Clinical Research Center for the Improved Prevention, Diagnosis, and Treatment of Vocal Hyperfunction

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Project Summary/Abstract Vocal hyperfunction (VH) is associated with the most frequently occurring types of voice disorders. These include benign vocal folds lesions (e.g., nodules and polyps) and dysphonia that occurs in the absence of concurrent pathology (e.g., muscle tension dysphonia). Effective prevention and clinical management of these disorders continue to be hampered by limited knowledge of the etiological and pathophysiological mechanisms that underlie specific voice disorders within the broad range of those associated with VH. To address this need, this Clinical Research Center brings together a multidisciplinary team of experienced investigators to pursue a comprehensive program of research focused on hyperfunctional voice disorders. The central theme of the Center is that the clinical management of hyperfunctional voice disorders can be significantly improved by attaining a better understanding of the etiology and pathophysiology of these disorders and then translating this knowledge into new, more effective methods for prevention, diagnosis, and treatment. A central premise of this work is that multiple factors contribute and interact in different ways to cause and maintain the various disorders linked to VH. The most important are associated with behavioral, sensorimotor, environmental, psychological/emotional, physiological, and biomechanical mechanisms. The interdisciplinary research program will focus on attaining a comprehensive understanding of the fundamental relationships between these factors and the different manifestations of VH. Research at the Center is guided and coordinated by a comprehensive theoretical framework for VH that clearly illustrates the key hypotheses that will be assessed in a coordinated effort overseen by an Administrative Core and carried out by the four Research Projects and Technology and Data Science Core. Projects will employ an innovative combination of laboratory studies of sensorimotor and physiological mechanisms; physical and computational modeling of biomechanical, aero- acoustic, and auditory-motor control mechanisms; and the use of improved ambulatory voice monitoring technology to investigate potential etiological and pathophysiological mechanisms of VH associated with daily voice use. A clinical trial will also assess the benefit of combining novel ambulatory biofeedback with evidence- based voice therapy to treat VH. A significant strength of the Center will be a centralized multidimensional database in the Technology and Data Science Core that receives comprehensive data from all of the projects for all enrolled patients and healthy controls, thus greatly facilitating the integration of results across the projects and magnifying the impact of the Center well beyond the sum of its parts. This program of research in hyperfunctional voice disorders is unprecedented in terms of its scope, integration of information across multiple domains, number of innovative concepts, and methods that are being simultaneously developed and tested. Achieving the goals of this research program will significantly improve the prevention and clinical management of these highly prevalent disorders.