Neural Correlates of Healthy Sustained Vowel Phonation Tasks: A Systematic Review and Meta-Analysis of Neuroimaging Studies

  • Marie Dedry
    Address correspondence and reprint requests to Marie Dedry, Psychological Sciences Research Institute (IPSY), Institute of NeuroSciences (IoNS), Université Catholique de Louvain (UCLouvain), Place Cardinal Mercier 10, B-1348 Louvain-la-Neuve, Belgium.
    Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium

    Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
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  • Youri Maryn
    European Institute for ORL-HNS, Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp, Belgium

    Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium

    Faculty of Education, Health and Social Work, University College Ghent, Gent, Belgium

    Phonanium, Lokeren, Belgium
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  • Arnaud Szmalec
    Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium

    Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium

    Department of Experimental Psychology, Faculty of Psychology and Educational Science, University of Ghent, Gent, Belgium
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  • Julie van Lith-Bijl
    ENT-Department, Flevoziekenhuis, Almere, The Netherlands
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  • Laurence Dricot
    Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
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  • Gauthier Desuter
    Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium

    Otolaryngology, Head and Neck Surgery Department, Voice and Swallowing Clinic, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Bruxelles, Belgium
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      This review of the methodology and results of studies involving a sustained vowel phonation task during functional Magnetic Resonance Imaging (fMRI) aims to contribute to the identification of brain regions involved in phonation for healthy subjects.

      Data sources

      This review was performed using the PubMed electronic database.

      Review Methods

      A review was conducted, according to PRISMA guidelines, between September and November 2020, using the following search term pairs: “fMRI and Phonation” and “fMRI and Voice.” Activation likelihood estimation analysis was performed. A qualitative analysis was also performed to specify the frequency of activation of each region, as well as the various activation clusters within a single region.


      Seven studies were included and analyzed. Five of the seven studies were selected for the activation likelihood estimation meta-analysis which revealed significant convergent activation for only one cluster located in the left precentral gyrus (BA4). A qualitative review provides an overview of brain activation. Primary motor and premotor areas were the only activated areas in all studies included. Other regions previously considered to be implicated in phonation were often activated in sustained vowel phonation tasks. Additionally, areas generally associated with articulation or language also showed activation.


      Methodological recommendations are suggested to isolate the phonatory component and reduce variability between future studies. Based on the qualitative analysis, this review does not support a distinction between regions more related to phonation and regions more related to articulation. Further research is required seeking to isolate the vocal component and to improve insight into human brain network involved in phonation.

      Key Words

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        • Jürgens U
        Neural pathways underlying vocal control.
        Neurosci Biobehav Rev. 2002; 26: 235-258
        • Belyk M
        • Brown R
        • Beal DS
        • et al.
        Human larynx motor cortices coordinate respiration for vocal-motor control.
        Neuroimage. 2021; 239118326
        • Ludlow CL
        Central nervous system control of voice and swallowing.
        J Clin Neurophysiol. 2015; 32: 294-303
        • Titze IR
        • Alipour F
        The Myoelastic Aerodynamic Theory of Phonation.
        National Center for Voice and Speech, Denver, Colorado2006
        • Ludlow CL
        Central nervous system control of the laryngeal muscles in humans.
        Respir Physiol Neurobiol. 2005; 147: 205-222
        • Larson CR
        • Altman KW
        • Liu H
        • et al.
        Interactions between auditory and somatosensory feedback for voice F0 control.
        Exp Brain Res. 2008; 187: 613-621
        • Foote AG
        • Thibeault SL
        Sensory innervation of the larynx and the search for mucosal mechanoreceptors.
        J Speech Lang Hear Res. 2021; 64: 371-391
        • Brown S
        • Laird AR
        • Pfordresher PQ
        • et al.
        The somatotopy of speech: phonation and articulation in the human motor cortex.
        Brain Cogn. 2009; 70: 31-41
        • Liberati A
        • Altman DG
        • Tetzlaff J
        • et al.
        The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration.
        BMJ. 2009; 339: b2700
        • Kryshtopava M
        • Van Lierde K
        • Meerschman I
        • et al.
        Brain activity during phonation in women with muscle tension dysphonia: an fMRI study.
        J Voice. 2017; 31: 675-690
        • Grabski K
        • Lamalle L
        • Vilain C
        • et al.
        Functional MRI assessment of orofacial articulators: neural correlates of lip, jaw, larynx, and tongue movements.
        Hum Brain Mapp. 2012; 33: 2306-2321
        • Kiyuna A
        • Kise N
        • Hiratsuka M
        • et al.
        Brain activity in patients with unilateral vocal fold paralysis detected by functional magnetic resonance imaging.
        J Voice. 2020; (S0892-199730294)
        • Kryshtopava M
        • Van Lierde K
        • Meerschman I
        • et al.
        Functional magnetic resonance imaging study of brain activity associated with pitch adaptation during phonation in healthy women without voice disorders.
        J Voice. 2017; 31: 118.e21-118.e28
        • Loucks TMJ
        • Poletto CJ
        • Simonyan K
        • et al.
        Human brain activation during phonation and exhalation: common volitional control for two upper airway functions.
        Neuroimage. 2007; 36: 131-143
        • Parkinson AL
        • Flagmeier SG
        • Manes JL
        • et al.
        Understanding the neural mechanisms involved in sensory control of voice production.
        Neuroimage. 2012; 61: 314-322
        • Peck KK
        • Galgano JF
        • Branski RC
        • et al.
        Event-related functional MRI investigation of vocal pitch variation.
        Neuroimage. 2009; 44: 175-181
        • Terumitsu M
        • Fujii Y
        • Suzuki K
        • et al.
        Human primary motor cortex shows hemispheric specialization for speech.
        Neuroreport. 2006; 17: 1091-1095
        • Talairach J
        • Tournoux P
        Co-Planar Stereotaxic Atlas of the Human Brain.
        Theime, Stuttgart1988
      1. Research Imaging Institute. Accessed 29 June 2021. Available at:

        • Eickhoff SB
        • Bzdok D
        • Laird AR
        • et al.
        Activation likelihood estimation meta-analysis revisited.
        Neuroimage. 2012; 59: 2349-2361
        • Eickhoff SB
        • Laird AR
        • Grefkes C
        • et al.
        Coordinate-based activation likelihood estimation meta-analysis of neuroimaging data: a random-effects approach based on empirical estimates of spatial uncertainty.
        Hum Brain Mapp. 2009; 30: 2907-2926
        • Turkeltaub PE
        • Eickhoff SB
        • Laird AR
        • et al.
        Minimizing within-experiment and within-group effects in activation likelihood estimation meta-analyses.
        Hum Brain Mapp. 2012; 33: 1-13
        • Fox PT
        • Laird AR
        • Fox SP
        • et al.
        BrainMap taxonomy of experimental design: description and evaluation.
        Hum Brain Mapp. 2005; 25: 185-198
        • Fox PT
        • Lancaster JL
        Opinion: mapping context and content: the BrainMap model.
        Nat Rev Neurosci. 2002; 3: 319-321
        • Laird AR
        • Lancaster JL
        • Fox PT
        BrainMap: the social evolution of a human brain mapping database.
        Neuroinformatics. 2005; 3: 65-78
        • Vanasse TJ
        • Fox PM
        • Barron DS
        • et al.
        BrainMap VBM: an environment for structural meta-analysis.
        Hum Brain Mapp. 2018; 39: 3308-3325
        • Eickhoff SB
        • Nichols TE
        • Hoffstaedter F
        • et al.
        Behavior, sensitivity, and power of activation likelihood estimation characterized by massive empirical simulation.
        Neuroimage. 2016; 137: 70-85
        • Mai JK
        • Majtanik M
        • Paxinos P
        Atlas of the Human Brain.
        4th ed. Academic Press - Elsevier, Cambridge, Massachusetts2006 (Available at:)
        • Ongür D
        • Ferry AT
        • Price JL
        Architectonic subdivision of the human orbital and medial prefrontal cortex.
        J Comp Neurol. 2003; 460: 425-449
        • Brown S
        • Ngan E
        • Liotti M
        A larynx area in the human motor cortex.
        Cereb Cortex. 2008; 18: 837-845
        • Schulz GM
        • Varga M
        • Jeffires K
        • et al.
        Functional neuroanatomy of human vocalization: an H215O PET study.
        Cereb Cortex. 2005; 15: 1835-1847
        • Linnman C
        • Moulton EA
        • Barmettler G
        • et al.
        Neuroimaging of the periaqueductal gray: state of the field.
        Neuroimage. 2012; 60: 505-522