Quantitative, clinically relevant acoustic measurements of focal embouchure dystonia.
Quantitative, clinically relevant acoustic measurements of focal embouchure dystonia.
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局灶性口型肌张力障碍的定量、临床相关声学测量。
DOI：
10.1002/mds.27298
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Mink,JonathanW
中科院分区：
文献类型：
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作者：
Morris,AimeeE;Norris,ScottA;Perlmutter,JoelS;Mink,JonathanW
背景：局灶性口唇肌张力障碍损害管乐音乐家的口面运动控制，并导致职业残疾。缺乏定量措施或评级量表阻碍客观评估的治疗effictiveness.Objectives：我们量化的具体功能，局灶性口部肌张力障碍使用声学措施，并制定了一个度量标准，以评估严重程度跨多个领域的symptomatic impairment.Methods：我们招募了9铜管音乐家和6没有口部肌张力障碍。确定了局灶性口部肌张力障碍的以下4个症状性功能障碍领域：音高不准确、声音不稳定和震颤、声音中断和时间变异性。音乐家进行持续的音调和序列，然后在每个域的声学变量进行量化。一个复合黄铜声学严重程度评分组成的这些变量进行了验证，对临床的全球印象severity.Results：音乐家与肌张力障碍进行更糟糕的声学领域的音高不准确（中位数：肌张力障碍= 100%，控制= 62%），不稳定（中位数微光：肌张力障碍= 3%，控制= 2%），和休息（中位数：肌张力障碍= 0.34%，控制= 0.05%）。口部肌张力障碍的震颤为5 ~ 8 Hz，间歇性，振幅可变。两组之间的节律变异性没有差异。口唇肌张力障碍的参与者在不同的变量上有不同的损伤模式。复合严重程度评分强烈预测临床的严重性（R2= 0.95）的整体印象。结论：声学变量区分音乐家与口部肌张力障碍的控制，并反映不同类型的症状性障碍。我们的复合声学严重程度评分预测严重程度的临床全球印象的音乐家与不同模式的症状性损害，并可能提供一个基础，开发一个临床评级量表。© 2018国际帕金森和运动障碍协会
Background: Focal embouchure dystonia impairs orofacial motor control in wind musicians and causes professional disability. A paucity of quantitative measures or rating scales impedes the objective assessment of treatment efficacy.Objectives: We quantified specific features of focal embouchure dystonia using acoustic measures and developed a metric to assess severity across multiple domains of symptomatic impairment.Methods:We recruited 9 brass musicians with and 6 without embouchure dystonia. The following 4 domains of symptomatic dysfunction in focal embouchure dystonia were identified: pitch inaccuracy, sound instability and tremor, sound breaks, and timing variability. Musicians performed sustained tones and sequences, and then acoustic variables within each domain were quantified. A composite brass acoustic severity score composed of these variables was validated against clinical global impressions of severity.Results:Musicians with dystonia performed worse in acoustic domains of pitch inaccuracy (median: dystonia = 100%, control = 62%), instability (median shimmer: dystonia = 3%, control = 2%), and breaks (median: dystonia = 0.34%, control = 0.05%). Tremor in embouchure dystonia was 5 to 8 Hz, intermittent, and variable in amplitude. Rhythmic variability did not differ between groups. Participants with embouchure dystonia had different patterns of impairment across variables. Composite severity scores strongly predicted clinical global impression of severity (R2= 0.95).Conclusions:Acoustic variables distinguish musicians with embouchure dystonia from controls and reflect different types of symptomatic impairments. Our composite acoustic severity score predicts severity of clinical global impression for musicians with different patterns of symptomatic impairment and may provide a foundation for developing a clinical rating scale. © 2018 International Parkinson and Movement Disorder Society