Anxiety and depression in spasmodic dysphonia patients

Hu, Amanda; Hıllel, Allen D.; Zhao, Wei; Meyer, Tanya K.

doi:10.1016/j.wjorl.2018.04.004

Cited by 10 publications

(8 citation statements)

References 31 publications

(73 reference statements)

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“…There was a hypothesis that SD patients in the past were associated with increased psychiatric conditions. 16 One previous study reported that high anxiety levels were associated with higher levels of patient-perceived hoarseness in adductor SD patients. 1 We examined whether psychiatric disorders would affect the success of injections.…”

Section: Discussionmentioning

confidence: 96%

Factors Associated with Failure of Botulinum Toxin Injection in Adductor Spasmodic Dysphonia

Zhao

Guillaud

2020

Ann Otol Rhinol Laryngol

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Objective: Electromyography (EMG) Guided botulinum toxin (BTX) injection is considered first-line treatment for adductor spasmodic dysphonia (SD). Failure rate can range between 6% and 29%. Study objective was to determine which factors were associated with failure. Methods: This was a retrospective review conducted at a tertiary, academic center. Adductor SD patients presenting for BTX injections from August 2017 to October 2018 were eligible. Age, gender, Voice Handicap Index (VHI-10), Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), number of injections, disease duration, unilateral/bilateral injection, right/left injection, dose quantity, body mass index (BMI), professional voice user, employment, psychiatric comorbidity, breathiness, and dysphagia were investigated. Outcomes included failure as defined by the patient and dosage change. Univariate and multivariate statistical analysis was conducted. Results: Sixty seven out of 564 injections (12%) were categorized as failure by 131 patients. In multivariate analysis, dosage change was associated with shorter duration of good effect ( P < .001), BTX dose ( P = .016), breathiness ( P < .001), bilateral injection ( P = .024), dysphagia ( P = .012) and professional voice user ( P = .021). Failure was associated with first injection with a new physician ( P < .001), professional voice user P < .001) and lack of breathiness ( P = .003). Failure rate was not associated with age, gender, VHI-10, CAPE-V, disease duration, left/right injection, dose quantity, BMI, psychiatric comorbidity, and dysphagia. Conclusion: Failure rate was 12% and associated with patients’ first injection with a physician, professional voice user, and lack of breathiness. Dosage change occurred in 29% of injections and was associated with injection side effects, bilateral injections, BTX dose, professional voice user, and shorter duration of good effect. Level of evidence: 3

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Section: Discussionmentioning

confidence: 96%

Factors Associated with Failure of Botulinum Toxin Injection in Adductor Spasmodic Dysphonia

Zhao

Guillaud

2020

Ann Otol Rhinol Laryngol

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“…It is possible that increased functional connectivity between the caudate and the precuneus in UVFP patients reflects a heightened sense of self‐referential awareness, compared to healthy controls without dysphonia. It is also possible that this increased connectivity between the caudate and the precuneus is reflective of heightened anxiety found to be more common in patients with dysphonia, similar to patients with generalized and social anxiety disorders who also show increased connectivity between the precuneus and the caudate …”

Section: Discussionmentioning

confidence: 99%

Cortical‐Basal Ganglia‐Cerebellar Networks in Unilateral Vocal Fold Paralysis: A Pilot Study

et al. 2019

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Objectives/Hypothesis To evaluate differences in cortical‐basal ganglia‐cerebellar functional connectivity between treated unilateral vocal fold paralysis (UVFP) and healthy control cohorts using resting‐state functional magnetic resonance imaging (RS‐fMRI). Study Design Cross‐sectional. Methods Ten UVFP study patients treated by type I thyroplasty and 12 control subjects underwent RS‐fMRI on a 3‐Tesla scanner to evaluate differences in functional connectivity of whole‐brain networks. Spontaneous RS‐fMRI data were collected using a gradient echo planar pulse sequence, preprocessed, and analyzed to compare seed‐to‐voxel maps between the two cohorts. Seeds were placed in the caudate, putamen, and globus pallidus divisions of the basal ganglia in both hemispheres. Group contrasts were tested for statistical significance using two‐tailed unpaired t tests corrected for multiple comparisons with a cluster false discovery rate threshold of P < .05. Results UVFP patients demonstrated increased connectivity between both caudate nuclei and the precuneus, a node of the default mode network, compared to healthy controls. Both caudate nuclei also showed decreased connectivity with the left cerebellar hemisphere. The putamen and globus pallidus divisions of the basal ganglia were not abnormally connected to other brain structures. Conclusions UVFP patients treated by type I thyroplasty exhibited long‐term alterations of cortical‐basal ganglia‐cerebellar networks thought to be important for self‐referential voice quality awareness and learning processes that compensate for changes to the paralyzed hemilarynx. This pilot study on relatively small cohorts adds to growing evidence for persistent central nervous system changes in treated UVFP. Replication studies with larger numbers of subjects will be essential to validate and extend findings. Level of Evidence 3b Laryngoscope, 130:460–464, 2020

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“…Given that a recent study by Hu et al showed the prevalence of anxiety among this patient population to be around 15%, more research should be done to identify risk factors and protective measures to help patients acclimate to their condition. 14…”

Section: Discussionmentioning

confidence: 99%

Demographics and Clinical Characteristics Associated with the Spread of New‐Onset Laryngeal Dystonia

Ghanouni,

Jona,

Jinnah

et al. 2023

The Laryngoscope

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ObjectivesAdult‐onset idiopathic laryngeal dystonia (LD) can be associated with the risk of spread to muscles in the body. Subjects with extralaryngeal onset of dystonia have exhibited spread to the larynx. Previous studies analyze the spread of other dystonias but emphasis has not been placed on LD. The objective was to identify demographic and clinical factors contributing to the spread of dystonia to and from the larynx.MethodsData were obtained from the Dystonia Coalition (DC)‐patients from 49 international clinical centers. Clinical and demographic data was taken from 143 out of 409 patients with diagnosed LD. Patient criteria included adult‐onset LD diagnosed on exam with no co‐morbid neurologic conditions and no dystonia in other locations.ResultsAmong the 143 patients, 94 (65.7%) patients were diagnosed with focal laryngeal onset, with the remainder having extralaryngeal onset. Family history and age at study were statistically significant indicators of a patient developing laryngeal versus extralaryngeal onset of dystonia. Among the laryngeal onset group, 21 cases (22.3%) had an average time of 5.81 ± 5.79 years to spread from diagnosis, most commonly to neck (61.9%). Among extralaryngeal onset patients, mean time of larynx spread was 7.92 ± 7.737 years, most commonly to neck (22.7%).ConclusionsOur data indicates approximately a quarter of patients with laryngeal‐onset dystonia will exhibit spread. There were no demographic or clinical factors that were statistically predictive of the likelihood of spread from larynx. Patients with dystonia elsewhere in the body should be counseled on the possibility of spread to larynx, and vice versa.Level of EvidenceLevel IV Laryngoscope, 2023

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Anxiety and depression in spasmodic dysphonia patients

Cited by 10 publications

References 31 publications

Factors Associated with Failure of Botulinum Toxin Injection in Adductor Spasmodic Dysphonia

Factors Associated with Failure of Botulinum Toxin Injection in Adductor Spasmodic Dysphonia

Cortical‐Basal Ganglia‐Cerebellar Networks in Unilateral Vocal Fold Paralysis: A Pilot Study

Demographics and Clinical Characteristics Associated with the Spread of New‐Onset Laryngeal Dystonia

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