Summary
Objectives
Cepstral analysis does not require the detection of pitch within waveforms, which
makes it suitable for acoustic evaluation of connected speech contexts and severely
disordered voice. Although the utility of cepstral measurements, including cepstral
peak prominence (CPP) and cepstral spectral index of dysphonia (CSID), has been reported
for several languages, it has yet to be demonstrated in the Japanese language. The
current study aimed to investigate the utility of cepstral acoustic analysis for the
Japanese language as an indicator of dysphonia and the degree of dysphonia severity.
Methods
Ninety-five patients with dysphonia and thirty volunteers without voice complaint
uttered the sustained vowel /a/ and read four Japanese sentences designed to elicit
different laryngeal behaviors. The recorded voice samples were evaluated perceptually
by three raters according to the GRBAS scale (grade) and overall severity (OS) on
a visual analog scale. Participants were then divided into four groups based on grade
and OS: non-, mildly, moderately, and severely dysphonic groups. For the acoustic
analysis, CPP and CSID were computed using the Analysis of Dysphonia in Speech and
Voice, while jitter percentage (Jitt), shimmer percentage (Shim), and noise to harmonic
ratio were computed using the Multi-Dimensional Voice Program.
Results
Statistical analysis revealed that both CPP and CSID differed significantly between
all groups, except for grade between the non-dysphonic and mildly dysphonic groups.
Pearson correlation analysis between the acoustic measurements and the perceptual
ratings revealed that the absolute correlation coefficients for CPP, CSID, and Jitt
were greater than 0.7. Specifically, those for CPP and CSID were greater than 0.8
for OS. Receiver operating characteristic curve analysis showed that the AUC for CPP,
CSID, Jitt, and Shim was greater than 0.8 for both grade and OS. The cut-off values
for CPP and CSID, as determined by the Youden Index, were 6.74–7.18 and 12.16–20.39,
respectively.
Conclusion
The current study demonstrated the validity of CPP and CSID as indicators of dysphonia
and indices of dysphonia severity in the Japanese language.
Key Words
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Article Info
Publication History
Published online: September 17, 2020
Footnotes
The authors report no conflicts of interest.
This study was supported by a research grant from the Japan Society of Logopedics and Phoniatrics.
Identification
Copyright
© 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
