Voice Disorders, Voice Fatigue
Conditions
Keywords
voice disorders, vocal fatigue, occupational voice disorders, stress reactivity, vocal control, laryngeal motor cortex, teachers, speech motor control, voice motor control
Brief summary
Primary muscle tension dysphonia voice disorder with symptoms of vocal strain and vocal fatigue is common and can have a significant negative impact on quality of Life. Yet, primary muscle tension dysphonia's causes are unknown precluding precise diagnostic classification. Stress and personality are thought to play a role and thus, the project aims to determine the practical and clinical effect of stress on the control of voice and speech in the brain. Participants are female early career teachers and student teachers with symptoms of vocal fatigue, as well as control participants without vocal fatigue, who perform speech tasks on two different occasions. Neural (imaging of brain), psychobiological (saliva, personality), and voice and speech (muscle activity of voice muscles on the neck with surface sensors, audio recordings) data will compare reactivity patterns of teachers who are stressresponders with those who are nonresponders as well as control participants. The central hypothesis is that voice box stress responders have heightened emotion-motor activations involving the emotional voice production pathway, which correlate with changes in voice muscle activity in the anterior neck. The results will provide fundamentally missing data in our understanding of the role of stress in vocal complaints and will yield new insights about the neural underpinnings of primary muscle tension dysphonia. The study findings will have a significant impact on how clinicians identify so-called laryngoresponders to help them prevent voice disorders.
Interventions
BEHAVIORALStress induction
Induction of anticipatory stress to compare voice and speech control and production with and without exposure to stress.
Sponsors
University Hospital, Bonn
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
21 Years to 39 Years
Healthy volunteers
Yes
Inclusion criteria
Teachers (max. 10 years full-time) or student teachers in good health between 21 and 39 years with symptoms of vocal fatigue. Control participants in good health between 21 and 39 years without symptoms of vocal fatigue.
Exclusion criteria
* Lefthandedness * Smoking (past 5 years) * Known changes of the vocal folds (e.g., vocal fold nodules), vocal fold paralysis, surgeries on the larynx or thryoid or current organic or neurological changes of the vocal folds or vocal function per videoendoscopy and -stroboscopy of the larynx * History of voice therapy * Hoarseness * Respiratory illness, allergies (respiratory, silver), reflux or asthma at time of participation * Hearing disorder or hearing aids * Psychological, neurological or endocrinological disorders * Psychotropic or steorid medications * Body mass index \> 30 * Indications against MRI such as metail parts in or on the body (e.g., permanent dental prostheses or braces, screws, prostheses, piercings or large tattoos * Nearsightedness \> -5 diopters, if only glasses are worn * Claustrophobia * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Vocal fatigue | through study completion, an average of 1 month | Raw scores, Vocal Fatigue Index, VFI Factor 1 |
| BOLD MRI area 4p | through study completion, an average of 1 month | MRI activation in regions of interest (BOLD area 4p in mean %) as a function of speech tasks with and without stress induction |
| Salivary cortisol | through study completion, an average of 1 month | Salivary cortisol (nmol/L) to determine stressresponders and nonresponders |
| Suprahyoid muscle activity | through study completion, an average of 1 month | Suprahyoid muscle activity (RMS) |
| Infrahyoid muscle activity | through study completion, an average of 1 month | Infrahyoid muscle activity (RMS) |
| Personality, Social Potency | through study completion, an average of 1 month | Personality trait Social Potency (T-scores, Multidimensional Personality Questionnaire, MPQ) |
| Personality, Stress Reaction | through study completion, an average of 1 month | Personality trait Stress Reaction (T-scores, Multidimensional Personality Questionnaire, MPQ) |
| Personality, social anxiety | through study completion, an average of 1 month | Personality trait social anxiety (T-scores, Liebowitz Social Anxiety Scale, LSAS-fear) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| BOLD MRI PAG | through study completion, an average of 1 month | MRI activation in regions of interest (BOLD area PAG in mean %) as a function of speech tasks with and without stress induction |
| Personality, Wellbeing | through study completion, an average of 1 month | Personality trait Wellbeing (T-scores, Multidimensional Personality Questionnaire, MPQ) |
| Personality, Social Closeness | through study completion, an average of 1 month | Personality trait Social Closeness (T-scores, Multidimensional Personality Questionnaire, MPQ) |
| Personality, social anxiety | through study completion, an average of 1 month | Personality trait social anxiety (T-scores, Liebowitz Social Anxiety Scale, LSAS-total) |
| Personality, self-esteem | through study completion, an average of 1 month | Personality self-esteem (raw data, Rosenberg self-esteem scale) |
| Behavioral inhibition and exhibition | through study completion, an average of 1 month | Behavioral inhibition and exhibition (raw data, BIS/BAS scales, BIS subscale) |
| Vocal fatigue | through study completion, an average of 1 month | Raw scores, Vocal Fatigue Index, VFI Factor 2 and 3 |
| Handedness | through study completion, an average of 1 month | Handedness (raw data, Edinburgh Handedness Inventory, EHI) |
| State positive and negative affect | through study completion, an average of 1 month | State positive and negative affect (raw data, Positive and Negative Affect Schedule, PANAS) |
| Voice quality, relative fundamental frequency | through study completion, an average of 1 month | Voice quality, relative fundamental frequency (relative fundamental frequency, RFF in semitones \[ST\]) |
| Voice quality, cepstral-spectral analysis | through study completion, an average of 1 month | Voice quality, cepstral-spectral analysis (cepstral peak prominence in dB) |
| Perceived vocal effort | through study completion, an average of 1 month | Perceived vocal effort (raw data, BORG-CR-10) |
| Cognitive effort | through study completion, an average of 1 month | Cognitive effort (raw data, NASA-TLX) |
| Chronic Stress | through study completion, an average of 1 month | Chronic stress (T-scores, Trier Inventory of Chronic Stress, TICS) |
| Voice quality of life | through study completion, an average of 1 month | Raw data, Voice Handicap Index, VHI |
| Vocal tract discomfort | through study completion, an average of 1 month | Raw data, Vocal Tract Discomfort Scale, VTD |
| Informal questionnaire on vocal health | through study completion, an average of 1 month | Raw data informal questionnaire on vocal health |
| BOLD MRI SMA | through study completion, an average of 1 month | MRI activation in regions of interest (BOLD area SMA in mean %) as a function of speech tasks with and without stress induction |
| BOLD MRI ACC | through study completion, an average of 1 month | MRI activation in regions of interest (BOLD area ACC in mean %) as a function of speech tasks with and without stress induction |
| BOLD MRI MCC | through study completion, an average of 1 month | MRI activation in regions of interest (BOLD area MCC in mean %) as a function of speech tasks with and without stress induction |
| BOLD MRI Amygdala | through study completion, an average of 1 month | MRI activation in regions of interest (BOLD area Amygdala in mean %) as a function of speech tasks with and without stress induction |
Countries
Germany
Contacts
Primary ContactMaria Dietrich, PhD
Backup ContactLisa Sindermann, PhD
Outcome results
None listed