Voice tremor: what we know and what we do not know

Gillivan-Murphy, Patricia; Miller, Nick

doi:10.1097/moo.0b013e328345970c

Cited by 16 publications

(5 citation statements)

References 18 publications

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“…Instability was also present at a slight degree for both licit and illicit drug users. According to the literature, this instability may be associated to a vibration of the vocal tract structures, common in neurological pathologies 29 , and the long-term substance use could be the cause of this type of pathology 30 .…”

Section: Resultsmentioning

confidence: 99%

Uso de substâncias psicoativas, alterações vocais e qualidade de vida em usuários de drogas lícitas e ilícitas

et al. 2015

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OBJETIVOS:investigar a qualidade de vida e voz, além das principais alterações perceptivo-auditivas e as medidas acústicas jitter, shimmer e Glottal Noise Excitation em usuários de substâncias psicoativas lícitas e/ou ilícitas que buscaram um centro de tratamento para dependência química.MÉTODOS:estudo transversal. Os participantes responderam aos questionários de Mensuração de Qualidade de Vida em Voze World Health Organization Quality of Life Instrument-Bref. Além disso foi realizado, um registro vocal da vogal /a/ e de uma contagem de números de 1 a 20. Os registros vocais foram avaliados por meio da escala GRBAS-I (G - grau global da disfonia, R - rugosidade, B - soprosidade, A - astenia, S - tensão) e a análise acústica (jitter, shimmer, Glottal noise excitation) pelo software VoxMetria.RESULTADOS:avaliaram-se 29 protocolos e registros de voz; na amostra, 19 (65,5%) eram homens; a idade média da amostra foi de 37,8 anos. Os escores de ambos os questionários não apresentaram diferenças entre os usuários de drogas lícitas e os de drogas ilícitas. Na análise perceptiva por meio da GRBAS-I, eles mostraram predominância de alterações discretas e moderadas nos itens grau geral da disfonia, rugosidade e instabilidade para usuárias de drogas ilícitas. A medida acústica jitter e o shimmerestavam alterados para homens e mulheres, e o desvio padrão da frequência fundamental também estava alterado.CONCLUSÃO:alterações de qualidade de vida e voz foram identificadas em ambos os usuários. A maioria dos usuários apresentou alterações nas medidas de jittere shimmer.Usuários de drogas ilícitas apresentaram mais alterações de Glottal Noise Excitation e desvio padrão da frequência fundamental.

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Section: Resultsmentioning

confidence: 99%

Uso de substâncias psicoativas, alterações vocais e qualidade de vida em usuários de drogas lícitas e ilícitas

et al. 2015

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“…Current recommendations dictate that clinical identification, quantification, and characterization of EVT be conducted using a sustained phonatory vowel task during fiberoptic nasolaryngoscopic examination of pharyngeal and laryngeal musculature supplemented with acoustic measures. 11 Transnasal endoscopy is preferred to oral endoscopy because it permits thorough evaluation of the pharynx and larynx in a more natural posture. 18 During transnasal endoscopy, rhythmic oscillatory motion of the vocal folds is considered diagnostic for laryngeal tremor.…”

Section: Assessment and Treatment Of Evtmentioning

confidence: 99%

Deep brain stimulation for vocal tremor: a comprehensive, multidisciplinary methodology

Ho¹,

Erickson‐DiRenzo

Pendharkar³

et al. 2015

FOC

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Tremulous voice is a characteristic feature of a multitude of movement disorders, but when it occurs in individuals diagnosed with essential tremor, it is referred to as essential vocal tremor (EVT). For individuals with EVT, their tremulous voice is associated with significant social embarrassment and in severe cases may result in the discontinuation of employment and hobbies. Management of EVT is extremely difficult, and current behavioral and medical interventions for vocal tremor result in suboptimal outcomes. Deep brain stimulation (DBS) has been proposed as a potential therapeutic avenue for EVT, but few studies can be identified that have systematically examined improvements in EVT following DBS. The authors describe a case of awake bilateral DBS targeting the ventral intermediate nucleus for a patient suffering from severe voice and arm tremor. They also present their comprehensive, multidisciplinary methodology for definitive treatment of EVT via DBS. To the authors’ knowledge, this is the first time comprehensive intraoperative voice evaluation has been used to guide microelectrode/stimulator placement, as well as the first time that standard pre- and post-DBS assessments have been conducted, demonstrating the efficacy of this tailored DBS approach.

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“…Voice tremor may be present (reportedly in between 15-55% of PwP), [8,9]. Notably, this may emanate not from intrinsic laryngeal musculature tremor (thyroarytenoids; cricoartytenoids) but more likely from tremor in respiratory muscles, pharyngeal walls, soft palate or tongue.…”

Section: Voice (Phonation)mentioning

confidence: 99%

Communication changes in Parkinson's disease

Miller

2009

Revista de Logopedia, Foniatría y Audiología

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This review looks at the nature and impact of communication changes in Parkinson's, approaches to assessment, and directions for intervention, especially given that medical and surgical interventions beneficial for limb movement are largely ineffective, or even detrimental, for speech. Most people with Parkinson's notice changes to their communication. Voice alters early oneven in the prodromal stage. Later, articulation may impair intelligibility further. These changes impact on mood and social participation.However, a full characterisation of communication changes in Parkinson's must acknowledge that changes are far more pervasive and varied than a quiet voice.Communication is affected by marked dysprosody, cognitive-linguistic impairment, alterations to social interaction and pragmatics. Changes entail not just expressive elements but also receptive. A comprehensive evaluation of potential communication challenges faced by people with Parkinson's must cover all these aspects. Similarly, intervention that ignores the breadth and depth of changes will always remain incomplete.

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Voice tremor: what we know and what we do not know

Abstract: A sustained phonatory vowel task with fibreoptic nasolaryngoscopic examination of pharyngeal and laryngeal musculature, supplemented by acoustic measures, is currently recommended for clinical identification, quantification and characterization of voice tremor.

Cited by 16 publications

References 18 publications

Uso de substâncias psicoativas, alterações vocais e qualidade de vida em usuários de drogas lícitas e ilícitas

Uso de substâncias psicoativas, alterações vocais e qualidade de vida em usuários de drogas lícitas e ilícitas

Deep brain stimulation for vocal tremor: a comprehensive, multidisciplinary methodology

Communication changes in Parkinson's disease

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