为期11周的振动触觉刺激疗法对喉肌张力障碍语音症状的影响。

Effects of an 11-week vibro-tactile stimulation treatment on voice symptoms in laryngeal dystonia.

作者信息

Konczak Jürgen, Bhaskaran Divya, Elangovan Naveen, Oh Jinseok, Goding George S, Watson Peter J

机构信息

Human Sensorimotor Control Laboratory, School of Kinesiology and Center for Clinical Movement Science, University of Minnesota, Minneapolis, MN, United States.

Department of Otolaryngology and Fairview Lion's Voice Clinic, University of Minnesota, Minneapolis, MN, United States.

出版信息

Front Neurol. 2024 May 30;15:1403050. doi: 10.3389/fneur.2024.1403050. eCollection 2024.

DOI:10.3389/fneur.2024.1403050

PMID:38872829

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11169659/

Abstract

BACKGROUND

Laryngeal dystonia is a task-specific focal dystonia of laryngeal muscles that impairs speech and voice production. At present, there is no cure for LD. The most common therapeutic option for patients with LD involves Botulinum neurotoxin injections.

OBJECTIVE

Provide empirical evidence that non-invasive vibro-tactile stimulation (VTS) of the skin over the voice box can provide symptom relief to those affected by LD.

METHODS

Single-group 11-week randomized controlled trial with a crossover between two dosages (20 min of VTS once or 3 times per week) self-administered in-home in two 4-week blocks. Acute effects of VTS on voice and speech were assessed in-lab at weeks 1, 6 and 11. Participants were randomized to receive either 40 Hz or 100 Hz VTS.

MAIN OUTCOME MEASURES

Primary: (CPPS) of the voice signal to quantify voice and speech abnormalities, and (PSE) ranked by participants as a measure of voice effort (scale 1-10). Secondary: during continuous speech, the (CAPE-V) inventory as a measure of overall disease severity and the 30-item self report.

RESULTS

Thirty-nine people with a confirmed diagnosis of adductor-type LD (mean [SD] age, 60.3 [11.3] years; 18 women and 21 men) completed the study. A single application of VTS improved voice quality (median CPPS increase: 0.41 dB, 95% CI [0.20, 0.61]) and/or reduced voice effort (PSE) by at least 30% in up to 57% of participants across the three study visits. Effects lasted from less than 30 min to several days. There was no effect of dosage and no evidence that the acute therapeutic effects of VTS increased or decreased longitudinally over the 11-week study period. Both 100 and 40 Hz VTS induced measurable improvements in voice quality and speech effort. VTS induced an additional benefit to those receiving Botulinum toxin. Participants, not receiving Botulinum treatment also responded to VTS.

CONCLUSION

This study provides the first systematic empirical evidence that the prolonged use of laryngeal VTS can induce repeatable acute improvements in voice quality and reductions of voice effort in LD.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov ID: NCT03746509.

摘要

背景

喉肌张力障碍是一种特定任务的喉部肌肉局灶性肌张力障碍，会损害言语和发声。目前，喉肌张力障碍无法治愈。对于喉肌张力障碍患者，最常见的治疗选择是注射肉毒杆菌神经毒素。

目的

提供经验证据，证明对喉上方皮肤进行非侵入性振动触觉刺激（VTS）可缓解喉肌张力障碍患者的症状。

方法

单组11周随机对照试验，在两个4周的时间段内，在家中自行进行两种剂量（每周1次或3次，每次20分钟VTS）的交叉试验。在第1、6和11周在实验室评估VTS对声音和言语的急性影响。参与者被随机分配接受40Hz或100Hz的VTS。

主要观察指标

主要指标：声音信号的（CPPS）以量化声音和言语异常，以及参与者评定的（PSE）作为声音努力程度的指标（1-10分）。次要指标：连续言语期间的（CAPE-V）量表作为整体疾病严重程度的指标，以及30项自我报告。

结果

39名确诊为内收型喉肌张力障碍的患者（平均[标准差]年龄，60.3[11.3]岁；18名女性和21名男性）完成了研究。在三次研究访视中，高达57%的参与者单次应用VTS可改善声音质量（CPPS中位数增加：0.41dB，95%CI[0.20，0.61]）和/或使声音努力程度（PSE）降低至少30%。效果持续时间从不到30分钟到数天不等。剂量没有影响，也没有证据表明在11周的研究期间VTS的急性治疗效果会纵向增加或减少。100Hz和40Hz的VTS均能使声音质量和言语努力程度得到可测量的改善。VTS对接受肉毒杆菌毒素治疗的患者有额外益处。未接受肉毒杆菌治疗的参与者对VTS也有反应。