NEUROPHYSIOLOGICAL BASES OF PHONATORY PATHOLOGY

目的是确定发声的神经生理学基础。 控制嗓音障碍。主要的重点是痉挛 发音困难，一种特发性喉局灶性肌张力障碍。在上一次 痉挛性发音障碍患者发声过程中呼吸控制的研究 第二项研究考察了呼吸控制是否也受到影响 耳语，一项非发音的言语任务。无论是发声还是窃窃私语， 患者的呼吸速度较慢，不协调，呼吸运动异常。 与正常情况相比。这些结果表明这是一台马达 控制障碍通常涉及喉部以外的其他部位，以及 不是任务特定的。内源性的神经生理学研究 喉部肌肉在静息状态下(在 呼吸)和痉挛性发音困难的发声。在正常情况下 对照组，安定降低了两次呼吸时喉部肌肉的张力 和发声。在患者身上没有发现任何效果。试验性的 患者暂时的神经阻滞改变了肌肉的激活水平 喉部的另一侧，表明肌梭反馈是 在这种疾病的病理生理学中很重要。数量和 已经制定了客观的程序来评估治疗 这种紊乱。患者随着时间的推移高度多变，并具有多发性 基准措施是必需的。

The purpose is to determine the neurophysiological bases of phonatory control in voice disorders. The primary emphasis has been on spasmodic dysphonia, an idiopathic laryngeal focal dystonia. Following a previous study of respiratory control during phonation in spasmodic dysphonia, a second study examined whether respiratory control was also affected during whisper, a nonphonatory speech task. Both in phonation and whisper, patients were slower, uncoordinated, and had abnormal respiratory movements in comparison with normal. These results suggest that this is a motor control disorder often involving other areas in addition to the larynx, and is not task specific. Neurophysiological studies of the intrinsic laryngeal muscles demonstrated increased tone both at rest (during respiration) and on phonation in spasmodic dysphonia. In the normal controls, diazepam reduced tone in laryngeal muscles in both respiration and phonation. No effects were found in the patients. An experimental temporary nerve block in patients altered the muscle activation levels on the opposite side of the larynx, suggesting that muscle spindle feedback is important in the pathophysiology of this disorder. Quantitative and objective procedures have been developed for evaluating treatments with this disorder. Patients are highly variable over time and multiple baseline measures are required.