Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA, 02215, USA.
Department of Biomedical Engineering, Boston University, Boston, MA, 02215, USA.
Sci Rep. 2021 Jun 23;11(1):13123. doi: 10.1038/s41598-021-92250-8.
Hyperfunctional voice disorders (HVDs) are the most common class of voice disorders, consisting of diagnoses such as vocal fold nodules and muscle tension dysphonia. These speech production disorders result in effort, fatigue, pain, and even complete loss of voice. The mechanisms underlying HVDs are largely unknown. Here, the auditory-motor control of voice fundamental frequency (f) was examined in 62 speakers with and 62 speakers without HVDs. Due to the high prevalence of HVDs in singers, and the known impacts of singing experience on auditory-motor function, groups were matched for singing experience. Speakers completed three tasks, yielding: (1) auditory discrimination of voice f; (2) reflexive responses to sudden f shifts; and (3) adaptive responses to sustained f shifts. Compared to controls, and regardless of singing experience, individuals with HVDs showed: (1) worse auditory discrimination; (2) comparable reflexive responses; and (3) a greater frequency of atypical adaptive responses. Atypical adaptive responses were associated with poorer auditory discrimination, directly implicating auditory function in this motor disorder. These findings motivate a paradigm shift for understanding development and treatment of HVDs.
功能性嗓音障碍（HVD）是最常见的一类嗓音障碍，包括声带小结和肌肉紧张性发音障碍等诊断。这些言语产生障碍会导致用力、疲劳、疼痛，甚至完全丧失声音。HVD 的发病机制在很大程度上尚不清楚。在这里，我们检查了 62 名患有 HVD 和 62 名无 HVD 的说话者的声音基频（f）的听觉-运动控制。由于 HVD 在歌唱者中高发，以及歌唱经验对听觉-运动功能的已知影响，因此按歌唱经验对两组进行了匹配。说话者完成了三项任务，分别为：（1）对声音 f 的听觉辨别；（2）对突然的 f 变化的反射性反应；（3）对持续的 f 变化的适应性反应。与对照组相比，无论是否有歌唱经验，患有 HVD 的个体表现出：（1）较差的听觉辨别力；（2）相当的反射性反应；（3）更频繁的异常适应性反应。异常适应性反应与较差的听觉辨别力相关，直接表明听觉功能在这种运动障碍中起作用。这些发现促使人们对 HVD 的发展和治疗的理解发生范式转变。
