Summary
Objectives
Differential diagnosis for adductor laryngeal dystonia (AdLD) is often carried out
by comparing symptom expression during sentences with either all voiced or voiced
and voiceless consonants. However, empirical research examining the effects of phonetic
context on symptoms is sparse. The purpose of this study was to examine whether symptom
probabilities varied across voiced speech segments in an all-voiced sentence, and
whether this variability was systematic with respect to phonetic features.
Methods
Eighteen speakers with AdLD read aloud a sentence comprised entirely of voiced speech
sounds. Speech segment boundaries and AdLD symptoms (phonatory breaks, frequency shifts,
and creak) were labeled separately, and speech segments were coded as symptomatic
or asymptomatic based on their temporal overlap. Generalized linear mixed effects
models with a binomial outcome variable were used to compare the probability of symptom
expression across: 1) all speech segments in the sentence, and 2) four speech sound
classes (vowels, approximants, nasals, and obstruents).
Results
Significant symptom variability was found across voiced speech segments in the sentence.
Furthermore, the estimated probability of a symptom occurring on vowels and approximants
was significantly greater than that of nasals and obstruents.
Conclusion
These results indicate that AdLD symptoms are not uniformly distributed across voiced
speech segments with systematic variation across speech sound classes.To explain these
findings, future work should investigate how the complex interactions between the
vocal tract articulators and glottal configurations may influence symptom expression
in this population.
Key words
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References
- Laryngeal dystonia: multidisciplinary update on terminology, pathophysiology, and research priorities.Neurology. 2021; 96: 989-1001https://doi.org/10.1212/WNL.0000000000011922
- The mayo clinic arizona spasmodic dysphonia experience: a demographic analysis of 718 patients.Ann Otol Rhinol Laryngol. 2015; 124: 859-863https://doi.org/10.1177/0003489415588557
- Phenomenology, genetics, and CNS network abnormalities in laryngeal dystonia: a 30-year experience.Laryngoscope. 2018; 128: S1-S9https://doi.org/10.1002/lary.27003
- Differentiation of spasmodic and psychogenic dysphonias with phonoscopic evaluation.Laryngoscope. 1999; 109: 295-300https://doi.org/10.1097/00005537-199902000-00022
- Functional but not structural networks of the human laryngeal motor cortex show left hemispheric lateralization during syllable but not breathing production.J Neurosci. 2009; 29: 14912-14923https://doi.org/10.1523/JNEUROSCI.4897-09.2009
- Abnormal structure-function relationship in spasmodic dysphonia.Cereb Cortex. 2012; 22: 417-425https://doi.org/10.1093/cercor/bhr120
- Neural correlates of abnormal sensory discrimination in laryngeal dystonia.Neuroimage Clin. 2015; 10: 18-26https://doi.org/10.1016/j.nicl.2015.10.016
- Altered sensory system activity and connectivity patterns in adductor spasmodic dysphonia.Sci Rep. 2020; 10 (10179-w)https://doi.org/10.1038/s41598-020-67295-w
- Suicidal ideations and attempts in patients with isolated dystonia.Neurology. 2021; 96: e1551-e1560https://doi.org/10.1212/WNL.0000000000011596
- Spasmodic dysphonia. emotional status and botulinum toxin treatment.Arch Otolaryngol Head Neck Surg. 1994; 120: 310-316https://doi.org/10.1001/archotol.1994.01880270056010
- Spasmodic dysphonia: onset, course, socioemotional effects, and treatment response.Ann Otol Rhinol Laryngol. 2011; 120: 465-473https://doi.org/10.1177/000348941112000708
- Spasmodic dysphonia: a laryngeal control disorder specific to speech.J Neurosci. 2011; 31: 793-797https://doi.org/10.1523/JNEUROSCI.2758-10.2011
- Identification of symptoms for spasmodic dysphonia and vocal tremor: a comparison of expert and nonexpert judges.J Commun Disord. 2001; 34 (S0021-9924(00)00039-3 [pii]): 21-37
- Consensus-based attributes for identifying patients with spasmodic dysphonia and other voice disorders.JAMA Otolaryngol Head Neck Surg. 2018; 144: 657-665https://doi.org/10.1001/jamaoto.2018.0644
- Diagnostic delays in spasmodic dysphonia: a call for clinician education.J Voice. 2015; 29: 592-594https://doi.org/10.1016/j.jvoice.2013.10.022
- The extrinsic risk and its association with neural alterations in spasmodic dysphonia.Parkinsonism Relat Disord. 2019; 65 (S1353-8020(19)30255-X [pii]): 117-123
- Research priorities in spasmodic dysphonia.Otolaryngol Head Neck Surg. 2008; 139: 495-505https://doi.org/10.1016/j.otohns.2008.05.624
- Symptom improvement of spastic dysphonia in response to phonatory tasks.Ann Otol Rhinol Laryngol. 1985; 94: 51-54https://doi.org/10.1177/000348948509400111
- A separation of innate and learned vocal behaviors defines the symptomatology of spasmodic dysphonia.Laryngoscope. 2019; 129: 1627-1633https://doi.org/10.1002/lary.27617
- Acoustic variations in adductor spasmodic dysphonia as a function of speech task.J Speech Lang Hear Res. 1999; 42: 127-140https://doi.org/10.1044/jslhr.4201.127
- Task specificity in adductor spasmodic dysphonia versus muscle tension dysphonia.Laryngoscope. 2005; 115 (00005537-200502000-00023 [pii]): 311-316
- Automated acoustic analysis of task dependency in adductor spasmodic dysphonia versus muscle tension dysphonia.Laryngoscope. 2014; 124: 718-724https://doi.org/10.1002/lary.24362
- Adductor spasmodic dysphonia and muscular tension dysphonia: Acoustic analysis of sustained phonation and reading.J Voice. 2000; 14 (S0892-1997(00)80008-9 [pii]): 502-520
- Toward improved differential diagnosis of adductor spasmodic dysphonia and muscle tension dysphonia.Folia Phoniatr Logop. 2007; 59 (000098341 [pii]): 83-90
- Influence of consonant voicing characteristics on sentence production in abductor versus adductor spasmodic dysphonia.J Voice. 2014; 28 (394.e13-394.e22)https://doi.org/10.1016/j.jvoice.2013.10.010
- Acoustic measures of symptoms in abductor spasmodic dysphonia.J Voice. 2001; 15 (S0892-1997(01)00038-8 [pii]): 362-372
- Effects of adductor muscle stimulation on speech in abductor spasmodic dysphonia.Laryngoscope. 2000; 110: 1943-1949https://doi.org/10.1097/00005537-200011000-00033
- Dynamic aspects of phonatory control in spasmodic dysphonia.J Speech Hear Res. 1987; 30: 197-206https://doi.org/10.1044/jshr.3002.197
- Effects of voicing and syntactic complexity on sign expression in adductor spasmodic dysphonia.Am J Speech Lang Pathol. 2003; 12: 416-424https://doi.org/10.1044/1058-0360(2003/087
- Cross-linguistic study of vocal pathology: perceptual features of spasmodic dysphonia in french-speaking subjects.J Multilingual Commun Disorders. 2003; 1: 35-52https://doi.org/10.1080/1476967021000044351
- Spastic Dysphonia: A Surgical and Voice Therapy Treatment Program.College Hill Press, San Diego, CA1980
- Intrinsic laryngeal muscle activity in a spastic dysphonia patient.J Speech Hear Disord. 1985; 50: 54-59https://doi.org/10.1044/jshd.5001.54
- Subglottal air pressure in spastic dysphonia speech.Folia Phoniatrica et Logopaedica. 1988; 40: 105-110https://doi.org/10.1159/000265895
- Lidocaine block of the recurrent laryngeal nerve in adductor spasmodic dysphonia: A multidimensional assessment.Laryngoscope. 2006; 116: 591-595https://doi.org/10.1097/01.mlg.0000205588.04450.ac
- Toward improved differential diagnosis of adductor spasmodic dysphonia and muscle tension dysphonia.Folia Phoniatrica et Logopaedica. 2007; 59: 83-90https://doi.org/10.1159/000098341
- Differential diagnosis of adductor spasmodic dysphonia and muscle tension dysphonia using phonatory break analysis.Laryngoscope. 2008; 118: 2245-2253https://doi.org/10.1097/mlg.0b013e318184577c
- Treatment of spasmodic dysphonia with a neuromodulating electrical implant.Laryngoscope. 2014; 124: 2537-2543https://doi.org/10.1002/lary.24749
- Acoustic model of perceived overall severity of dysphonia in adductor-type laryngeal dystonia.J Speech, Lang HearRes. 2020; 63: 2713-2722https://doi.org/10.1044/2020_jslhr-19-00354
- Speaker identification on the SCOTUS corpus.J Acoust Soc Am. 2008; 123: 3878https://doi.org/10.1121/1.2935783
Boersma P, Weenink D. Praat: Doing phonetics by computer. 2022;Version 6.2.09, retrieved 15 February 2022 from http://www.praat.org/
- Spectral aggregate of the high-passed fundamental frequency and its relationship to the primary acoustic features of adductor laryngeal dystonia.J Speech Lang Hear Res. 2022; 65: 4085-4095https://doi.org/10.1044/2022_JSLHR-22-00157
- Acoustic properties of different kinds of creaky voice.ICPhS Proc. 2015; 1: 2-7
- Fitting linear mixed-effects models using lme4.J Stat Soft. 2015; 67 (Available at): 1https://doi.org/10.18637/jss.v067.i01
- Voice training and therapy with a semi-occluded vocal tract: rationale and scientific underpinnings.J Speech, Lang, Hear Res. 2006; 49: 448-459https://doi.org/10.1044/1092-4388(2006/035)
- Intraoral pressures produced by thirteen semi-occluded vocal tract gestures.null. 2015; 40: 86-92https://doi.org/10.3109/14015439.2014.913074
- Effects of a vocal-tract constriction on the glottal source: experimental and modelling studies.J Phon. 1986; 14 (Available at): 373-382https://doi.org/10.1016/S0095-4470(19)30711-9
- A randomized controlled trial of two semi-occluded vocal tract voice therapy protocols.J Speech, Lang, Hear Res. 2015; 58: 535-549https://doi.org/10.1044/2015_JSLHR-S-13-0231
Risdal M, Aly A, Chong AJ, et al. On the link between glottal vibration and sonority. LabPhon15: Speech Dynamics and Phonological Representation. 2016. Accessed June 10, 2022.
- Effects of consonantal constrictions on voice quality.J Acoust Soc Am. 2020; 148: EL65-EL71https://doi.org/10.1121/10.0001585
- Study of the effects of vocal tract constriction on glottal vibration.J Acoust Soc Am. 2014; 136: 1932-1941https://doi.org/10.1121/1.4894789
- Quantifying the Sonority Hierarchy.Doctoral Dissertations Available from Proquest, 2002AAI3056268
- Sound level protrusions as physical correlates of sonority.J Phon. 2008; 36 (Available at): 55-90https://doi.org/10.1016/j.wocn.2007.09.003
- Immediate effects of humming on computed electroglottographic parameters in patients with muscle tension dysphonia.J Voice. 2014; 28 (Available at): 733-741https://doi.org/10.1016/j.jvoice.2014.02.004
- Electroglottographic study of seven semi-occluded exercises: LaxVox, straw, lip-trill, tongue-trill, humming, hand-over-mouth, and tongue-trill combined with hand-over-mouth.J Voice. 2014; 28 (Available at): 589-595https://doi.org/10.1016/j.jvoice.2013.11.004
- Investigation of the immediate effects of humming on vocal fold vibration irregularity using electroglottography and high-speed laryngoscopy in patients with organic voice disorders.J Voice. 2017; 31 (Available at): 48-56https://doi.org/10.1016/j.jvoice.2016.03.010
- Immediate effectiveness of humming on the supraglottic compression in subjects with muscle tension dysphonia.Folia Phoniatr Logop. 2013; 65 (Available at): 123-128https://doi.org/10.1159/000353539
- Influence of supraglottal structures on the glottal jet exiting a two-layer synthetic, self-oscillating vocal fold model.J Acoust Soc Am. 2008; 123: 4434-4445https://doi.org/10.1121/1.2897040
- Influence of a constriction in the near field of the vocal folds: physical modeling and experimental validation.J Acoust Soc Am. 2008; 124: 3296-3308https://doi.org/10.1121/1.2977740
- A computational study of the effect of false vocal folds on glottal flow and vocal fold vibration during phonation.Ann Biomed Eng. 2009; 37: 625-642https://doi.org/10.1007/s10439-008-9630-9
- Use of flexible fiberoptic laryngoscopy to assess patients with spasmodic dysphonia.J Voice. 1991; 5 (Available at): 85-91https://doi.org/10.1016/S0892-1997(05)80168-7
- Ventricular-fold dynamics in human phonation.J Speech, Lang, Hear Res. 2014; 57: 1219-1242https://doi.org/10.1044/2014_JSLHR-S-12-0418
- The role of sensory information in the pathophysiology of focal dystonias.Nat Rev Neurol. 2019; 15: 224-233https://doi.org/10.1038/s41582-019-0137-9
- Laryngeal vibration as a non-invasive neuromodulation therapy for spasmodic dysphonia.Sci Rep. 2019; 9: 17955https://doi.org/10.1038/s41598-019-54396-4
Article Info
Publication History
Published online: November 21, 2022
Accepted:
October 5,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
