Voice Disorders Center, The University of Utah, Salt Lake City, Utah 84108, USA.
J Voice. 2011 Jan;25(1):e35-46. doi: 10.1016/j.jvoice.2009.09.004. Epub 2010 Feb 19.
Spasmodic dysphonia (SD) is a chronic, incurable, and often disabling voice disorder of unknown pathogenesis. The purpose of this study was to identify possible endogenous and exogenous risk and protective factors uniquely associated with SD.
Prospective, exploratory, case-control investigation.
One hundred fifty patients with SD and 150 medical controls (MCs) were interviewed regarding their personal and family histories, environmental exposures, illnesses, injuries, voice use patterns, and general health using a previously vetted and validated epidemiologic questionnaire.
Odds ratios and multiple logistic regression analyses (α<0.15) identified several factors that significantly increased the likelihood of having SD. These factors included (1) a personal history of mumps, blepharospasm, tremor, intense occupational and avocational voice use, and a family history of voice disorders; (2) an immediate family history of meningitis, tremor, tics, cancer, and compulsive behaviors; and (3) an extended family history of tremor and cancer.
SD is likely multifactorial in etiology, involving both genetic and environmental factors. Viral infections/exposures, along with intense voice use, may trigger the onset of SD in genetically predisposed individuals. Future studies should examine the interaction among genetic and environmental factors to determine the pathogenesis of SD.
痉挛性发音障碍（SD）是一种慢性、无法治愈且常导致残疾的未知病因的嗓音障碍。本研究旨在确定可能与 SD 相关的独特的内源性和外源性风险和保护因素。
前瞻性、探索性、病例对照研究。
使用先前经过验证的流行病学问卷，对 150 名 SD 患者和 150 名医学对照（MCs）进行访谈，了解他们的个人和家族史、环境暴露、疾病、损伤、嗓音使用模式和一般健康状况。
比值比和多变量逻辑回归分析（α<0.15）确定了一些显著增加患 SD 可能性的因素。这些因素包括：（1）个人史中有腮腺炎、眼睑痉挛、震颤、高强度职业和业余嗓音使用以及家族史中有嗓音障碍；（2）直系亲属中有脑膜炎、震颤、抽搐、癌症和强迫行为史；（3）家族中有震颤和癌症史。
SD 的病因可能是多因素的，涉及遗传和环境因素。病毒感染/暴露以及高强度的嗓音使用可能会触发遗传易感个体发生 SD。未来的研究应检查遗传和环境因素之间的相互作用，以确定 SD 的发病机制。
