Relationship Between Masking Levels and Phonatory Stability in Normal-Speaking Women

Disruption of auditory feedback such as masking has been shown to influence vocal production. A reliable finding is an increase in intensity level; an increase in fundamental frequency (F0) is a less robust finding. Research is lacking concerning the effects of auditory masking on measures of phonatory stability such as jitter and harmonics-to-noise ratio (HNR). This study investigated changes in intensity, F0, jitter, and HNR in 22 normally speaking college aged women. Subjects produced the vowel /a/ under three conditions: no masking level (0-dB ML), 50-dB ML, and 80-dB ML. Significant differences between conditions emerged for intensity; means for the other measures were not significantly different. Intraindividual differences between conditions for each variable are discussed in the framework of auditory versus kinesthetic feedback.     

Twelve-Month Clinical Follow-Up Study of Voice Patients' Recovery Using the Voice Activity and Participation Profile (VAPP)

Objective

To study the effects of voice treatment including brief voice therapy for 12 months in two groups of voice patients: organic and functional.

Design and Methods

A clinical prospective follow-up study with repeated measurements in five phases: medical session, first voice therapy session, last voice therapy session, and 6 months and 12 months after voice therapy. The mean number of voice therapy sessions was 3.4. The main outcome measures were the Voice Activity and Participation Profile (VAPP) and the Symptom Questionnaire.Of consenting patients (n = 141) with chronic voice disorders, 46 dropped out during follow-up. Ninety-five patients formed the study group. Forty-one of them received only voice therapy, but the rest of them received combined treatment (medication, amplifiers, and voice massage), but also experienced life events affecting voice. Patients with any laryngeal pathology formed the organic group (n = 47), others had a functional voice disorder.

Results

Using the improvement criterion that the change of the VAPP score should exceed standard error of measurement, the percentage of individual patients achieving improvement was 47% in the mild, 59% in the moderate, and 75% in the severe disorder groups. Effect size for VAPP total score was 0.89. The positive effect continued to progress after the therapy ended. Patients with functional or organic voice disorder improved almost equally, although minor findings indicate that functional patients benefited more.

Conclusions

Voice treatment had a progressive effect for 1 year in half of our patients. No statistical difference was found between the functional and organic patient groups.     

Harmonics-to-Noise Ratio: An Index of Vocal Aging

Distinguishing between vocal changes that occur with normal aging and those that are associated with disease is an important goal of research in voice. Several acoustic measures have been used in an attempt to illuminate the integrity of the vocal mechanism, including harmonics-to-noise ratio (HNR), jitter, and fundamental frequency (F₀). HNR is a measure that quantifies the amount of additive noise in the voice signal; jitter reflects the periodicity of vocal fold vibration. In this study, measures of HNR, jitter and F₀ were used to compare vocal function in three groups of normally speaking women: young adults, middle-aged adults, and elderly adults. Significant differences in HNR emerged between the elderly women and the other two groups. F₀ differences were also apparent between the elderly group and the two younger groups; there were no significant differences in jitter between the three groups. HNR was found to be a more sensitive index of vocal function than jitter. The significant lowering of HNR evident in the elderly speakers may be attributable in part to medications taken by the majority of these elderly subjects.     

Learning to produce speech with an altered vocal tract: the role of auditory feedback

Modifying the vocal tract alters a speaker's previously learned acoustic-articulatory relationship. This study investigated the contribution of auditory feedback to the process of adapting to vocal-tract modifications. Subjects said the word /tas/ while wearing a dental prosthesis that extended the length of their maxillary incisor teeth. The prosthesis affected /s/ productions and the subjects were asked to learn to produce "normal" /s/'s. They alternately received normal auditory feedback and noise that masked their natural feedback during productions. Acoustic analysis of the speakers' /s/ productions showed that the distribution of energy across the spectra moved toward that of normal, unperturbed production with increased experience with the prosthesis. However, the acoustic analysis did not show any significant differences in learning dependent on auditory feedback. By contrast, when naive listeners were asked to rate the quality of the speakers' utterances, productions made when auditory feedback was available were evaluated to be closer to the subjects' normal productions than when feedback was masked. The perceptual analysis showed that speakers were able to use auditory information to partially compensate for the vocal-tract modification. Furthermore, utterances produced during the masked conditions also improved over a session, demonstrating that the compensatory articulations were learned and available after auditory feedback was removed.     

Comfortable effort level revisited

The purpose of this study was to measure the variability of frequency and intensity of speech, using multiple voice samples obtained over a period of time at a speaker's “comfortable effort level.” Variability in vocal output within and across several experimental sessions was assessed from measures of speaking fundamental frequency (SFF) and vocal intensity for utterances repeated three times a day over a 3-day period. Three distinct age groups of men and women—young, middle-aged and elderly—repeated the vowel /a/, read a standard passage, and spoke extemporaneously during each experimental session. Results indicated that variability in SFF and intensity were present across experimental sessions, age groups, gender, and speaking samples. Generally, group means indicated that ±1 semitone of variability for SFF and 2 db sound pressure level (SPL) variation in vocal intensity from any one experimental session to the next could be expected; individual variations within any group may reach two semitones and 6 db SPL.     

Reliability of single sample experimental designs: Comfortable effort level

This study was designed to ascertain the intrasubject variabilityacross multiple recording sessions-most often disregarded in reporting group mean data or unavailable because of single sample experimental designs. Intrasubject variability was assessed within and across several experimental sessions from measures of speaking fundamental frequency, vocal intensity, and reading rate. Three age groups of men and women-young, middle-aged, and elderly—repeated the vowel /a/, read a standard passage, and spoke extemporaneously during each experimental session. Statistical analyses were performed to assess each speaker's variability from his or her own mean, and that which consistently varied for any one speaking sample type, both within or across days. Results indicated that intrasubject variability was minimal, with approximately 4% of the data exhibiting significant variation across experimental sessions.     

Consistency of acoustic and aerodynamic measures of voice production over 28 days under various testing conditions

The value of any measure of voice production is dependent on its repeatability over time. The purpose of the present study was to determine the consistency of selected acoustic and aerodynamic measures of voice production over 28 days, under various test/retest conditions. Three groups of healthy young adult females sustained three vowels at comfortable, high, and low pitch levels. Subjects in Group 1 chose their own intensity levels, but matched the fundamental frequencies produced at Test 1 during Test 2. Group 2 controlled intensity levels during both tests, but fundamental frequency was free to vary. Group 3 controlled both intensity and fundamental frequency. Measures of fundamental frequency, jitter, maximum phonation time, phonation volume, and flow rate were compared. Subjects who matched both fundamental frequency and intensity showed repeatable, consistent results for all measures during both tests. Controlling intensity but not fundamental frequency resulted in statistically significant differences in fundamental frequency at comfortable and high pitches, but there was minimal effect on other variables. Controlling fundamental frequency but not intensity led to the most inconsistency between tests, affecting both acoustic and aerodynamic measures. Results underscore the need to control the conditions under which measures are obtained.     

Double-Blind Study on the Effects of Topical Anesthesia on Laryngeal Secretions

The application of topical anesthesia to the oropharynx is a common clinical practice during oral and nasal laryngoscopy. Clinically, questions have been raised about whether topical anesthesia alters laryngeal secretions, which distorts clinical impressions. A double-blind, placebo controlled design was employed to address this issue. Ten premenopausal women with healthy vocal folds and 10 premenopausal women with phonotraumatic lesions underwent oral videolaryngoscopic examinations on subsequent days under both anesthesia and placebo conditions, in counterbalanced order. Video segments were rated by three judges. Dependent variables were balling and pooling of secretions, as previously described in the literature. Statistical analyses failed to reveal any clear effect of topical anesthesia on either secretion balling or pooling for the collapsed data set, but one cannot exclude changes in individual cases. Moreover, there was no evidence that secretions were differentially affected by anesthesia across subject groups. Null results in this data set replicate and extend previously reported findings by other authors. An incidental but potentially interesting finding was that the order of treatment condition (anesthesia versus placebo first) seemed relevant for secretions: Subjects who received the anesthesia condition first tended to show more secretion balling in general, as compared with subjects who received the placebo condition first. Speculation is entertained regarding possible physiological pathways for these incidental findings, which could be relevant for some clinical practice.     

Active synchronization of two mode-locked lasers with optical cross correlation

Two mode-locked Ti:sapphire lasers of different wavelengths were precisely synchronized by a simple feedback system employing sum-frequency generation (cross correlation). When the timing error exceeded the pulse duration, the periodic bunch of the sum-frequency pulse was used for rough timing adjustment. Using cross correlation with a stretched pulse, we struck a balance between wide locking range and sensitive timing detection. When the two lasers were well-synchronized, we obtained a continuous cross-correlation pulse train for 3 min. The holding time of the laser synchronization was extended to over one hour by adding a motorized stage to the PZT-mounted cavity mirror. We estimated the rms timing jitter between the two lasers by a scanning cross-correlation measurement. We confirmed that the rms timing jitter of the two lasers during 1.8 s was 28 fs. Received: 30 January 2002 / Revised version: 14 June 2002 / Published online: 8 August 2002     

Gene expression changes following extinction testing in a heroin behavioral incubation model

Background  

A number of gene expression studies have investigated changes induced by drug exposure, but few reports describe changes that persist following relapse. In this study, genome-wide analysis of gene expression was conducted following an extinction session (90 min) in rats that expressed behavioral incubation of heroin-seeking and goal-directed behavior. As an important modulator of goal-directed behavior, the medial prefrontal cortex (mPFC) was the target of genomic analysis. Rats were trained to self-administer heroin during 3 h daily sessions for 14 d. Following the self-administration period, rats were reintroduced to the self-administration chambers for a 90-minute extinction session in which they could seek heroin, but received none. Extinction sessions were conducted on groups after either 1 d or 14 d of drug-free enforced abstinence to demonstrate behavioral incubation.     

Reliability of student evaluations of voice therapy implications for theory and training

This study examines reliability and the focus of attention of evaluations of voice therapy sessions. Therapy sessions were provided by 8 clinician-client pairs. For each pair, two 20-minute therapy sessions were evaluated by 50 undergraduate student raters and by 3 experienced clinicians. The goal of all therapy sessions was the modification of the frequency and type of voice onset. Raters evaluated each session using 12 behavioral and interpersonal criteria. Results indicated that (1) interrater reliability coefficients for each of the 12 criteria were moderately high to high, (2) the highest coefficients were found for ratings of the client, and (3) ratings of the client were found to be the most consistent across 2 sessions. Intrarater reliability was highest in ratings of quality, use of counseling, clarity and use of feedback, and amount of explanation by the clinician.     

Ultrasound therapy modulates osteocalcin expression during bone repair in rats

The aim of this study was to measure the temporal pattern of the protein expression of RUNX2, RANKL, OPG, and osteocalcin after ultrasound therapy during the process of bone healing by immunohistochemistry. The animals were randomly distributed into two groups: control or ultrasound-treated group. A non-critical size bone defects were surgically created at the upper third of the tibia. The treatments started 24 h post-surgery, and they are performed for 3, 6, and 12 sessions, with an interval of 48 h. A low-intensity pulsed ultrasound (1.5 MHz, 1:4 duty cycle, intensity SATA 30 mW/cm², 20 min/session, stationary mode application) was used. On days 7, 13, and 25 post-injury, rats were killed individually by carbon dioxide asphyxia. The tibias were removed for analysis. The histopathological analysis pointed out no remarkable differences between groups for all periods evaluated. However, immunohistochemical data revealed that ultrasound therapy produced an up-regulation of osteocalcin at day 7th and 13th post-surgery. Taken together, our results indicate that ultrasound therapy modulates osteocalcin expression during bone repair in rats as depicted by differential immunopression at the initial and intermediate stages of recovery.     

Comparisons of jitter, shimmer, and signal-to-noise ratio from directly digitized versus taped voice samples

The purpose of this study was to compare jitter, shimmer, and signal-to-noise ratio (SNR) measures obtained from tape-recorded samples with the same measures made on directly digitized voice samples, with use of the CSpeech acoustic analysis program. Subjects included 30 young women who phonated the vowel /a/ at a comfortable pitch and loudness level. Voice samples were simultaneously recorded and digitized, and the resulting perturbation measures for the two conditions were compared. Results indicated that there were small but statistically significant differences between percent jitter, percent shimmer, and SNR calculated from taped samples compared with the same measures calculated from directly digitized samples. It was concluded that direct digitization for clinical measures of vocal perturbation was most desirable, but that taped samples could be used, if necessary, with some caution.     

Discrimination of rising and falling simulated single-formant frequency transitions: practice and transition duration effects

Two experiments evaluated discrimination of simulated single-format frequency transitions. In the first experiment, listeners received practice with trial-by-trial feedback in discriminating either rising or falling frequency transitions of three different durations (30, 60, and 120 ms). Transitions either occurred in isolation or were followed by a steady-state sound matched in frequency to the transition end point. Some improvement in discrimination over practice runs occurred for the shortest transitions. Whether performance was evaluated at the beginning or end of practice, there were no differences attributable to transition direction or to whether transitions were followed by steady-state sound. Discrimination, however, was significantly better for the longest transitions. Just noticeable differences (jnd's) for the longest transitions, measured in Hz at transition onsets, were of approximately the same magnitude as jnd's for steady-state sounds that were equal in frequency to the midpoints of the transitions. Subjects of the second experiment discriminated the longer rising and falling transitions, but did not receive extensive practice. Results of experiment 2 replicated results of experiment 1 in showing similar jnd's. Experiment 2 also showed no differences attributable to transition direction or to the presence of the steady-state sound following transitions.     

Effects of head extension and tongue protrusion on voice perturbation measures

Head extension with protruded tongue is the position for video-laryngoscopy and simultaneous glottographic recordings including photoglottographic signals. This study investigated the effect of head extension and tongue protrusion on the measures of fundamental frequency, frequency perturbation (jitter), and amplitude perturbation (shimmer). Acoustic signals recorded during sustained vowels were obtained from 49 women and 66 men with no speech or voice disorders in different head-tongue positions. Head extension was associated with increased fundamental frequency and decreased shimmer. In men, head extension did not appear to affect jitter. When the tongue was protruded, head extension tended to lower jitter. For both genders, tongue protrusion was associated with decreased fundamental frequency with head extension. In the men, tongue protrusion tended to increase shimmer when the head was in the neutral position. In the women, tongue protrusion was associated with increased jitter and increased shimmer and was most evident in the head-neutral position. These findings supported a physical linkage hypothesis of the relationship between vocal tract configuration and vocal fold vibration, suggesting that head-tongue position must be taken into account when comparing voice measures.     

Clinical Analysis of Voice Change as a Parameter of Premenstrual Syndrome

We have evaluated the relationship between voice change and premenstrual syndrome (PMS) by comparing acoustic measurements made during the follicular phase and the premenstrual phase. Twenty-eight women were followed for 2 months for this study. Each participant was asked to produce an /a/ sound for 5 seconds at the midfollicular phase of the menstrual cycle and then 2-3 days before menstruation. Each voice sample was stored and analyzed by the Dr. Speech Science program. The voice data collected from all subjects during the two phases were compared. After that, the subjects were divided into a PMS-positive and PMS-negative group according to the criteria cited in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV); the voice data from each group were compared separately between the two phases. There was no significant difference in the acoustic parameters between the two phases in all subjects (N = 28). In the PMS-positive group (N = 16), jitter was significantly increased during the premenstrual phase compared to the follicular phase (p = 0.048). The patient's PMS score was not correlated with the severity of voice change. We conclude that the change of voice parameter was objectively identified in the PMS-positive group, therefore more careful voice habituation is required during the premenstrual phase in that group.     

Effects of initial consonant, pneumotachographic mask, and oral pressure tube on vocal perturbation, harmonics-to-noise, and intensity measurements

Vocal perturbation, harmonics-to-noise, and intensity measures were obtained for 10 subjects during three experimental tasks: (a) prolonged /a/, (b) /pa/ with vowel prolonged, and (c) same as (b) with subjects wearing a pneumotachographic mask and oral pressure tube inserted between the lips. There were no statistically significant differences among the experimental conditions for any of the measures. The findings suggest that a single task may be used to obtain airflow, oral pressure, and acoustic measures of vocal performance. Observed differences in jitter and harmonic-to-noise means for the male and female speakers are discussed.     

Voice of Postradiotherapy Nasopharyngeal Carcinoma Patients: Evidence of Vocal Tract Effect

This study was aimed at identifying acoustic and physiological measures useful for monitoring voice changes in postnasopharyngeal patients with nonlaryngeal malignancies, and providing evidences of vocal tract effect on voice through comparisons between individuals with and without intact vocal tract. Simultaneous acoustic-electroglottographic signals recorded during phonation of vowels /i/ and /a/ sustained at habitual, high, and low pitch levels were compared among 10 postradiotherapy patients with nasopharyngeal carcinoma (NPC), 10 voice patients (VPs) with intact vocal tract, and 10 healthy individuals with normal voice (NORM). Results from a series of discriminant analyses revealed that the NPC group generally exhibited lower signal-to-noise (SNR) and open quotient (OQ) and higher Formant 1 frequency (F(1)) and speed quotient (SQ) than the NORM group. Unlike both VP and NORM groups, the NPC group failed to show a pitch effect on all voice measures, including OQ, SQ, percent jitter, percent shimmer, and SNR, suggesting an effect of radiotherapy and/or vocal tract on laryngeal behaviors. For the vowel /i/, on the other hand, only the NPC and NORM groups showed a pattern of pitch-dependent F(1) raising, a reflection of increased pharyngeal narrowing. These findings suggested that the pitch effect on laryngeal behaviors differed not only between individuals with intact vocal tract and those without but also between those with structural and dynamic changes of vocal tract.     

Correlation between skin temperature and heart rate during exercise and recovery,and the influence of body position in these variables in untrained women

It was known that the thermal response varies according to some variables. Until now, there are no studies that have investigated the relationship of skin temperature and heart rate during and after the workout, either the thermal behavior during postural changes. Objective: the aim of this study was to evaluate the behavior of skin temperature and heart rate, during exercise and up to an hour of recovery (with postural change), performed in two different intensities sessions (70% and 85% of 10 repetitions maximum) and observe the correlation between them. Method: This was a short longitudinal study, carried out with women aged from 18 to 30 years. A sample of 31 untrained women, aged 18 and 30 was used. The volunteers were randomized into two groups: Biceps Group (BG), with 15 women, and Quadriceps Group (QG) with 16 women. Results: During and after completion of the exercise session, there was a significant reduction in skin temperature on the active muscles in both groups (BG and QG), with similar thermal responses for the two intensities studied (70% and 85%) to the minute 15 (which marks the end of the recovery in the standing position). From minute 15 to minute 20–60, the skin temperature increases abruptly and significantly, returning to levels close to those observed before exercise. Conclusion: There were no statistical differences in thermal response to exercises in 70% or 85% of 10RM. There is a negative correlation between heart rate and skin temperature when untrained women perform anaerobic exercise. It was observed that after a change of posture (from a standing position to a sitting posture) skin temperature increased abruptly and significantly.     

Habitual use of vocal fry in young adult female speakers

The purpose of this study was to examine the use of vocal fry in young adult Standard American-English (SAE) speakers. This was a preliminary attempt (1) to determine the prevalence of the use of this register in young adult college-aged American speakers and (2) to describe the acoustic characteristics of vocal fry in these speakers. Subjects were 34 female college students. They were native SAE speakers aged 18-25 years. Data collection procedures included high quality recordings of two speaking conditions, (1) sustained isolated vowel /a/ and (2) sentence reading task. Data analyses included both perceptual and acoustic evaluations. Results showed that approximately two-thirds of this population used vocal fry and that it was most likely to occur at the end of sentences. In addition, statistically significant differences between vocal fry and normal register were found for mean F(0) minimum, F(0) maximum, F(0) range, and jitter local. Preliminary findings were taken to suggest that use of the vocal fry register may be common in some adult SAE speakers.