Physiologic Correlates of Vocal Tremor affecting those with Essential Tremor

声音震颤影响特发性震颤患者的生理相关性

• 批准号: 10331728
• 负责人: Julie M Barkmeier-Kraemer
• 金额: $ 60.66万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-12 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10331728
• 关键词: Abdomen; Acoustics; Affect; Age; Age-Years; Anxiety; Articulators; Basal Ganglia; Caliber; Characteristics; Clinical; Clinical Treatment; Communication; Communication impairment; Complex; Computer Models; Deep Brain Stimulation; Diagnosis; Diagnostic; Disease; Dystonia; Essential Tremor; Etiology; Exhibits; Female; Frequencies; Future; Gender; Goals; Hand; Head; Image; Impairment; Individual; Investigation; Knowledge; Laryngeal muscle structure; Larynx; Lead; Leg; Length; Limb Tremors; Limb structure; Link; Literature; Magnetic Resonance Imaging; Matched Case-Control Study; Measures; Medical; Methods; Modeling; Movement; Movement Disorders; Neurologic; Outcome; Outcomes Research; Output; Parkinson Disease; Participant; Pathway interactions; Patient Simulation; Pattern; Persons; Pharmaceutical Preparations; Phonation; Physiological; Population; Production; Public Health; Quality of life; Reporting; Research; Respiratory System; Signal Transduction; Source; Speech; Structure; Surface; Testing; Time; Tongue; Transducers; Tremor; Voice; Work; abdominal wall; arm; base; design; illness length; improved; insight; kinematics; lung pressure; neurophysiology; pressure; research clinical testing; respiratory; response; rib bone structure; sound; tongue root; vocal cord

PROJECT SUMMARY / ABSTRACT Essential tremor is one of the most common movement disorders in the world affecting approximately 4.6% of those 65 years of age or older and approximately 2.2% of the US population, or 7 million people. Approximately 30% of these individuals exhibit a vocal tremor due to essential tremor (ET), or Essential Vocal Tremor (EVT), with the majority being female. EVT significantly impacts quality of life and does not consistently or significantly benefit from medications or medical management approaches that are currently used to treat limb tremor. The differing response to current medical treatments between those with EVT and those with ET without vocal tremor (EVT0) highlights the need for determining differing characteristics between those with EVT compared to EVT0. Individuals with EVT report increased effort during speaking and worsening of their vocal tremor during stressful activities that promote anxiety or require more concentration and effort. To date, EVT has been characterized primarily by acoustic measures of voice modulation resulting in limited understanding regarding speech structure contributions to the onset and progression of this disorder. This is in contrast to longstanding diagnostic characteristics of tremor rate and extent described in the literature for tremor affecting the arms, hands, head, or legs that can be used to distinguish between neurologic etiologies. Insight into the physiologic underpinnings of speech structures affected by tremor and their links to impaired speech production would enable insights regarding optimal clinical approaches for evaluating and managing vocal tremor. Further, determining salient physiologic characteristics associated with vocal tremor could potentially lead to clinical evaluation approaches that enable identification of the different neurogenic causes of vocal tremor (e.g. basal ganglia, cerebellar, extrapyramidal pathways). The goal of this project is to systematically evaluate and model the contribution of tremor affecting the respiratory, laryngeal, and articulatory structures to vocal tremor acoustic patterns. Outcomes of this research will significantly advance our scientific knowledge regarding the physiologic underpinnings of EVT and its correspondence to impaired communication function. Further, outcomes will advance current clinical evaluation and treatment methods and enable future investigation of unique physiologic characteristics across other etiologies of vocal tremor (e.g. Parkinson Disease, Dystonia) that will advance current and future treatment approaches.

项目摘要 /摘要 基本震颤是世界上最常见的运动障碍之一，影响约4.6％ 这65岁或大于美国人口的约2.2％，或700万人。大约 这些人中有30％由于基本震颤（ET）或必要的声音震颤（EVT）而表现出声音震颤， 大多数是女性。 EVT显着影响生活质量，并且不始终如一或 当前用于治疗肢体的药物或医疗管理方法可显着受益 震颤。 EVT和ET患者之间对当前医疗治疗的反应不同 没有声音震颤（EVT0）强调了确定患有不同特征的特征 EVT与EVT0相比。 EVT报告的个人在说话和恶化期间加大了努力 压力活动中的声音震颤会促进焦虑或需要更多的集中精力和努力。迄今为止， EVT主要由语音调制的声学度量来表征，导致有限 关于言语结构对这种疾病发作和进展的贡献的理解。这是 与文献中描述的震颤率和范围的长期诊断特征形成鲜明对比 震颤影响手臂，手，头部或腿部，可用于区分神经系统病因。 深入了解受震颤影响的语音结构的生理基础及其与障碍的联系 语音生产将使有关评估和管理的最佳临床方法的见解 声音震颤。此外，确定与人声震颤相关的显着生理特征可以 有可能导致临床评估方法，以鉴定出不同的神经源性原因 声带震颤（例如基底神经节，小脑，锥体旁途径）。这个项目的目标是 系统地评估和建模影响呼吸系统，喉和的震颤的贡献 发声声音模式的发音结构。这项研究的结果将大大进步 我们关于EVT生理基础的科学知识及其对信函的信件 沟通功能。此外，结果将推动当前的临床评估和治疗方法 并能够对其他病因的独特生理特征进行未来的研究 （例如帕金森氏病，肌张力障碍）将推进当前和将来的治疗方法。