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1.
Artigo em Chinês | MEDLINE | ID: mdl-33541000

RESUMO

Objective:The aim of this study is to evaluate the efficacy of CO2 laser and CO2 laser combined with microsuture in the treatment of bilateral sessile polyps of vocal cords. Methods:Forty-eight patients with bilateral sessile polyps of vocal cords were randomly divided into CO2 laser group and CO2 laser combined with microsuture group. The surgical effect of each group and the difference between the two groups were evaluated by subjective score and objective voice analysis. Results:One month and three month after operation, Jitter, Shimmer, dysphonia severity index(DSI), the maximum phonation time(MPT), the parameters of G and voice handicap index(VHI-10) in the two groups were significantly different from pre-operation(P<0.05). There were also significant differences in Jitter, Shimmer, DSI and MPT between the two groups one month and three month after operation respectively(P<0.05). But no significant differences of the parameters of G and VHI-10 was noted between two groups(P>0.05). The incidence of postoperative vocal cord adhesion was 8.3% and 0 in two groups respectively, and there was no significant difference between the two groups(P>0.05). Conclusion:The CO2 laser combined with microsuturing technique can effectively improve the voice quality of patients with bilateral wide-based vocal cord polyps, and the effect is better than that of using CO2 laser alone.


Assuntos
Disfonia , Doenças da Laringe , Pólipos , Humanos , Doenças da Laringe/cirurgia , Fonação , Pólipos/cirurgia , Resultado do Tratamento , Prega Vocal/cirurgia , Qualidade da Voz
2.
Eur Arch Otorhinolaryngol ; 278(3): 839-841, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33392763

RESUMO

INTRODUCTION: Spasmodic dysphonia (SD), a form of focal dystonia, has been defined as a neurogenic, task-specific disorder characterized by abrupt spasms of intrinsic laryngeal muscles that result in phonatory breaks. There are three classic types of SD: adductor SD, abductor (ABSD) and mixed SD. Compared with the more common adductor form, treatment of ABSD with botulinum toxin injection is related to a shorter efficacy and improvement in only about 70% of patients [Blitzer et al. in Laryngoscope 108:1435-1441, 1998]. Moreover, due to the possible loss of efficacy over time or patient refusal for repeated injections, surgical solutions for permanent or at least long-term results must be considered. METHOD: The surgical technique we propose is based on transoral bilateral posterior cricoarytenoid muscle (PCA) coagulation by radiofrequency (Celon, pro surg 250-T30, Olympus, Germany, 10 W, in 3 spots, each side) under a microscope or rigid scope control. The procedure is performed in two sessions distant of 2-3 weeks to avoid the risk of bilateral vocal fold temporary paralysis in adduction. A 52-year-old female patient with no audible voicing, resistant to botulinum toxin and after failure of relaxation thyroplasty type III according to lssihki [Saito et al. in Case Rep Otolaryngol 2018:4280381, 2018] showed an improvement of the Voice Handicap Index (VHI-10) from 35/40 to 19/40. The patient was rated G2R3B2A1S2 according to GRABS scale. CONCLUSION: PCA coagulation for ABSD is a safe and reusable surgical option. It is less invasive than other techniques described before. To the best of our knowledge, this technique was never reported before in this type of SD.


Assuntos
Disfonia , Disfonia/tratamento farmacológico , Feminino , Alemanha , Humanos , Músculos Laríngeos , Pessoa de Meia-Idade , Fonação , Resultado do Tratamento , Distúrbios da Voz
4.
Codas ; 32(6): e20190006, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33237186

RESUMO

PURPOSE: This study aims to measure the pressure of the pharynx and the pharyngoesophageal segment (PES) at rest and during phonation in total laryngectomized patients, with different levels of voice production. METHODS: four total laryngectomized individuals participated in the study, All patients underwent High Resolution Manometry (MAR) at rest and during phonation. After this process, a descriptive analysis of the results was performed. RESULTS: we observed that during rest the patients had PES pressure below normal and this data may be related to changes in the muscular connections at the level of the upper esophageal sphincter (UES) especially the interruption of the cricopharyngeal plexus. During phonation, two patients presented higher UES pressure values during phonation, when compared to the values found at rest, suggesting that introduction of air into the esophagus is followed by pharyngoesophageal contraction and that during phonation the patients with good esophageal speech may develop more pressure in this region. CONCLUSION: Studies with a greater number of participants may help define, for example, subjects who may benefit from procedures such as cricopharyngeal myotomy or other medical conduct in order to facilitate the acquisition of esophageal voice in these patients.


Assuntos
Laringectomia , Voz Esofágica , Esôfago/cirurgia , Humanos , Manometria , Faringe , Fonação
5.
Codas ; 32(5): e20190079, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33053084

RESUMO

PURPOSE: To investigate the self-perception by individuals on the immediate effects of three semi-occluded vocal tract exercises (SOVTE), that is, phonation into a latex tube, finger kazoo and phonation into a high-resistance straw, and to compare the self-perception results between the high and low voice groups. METHOD: The study participants consisted of 26 choristers (seven sopranos, seven altos, six tenors, and six basses) subdivided into high and low voices with ages ranging from 18 to 58 years. Voice samples of each subject were recorded before and after performing the exercises randomly for three subsequent weeks. A self-assessment questionnaire was applied. RESULTS: All exercises had a statistically significant improvement, according to the participants' self-perception. Latex tube phonation was the preferred technique for 11 (84.62%) participants in the low voice group; while the high-resistance straw was reported as the less beneficial exercise by 10 (79.92%) participants in the same group. On the other hand, the high-resistance straw (9; 69.2%) was the preferred exercise for the high voice group; while finger kazoo (6; 46.15%) and latex tube (5; 38.4%) were the least beneficial exercises. CONCLUSION: The study showed that the effects of these exercises are different and should be suited for each type of voice, such as the latex tube, which was the most preferred by low voice participants and also rated as less beneficial by high voice participants, and the high-resistance straw, which was the most preferred by the high voice participants and also rated as less beneficial by low voice participants.


Assuntos
Qualidade da Voz , Voz , Adolescente , Adulto , Humanos , Pessoa de Meia-Idade , Fonação , Autoimagem , Treinamento da Voz , Adulto Jovem
6.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3666-3669, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018796

RESUMO

This study has investigated the efficiency of voice features in estimating the motor Unified Parkinson's Disease Rating Scale (UPDRS) score in Parkinson's disease (PD) patients. A total of 26 PD patients (mean age = 72) and 22 control subjects (mean age = 66.91) were recruited for the study. The sustained phonation /a/, /u/ and /m/ were collected in both off-state and on-state of Levodopa medication. The average motor UPDRS for PD off-state patients was 27.31, on-state was 20.42 and that of controls was 2.63. Voice features were extracted from the phonation tasks and were reduced to the most relevant 6 features for each phonation task using the Least Absolute Shrinkage and Selection Operator (LASSO) feature ranking method. The correlation between the reduced features and motor UPDRS was tested using the Spearman correlation coefficient test. AdaBoost regression learner was trained and used for automatically estimating the motor UPDRS score using the voice features. The results show that the vocal features for /m/ performed best by estimating the motor UPDRS score for PD off-state with the mean absolute error (MAE) of 3.52 and 5.90 for PD on-state. This study shows that assessment of voice can be used for day to day remote monitoring of PD patients.


Assuntos
Doença de Parkinson , Voz , Humanos , Levodopa/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Fonação
7.
Medicine (Baltimore) ; 99(39): e22236, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991418

RESUMO

Articulation disorder is associated with impaired control of respiration and speech organ movement. There are many cases of dysarthria and dysphonia in stroke patients. Dysphonia adversely affects communication and social activities, and it can interfere with everyday life. The purpose of this study is to assess the association between phonation abilities and the vowel quadrilateral in stroke patients.The subjects were stroke patients with pronunciation and phonation disorders. The resonance frequency was measured for the 4 corner vowels to measure the vowel space area (VSA) and formant centralization ratio (FCR). Phonation ability was evaluated by the Dysphonia Severity Index (DSI) and maximal phonation time (MPT) through acoustic evaluation for each vowel. Pearsons correlation analysis was performed to confirm the association, and multiple linear regression analysis was performed between variables.The correlation coefficients of VSA and MPT/u/ were 0.420, VSA and MPT/i/ were 0.536, VSA and DSI/u/ were 0.392, VSA and DSI /i/ were 0.364, and FCR and DSI /i/ were -0.448. Multiple linear regression analysis showed that VSA was a factor significantly influencing MPT/u/ (ß = 0.420, P = .021, R = 0.147), MPT/i/ (ß = 0.536, P = .002, R = 0.262), DSI/u/ (ß = 0.564, P = .045, R = 0.256), and DSI/i/ (ß = 0.600, P = .03, R = 0.302).The vowel quadrilateral can be a useful tool for evaluating the phonation function of stroke patients.


Assuntos
Disfonia/terapia , Fonação , Reabilitação do Acidente Vascular Cerebral/métodos , Idoso , Disfonia/etiologia , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Acidente Vascular Cerebral/complicações
8.
PLoS One ; 15(9): e0237702, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915785

RESUMO

Language input in childhood and literacy (and/or schooling) have been described as two key experiences impacting phonological processing. In this study, we assess phonological processing via a non-word repetition (NWR) group game, in adults and children living in two villages of an ethnic group where infants are rarely spoken to, and where literacy is variable. We found lower NWR scores than in previous work for both children (N = 17; aged 1-12 years) and adults (N = 13; aged 18-60 years), which is consistent with the hypothesis that there would be long-term effects on phonological processing of experiencing low levels of directed input in infancy. Additionally, we found some evidence that literacy and/or schooling increases NWR scores, although results should be interpreted with caution given the small sample size. These findings invite further investigations in similar communities, as current results are most compatible with phonological processing being influenced by aspects of language experience that vary greatly between and within populations.


Assuntos
Alfabetização/etnologia , Fonação , Percepção da Fala , Adulto , Bolívia , Criança , Pré-Escolar , Feminino , Humanos , Povos Indígenas/psicologia , Lactente , Desenvolvimento da Linguagem , Alfabetização/psicologia , Masculino , Pessoa de Meia-Idade
9.
PLoS One ; 15(9): e0238451, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32881917

RESUMO

Organizational effectiveness is contingent upon employees' contributions; however, the role of employee voice behavior as a critical component of employees' contribution to the organization has not been sufficiently acknowledged. Based on proactive behavior theory, we present a model to investigate employee voice behavior as an underlying mechanism in the relationship between supervisor delegation and perceived workplace inclusion. Using the SEM (structural equation modeling) method, we test our model's hypotheses with data from 271 employee-supervisor questionnaires administered in state-owned enterprises in the telecommunications industry. The results show that supervisor delegation is positively related to employees' promotive and prohibitive voice behavior. Promotive voice significantly influences perceived workplace inclusion, but prohibitive voice behavior was not found to have any impact on perceived workplace inclusion. Moreover, both dimensions of voice behavior, i.e., promotive and prohibitive voice behavior, significantly mediate the relationship between supervisor delegation and perceived workplace inclusion.


Assuntos
Emprego/organização & administração , Telecomunicações/tendências , Qualidade da Voz/fisiologia , Adulto , Idoso , Feminino , Humanos , Indústrias , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Organizações , Fonação/fisiologia , Comportamento Social , Inquéritos e Questionários , Voz/fisiologia , Local de Trabalho/organização & administração
10.
Adv Clin Exp Med ; 29(7): 865-871, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32620054

RESUMO

BACKGROUND: Short and long-term results of microsurgical treatment with the mini-microflap technique in patients with Reinke's edema (RE) were assessed based on the phonatory and ventilatory functions of the larynx. OBJECTIVES: To assess the short and long-term results of microsurgical treatment with the mini-microflap technique in patients with RE based on the phonatory and ventilatory functions of the larynx. MATERIAL AND METHODS: Twenty patients diagnosed with advanced stage of RE confirmed with laryngovideostroboscopy (LVS) were enrolled in the study. Phonatory function disturbances were additionally assessed on the basis of Maximum Phonation Time (MPT) measurement, Voice Handicap Index (VHI) and Voice-Related Quality of Life (V-ROOL) questionnaires. Ventilatory function was assessed using spirometry. The aforementioned complex examinations were conducted prior to surgery and 1, 6 and 9 months following the surgery. RESULTS: Good postsurgical results were obtained in subjective and objective evaluation, which assessed the phonatory function and ventilatory parameters. Post-surgery increase in MPT, VHI and VQROL was noticed in all patients in 3 check points (p < 0.001). The results demonstrate postsurgical improvement for some LVS parameters, including assessment of glottis closure (p < 0.003) observed 6 months after the surgery. An improvement in most of the ventilation parameters was observed also 6 months after surgery (p < 0.001). For the spirometry flow parameter PEF, significant improvement was noted in each check point (p1 < 0.004, p6 < 0.001, p9 < 0.001). The study revealed a correlation between phonatory parameter - MPT and PEF observed 1 month after the procedure (p = 0.026), confirming the interdependence of ventilatory efficiency and phonatory condition of larynx. CONCLUSIONS: Mini-microflap surgery brings satisfactory clinical effect in patients with advanced stages of RE by optimization of phonatory and ventilatory functions of the larynx.


Assuntos
Microcirurgia , Qualidade de Vida , Edema/cirurgia , Humanos , Fonação , Resultado do Tratamento , Prega Vocal , Qualidade da Voz
11.
Am J Otolaryngol ; 41(4): 102455, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32475619

RESUMO

BACKGROUND: There are no reliable outcome predictors for functional dysphonia (FD) patients. OBJECTIVES: To investigate if any clinical or phoniatric characteristics could identify FD patients at risk of negative outcome after speech therapy. METHODS: We retrospectively reviewed the results of 78 FD patients treated with the proprioceptive elastic method. Before and one-month after therapy, patients underwent endoscopy, acoustic analysis with Multi-Dimensional Voice Program, and Voice Handicap Index-10 questionnaire (VHI-10). Negative outcome was the persistence of VHI-10 ≥ 13. RESULTS: 26 FD patients had negative outcome (i.e. VHI-10 ≥ 13) after speech therapy. At univariate analysis, clinical variables (i.e. sex, age, comorbidities, dysphonia duration, and professional voice use) were not associated with the outcome. Elevated Jitter% (Jitt; p = 0.03), Shimmer% (Shim; statistical trend, p = 0.06), and Noise to Harmonics Ratio (statistical trend, p = 0.06) were found in patients with poor results. At multivariate analysis, higher Jitt was an independent negative prognostic factor (p = 0.02), while a statically trend was identified for Shim (p = 0.06). A panel of Jitt >1.5 and Shim >5.1 showed an acceptable discriminatory power (AUC [ROC] = 0.76) according to Hosmer and Lemeshow scale. CONCLUSION: A panel of two acoustic analysis parameters could help in identifying FD patients at risk of speech therapy failure. Further studies in these patients are needed to evaluate the most efficient treatment protocol.


Assuntos
Disfonia/diagnóstico , Disfonia/reabilitação , Fonação , Acústica da Fala , Medida da Produção da Fala/métodos , Fonoterapia/métodos , Falha de Tratamento , Qualidade da Voz , Voz , Adulto , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Risco
12.
Sci Rep ; 10(1): 10179, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32576918

RESUMO

Adductor-type spasmodic dysphonia (ADSD) manifests in effortful speech temporarily relievable by botulinum neurotoxin type A (BoNT-A). Previously, abnormal structure, phonation-related and resting-state sensorimotor abnormalities as well as peripheral tactile thresholds in ADSD were described. This study aimed at assessing abnormal central tactile processing patterns, their spatial relation with dysfunctional resting-state connectivity, and their BoNT-A responsiveness. Functional MRI in 14/12 ADSD patients before/under BoNT-A effect and 15 controls was performed (i) during automatized tactile stimulus application to face/hand, and (ii) at rest. Between-group differential stimulation-induced activation and resting-state connectivity (regional homogeneity, connectivity strength within selected sensory(motor) networks), as well as within-patient BoNT-A effects on these differences were investigated. Contralateral-to-stimulation overactivity in ADSD before BoNT-A involved primary and secondary somatosensory representations, along with abnormalities in higher-order parietal, insular, temporal or premotor cortices. Dysphonic impairment in ADSD positively associated with left-hemispheric temporal activity. Connectivity was increased within right premotor (sensorimotor network), left primary auditory cortex (auditory network), and regionally reduced at the temporoparietal junction. Activation/connectivity before/after BoNT-A within-patients did not significantly differ. Abnormal ADSD central somatosensory processing supports its significance as common pathophysiologic focal dystonia trait. Abnormal temporal cortex tactile processing and resting-state connectivity might hint at abnormal cross-modal sensory interactions.


Assuntos
Disfonia/fisiopatologia , Distúrbios Distônicos/fisiopatologia , Células Receptoras Sensoriais/fisiologia , Toxinas Botulínicas Tipo A/uso terapêutico , Mapeamento Encefálico/métodos , Disfonia/tratamento farmacológico , Distúrbios Distônicos/tratamento farmacológico , Feminino , Mãos/fisiopatologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Córtex Motor/efeitos dos fármacos , Córtex Motor/fisiopatologia , Fonação/efeitos dos fármacos , Fonação/fisiologia , Células Receptoras Sensoriais/efeitos dos fármacos , Fala/efeitos dos fármacos , Fala/fisiologia
13.
Am J Otolaryngol ; 41(4): 102532, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32409162

RESUMO

OBJECTIVE: The aging larynx undergoes structural changes that have functional consequences for voice production known as presbyphonia. Treatment of presbyphonia includes voice therapy and surgery. This review seeks to examine voice outcomes after surgery for presbyphonia. DATA SOURCES: Three electronic databases (PreMed, ScienceDirect, Embase) were reviewed for articles published between 1 January 1900 and 1 June 2019. REVIEW METHODS: Original English-language studies examining surgical treatment of presbyphonia in elderly patients (≥65 years) were included according to PRISMA. Two researchers independently analyzed articles. Outcome measures were extracted from and qualitatively compared across studies. RESULTS: Of the 118 articles identified, five satisfied eligibility criteria. In all studies, diagnosis of presbyphonia was based on videostroboscopy. 85 patients (61M, 21F) were evaluated. 37.6% underwent implantation thyroplasty (IT), 48.2% underwent injection augmentation (IA), 7.1% underwent both, and 7.1% underwent basic-fibroblastic growth factor (b-FGF) injection. Average patient age was 71.3 years. Average follow-up time was 5.4 months. Three months post-intervention, IT patients self-reported greater improvement in quality of life (QoL) metrics compared to IA patients. Aerodynamic measures, like mean phonation time, were significantly improved in IT and IA, but not b-FGF-injected patients. All patients experienced improvements in the auditory perception of voice three months post-intervention. CONCLUSION: Surgical modalities currently utilized for presbyphonia include IT and IA, with bFGF-injection being trialed abroad. IT patients reported enhanced QoL relative to IA and bFGF-injected patients. Overall there is a paucity of high-power, prospective studies that explore the efficacy of these modalities. Moreover, wide variability exists in reported outcomes among published studies.


Assuntos
Laringoplastia/métodos , Distúrbios da Voz/cirurgia , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Percepção Auditiva , Feminino , Fator 2 de Crescimento de Fibroblastos/administração & dosagem , Seguimentos , Humanos , Injeções , Masculino , Fonação , Qualidade de Vida , Resultado do Tratamento , Voz , Distúrbios da Voz/fisiopatologia
14.
Respir Med ; 168: 105990, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32364960

RESUMO

BACKGROUND AND AIM: Vocal Cord Dysfunction (VCD) and chronic cough (CC) are challenging conditions which lead to significant quality of life impairment. The underlying mechanisms are poorly understood, but laryngeal dysfunction may be common to both conditions. The aim of this study was to determine the characteristics of cough in VCD and whether patients with cough have coexisting VCD. METHOD: Participants included 51 patients with VCD and a comparison group of 39 patients with chronic cough that was refractory to medical treatment. Participants underwent a comprehensive assessment including questionnaires, laryngoscopy, cough frequency monitoring and voice testing. RESULTS: Patients with VCD had significant cough morbidity with an increased cough frequency of 17.3 coughs/hour and reduced cough quality of life with mean Leicester Cough Questionnaire Score of 12.8. Breathing pattern abnormalities were also common in VCD and there was a strong correlation between the number of breathing pattern abnormalities and cough frequency (r = -0.827, p = 0.002). Cough measures were not significantly different between patients with VCD and those with CC. Moderate-severe PVFM was present in 69% of patients with CC. Abnormal vocal fold closure during phonation was also present in patients with chronic cough and was similar between the VCD (n = 40, 78.4%) and cough (n = 25, 64.1%) groups, p = 0.240. CONCLUSION: Cough is an important symptom in VCD. Patients presenting with chronic cough may have underlying VCD as a cause of their cough. Since cough and VCD symptoms co-occur clinicians need to consider cough when are treating VCD and VCD when treating chronic cough.


Assuntos
Tosse/diagnóstico , Doenças da Laringe/complicações , Disfunção da Prega Vocal/diagnóstico , Adulto , Idoso , Doença Crônica , Tosse/etiologia , Feminino , Humanos , Laringoscopia , Masculino , Pessoa de Meia-Idade , Morbidade , Fonação , Respiração , Transtornos Respiratórios/complicações , Transtornos Respiratórios/fisiopatologia , Inquéritos e Questionários , Disfunção da Prega Vocal/etiologia , Prega Vocal/fisiopatologia
15.
Sci Rep ; 10(1): 5807, 2020 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-32242032

RESUMO

The capability of differentiating between various emotional states in speech displays a crucial prerequisite for successful social interactions. The aim of the present study was to investigate neural processes underlying this differentiating ability by applying a simultaneous neuroscientific approach in order to gain both electrophysiological (via electroencephalography, EEG) and vascular (via functional near-infrared-spectroscopy, fNIRS) responses. Pseudowords conforming to angry, happy, and neutral prosody were presented acoustically to participants using a passive listening paradigm in order to capture implicit mechanisms of emotional prosody processing. Event-related brain potentials (ERPs) revealed a larger P200 and an increased late positive potential (LPP) for happy prosody as well as larger negativities for angry and neutral prosody compared to happy prosody around 500 ms. FNIRS results showed increased activations for angry prosody at right fronto-temporal areas. Correlation between negativity in the EEG and activation in fNIRS for angry prosody suggests analogous underlying processes resembling a negativity bias. Overall, results indicate that mechanisms of emotional and phonological encoding (P200), emotional evaluation (increased negativities) as well as emotional arousal and relevance (LPP) are present during implicit processing of emotional prosody.


Assuntos
Circulação Cerebrovascular , Emoções , Potenciais Evocados , Fonação , Percepção da Fala , Adulto , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/fisiologia , Eletroencefalografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espectroscopia de Luz Próxima ao Infravermelho
16.
Brain Stimul ; 13(3): 908-915, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32289724

RESUMO

BACKGROUND: Reduced intracortical inhibition is a neurophysiologic finding in focal dystonia that suggests a broader problem of impaired cortical excitability within the brain. A robust understanding of the neurophysiology in dystonia is essential to elucidate the pathophysiology of the disorder and develop new treatments. The cortical silent period (cSP) is a reliable, non-invasive method to measure intracortical inhibition in the primary motor cortex associated with a muscle of interest. In adductor spasmodic dysphonia (AdSD), cSP of the laryngeal motor cortex (LMC) which directly corresponds to the affected musculature, the thyroarytenoid (TA), has not been examined. OBJECTIVE: This work evaluated the cSP of the LMC and the relationship between cSP and functional magnetic resonance imaging (fMRI) blood-oxygen-level dependent (BOLD) activation in people with AdSD (n = 12) compared to healthy controls (CTL, n = 14). RESULTS: Shortened LMC cSP were observed bilaterally in people with AdSD vs CTL (F(1, 99) = 19.5226, p < 0.0001), with a large effect size (η2 = 0.1834). Between-group fMRI analysis revealed greater activation in bilateral LMC in the AdSD > CTL contrast as compared to CTL > AdSD contrast. Correlation analysis showed that people with AdSD have positive correlation of left LMC BOLD activation and the cSP. Further, the right LMC cSP lacks either positive or negative associations with BOLD activation. CTL individuals displayed both positive and negative correlations between cSP and BOLD activation in the left LMC. In CTL, the LMC cSP and BOLD activation showed exclusively negative correlations in both hemispheres. CONCLUSION: In AdSD, the cortical activation during phonation may not be efficiently or effectively associated with inhibitory processes, leading to muscular dysfunction. These findings may give insight into the maladaptive cortical control during phonation in people with AdSD.


Assuntos
Disfonia/diagnóstico por imagem , Disfonia/terapia , Imagem por Ressonância Magnética/métodos , Córtex Motor/diagnóstico por imagem , Fonação/fisiologia , Estimulação Magnética Transcraniana/métodos , Adulto , Idoso , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Córtex Motor/fisiopatologia
18.
Nat Commun ; 11(1): 1189, 2020 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-32132541

RESUMO

Changes in potential regulatory elements are thought to be key drivers of phenotypic divergence. However, identifying changes to regulatory elements that underlie human-specific traits has proven very challenging. Here, we use 63 reconstructed and experimentally measured DNA methylation maps of ancient and present-day humans, as well as of six chimpanzees, to detect differentially methylated regions that likely emerged in modern humans after the split from Neanderthals and Denisovans. We show that genes associated with face and vocal tract anatomy went through particularly extensive methylation changes. Specifically, we identify widespread hypermethylation in a network of face- and voice-associated genes (SOX9, ACAN, COL2A1, NFIX and XYLT1). We propose that these repression patterns appeared after the split from Neanderthals and Denisovans, and that they might have played a key role in shaping the modern human face and vocal tract.


Assuntos
Metilação de DNA , DNA Antigo , Face/anatomia & histologia , Fenótipo , Fonação/genética , Adulto , Idoso , Animais , Células Cultivadas , Criança , Condrócitos , Evolução Molecular , Feminino , Redes Reguladoras de Genes , Especiação Genética , Humanos , Laringe/anatomia & histologia , Masculino , Pessoa de Meia-Idade , Homem de Neandertal/genética , Pan troglodytes/genética , Cultura Primária de Células , Língua/anatomia & histologia , Prega Vocal/anatomia & histologia , Vocalização Animal
19.
PLoS One ; 15(3): e0229960, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32160255

RESUMO

BACKGROUND/AIM: It is widely believed that 'creaky voice' ('creak', 'vocal fry', 'glottal fry') is increasingly prevalent among some English speakers, particularly among young American women. Motivated by the widespread and cross-disciplinary interest in the phenomenon, this paper offers a systematic review of peer-reviewed research (up to January 2019) on the prevalence of creaky voice in varieties of English. The review aimed to understand whose and what speech has been studied, how creaky voice prevalence has been measured, and what the findings collectively reveal. METHOD: Literature was located by searching four electronic databases (ProQuest, PubMed, SCOPUS, Web of Science) and the proceedings of two recurrent conferences ('ICPhS' and 'SST'). Studies were included if they reported the prevalence of creaky voice in naturalistic samples of English spoken by vocally-healthy speakers. Reference lists of included studies were cross-checked. RESULTS: Only ten studies meeting inclusion criteria were identified. All studies sampled a small number of speakers and/or short durations of speech. Nine were recent studies of American-English speakers, and many of these sampled young, female, college students. Across the ten studies, creaky voice was detected using three types of methods, and prevalence was calculated using five different formulae. The findings show that prevalence varies across groups, individuals, and contexts. However, the precise nature of this variability remains unclear due to the scarcity and methodological heterogeneity of the research. CONCLUSIONS: This paper illustrated the application of systematic literature review methods in sociophonetic research-a field in which such methods are not common. The review found that creaky voice prevalence in English is not well understood, and that widespread claims of its recent increase among young American women have not been empirically confirmed. A number of specific limitations in the existing research are highlighted, which may serve as a guide for future research design.


Assuntos
Percepção da Fala/fisiologia , Fala/fisiologia , Voz/fisiologia , Fatores Etários , Humanos , Idioma , Fonação/fisiologia , Fatores Sexuais , Acústica da Fala , Medida da Produção da Fala , Fatores de Tempo , Qualidade da Voz/fisiologia
20.
Sci Rep ; 10(1): 4529, 2020 03 11.
Artigo em Inglês | MEDLINE | ID: mdl-32161310

RESUMO

Speaking involves coordination of multiple neuromotor systems, including respiration, phonation and articulation. Developing non-invasive imaging methods to study how the brain controls these systems is critical for understanding the neurobiology of speech production. Recent models and animal research suggest that regions beyond the primary motor cortex (M1) help orchestrate the neuromotor control needed for speaking, including cortical and sub-cortical regions. Using contrasts between speech conditions with controlled respiratory behavior, this fMRI study investigates articulatory gestures involving the tongue, lips and velum (i.e., alveolars versus bilabials, and nasals versus orals), and phonatory gestures (i.e., voiced versus whispered speech). Multivariate pattern analysis (MVPA) was used to decode articulatory gestures in M1, cerebellum and basal ganglia. Furthermore, apart from confirming the role of a mid-M1 region for phonation, we found that a dorsal M1 region, linked to respiratory control, showed significant differences for voiced compared to whispered speech despite matched lung volume observations. This region was also functionally connected to tongue and lip M1 seed regions, underlying its importance in the coordination of speech. Our study confirms and extends current knowledge regarding the neural mechanisms underlying neuromotor speech control, which hold promise to study neural dysfunctions involved in motor-speech disorders non-invasively.


Assuntos
Mapeamento Encefálico , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/fisiologia , Imagem por Ressonância Magnética , Fonação , Fala , Adulto , Conectoma , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Modelos Biológicos , Córtex Motor/fisiologia , Reprodutibilidade dos Testes , Adulto Jovem
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