Analogy between laryngeal gesture in Mongolian Long Song and supracricoid partial laryngectomy

This article reports the results of a multiparametrical analysis of Mongolian Long Song, characterised by multiple ornamentation and shows the similarities between the laryngeal behaviour observed during these ornamentations and the compensatory gesture produced by patients after supracricoid partial laryngectomy. This study includes (1) a physiological analysis of videofiberscopic laryngeal data from a healthy Mongolian singer and from three non-singer French-speaking clinical patients; and (2) an acoustical analysis (fundamental frequency and intensity). For the singer, the fiberoptic analysis showed two main laryngeal behaviours in producing ornamentations: (1) 'lyrical' vibratos mobilising the entire laryngeal block; (2) 'Mongolian' trills with essentially supraglottic movements, the arytenoids being mobilised independently of the rest of the laryngeal block. Patients demonstrated similar aryepiglottic trilling to fulfil a function of voicing. The acoustic analysis showed that the fundamental frequency and the intensity were in phase for vibrato, contrary to the 'Mongolian' trills which were in opposite phase, underlying a change of laryngeal vibratory mechanisms.     

The effect of levodopa on vocal function in Parkinson's disease

Phonatory and articulatory dysfunctions are frequent observations in Parkinson's disease. We have investigated, using acoustic measures, the effects of levodopa treatment on vocal function in 20 patients with Parkinson's disease before and after levodopa. These patients were also compared with a matched control group. The mean age was 63.5 +/- 9.66 years, Hoehn-Yahr stage was 2.38 +/- 0.45, and onset mean age was 56.5 +/- 10.36 years. Paired Wilcoxon tests were performed to compare measurements before and after levodopa. The acoustic analysis using Computerized Speech Lab and MultiDimensional Voice Program software programs (Kay Elemetrics, Lincoln Park, NJ, USA) showed that measurements of fundamental frequency (p < 0.017) were significantly increased after medication, whereas short-term frequency perturbation jitter (p < 0.033), soft phonation index (noise parameter) (p < 0.015 ), and frequency tremor intensity index (p < 0.018) were significantly decreased after medication. The objective measurements of acoustic analysis are useful in evaluating the dopaminergic pharmacologic response in Parkinson's disease. The improvement in fundamental frequency and other vocal parameters may be a result of decrease in laryngeal hypokinesia and rigidity.     

Acoustic voice analysis in untreated patients with Parkinson's disease

To quantify several acoustic features of the voice in patients with Parkinson's disease (PD) not treated with dopaminergic drugs, 22 PD patients and 28 age and sex-matched controls were studied. The Computerized Speech Lab 4300 program (Kay Elemetrics) was used. Two seconds of a sustained /a/ and a sentence were captured with a microphone and laryngograph equipment. Measures included fundamental frequency (F(0)), frequency perturbation (jitter), intensity perturbation (shimmer), and harmonic/noise ratio (HIN) of the vowel /a/, and frequency and intensity variability of a sentence, phonational range, dynamic range at the natural frequency, maximum phonational time and s z ratio. All subjects underwent indirect laryngoscopy and/or laryngeal fibroscopy. When compared to controls, PD patients showed higher jitter and shimmer, lower H N ratio, and lower frequency variability of the sentence in the microphonic signal and reported a higher frequency of presence of low voice intensity, monopitch, harshness, voice arrests, and tremor.     

Impaired laryngeal voice production in a patient with foreign accent syndrome

We report a Japanese-speaking monolingual woman who developed foreign accent syndrome (FAS) following an infarction in the precentral and premotor cortices (Brodmann Area 6) at and around the inferior frontal sulcus. Her speech sounded Chinese or Korean to our bilingual coauthor who speaks Chinese and Japanese. Quantitative acoustic analyses of words and sentences showed that pitch (fundamental frequency variation) and intensity variances appeared lowered and fully voiced glottal pulses were reduced. These findings suggest laryngeal dysfunction that contributes to the unusual speech production in a case of FAS. This may be caused by damage to a restricted area of the motor and premotor cortices that controls laryngeal function.     

Tap and trill clusters in typical and protracted phonological development: Challenging segments in complex phonological environments. Introduction to the special issue

ABSTRACT

The papers in this crosslinguistic issue address children’s acquisition of word-initial rhotic clusters in languages with taps/trills, that is, the acquisition of challenging segments in complex environments. Several papers also include comparisons with singleton rhotics and/or /l/ as a singleton or in clusters. The studies are part of a larger investigation that uses similar methodologies across languages in order to enhance crosslinguistic comparability (Bernhardt and Stemberger, 2012, 2015). Participants for the current studies were monolingual preschoolers with typical or protracted phonological development who speak one of the following languages: Germanic (Icelandic/Swedish); Romance (Portuguese/Spanish); Slavic (Bulgarian/Slovenian) and Finno-Ugric (Hungarian). This introductory paper describes characteristics of taps/trills and general methodology across the studies, concluding with predicted patterns of acquisition. The seven papers that follow are in a sense the ‘results’ for this introduction. A concluding paper discusses major findings and their implications for theory, research and clinical practice.     

The effect of esomeprazole 20 mg twice daily on acoustic and perception parameters of the voice in laryngopharyngeal reflux

Background Randomized, placebo‐controlled studies have failed to demonstrate a significant treatment effect for laryngopharyngeal reflux (LPR) using traditional clinical endpoints. We compared the effect of esomeprazole 20 mg twice daily (b.i.d.) vs placebo on voice and acoustic‐related measures in patients with LPR. Methods Patients with LPR underwent endoscopy and pH testing. Subsequently, patients underwent videostroboscopic recordings of the larynx, acoustic voice and speech analysis. A voice use and quality diary and oesophageal symptom diary were completed at baseline. Thereafter, patients were randomized to esomeprazole 20 mg twice daily vs placebo for 3 months. The voice use and quality diary and oesophageal symptom dairy were repeated during the last week of treatment. Videostroboscopy and acoustic voice and speech analysis were also performed at the end of treatment. Key Results Twenty‐four patients were randomized to the esomeprazole group and 17 to the placebo group. There was no significant difference in videostroboscopic reflux finding scores from baseline to post‐treatment. Acoustic measures also failed to demonstrate significant differences within the same or between groups, even when a sub‐group analysis of patients with endoscopically documented oesophageal inflammation at baseline was performed. Additionally, no significant differences were found between groups when using voice use and quality diary. Conclusions & Inferences Use of more specific laryngeal functional parameters such as voice‐related acoustic measures of pitch range, fundamental frequency and intensity also failed to demonstrate a significant response to proton pump inhibitor treatment as compared to placebo in patients with suspected LPR.     

The Marke-Nyman Temperament (MNT) Scale in suicide attempters

A total of 89 suicide attempters were diagnosed according to the DSM-III-R, and categorized according to suicide method as ‘violent’ and ‘non-violent’ attempters, and also as those who had made previous suicide attempts (‘repeaters’) and those who had not (‘non-repeaters’). All of the subjects completed the MNT questionnaire. Our hypothesis was that the temperament patterns would reflect specific clinical characteristics, such as psychiatric diagnoses and type of suicidal behaviour. The ‘validity’ (ranging from fatiguableness to a high level of psychic energy) showed a bimodal distribution, suggesting the existence of two subgroups. The subjects with adjustment disorders displayed a significantly higher mean validity than the other patients. The lowest validity scores were found in subjects with bipolar depression. Men showed significantly higher 'stability’ (reflecting emotional distance from others) than women. Subjects with major depression and those who were ‘violent’ suicide attempters showed somewhat higher 'solidity’ (unchangeability, non-impulsiveness) compared with the other groups. Female ‘non-repeaters’ displayed significantly lower solidity than males or other females. In general, no clear temperament patterns were detected in patients categorized according to type of suicidal behaviour. In contrast to the findings of studies of normal populations, the intercorrelations between the dimensions were considerable, especially among the men. This prompted us to perform a cluster analysis procedure in which the subjects were allocated to five clusters according to the MNT dimensions. No distinct clinical characteristics appeared in these clusters, except in the cluster with the highest validity and the lowest stability, as 54% (P= 0.014) of the patients in this cluster had an adjustment disorder diagnosis. These temperament results reflect the clinical heterogeneity of patients who attempt suicide.     

Lexical stress contrast marking in fluent and non-fluent aphasia in Spanish: The relationship between acoustic cues and compensatory strategies

ABSTRACT

This study sought to investigate stress production in Spanish by patients with Broca’s (BA) and conduction aphasia (CA) as compared to controls. Our objectives were to assess whether: a) there were many abnormal acoustic correlates of stress as produced by patients, b) these abnormalities had a phonetic component and c) ability for articulatory compensation for stress marking was preserved. The results showed abnormal acoustic values in both BA and CA’s productions, affecting not only duration but also F0 and intensity cues, and an interaction effect of stress pattern and duration on intensity cubes in BA, but not in CA or controls. The results are interpreted as deriving from two different underlying phenomena: in BA, a compensatory use of intensity as a stress cue in order to avoid ‘equal stress’; in CA, related to either a ‘subtle phonetic deficit’ involving abnormal stress acoustic cue-processing or to ‘clear-speech’ effects.     

Voice abnormalities and their relation with motor dysfunction in Parkinson's disease

Objective – To evaluate changes in perceptual and several acoustic parameters of voice in patients with Parkinson’s disease (PD) and to find out any relation with these parameters and motor components of Unified Parkinson’s Disease Rating Scale (UPDRS) in this patient group. Materials and methods – Twenty patients with PD (12 male and 8 female) were given objective and subjective voice tests and results were compared with those of 20 age‐ and sex‐matched controls. Patient's perceptual voice analysis was assessed using GRBAS scale including Grade of Dysphonia, Roughness, Breathiness, Asthenia and Strain items. Measurements for objective voice analysis, acoustic assessment tests including frequency perturbation [jitter (jitt)%], intensity perturbation [shimmer (shim)%], noise to harmonic ratio (NHR), fundamental frequency (F0), variability of fundamental frequency (vF0), diadochokinetic rate (DDK) and maximum phonation time (MPT) were used. An assessment of disability caused by voice disorders was scored according to the Voice Handicap Index (VHI) by the patient. All subjects also underwent videolaryngostroboscopic (VLS) examination. Motor components of UPDRS and acoustic parameters of voice were investigated for any correlations. Results – Compared with controls, roughness (P = 0.15), breathiness (P = 0.004) and asthenia (P = 0.031) values of males and breathiness (P = 0.043) and asthenia (P = 0.023) values of females were higher in patients with PD. Mean VHI scores of patients with PD were higher for both male and female patients (P = 0.0001 for male, P = 0.002 for female). The mean values for MPT (P = 0.02) and DDK (P = 0.025) were shorter in patients with PD. Jitt%, shim% and mean F0 values were similar among the two groups. But mean vF0 values were significantly higher in male patients with PD (P = 0.05). On VLS examination, non‐closure glottic pattern was found to be more frequent in the PD group. Conclusion – Although it is well known that pathophysiological changes in PD affect the voice, the present study found only few significant correlations between motor component of UPDRS and voice parameters.     

Spectral envelope coding in cat primary auditory cortex: linear and non‐linear effects of stimulus characteristics

Electrophysiological studies in mammal primary auditory cortex have demonstrated neuronal tuning and cortical spatial organization based upon spectral and temporal qualities of the stimulus including: its frequency, intensity, amplitude modulation and frequency modulation. Although communication and other behaviourally relevant sounds are usually complex, most response characterizations have used tonal stimuli. To better understand the mechanisms necessary to process complex sounds, we investigated neuronal responses to a specific class of broadband stimuli, auditory gratings or ripple stimuli, and compared the responses with single tone responses. Ripple stimuli consisted of 150–200 frequency components with the intensity of each component adjusted such that the envelope of the frequency spectrum is sinusoidal. It has been demonstrated that neurons are tuned to specific characteristics of those ripple stimulus including the intensity, the spacing of the peaks, and the location of the peaks and valleys (C. E. Schreiner and B. M. Calhoun, Auditory Neurosci. 1994; 1 : 39–61). Although previous results showed that neuronal response strength varied with the intensity and the fundamental frequency of the stimulus, it is shown here that the relative response to different ripple spacings remains essentially constant with changes in the intensity and the fundamental frequency. These findings support a close relationship between pure-tone receptive fields and ripple transfer functions. However, variations of other stimulus characteristics, such as spectral modulation depth, result in non-linear alterations in the ripple transformation. The processing between the basilar membrane and the primary auditory cortex of broadband stimuli appears generally to be non-linear, although specific stimulus qualities, including the phase of the spectral envelope, are processed in a nearly linear manner.     

Acoustic markers of syllabic stress in Spanish excellent oesophageal speakers

The purpose of this investigation is to explore the use by Spanish excellent oesophageal speakers of acoustic cues to mark syllabic stress. The speech material has consisted of five pairs of disyllabic words which only differed in stress position. Total 44 oesophageal and 9 laryngeal speakers were recorded and a computerised designed ad hoc perceptual test was run in order to assess the accurate realisation of stress. The items produced by eight excellent oesophageal speakers with highest accuracy levels in the perception experiment were analysed acoustically with Praat, to be compared with the laryngeal control group. Measures of duration, fundamental frequency, spectral balance and overall intensity were taken for each target vowel and syllable. Results revealed that Spanish excellent oesophageal speakers were able to retain appropriate acoustic relations between stressed and unstressed syllables. Although spectral balance revealed as a strong cue for syllabic stress in the two voicing modes, a different hierarchy of acoustic cues in each voicing mode was found.     

Prosodic changes in aphasic speech: timing

Controversy remains about the impairment of prosody in aphasia, particularly with regard to speech timing. This paper addresses this topic through an analysis of timing in four sets of a common morphological paradigm. The paradigm consisted of a basic form (stem) and two longer derived forms (e.g. zip, zipper, zippering). Normally, vowel durations are shorter in longer derived forms (e.g. zippering) than in the stem (e.g. zip), due to a process called ‘initial shortening’. Twelve patients with aphasia (four each Broca, Wernicke, and Anomic), and 11 age-matched healthy adults were assessed. Structural (CT) and functional brain imaging (PET) were available for all patients. While all groups showed initial shortening between the stem and the derived forms, the patients with Broca's aphasia presented an inverse pattern between the two derived forms (longer initial vowel in ‘zippering’ than ‘zipper’), and the patients with Wernicke's aphasia produced significantly longer vowel durations overall than the healthy participants. The results are related to radiological information regarding the location of structural and functional brain damage and relative preservation and loss of prosodic features in cerebral damage.     

Characteristics of slow and fast phases of the optocollic reflex (OCR) in head free pigeons (Columba livia): influence of flight behaviour

The effect of behavioural context on the properties of slow and fast phases of the horizontal optocollic reflex (OCR) were investigated in head free pigeons for two situations, i.e.: (i) animals were hung in a harness (‘resting condition’); (ii) animals were additionally submitted to a frontal airflow that provoked a flight posture (‘flying condition’) [ Bilo & Bilo (1983 ) J. Comp. Physiol., 153, 111]. A ‘transient flight’ was also provoked in the ‘resting condition’ by tapping the breastbone region. Stimuli consisted either of velocity steps (30–300 °/s) or of an increasing velocity stimulus (0–300 °/s). The amplitude of nystagmic beats and the OCR gain increased in the ‘flying condition’ and during ‘transient flight’ as compared to the ‘resting condition’. The OCR working range was considerably extended toward high velocities by the flying behaviour. In the ‘resting condition’, spontaneous head oscillations generally triggered a high-gain OCR, close to that obtained in the ‘flying condition’. One-third of the animals showed a higher gain in response to an increasing velocity stimulus than with step stimuli, in the high velocity range. The linear relation between amplitude and peak velocity of OCR fast phases was independent of the stimulation velocity in the ‘resting condition’, whereas the amplitude and peak velocity increased with the stimulation velocity in the ‘flying condition’. In this condition, the fast phase velocity was correlated with the slow phase velocity, but not with the retinal slip velocity. Thus, both the slow and fast phases of the OCR are dependent on the behavioural context.     

Early versus delayed initiation of entacapone in levodopa‐treated patients with Parkinson’s disease: a long‐term,retrospective analysis

Background: We analysed data from three clinical trials in Parkinson’s disease (PD) patients with wearing‐off to determine whether early enhancement of levodopa therapy with entacapone can lead to better long‐term outcomes than delayed entacapone treatment. Methods: Post‐hoc analysis of pooled data from three randomized, double‐blind, placebo‐controlled studies and their long‐term, open‐label extension phases. In all three studies, patients on levodopa/dopa‐decarboxylase inhibitor (DDCI) were first randomized to entacapone (‘early‐start’ group) or placebo (‘delayed‐start’ group) for the initial 6‐month double‐blind phase, after which all patients received open‐label levodopa/DDCI and entacapone treatment for up to 5 years. Results: A total of 488 PD patients with wearing‐off were included in the analysis. A statistically significant benefit of early initiation of levodopa/DDCI and entacapone was found, with an improvement in Unified Parkinson’s Disease Rating Scale Part III (motor) score of ?1.66 (95% confidence intervals [?3.01, ?0.31]) points compared with the delayed‐start treatment group (P < 0.05). Levodopa/DDCI and entacapone therapy was well tolerated. There was no excess of dyskinesia in the early‐start group. Conclusions: These data suggest that early rather than delayed addition of entacapone to levodopa/DDCI in PD patients with wearing‐off provides a modest clinical benefit over levodopa/DDCI that is maintained for up to 5 years.     

Acoustic Properties of Cries in 12-Month Old Infants at High-Risk of Autism Spectrum Disorder

There is preliminary evidence that infant siblings of children with Autism Spectrum Disorder (ASD) have an atypical pattern of cry, characterized by higher fundamental frequency and increased dysphonation. This prospective study collected multiple cry samples of 12-month old siblings of children with ASD (n?=?22, ‘high-risk’ group) and 12-month olds with no family history of ASD (n?=?27, ‘low risk’ group). While there was no difference between groups in the fundamental frequency or degree of phonation of the cry samples, the duration of each cry unit was significantly shorter in the high-risk siblings (p?<?.05). The six infant siblings who received a diagnosis of ASD at age two had amongst the shortest recorded cry durations.     

Cerebellar voice tremor: an acoustic analysis.

Patients with cerebellar disease may exhibit tremulous phonation as part of their dysarthria. The results of an acoustic analysis of cerebellar voice tremor in a patient with hereditary ataxia and presenting with a purely cerebellar syndrome are reported. Analysis included computation of speech intensity contours, fundamental frequency contours, and spectral parameters from sustained productions of vowels and voiceless fricatives. Fundamental frequency contours during sustained phonation of vowels showed rhythmic oscillations at a rate of about 3 Hz. No concomitant periodicity could be detected for the parameters characterising voiceless fricative production. The results indicate an impairment of phonatory control in relation to the maintenance of a constant isometric activity of the internal laryngeal muscles. Cerebellar voice tremor may therefore be classified as a form of postural tremor.     

The effect of delayed auditory feedback (DAF) and frequency altered feedback (FAF) on speech production: cochlear implanted versus normal hearing individuals

Normal auditory feedback contributes to moment-to-moment control of speech production. Effects of auditory feedback’s absence on hearing-impaired individuals are widely documented, but auditory perturbation has not been investigated. Our objective was to evaluate the effect of delayed auditory feedback (DAF) and frequency altered feedback (FAF) on speech production among prelingual cochlear implant (CI) users and normal hearing (NH) individuals, to evaluate CI users’ reliance on auditory feedback. Twenty young adults (10 CI, 10 NH), without developmental and cognitive impairments, participated in the study. Under variable auditory feedback conditions, speech production (spontaneous or reading aloud) was measured using speech rate, percentage of interruptions, fundamental frequency (F0), and relative intensity. Results showed that (1) both DAF and FAF caused slower speech rates and more interruptions while reading aloud, with DAF having larger effect; (2) altered feedback produced no differences between groups, except an increase in F0 for CI users during DAF; and (3) CI users’ ability to understand speech via phone and without lip-reading was positively correlated with performance under DAF. These findings suggest that auditory perturbation similarly affects speech production among prelingual CI users and NH individuals, indicating CI users depend on auditory feedback to the same degree as normal hearing individuals.     

Lee Silverman Voice Treatment for dysarthria in patients with Parkinson’s disease: a systematic review and meta‐analysis

Approximately 89% of patients with Parkinson’s disease (PD) suffer from dysarthria. Lee Silverman Voice Treatment (LSVT), a behavioral therapy, aims to improve speech and voice functions. The objective was to assess the effectiveness of LSVT compared with other/no speech interventions for dysarthria in patients with PD. Electronic databases, including PubMed, Embase and the Cochrane Library, were searched. The publication date of all included studies was before 6 March 2020. Only randomized controlled trials (RCTs) that evaluated the LSVT intervention compared with other/no speech intervention were considered. The data obtained from the included studies were described and the mean differences were calculated. Eight RCTs were included in this meta‐analysis comparing LSVT with other/no speech interventions. In the comparison of LSVT versus no intervention, vocal intensity for sustained ‘Ah’ phonation, reading the ‘Rainbow passage’, monologue and describing a picture increased by 8.87, 4.34, 3.25 and 3.31 dB, respectively, after 1 month of therapy. Compared with the respiratory therapy group, the LSVT group also showed significant improvement in vocal intensity for sustained ‘Ah’ phonation, reading the ‘Rainbow passage’ and monologue immediately after treatment (13.39, 6.66 and 3.19 dB). Positive improvement still existed after 24 months. There was no difference in the therapeutic effect between face‐to‐face and online LSVT. The effectiveness of LSVT for dysarthria in patients with PD was verified in these trials. However, future RCTs with sufficient participants are essential to evaluate the effectiveness of LSVT for dysarthria.     

Presynaptic and postsynaptic origin of multicomponent extracellular waveforms at the endbulb of Held–spherical bushy cell synapse

Extracellular signals from the endbulb of Held–spherical bushy cell (SBC) synapse exhibit up to three component waves (‘P’, ‘A’ and ‘B’). Signals lacking the third component (B) are frequently observed but as the origin of each of the components is uncertain, interpretation of this lack of B has been controversial: is it a failure to release transmitter or a failure to generate or propagate an action potential? Our aim was to determine the origin of each component. We combined single‐ and multiunit in vitro methods in Mongolian gerbils and Wistar rats and used pharmacological tools to modulate glutamate receptors or voltage‐gated sodium channels. Simultaneous extra‐ and intracellular recordings from single SBCs demonstrated a presynaptic origin of the P‐component, consistent with data obtained with multielectrode array recordings of local field potentials. The later components (A and B) correspond to the excitatory postsynaptic potential (EPSP) and action potential of the SBC, respectively. These results allow a clear interpretation of in vivo extracellular signals. We conclude that action potential failures occurring at the endbulb–SBC synaptic junction largely reflect failures of the EPSP to trigger an action potential and not failures of synaptic transmission. The data provide the basis for future investigation of convergence of excitatory and inhibitory inputs in modulating transmission at a fully functional neuronal system using physiological stimulation.