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Vocal tremor

Yasaman Safarpour, Bahman Jabbari
Botulinum neurotoxins (BoNTs) are now among the most widely used therapeutic agents in clinical medicine with indications applied to the fields of movement disorders, pain disorders, and autonomic dysfunction. In this literature review, the efficacy and utility of BoNTs in the field of movement disorders are assessed using the criteria of the Guideline Development Subcommittee of the American Academy of Neurology. The literature supports a level A efficacy (established) for BoNT therapy in cervical dystonia and a level B efficacy (probably effective) for blepharospasm, hemifacial spasm, laryngeal dystonia (spasmodic dysphonia), task-specific dystonias, essential tremor, and Parkinson rest tremor...
February 24, 2018: Current Treatment Options in Neurology
Brittany R Burk, Christopher R Watts
OBJECTIVES: The physiological manifestations of Parkinson disease are heterogeneous, as evidenced by disease subtypes. Dysphonia has been well documented as an early and progressively significant impairment associated with the disease. The purpose of this study was to investigate how acoustic and aerodynamic measures of vocal function were affected by Parkinson tremor subtype (phenotype) in an effort to better understand the heterogeneity of voice impairment severity in Parkinson disease...
February 19, 2018: Journal of Voice: Official Journal of the Voice Foundation
Priyesh N Patel, Edmond K Kabagambe, Jennifer C Starkweather, Matthew Keller, Vahram Gamsarian, Jane Lee, Vishnutheert Kulkarni, C Gaelyn Garrett, David O Francis
Importance: The relative outcomes of onabotulinum toxin A injections for treatment of adductor spasmodic dysphonia (ADSD), ADSD with lateral laryngeal tremor (ADSD+LT), and lateral LT without ADSD are unclear. Objective: To compare the outcomes of onabotulinum toxin A treatment on ADSD, ADSD+LT, and lateral LT without ADSD. Design, Setting, and Participants: A retrospective cohort study was conducted from January 1, 1990, to September 30, 2016, at a tertiary referral voice center...
February 8, 2018: JAMA Otolaryngology—Head & Neck Surgery
Qi Wei Oung, Hariharan Muthusamy, Shafriza Nisha Basah, Hoileong Lee, Vikneswaran Vijean
Parkinson's disease (PD) is a type of progressive neurodegenerative disorder that has affected a large part of the population till now. Several symptoms of PD include tremor, rigidity, slowness of movements and vocal impairments. In order to develop an effective diagnostic system, a number of algorithms were proposed mainly to distinguish healthy individuals from the ones with PD. However, most of the previous works were conducted based on a binary classification, with the early PD stage and the advanced ones being treated equally...
December 29, 2017: Journal of Medical Systems
Lindsey A Parker, Melda Kunduk, Daniel S Fink, Andrew McWhorter
OBJECTIVES: The main objectives of this study were to (1) examine intrarater and inter-rater reliabilities in perceptual ratings of vocal fold vibratory patterns and supraglottic characteristics for essential vocal tremor and adductor spasmodic dysphonia (AdSD) using high-speed videoendoscopy (HSV), and (2) to investigate the specificity of the parameters in differentiating these two voice disorders. METHODS: HSV recordings of 34 cases diagnosed with essential vocal tremor, AdSD, or AdSD with vocal tremor were evaluated blindly by two voice speech pathologists...
December 12, 2017: Journal of Voice: Official Journal of the Voice Foundation
Bornali Kundu, Lauren Schrock, Tyler Davis, Paul A House
OBJECTIVE: Voice tremor is a common feature of essential tremor (ET) that is difficult to treat medically and significantly affects quality of life. Deep brain stimulation (DBS) of the ventral intermediate nucleus (Vim) of the thalamus is effective in improving contralateral distal limb tremor and has been shown in limited studies to affect voice tremor. Our objective was to retrospectively evaluate whether Vim-DBS used to treat patients with essential motor tremor also effectively treated underlying concurrent voice tremor and assess whether particular lead locations were favorable for treating vocal tremor...
December 12, 2017: Neuromodulation: Journal of the International Neuromodulation Society
Rachel Kaye, Andrew Blitzer
Botulinum neurotoxin (BoNT) has existed for thousands of years; however, it was not medically utilized until investigations into its therapeutic use began in sincerity during the late 1970s and 1980s. This, coupled with the reclassification of spasmodic dysphonia as a focal dystonia, led to the use of chemodenervation for this disorder, which has since become a refined technique. Indeed, due to its safety and efficacy, BoNT has been investigated in multiple neurolaryngology disorders, including spasmodic dysphonia, vocal tremor, and muscle tension dysphonia...
November 2, 2017: Toxins
Christine Estes, Babak Sadoughi, Rachel Coleman, Harini Sarva, Elizabeth Mauer, Lucian Sulica
OBJECTIVES/HYPOTHESIS: Botulinum toxin chemodenervation (BTX) is used to treat essential voice tremor (EVT), but results are not uniformly satisfactory. This study sought to assess the comparative utility of injection augmentation (IA) for EVT. STUDY DESIGN: Prospective crossover treatment study. METHODS: Patients with EVT underwent BTX. After washout patients underwent IA. Multidimensional assessment carried out prior to and 30 days after each treatment included 1) videostroboscopy graded by the Vocal Tremor Scoring System (VTSS), 2) acoustic and aerodynamic assessment (cepstral peak prominence, cepstral spectral index of dysphonia, cepstral peak prominence fundamental frequency, airflow, peak air pressure and intensity, maximum phonation time, and amplitude/frequency of tremor), 3) audio-perceptual assessment via Consensus Audio-Perceptual Evaluation of Voice (CAPE-V), and 4) patient self-assessment via Voice Handicap Index-10 (VHI-10) and Percent of Normal Function (PNF) scale...
October 8, 2017: Laryngoscope
Julie M Barkmeier-Kraemer, Heather M Clark
BACKGROUND: Hyperkinetic dysarthria is characterized by abnormal involuntary movements affecting respiratory, phonatory, and articulatory structures impacting speech and deglutition. Speech-language pathologists (SLPs) play an important role in the evaluation and management of dysarthria and dysphagia. This review describes the standard clinical evaluation and treatment approaches by SLPs for addressing impaired speech and deglutition in specific hyperkinetic dysarthria populations. METHODS: A literature review was conducted using the data sources of PubMed, Cochrane Library, and Google Scholar...
2017: Tremor and Other Hyperkinetic Movements
Amanda L Richards
PURPOSE OF REVIEW: Vocal tremor in movement disorders is often overlooked, although it has a significant impact on quality of life. Careful observation of tremor phenomenology allows for accurate diagnosis and tailored treatment. RECENT FINDINGS: The central pathways associated with various vocal tremor-associated diseases have been further elucidated. SUMMARY: Patients are likely to benefit from a combination of medical and interventional treatments delivered within a multidisciplinary setting...
December 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
Irene Hidalgo de la Guía, Pedro Gómez Vilda, Elena Garayzábal Heinze
The voice of persons with Williams syndrome (WS) is described as hoarse with a deep and unstable fundamental frequency (f0). These observations may be justified by the deficit of elastin due to a haplo-insufficiency in the ELN gene characteristic of the syndrome. In view of the possible relationship between elastin deficit and dysphonia, a study of the dynamic function of WS phonation was conducted by means of biomechanical analysis. In order to assess the presence of dysphonic symptoms and their degree of severity, the biomechanical description of WS phonation has been evaluated in terms of dynamic mass and viscoelasticity estimates...
August 2, 2017: Journal of Voice: Official Journal of the Voice Foundation
Temístocles Soares de Oliveira Neto, Franklin Riet-Correa, Stephen T Lee, Daniel Cook, Francisca Maria Sousa Barbosa, José Ferreira da Silva Neto, Sara Vilar Dantas Simões, Ricardo Barbosa Lucena
The epidemiological, clinical and pathological aspects of a spontaneous outbreak of Palicourea aeneofusca poisoning in goats are reported. The main clinical signs were motor incoordination, generalized muscle tremors, broad-based posture, tachypnea, tachycardia, vocalization and respiratory distress. Two goats died 5 and 20 min after the observation of the first clinical signs. Another that was found recumbent died 80 h later. One goat with mild clinical signs recovered. Congestion and hemorrhages were observed macroscopically and histologically in most organs...
May 31, 2017: Toxicon: Official Journal of the International Society on Toxinology
Anujan Poologaindran, Zurab Ivanishvili, Murray D Morrison, Linda A Rammage, Mini K Sandhu, Nancy E Polyhronopoulos, Christopher R Honey
Spasmodic dysphonia (SD) is a neurological disorder of the voice where a patient's ability to speak is compromised due to involuntary contractions of the intrinsic laryngeal muscles. Since the 1980s, SD has been treated with botulinum toxin A (BTX) injections into the throat. This therapy is limited by the delayed-onset of benefits, wearing-off effects, and repeated injections required every 3 months. In a patient with essential tremor (ET) and coincident SD, the authors set out to quantify the effects of thalamic deep brain stimulation (DBS) on vocal function while investigating the underlying motor thalamic circuitry...
March 17, 2017: Journal of Neurosurgery
Mohammad Javad Saeedi Borujeni, Ebrahim Esfandiary, Mostafa Almasi-Dooghaee
INTRODUCTION: Dystonia is a disorder of movement caused by various etiologies. Laryngeal dystonia is caused by the spasm of laryngeal muscles. It is a disorder caused by vocal fold movement in which excessive adduction or abduction of the vocal folds occurs during speech. The pathophysiology of this type of dystonia is not fully known. Some researchers have suggested that basal ganglia structures and their connections with cortical areas have been involved in the pathogenesis of dystonia...
January 2017: Iranian Journal of Otorhinolaryngology
Patrick R Blackburn, Michael T Zimmermann, Jennifer M Gass, Kimberly G Harris, Margot A Cousin, Nicole J Boczek, Owen A Ross, Eric W Klee, Paul W Brazis, Jay A Van Gerpen, Paldeep S Atwal
BACKGROUND: Cervical dystonias have a variable presentation and underlying etiology, but collectively represent the most common form of focal dystonia. There are a number of known genetic forms of dystonia (DYT1-27); however the heterogeneity of disease presentation does not always make it easy to categorize the disease by phenotype-genotype comparison. CASE PRESENTATION: In this report, we describe a 53-year-old female who presented initially with hand tremor following a total hip arthroplasty...
December 5, 2016: BMC Medical Genetics
Rosemary A Lester-Smith, Brad H Story
The purpose of this study was to investigate the effects of physiological adjustments on listeners' perception of the magnitude of modulation of voice and to determine the characteristics of the acoustical modulations that explained listeners' judgments. This research was carried out using singers producing vibrato as a model of vocal tremor. Twenty healthy adults participated in a perceptual study involving pair-comparisons of the magnitude of "shakiness" with singers' samples, which differed by fundamental frequency, vocal quality, and vowel...
November 2016: Journal of the Acoustical Society of America
Gleidy Vannesa E Rojas, Hilton Ricz, Vitor Tumas, Guilherme R Rodrigues, Patrícia Toscano, Lílian Aguiar-Ricz
OBJECTIVE: The study aimed to compare and correlate perceptual-auditory analysis of vocal parameters and self-perception in individuals with adductor spasmodic dysphonia before and after the application of botulinum toxin. STUDY DESIGN: This is a prospective cohort study. METHODS: Sixteen individuals with a diagnosis of adductor spasmodic dysphonia were submitted to the application of botulinum toxin in the thyroarytenoid muscle, to the recording of a voice signal, and to the Voice Handicap Index (VHI) questionnaire before the application and at two time points after application...
November 17, 2016: Journal of Voice: Official Journal of the Voice Foundation
Mohammad Javad Saeedi, Ebrahim Esfandiary, Mostafa Almasi Dooghaee
Objective The basal ganglia are a group of structures that act as a cohesive functional unit. They are situated at the base of the forebrain and are strongly connected with the cerebral cortex and thalamus. Some speech disorders such as stuttering can resulted from disturbances in the circuits between the basal ganglia and the language motor area of the cerebral cortex. Stuttering consists of blocks, repetitive, prolongation or cessation of speech. We present a 7.5 -year-old male child with bilateral basal ganglia lesion in globus pallidus with unclear reason...
2016: Iranian Journal of Child Neurology
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...
May 2017: Laryngoscope
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