Auditory-Motor Control of Voice in Individuals with Essential Vocal Tremor

项目摘要 特发性震颤（ET）是最常见的运动障碍，几乎每100人中就有一人受到影响 国际吧高达62%的ET患者会出现发声震颤（VT），这是一种运动过度的神经系统疾病。 言语障碍VT的特征在于调制的频率（音高）和振幅（响度）的， 这会导致声音“颤抖”，并在讲话过程中增加努力。神经性 像VT这样的言语障碍对交流、专业生产力和生活质量是有害的。 不幸的是，目前VT的医疗管理方法对声音的影响不一致 生产，往往造成不良影响。此外，支持以下益处的证据有限 VT的行为管理管理VT的挑战源于缺乏对 潜在的感觉运动缺陷 以往对声音的典型感觉运动控制的研究表明，健康的说话者使用 听觉反馈，用于立即纠正音调错误和防止将来的错误。基于 向关节速度（DIVA）模型的方向，这是一个计算模型， 紊乱的言语运动控制，反馈和前馈机制的神经网络驱动听觉- 运动反应，并确保预期语音输出和实际语音输出之间的任何不匹配， 更正。当VT患者试图产生稳定的音高时，他们的声音输出的特征是： 4-8基频和振幅的Hz非自主调制。目前尚不清楚， 反馈和/或前馈系统试图校正这些调制并稳定语音输出， 或者这些系统是否存在进一步促成调制输出的功能障碍。 因此，本研究旨在探讨听觉反馈如何影响VT患者的音高控制 与健康的演讲者相比。本研究的结果可能会提高对感觉运动的理解 控制室性心动过速，并指导开发基于感觉运动的治疗方法。此外，这将 是前馈和反馈控制电机控制的当前模型的新应用，其可以 帮助完善这些计算模型并激励未来的研究。

Project Summary Essential tremor (ET) is the most prevalent movement disorder affecting nearly one in every 100 people worldwide. Up to sixty-two percent of individuals with ET develop vocal tremor (VT), a hyperkinetic neurological speech disorder. VT is characterized by modulation of the frequency (pitch) and amplitude (loudness) of the voice, which results in a ‘shaky’ sounding voice and increased effort during speech production. Neurogenic speech disorders like VT are detrimental to communication, professional productivity, and quality of life. Unfortunately, the current approaches for medical management of VT have inconsistent effects on voice production and often cause adverse effects. Furthermore, there is limited evidence supporting the benefit of behavioral management for VT. The challenges in managing VT stem from a lack of understanding of the underlying sensorimotor deficits in this population. Previous research on typical sensorimotor control of voice demonstrated that healthy speakers use auditory feedback for immediate correction of pitch errors and prevention of future errors. Based on the Directions into the Velocities of Articulators (DIVA) model, a computational model accounting for normal and disordered speech motor control, a neural network of feedback and feedforward mechanisms drive auditory- motor responses and ensure that any mismatch between the intended voice output and actual voice output is corrected. When individuals with VT attempt to produce a steady pitch, their voice output is characterized by a 4-8 Hz involuntary modulation of the fundamental frequency and amplitude. It is unknown whether the feedback and/or feedforward systems attempt to correct for these modulations and stabilize the voice output, or if there is dysfunction of these systems that further contributes to the modulated output. Thus, this study aims to investigate how auditory feedback influences pitch control in individuals with VT compared with healthy speakers. The findings of this study may improve the understanding of sensorimotor control in VT and guide development of sensorimotor-based treatments for the disorder. Additionally, this will be a novel application of the current models of feedforward and feedback auditory-motor control, which may help refine these computational models and motivate future research.