Article

Toward improved differential diagnosis of adductor spasmodic dysphonia and muscle tension dysphonia.

Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, UT 84112-0252, USA.
Folia Phoniatrica et Logopaedica (impact factor: 1.12). 01/2007; 59(2):83-90. DOI:10.1159/000098341
Source: PubMed

ABSTRACT Adductor spasmodic dysphonia (ADSD) is characterized by a strained-strangled voice quality, whose diagnosis relies exclusively on auditory-perceptual features. However, muscle tension dysphonia (MTD) -- a functional voice disorder -- can mimic ADSD thereby contributing to diagnostic confusion. Unlike MTD, ADSD has been described as 'task-specific', implying that certain vocal tasks such as sentences loaded with predominantly voiced consonants will provoke greater sign expression. This investigation examined the diagnostic value of variable sign expression based upon phonetic loading as a means to disambiguate ADSD and MTD.
Five listeners, who were blinded to the purpose of the study, used a 10-cm visual analog scale to rate the dysphonia severity of two sentences (one all-voiced and one containing primarily voiceless consonants) produced by participants with ADSD (n = 29) or MTD (n = 33).
A mixed-design ANOVA, with Group (ADSD vs. MTD) as the between-subjects variable and Sentence Type (all-voiced vs. voiceless) as the within-subjects variable, confirmed a significant Group-by-Sentence Type interaction effect (p = 0.0002). In ADSD, ratings of dysphonia severity for the all-voiced sentence were significantly more severe than for the voiceless sentence (p < 0.0001), whereas in MTD no significant difference was observed (p = 0.9981). The ROC curve confirmed that differences in dysphonia severity between voiced and voiceless sentences represented a highly specific (88-100%), but only 48% sensitive diagnostic marker.
Phonetic loading influences sign expression in ADSD, and assists in discriminating ADSD from MTD.

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    Article: Spasmodic dysphonia, perceptual and acoustic analysis: presenting new diagnostic tools.
    Denise Irene Siemons-Lühring, Mieke Moerman, Jean-Pierre Martens, Dirk Deuster, Frank Müller, Philippe Dejonckere
    [show abstract] [hide abstract]
    ABSTRACT: In this article, we investigate whether (1) the IINFVo (Impression, Intelligibility, Noise, Fluency and Voicing) perceptual rating scale and (2) the AMPEX (Auditory Model Based Pitch Extractor) acoustical analysis are suitable for evaluating adductor spasmodic dysphonia (AdSD). Voice recordings of 12 patients were analysed. The inter-rater and intra-rater consistency showed highly significant correlations for the IINFVo rating scale, with the exception of the parameter Noise. AMPEX reliably analyses vowels (correlation between PUVF (percentage of frames with unreliable F0/voicing 0.748), running speech (correlation between PVF (percentage of voiced frames)/voicing 0.699) and syllables. Correlations between IINFVo and AMPEX range from 0.608 to 0.818, except for noise. This study indicates that IINFVo and AMPEX could be robust and complementary assessment tools for the evaluation of AdSD. Both the tools provide us with the valuable information about voice quality, stability of F0 (fundamental frequency) and specific dimensions controlling the transitions between voiced and unvoiced segments.
    Archives of Oto-Rhino-Laryngology 12/2009; 266(12):1915-22. · 1.29 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

10-cm visual analog scale
 
48% sensitive diagnostic marker
 
Adductor spasmodic dysphonia
 
all-voiced sentence
 
between-subjects variable
 
diagnostic value
 
disambiguate ADSD
 
discriminating ADSD
 
dysphonia severity
 
functional voice disorder
 
muscle tension dysphonia
 
phonetic loading
 
Phonetic loading influences sign expression
 
sentences
 
significant Group-by-Sentence Type interaction effect
 
strained-strangled voice quality
 
variable sign expression
 
voiceless sentence
 
voiceless sentences
 
within-subjects variable