■喉肌张力障碍是喉部肌肉的任务特异性局灶性肌张力障碍,会损害言语和声音的产生。目前,LD没有治愈方法。LD患者最常见的治疗选择包括肉毒杆菌神经毒素注射。
■提供经验证据,证明语音盒上方皮肤的非侵入性振动触觉刺激(VTS)可以为受LD影响的人提供症状缓解。
■单组11周随机对照试验,在两个4周的块中在家中自我给药两次剂量(每周20分钟一次或3次)之间进行交叉。在第1、6和11周在实验室中评估VTS对语音和言语的急性影响。参与者随机接受40Hz或100HzVTS。
■主要:语音信号的平滑倒谱峰突出度(CPPS),以量化语音和语音异常,和感知的语音努力(PSE)被参与者排名作为语音努力的衡量标准(量表1-10)。次要:连续讲话期间的语音中断次数,语音共识听觉感知评估(CAPE-V)清单作为总体疾病严重程度的量度和语音障碍指数30项自我报告。
■39名确诊为内收肌型LD的患者(平均[SD]年龄,60.3[11.3]年;18名女性和21名男性)完成了研究。VTS的单一应用改善了语音质量(CPPS中位数增加:0.41dB,95%CI[0.20,0.61])和/或在三次研究访问中,多达57%的参与者中,语音努力(PSE)减少了至少30%。效果从不到30分钟持续到几天。在11周的研究期间,没有剂量影响,也没有证据表明VTS的急性治疗效果纵向增加或减少。100和40HzVTS均可引起语音质量和语音工作量的可测量改善。VTS对接受肉毒杆菌毒素的那些人诱导了额外的益处。参与者,未接受肉毒杆菌治疗也对VTS有反应。
■这项研究提供了第一个系统的经验证据,证明长时间使用喉部VTS可以引起声音质量的可重复的急性改善和LD中声音努力的减少。
■ClinicalTrials.govID:NCT03746509。
UNASSIGNED: Laryngeal dystonia is a task-specific focal dystonia of laryngeal muscles that impairs speech and voice production. At present, there is no cure for LD. The most common therapeutic option for patients with LD involves Botulinum neurotoxin injections.
UNASSIGNED: Provide empirical evidence that non-invasive vibro-tactile stimulation (VTS) of the skin over the voice box can provide symptom relief to those affected by LD.
UNASSIGNED: Single-group 11-week randomized controlled trial with a crossover between two dosages (20 min of VTS once or 3 times per week) self-administered in-home in two 4-week blocks. Acute effects of VTS on voice and speech were assessed in-lab at weeks 1, 6 and 11. Participants were randomized to receive either 40 Hz or 100 Hz VTS.
UNASSIGNED: Primary: smoothed cepstral peak prominence (CPPS) of the voice signal to quantify voice and speech abnormalities, and perceived speech effort (PSE) ranked by participants as a measure of voice effort (scale 1-10). Secondary: number of voice breaks during continuous speech, the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) inventory as a measure of overall disease severity and the Voice Handicap Index 30-item self report.
UNASSIGNED: Thirty-nine people with a confirmed diagnosis of adductor-type LD (mean [SD] age, 60.3 [11.3] years; 18 women and 21 men) completed the study. A single application of VTS improved voice quality (median CPPS increase: 0.41 dB, 95% CI [0.20, 0.61]) and/or reduced voice effort (PSE) by at least 30% in up to 57% of participants across the three study visits. Effects lasted from less than 30 min to several days. There was no effect of dosage and no evidence that the acute therapeutic effects of VTS increased or decreased longitudinally over the 11-week study period. Both 100 and 40 Hz VTS induced measurable improvements in voice quality and speech effort. VTS induced an additional benefit to those receiving Botulinum toxin. Participants, not receiving Botulinum treatment also responded to VTS.
UNASSIGNED: This study provides the first systematic empirical evidence that the prolonged use of laryngeal VTS can induce repeatable acute improvements in voice quality and reductions of voice effort in LD.
UNASSIGNED: ClinicalTrials.gov ID: NCT03746509.