Henry Trent M, Deliyski Dimitar D, Zayernouri Mohsen, Zacharias Stephanie R C, Naghibolhosseini Maryam
Department of Communicative Sciences and Disorders, Michigan State University, 1026 Red Cedar Rd, East Lansing, MI.
Department of Mechanical Engineering, and Statistics and Probability, Michigan State University, 474 S Shaw Ln, East Lansing, MI.
J Voice. 2025 Mar 18. doi: 10.1016/j.jvoice.2025.02.030.
Neurogenic voice disorders like adductor laryngeal dystonia (AdLD), vocal tremor, and vocal paresis/paralysis impact the neuromuscular control of the phonatory system, which might lead to an impaired phonation onset/offset. Utilizing laryngeal high-speed videoendoscopy (HSV), this study investigates the glottal attack time (GAT) and glottal offset time (GOT) during soft, habitual, and hard glottal attack modalities in sustained phonation for several neurogenic voice disorders.
HSV data and audio recordings were obtained simultaneously from 14 participants with neurogenic voice disorders and 14 normophonic participants during two productions of the /i/ vowel at soft, habitual, and hard glottal attacks. Using HSV, GAT, defined as the time interval between the first oscillation and the first contact of the vocal folds at phonation onset, and GOT, the time interval between the last oscillation and the last contact of the vocal folds at phonation offset, were measured. GAT and GOT for different glottal attack modalities were compared within each group, also among the different disorders and normophonic participants. Additionally, these values were compared between sustained phonation and connected speech for the normophonic participants and those with AdLD.
The neurogenic disorders group exhibited significantly higher GAT values than the normophonic participants during the hard glottal attack modality. Habitual GOTs for vocal tremor were significantly different than those of unilateral vocal fold paralysis and AdLD. Moreover, the normophonic participants shared similar trends between connected speech and sustained phonation across glottal attack modalities for GAT, while the AdLD group did not. AdLD participants shared the same trend for GOT, while normophonic participants did not.
This study provides evidence of differences in GAT and GOT values during sustained phonation across different neurogenic voice disorders, contributing to the understanding of their pathophysiology. These findings may inform the development of strategies and speech tasks for clinical assessment of neurogenic voice disorders.
诸如内收性喉肌张力障碍（AdLD）、声带震颤以及声带轻瘫/麻痹等神经源性嗓音障碍会影响发声系统的神经肌肉控制，这可能导致发声起始/终止受损。本研究利用喉高速视频内镜检查（HSV），调查了几种神经源性嗓音障碍在持续发声时，柔和、习惯性及用力声门起始方式下的声门开启时间（GAT）和声门关闭时间（GOT）。
在14名患有神经源性嗓音障碍的参与者和14名嗓音正常的参与者发出/i/元音的两个过程中，于柔和、习惯性及用力声门起始时，同时获取HSV数据和音频记录。使用HSV测量GAT（定义为发声起始时声带首次振动与首次接触之间的时间间隔）和GOT（发声终止时声带最后一次振动与最后一次接触之间的时间间隔）。比较了每组内不同声门起始方式的GAT和GOT，也比较了不同障碍组与嗓音正常参与者之间的GAT和GOT。此外，还比较了嗓音正常参与者和患有AdLD的参与者在持续发声和连贯言语中的这些值。
在用力声门起始方式下，神经源性障碍组的GAT值显著高于嗓音正常的参与者。声带震颤的习惯性GOT与单侧声带麻痹和AdLD的习惯性GOT显著不同。此外，嗓音正常的参与者在不同声门起始方式下，连贯言语和持续发声的GAT具有相似趋势，而AdLD组则不然。AdLD参与者的GOT具有相同趋势，而嗓音正常的参与者则没有。
本研究提供了证据，表明在持续发声时，不同神经源性嗓音障碍的GAT和GOT值存在差异，这有助于理解其病理生理学。这些发现可能为神经源性嗓音障碍的临床评估策略和言语任务的制定提供参考。
