Biophysiological Mechanisms of 'Heightened Speech'

描述（由申请人提供）：广泛的目标是研究“大声”或“提高”讲话的生物力学，并研究如何在有声音创伤的个人中安全地训练，这些人需要它来工作大声讲话传统上被视为对声乐健康的诅咒。在本申请中，我们持有相反的观点，即专门的大声训练方法不仅可以防止损伤;某些方法实际上可能在治疗急性和慢性损伤方面具有治疗价值。在这些研究中，我们关注的是教师，他们代表了美国最常见的职业。教师的经验接近流行病比例的声音问题，可追溯的长期，大声讲话的工作。这些问题的功能后果包括减少和损失的工作，并减少学生的认知功能。在美国，每年的社会成本似乎在数十亿美元的范围内。因此，在这一人群中进行一项安全的、甚至是治疗性的大声讲话的研究是至关重要的，也是及时的。我们开始我们的研究，通过调查生物力学因素，影响声乐响度操作的辐射语音输出功率。具体目标#1通过测量辐射输出功率的变化作为喉上皮-声门横截面积比的函数，评估最近的大声讲话产生的非线性模拟模型是否适用于人类受试者。我们使用单次激发快速自旋回波（SSFSE）磁共振成像（MRI）。我们希望复制理论研究结果，即阻抗匹配的发声条件-特别是那些涉及中性的喉后和声门区发现的“共鸣的声音”-将最大限度地提高输出功率，而在同一时间限制损害声带冲击应力。具体目标#2评估了“共振声音”练习对急性声音创伤逆转的效用。主要因变量是来自喉表面分泌物的炎性标志物的浓度，其次是空气动力学和感知测量。最后，具体目标#3使用随机前瞻性临床试验，检查了“共振声音”训练对慢性语音创伤教师的影响。我们将提供一个标准化的共振语音治疗计划和控制治疗的教师与语音创伤。主要的因变量是与声音有关的生活质量，用声音障碍指数来衡量。次要变量是空气动力学、喉部和声音质量测量。

DESCRIPTION (provided by applicant): The broad objectives are to study the biomechanics of "loud" or "heightened" speech, and to study how it can be safely trained in individuals with phonotrauma, who need it for their work Loud speech traditionally has been viewed as an anathema for vocal health. In this application we hold an opposing view that specialized approaches to loud voice training not only may prevent injury; some approaches actually may have therapeutic value in the treatment of both acute and chronic injury. In these studies, we focus on teachers, who represent the most common occupation in the United States. Teachers experience near epidemic proportions of voice problems, traceable prolonged, loud speech on the job. Functional consequences of such problems include reduction and loss of work, and reduced cognitive functioning for students. Societal costs appear to range in the billions of dollars annually in the U.S. Thus, a study of safe--and even therapeutic loud speech in this population is both critical and timely. We initiate our studies by investigating biomechanical factors that influence vocal loudness operationalized as radiated voice output power. Specific Aim #1 assesses whether recent, non-linear simulation models of loud speech production apply to human subjects, by measuring variations in radiated output power as a function of epilaryngeal-to-glottal cross-sectional area ratios. We use Single-Shot Fast Spin Echo (SSFSE) Magnetic Resonance Imaging (MRI). We expect to replicate theoretical findings that impedance-matched vocalization conditions--in particular those involving neutral epilaryngeal and glottal areas found with "resonant voice"--will maximize output power, while at the same time limiting damaging vocal fold impact stress. Specific Aim #2 assesses the utility of "resonant voice" exercises for the reversal of acute phonotrauma. The primary dependent variable is concentration of inflammatory markers from laryngeal surface secretions, and secondarily, aerodynamic and perceptual measures. Finally, Specific Aim #3 examines the effect of "resonant voice" training for teachers with chronic phonotrauma, using a randomized, prospective clinical trial. We will deliver a standardized resonant voice therapy program and a control treatment to teachers with phonotrauma. The primary dependent variable is quality of life in relation to voice, measured with the Voice Handicap Index. Secondary variables are aerodynamic, laryngeal, and vocal quality measures.