Sensory Interaction In Voice And Voice Disorders

声音和声音障碍中的感觉相互作用

• 批准号: 9115553
• 负责人: Michael J Hammer
• 金额: $ 38.09万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2020-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9115553
• 关键词: Accounting; Acoustics; Air; Auditory; Behavioral; Botulinum Toxins; Breathing; Caring; Clinical; Clinical Data; Data; Exhibits; Functional disorder; Future; Goals; Health; Hearing; Individual; Intervention; Knowledge; Laboratories; Laryngeal Mucosa; Larynx; Measures; Mechanoreceptors; Medical; Modality; Modeling; Monitor; Movement; Nature; Needs Assessment; Neural Pathways; Neurology; Parkinson Disease; Participant; Physiologic pulse; Positioning Attribute; Production; Research; Sensory; Severities; Signal Transduction; Spastic Dysphonias; Staging; Stimulus; Techniques; Testing; Translations; Voice; Voice Disorders; Voice Disturbances; Work; auditory feedback; base; clinical care; improved; innovation; insight; pressure; respiratory; response; sensorimotor system; sensory input; sensory mechanism; treatment response; voice therapy

 DESCRIPTION (provided by applicant): Recent models of the vocal sensorimotor system suggest that mechanosensory and auditory input interact to monitor voice production. Initiation of the respiratory, laryngeal, and supralaryngeal movements for voice occur prior to an audible acoustic signal. Consequently, auditory feedback alone is insufficient to guide these movements. Evidence suggests that mechanoreceptors within the laryngeal mucosa may provide perceptual and proprioceptive afference that allow interaction with auditory feedback for voice control. However, the nature of laryngeal mechanosensory monitoring and its interaction with auditory feedback are poorly understood. The distinct voice disorders commonly observed in Adductor Spasmodic Dysphonia (ADSD) and Parkinson's Disease (PD) may each be uniquely associated with abnormal mechanosensory and auditory monitoring of voice production. This view is reinforced by current approaches to voice therapy that emphasize the importance of sensory monitoring and by recent evidence of sensory responses to botulinum toxin. However, the distinct sensory mechanisms associated with each of these voice disorders and how these mechanisms may respond to intervention remain largely unexplored. We will combine mechanosensory and auditory techniques developed in our laboratories to directly assess the mechanosensory and auditory mechanisms of the vocal sensorimotor system and the interaction between these sensory modalities in healthy participants and clinical participants with ADSD and PD. We have two specific aims: (1) To determine if mechanosensory monitoring is modulated during voice production and how it interacts with auditory feedback - to expand our understanding of the vocal sensorimotor system; (2) To define the association between voice-related sensory monitoring with voice severity and voice improvement in ADSD and PD. Based on our preliminary data, we hypothesize that mechanosensory monitoring is modulated during healthy voice production and interacts with auditory feedback to maintain voice in the presence of laryngeal sensory input. Based on our preliminary clinical data, we hypothesize that abnormal sensory monitoring is uniquely associated with voice disturbances in ADSD and PD and that each will improve with intervention. We have developed a sensorimotor assessment battery to define the sensory pathophysiology of ADSD and of PD. Our assessments will be immediately applied in the clinical setting to gauge severity and treatment response. Therefore, the scientific impact and clinical translation of this programmatic research is immediate. Our collaborative team is in a unique position to integrate mechanosensory and auditory assessment techniques. Our approach will substantially expand basic knowledge about the vocal sensorimotor system and will offer powerful insights into the distinct sensory mechanisms of ADSD and of PD. Therefore, our studies will have a high overall impact, setting the stage for future hypothesis-driven studies of the associated neural pathways and innovative sensory-based medical and behavioral approaches to voice care.

 描述（由申请人提供）：声音感觉运动系统的最新模型表明机械感觉和听觉输入相互作用以监测声音的产生。声音的呼吸、喉部和喉上运动的启动发生在可听见的声音信号之前。因此，仅听觉反馈不足以指导这些动作。有证据表明，喉粘膜内的机械感受器可以提供知觉和本体感觉传入，从而允许与声音控制的听觉反馈相互作用。然而，人们对喉部机械感觉监测的本质及其与听觉反馈的相互作用知之甚少。内收肌痉挛性发声障碍 (ADSD) 和帕金森病 (PD) 中常见的不同发声障碍可能都与发声的机械感觉和听觉监测异常相关。当前强调感觉监测重要性的声音治疗方法以及最近对肉毒杆菌毒素的感觉反应的证据强化了这一观点。然而，与这些声音障碍相关的不同感觉机制以及这些机制如何对干预做出反应在很大程度上仍未被探索。我们将结合实验室开发的机械感觉和听觉技术，直接评估声音感觉运动系统的机械感觉和听觉机制，以及健康参与者和患有 ADSD 和 PD 的临床参与者这些感觉方式之间的相互作用。我们有两个具体目标：（1）确定机械感觉监测在发声过程中是否受到调节以及它如何与听觉反馈相互作用 - 扩大我们对声音感觉运动系统的理解； (2) 定义 ADSD 和 PD 中语音相关感官监测与语音严重程度和语音改善之间的关联。根据我们的初步数据，我们假设机械感觉监测在健康发声过程中受到调节，并与听觉反馈相互作用，以在存在喉部感觉输入的情况下保持声音。根据我们的初步临床数据，我们假设异常的感觉监测与 ADSD 和 PD 中的声音障碍具有独特的相关性，并且每种情况都会通过干预得到改善。我们开发了一套感觉运动评估系统来定义 ADSD 和 PD 的感觉病理生理学。我们的评估将立即应用于临床环境，以衡量严重程度和治疗反应。因此，这项纲领性研究的科学影响和临床转化是立竿见影的。我们的协作团队在整合机械感觉和听觉评估技术方面处于独特的地位。我们的方法将大大扩展有关声音感觉运动系统的基础知识，并将为 ADSD 和 PD 的独特感觉机制提供有力的见解。因此，我们的研究将产生很大的总体影响，为未来相关神经通路的假设驱动研究以及基于感觉的创新医学和行为声音护理方法奠定基础。