Sustained Vowel Research Articles

Acoustic Variability in the Healthy Female Voice Within and Across Days: How Much and Why?

Purpose The aims of this study were (1) to quantify variability in voice production (as measured acoustically) within and across consecutive days in vocally healthy female speakers, (2) to identify which acoustic measures are sensitive to this variability, and (3) to identify participant characteristics related to such voice variability. Method Participants included 45 young women with normal voices who were stratified by age, specifically 18-23, 24-29, and 30-35 years. Following an initial acoustic and auditory-perceptual voice assessment, participants performed standardized field voice recordings 3 times daily across a 7-day period. Acoustic analyses involved 32 cepstral-, spectral-, and time-based measures of connected speech and sustained vowels. Relationships among acoustic data and select demographic, health, and lifestyle (i.e., participant-based) factors were also examined. Results Significant time-of-day effects were observed for acoustic analyses within speakers (p < .05), with voices generally being worse in the morning. No significant differences were observed across consecutive days. Variations in voice production were associated with several participant factors, including improved voice with increased voice use; self-perceived poor voice function, minimal or no alcohol consumption, and extroverted personality; and worse voice with regular or current menstruation, depression, and anxiety. Conclusions This acoustic study provides essential information regarding the nature and extent to which healthy voices vary throughout the day and week. Participant-based factors that were associated with improved voice over time included increased voice use, self-perceived poor voice function, minimal or no alcohol consumption, and extroverted personality. Factors associated with worse voice production over time included regular or current menstruation, and depression and anxiety.

Improved Estimation of Parkinsonian Vowel Quality through Acoustic Feature Assimilation.

This paper investigated the performance of a number of acoustic measures, both individually and in combination, in predicting the perceived quality of sustained vowels produced by people impaired with Parkinson's disease (PD). Sustained vowel recordings were collected from 51 PD patients before and after the administration of the Levodopa medication. Subjective ratings of the overall vowel quality were garnered using a visual analog scale. These ratings served to benchmark the effectiveness of the acoustic measures. Acoustic predictors of the perceived vowel quality included the harmonics-to-noise ratio (HNR), smoothed cepstral peak prominence (CPP), recurrence period density entropy (RPDE), Gammatone frequency cepstral coefficients (GFCCs), linear prediction (LP) coefficients and their variants, and modulation spectrogram features. Linear regression (LR) and support vector regression (SVR) models were employed to assimilate multiple features. Different feature dimensionality reduction methods were investigated to avoid model overfitting and enhance the prediction capabilities for the test dataset. Results showed that the RPDE measure performed the best among all individual features, while a regression model incorporating a subset of features produced the best overall correlation of 0.80 between the predicted and actual vowel quality ratings. This model may therefore serve as a surrogate for auditory-perceptual assessment of Parkinsonian vowel quality. Furthermore, the model may offer the clinician a tool to predict who may benefit from Levodopa medication in terms of enhanced voice quality.

The Relationships Among Vocal Variability, Vocal-Articulatory Coordination, and Dysphonia in Children

ObjectiveThe purpose of this study was to evaluate the relationship between vocal variability and variability of vocal-articulatory coordination in children. Furthermore, this study examined if this relationship was impacted by pediatric dysphonia. Study DesignRetrospective analysis of speech samples in the Arizona Child Acoustic Database. MethodsSpeech samples from children 2–7 years of age were selected for analysis. Vocal variability was defined as the coefficient of variation (CoV) of fundamental frequency, taken from the center of sustained vowels. Variability of vocal-articulatory coordination was defined as the CoV of voice onset time (VOT) of voiceless stop consonants. Both objective and subjective measures of dysphonia were completed for each participant. ResultsChildren had a negative correlation between VOT variability and vocal variability. Further analysis indicated that this relationship was present in children with typical developmental levels of dysphonia but absent for children with moderate to severe dysphonia. Increased dysphonia severity was associated with increased vocal variability. ConclusionIncreased VOT variability was associated with decreased vocal variability in children with dysphonia severities consistent with typical vocal development. However, this relationship was not present in children with moderate to severe dysphonia. This study suggests that future work is needed to examine the relationships between the vocal system and vocal-articulatory coordination in children with and without diagnosed voice disorders.

A Cross-sectional Study of Perceptual and Acoustic Voice Characteristics in Healthy Aging

The human voice qualitatively changes across the lifespan. Although some of these vocal changes may be pathologic, other changes likely reflect natural physiological aging. Normative data for voice characteristics in healthy aging is limited and disparate studies have used a range of different acoustic features, some of which are implicated in pathologic voice changes. We examined the perceptual and acoustic features that predict healthy aging. Participants (N = 150) aged between 50 and 92 years performed a sustained vowel task. Acoustic features were measured using the Multi-Dimensional Voice Program and the Analysis of Dysphonia in Speech and Voice. We used forward and backward variable elimination techniques based on the Bayesian information criterion and linear regression to assess which of these acoustic features predict age and perceptual features. Hearing thresholds were determined using pure-tone audiometry tests at frequencies 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz. We further explored potential relationships between these acoustic features and clinical assessments of voice quality using the Consensus Auditory-Perceptual Evaluation of Voice. Chronological age was significantly predicted by greater voice turbulence, variability of cepstral fundamental frequency, low relative to high spectral energy, and cepstral intensity. When controlling for hearing loss, age was significantly predicted by amplitude perturbations and cepstral intensity. Clinical assessments of voice indicated perceptual characteristics of speech were predicted by different acoustic features. For example, breathiness was predicted by the soft phonation index, mean cepstral peak prominence, mean low-high spectral ratio, and mean cepstral intensity. Findings suggest that acoustic features that predict healthy aging are different than those previously reported for the pathologic voice. We propose a model of healthy and pathologic voice development in which voice characteristics are mediated by the inability to monitor vocal productions associated with age-related hearing loss. This normative data of healthy vocal aging may assist in separating voice pathologies from healthy aging.

Characterization of Dermatoglyphic Profiles and its Relation to Acoustic Measures in Voice Professionals

IntroductionAcoustic analysis is widely used for assessing and monitoring vocal function. Dermatoglyphics is a method that analyzes genetic fingerprint markers, and uses that information for predicting physical skills related to anaerobic (explosive strength and speed) and aerobic (motor coordination and resistance) mechanisms. Therefore, it can be used as an indicator for individualized vocal training. ObjectiveTo characterize the dermatoglyphic profiles and their relation to acoustic measures in voice professionals. MethodsA cross-sectional study involving 79 voice professionals. Acoustic analysis was performed using the PRAAT software. Mean intensity, fundamental frequency (F0), and cepstral peak prominence (CPP) value were extracted from the sustained vowel /a/. Fingerprints were collected using a Watson mini-integrated biometric scanner, and were quantified by design predominance, delta index (D10), total ridge count (TRC), and dermatoglyphic profile. The acoustic measures were analyzed descriptively and compared, considering the subjects’ dermatoglyphic profiles. The confidence levels ranged from 90% to 95%. ResultsMost subjects exhibited anaerobic dermatoglyphic profiles (P = 0.004) and low TRC (p < 0.001). Higher F0 (P = 0.061), intensity (P = 0.065), and CPP (P = 0.073) were found for anaerobics (P < 0.001). There was a weak and negative correlation between TRC and intensity (P = 0.026), as well as between F0 (P = 0.017) and CPP (P = 0.069). ConclusionAnaerobic profiles were predominant. The values of F0, intensity, and CPP increased for the anaerobics. There was a weak negative correlation between the TRC and intensity, F0, and CPP measures. Dermatoglyphics could have been seen as an interesting tool in the voice assessment and training direction for voice professionals.

Cerebellar Continuous Theta Burst Stimulation Facilitates Auditory–Vocal Integration in Spinocerebellar Ataxia

Abstract Clinical studies have shown the efficacy of transcranial magnetic stimulation in treating movement disorders in patients with spinocerebellar ataxia (SCA). However, whether similar effects occur for their speech motor disorders remains largely unknown. The present event-related potential study investigated whether and how abnormalities in auditory–vocal integration associated with SCA can be modulated by neuronavigated continuous theta burst stimulation (c-TBS) over the right cerebellum. After receiving active or sham cerebellar c-TBS, 19 patients with SCA were instructed to produce sustained vowels while hearing their voice unexpectedly pitch-shifted by ±200 cents. Behaviorally, active cerebellar c-TBS led to smaller magnitudes of vocal compensations for pitch perturbations than sham stimulation. Parallel modulatory effects were also observed at the cortical level, as reflected by increased P1 and P2 responses but decreased N1 responses elicited by active cerebellar c-TBS. Moreover, smaller magnitudes of vocal compensations were predicted by larger amplitudes of cortical P1 and P2 responses. These findings provide the first neurobehavioral evidence that c-TBS over the right cerebellum produces modulatory effects on abnormal auditory–motor integration for vocal pitch regulation in patients with SCA, offering a starting point for the treatment of speech motor disorders associated with SCA with cerebellar c-TBS.

Impact of noise on the performance of automatic systems for vocal fold lesions detection

Automatic voice condition analysis systems have been developed to automatically discriminate pathological voices from healthy ones in the context of two disorders related to exudative lesions of Reinke’s space: nodules and Reinke’s edema. The systems are based on acoustic features, extracted from sustained vowel recordings. Reduced subsets of features have been obtained from a larger set by a feature selection algorithm based on Whale Optimization in combination with Support Vector Machine classification. Robustness of the proposed systems is assessed by adding noise of two different types (synthetic white noise and actual noise recorded in a clinical environment) to corrupt the speech signals. Two speech databases were used for this investigation: the Massachusetts Eye and Ear Infirmary (MEEI) database and a second one specifically collected in Hospital San Pedro de Alcántara (Cáceres, Spain) for the scope of this work (UEX-Voice database). The results show that the prediction performance of the detection systems appreciably decrease when moving from MEEI to a database recorded in more realistic conditions. For both pathologies, the prediction performance declines under noisy conditions, being the effect of white noise more pronounced than the effect of noise recorded in the clinical environment.

Objective Voice Analysis of Mongolian Adults with a Normal Voice Across Age and Gender

Objectives: We aimed to standardize main vocal parameters including fundamental frequency (F0), jitter, shimmer, harmonic-noise ratio (HNR), and smoothed cepstral peak prominence (CPPs) for Mongolian adults with a normal voice across a range of age groups and genders. Methods: A total of 360 voice recordings belonging to adults between 20 and 79 years old were analyzed. An acoustic analysis was performed using the Praat Program with a sustained vowel /a/ or /α/. A one-way analysis of variance and an unpaired t-test were used to measure differences in voice parameters for the age groups and genders. Results: The mean value of F0 was higher in women (254.4 ± 17.9 Hz) compared with men (149.6 ± 15.3 Hz). The average jitter was 0.26% ± 0.12% (W = 0.25 ± 0.13) and the shimmer was 1.95% ± 0.45% (W = 2.01% ± 0.45%). The mean value of HNR was 11.9 ± 1.33 dB (W = 12.1 ± 1.36 dB) and CPPs was 16.3 dB (W = 16.1 dB). Conclusion: The F0 and HNR significantly increased with age for men. The F0 and CPPs decreased, whereas the shimmer and HNR increased with age in women.

Analysis of Subgroup Distribution and Discriminant Function Analysis in Children with Cerebral Palsy Based on Speech Language Profile Group

Objectives: This study aimed to identify the subgroups distribution of children with cerebral palsy (CP) by using Speech, Language Profile Group (SLPG), and examine discriminant factors that differentiate subgroups.Methods: Eighty-seven children aged 4-16 years with CP participated in the study (spastic 67, dyskinetic 4, ataxic 3, mixed 13). Data was collected from a speech production task (sustained vowel /a/, Assessment of Articulation and Phonology for Children, sentence repetition), language test (receptive vocabulary), and PIQ test (K-WISC-III, K-WIPPSI). Independent variables were maximum phonation time (MPT), intensity, speech rate, intelligibility, receptive vocabulary score, and cognition ability. For the analysis, children with CP were classified into six speech language profile groups; NSMILCT (no clinical speech motor involvement and age appropriate language, cognition abilities), NSMI-LCI (no clinical speech motor involvement and impaired language, cognition abilities), SMI-LCT (speech motor impairment and age appropriate language, cognition abilities), SMI-LCI (speech motor impairment and impaired language, cognition abilities), ANAR-LCT (anarthria and age appropriate language, cognition abilities), and ANAR-LCI (anarthria and impaired language, cognition abilities).Results: Descriptive study showed that of all children with CP, the proportion of NSMI-LCT was 11.5%, NSMI-LCI was 8.0%, SMI-LCT was 12.6%, SMI-LCI was 19.5%, ANAR-LCT was 11.5%, and ANAR-LCI was 36.8%. Very strong relationships were noted between SLPG and CFCS, and moderate relationships were noted between SLPG and GMFCS. Canonical discriminant function analysis revealed that the speech intelligibility variable accounted for 85.1%, the speech rate variable was 9.7%, and the language variable was 5.2%.Conclusion: This study suggested that the SLPG classification system helps us to stratify the subgroups for understanding speech, language features in children with CP.

Comparison of Four Different Warm-up Tasks, Using Special Tools Also

"Introduction: In our investigation, we compared four different warming-up sections on the singing voice, always using the same task-melodies. In the first section, we used traditionally only “on vowel articulation based” – called vocalization – tasks. In the second section we used resonant tube, which is used for voice therapy mostly. In the third sections, the participants used the melodies for humming. In the fours we used - by us developed - unusual tool, called “nose-pipe” for singing voice warm-up. The theoretical basis of the first section is the so-called “linear-model” of the singing phenomenon, why the basis of the further three sections is the “non-linear” models as well as also the experiences of the SOVT (semi-occluded vocal tract) exercises, and practice. Methods: on all the four sections the same 33 people took part. 20 of them were females and 13 males. All the participants attended several years of classical singing education. We organized four independent sections one-week apart. The participants came on the sections without previous warming-up for the singing voice. Before the warming-up at first, we recorded three vowels – [y, u, ɒ] (according to IPA) – for females on G4, for males on G3 - sustaining for longer than 2 second-long, with comfortable volume, then came the 20’-25’ minutes long warming-up procedures. After the procedure, we repeated the recordings of the same vowels on the same pitches. For every warming-up procedure we used the same melodies. Recording the sustained vowels we used TASCAM DR-07 MKII equipment. With the help of a stage, the microphones were held before the mouth of every participant, at the same – 10cm – distance. For generating the FFT figure of the sound image and for analyzing we used SIGVIEW 2.4., to appreciate the values of the parameters we used the SPSS 20 software. We analyzed one-second-long part – in sound level well balanced - of the records. The investigated parameters were: mean of the FFT signal between 0-21kHz, 0-12kHz as well as 2-4 kHz; number from the noise overriding overtones; the volume of f0, and H1H7 overtones. We detected also during the warm-ups reached voice ranges. Results: according to our results all the sections have beneficial effects on the singing voice. Most of the significant effects on the analyzed parameters have the humming and the nose-pipe sections by every vowel. The reached voice range was the longest at the fours, nose-pipe section. Conclusion: we can enhance that each of the four sections is useful. The combined, conscious application of them is correct. Using the new tool – called nose pipe – has dominant preference for developing the voice range of the singing voice. Keywords: vocalization, resonant tube, humming, nose-pipe, voice range "

Investigating the cepstral acoustic characteristics of voice in healthy children

ObjectivesThis study aimed to determine the cepstral acoustic parameters that vary depending on age and gender in vocally healthy children, and to establish normative data for cepstral analysis. BackgroundCepstral measurements are among the strongest predictors of auditory-perceptual evaluation of voice and differentiate between healthy and dysphonic voices. More spesificially, ceptral peak prominence is accepted to be as a strong acoustic predictor of breathiness and overall severity of dysphonia. Cepstral measures determine voice quality reliably not only in sustained vowel samples but also in running speech samples. Determining the parameters related to the acoustic profile of children with normal voices can lead us to a better understanding of the effect of changes in the larynx and vocal fold structure during growth and development. There is a limited number of norm studies examining the cepstral acoustic properties of pediatric voice. Determining norm-specific values and clinical guidelines of cepstral acoustics according to the age and gender in vocally healthy children are utmost important. MethodsA total of 160 vocally healthy children were divided into the following four age groups: Group-I included children within the age range of 4–7 years, Group-II included 7–11 years, Group-III 11–14 years, and Group-IV included children within the age range of 14–18 years. An equal number of male and female participants were assigned to each group. PENTAX Medical CSL Model 4500 was used for recording all tasks. For acoustic analysis, Multi-Dimensional Voice Program and Analysis of Dysphonia in Speech and Voice were used. ResultsCepstral Peak Prominence (CPP), Cepstral Peak Prominence Standard Deviation (CPP SD), and Low-To-High Spectral Ratio (L/H Ratio) increased with age. It is found that the CPP parameter of all-voiced sentences and nasal-weighted sentences increased with age in boys, while no significant pattern was observed in any sample for girls. For L/H ratio, it can be said that there is a general increase with age in all speech samples, except for the vowel-weighted and voiceless plosive sentence samples, evident especially in the group above the age of 15 years. This study concluded that the CPP SD parameter in the vowel-weighted sentences increased with age in boys. It was also noticed in this study that CPP F0 standard deviation (SD) intervals were narrower in vowel-weighted, easy onset, and voiceless plosive sentence samples than in all-voiced, hard glottal attack and nasal-weighted sentence samples. ConclusionThis study established cepstral acoustic normative values for a wide age range of the pediatric population. It is thought that age and gender specific cepstral acoustic findings presented in this study contributed to the related literature. In addition, to our knowledge, this is the first study that provides a normative cepstral acoustic database of the CAPE-V/Turkish sentences in the pediatric population.

COVID-19: Acoustic Measures of Voice in Individuals Wearing Different Facemasks

AimThe global health pandemic caused by the SARS-coronavirus 2 (COVID-19) has led to the adoption of facemasks as a necessary safety precaution. Depending on the level of risk for exposure to the virus, the facemasks that are used can vary. The aim of this study was to examine the effect of different types of facemasks, typically used by healthcare professionals and the public during the COVID-19 pandemic, on measures of voice. MethodsNineteen adults (ten females, nine males) with a normal voice quality completed sustained vowel tasks. All tasks were performed for each of the six mask conditions: no mask, cloth mask, surgical mask, KN95 mask and, surgical mask over a KN95 mask with and without a face shield. Intensity measurements were obtained at a 1ft and 6ft distance from the speaker with sound level meters. Tasks were recorded with a 1ft mouth-to-microphone distance. Acoustic variables of interest were fundamental frequency (F0), and formant frequencies (F1, F2) for /a/ and /i/ and smoothed cepstral peak prominence (CPPs) for /a/. ResultsData were analyzed to compare differences between sex and mask types. There was statistical significance between males and females for intensity measures and all acoustic variables except F2 for /a/ and F1 for /i/. Few pairwise comparisons between masks reached significance even though main effects for mask type were observed. These are further discussed in the article. ConclusionThe masks tested in this study did not have a significant impact on intensity, fundamental frequency, CPPs, first or second formant frequency compared to voice output without a mask. Use of a face shield seemed to affect intensity and CPPs to some extent. Implications of these findings are discussed further in the article.

Bilingualism and Voice Production. Differences Between Bilingual Latin-American Spanish- English Female Speakers and Monolingual Spanish Female Speakers During Spanish Productions

BackgroundSpeaking a second language influences jitter and shimmer when comparing monolingual English speakers with bilingual English-Spanish speakers. However, there is little information about differences on voice acoustic parameters when comparing monolingual Spanish speakers with bilingual Spanish-English speakers during their productions in Spanish. AimDetermine differences in five voice acoustic parameters commonly used in voice assessments (fundamental frequency, jitter, shimmer, Harmonics-to-Noise Ratio and Cepstral Peak Prominence Smoothed) which may be influenced by bilingualism. MethodsExploratory cross-sectional study with two groups of female participants: monolingual Spanish speakers (n = 17), and bilingual Spanish-English speakers (n = 11). Participants filled out a questionnaire and recorded two voice samples (sustained vowel /a/ and reading). For this study, all the participants reported that their native language was Spanish. ResultsBeing a female bilingual speaker had a significant effect on Shimmer (%) with a Beta = -0.7. Similar tendency was found on harmonics-to-noise ratio (B = 0.2) and cepstral peak prominence smoothed (B = 0.2). ConclusionsOur results indicate that being a native Spanish female speaker, speaking English as a second language, has significant small effects on voice acoustic parameters, such as shimmer, harmonics-to-noise ratio and cepstral peak prominence smoothed, during their productions in Spanish. This information is of interest for assessment and intervention plans of bilingual speakers at clinical and work-related settings.

Acoustic Analysis of Phonation in Children With Smith-Magenis Syndrome.

Complex simultaneous neuropsychophysiological mechanisms are responsible for the processing of the information to be transmitted and for the neuromotor planning of the articulatory organs involved in speech. The nature of this set of mechanisms is closely linked to the clinical state of the subject. Thus, for example, in populations with neurodevelopmental deficits, these underlying neuropsychophysiological procedures are deficient and determine their phonation. Most of these cases with neurodevelopmental deficits are due to a genetic abnormality, as is the case in the population with Smith–Magenis syndrome (SMS). SMS is associated with neurodevelopmental deficits, intellectual disability, and a cohort of characteristic phenotypic features, including voice quality, which does not seem to be in line with the gender, age, and complexion of the diagnosed subject. The phonatory profile and speech features in this syndrome are dysphonia, high f0, excess vocal muscle stiffness, fluency alterations, numerous syllabic simplifications, phoneme omissions, and unintelligibility of speech. This exploratory study investigates whether the neuromotor deficits in children with SMS adversely affect phonation as compared to typically developing children without neuromotor deficits, which has not been previously determined. The authors compare the phonatory performance of a group of children with SMS (N = 12) with a healthy control group of children (N = 12) matched in age, gender, and grouped into two age ranges. The first group ranges from 5 to 7 years old, and the second group goes from 8 to 12 years old. Group differences were determined for two forms of acoustic analysis performed on repeated recordings of the sustained vowel /a/ F1 and F2 extraction and cepstral peak prominence (CPP). It is expected that the results will enlighten the question of the underlying neuromotor aspects of phonation in SMS population. These findings could provide evidence of the susceptibility of phonation of speech to neuromotor disturbances, regardless of their origin.

The voice of COVID-19: Acoustic correlates of infection in sustained vowels.

COVID-19 is a global health crisis that has been affecting our daily lives throughout the past year. The symptomatology of COVID-19 is heterogeneous with a severity continuum. Many symptoms are related to pathological changes in the vocal system, leading to the assumption that COVID-19 may also affect voice production. For the first time, the present study investigates voice acoustic correlates of a COVID-19 infection based on a comprehensive acoustic parameter set. We compare 88 acoustic features extracted from recordings of the vowels /i:/, /e:/, /u:/, /o:/, and /a:/ produced by 11 symptomatic COVID-19 positive and 11 COVID-19 negative German-speaking participants. We employ the Mann-Whitney U test and calculate effect sizes to identify features with prominent group differences. The mean voiced segment length and the number of voiced segments per second yield the most important differences across all vowels indicating discontinuities in the pulmonic airstream during phonation in COVID-19 positive participants. Group differences in front vowels are additionally reflected in fundamental frequency variation and the harmonics-to-noise ratio, group differences in back vowels in statistics of the Mel-frequency cepstral coefficients and the spectral slope. Our findings represent an important proof-of-concept contribution for a potential voice-based identification of individuals infected with COVID-19.

Electroglottographic and Acoustic Parametrization of Phonatory Quality Provide Voice Profiles of Pathological Speakers

The present study firstly tries to find subgroups of pathological male and female phonation using data from a number of 534 pathological speakers. Secondly, this subgroup classification provides a basis for achieving voice profiles of pathological phonatory quality. Using complementarily orientated electroglottographic and acoustic parametrization of phonatory quality, sustained vowel productions of 267 male and 267 female speakers were considered. In a first step, a clustering technique differentiates three subgroups within each gender on the basis of the EGG- and three subgroups on the basis of the acoustic parameters. In a second step, this subgroup definition allows one to present voice profiles of pathological speakers by combining the parameter means of the electroglottographically determined subgroups with those of the acoustically determined subgroups. The presented voice profiles provide a finer reference basis for the classification of different pathological phonation types as well as for the evaluation of shifts in individual phonatory behavior due to therapy or spontaneous recovery.

Objective vowel sound characteristics and their relationship with motor dysfunction in Asian Parkinson's disease patients

BackgroundSpeech impairments are very common in patients with Parkinson's disease (PD). However, knowledge of their objective characteristics and relationship to other motor symptoms amongst Asian PD patients is limited. ObjectivesTo identify objective vowel sound characteristics in Thai PD patients and correlate with disease severity, as determined by UPDRS and various sub-scores. MethodWe evaluated 100 Thai PD patients, with a mean age of 66.56 years (±7.52) and HY of 2.7 (±1.08), and 101 age-matched controls. Phonatory evaluation, comprising of 15 objective parameters, was conducted using the Multi-Dimensional Voice Programme with a sustained /a/ phonation. ResultsPD patients exhibited significantly higher values of all dimensions of the phonatory parameters evaluated compared to controls (All, p < 0.001) except for duration of sustained phonation, which was significantly shorter in PD patients. When early- and advanced-stage patients were compared, significantly different parameters were limited to frequency perturbation parameters (Jitt, p = 0.01; RAP, p = 0.013; PPQ, p = 0.01; sPPQ, p = 0.001; vF0, p = 0.011), and NHR (p = 0.028). Several significant and moderate correlations were observed between both STD and frequency perturbation parameters and UPDRS-III, bradykinesia sub-score, and gait and postural instability sub-score. Both vF0, and STD significantly correlated with UPDRS-III and sub-scores in advanced stage patients. ConclusionOur study provides objective evidence of phonatory dysfunction in Asian PD patients with certain characteristics correlated with advanced stage or different motor dysfunction. Sustained vowel phonation is a promising digital outcome for global phenotyping a large number of PD patients.

Data mining of an acoustic biomarker in tongue cancers and its clinical validation.

The promise of speech disorders as biomarkers in clinical examination has been identified in a broad spectrum of neurodegenerative diseases. However, to the best of our knowledge, a validated acoustic marker with established discriminative and evaluative properties has not yet been developed for oral tongue cancers. Here we cross‐sectionally collected a screening dataset that included acoustic parameters extracted from 3 sustained vowels /ɑ/, /i/, /u/ and binary perceptual outcomes from 12 consonant‐vowel syllables. We used a support vector machine with linear kernel function within this dataset to identify the formant centralization ratio (FCR) as a dominant predictor of different perceptual outcomes across gender and syllable. The Acoustic analysis, Perceptual evaluation and Quality of Life assessment (APeQoL) was used to validate the FCR in 33 patients with primary resectable oral tongue cancers. Measurements were taken before (pre‐op) and four to six weeks after (post‐op) surgery. The speech handicap index (SHI), a speech‐specific questionnaire, was also administrated at these time points. Pre‐op correlation analysis within the APeQoL revealed overall consistency and a strong correlation between FCR and SHI scores. FCRs also increased significantly with increasing T classification pre‐operatively, especially for women. Longitudinally, the main effects of T classification, the extent of resection, and their interaction effects with time (pre‐op vs. post‐op) on FCRs were all significant. For pre‐operative FCR, after merging the two datasets, a cut‐off value of 0.970 produced an AUC of 0.861 (95% confidence interval: 0.785–0.938) for T3‐4 patients. In sum, this study determined that FCR is an acoustic marker with the potential to detect disease and related speech function in oral tongue cancers. These are preliminary findings that need to be replicated in longitudinal studies and/or larger cohorts.

Comparisons of 4-Point GRBAS, 7-Point-GRBAS, and CAPE-V for Auditory Perceptual Evaluation of Dysphonia

Purpose: The GRBAS (grade, roughness, breathiness, asthenia, strain) scale, a 4-point scale, has been most widely used for judging auditory-perceptual severity for dysphonia. However, in current clinical practice, sometimes a more fragmented 0.5 scheme is being used if the original GRBAS scale is ambiguous to assess. Thus, the aim of the present study was to compare the dysphonia severity using the three auditory-perceptual evaluation tools, 4-point, 7-point GRBAS scale, and CAPEV and provide the information regarding differentiation of perceptual severity and acoustic correlations.Methods: Voice samples for sustained vowel and connected speech were obtained from 101 dysphonic patients. Auditory-perceptual assessments of dysphonia severity were performed by two certified experienced speech-language pathologists specializing in voice disorders using the grade of a 4-point and a 7-point GRBAS, OS of CAPE-V and also were compared with cepstral measures [cepstrum peak prominence (CPP), low/high spectral ratio].Results: OS and G of inter-rater reliability of dysphonia using CAPE-V and 4-point GRBAS scales were good (ICC &gt; 0.800) while G of 7-point GRBAS was less strong (ICC &gt; 0.681) than OS of CAPE-V and G of 4-point GRBAS scale. The highest correlation with CPP was the OS of CAPE-V in both vowel and connected speech, while L/H ratio showed low correlation with dysphonia severity. The OS of CAPE-V in vowel and connected speech differed significantly in G of both GRBAS scales. On the 4-point GRBAS scale, CPP showed only the difference between G1-G2, G2-G3 groups in /a/ vowel, whereas in the connected speech, the difference between G0-G1, G1-G2, and G2-G3 groups was relatively differentiated. Meanwhile, on a 7-point GRBAS scale, CPP showed only differences between G1.5-G2 groups in sustained vowel, while CPP showed no differences between G0-G0.5, G0.5-G1, G1-G1.5, G2-G2.5, and G2.5-G3 groups respectively in connected speech.Conclusion: 7-point GRBAS scale showed a higher correlation with CPP measures than the original GRBAS, but reduced the discrimination of dysphonia severity compared to the 4-point GRBAS scale. Consequently, modified 7-point GRBAS scale could be useful as a clinically-perceptual evaluation tool, along with the original GRBAS scale and CAPE-V.

A novel pre-processing technique in pathologic voice detection: Application to Parkinson’s disease phonation

This paper proposes a methodology that can help in the detection of Parkinson’s disease (PD) from voice recordings. It is based on eight of voice features, describing vocal folds behavior such as frequency and amplitude perturbations, biomechanical instability and neurological tremor, where, each of the proposed features will be represented by one vector representing their statistical distribution by using their probability density functions. The features are extracted from 42 samples of sustained vowel emissions of /a/, from both healthy and PD voices subjects to fulfill this purpose. A new preprocessing technique is then conducted. The approach uses pertinent matrices built for each subject. The matrices are composed of vectors arranged by segment, feature and number of phonation cycles. An estimation of the maxima maximorum (MM) and minima minimorum (mm) values is used to normalize the data. Then, each of the normalized vectors is submitted to an outlier removal process. The performance of the effective predicted attributes has been tested using rank feature selection. Then, the decision phase is realized by applying three types of Machine Learning (ML) classifiers: a K-Nearest Neighbor algorithm (K-NN), a Support Vector Machine (SVM), and a Random Forest (RF) classifier. Even though the three types of used ML classifiers give high rate decisions, the experimental results showed that the RF classifier can improve the efficiency of the preprocessing approach achieving a recognition rate of 99 % for females and 98 % for males, in detecting PD dysphonia. The results presented here outperform those published in the literature.