Physiologic Correlates of Vocal Tremor affecting those with Essential Tremor

声音震颤影响特发性震颤患者的生理相关性

• 批准号: 10331728
• 负责人: Julie M Barkmeier-Kraemer
• 金额: $ 60.66万
• 依托单位: UNIVERSITY OF UTAH
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-12 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10331728
• 关键词: Abdomen; Acoustics; Affect; Age; Age-Years; Anxiety; Articulators; Basal Ganglia; Caliber; Characteristics; Clinical; Clinical Treatment; Communication; Communication impairment; Complex; Computer Models; Deep Brain Stimulation; Diagnosis; Diagnostic; Disease; Dystonia; Essential Tremor; Etiology; Exhibits; Female; Frequencies; Future; Gender; Goals; Hand; Head; Image; Impairment; Individual; Investigation; Knowledge; Laryngeal muscle structure; Larynx; Lead; Leg; Length; Limb Tremors; Limb structure; Link; Literature; Magnetic Resonance Imaging; Matched Case-Control Study; Measures; Medical; Methods; Modeling; Movement; Movement Disorders; Neurologic; Outcome; Outcomes Research; Output; Parkinson Disease; Participant; Pathway interactions; Patient Simulation; Pattern; Persons; Pharmaceutical Preparations; Phonation; Physiological; Population; Production; Public Health; Quality of life; Reporting; Research; Respiratory System; Signal Transduction; Source; Speech; Structure; Surface; Testing; Time; Tongue; Transducers; Tremor; Voice; Work; abdominal wall; arm; base; design; illness length; improved; insight; kinematics; lung pressure; neurophysiology; pressure; research clinical testing; respiratory; response; rib bone structure; sound; tongue root; vocal cord

PROJECT SUMMARY / ABSTRACT Essential tremor is one of the most common movement disorders in the world affecting approximately 4.6% of those 65 years of age or older and approximately 2.2% of the US population, or 7 million people. Approximately 30% of these individuals exhibit a vocal tremor due to essential tremor (ET), or Essential Vocal Tremor (EVT), with the majority being female. EVT significantly impacts quality of life and does not consistently or significantly benefit from medications or medical management approaches that are currently used to treat limb tremor. The differing response to current medical treatments between those with EVT and those with ET without vocal tremor (EVT0) highlights the need for determining differing characteristics between those with EVT compared to EVT0. Individuals with EVT report increased effort during speaking and worsening of their vocal tremor during stressful activities that promote anxiety or require more concentration and effort. To date, EVT has been characterized primarily by acoustic measures of voice modulation resulting in limited understanding regarding speech structure contributions to the onset and progression of this disorder. This is in contrast to longstanding diagnostic characteristics of tremor rate and extent described in the literature for tremor affecting the arms, hands, head, or legs that can be used to distinguish between neurologic etiologies. Insight into the physiologic underpinnings of speech structures affected by tremor and their links to impaired speech production would enable insights regarding optimal clinical approaches for evaluating and managing vocal tremor. Further, determining salient physiologic characteristics associated with vocal tremor could potentially lead to clinical evaluation approaches that enable identification of the different neurogenic causes of vocal tremor (e.g. basal ganglia, cerebellar, extrapyramidal pathways). The goal of this project is to systematically evaluate and model the contribution of tremor affecting the respiratory, laryngeal, and articulatory structures to vocal tremor acoustic patterns. Outcomes of this research will significantly advance our scientific knowledge regarding the physiologic underpinnings of EVT and its correspondence to impaired communication function. Further, outcomes will advance current clinical evaluation and treatment methods and enable future investigation of unique physiologic characteristics across other etiologies of vocal tremor (e.g. Parkinson Disease, Dystonia) that will advance current and future treatment approaches.

项目摘要/摘要 特发性震颤是世界上最常见的运动障碍之一，影响约4.6%的 那些65岁或以上的人和大约2.2%的美国人口，即700万人。大致 这些人中有30%的人因特发性震颤(ET)或特发性声带震颤(EVT)而出现发声颤动， 其中大多数是女性。事件会显著影响生活质量，并且不会持续或 显著受益于目前用于治疗肢体的药物或医疗管理方法 震颤。EVT和ET患者对现有药物治疗的不同反应 无声带震颤(EVT0)突出了确定有声带震颤的患者之间不同特征的必要性 EVT与EVT0的比较。患有室上性心动过速的人报告说，他们在说话时付出了更多的努力，并且他们的 在紧张的活动中发声颤抖，这种活动会引起焦虑或需要更多的注意力和精力。到目前为止， EVT的主要特征是声音调制的声学测量导致有限的 对言语结构的理解有助于这种疾病的发生和发展。这是在 与文献中描述的震颤速度和程度的长期诊断特征形成对比 震颤影响手臂、手、头或腿的震颤，可用来区分神经病因。 洞察受震颤影响的言语结构的生理基础及其与受损的联系 语音生成将使人们能够深入了解评估和管理的最佳临床方法 嗓音震颤。此外，确定与声带震颤相关的显著生理特征可以 可能导致临床评估方法，使识别不同的神经原性原因 声带震颤(例如，基底节、小脑、锥体外通路)。这个项目的目标是 系统地评估和模拟震颤对呼吸、喉咙和 从发音结构到发声震颤的声学模式。这项研究的成果将极大地推动 我们对EVT的生理基础及其与受损的对应关系的科学知识 通信功能。此外，结果将促进当前的临床评估和治疗方法。 并使未来能够跨声带震颤的其他病因研究独特的生理特征 (例如帕金森病、肌萎缩症)，这将推动当前和未来的治疗方法。