Multi-Dimensional Voice Program Software Research Articles

Acoustic Characteristics of the Voice for Brazilian Portuguese Speakers Across the Life Span

Vocal changes occur across the life span and can be reflected in acoustic measurements. To investigate the characteristics of voice production of the Brazilian Portuguese speakers across the life span based on acoustic measures of Fundamental Frequency (fo) and noise-to-harmonic ratio (NHR) and to verify the differences in these measures between men and women. A total of 526 recordings from Brazilian Portuguese speakers aged 5-93 years were included. Voices from these speakers were judged with normal vocal quality for their age using the G parameter of the GRBAS scale. The recordings were divided into 12 age groups (5-7 years; 8-9; 10-11; 12; 13-15; 16-18; 19-29; 30-39; 40-49; 50-59; 60-69 and, 70-93 years old). Acoustic analysis was conducted, extracting the parameters fo and NHR through Multi-Dimensional Voice Programsoftware. For women, there was a gradual decrease in fo from childhood to older age. Older women (60-93 years old) showed a lower fo than age groups up to 19-29 years (P< 0.00). For men, there was a decrease in fo up to the age group of 13-15 years (P< 0.00) and, then, it remained stable. Differences between sexes occurred from 12 years old, with higher fo values for women than men (P< 0.00). The NHR parameter remained stable across the life span for women while higher values for older subjects were found for men (P< 0.04). Regarding sex, men showed a higher NHR value than women (P< 0.002). Vocal changes occur across the life span and are reflected in the acoustic measure of fo for men and women. The beginning of vocal changes occurs from 12 years old with differences between sexes. The NHR measure was sensitive to indicate changes over a lifetime for men, with higher values for older subjects.

Voice Assessment Pre- and Post-Adenotonsillectomy in Children.

Objective Changes in vocal patterns after adenotonsillectomy are questionable. Few studies have assessed acoustic voice changes before and after adenotonsillectomy. The objective of this study wasto evaluate the impact of adenotonsillectomy on the voice of children with adenotonsillar hypertrophy. Participants and Methods The study included fifty children ranging in age between 4 and 12 years, with adenotonsillar hypertrophy, indicated for adenotonsillectomy. Auditory perceptual assessment of speech included nasality, degree of hyponasality, degree of open nasality, and degree of dysphonia. Acoustic analysis was carried out before and after one month and three months of surgery, using multidimensional voice program software (MVDP). The vowels were analyzed as to their acoustic parameters: fundamental frequency (Hz), jitter (%), shimmer (dB) and noise-harmony ratio (NHR; dB). Results At oneand threemonths after surgery, preoperative readings were of F0 score while jitter and shimmer normalized only at the 3rd month. There were significant differences between readings at one month and threemonths of F0 and jitter. Auditory perceptual assessment(APA) of voice (dysphonia) and APA of speech (hyponasality) significantly improved at 1st and 3rd month after surgery with significant differences between results of 1st and 3rd month. Harmonic noise ratio (HNR) had negative, significantly fair correlation with APA of Voice (dysphonia). Conclusion Hyponasal speech and with dysphonia preoperatively often have normal resonance and voice following adenotonsillectomy. Objective and subjective evaluation of speech and voice can help the specialist in the management of patients with adenotonsillar hypertrophy.

Perceptual-Auditory and Acoustical Analysis of the Voices of Transgender Women

Voice is an important gender marker in the transition process as a transgender individual accepts a new gender identity. The objectives of this study were to describe and relate aspects of a perceptual-auditory analysis and the fundamental frequency (F0) of male-to-female (MtF) transsexual individuals. A case-control study was carried out with individuals aged 19-52 years who attended the Gender Identity Program of the Hospital de Clínicas of Porto Alegre. Vocal recordings from the MtF transgender and cisgender individuals (vowel /a:/ and six phrases of Consensus Auditory Perceptual Evaluation Voice [CAPE-V]) were edited and randomly coded before storage in a Dropbox folder. The voices (vowel /a:/) were analyzed by consensus on the same day by two judge speech therapists who had more than 10 years of experience in the voice area using the GRBASI perceptual-auditory vocal evaluation scale. Acoustic analysis of the voices was performed using the advanced Multi-Dimensional Voice Program software. The resonance focus and the degrees of masculinity and femininity for each voice recording were determined by listening to the CAPE-V phrases, for the same judges. There were significant differences between the groups regarding a greater frequency of subjects with F0 between 80 and 150 Hz (P = 0.003), and a greater frequency of hypernasal resonant focus (P < 0.001) in the MtF cases and greater frequency of subjects with absence of roughness (P = 0.031) in the control group. The MtF group of individuals showed altered vertical resonant focus, more masculine voices, and lower fundamental frequencies. The control group showed a significant absence of roughness.

Voice evaluation in asthma patients using inhaled corticosteroids.

This study aims to assess voice changes and laryngeal abnormalities in asthmatic patients using inhaled corticosteroids (ICSs). This study included 30 patients (15 females; mean age 21.3±2.6 years; range, 17 to 26 years and 15 males; mean age 20.7±2.3 years; range, 16 to 27 years) with bronchial asthma treated with ICSs between May 2013 and December 2013. A speech sample from each patient was evaluated by two phoniatricians and the degrees of dysphonia were scored. Each patient's voice was acoustically analyzed using the multidimensional voice program software. Videolaryngoscopy was used to detect laryngeal abnormalities including the vocal folds. A total of 53.3% of ICSs users had dysphonia; most of them had a mild degree dysphonia. Of patients, vocal folds erythema was present in 56.7%, interarytenoid thickening in 56.7%, vocal folds bowing in 5.3% and vocal fold atrophy in 5.5%. A total of 36.7% patients had manifestations of laryngopharyngeal reflux. The presence of vocal fold bowing and atrophy was significantly related to the duration of ICS use (p=0.048). Soft phonation index values were positively associated with the duration of the ICS use (p=0.013). Inhaled corticosteroids have abnormally adverse effects both on the function and the structure of the vocal folds.

Assessment of Voice Quality After Carbon Dioxide Laser and Microdebrider Surgery for Reinke Edema

Surgery of Reinke edema requires reduction of the degenerated superficial lamina propria and preservation of the vibratory epithelium. Sixteen patients were included for microdebrider and 10 patients for carbon dioxide (CO2) laser surgery. Vocal analysis was performed before and at 1 and 3months after surgery. Subjective rating of voice quality was completed by the grade, roughness, breathiness, asthenia, and strain scale. The objective assessment was conducted by Multi-Dimensional Voice Program software. We found consistent improvement in all parameters both in CO2 laser and microdebrider group. The normalization of all parameters were statistically better after microdebrider surgery. The most statistically significant improvements were accounted in reduction in grade of hoarseness, roughness, and asthenia and acoustic analysis. Microdebrider is a useful and safe tool for Reinke edema treatment. The oscillatory cutting knife and low suction protect lamina propria resulting in better vibratory function.

The normative study of acoustic parameters in normal Egyptian children aged 4–12 years

The study of normative data of childhood voice is very important to aid in the identification of pathological voices in this age group. ObjectivesThe aim of this study was to establish a database of the normal acoustic parameters in children aged 4–12 years. MethodsThe study was carried out at the Unit of Phoniatrics, Faculty of Medicine, Alexandria Main University Hospital, on one hundred normal children of both sexes aged from 4 to 12 years, all children were subjected to computerized acoustic analysis using Multidimensional voice program software. The vocal samples were obtained from the children by holding a microphone 10 cm in front of their mouth and producing sustained phonation. The analyses of the vocal parameters were carried out with the sustained/a/vowel, with elimination of the irregularities in the beginning and end of utterance .The studied acoustic parameters were the fundamental frequency, shimmer and jitter disturbance measures, and the harmonic/noise ratios.A full informed consent was taken from all subjects contributing to the study. ResultsThe mean Fundamental frequency was around 260.46 Hz. Jitter and jitter % were around 81.8% and 1.9% in boys and 62.8% and 1.6% in girls. ConclusionThe inclusion of computerized acoustic analyses makes the vocal assessment more accurate and less subjective, thus representing an important tool for vocal screening, for it is a simple, fast and reliable method.To construct a representative database of normal children, we recommend the recruitment of large number of subjects, inclusion of younger age group, and covering other acoustic parameters.

Speech impairment in primary hypothyroidism

Thyroid hormone deficiency may affect human speech and voice. The aim of this study was to evaluate speech variables in patients with hypothyroidism. A case control study. One hundred and twenty patients, 106 women and 14 men with symptoms and signs of thyroid failure; the diagnosis was confirmed by serum T4<4.5 μg/dl and serum TSH>10 mU/l. Eighty-eight normal subjects, 78 women and 10 men, age-, sex-, and smoking status- matched, served as controls. All symptoms and signs of hypothyroidism were recorded. Serum T4, T3, and TSH concentrations were measured. Speech parameters were analyzed by the Visipitch III system model 3900 and multidimensional voice program software and compared to a group of normal subjects with no thyroid disease. Mean age was 35.9±11.4 yr. Dryness in larynx and pharynx, dyspnea, and sensation of lump in the throat were reported by 53.49 and 43% of patients, respectively. Fundamental frequency, voice turbulence index, and soft phonation index were significantly different from control values. There was positive correlation between TSH concentration and variation in fundamental frequency and prevalence of voice disorders (37.2±31.2 vs 23.9±25.8 mU/l, p<0.003). Frequent speech disturbances occur in patients with primary hypothyroidism.

Vocal Acoustic Characteristics of Patients with Parkinson’s Disease

Speech samples obtained from 39 idiopathic Parkinson’s disease (PD) patients with vocal pathologies were compared with those from 62 age-matched vocally normal non-PD controls. Voice samples collected from sustained vowel phonation and passage reading were acoustically analyzed using Computer Speech Lab and Multi-Dimensional Voice Program software. Noise-to-harmonic ratio, voice turbulence index (VTI) and soft phonation index (SPI) were incorporated as noise-related measurements, fundamental frequency-tremor intensity index (FTRI), amplitude tremor intensity, fundamental frequency-tremor frequency (Fftr), and amplitude-tremor frequency as tremor-related measurements. Compared with controls, the following results were noted: (1) male and female PD patients exhibited significant differences in acoustic parameters of all frequency and amplitude perturbation measurements and noise-related measurements (except VTI in males); (2) speaking fundamental frequency was significantly higher only in male PD patients; (3) FTRI and Fftr in male (only FTRI in female) PD patients were significantly higher, and (4) disease severity and MDVP analysis showed significant correlations between SPI and the Unified Parkinson’s Disease Rating Scale Part I (mentation, behavior, mood) and Part II (activities of daily living) in male PD patients; however, this was not the case in female PD patients.

Analysis of voice in patients with untreated active acromegaly

Voice changes are common clinical findings of acromegaly, although scanty data are available so far. To analyze features and quantify changes of voice in patients with untreated active acromegaly. This was a pilot case-control study. Voice was analyzed using the Multi Dimensional Voice Program software, which generates 33 parameters related to fundamental frequency (F0), micro-perturbation of F0 and amplitude, noise, tremor, voice breaks and irregularities, and diplophony. Thirteen consecutive patients (8 women, 5 men, mean age 48+/-9 yr) with active acromegaly, at first diagnosis, and 13 sex- and age-matched normal subjects (controls). Patients with untreated active acromegaly had mean values of parameters related to F0 significantly lower than those of controls, although mostly remaining in the normal range. Most acromegalic patients had micro-perturbation of F0, as indicated by higher mean of absolute or percentage jitter values than those of controls; micro-perturbation of amplitude was a common feature of voice in most acromegalic men. Noise-related parameters were also affected by acromegaly, being higher in male acromegalic patients than in controls and acromegalic women. On the contrary, parameters related to tremors, voice breaks, voice irregularities and diplophony did not differ in acromegalic patients and controls. Patients with untreated active acromegaly had low-pitched voice characterized by lowering F0 and increased values related to noise, micro perturbation of frequency, and amplitude.

The Effect of Noise on Computer-Aided Measures of Voice: A Comparison of CSpeechSP and the Multi-Dimensional Voice Program Software Using the CSL 4300B Module and Multi-Speech for Windows

Summary: The effect of noise on computer-derived samples of voice was compared across three different hardware/software configurations. The hardware/software systems included a stand-alone A/D converter (CSL Module 4300B) coupled to a custom Pentium PC used in conjunction with the Multi-Dimensional Voice Program (MDVP) software, and a Creative Labs A/D converter coupled to the same custom PC under software control of MDVP/Multispeech and CSpeechSP. Voice samples were taken from 10 female subjects, then mixed with computer fan noise creating three different signal-to-noise (S/N) levels. Mixed signals were analyzed on the three hardware/software systems. Results revealed that fundamental frequency was most resistant to the degradation effect of noise across systems; jitter and shimmer values, however, were more variable across all configurations. Jitter and shimmer values were significantly higher under certain S/N levels for the MDVP 4300B based system as compared to MDVP for Multi-Speech and CSpeechSP. The findings punctuate the need for sensitivity to recording environments, careful selection of hardware/software equipment arrays, and the establishment of minimal recording conditions (>25dBA S/N) for voice sampling and analysis using computer-assisted methods.

The effect of levodopa on vocal function in Parkinson's disease.

Phonatory and articulatory dysfunctions are frequent observations in Parkinson's disease. We have investigated, using acoustic measures, the effects of levodopa treatment on vocal function in 20 patients with Parkinson's disease before and after levodopa. These patients were also compared with a matched control group. The mean age was 63.5 +/- 9.66 years, Hoehn-Yahr stage was 2.38 +/- 0.45, and onset mean age was 56.5 +/- 10.36 years. Paired Wilcoxon tests were performed to compare measurements before and after levodopa. The acoustic analysis using Computerized Speech Lab and MultiDimensional Voice Program software programs (Kay Elemetrics, Lincoln Park, NJ, USA) showed that measurements of fundamental frequency (p < 0.017) were significantly increased after medication, whereas short-term frequency perturbation jitter (p < 0.033), soft phonation index (noise parameter) (p < 0.015 ), and frequency tremor intensity index (p < 0.018) were significantly decreased after medication. The objective measurements of acoustic analysis are useful in evaluating the dopaminergic pharmacologic response in Parkinson's disease. The improvement in fundamental frequency and other vocal parameters may be a result of decrease in laryngeal hypokinesia and rigidity.