Task specificity in adductor spasmodic dysphonia versus muscle tension dysphonia
Task specificity in adductor spasmodic dysphonia versus muscle tension dysphonia
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DOI：
10.1097/01.mlg.0000154739.48314.ee
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发表时间：
2005-02-01
期刊：
影响因子：
2.6
通讯作者：
Smith, ME
中科院分区：
文献类型：
--
作者：
Roy, N;Gouse, M;Smith, ME
目的：内收肌痉挛性发声障碍（ADSD）被认为是一种“任务特异性”喉张力障碍，这意味着发声障碍的严重程度取决于发声任务的要求。与持续元音相比，在连音中产生的声音据说会引起更频繁和严重的喉部痉挛。本研究检验了“任务特异性”作为ADSD标志物的诊断价值，以及区分ADSD与肌张力性发声障碍（MTD）的潜力。MTD是一种功能性语音障碍，通常可以伪装成ADSD。研究设计：病例对照研究。方法：五名不知道研究目的的听众，使用一个10厘米的视觉模拟量表来评估患有ADSD （n = 36）和MTD （n = 45）的受试者的语音障碍严重程度，这些受试者要么发出连音，要么发出持续元音“ah”。结果。在ADSD中，连续发声障碍的严重程度（M = 6.22 cm, SD = 2.56）明显高于持续发元音的严重程度（M = 4.8 cm, SD = 2.8 [t (35) = 3.67, P < 0.01]）。然而，在MTD中，连接语音样本的严重程度没有显著差异（M = 5.98 cm, SD = 2.83与持续元音M = 5.86 cm, SD = 2.87 [t (44) = 0.378, P = .707]）。受试者工作特征（ROC）曲线（任务特异性作为诊断指标的准确性指标）显示，1 cm差异标准正确识别了53%的ADSD病例（敏感性）和76%的MTD病例（特异性）(x（2) (1) = 6.88, P = 0.0087）。结论：持续元音发音障碍严重程度的降低支持ADSD的任务特异性，但不支持MTD，并强调了一个有价值的诊断标记，其识别应有助于提高诊断准确性。
Objectives: Adductor spasmodic dysphonia (ADSD) has been characterized as a "task specific" laryngeal dystonia, meaning that the severity of dysphonia varies depending on the demands of the vocal task. Voice produced in connected speech as compared with sustained vowels is said to provoke more frequent and severe laryngeal spasms. This study examined the diagnostic value of "task specificity" as a marker of ADSD and its potential to differentiate ADSD from muscle tension dysphonia (MTD), a functional voice disorder that can often masquerade as ADSD. Study Design: Case-control study. Methods: Five listeners, blinded to the purpose of the study, used a 10 cm visual analogue scale to rate dysphonia severity of subjects with ADSD (n = 36) and MTD (n = 45) producing either connected speech or a sustained vowel "ah." Results. In ADSD, dysphonia severity for connected speech (M = 6.22 cm, SD = 2.56) was rated significantly more severe than sustained vowel productions (M = 4.8 cm, SD = 2.8 [t (35) = 3.67, P < .01]). In MTD, however, no significant difference in severity was observed for the connected speech sample (M = 5.98 cm, SD = 2.83 versus the sustained vowel M = 5.86 cm, SD = 2.87 [t (44) = 0.378, P = .707]). The receiver operating characteristic (ROC) curve, an index of the accuracy of task specificity as a diagnostic marker, revealed that a 1 cm difference criterion correctly identified 53% of ADSD cases (sensitivity) and 76% of MTD cases (specificity) (x(2) (1) = 6.88, P = .0087). Conclusions: Reduced dysphonia severity during sustained vowels supports task specificity in ADSD but not MTD and highlights a valuable diagnostic marker whose recognition should contribute to improved diagnostic precision.