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Vocal tremor

Vinod K Ravikumar, Allen L Ho, Jonathon J Parker, Elizabeth Erickson-DiRenzo, Casey H Halpern
Tremulous voice is characteristically associated with essential tremor, and is referred to as essential vocal tremor (EVT). Current estimates suggest that up to 40% of individuals diagnosed with essential tremor also present with EVT, which is associated with an impaired quality of life. Traditional EVT treatments have demonstrated limited success in long-term management of symptoms. However, voice tremor has been noted to decrease in patients receiving deep brain stimulation (DBS) with the targeting of thalamic nuclei...
October 10, 2016: Brain Sciences
Michael Z Lerner, Benjamin A Lerner, Amit A Patel, Andrew Blitzer
OBJECTIVES/HYPOTHESIS: The objective of this study was to determine the influence of gender on onabotulinum toxin A dosing for the treatment of adductor spasmodic dysphonia symptoms. STUDY DESIGN: Retrospective review. METHODS: A chart review of the senior author's database of botulinum toxin injections was performed. Patients diagnosed with adductor spasmodic dysphonia who received onabotulinum toxin A (BoNTA) injections to the thyroarytenoid muscle for at least 5 years were included for study...
September 16, 2016: Laryngoscope
Robert Harris, Klaus L Leenders, Bauke M de Jong
Parkinson's disease is characterized not only by bradykinesia, rigidity, and tremor, but also by impairments of expressive and receptive linguistic prosody. The facilitating effect of music with a salient beat on patients' gait suggests that it might have a similar effect on vocal behavior, however it is currently unknown whether singing is affected by the disease. In the present study, fifteen Parkinson patients were compared with fifteen healthy controls during the singing of familiar melodies and improvised melodic continuations...
September 9, 2016: Brain and Language
Abby L Hemmerich, Eileen M Finnegan, Henry T Hoffman
BACKGROUND: Vocal tremor may be associated with cyclic oscillations in the pulmonary, laryngeal, velopharyngeal, or oral regions. OBJECTIVES: This study aimed to correlate the overall severity of vocal tremor with the distribution and severity of tremor in structures involved. METHODS: Endoscopic and clinical examinations were completed on 20 adults with vocal tremor and two age-matched controls during sustained phonation. Two judges rated the severity of vocal tremor and the severity of tremor affecting each of 13 structures...
June 8, 2016: Journal of Voice: Official Journal of the Voice Foundation
Dietrich Haubenberger, Giovanni Abbruzzese, Peter G Bain, Nin Bajaj, Julián Benito-León, Kailash P Bhatia, Günther Deuschl, Maria João Forjaz, Mark Hallett, Elan D Louis, Kelly E Lyons, Tiago A Mestre, Jan Raethjen, Maria Stamelou, Eng-King Tan, Claudia M Testa, Rodger J Elble
The International Parkinson and Movement Disorder Society established a task force on tremor that reviewed the use of transducer-based measures in the quantification and characterization of tremor. Studies of accelerometry, electromyography, activity monitoring, gyroscopy, digitizing tablet-based measures, vocal acoustic analysis, and several other transducer-based methods were identified by searching The availability, use, acceptability, reliability, validity, and responsiveness were reviewed for each measure using the following criteria: (1) used in the assessment of tremor; (2) used in published studies by people other than the developers; and (3) adequate clinimetric testing...
September 2016: Movement Disorders: Official Journal of the Movement Disorder Society
Soo Yeon Jung, Hae Sang Park, Hasuk Bae, Jeong Hyun Yoo, Hyung Jun Park, Kee Duk Park, Han Su Kim, Sung Min Chung
OBJECTIVE: To consider the feasibility of diagnosing intrinsic laryngeal muscle myofascial pain syndrome (MPS) in dysphonic patients who demonstrated immediate symptom and stroboscopic finding improvement after laryngeal electromyography (LEMG) without further treatment. METHODS: A chart review of patients who showed subtle vocal fold movement abnormalities on a stroboscopic examination and underwent ultrasonography (US)-guided LEMG was performed. Patients with vocal fold paralysis, mucosal lesions, spasmodic dysphonia, and vocal tremor on stroboscopic examination were excluded...
June 1, 2016: Auris, Nasus, Larynx
Christian T Herbst, Stellan Hertegard, Daniel Zangger-Borch, Per-Åke Lindestad
Freddie Mercury was one of the twentieth century's best-known singers of commercial contemporary music. This study presents an acoustical analysis of his voice production and singing style, based on perceptual and quantitative analysis of publicly available sound recordings. Analysis of six interviews revealed a median speaking fundamental frequency of 117.3 Hz, which is typically found for a baritone voice. Analysis of voice tracks isolated from full band recordings suggested that the singing voice range was 37 semitones within the pitch range of F#2 (about 92...
April 15, 2016: Logopedics, Phoniatrics, Vocology
Soren Y Lowell, Richard T Kelley, Lauren Busekroos, Ramani Voleti, Carly J Hosbach-Cannon, Raymond H Colton, Dragos Mihaila
OBJECTIVES/HYPOTHESIS: The purpose of this study was to determine the effects of anchors and training on intrarater and inter-rater reliability for visual-perceptual, endoscopic tremor ratings. STUDY DESIGN: Prospective cohort study. METHODS: Nasoendoscopy recordings of 10 participants with a diagnosis of essential voice tremor were evaluated by five voice specialists using the Vocal Tremor Scoring System. Ratings were performed before, immediately after, and 4 weeks after implementation of a training program with anchor stimuli...
April 14, 2016: Laryngoscope
Mila Bunijevac, Mirjana Petrović-Lazić, Nadica Jovanović-Simić, Mile Vuković
BACKGROUND/AIM: The major role of larynx in speech, respiration and swallowing makes carcinomas of this region and their treatment very influential for patients' life quality. The aim of this study was to assess the importance of voice therapy in patients after open surgery on vocal cords. METHODS: This study included 21 male patients and the control group of 19 subjects. The vowel (A) was recorded and analyzed for each examinee. All the patients were recorded twice: firstly, when they contacted the clinic and secondly, after a three-month vocal therapy, which was held twiceper week on an outpatient basis...
February 2016: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
Patricia Gillivan-Murphy, Paul Carding, Nick Miller
PURPOSE OF REVIEW: Voice tremor is strongly linked to the Parkinson's disease speech-voice symptom complex. Little is known about the underlying anatomic source(s) of voice tremor when it occurs. We review recent literature addressing this issue. Additionally we report findings from a study we conducted employing rating of vocal tract structures viewed using nasolaryngoscopy during vocal and nonspeech tasks. RECENT FINDINGS: In Parkinson's disease, using laryngeal electromyography, tremor has not been identified in muscles in the vocal folds even when perceived auditorily...
June 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Rohan R Mahale, Ravi Yadav, Pramod Kr Pal
Rapid eye movement sleep behavior disorder (RBD) is common in Parkinson's disease (PD). Little information exists about RBD in women with PD. The aim of this study was to determine the clinical expression of RBD in women with PD and note any differences in women with PD with and without RBD. One hundred fifty-six patients with PD were recruited. There were 37 women with PD and probable RBD was diagnosed using the RBD Screening Questionnaire. Other scales included Pittsburgh Sleep Quality Index, Parkinson's Disease Sleep Scale, Epworth Sleep Scale, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale...
June 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Bruno Teixeira de Moraes, Noemi Grigoletto de Biase
INTRODUCTION: Although syndromes that cause voice tremor have singular characteristics, the differential diagnosis of these diseases is a challenge because of the overlap of the existing signs and symptoms. OBJECTIVE: To develop a task-specific protocol to assess voice tremor by means of nasofibrolaryngoscopy and to identify those tasks that can distinguish between essential and dystonic tremor syndromes. METHODS: Cross-sectional study. The transnasal fiberoptic laryngoscopy protocol, which consisted of the assessment of palate, pharynx and larynx tremor during the performance of several vocal and non-vocal tasks with distinct phenomenological characteristics, was applied to 19 patients with voice tremor...
January 2016: Brazilian Journal of Otorhinolaryngology
Andrew Nida, Josie Alston, John Schweinfurth
IMPORTANCE: Essential vocal tremor is difficult to treat. An effective pharmacologic treatment could allow patients to avoid or decrease the frequency or dosage of botulinum neurotoxin injections. OBJECTIVE: To evaluate the efficacy of primidone in the treatment of essential vocal tremor. DESIGN, SETTING, AND PARTICIPANTS: Medical records of all patients with a primary or secondary diagnosis of laryngeal spasm or essential tremor treated with primidone between June 1, 2012, and March 21, 2014, at a tertiary care medical center were reviewed...
February 2016: JAMA Otolaryngology—Head & Neck Surgery
Rosemary A Lester, Brad H Story
The purpose of this study was to determine if adjustments to the voice source [i.e., fundamental frequency (F0), degree of vocal fold adduction] or vocal tract filter (i.e., vocal tract shape for vowels) reduce the perception of simulated laryngeal vocal tremor and to determine if listener perception could be explained by characteristics of the acoustical modulations. This research was carried out using a computational model of speech production that allowed for precise control and manipulation of the glottal and vocal tract configurations...
August 2015: Journal of the Acoustical Society of America
Adam P Vogel, Hugh J McDermott, Thushara Perera, Mary Jones, Richard Peppard, Colette M McKay
BACKGROUND: Deep brain stimulation (DBS) is an effective treatment for reducing symptoms of tremor. A common and typically subjectively determined adverse effect of DBS is dysarthria. Current assessment protocols are driven by the qualitative judgments of treating clinicians and lack the sensitivity and objectivity required to optimize patient outcomes where multiple stimulation parameters are trialed. OBJECTIVE: To examine the effect of DBS on speech in patients receiving stimulation to the posterior sub-thalamic area (PSA) via randomized manipulation of amplitude parameters...
2015: Frontiers in Bioengineering and Biotechnology
Leah E Ferguson, Mary Kay McLean, Julia A Bates, Jessica M Quimby
OBJECTIVES: Mirtazapine is commonly used in veterinary medicine at doses of 1.88 or 3.75 mg as an appetite stimulant. The objectives of this study were to determine the most common adverse effects reported and the dose associated with these signs. METHODS: Records of cats with mirtazapine exposure (2006-2011) were obtained from the American Society for the Prevention of Cruelty to Animals' Animal Poison Control Center. The following parameters were recorded: signalment, weight, outcome, agent ingested, amount ingested, route of exposure, clinical signs observed, intent of use, onset time of signs and duration of signs...
July 30, 2015: Journal of Feline Medicine and Surgery
Natalie Justicz, Edie R Hapner, Joshua S Josephs, Benjamin C Boone, Hyder A Jinnah, Michael M Johns
OBJECTIVES/HYPOTHESIS: To assess the comparative effectiveness of botulinum toxin and propranolol in patients with essential vocal tremor (EVT). STUDY DESIGN: Individual prospective cohort study. METHODS: Study patients were recruited at the Emory Voice Center from patients seeking treatment for EVT. Exclusion criteria included current β-blocker treatment, spasmodic dysphonia, or other disease that prevented the use of propranolol therapy...
January 2016: Laryngoscope
Allen L Ho, Omar Choudhri, C Kwang Sung, Elizabeth E DiRenzo, Casey H Halpern
Essential vocal tremor (EVT) is the presence of a tremulous voice that is commonly associated with essential tremor. Patients with EVT often report a necessary increase in vocal effort that significantly worsens with stress and anxiety and can significantly impact quality of life despite optimal medical and behavioral treatment options. Deep brain stimulation (DBS) has been proposed as an effective therapy for vocal tremor, but very few studies exist in the literature that comprehensively evaluate the efficacy of DBS for specifically addressing EVT...
March 2015: Curēus
Allen L Ho, Elizabeth Erickson-Direnzo, Arjun V Pendharkar, Chih-Kwang Sung, Casey H Halpern
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...
June 2015: Neurosurgical Focus
Alpen B Patel, Stephen F Bansberg, Charles H Adler, David G Lott, Lisa Crujido
OBJECTIVE: Analyze demographic data collected over a 25-year experience of 718 patients with spasmodic dysphonia (SD) who have been treated with botulinum toxin-A (BoNT-A) and compare our data with previously published studies. METHODS: Seven hundred eighteen patients with SD were treated with 6621 BoNT-A injections at Mayo Clinic Arizona between 1989 and 2014. All patients were treated by the same physician team. Background demographic data for each patient were recorded...
November 2015: Annals of Otology, Rhinology, and Laryngology
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