Changes In Voice Pitch Research Articles

Comparison of Involuntary and Volitional Responses to Pitch-Shifted Auditory Feedback: Evidence for Tone Speakers' Flexibility to Switch Between Opposing and Following Responses.

Our audio-vocal system involves a negative feedback system that functions to correct for fundamental frequency (f 0) errors in production. Therefore, automatic and opposing responses appear when an unexpected change in voice pitch is present in auditory feedback. This study explores following responses to pitch perturbation in auditory feedback in tonal language speakers, which have been commonly overlooked or discarded by past research. We examine whether the number of response types (opposing vs. following) and their dynamic f 0 contours in tone word production vary as a function of instruction (involuntary ["to ignore"] vs. volitional ["to compensate"]). Twenty-four native speakers of Taiwanese Southern Min (TSM) produced three disyllabic TSM words while receiving pitch perturbation through headphones. The three disyllabic words were tsau55-im55 ("out of tune"; HH), kau33-uann33 ("exchange"; MM), and pan11-an11 ("handle a case"; LL) that carry an identical high-, mid-, or low-level tone. The participants were instructed either "to ignore" or "to compensate" for the pitch shifts. Results from a Bayesian Poisson regression show that the number of opposing and following responses were split nearly 50-50 for the "ignore" condition and 55%-35% for the "compensate" condition. The simulation results indicate that the speakers were able to switch between the feedback and the feedforward mode during the testing. On the other hand, f 0 contour analyses using generalized additive models show that pitch-increasing responses (i.e., oppose to downshifts or follow upshifts) were significantly larger than pitch-decreasing responses (i.e., oppose to upshifts or follow downshifts) for the MM and LL words, but not for the HH word. Our results provide support for the view that, for tone speakers, following responses are not uncommon. The magnitudes of pitch shift response trajectories have to do with the available pitch range for moving up or down in tone word production.

Cortical activity evoked by voice pitch changes: A combined fNIRS and EEG study

Functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) data were simultaneously obtained from normal-hearing listeners presented with continuous natural vowel sequences to study the interrelation of the haemodynamic and electrophysiological cortical responses evoked by voice pitch changes. fNIRS topographies and distributed ERP source reconstructions both indicated additional activity in the right superior temporal cortex if the prosodic contours varied between successive vowels, rather than being the same throughout the sequences. The source-level ERPs furthermore revealed two temporally and spatially separable adaptation processes in superior temporal cortex: Firstly, the early P1 component was bilaterally attenuated when vowels with the same prosodic contours were presented repeatedly, reflecting sensory adaptation. Secondly, the later P2 and sustained potential components were smaller in the right hemisphere during sequences without prosodic changes, which is taken to represent an attention-based adaptation effect. The present results demonstrate the convergence of both methods and demonstrate which ERPs underlie the right-lateralised activity in superior temporal cortex evoked in response to pitch changes that has been observed in many neuroimaging studies.

Neural encoding of voice pitch and formant structure at birth as revealed by frequency-following responses

Detailed neural encoding of voice pitch and formant structure plays a crucial role in speech perception, and is of key importance for an appropriate acquisition of the phonetic repertoire in infants since birth. However, the extent to what newborns are capable of extracting pitch and formant structure information from the temporal envelope and the temporal fine structure of speech sounds, respectively, remains unclear. Here, we recorded the frequency-following response (FFR) elicited by a novel two-vowel, rising-pitch-ending stimulus to simultaneously characterize voice pitch and formant structure encoding accuracy in a sample of neonates and adults. Data revealed that newborns tracked changes in voice pitch reliably and no differently than adults, but exhibited weaker signatures of formant structure encoding, particularly at higher formant frequency ranges. Thus, our results indicate a well-developed encoding of voice pitch at birth, while formant structure representation is maturing in a frequency-dependent manner. Furthermore, we demonstrate the feasibility to assess voice pitch and formant structure encoding within clinical evaluation times in a hospital setting, and suggest the possibility to use this novel stimulus as a tool for longitudinal developmental studies of the auditory system.

Human Stress Detection: Cortisol Levels in Stressed Speakers Predict Voice-Based Judgments of Stress.

Despite recent evidence of a positive relationship between cortisol levels and voice pitch in stressed speakers, the extent to which human listeners can reliably judge stress from the voice remains unknown. Here, we tested whether voice-based judgments of stress co-vary with the free cortisol levels and vocal parameters of speakers recorded in a real-life stressful situation (oral examination) and baseline (2 weeks prior). Hormone and acoustic analyses indicated elevated salivary cortisol levels and corresponding changes in voice pitch, vocal tract resonances (formants), and speed of speech during stress. In turn, listeners' stress ratings correlated significantly with speakers' cortisol levels. Higher pitched voices were consistently perceived as more stressed; however, the influence of formant frequencies, vocal perturbation and noise parameters on stress ratings varied across contexts, suggesting that listeners utilize different strategies when assessing calm versus stressed speech. These results indicate that nonverbal vocal cues can convey honest information about a speaker's underlying physiological level of stress that listeners can, to some extent, detect and utilize, while underscoring the necessity to control for individual differences in the biological stress response.

Can Voice Pitch Be Preserved in Patients after Transoral Endoscopic Thyroidectomy Vestibular Approach?

Introduction: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) has become increasingly popular. Several reports have emphasized the safety and efficacy of this new approach. However, there is no report on functional voice outcomes, including voice pitch change after TOETVA. Methods: The functional voice outcomes of patients undergoing TOETVA were compared with those of patients undergoing conventional thyroidectomy. A total of 82 consecutive patients were included in the study: 44 underwent thyroid lobectomy via TOETVA (transoral group) and 38 underwent thyroid lobectomy via the classic cervical approach (open group). Thyroidectomy-related voice questionnaire (TVQ), perceptual voice analysis, fiberoptic laryngoscopic and videolaryngostroboscopic examinations, and acoustic analysis were carried out before and one month after surgery. The changes in these values after surgery and the differences between the transoral and open groups were analyzed. Results: We found no significant postoperative change in voice workups in either group. The mean high pitch decreased (from 367.91 ± 120.98 to 325.80 ± 100.86 Hz, p = 0.069) in the transoral group, but statistical significance was not attained. Clinically significant changes in pitch (postoperative change in speaking fundamental frequency, ΔSFF ≥ 12) after surgery were evident in seven (15.91%) patients in the transoral group and eight (21.05%) patients in the open group without significant difference (p = 0.579). Conclusions: This is the first study to assess functional voice outcomes (including pitch) after TOETVA compared with conventional open surgery. TOETVA was associated with good voice outcomes without any significant drop in pitch.

Vocal Feminization for Transgender Women: Current Strategies and Patient Perspectives.

Voice feminization for transgender women is a highly complicated comprehensive transition process. Voice feminization has been thought to be equal to pitch elevation. Thus, many surgical procedures have only focused on pitch raising for voice feminization. However, voice feminization should not only consider voice pitch but also consider gender differences in physical, neurophysiological, and acoustical characteristics of voice. That is why voice therapy has been the preferred choice for the feminization of the voice. Considering gender difference of phonatory system, the method for voice feminization consists of changing the following four critical elements: fundamental frequency, resonance frequency related to vocal tract volume and length, formant tuning, and phonatory pattern. Voice feminizing process can be generally divided into non-surgical feminization and surgical feminization. As a non-surgical procedure, feminization voice therapy consists of increasing fundamental frequency, improving oral and pharyngeal resonance, and behavioral therapy. Surgical feminization usually can be achieved by external approach or endoscopic approach. Based on three factors (length, tension and mass) of vocal fold for pitch modulation, surgical procedure can be classified as one-factor, two-factors and three-factors modification of vocal folds. Recent systematic reviews and meta-analysis studies have reported positive outcomes for both the voice therapy and voice feminization surgery. The benefits of voice therapy, as it is highly satisfactory, mostly increase vocal pitch, and are noninvasive. However, the surgical voice feminization of three-factors modification of vocal folds is also highly competent and provides a maximum absolute increase in vocal pitch. Voice feminization is a long transition journey for physical, neurophysiological, and psychosomatic changes that convert a male phonatory system to a female phonatory system. Therefore, strategies for voice feminization should be individualized according to the individual’s physical condition, the desired change in voice pitch, economic conditions, and social roles.

The Effect of Robot Attentional Behaviors on User Perceptions and Behaviors in a Simulated Health Care Interaction: Randomized Controlled Trial.

BackgroundFor robots to be effectively used in health applications, they need to display appropriate social behaviors. A fundamental requirement in all social interactions is the ability to engage, maintain, and demonstrate attention. Attentional behaviors include leaning forward, self-disclosure, and changes in voice pitch.ObjectiveThis study aimed to examine the effect of robot attentional behaviors on user perceptions and behaviors in a simulated health care interaction.MethodsA parallel randomized controlled trial with a 1:1:1:1 allocation ratio was conducted. We randomized participants to 1 of 4 experimental conditions before engaging in a scripted face-to-face interaction with a fully automated medical receptionist robot. Experimental conditions included a self-disclosure condition, voice pitch change condition, forward lean condition, and neutral condition. Participants completed paper-based postinteraction measures relating to engagement, perceived robot attention, and perceived robot empathy. We video recorded interactions and coded for participant attentional behaviors.ResultsA total of 181 participants were recruited from the University of Auckland. Participants who interacted with the robot in the forward lean and self-disclosure conditions found the robot to be significantly more stimulating than those who interacted with the robot in the voice pitch or neutral conditions (P=.03). Participants in the forward lean, self-disclosure, and neutral conditions found the robot to be significantly more interesting than those in the voice pitch condition (P<.001). Participants in the forward lean and self-disclosure conditions spent significantly more time looking at the robot than participants in the neutral condition (P<.001). Significantly, more participants in the self-disclosure condition laughed during the interaction (P=.01), whereas significantly more participants in the forward lean condition leant toward the robot during the interaction (P<.001).ConclusionsThe use of self-disclosure and forward lean by a health care robot can increase human engagement and attentional behaviors. Voice pitch changes did not increase attention or engagement. The small effects with regard to participant perceptions are potentially because of the limitations in self-report measures or a lack of comparison for most participants who had never interacted with a robot before. Further research could explore the use of self-disclosure and forward lean using a within-subjects design and in real health care settings.

Multimodal stress detection: Testing for covariation in vocal, hormonal and physiological responses to Trier Social Stress Test

Examining the effects of acute stress across multiple modalities (behavioral, physiological, and endocrinological) can increase our understanding of the interplay among stress systems, and may improve the efficacy of stress detection. A multimodal approach also allows for verification of the biological stress response, which can vary between individuals due to myriad internal and external factors, thus allowing for reliable interpretation of behavioral markers of stress. Here, controlling for variables known to affect the magnitude of the stress response, we utilized the Trier Social Stress Test (TSST) to elicit an acute stress response in 80 healthy adult men and women. The TSST involves an interview-style oral presentation and critical social evaluation, and is highly effective in inducing psychosocial stress. Participants completed the study in individual 2 h sessions, during which we collected voice, polygraph and salivary hormone measures in baseline, stress, and relaxation phases. Our results show sizeable systematic increases in voice pitch (mean, minimum and variation in fundamental frequency, F0), hormone levels (cortisol) and decreases in skin temperature and hand movement during psychosocial stress, with striking similarities between men and women. However, cortisol and skin temperature only weakly predicted changes in voice pitch during stress, in either women or men, respectively. Thus, while our results provide compelling evidence that psychosocial stress manifests itself behaviorally by increasing voice pitch and its variability alongside simultaneous activation of physiological and endocrinological stress systems, our results also highlight a relatively weak degree of intra-individual ‘response coherence’ across these stress systems, with dissociations among different stress measures related most strongly to sex.

Voice Range Change After Injection Laryngoplasty for Unilateral Vocal Fold Paralysis

Patients with unilateral vocal fold paralysis (UVFP) caused by nerve injury manifest with voice changes. This study investigated vocal performance measured by voice range profile (VRP) in patients with UVFP and changes in VRP in response to intracordal hyaluronate injection. Eighty-five patients with UVFP were enrolled prospectively, among whom 68 received intracordal hyaluronate injections. The outcome measurements included VRP, acoustic and aerodynamic analyses, peak turn frequency of thyroarytenoid-lateral cricoarytenoid muscle complex (TA-LCA) measured by laryngeal electromyography, and normalized glottal gap area by videolaryngostroboscopy. The peak turn frequency of the paralyzed TA-LCA showed a modest correlation with max fundamental frequency (F0) and F0 range. Closed-phase normalized glottal gap area showed modest negative correlations with max F0 and F0 semitone range. Regarding conventional acoustic and aerodynamic analyses, the paralyzed TA-LCA peak turn frequency was only correlated with maximal phonation time. Intracordal hyaluronate injection improved VRP performance by increasing max F0, decreasing min F0, increasing F0 range, and increasing semitone range (all P <0.01) with small or medium strength of effect size (Cohen d, 0.39-0.76). Change in voice pitch in patients with UVFP can partly predict impairment of neuromuscular functions and glottal gap. VRP provides a more sensitive reflection of the severity of neuromuscular impairment, compared with conventional voice analysis. The validity of VRP is further supported by a robust response to voice improvements following injection laryngoplasty.

The Effects of Intralaryngeal Needle Technique in Intracordal Cyst

Background and Objectives Surgery is considered the primary treatment for intracordal cyst. However, patients who had undergone surgery are still subject to recurrence and continued voice changes. Intracordal cysts naturally disappear in some patient population. Cyst does not always recur in patients who had received partial surgical removal, too. Contradicting results raises a question whether complete surgical removal of intracordal cyst is necessary and demonstrate need for better treatment. Herein, the author proposes novel surgical method technique intralaryngeal needle technique (INT), a technique using surgical needle for not only injection but also for aspiration and excision of cyst. This study aims to examine the potential of intralaryngeal needle technique in treating intracordal cysts. Materials and Methods Surgical procedures were done on in-patients diagnosed with intracordal cyst. 23 patients received follow-up screening after the surgery for one year. Patients’ subjective satisfaction levels, acoustic measures, aerodynamic measures, laryngeal stroboscopic results were compared before and after the treatment. Results Overall patients were satisfied with novel surgical excision method. In terms of aerodynamic measures, maximum phonation time, mean air flow rate improved after the surgery. In terms of acoustic measures, Jitter, Shimmer, NHR, and voice pitch changes after the treatment showed statistically significant differences. Laryngeal stroboscopy results showed significant decreases in cyst sizes. Post-surgery patients had improved mucosal waves and amplitudes values. Conclusion The results show the validity of intralaryngeal needle technique in reducing intracordal cyst size by excision, aspiration, and injection. The author believes this novel technique can be used as an alternative surgical method for intracordal cysts. Key words: Intracordal cyst ㆍ Intralaryngeal needle technique 핵심용어: ì„±ëŒ€ë‚´ë‚­ì¢ ã† 성대내바늘기법

The Long-Term Prognosis of Voice Pitch Change in Female Patients After Thyroid Surgery.

Relatively large numbers of patients complain of lower-pitched voices after thyroidectomy. However, little is known about the risk factors for, prognosis of, or progression over time of, such changes, in female patients. We analyzed the data of 217 patients who underwent thyroid surgery and postoperative (2weeks, and 3, 6, and 12months after surgery) voice work-ups. To identify patients with lower-pitched voices, speaking fundamental frequencies (SFFs) were compared before and after surgery. The change was calculated for all patients (postoperative change in SFF, ΔSFF). The mean ΔSFF was 8.35±17.06Hz and significant changes in voice pitch (ΔSFF≥12Hz) were evident in 93 (42.85%) patients after surgery, mostly within 6months, and only 18.4% of patients had lower-pitched voices 1year after surgery. On multivariate analysis, age (≥52 vs.<52years) and extent of surgery remained significant predictors of lower-pitched voice after surgery. The ΔSFFs of older patients (≥52) were significantly greater than those of younger patients (<52) at the 2-week follow-up, but not at the 3-, 6-, or 12-month follow-ups. The ΔSFFs of patients who underwent total thyroidectomy were significantly higher than those who underwent lobectomy at the postoperative 2-week follow-up, but did not differ at the 3-, 6-, and 12-month follow-ups. Patients frequently experience a lower-pitched voice after thyroid surgery. Such problems develop more frequently in the early postoperative period, in aged patients, and in those who had undergone total thyroidectomy. However, over time, the changes usually decrease to levels similar to those of patients without these risk factors.

Enhanced early-latency electromagnetic activity in the left premotor cortex is associated with successful phonetic categorization

Sensory-motor interactions between auditory and articulatory representations in the dorsal auditory processing stream are suggested to contribute to speech perception, especially when bottom-up information alone is insufficient for purely auditory perceptual mechanisms to succeed. Here, we hypothesized that the dorsal stream responds more vigorously to auditory syllables when one is engaged in a phonetic identification/repetition task subsequent to perception compared to passive listening, and that this effect is further augmented when the syllables are embedded in noise. To this end, we recorded magnetoencephalography while twenty subjects listened to speech syllables, with and without noise masking, in four conditions: passive perception; overt repetition; covert repetition; and overt imitation. Compared to passive listening, left-hemispheric N100m equivalent current dipole responses were amplified and shifted posteriorly when perception was followed by covert repetition task. Cortically constrained minimum-norm estimates showed amplified left supramarginal and angylar gyri responses in the covert repetition condition at ~100ms from stimulus onset. Longer-latency responses at ~200ms were amplified in the covert repetition condition in the left angular gyrus and in all three active conditions in the left premotor cortex, with further enhancements when the syllables were embedded in noise. Phonetic categorization accuracy and magnitude of voice pitch change between overt repetition and imitation conditions correlated with left premotor cortex responses at ~100 and ~200ms, respectively. Together, these results suggest that the dorsal stream involvement in speech perception is dependent on perceptual task demands and that phonetic categorization performance is influenced by the left premotor cortex.

Minimally Invasive Video-Assisted Thyroidectomy

To report the results of a multi-institutional experience with the minimally invasive video-assisted thyroidectomy, which was conceived in Europe and Asia and has only recently been embraced in the United States. Prospective, nonrandomized analysis. Four academic thyroid surgical practices. Consecutive series of 228 patients who required thyroid surgery and were deemed at surgeon discretion to be eligible for a minimal access surgery. Minimally invasive video-assisted thyroidectomy was performed in 216 patients. The data, which were recorded prospectively, included age, sex, indication for surgery, incision length, and complications of surgery. Because conversion to an open approach was required in 12 of the 228 patients, the study group comprised 216 patients (25 men and 191 women; mean [SD] age, 44.5 [14.1] years). There were no hematomas and no cases of permanent hypoparathyroidism or permanent vocal cord paralysis. Nine patients had a transient vocal cord paresis (3.2% of nerves at risk); 5 patients experienced temporary hypocalcemia (8.1% of total thyroidectomies); 1 patient reported a change in voice pitch; and 1 patient required a scar revision. Use of the minimally invasive video-assisted thyroidectomy technique has been adopted cautiously in the United States. The safety of the procedure represented by the data from this multi-institutional experience would support its expanded adoption by high-volume thyroid surgeons.

Improving the voice pitch discrimination threshold through cochlear implants

Aiming at the maximum use of linguistic information conveyed by the periodicity pitch of speech sound through cochlear implants, the possibility of improving the voice pitch discrimination threshold was examined for cochlear implantees: three acquired deaf adults and four congenitally deaf children. Female and male adult speech samples of vowel /a/ were analyzed and resynthesized using the STRAIGHT computer program to shift the original voice pitch (c1 and c) one octave upward and downward with a half‐step interval on the musical scale. By presenting those synthetic speech samples in pairs, the discrimination threshold of the voice pitch interval was observed. Association of the speech samples to the picture of a piano keyboard was helpful for conceptualizing the voice pitch change, especially for children. Preliminary observation results suggested that the discrimination threshold can be improved by less than one whole step by adults and two whole steps by children. Those figures were promising because, even for Japanese word accent and Chinese tones, which were conveyed by the precise changes in voice pitch, it was ascertained by acoustical analyses of both their production and perception that discrimination of a half‐step difference was small enough to recognize their pitch patterns.

Voice changes after thyroidectomy without recurrent laryngeal nerve injury.

Injury of the inferior laryngeal nerve is not the only cause of voice alteration after thyroidectomy; many patients notice minimal changes immediately after operation, without evidence of inferior laryngeal nerve damage. We hypothesized that there may be other causes for voice modification, such as injuries of the superior laryngeal nerve, prethyroid strap muscles, and cricothyroid muscles. We describe voice changes after total thyroidectomy, without inferior laryngeal nerve injury, using a computer program to objectively compare different patterns of voice. Forty-six consecutive patients who underwent total thyroidectomy were studied between March 1997 and December 1999. Acoustic voice analysis was performed preoperatively and at the second, fourth, and sixth postoperative months using a microphone adapted to a personal computer. Parameters measured were intensity of the voice (Shimmer) and fundamental frequency (Fo). No complications occurred during operation or in the postoperative period. Voice fatigue during phonation was the most common symptom after thyroidectomy. Forty patients (87%) stated that their voices had changed since the operation, and common complaints were voice alteration while speaking loudly, changes in voice pitch, and voice disorder while singing. Changes in the Fo and Shimmer values in smokers versus nonsmokers were similar (Fo overall, p = 0.56; Shimmer overall, p = 0.66), as were the same parameters in benign and malignant pathologies (Fo overall, p = 0.66; Shimmer overall, p = 0.67). Voice changes after uncomplicated thyroidectomy occur and can be objectively measured. This is important in the preoperative counseling of patients before thyroidectomy, for ethical and legal purposes.

CAI system for testing and training discrimination ability of change in voice pitch through the cochlear implant

In the cochlear implant, change in voice pitch is transmitted through the periodicity of change in density of neural pulse trains excited by the electrical signal. As the transmission quality of the voice pitch depends on the setting of the processor of each device, it is necessary to measure precisely the discrimination ability of change in voice pitch for each user, and to make maximum use of it. For this purpose, a CAI (Computer Assisted Instruction) system for testing and training the discrimination was developed.

CAI system for testing and training discrimination ability of change in voice pitch through the cochlear implant

CAI system for testing and training discrimination ability of change in voice pitch through the cochlear implant

The Response of Children with Autism to Preferred Prosody During Instruction

Two related studies determined (a) if children with autism would have a preference for prosody of voice, or changes in voice pitch and stress placed on syllables, and (b) if the preferred prosody of voice is the most effective when used by their teachers. Twelve children with autism and 12 typical children selected their preferred prosody of voice for a story passage recorded by their teacher using monotonous, conversational, and enthusiastic prosodies. Significant preferences were revealed for 3 children with autism, who were then observed during classroom activities as they responded to teacher instructions in various prosodies. Results revealed that the children's responses to prosody of voice differed, with children less likely to respond if a monotonous prosody was used.

Early pitch-shift response is active in both steady and dynamic voice pitch control.

When air conducted auditory feedback pitch is experimentally shifted upward or downward during steady phonation, voice pitch changes in response. The first pitch change is an automatic deflection opposite in direction to the feedback shift. It appears to help stabilize voice pitch by counteracting unintended changes. But what happens during an intended pitch change? If the purpose of the first pitch-shift response is to stabilize voice pitch around a fixed target, it should be suppressed during voluntary pitch changes. Alternatively, if the pitch-shift response is a general process of voice control it should be modified during intended pitch changes to bring production in line with the desired output. Auditory feedback pitch was shifted during steady pitch and upward glissando vocalizations by thirty trained singers. Contrary to the "steady-specific" hypothesis, pitch-shift responses occurred during dynamic pitch vocalizations. Responses were comparable in direction, peak time, and slope, but had significantly longer latency and smaller magnitude than responses elicited during steady note phonation. Results indicate that the early pitch-shift response is a general component of voice control that serves to automatically bring phonation pitch into agreement with an intended target, whether that target is constant or changing in time.

Unilateral true vocal fold paralysis: Cause of right‐sided lesions

At the Georgetown University Center for the Voice, 778 patients were referred for evaluation between July 1, 1990, and June 30, 1995. During this 5-year period, right true vocal fold paralysis or paresis was diagnosed in 24 of these patients (3%). Videostroboscopy, voice analysis, and patient records were reviewed. Ages ranged from 23 to 80 years, and sex distribution approximated a 1:1 ratio. The patients presenting symptoms included hoarseness, dysphagia, choking, voice pitch change, voice weakness, fatigability, and breathiness. Sources of the vocal fold dysfunction included iatrogenic, traumatic, central, and infectious causes.