Acoustic Voice Research Articles

Effects of Increased Nasal Volume due to Topical Adrenaline on the Voice

Resonance properties of the nasal and sinus cavities are involved in the individuality of speech. However, detailed information on how alterations in the nasal cavity morphology affect voice quality is lacking. The aim of the present study was to investigate the effects of structural changes in the nasal cavity on voice production by spraying a topical adrenaline solution with a vasoconstrictive effect into the nasal cavity, causing nasal mucosal contraction. Prospective. Overall, 51 adult volunteers were recruited from the Otorhinolaryngology Outpatient Department of the Jikei University Hospital from June to September 2022. Among them, 20 completed acoustic rhinometry and voice recordings before and after adrenaline spraying. The nasal consonant [N] uttered with the mouth completely closed was recorded for 5seconds. The remaining 31 volunteers completed all auditory experiments. This was conducted to determine whether the changes in voice before and after adrenaline spraying could be discriminated against by the participants. The nasal volume had increased 5 and 10minutes after spraying compared to that before spraying, reaching a significance at 10minutes (P=0.06). It had increased at 2 and 5cm from the external nostrils compared to that within 3cm of the external nostrils (P=0.04). Among the 31 volunteers in the auditory experiments, 30 had a discrimination rate >90%, with a mean of 96.3% (standard error, 3.2). The spectral envelope of the 16 frequency bands varied significantly at 500-Hz increments (P=0.0006). In particular, changes in the high-frequency bands were larger between 4500 and 6000Hz. Nasal enlargement with 0.02% topical adrenaline affects the spectral envelope, particularly in the high-frequency bands between 4500 and 6000Hz, and perceptibly alters the voice.

Acoustic Voice Analysis as a Useful Tool to Discriminate Different ALS Phenotypes.

Approximately 80-96% of people with amyotrophic lateral sclerosis (ALS) become unable to speak during the disease progression. Assessing upper and lower motor neuron impairment in bulbar regions of ALS patients remains challenging, particularly in distinguishing spastic and flaccid dysarthria. This study aimed to evaluate acoustic voice parameters as useful biomarkers to discriminate ALS clinical phenotypes. Triangular vowel space area (tVSA), alternating motion rates (AMRs), and sequential motion rates (SMRs) were analyzed in 36 ALS patients and 20 sex/age-matched healthy controls (HCs). tVSA, AMR, and SMR values significantly differed between ALS and HCs, and between ALS with prevalent upper (pUMN) and lower motor neuron (pLMN) impairment. tVSA showed higher accuracy in discriminating pUMN from pLMN patients. AMR and SMR were significantly lower in patients with bulbar onset than those with spinal onset, both with and without bulbar symptoms. Furthermore, these values were also lower in patients with spinal onset associated with bulbar symptoms than in those with spinal onset alone. Additionally, AMR and SMR values correlated with the degree of dysphagia. Acoustic voice analysis may be considered a useful prognostic tool to differentiate spastic and flaccid dysarthria and to assess the degree of bulbar involvement in ALS.

Psychometric features of Acoustic Voice Quality Index, version 03.01, in Persian language

ABSTRACT The goal of this study was to investigate the psychometric features of the Acoustic Voice Quality Index, in Persian, as an objective and multi-parameter tool for evaluating the overall voice quality. Three hundred and ten Persian-speaking individuals, 155 with various types and severity of dysphonia, and 155 healthy individuals, performed two tasks: reading a phonetically balanced text and a sustained vowel /a/. Voice recordings were made. Perceptual evaluation with the G score of the GRBAS scale was completed by five raters, and intra-rater reliability and inter-rater reliability were calculated. The Acoustic Voice Quality Index was calculated with standard syllables corresponding to 3 s of voiced speech and 3 s of vowels. Concurrent validity, construct validity, test–retest reliability, and diagnostic accuracy of the AVQI were analyzed. The results suggest that the number of syllables corresponding to 3 s of voiced speech was 23. Perceptual evaluation demonstrated excellent intra-rater and inter-rater reliability. The AVQI demonstrated a strong correlation with perceptual evaluation (rs = 0.877, P < 0.001), as well as high construct validity. In addition, the index had very good test–retest reliability (icc = 0.992). The cut-off point of the index was 3.62 in Persian. The area under the ROC curve was 0.815, indicating that the index had the ability to differentiate between dysphonic and non-dysphonic voices. And it can be stated that the AVQI 03.01 is a reliable objective tool for distinguishing dysphonic from non-dysphonic voice in Persian that can be utilized in clinical and research settings.

Modified subtotal laryngectomy with formation of a tracheopharyngeal shunt for locally advanced cancer of the larynx and hypopharynx

Aim. To study the effectiveness of modified subtotal laryngectomy with the formation of a tracheopharyngeal shunt in patients with locally advanced cancer of the larynx and laryngopharynx.Materials and methods. We conducted a cohort study on the use of combined treatment (surgical and radiation/ polychemotherapy) in 25 patients: 24 men, 1 woman; median age – 56 years. The subtotal laryngectomy technique that we developed and used included the preservation of one arytenoid cartilage, the posterior third of the vocal fold, and the recurrent nerve on the side not affected by the tumor. We studied postoperative complications, the length and diameter of the tracheopharyngeal shunt, the functioning of the arytenoid cartilage, the frequency of voice recovery and its quality, and overall and relapse-free survival.Results. In the postoperative period, 8 (32%) patients developed a pharyngocutaneous fistula; tracheal stenosis after tracheostomy was observed in 8 (32%) cases. The length of the tracheopharyngeal shunt varied from 16.4 to 25.6 mm, in all cases its course was tortuous, the diameter of the preserved part of the vocal fold varied from 1.1 to 1.5 mm. 24 (96%) patients demonstrated the functioning of the arytenoid cartilage and its work as a valve. Voice function recovered in 24 (96%) patients. Fundamental frequency was 155.3 ± 20.9 Hz, maximum phonation time of the vowel “A” – 3.5 ± 1.0 s, duration of pauses in phrase – 0.24 ± 0.03 s, speech rate – 99.8 ± 8.4 words/ min, number of words in phrase 6.5 ± 0.3. The average value of the Acoustic Voice Quality Index was 6.74, which indicates dysphonia (for the Russian language, the threshold value for dysphonia is 4.86), but this did not interfere with patients’ communication at home and on the phone. Overall and relapse-free survival at 1, 2, and 3 years were 100%, 89%, 78% and 86%, 78%, 72%, respectively.Conclusion. The method of operation proposed by us contributes to the restoration of voice function in the majority of patients with oncological outcomes comparable to total laryngectomy.

Effects of different medical masks on acoustic and aerodynamic voice assessment during the COVID-19 pandemic.

The purpose of the study was to investigate the effect of the surgical masks and N95 masks on the acoustic and aerodynamic parameters of voice assessment during the coronavirus disease 2019 pandemic. The challenge of the study was to enable each inexperienced participant to perform a number of acoustic and aerodynamic voice assessment in a qualified and homogeneous manner without and with medical masks, and to minimize the individual differences. There were 32 healthy participants recruited in the study, including 16 males and 16 females. The acoustic parameters analyzed included fundamental frequency, standard deviation of fundamental frequency (fundamental frequency standard deviation), percentage of jitter (%), percentage of shimmer (%), glottal-to-noise excitation ratio (GNE), and the parameters of irregularity, noise and overall severity. The aerodynamic parameters included s time, z time, s/z ratio and maximum phonation time. When wearing surgical masks, the GNE ratio (P = .043) significantly increased, whereas noise (P = .039) and s time (P = .018) significantly decreased. When wearing N95 masks, the percentage of shimmer (P = .049), s time (P = .037) and s/z ratio (P = .048) significantly decrease. In general, performing voice assessment with a medical mask proved to be reliable for most of the acoustic and aerodynamic parameters. It is worth noting that the shimmer (%), could be slightly impacted when wearing N95 masks. Wearing surgical masks might slightly influence the measurement of noise and higher GNE ratio. The s/z ratio could be affected when wearing N95 masks. The contribution of the study is to explore acoustic and aerodynamic parameters that might be easily affected by wearing masks during the voice assessment, and provide references for clinical evaluation of voice disorders during the pandemic of coronavirus disease 2019.

Evaluation of the Effectiveness of Resonant Voice Therapy in Patients with Functional Voice Disorder

This study aims to determine the effectiveness of resonant voice therapy (RVT) in patients with functional voice disorder and to examine the subjective and objective voice changes after the therapy. This study adopted an experimental research design with a pretest-posttest control group. Thirty-four women participated in the study-17 in the experimental group and 17 in the control group. Voice hygiene training and RVT were applied to the experimental group. The Turkish version of the Voice Handicap Index (VHI-10) and GRBAS (Grade, Roughness, Breathiness, Asthenia, and Strain)scale were used for subjective voice assessment. Voice recordings were subjected to acoustic analysis on the PRAAT program. After an 8-week therapy program, the same process was repeated for post-test assessment. In the voice analyses performed after RVT, which was applied to patients with functional voice disorders, the results of the acoustic analysis showed statistically significant differences in jitter, PPQ5, RAP, shimmer, APQ11, and NHR parameters. Subjective voice analysis indicated a statistically significant decrease in VHI-10 scores from 20.88±5.33-9.06±3.3 in the experimental group. The GRBAS score was 4.29±1.2 before the therapy and 1.71±1.1 after the therapy, which is a statistically significant decrease. The results point out that RVT has been effective in improving the objective and subjective parameters of patients with functional voice disorders. RVT applied to patients with functional voice disorders provides significant improvement in acoustic and perceptual voice parameters. The RVT is an effective therapy method in the treatment of patients with functional voice disorders and should be considered as a therapeutic option.

Investigating the Impact of Visual Input on Voice Production in Virtual Reality

This study explored the independent effects of visual input on voice production using virtual reality. Specifically, its effects on acoustic voice parameters and vocal status ratings, with the hypothesis that larger (a virtual lecture hall and theater compared to an office) and more full virtual rooms (75% of the capacity compared to 45%) would result in changes to the voice parameters and vocal status ratings. Voice production from 30 vocally healthy participants was recorded in six virtual reality conditions. After each condition, the participants provided vocal status ratings. The voice recordings were processed to calculate mean and standard deviation of sound pressure level and fundamental frequency, mean pitch strength, time dose, and cepstral peak prominence smoothed. The effects of the virtual reality conditions on these voice acoustic parameters and the vocal status ratings were analyzed. The full virtual reality rooms resulted in significantly higher vocal fatigue and vocal discomfort ratings. The larger virtual reality rooms were significantly related to increases in mean and the standard deviation of sound pressure level, mean pitch strength, and cepstral peak prominence smoothed. This study demonstrated that visual size and visual fullness input during speech tasks have distinct effects on voice production and self-reported vocal status. Visual size is related to voice acoustic outcomes, while visual fullness is related to self-reported outcomes.

Test-Retest Reliability of the Acoustic Voice Quality Index and the Acoustic Breathiness Index

The acoustic voice quality index (AVQI) and the acoustic breathiness index (ABI) are two validated measurements for the objective-acoustic assessment of voice quality. The aim of this study was to evaluate the relative and absolute reliability of AVQI and ABI as well as detect the natural variability of vocally-healthy voices. Totally, 39 vocally-healthy participants received weekly an AVQI- and ABI measurement using the freeware VOXplot over a period of 3 weeks. This study is a within-subject design to assess significant differences between the test and retest measurements (test and mean of two retests) of AVQI and ABI with the paired sample t test and to investigate the reliability of these two acoustic parameters with the intraclass correlation coefficient (ICC), Bland-Altman plot, and the minimal detectable change (MDC). No significant differences between the test-retest measurements of AVQI and ABI were revealed (all P-values>0.05). The relative reliability of AVQI and ABI showed good results (eg, ICC=0.81, and ICC=0.92, respectively). Absolute reliability measured with the MDC yielded a test-retest value of 0.78 and 0.66 for the AVQI and ABI, respectively. Deviations within this range may be due to natural variations of the voice (random bias). AVQI and ABI revealed high-reliability results in a test-retest measurement of vocally-healthy participants.

Analysis of Voice Quality After Thyroid Surgery

Voice changes are a common complication after a thyroidectomy, which isa surgical procedure involving partial or total removal of the thyroid gland. The main objective of this work is to examine the possible voice disorders after thyroid surgery. More precisely, it is an investigation of partial and total thyroidectomy, as well as the effects that cancerous and noncancerous thyroid glands can have regarding postsurgical vocal and their association with age and gender. Patients were evaluated using acoustic voice parameters, including harmonics-to-noise ratio (HNR), fundamental frequency (F0), jitter, speaker phonation frequency (SPF) range, cepstral peak prominence (CPP), maximum phonational frequency range (MPFR), and shimmer at the preoperative stage and postoperatively at the 1day, and first-month stages. Results demonstrated a significant change in F0 parameters, SPF range, and CPP feature 1 month after surgery, depending on the type of thyroidectomy and thyroid pathology. No significant changes were observed in the HNR, shimmer, and jitter features. Age was associated with the CPP parameter in the entire sample. In contrast, the MPFR parameter was also related to the type of thyroidectomy in the entire sample. However, maximum F0 was significantly associated with the type of thyroidectomy, specifically in the female sample. Results indicated that a thyroidectomy can have a negative impact on voice quality. The age and type of thyroidectomy performed are not responsible for this change. Potentially this change can be due to factors such as nerve damage or the subjects' experience, such as job, anxiety, and their physical condition, as well as treatments they may have undergone before thyroidectomy. Further efforts are needed to fully understand the background of voice changes after thyroidectomy.

Introduction of Voice Type Component (VTC) as an Effective Acoustic Voice Analysis Method in Tele-evaluation

Telepractice in voice healthcare and evaluation services has attracted much attention in recent years. Multiple studies have proven the effectiveness of voice therapy with telepractice. However, voice evaluations are still mostly conducted in person due to the lack of sensitive acoustic analysis methods. This study examined various acoustic analysis methods for voice evaluation in telepractice. Eighteen female elementary school teachers with self-reported voice disorders volunteered to participate in the study. Speech samples were collected before and after the interventions using two voice sampling methods concurrently. One set of data was collected using the traditional voice sample collection method by the therapist in person. The second set of data was collected on the same speech samples using the clients' own smartphones, and the collected voice samples were later sent to the researcher for further acoustic analysis. The voice type component (VTC) measurement represented the proportion of different VTCs in a voice by measuring the chaos and intrinsic dimension. Voice analyses were conducted on both sets of data, and the correlation between the two sampling procedures was analyzed. It appears that the VTC could be a more reliable method for producing acoustic analysis results with voice samples collected from smartphones compared to other objective voice assessment procedures. This reliability has been demonstrated via statistical analysis, including correlation coefficient, pairwise t test, d-prime,and area under the curve. The results of this study highlighted the VTC as an effective and accurate acoustic analysis method in tele-evaluation. This feasible voice sampling method, which utilizes participants' own smartphones, will reduce barriers to accessing limited voice specialists due to distance and will decrease the cost of care by minimizing expenses associated with travel and additional equipment for voice sampling. Ultimately, this approach will enhance the effectiveness of voice care delivered through telepractice to patients in remote and underserved areas.

Validation of the Acoustic Voice Quality Index and the Acoustic Breathiness Index in the Persian Language

This study aimed to validate the acoustic voice quality index version 03.01 (AVQIv3) and the acoustic breathiness index (ABI) in the Persian language. Six judges assessed the severity degree of the abnormal overall voice quality (hoarseness) and breathiness from continuous speech (cs) and sustained vowel (sv) in 136 voices samples of dysphonic and 45 vocally healthy participants. Firstly, the time length of cs and sv was balanced out for a higher level of ecological validity. Secondly, the concurrent validity and diagnostic accuracy were statistically analyzed with the Spearman rank-order correlation, and the receiver operating characteristics, likelihood ratio, and Youden index. There was substantial inter-rater reliability between judges regarding hoarseness and breathiness. Twenty syllables were identified as the standardized number of syllables for the cs part. Sufficient correlations were found between AVQI and hoarseness (rs =0.74), and between ABI and breathiness (rs =0.74), respectively. The thresholds of 1.63 (sensitivity of 73.2% and specificity of 91%) and 2.97 (sensitivity of 70% and specificity of 87%) yielded the highest level of diagnostic findings for AVQI and ABI, respectively. The AVQIv3 and ABI are reliable indices to quantify the abnormal overall voice quality and breathiness in the Persian language.

Acoustic Characteristics and Voice Fatigue in Hearing Impared Adult Males according to the Degree of Hearing Loss

This study was conducted to use it as basic information to suggest the necessity and program for self-regulation that can properly maintain voice according to the degree of hearing loss. For this purpose, twenty-six men in their fifties were classified according to the degree of hearing loss, and multidimensional voice program (MDVP) (F&lt;sub&gt;0&lt;/sub&gt;, jitter, shimmer, noise to harmonics ratio [NHR]), cepstrum (cepstral peak prominence [CPP], low/high spectral ratio [L/H ratio], mean CPP F&lt;sub&gt;0&lt;/sub&gt;, cepstral/spectral index of dysphonia [CSID]) and vocal fatigue index (fatigue, physical, rest, total) were performed and analyzed. The more severe the degree of hearing loss, the higher the F&lt;sub&gt;0&lt;/sub&gt; and CSID, and the lower the L/H ratio, the overall quality of the voice deteriorated. Normal-mild hearing loss group indicated a positive correlation between mean CPP F&lt;sub&gt;0&lt;/sub&gt; and fatigue, rest and total, and negative correlation between CPP and rest. In severe-profound group, F&lt;sub&gt;0&lt;/sub&gt; and rest showed a negative correlation, and shimmer and rest showed a positive correlation. Through the analysis of vowel and connected speech, it was found that the more severe the degree of hearing loss, the higher the F&lt;sub&gt;0&lt;/sub&gt; in vowel phonation, the lower the L/H ratio and the higher the CSID, and the lower the overall sound quality. In addition, it was observed that that the more severe the hearing loss, the higher the fatigue level of the hearing-loss person who speaks due to severe voice misuse and abuse. Therefore, auditory rehabilitation patients with hearing loss optimal voice production, and voice rehabilitation programs that use proper voices should be supported.

Feasibility and efficacy of video-call speech therapy in patients with Parkinson's disease: A preliminary study

BackgroundSpeech therapy is highly effective for patients with Parkinson's disease (PD) who have speech difficulties; however, its accessibility is limited. Online video-call speech therapy has been explored as an alternative option for PD patients. ObjectivesTo evaluate the feasibility and efficacy of video-call speech therapy for PD patients. MethodsThis prospective, comparative study was conducted between July and September 2022. PD patients with speech difficulties were divided into two groups, online speech therapy via video call and in-person therapy at hospital, based on their willingness to visit the hospital frequently. The patients underwent 12 sessions of speech therapy, focusing on respiration and phonation. Acoustic assessments, auditory-perceptual assessment, and voice handicap index (K–VHI10) were evaluated at baseline, post-therapy, and follow-up. ResultsEleven patients were enrolled in the study, though one patient from the online group withdrew. Ten patients completed the therapy (five in each group) without missing a session. The baseline acoustic measurements did not differ between the two groups. After therapy, both group showed an increase in voice intensity and improvement in overall loudness. The post-therapy change from baseline in the acoustic measurements was not significantly different between the two groups. The effect of therapy were maintained in the follow-up evaluation in both groups. The K–VHI10 decreased significantly from baseline to post-therapy and further at follow-up in both groups, with no significant difference between two groups. ConclusionThe online speech therapy via video call is feasible in PD patients with speech difficulties and as effective as in-person therapy.

Automated Classification of Cognitive Decline and Probable Alzheimer's Dementia Across Multiple Speech and Language Domains.

Decline in language has emerged as a new potential biomarker for the early detection of Alzheimer's disease (AD). It remains unclear how sensitive language measures are across different tasks, language domains, and languages, and to what extent changes can be reliably detected in early stages such as subjective cognitive decline (SCD) and mild cognitive impairment (MCI). Using a scene construction task for speech elicitation in a new Spanish/Catalan speaking cohort (N = 119), we automatically extracted features across seven domains, three acoustic (spectral, cepstral, and voice quality), one prosodic, and three from text (morpholexical, semantic, and syntactic). They were forwarded to a random forest classifier to evaluate the discriminability of participants with probable AD dementia, amnestic and nonamnestic MCI, SCD, and cognitively healthy controls. Repeated-measures analyses of variance and paired-samples Wilcoxon signed-ranks test were used to assess whether and how performance differs significantly across groups and linguistic domains. The performance scores of the machine learning classifier were generally satisfactorily high, with the highest scores over .9. Model performance was significantly different for linguistic domains (p < .001), and speech versus text (p = .043), with speech features outperforming textual features, and voice quality performing best. High diagnostic classification accuracies were seen even within both cognitively healthy (controls vs. SCD) and MCI (amnestic and nonamnestic) groups. Speech-based machine learning is powerful in detecting cognitive decline and probable AD dementia across a range of different feature domains, though important differences exist between these domains as well. https://doi.org/10.23641/asha.23699733.

Advances in Clinical Voice Quality Analysis with VOXplot.

The assessment of voice quality can be evaluated perceptually with standard clinical practice, also including acoustic evaluation of digital voice recordings to validate and further interpret perceptual judgments. The goal of the present study was to determine the strongest acoustic voice quality parameters for perceived hoarseness and breathiness when analyzing the sustained vowel [a:] using a new clinical acoustic tool, the VOXplot software. A total of 218 voice samples of individuals with and without voice disorders were applied to perceptual and acoustic analyses. Overall, 13 single acoustic parameters were included to determine validity aspects in relation to perceptions of hoarseness and breathiness. Four single acoustic measures could be clearly associated with perceptions of hoarseness or breathiness. For hoarseness, the harmonics-to-noise ratio (HNR) and pitch perturbation quotient with a smoothing factor of five periods (PPQ5), and, for breathiness, the smoothed cepstral peak prominence (CPPS) and the glottal-to-noise excitation ratio (GNE) were shown to be highly valid, with a significant difference being demonstrated for each of the other perceptual voice quality aspects. Two acoustic measures, the HNR and the PPQ5, were both strongly associated with perceptions of hoarseness and were able to discriminate hoarseness from breathiness with good confidence. Two other acoustic measures, the CPPS and the GNE, were both strongly associated with perceptions of breathiness and were able to discriminate breathiness from hoarseness with good confidence.

Voice acoustics allow classifying autism spectrum disorder with high accuracy

Early identification of children on the autism spectrum is crucial for early intervention with long-term positive effects on symptoms and skills. The need for improved objective autism detection tools is emphasized by the poor diagnostic power in current tools. Here, we aim to evaluate the classification performance of acoustic features of the voice in children with autism spectrum disorder (ASD) with respect to a heterogeneous control group (composed of neurotypical children, children with Developmental Language Disorder [DLD] and children with sensorineural hearing loss with Cochlear Implant [CI]). This retrospective diagnostic study was conducted at the Child Psychiatry Unit of Tours University Hospital (France). A total of 108 children, including 38 diagnosed with ASD (8.5 ± 0.25 years), 24 typically developing (TD; 8.2 ± 0.32 years) and 46 children with atypical development (DLD and CI; 7.9 ± 0.36 years) were enrolled in our studies. The acoustic properties of speech samples produced by children in the context of a nonword repetition task were measured. We used a Monte Carlo cross-validation with an ROC (Receiving Operator Characteristic) supervised k-Means clustering algorithm to develop a classification model that can differentially classify a child with an unknown disorder. We showed that voice acoustics classified autism diagnosis with an overall accuracy of 91% [CI95%, 90.40%-91.65%] against TD children, and of 85% [CI95%, 84.5%–86.6%] against an heterogenous group of non-autistic children. Accuracy reported here with multivariate analysis combined with Monte Carlo cross-validation is higher than in previous studies. Our findings demonstrate that easy-to-measure voice acoustic parameters could be used as a diagnostic aid tool, specific to ASD.

Voice Acoustic Instability During Spontaneous Speech in Parkinson’s Disease

In people with Parkinson's disease (PwPD), both motor and cognitive deficits influence voice and other aspects of communication. PwPD demonstrate vocal instability, but acoustic declines over the course of speaking are not well characterized and the role of cognition on these declines is unknown. We examined voice acoustics related to speech motor instability by comparing the first and the last utterances within a speech task. Our objective was to determine if mild cognitive impairment (MCI) status was associated with different patterns of acoustic change during these tasks. Participants with PD (n=44) were enrolled at University of Massachusetts Chan Medical School and classified by gold-standard criteria as normal cognition (PD-NC) or mild cognitive impairment (PD-MCI). The speech was recorded during the Rainbow Passage and a picture description task (Cookie Theft). We calculated the difference between first and last utterances in fo mean and standardized semitones (STSD), cepstral peak prominence-smoothed (CPPS), and low to high ratio (LH). We used t-tests to compare the declines in acoustic parameters between the task types and between participants with PD-NC versus PD-MCI. Mean fo, fo variability (STSD) and CPPS declined from the first to the last utterance in both tasks, but there was no significant difference in these declines between the PD-NC and PD-MCI groups. Those with PD-MCI demonstrated lower fo variability on the whole in both tasks and lower CPPS in the picture description task, compared to those with PD-NC. Mean and STSD fo as well as CPPS may be sensitive to PD-MCI status in reading and spontaneous speech tasks. Speech motor instability can be observed in these voice acoustic parameters over brief speech tasks, but the degree of decline does not depend on cognitive status. These findings will inform the ongoing development of algorithms to monitor speech and cognitive function in PD.

Evaluation of Immediate Effects of Straw Phonation Exercise and Determination of the Ideal Performance Time in Healthy Adults

The ideal performance time of straw phonation exercise, one of the semi-occluded vocal tract exercise types, in which optimal effects are seen in healthy voices is still unknown. The aim of this study was to investigate the immediate effect of straw phonation exercise in healthy adults after 1, 3, 5, 7, and 10 minutes, considering: acoustic parameters, electroglottographic parameters, auditory-perceptual general voice quality, the participants' self-assessment regarding vocal effort, and laryngeal discomfort during exercise. This study included 69 participants (35 women, 34 men) with a healthy voice. Participants performed the exercise with straw for a total of 10 minutes. The data were collected before (m0) and immediately after exercises at the first (m1), third (m3), fifth (m5), seventh (m7), and tenth (m10) minutes of performance using sustained emission of vowel /a/ and a sentence. There was an increase in the fundamental frequency at m7 and a decrease in the shimmer from m5 in men. The sound pressure level increased at m5 and m10 in women and from m1 in men. The Acoustic Voice Quality Index score decreased at m5 in men. The mean average closed quotient decreased at m10 in women. Auditory-perceptual general voice quality was optimal at m3 in women and at m5 in men, it deteriorated at m7 in women and at m10 in men. The vocal effort during the exercise increased at m7 in women and at m10 in men. The laryngeal discomfort during the exercise increased for both sexes at m10. The straw phonation exercise in healthy individuals promoted optimal effects on voice quality after 5 and 7 minutes for men and 3 and 5 minutes for women. Prolongation of the exercise time causes negative effects on voice quality and an increase in vocal effort and laryngeal discomfort presented by the participants.

The Occurrence of Laryngeal Pathologies in a Treatment-Seeking Pediatric Population

The purpose of this study was to 1) describe the age- and sex-specific occurrence of laryngeal pathologies in a treatment-seeking pediatric population in the voice unit of Ghent University Hospital, Belgium, and 2) describe this population in terms of vocal parameters, vocal complaints, influencing factors, and treatment history and recommendation. Retrospective, observational study. All patient records were analyzed for children (0-18 years) who consulted the ear, nose, and throat department of Ghent University Hospital for the first time between July 2015 and June 2021 with complaints of dysphonia. In total, 103 children (66 males, 37 females) with a mean age of 10.01 years (SD: 3.4, range 3.93-17.96) were included in this study. Laryngeal pathology was diagnosed using a flexible videolaryngo(strobo)scopy. The influence of age and sex on laryngeal etiology (organic/functional voice disorder) was examined using a Welch-modified t test and a Fisher's exact test, respectively. Organic lesions were observed in 77.7% of the participants, with vocal fold nodules (VFNs) being the most common diagnosis (66.0%). A functional voice disorder was diagnosed in 22.3% of the children. Children with a functional voice disorder are significantly older than children with an organic voice disorder. There was no statistically significant difference between males and females in laryngeal etiology. Mean dysphonia severity index was -2.7 (SD: 3.2, range -9.3 to +3.7), the mean acoustic voice quality index 4.70 (SD: 1.5, range 2.35-8.27), and the mean pediatric voice handicap index 29.8 (SD: 13.6, range 5-60). The occurrence of vocal misuse was mentioned in 80.6% of the patient records. Organic voice disorders, especially VFNs, are predominant in treatment-seeking children with dysphonia. Functional voice disorders become more common with increasing age during childhood. A disordered vocal quality, reduced vocal capabilities and reduced voice-related quality of life were found.

Assessing the Reliability of a Mobile Phone Recorder in Acoustic Voice Analysis: A Cross-sectional Study

Assessing the Reliability of a Mobile Phone Recorder in Acoustic Voice Analysis: A Cross-sectional Study