040937

RESUMO

PURPOSE: To assess the outcomes of endoscopic assisted microscopic posterior cordotomy for bilateral abductor vocal fold paralysis (BAVFP) using radiofrequency versus coblation. METHODS: This was a randomized prospective cohort study that carried out on 40 patients with BAVFP who were subjected to endoscopic/assisted microscopic posterior cordotomy. The patients were randomly allocated into two groups: group (A) patients were operated with radiofrequency, and group (B) patients were operated with coblation. Glottic chink, grade of dyspnea, voice handicap index 10 (VHI10), and aspiration were evaluated pre-operatively and 2 weeks and 3 months post-operatively. RESULTS: There was a significant improvement in the glottic chink and VHI10 scores postoperatively with a non-significant difference between both groups regarding the degree of improvement. In addition, there was a significant improvement of the grade of dyspnea with a non-significant impact on the degree of aspiration in both groups post operatively. There was a lower incidence of oedema and granulation formation in the coblation group but without a statistical significance. CONCLUSION: Both techniques are effective alternatives for performing posterior transverse cordotomy in cases of BAVFP.


Assuntos
Paralisia das Pregas Vocais , Prega Vocal , Humanos , Prega Vocal/cirurgia , Cordotomia/efeitos adversos , Cordotomia/métodos , Estudos Prospectivos , Laringoscopia/métodos , Resultado do Tratamento , Qualidade da Voz , Paralisia das Pregas Vocais/cirurgia , Paralisia das Pregas Vocais/complicações , Dispneia/etiologia , Dispneia/cirurgia , Aspiração Respiratória/complicações
16.
Eur Arch Otorhinolaryngol ; 281(2): 1025-1030, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37947817

RESUMO

OBJECTIVE: The study aims to investigate the estrogen-agonistic effects of tamoxifen on voice parameters in premenopausal women diagnosed with breast cancer. METHODS: A total of 108 premenopausal women were included, segmented into distinct treatment groups and a control group. Objective sound analysis was conducted using robust statistical methods, employing SPSS 25.0 for data analysis. RESULTS: The study identified a statistically significant reduction in Jitter values across all treatment groups compared to the control group. No significant changes were observed in other voice quality parameters such as F0, Shimmer, NHR, and HNR. CONCLUSIONS: The findings suggest that tamoxifen may have an estrogen-agonistic effect on voice quality, thereby potentially influencing future treatment protocols. This research fills a critical void in existing literature and sets the stage for more comprehensive studies that consider affects of hormonal therapies to voice.


Assuntos
Neoplasias da Mama , Voz , Humanos , Feminino , Tamoxifeno/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Qualidade da Voz , Estrogênios , Acústica da Fala , Acústica
17.
J Exp Psychol Gen ; 153(2): 511-530, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38010781

RESUMO

Across many species, a major function of vocal communication is to convey formidability, with low voice frequencies traditionally considered the main vehicle for projecting large size and aggression. Vocal loudness is often ignored, yet it might explain some puzzling exceptions to this frequency code. Here we demonstrate, through acoustic analyses of over 3,000 human vocalizations and four perceptual experiments, that vocalizers produce low frequencies when attempting to sound large, but loudness is prioritized for displays of strength and aggression. Our results show that, although being loud is effective for signaling strength and aggression, it poses a physiological trade-off with low frequencies because a loud voice is achieved by elevating pitch and opening the mouth wide into a-like vowels. This may explain why aggressive vocalizations are often high-pitched and why open vowels are considered "large" in sound symbolism despite their high first formant. Callers often compensate by adding vocal harshness (nonlinear vocal phenomena) to undesirably high-pitched loud vocalizations, but a combination of low and loud remains an honest predictor of both perceived and actual physical formidability. The proposed notion of a loudness-frequency trade-off thus adds a new dimension to the widely accepted frequency code and requires a fundamental rethinking of the evolutionary forces shaping the form of acoustic signals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Assuntos
Voz , Humanos , Qualidade da Voz , Agressão , Comunicação , Som
18.
Folia Phoniatr Logop ; 76(1): 1-21, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37393892

RESUMO

PURPOSE: Considering the conceptual migration from vocal load and vocal loading to vocal demand and vocal demand response, this review of literature aimed to identify physiological explanations, reported measurements, and associated factors (vocal demands) reported in the literature when considering the phonatory response to a vocal demand. METHODS: A systematic review of literature, following the PRISMA Statement, was conducted using Web of Science, PubMed, Scopus, and ScienceDirect. Data were analyzed and presented in two parts. First, a bibliometric analysis, co-occurrence analysis, and content analysis were performed. Three criteria that got article inclusion were defined: (1) written in English, Spanish, and Portuguese; (2) published between 2009 and 2021; and (3) focused on vocal load and loading, vocal demand response, and voice assessment parameters. A total of 54 publications met the criteria and were included in this review. The second part included a conceptual framework based on the content analysis of three aspects of vocal demand response: (1) physiological explanations, (2) reported measurements, and (3) vocal demands. RESULTS AND CONCLUSION: As would be expected since vocal demand response is a relatively new term and not yet commonly used in literature when discussing way that the speakers respond to communicative scenarios, most of the studies reviewed (both historical and recent) still use the term of vocal load and vocal loading. Although there is a broad variety of literature discussing a wide range of vocal demands and voice parameters used to characterize the vocal demand response, results show that there is consistency across the studies. While vocal demand response is unique and intrinsic to the talker, associated factors that contribute to this response include both internal talker and external talker factors. Internal factors include muscle stiffness, viscosity in the phonatory system, vocal fold tissue damage, elevated sound pressure levels during occupational voice demands, extended periods of voice use, suboptimal body posture, difficulties in breathing technique, and sleep disturbances. Associated external factors include the working environment (noise, acoustics, temperature, humidity). In conclusion, although vocal demand response is intrinsic to the speaker, the speaker's response is affected by external vocal demands. However, due to the wide methods to evaluate vocal demand response, it has been difficult to establish its contribution to voice disorders in the general population and, specifically, among occupational voice users. This literature review identified commonly reported parameters and factors that may help clinicians and researchers define vocal demand response.


Assuntos
Distúrbios da Voz , Voz , Humanos , Qualidade da Voz , Voz/fisiologia , Fonação/fisiologia , Prega Vocal
19.
Folia Phoniatr Logop ; 76(1): 91-101, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37499642

RESUMO

INTRODUCTION: Previous research on voice in Parkinson's disease (PD) has consistently demonstrated alterations in acoustic parameters, including fundamental frequency (F0), maximum phonation time, Shimmer, and Jitter. However, investigations into acoustic parameter alterations in individuals with PD are limited. METHODS: We conducted an experimental study involving 20 PD patients (six women and fourteen men). Subjective measures of voice (VHI-30 scale and GRBAS) and objective measures using the OnlineLAB App tool for analyzing biomechanical correlates of voice were recorded. The app analyzed a total of 22 biomechanical parameters of voice. RESULTS: The results of subjective measures were consistent with findings from previous studies. However, the results of objective measures did not align with studies that employed acoustic measures. CONCLUSIONS: The biomechanical analysis revealed alterations in various parameters according to gender. These findings open up a new avenue of research in voice analysis for patients with PD, whether through acoustic or biomechanical analysis, aiming to determine whether the observed changes in these patients' voices are attributable to age or disease progression. This line of investigation will help elucidate the relative contribution of these factors to vocal alterations in PD patients and provide a more comprehensive understanding of the underlying mechanisms.


Assuntos
Doença de Parkinson , Distúrbios da Voz , Voz , Masculino , Humanos , Feminino , Doença de Parkinson/complicações , Qualidade da Voz , Fonação , Acústica da Fala , Distúrbios da Voz/etiologia
20.
Laryngoscope ; 134(1): 315-317, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37530589

RESUMO

OBJECTIVE: Muscle tension in the head and neck may co-occur with temporomandibular dysfunction (TMD) possibly leading to voice change. Several studies have reported a correlation between TMD and dysphonia. However, literature on TMD and voice-related quality of life (QOL) is scant. This study aimed to investigate the relationship between TMD and self-perceived voice-related QOL impairment. METHODS: Patients from TMD clinic were prospectively surveyed on voice-related quality of life using the Voice Handicap Index (VHI) questionnaire. Patients were queried using paper and pen upon initial evaluation in dentistry clinic for temporomandibular disorders by a single dentist or dental assistant in the otolaryngology department. RESULTS: A total of 53 patients completed the VHI. 80% of patients presenting to TMD clinic had VHI scores above zero, but most had minimal to mild impairment. Forty-two patients had scores between 1 and 86, (average 10.98); 11 patients had a score of zero (20.75%). Total average score: 8.70, range: 0-86, median: 4. Functional average score: 3.13, range: 0-29, median: 1. Physical average score: 3.58. range: 0-25, median: 2. Emotional average score: 1.98, range: 0-32, median: 0; these averages did not differ from historical controls. CONCLUSION: The majority of patients presenting to TMD clinic also presented with some level of voice-related QOL impairment, although minimal and consistent with historical VHI controls. Data indicates that TMD disease may be primarily defined as functionally and physically uncomfortable. Incorporation of interdisciplinary care, with laryngology, speech pathology, physical therapy, counseling, and pain management may be warranted. LEVEL OF EVIDENCE: 4 Laryngoscope, 134:315-317, 2024.


Assuntos
Disfonia , Transtornos da Articulação Temporomandibular , Voz , Humanos , Qualidade de Vida/psicologia , Qualidade da Voz , Inquéritos e Questionários , Índice de Gravidade de Doença , Transtornos da Articulação Temporomandibular/complicações , Avaliação da Deficiência
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