Evidence for Auditory-Motor Impairment in Individuals With Hyperfunctional Voice Disorders

Abstract

Purpose: The vocal auditory-motor control of individuals with hyperfunctional voice disorders was examined using a sensorimotor adaptation paradigm. Method: Nine individuals with hyperfunctional voice disorders and 9 individuals with typical voices produced sustained vowels over 160 trials in 2 separate conditions: (a) while experiencing gradual upward perturbations in the fundamental frequency (f o ) of their auditory feedback (shift-up) and (b) under no auditory perturbation (control). The shift-up condition consisted of 4 ordered (fixed) phases: baseline (no perturbation), ramp (gradual increases in heard f o ), hold (a consistently higher heard f o ), and after-effect (no perturbation). Adaptive responses were defined as the difference in produced f o during control and shift-up conditions.Results: Adaptive responses were significantly different between groups. Individuals with typical voices generally showed compensatory adaptive responses, with decreased f o during the ramp and hold phases. Conversely, many individuals with hyperfunctional voice disorders instead displayed the opposite effect by following the direction of the perturbation. When f o was experimentally increased, speakers further increased their f o . Conclusion: Results indicate that some individuals diagnosed with hyperfunctional voice disorders have disrupted auditory-motor control, suggesting atypical neurological function. These findings may eventually allow for the development of new interventions for hyperfunctional voice disorders.

A Simple 3-Parameter Model for Examining Adaptation in Speech and Voice Production

“…been used to assess speech motor control of individuals with Parkinson's disease (PD;Mollaei et al, 2013;Abur et al, 2018), hyperfunctional voice disorder (Stepp et al, 2017), cerebellar degeneration (Parrell et al, 2017), apraxia of speech (Ballard et al, 2018), autism (Demopoulos et al, 2018), developmental dyslexia (van den Bunt et al, 2017), and stuttering . The findings of these studies have important implications for uncovering the underlying neural mechanisms of these disorders and may shed light on future treatment strategies.…”

Relationships between vocal pitch perception and production: a developmental perspective

“…Of note, the DIVA model is primarily designed for speech motor control, yet ample behavioral work suggests that similar control systems are involved in vocal motor control [e.g. [6][7][8][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] ]. According to DIVA, early vocalizations allow the auditory and somatosensory sensory feedback systems to learn the relationships between a given motor command and the sensory feedback stemming from the resultant vocalization.…”

“…An alternative for why some individuals may have smaller response magnitudes to unexpected pitch-shifts is that they may decrease weighting on any sensory feedback system and become more reliant on a third control system, forward control 9,10,13,14 . Behaviorally, the process of updating the forward system through sensorimotor adaptation is examined via evaluation of vocal response magnitudes to predictable, sustained auditory pitch-shifts [21][22][23]28,29,31,32 . Larger vocal response magnitudes in this type of experimental paradigm are suggestive of a system that can effectively incorporate error corrections from the auditory feedback system and use this information to update the stored motor plan.…”

“…Larger vocal response magnitudes in this type of experimental paradigm are suggestive of a system that can effectively incorporate error corrections from the auditory feedback system and use this information to update the stored motor plan. Conversely, small or absent vocal responses suggest either a low weighting of forward control or decreased ability to execute sensorimotor adaptation [21][22][23]28,29,31,32 . Examination of sensorimotor adaptation in adults shows variable magnitudes of vocal responses to sustained pitch-shifts [e.g.…”

“…Examination of sensorimotor adaptation in adults shows variable magnitudes of vocal responses to sustained pitch-shifts [e.g. [21][22][23]28,29,31,32 ]. This variability may indicate that, even in the mature system, there is variation in the weightings of the sensory feedback and forward control systems or differing abilities to integrate feedback commands into the stored motor program.…”