Abstract：
OBJECTIVE: This study aims to evaluate the demographic differences between those with adductor spasmodic dysphonia with vocal tremor (AdSD(+)VT) and those without vocal tremor (AdSD(-)VT) and to analyze their response to treatment with botulinum neurotoxin (BoNT-A).
METHODS: Retrospective cohort study.
METHODS: A database review of all spasmodic dysphonia patients treated with BoNT from 1989 to 2018 at the Mayo Clinic in Arizona was performed. Only patients who had received ≥4 injections of BoNT-A for AdSD were included. Patients were divided into two cohorts: those with coexistent vocal tremor (AdSD(+)VT) and those without vocal tremor (AdSD(-)VT).
RESULTS: The final analysis included 398 patients, with 210 AdSD(+)VT patients (53%) and 188 AdSD(-)VT patients (47%). The length of follow-up and median number of treatments were similar between cohorts. AdSD(+)VT patients were more likely to be female (P < 0.001), and older at onset (P < 0.001) and first injection (P < 0.001). The mean maximal benefit was significantly lower for the AdSD(+)VT cohort (P < 0.01), however the mean length of benefit was similar (P = 0.70).
CONCLUSIONS: Demographic differences exist between AdSD(+)VT and AdSD(-)VT patients. AdSD(+)VT patients benefit from BoNT-A treatment; however, our analysis suggests that the degree of their maximal benefit is less than in those without VT.
METHODS: Retrospective cohort study.
METHODS: A database review of all spasmodic dysphonia patients treated with BoNT from 1989 to 2018 at the Mayo Clinic in Arizona was performed. Only patients who had received ≥4 injections of BoNT-A for AdSD were included. Patients were divided into two cohorts: those with coexistent vocal tremor (AdSD(+)VT) and those without vocal tremor (AdSD(-)VT).
RESULTS: The final analysis included 398 patients, with 210 AdSD(+)VT patients (53%) and 188 AdSD(-)VT patients (47%). The length of follow-up and median number of treatments were similar between cohorts. AdSD(+)VT patients were more likely to be female (P < 0.001), and older at onset (P < 0.001) and first injection (P < 0.001). The mean maximal benefit was significantly lower for the AdSD(+)VT cohort (P < 0.01), however the mean length of benefit was similar (P = 0.70).
CONCLUSIONS: Demographic differences exist between AdSD(+)VT and AdSD(-)VT patients. AdSD(+)VT patients benefit from BoNT-A treatment; however, our analysis suggests that the degree of their maximal benefit is less than in those without VT.
摘要：
目的：本研究旨在评估内收肌痉挛性发声障碍伴声带震颤患者（AdSD(+)VT）和无声带震颤患者（AdSD(-)VT）的人口统计学差异，并分析其对肉毒杆菌神经毒素（BoNT-A）治疗的反应。
方法：回顾性队列研究。
方法：对1989年至2018年在亚利桑那州梅奥诊所接受BoNT治疗的所有痉挛性发声障碍患者进行了数据库回顾。仅包括接受≥4次BoNT-A注射治疗AdSD的患者。患者分为两组：伴有声带震颤的患者（AdSD（）VT）和无声带震颤的患者（AdSD（-）VT）。
结果：最终分析包括398名患者，210例AdSD(+)VT患者(53%)和188例AdSD(-)VT患者(47%)。队列之间的随访时间和中位治疗次数相似。AdSD(+)VT患者更可能是女性(P<0.001),和年龄在发病（P<0.001）和第一次注射（P<0.001）。AdSD(+)VT队列的平均最大获益显著较低(P<0.01),然而,平均获益时间相似(P=0.70).
结论：AdSD(+)VT和AdSD(-)VT患者之间存在人口统计学差异。AdSD(+)VT患者从BoNT-A治疗中获益；然而，我们的分析表明,他们的最大获益程度低于没有VT的患者.
方法：回顾性队列研究。
方法：对1989年至2018年在亚利桑那州梅奥诊所接受BoNT治疗的所有痉挛性发声障碍患者进行了数据库回顾。仅包括接受≥4次BoNT-A注射治疗AdSD的患者。患者分为两组：伴有声带震颤的患者（AdSD（）VT）和无声带震颤的患者（AdSD（-）VT）。
结果：最终分析包括398名患者，210例AdSD(+)VT患者(53%)和188例AdSD(-)VT患者(47%)。队列之间的随访时间和中位治疗次数相似。AdSD(+)VT患者更可能是女性(P<0.001),和年龄在发病（P<0.001）和第一次注射（P<0.001）。AdSD(+)VT队列的平均最大获益显著较低(P<0.01),然而,平均获益时间相似(P=0.70).
结论：AdSD(+)VT和AdSD(-)VT患者之间存在人口统计学差异。AdSD(+)VT患者从BoNT-A治疗中获益；然而，我们的分析表明,他们的最大获益程度低于没有VT的患者.
