Brain and Voice Signatures in Teachers

University Hospital, Bonn100 enrolled

Overview

Primary muscle tension dysphonia voice disorder with symptoms of vocal strain and vocal fatigue is common and can have a significant negative impact on quality of Life. Yet, primary muscle tension dysphonia's causes are unknown precluding precise diagnostic classification. Stress and personality are thought to play a role and thus, the project aims to determine the practical and clinical effect of stress on the control of voice and speech in the brain. Participants are female early career teachers and student teachers with symptoms of vocal fatigue, as well as control participants without vocal fatigue, who perform speech tasks on two different occasions. Neural (imaging of brain), psychobiological (saliva, personality), and voice and speech (muscle activity of voice muscles on the neck with surface sensors, audio recordings) data will compare reactivity patterns of teachers who are stressresponders with those who are nonresponders as well as control participants. The central hypothesis is that voice box stress responders have heightened emotion-motor activations involving the emotional voice production pathway, which correlate with changes in voice muscle activity in the anterior neck. The results will provide fundamentally missing data in our understanding of the role of stress in vocal complaints and will yield new insights about the neural underpinnings of primary muscle tension dysphonia. The study findings will have a significant impact on how clinicians identify so-called laryngoresponders to help them prevent voice disorders.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

BASIC_SCIENCE

Masking

NONE

Enrollment

100

Conditions

Voice Disorders

Interventions

Stress inductionBEHAVIORAL

Induction of anticipatory stress to compare voice and speech control and production with and without exposure to stress.

Eligibility

Sex: FEMALEMin age: 21 YearsMax age: 39 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: Teachers (max. 10 years full-time) or student teachers in good health between 21 and 39 years with symptoms of vocal fatigue. Control participants in good health between 21 and 39 years without symptoms of vocal fatigue. Exclusion Criteria: * Lefthandedness * Smoking (past 5 years) * Known changes of the vocal folds (e.g., vocal fold nodules), vocal fold paralysis, surgeries on the larynx or thryoid or current organic or neurological changes of the vocal folds or vocal function per videoendoscopy and -stroboscopy of the larynx * History of voice therapy * Hoarseness * Respiratory illness, allergies (respiratory, silver), reflux or asthma at time of participation * Hearing disorder or hearing aids * Psychological, neurological or endocrinological disorders * Psychotropic or steorid medications * Body mass index \> 30 * Indications against MRI such as metail parts in or on the body (e.g., permanent dental prostheses or braces, screws, prostheses, piercings or large tattoos * Nearsightedness \> -5 diopters, if only glasses are worn * Claustrophobia * Pregnancy

Locations (1)

University Hospital Bonn

Bonn, Germany

RECRUITING

Outcomes

Primary Outcomes

Vocal fatigue

Raw scores, Vocal Fatigue Index, VFI Factor 1

Time frame: through study completion, an average of 1 month

BOLD MRI area 4p

MRI activation in regions of interest (BOLD area 4p in mean %) as a function of speech tasks with and without stress induction

Time frame: through study completion, an average of 1 month

Salivary cortisol

Salivary cortisol (nmol/L) to determine stressresponders and nonresponders

Time frame: through study completion, an average of 1 month

Suprahyoid muscle activity

Suprahyoid muscle activity (RMS)

Time frame: through study completion, an average of 1 month

Infrahyoid muscle activity

Infrahyoid muscle activity (RMS)

Time frame: through study completion, an average of 1 month

Personality, Social Potency

Personality trait Social Potency (T-scores, Multidimensional Personality Questionnaire, MPQ)

Time frame: through study completion, an average of 1 month

Personality, Stress Reaction

Personality trait Stress Reaction (T-scores, Multidimensional Personality Questionnaire, MPQ)

Time frame: through study completion, an average of 1 month

Personality, social anxiety

Personality trait social anxiety (T-scores, Liebowitz Social Anxiety Scale, LSAS-fear)

Time frame: through study completion, an average of 1 month

Secondary Outcomes

Vocal fatigue

Raw scores, Vocal Fatigue Index, VFI Factor 2 and 3

Time frame: through study completion, an average of 1 month

Voice quality of life

Raw data, Voice Handicap Index, VHI

Time frame: through study completion, an average of 1 month

Vocal tract discomfort

Raw data, Vocal Tract Discomfort Scale, VTD

Time frame: through study completion, an average of 1 month

Informal questionnaire on vocal health

Raw data informal questionnaire on vocal health

Time frame: through study completion, an average of 1 month

BOLD MRI SMA

MRI activation in regions of interest (BOLD area SMA in mean %) as a function of speech tasks with and without stress induction

Time frame: through study completion, an average of 1 month

BOLD MRI ACC

MRI activation in regions of interest (BOLD area ACC in mean %) as a function of speech tasks with and without stress induction

Time frame: through study completion, an average of 1 month

BOLD MRI MCC

MRI activation in regions of interest (BOLD area MCC in mean %) as a function of speech tasks with and without stress induction

Time frame: through study completion, an average of 1 month

BOLD MRI Amygdala

MRI activation in regions of interest (BOLD area Amygdala in mean %) as a function of speech tasks with and without stress induction

Time frame: through study completion, an average of 1 month

Central Contacts

Maria Dietrich, PhD

CONTACT

+49228287 Maria.Dietrich@ukbonn.de

Lisa Sindermann, PhD

CONTACT

+49228287 Lisa.Sindermann@ukbonn.de

Data from ClinicalTrials.gov

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MRI activation in regions of interest (BOLD area PAG in mean %) as a function of speech tasks with and without stress induction

Time frame: through study completion, an average of 1 month

Personality, Wellbeing

Personality trait Wellbeing (T-scores, Multidimensional Personality Questionnaire, MPQ)

Time frame: through study completion, an average of 1 month

Personality, Social Closeness

Personality trait Social Closeness (T-scores, Multidimensional Personality Questionnaire, MPQ)

Time frame: through study completion, an average of 1 month

Personality, social anxiety

Personality trait social anxiety (T-scores, Liebowitz Social Anxiety Scale, LSAS-total)

Time frame: through study completion, an average of 1 month

Personality, self-esteem

Personality self-esteem (raw data, Rosenberg self-esteem scale)

Time frame: through study completion, an average of 1 month

Behavioral inhibition and exhibition

Behavioral inhibition and exhibition (raw data, BIS/BAS scales, BIS subscale)

Time frame: through study completion, an average of 1 month

Chronic Stress

Chronic stress (T-scores, Trier Inventory of Chronic Stress, TICS)

Time frame: through study completion, an average of 1 month

Handedness

Handedness (raw data, Edinburgh Handedness Inventory, EHI)

Time frame: through study completion, an average of 1 month

State positive and negative affect

State positive and negative affect (raw data, Positive and Negative Affect Schedule, PANAS)

Time frame: through study completion, an average of 1 month

Voice quality, relative fundamental frequency

Voice quality, relative fundamental frequency (relative fundamental frequency, RFF in semitones \[ST\])

Time frame: through study completion, an average of 1 month

Voice quality, cepstral-spectral analysis

Voice quality, cepstral-spectral analysis (cepstral peak prominence in dB)

Time frame: through study completion, an average of 1 month

Perceived vocal effort

Perceived vocal effort (raw data, BORG-CR-10)

Time frame: through study completion, an average of 1 month

Cognitive effort

Cognitive effort (raw data, NASA-TLX)

Time frame: through study completion, an average of 1 month