Summary
Objectives/Hypothesis
The validity of cepstral analysis (Cepstral Peak Prominence [CPP] and Cepstral Peak
Prominence-Smoothed [CPPS]) as an indicator of perceptual dysphonia was investigated
in the Persian language
Study design
Cross-sectional study.
Methods
A total of 223 participants (159 with and 64 without dysphonia) uttered vowels /a/
and /i/, six standard sentences, and non-standard connected speech. All vocal samples
were perceptually evaluated by three raters on a visual analog scale and put into
four groups (normal voice, mild, moderate, and severe perpetual dysphonia). CPP and
CPPS of sustained vowel /a/, reading the second standard sentence, and a sentence
extracted from non-standard connected speech were established using “Praat” software. Statistical analysis involved a one-way factorial analysis of variance
(ANOVA), Kruskal-Wallis H, Kendall's Tau-b correlation, t test, and receiver operating characteristics (ROC) curve.
Results
The results showed that CPP of sustained vowels and reading the standard sentence
and CPPS of sustained vowel differed significantly (P < 0.05), except between the normal voice and mild perpetual dysphonia groups (P > 0.05). The CPP of non-standard connected speech, CPPS of reading the standard sentence,
and non-standard connected speech differed significantly between all groups (P < 0.05). The mean of cepstral analysis of all tasks, “averaged CPP,” and “averaged
CPPS” were significantly different between two groups of the normal voice and perceptual
dysphonia (P < 0.05). Correlation between the cepstral analysis and the perceptual ratings demonstrated
that the correlation coefficients for CPP and CPPS were between 0.4 and 0.6 (P < 0.05). ROC curve analysis revealed that the area under the ROC curve for “averaged
CPP” and “averaged CPPS” was greater than 0.8 (P < 0.05). The values of 22.11 and 12.29 were determined as cut-off scores of “averaged
CPP” and “averaged CPPS,” respectively.
Conclusions
Cepstral analysis was known as useful clinical tool for diagnosis of perpetual dysphonia
and determining its severity level in the Persian language.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of VoiceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
Boone DR, McFarlane SC, Berg SLV. The Voice and Voice Therapy. Pearson Education; 2014. The Voice and Voice Therapy, 9th ed. (Pearson, Boston, MA.
- Validation of the measures of cepstral peak prominence as a measure of dysphonia severity in Spanish-Speaking Subjects.Acta Otorrinolaringologica (English Edition). 2019; 70: 222-228
- Cepstral analysis of normal and pathological voice in Spanish adults. Smoothed cepstral peak prominence in sustained vowels versus connected speech.Acta Otorrinolaringologica (English Edition). 2018; 69: 134-140
- A cepstral analysis of normal and pathologic voice qualities in Iranian adults: a comparative study.J Voice. 2017; 31: 508.e17-508.e23
- A basic protocol for functional assessment of voice pathology, especially for investigating the efficacy of (phonosurgical) treatments and evaluating new assessment techniques.Eur Arch Otorhinolaryngol. 2001; 258: 77-82
- Acoustic discrimination of pathological voice.J Speech Lang Hear Res. 2001; 44: 327-339
- Acoustic and perceptual classification of within-sample normal, intermittently dysphonic, and consistently dysphonic voice types.J Voice. 2017; 31: 218-228
- Cepstral analysis of voice in persons with vocal nodules.J Voice. 2010; 24: 651-653
Stemple JC, Roy N, Klaben BK. Clinical Voice Pathology Theory and Management. Plural Publishing; 2014. Plural Publishing; 2018 Dec 20.
- Acoustic correlates of breathy vocal quality: dysphonic voices and continuous speech.J Speech Lang Hear Res. 1996; 39: 311-321
- Acoustic correlates of breathy vocal quality.J Speech Lang Hear Res. 1994; 37: 769-778
- Effects of vocal intensity and fundamental frequency on cepstral peak prominence in patients with voice disorders and vocally healthy controls.J Voice. 2019; 35: 411-417
- Cepstral peak prominence: a comprehensive analysis.Biomed Signal Process Control. 2014; 14: 42-54
- Efficacy of cepstral measures in voice disorder diagnosis: a literature review.J Modern Rehabilitation. 2022; (In press)
- Recommended protocols for instrumental assessment of voice: American Speech-Language-Hearing Association expert panel to develop a protocol for instrumental assessment of vocal function.Am J Speech Lang Pathol. 2018; 27: 887-905
- Quantifying the cepstral peak prominence, a measure of dysphonia.J Voice. 2014; 28: 783-788
- Cepstral peak prominence: a more reliable measure of dysphonia.Ann Otol, Rhinol Laryngol. 2003; 112: 324-333
- Acoustic measurement of overall voice quality: a meta-analysis.J Acoust Soc Am. 2009; 126: 2619-2634
- Cepstral measures in the assessment of severity of voice disorders.SciELO Brasil;. 2019; 31e20180175
- Validation of cepstral acoustic analysis for normal and pathological voice in the Japanese Language.J Voice. 2020; 17 (S0892-1997(20)30325-8)
- Assessment of dysphonia: cepstral analysis versus conventional acoustic analysis.Logoped Phoniatr Vocol. 2021; 46: 99-109
- Toward improved ecological validity in the acoustic measurement of overall voice quality: combining continuous speech and sustained vowels.J Voice. 2010; 24: 540-555
- The effect of speaking task on perceptual judgment of the severity of dysphonic voice.J Voice. 2005; 19: 574-581
- Speech waveform perturbation analysis: a perceptual-acoustical comparison of seven measures.J Speech Lang Hear Res. 1986; 29: 50-64
- Use of spectral/cepstral analyses for differentiating normal from hypofunctional voices in sustained vowel and continuous speech contexts.J Speech Lang Hear Res. 2011; 54: 1525-1537
- Comparing measures of voice quality from sustained phonation and continuous speech.J Speech Lang Hear Res. 2016; 59: 994-1001
- The effect of speaking context on spectral-and cepstral-based acoustic features of normal voice.Clin Linguist Phon. 2016; 30: 1-11
- Vowel-and text-based cepstral analysis of chronic hoarseness.J Voice. 2012; 26: 416-424
- Acoustic and perceptual parameters relating to connected speech are more reliable measures of hoarseness than parameters relating to sustained vowels.ORL. 2004; 66: 70-73
- The relationship between cepstral peak prominence and selected parameters of dysphonia.J Voice. 2002; 16: 20-27
- Effect of vowel context in cepstral and entropy analysis of pathological voices.Biomed Signal Proc Contr. 2019; 47: 350-357
- Contemporary medical ethics: an overview from Iran.Devel World Bioeth. 2008; 8: 192-196
- Relationship between laryngeal signs and symptoms, acoustic measures, and quality of life in Finnish primary and kindergarten school teachers.J Voice. 2018; 34: 259-271
- Responsiveness of Persian version of Consensus Auditory Perceptual Evaluation Of Voice (CAPE-V), Persian version of Voice Handicap Index (VHI), and praat in vocal mass lesions with muscle tension dysphonia.J Voice. 2018; 32: 770.e21-770.e30
- Cepstral and perceptual investigations in female teachers with functionally healthy voice.J Voice. 2018; 34: 485.e33-485.e43
- Objective dysphonia measures in the program Praat: smoothed cepstral peak prominence and acoustic voice quality index.J Voice. 2015; 29: 35-43
- Adverse effects of environmental noise on acoustic voice quality measurements.J Voice. 2005; 19: 15-28
Watts CR, Awan SN. Laryngeal Function and Voice Disorders: Basic Science to Clinical Practice. Thieme; 2019; 2019 Jan 7.
- Cepstral analysis of voice in unilateral adductor vocal fold palsy.J Voice. 2011; 25: 326-329
- Use of cepstral analyses for differentiating normal from dysphonic voices: a comparative study of connected speech versus sustained vowel in European Portuguese female speakers.J Voice. 2014; 28: 282-286
- Comparison of cepstral analysis based on voiced-segment extraction and voice tasks for discriminating dysphonic and normophonic Korean speakers.J Voice. 2019; 35: 328.e11-328.e22
- Predictive value and discriminant capacity of cepstral-and spectral-based measures during continuous speech.J Voice. 2013; 27: 393-400
Article info
Publication history
Published online: May 19, 2022
Accepted:
April 8,
2022
Publication stage
In Press Corrected ProofFootnotes
Conflict of interest: The authors report no conflicts of interest.
This study was part of the first author's Master Science (MSc) thesis supported by Speech Therapy Department, School of Rehabilitation, Tehran University of Medical Sciences (Grant Number: 1400-2-103-53808).
Identification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
