Physiologic Correlates of Vocal Tremor affecting those with Essential Tremor

项目总结/摘要 特发性震颤是世界上最常见的运动障碍之一， 65岁或以上的人，约占美国人口的2.2%，即700万人。约 这些个体中的30%表现出由于原发性震颤（ET）或原发性声带震颤（EVT）引起的声带震颤， 大多数是女性。EVT显著影响生活质量，并不一致或 显著受益于目前用于治疗肢体药物或医疗管理方法 震颤EVT和ET患者对当前药物治疗的不同反应 没有发声震颤（EVT 0）的人强调了确定那些有发声震颤的人之间的不同特征的必要性。 EVT与EVT 0相比。EVT患者报告说，他们在说话时会更加努力， 在紧张的活动中引起焦虑或需要更多注意力和努力的声音震颤。到目前为止， EVT的特征主要在于声音调制的声学测量，导致有限的 理解言语结构对这种疾病的发作和进展的贡献。这是 与文献中描述的震颤率和程度的长期诊断特征相比， 影响手臂、手、头或腿的震颤，可用于区分神经学病因。 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 语音产生将使人们能够了解最佳的临床方法， 声带震颤此外，确定与发声震颤相关的显著生理特征可以 可能导致临床评价方法，使识别不同的神经源性原因， 发声震颤（例如基底神经节、小脑、锥体外系通路）。该项目的目标是 系统地评估和模拟震颤对呼吸、喉和 发音结构到发声震颤的声学模式。这项研究的结果将大大提高 我们关于EVT的生理基础及其与受损的 沟通功能。此外，结果将推进当前的临床评估和治疗方法 并使未来的调查独特的生理特征，在其他病因的发声震颤 (e.g.帕金森病，肌张力障碍），这将推动当前和未来的治疗方法。

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.