Examining the Links Among Motor Symptoms in Vocal Hyperfunction, Auditory Acuity, and Auditory-Motor Function

检查运动症状与发声功能亢进、听觉敏锐度和听觉运动功能之间的联系

• 批准号: 10534635
• 负责人: Mara Kapsner-Smith
• 金额: $ 4.36万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-16 至 2024-06-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10534635
• 关键词: Acoustics; Address; Affect; Auditory; Basic Science; Behavior; Behavior Therapy; Characteristics; Clinic; Clinical; Clinical Management; Clinical Research; Data; Development; Discrimination; Disease; Dysphonia; Electromyography; Elements; Environment; Exhibits; Fatigue; Feedback; Foundations; Frequencies; Functional disorder; Future; Goals; Health Care Costs; Impairment; Individual; Knowledge; Larynx; Lead; Limb structure; Link; Loudness; Measures; Motor; Movement; Muscle; Muscle Tension; Nodule; Outcomes Research; Participant; Patients; Persons; Phase; Phonation; Plant Roots; Population; Prevalence; Production; Productivity; Psychoacoustics; Quality of life; Recurrence; Research; Scientist; Sensory; Signs and Symptoms; Specificity; Stimulus; Surface; Techniques; Testing; Time; Voice; Voice Disorders; Voice Quality; Work; adaptive learning; auditory discrimination; auditory feedback; base; career; clinical practice; disorder control; evidence base; improved; motor behavior; motor impairment; motor symptom; multidisciplinary; prevent; programs; response; skills; societal costs; treatment research; vocal cord; vocal learning; voice therapy

Project Summary Voice disorders are common, affecting up to 9% of the U.S. population at any given time, and the majority of patients referred to multidisciplinary voice clinics have hyperfunctional voice disorders (HVDs; e.g., vocal fold nodules and muscle tension dysphonia). Clinically, HVDs are characterized by vocal fatigue, dysphonia, and dysregulated muscle activation during voicing. Yet, relatively little is understood about the pathophysiology underlying these signs and symptoms. Elucidating the mechanisms that cause and sustain HVDs is necessary to guide impactful treatment research. Recent studies have identified auditory-motor impairments, including atypical auditory discrimination of voice fundamental frequency (fo) and atypical adaptive vocal learning in response to fo auditory feedback perturbations, in a subset of individuals with HVDs. People with HVDs display atypical voicing across multiple parameters of voice, such as intensity and voice quality, in addition to fo. It is possible that these behaviors relate to a broad auditory-motor impairment for vocal sensorimotor control. Thus, the proposed studies will address the specificity of auditory-motor impairment in HVDs by examining auditory acuity and adaptive vocal learning across two important parameters for vocal sensorimotor control: fo and intensity. In addition to understanding the extent of auditory-motor impairment in HVDs, determining the relationship between such impairments and the clinical characteristics of these disorders is critical to guide clinical research. To date, a direct relationship between auditory-motor impairment and dysregulated muscle activation during voicing, a hallmark of HVDs, has not been established. Co-contraction of opposing perilaryngeal muscles occurs when speakers increase their vocal effort, and is thought to occur during voicing in HVDs. In studies of reaching movements, co-contraction occurs in the limbs in response to feedback perturbations in order to stabilize movements, and decreases as participants adapt to the perturbations. Crucially, studies of limb sensorimotor control also suggest that worse sensory acuity reduces adaptation. Thus, we propose that perilaryngeal co-contraction may occur in response to auditory feedback perturbations in order to stabilize the larynx, and will decrease with adaptive vocal learning. Furthermore, impaired auditory acuity in some speakers with HVDs may be associated with both atypical adaptive vocal learning and persistent perilaryngeal co- contraction compared to speakers without HVDs. Therefore, Aim 1 will compare adaptive vocal learning and perilaryngeal co-contraction in response to perturbations of fo and intensity of auditory feedback in individuals with (n = 26) and without (n = 26) HVDs. Aim 2 will evaluate the prevalence of atypical auditory acuity for vocal fo and intensity in the same groups of speakers. In Aim 3, relationships among auditory acuity, adaptive vocal learning, and perilaryngeal co-contraction will be examined. This work will be the first to examine laryngeal stabilization responses following auditory feedback perturbations, and may identify a potential mechanistic connection between auditory-motor impairment and dysregulated muscle activation during voicing in HVDs.

项目摘要 语音障碍很常见，在任何给定时间都会影响多达9％的美国人口，大多数 转介到多学科语音诊所的患者患有高功能性语音障碍（HVD；例如，人声折叠 结节和肌肉张力烦躁不安）。在临床上，HVD的特征是人声疲劳，吞咽困难和 发声过程中的肌肉激活失调。然而，关于病理生理学的相对较少的理解 这些体征和症状的基础。阐明导致和维持HVD的机制是必要的 指导有影响力的治疗研究。最近的研究确定了听觉运动障碍，包括 语音基本频率（FO）和非典型自适应声音学习的非典型听觉歧视 对HVD的个体的子集，对FO听觉反馈扰动的响应。 HVD显示的人 除了FO之外，跨多个语音参数（例如强度和语音质量）的声音非典型声音。这是 这些行为可能与声音感觉控制的广泛听觉运动障碍有关。因此， 拟议的研究将通过检查听觉来解决HVD中听觉运动障碍的特异性 声带控制控制的两个重要参数的敏锐和自适应声音学习：FO和 强度。除了了解HVD中听觉运动障碍的程度外，还确定了 这些障碍与这些疾病的临床特征之间的关系对于指导至关重要 临床研究。迄今为止，听觉运动障碍与肌肉失调之间的直接关系 尚未建立声音的激活，这是HVD的标志。对立逆转的共同收缩 当说话者增加声音努力时，就会发生肌肉，并被认为在HVD中发声时发生。在 有关到达运动的研究，在四肢中进行共同收集，以响应反馈扰动的顺序 稳定运动，并随着参与者适应扰动而减小。至关重要的是肢体的研究 感觉运动控制还表明，较差的感觉敏锐度降低了适应性。因此，我们提出 危险的共同收集可能是在听觉反馈扰动中发生的，以稳定 喉部，并会随着自适应的声音学习而减少。此外，某些说话者的听觉敏锐度受损 使用HVD可能与非典型的自适应声音学习和持续的危险性共同 与没有HVD的说话者相比，收缩。因此，AIM 1将比较自适应的声音学习和 逆转障碍响应FO的扰动和个体的听觉反馈强度的共同收集 具有（n = 26），没有（n = 26）HVD。 AIM 2将评估声音非典型听觉敏锐度的患病率 同一扬声器组的FO和强度。在AIM 3中，听觉敏锐度，自适应声音之间的关系 将检查学习和危险的共同收集。这项工作将是第一个检查喉部的工作 听觉反馈扰动后的稳定响应，并可能识别潜在的机理 在HVD中发声期间，听觉运动障碍与肌肉激活失调之间的联系。