Neuropathological Basis of Spasmodic Dysphonia and Related Voice Disorders
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 97
- 试验地点
- 1
- 主要终点
- Premortem imaging techniques will determine if there are differences in the brain anatomy of patients with SD compared to MTD, VT andto research volunteers
研究概览
简要总结
This study will look for abnormalities in a brain of persons affected with spasmodic dysphonia, a form of movement disorder that involves involuntary "spasms" of the muscles in the vocal folds causing breaks of speech and affecting voice quality. The causes of this disorder are not known. The study will compare results of magnetic resonance imaging (MRI) in people with spasmodic dysphonia and in healthy volunteers.
People with adductor or abductor spasmodic dysphonia and healthy volunteers may be eligible for this study. Candidates are screened with a medical history, physical examination, and a test called nasolaryngoscopy. For this test, the inside of the subject's nose is sprayed with a decongestant, and a small, flexible tube called a nasolaryngoscope is passed through the nose to the back of the throat to allow examination of the larynx (voice box). During this procedure, the subject is asked to perform tasks such as talking, singing, whistling, and saying prolonged vowels. The nasolaryngoscope is connected to a camera to record the movements of the vocal folds during these tasks.
Eligible participants then undergo MRI of the brain. MRI uses a strong magnetic field and radio waves instead of x-rays to obtain images of body organs and tissues. For this test, the subject lies on a table that slides into the MRI scanner, a narrow metal cylinder, wearing ear plugs to muffle loud knocking sound that occurs during the scan. During MRI anatomical images of the brain are obtained. Subject may be asked to participate in up to two scanning sessions. Each session takes about 1-1/2 hours.
Participants may also be asked to volunteer for a brain donation program which is optional. Information gained from donated tissue may lead to better treatments and potential cures for spasmodic dysphonia.
详细描述
Spasmodic dysphonia (SD) is a focal dystonia affecting the neural control of the laryngeal musculature for speech production. Although the clinical symptoms of SD have been described, the underlying pathological mechanisms remain unknown. Treatment strategies are of short benefit and expensive.
Muscle tension dysphonia (MTD) is considered a behavioral voice disorder because many cases benefit from behavioral therapy. The etiology of this vocal misuse disorder remains unknown but is not considered neurological and is thought to differ from SD.
Vocal tremor (VT) is a form of benign essential tremor. In less severely affected persons, vocal tremor is action-induced and occurs during vocalization only. In more severe cases, the tremor can be present also during exhalation and whispering and affect other structures, such as the velum and pharynx. This is also considered a neurological disorder but may differ in character from SD. Both these disorders can co-occur with SD but can also occur independently.
The anatomical characteristics of pre- and postmortem brains in patients with SD, MTD and VT and healthy volunteers will be investigated using imaging and neurohistological techniques to provide insight into the pathogenesis of SD. Identification of the neuropathological basis of SD and how it differs from other voice disorders would enhance our understanding of the neurological basis of SD.
OBJECTIVES:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 21 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
结局指标
主要结局
Premortem imaging techniques will determine if there are differences in the brain anatomy of patients with SD compared to MTD, VT andto research volunteers
时间窗: on going
Premortem imaging techniques will determine if there are differences in the brain anatomy of patients with SD compared to MTD, VT and to research volunteers:a) Volumetric reconstruction of gray matter regions involved in voice production;b) Visualization of the white matter tracts between brain regions of interest.
Postmortem MRI will identify discrepancies between premortem and postmortem brains of the same persons with SD in comparisons to MTD, VT and to research volunteers
时间窗: after postmortem MRI
Postmortem MRI will identify discrepancies between premortem and postmortem brains of the same persons with SD in comparisons to MTD, VT and to research volunteers
Microscopic examination of brain sections will determine whether abnormalities can be found in the cortical and subcortical regions involved in voice production in persons with SD that differ from patients with MTD and VT
时间窗: Postmortem
Microscopic examination of brain sections will determine whether abnormalities can be found in the cortical and subcortical regions involved in voice production in persons with SD that differ from patients with MTD and VT
Microscopic examination of the larynx will determine distribution of motor and sensory nerve endings in persons with SD and in patients with MTD and VT and controls
时间窗: Postmortem
Microscopic examination of the larynx will determine distribution of motor and sensory nerve endings in persons with SD and in patients with MTD and VT and controls
次要结局
未报告次要终点
