Muscle Tension Dysphonia. Dysphonia
Conditions
Interventions
Intervention 1: Intervention group: First, for both the intervention and control groups, we implement the initial treatment level based on Dr. Sataloff’s classification of treatment levels for voice d
Sponsors
Iran University of Medical Sciences
Eligibility
Sex/Gender
All
Age
20 Years to 40 Years
Inclusion criteria
Inclusion criteria: After being informed about the conditions and the execution of the study, they should provide their informed consent to participate. According to the consensus of laryngologists and speech-language pathologists, and based on the results of voice history taking, auditory-perceptual evaluation, tactile examination, and video laryngoscopy, a primary diagnosis of MTD will be made. Men and women aged between 20 and 40 years will be included. They should not have received voice therapy or any other voice-related treatments during the study. There should be no neurological disorders affecting the larynx, hearing disorders, head and neck surgeries, or behavioral and psychological disorders.
Exclusion criteria
Exclusion criteria: Due to reasons such as data loss related to evaluations or data distortion, it may not be possible to analyze the data. They may withdraw from treatment or fail to attend therapy sessions regularly.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| If an upward perturbation is applied to the fundamental frequency (F0) of auditory feedback—causing the individual to perceive their voice as higher-pitched—the auditory-motor integration system, responsible for comparing expected auditory feedback (based on an internal copy of the motor command) with the actual auditory output, detects this prediction-feedback mismatch. To compensate, it generates an adaptive vocal response in the opposite direction of the auditory feedback by producing a lower F0. However, if the auditory-motor integration system is impaired, it fails to detect this mismatch and accepts the altered feedback as the intended output. Consequently, the speech motor control system will adjust, leading the individual to produce a higher-pitched voice. Timepoint: 12 Days. Method of measurement: Altered Auditory Feedback (AAF): vocal compensation magnitudes: In this study, we assess auditory-motor integration through a fundamental frequency (F0) auditory feedback perturbation experiment. In this experiment, F0 is altered to determine the extent of compensatory vocal responses and to provide insights into the feedforward and feedback mechanisms of speech motor control. The magnitude of the adaptive vocal response is reported in cents.;Auditory working memory refers to the neural process by which auditory information is stored and manipulated over a short period to adapt the feedforward and feedback mechanisms of speech motor control. Timepoint: 12 Days. Method of measurement: During the pre- and post-training phases of auditory working memory, both groups are tested using a four-tone pure tone frequency pattern reconstruction (FPR) paradigm to document practice-related changes in auditory working memory capacity. The FPR score is a percentage reflecting the accuracy of sequence reconstruction. For instance, if there are 25 trials and a participant correctly reconstructs 10 sequences, their FPR score would be (10/25)*100(10/25)*100, or 40%. | — |
Secondary
| Measure | Time frame |
|---|---|
| Jitter or frequency perturbation refers to variations in frequency across consecutive vibratory cycles of the vocal folds. Cycle-to-cycle irregularity in the fundamental frequency during periodic vibratory cycles is termed jitter. Fundamental frequency perturbation is an acoustic measure that indicates the presence of vocal roughness in patients, resulting from irregular collisions of the vocal folds during phonation. Timepoint: 12 Days. Method of measurement: In this study, the criterion for jitter is Local Jitter. As an acoustic correlate of voice roughness, a higher percentage of jitter indicates greater vocal roughness . During three sustained phonations of the vowels /a/ and /i/ at habitual pitch and loudness, Local Jitter is measured and recorded as a percentage using the Praat software.;Shimmer, or amplitude perturbation, refers to variations in the amplitude of consecutive vibratory cycles of the vocal folds. Cycle-to-cycle irregularity in the peak-to-peak amplitude of sound intensity is termed shimmer. Timepoint: 12 Days. Method of measurement: Shimmer is measured during three sustained phonations of the vowels /a/ and /i/ at habitual pitch and loudness, using the Praat software, recorded as Local Shimmer in percentage.;Harmonic-to-Noise Ratio (HNR) is a numerical evaluation of the ratio of fundamental and harmonic energy to aperiodic or noise energy in the speech signal, averaged over multiple cycles. Timepoint: 12 Days. Method of measurement: The Harmonic-to-Noise Ratio (HNR) measures the ratio between the periodic and aperiodic components of the speech signal, serving as an indicator of the amount of noise present in the vocal signal. In the present study, the average ratio of regular to irregular energy during three sustained phonations of the vowels /a/ and /i/ at habitual pitch and loudness will be recorded using the Praat software and reported in decibels.". | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactSirvan Savareh Sonj
Iran University of Medical Sciences
Outcome results
None listed