Petit Jimmy, Ehrlich Stefan K, Tougas Garrett, Bernstein Jacob M, Buie Nicole E, Simonyan Kristina
Department of Otolaryngology-Head & Neck Surgery, Harvard Medical School and Massachusetts Eye and Ear, Boston, Massachusetts, U.S.A.
Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.
Laryngoscope. 2025 Feb;135(2):787-793. doi: 10.1002/lary.31800. Epub 2024 Oct 2.
Laryngeal dystonia (LD) is an isolated focal dystonia characterized by involuntary spasms in laryngeal muscles selectively impairing speech production. Anecdotal observations reported the worsening of LD symptoms in stressful or vocally demanding situations.
To examine the impact of surrounding audio-visual complexity on LD symptomatology for a better understanding of disorder phenomenology.
We developed well-controlled virtual reality (VR) environments of real-life interpersonal communications to investigate how different levels of audio-visual complexity may impact LD symptoms. The VR experiments were conducted over five consecutive days, during which each patient experienced 10 h of 4100 experimental trials in VR with gradually increasing audio-visual complexity. Daily reports were collected about patients' voice changes, as well as their comfort, engagement, concentration, and drowsiness from using VR technology.
After a weekly VR exposure, 82% of patients reported changes in their voice symptoms related to changes in background audio-visual complexity. Significant differences in voice symptoms were found between the first two levels of the audio-visual challenge complexity independent of study sessions or VR environments.
This study demonstrated that LD symptoms are impacted by audio-visual background across various virtual realistic settings. These findings should be taken into consideration when planning behavioral experiments or evaluating the outcomes of clinical trials in these patients. Moreover, these data show that VR presents a reliable and useful technology for providing real-life assessments of the impact of various experimental settings, such as during the testing of novel therapeutic interventions in these patients.
3 Laryngoscope, 135:787-793, 2025.
喉肌张力障碍（LD）是一种孤立的局灶性肌张力障碍，其特征为喉肌不自主痉挛，选择性地损害言语产生。轶事观察报告称，在压力大或对发声要求高的情况下，LD症状会加重。
研究周围视听复杂性对LD症状学的影响，以更好地理解该疾病的现象学。
我们开发了真实人际交流的严格控制的虚拟现实（VR）环境，以研究不同程度的视听复杂性如何影响LD症状。VR实验连续进行五天，在此期间，每位患者在VR中经历了10小时的4100次实验，视听复杂性逐渐增加。收集了关于患者声音变化以及使用VR技术时的舒适度、参与度、注意力和困倦程度的每日报告。
经过一周的VR暴露后，82%的患者报告其声音症状的变化与背景视听复杂性的变化有关。在视听挑战复杂性的前两个水平之间发现了声音症状的显著差异，与研究时段或VR环境无关。
本研究表明，LD症状在各种虚拟现实环境中均受到视听背景的影响。在规划行为实验或评估这些患者的临床试验结果时，应考虑这些发现。此外，这些数据表明，VR是一种可靠且有用的技术，可用于对各种实验环境的影响进行现实生活评估，例如在对这些患者进行新型治疗干预测试期间。
3 喉镜，135:787 - 793，2025年。
