Validation of an automated acoustic outcome measure for AdLD

项目摘要 喉肌张力障碍(LD)是一种神经性发声障碍，其特征是喉部不由自主的痉挛 发声时的肌肉，这对心理社会健康和生活质量有很大影响。最多的 LD的常见亚型是内收肌张力障碍(AdLD)，它涉及喉部肌肉的痉挛 这会累及声带，导致声带不连续。语言不连续是对演讲的干扰 由痉挛引起的声音信号，包括发音中断(声音中断)和频率变化(音调 间歇)，在发出浊音时最为严重。治疗ADLD的一个重要问题是经常发生 误诊。ADLD经常被误认为肌肉紧张性发音障碍(MTD)，这是一种功能性语音障碍，具有 全喉张力增加，但没有喉部痉挛。ADLD的临床结果衡量标准是非 特异性ADLD的主要体征和/或临床上不可行。最近，一种新的自动化声学测量， 基于高通基频等值线(SAHfo)的频谱聚集，设计了 对特定于ADLD的LD中断敏感。然而，在该措施可以在临床上实施之前，它 对于评估SAHfo是否与AdLD：内收的核心征兆的变化有关并对其敏感 喉部痉挛和由此产生的非典型发声事件。这项提案的目标是调查SAHfo 作为ADLD的一种临床上可行的结果衡量标准。我们将记录高速视频内窥镜检查和 30例成人多动症患者最有症状时的言语声学研究在目标1中，我们将 确定SAHfo是否反映了ADLD的主要迹象，将SAHfo(自动计算)与 LD不连续数(根据声学信号手动计算)和喉部数 痉挛(在高速视频内窥镜检查期间计算)。这一目标的结果将提供基本的证据 SAHfo作为ADLD结果测量的同时效度。在目标2中，我们将录制来自 30例MTD患者评估SAHfo的判别效度，并将其在说话者中的值与 ADLD和带MTD的扬声器。临床上可行的、客观的ADLD主要体征的测量方法是 对ADLD患者具有变革性，导致更早的诊断和成功评估新的 治疗。通过这项工作，申请人将建立在她以前的研究经验的基础上，感知和 通过培训先进的声学和高速视频内窥镜方法进行空气动力学测量。这个 培训将在波士顿大学进行，由她的赞助商斯特普博士和根瑟博士提供支持。这个 培训计划将包括在MatLab中的正式课程和语音的神经控制。这项研究将提供 这位有前途的调查员在客观测量的心理测量分析方面具有经验和专业知识，如 她开始了成功的职业生涯，成为一名独立的临床医生兼嗓音障碍科学家。

Project Summary Laryngeal dystonia (LD) is a neurological voice disorder characterized by involuntary spasms of the laryngeal muscles during phonation, which significantly impacts psychosocial well-being and quality of life. The most common subtype of LD is adductor laryngeal dystonia (AdLD), which involves spasms of the laryngeal muscles that adduct the vocal folds, resulting in LD discontinuities. LD discontinuities are disruptions to the speech acoustic signal caused by the spasms and include phonatory breaks (voice breaks) and frequency shifts (pitch breaks) that are most severe during production of voiced sounds. A significant issue in treating AdLD is frequent misdiagnosis. AdLD is often mistaken for muscle tension dysphonia (MTD), a functional voice disorder with increased global laryngeal tension, but without laryngeal spasms. Clinical outcome measures for AdLD are non- specific to the primary signs of AdLD and/or clinically unfeasible . Recently, a new automated acoustic measure, based on spectral aggregate of the high-passed fundamental frequency contour (SAHfo) was designed to be sensitive to LD discontinuities specific to AdLD. However, before the measure can be implemented clinically, it is essential to assess whether SAHfo is related to and sensitive to changes in the core signs of AdLD: adductory laryngeal spasms and the resulting atypical phonatory events. The goal of this proposal is to investigate SAHfo as a clinically feasible outcome measure specific to AdLD. We will record high-speed videoendoscopy and speech acoustics of 30 adults with AdLD while they are in their most symptomatic state. In Aim 1, we will determine whether SAHfo reflects the primary signs of AdLD, comparing SAHfo (calculated automatically) to the number of LD discontinuities (calculated manually from the acoustic signal) and to the number of laryngeal spasms (computed during high-speed videoendoscopy). Results of this aim will provide essential evidence of concurrent validity of SAHfo as an outcome measure in AdLD. In Aim 2, we will record speech acoustics from 30 individuals with MTD to evaluate the discriminant validity of SAHfo, comparing its values in speakers with AdLD and speakers with MTD. A clinically feasible, objective measure of the primary signs of AdLD would be transformative for patients with AdLD, leading to earlier diagnoses and a path to successful evaluation of new treatments. Through this work, the applicant will build on her previous research experience with perceptual and aerodynamic measures by training in advanced acoustics and high-speed videoendoscopic methods. The training will take place at Boston University, with support from her sponsors: Dr. Stepp and Dr. Guenther. The training plan will include formal coursework in MATLAB and neural control of speech. This research will provide this promising investigator with the experience and expertise in psychometric analysis of objective measures as she embarks on a successful career as an independent clinician-scientist in voice disorders.