MedPath

Brain and Voice Signatures in Teachers

Not Applicable
Recruiting
Conditions
Voice Disorders
Voice Fatigue
Interventions
Behavioral: Stress induction
Registration Number
NCT06126627
Lead Sponsor
University Hospital, Bonn
Brief Summary

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.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
100
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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Teachers/student teachers with vocal fatigueStress inductionTeachers/student teachers with vocal fatigue based on Vocal Fatigue Index (VFI, German). Pre-Screening and Screening. Experiment 1: MRI with MRI-compatible surface electrodes on the neck and audio recordings during MRI with and without stress induction. Prior to MRI, questionnaires on voice, personality, and stress and practice oft the tasks. During experiment, collection of saliva samples (before, during, and after MRI). During MRI, multiple subjective ratings of emotional state by the participants. Experiment 2 (approximately 2 weeks later): Speech tasks with surface electromyographic sensors applied to the neck with concurrent audio recordings. Prior to the experiment questionnaires on voice and practice of tasks. Subjective ratings of vocal and cognitive effort during the experiment by the participants.
Control groupStress inductionControl participants without vocal fatigue based on Vocal Fatigue Index (VFI, German). Same experimental procedures as in arm 1.
Primary Outcome Measures
NameTimeMethod
Personality, Stress Reactionthrough study completion, an average of 1 month

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

Infrahyoid muscle activitythrough study completion, an average of 1 month

Infrahyoid muscle activity (RMS)

Salivary cortisolthrough study completion, an average of 1 month

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

Personality, social anxietythrough study completion, an average of 1 month

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

Suprahyoid muscle activitythrough study completion, an average of 1 month

Suprahyoid muscle activity (RMS)

Personality, Social Potencythrough study completion, an average of 1 month

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

Vocal fatiguethrough study completion, an average of 1 month

Raw scores, Vocal Fatigue Index, VFI Factor 1

BOLD MRI area 4pthrough study completion, an average of 1 month

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

Secondary Outcome Measures
NameTimeMethod
Personality, Wellbeingthrough study completion, an average of 1 month

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

BOLD MRI Amygdalathrough study completion, an average of 1 month

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

Personality, Social Closenessthrough study completion, an average of 1 month

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

Personality, social anxietythrough study completion, an average of 1 month

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

Perceived vocal effortthrough study completion, an average of 1 month

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

Voice quality of lifethrough study completion, an average of 1 month

Raw data, Voice Handicap Index, VHI

Vocal tract discomfortthrough study completion, an average of 1 month

Raw data, Vocal Tract Discomfort Scale, VTD

BOLD MRI SMAthrough study completion, an average of 1 month

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

Personality, self-esteemthrough study completion, an average of 1 month

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

Handednessthrough study completion, an average of 1 month

Handedness (raw data, Edinburgh Handedness Inventory, EHI)

Voice quality, relative fundamental frequencythrough study completion, an average of 1 month

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

Vocal fatiguethrough study completion, an average of 1 month

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

Informal questionnaire on vocal healththrough study completion, an average of 1 month

Raw data informal questionnaire on vocal health

BOLD MRI MCCthrough study completion, an average of 1 month

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

State positive and negative affectthrough study completion, an average of 1 month

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

Voice quality, cepstral-spectral analysisthrough study completion, an average of 1 month

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

BOLD MRI ACCthrough study completion, an average of 1 month

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

BOLD MRI PAGthrough study completion, an average of 1 month

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

Behavioral inhibition and exhibitionthrough study completion, an average of 1 month

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

Chronic Stressthrough study completion, an average of 1 month

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

Cognitive effortthrough study completion, an average of 1 month

Cognitive effort (raw data, NASA-TLX)

Trial Locations

Locations (1)

University Hospital Bonn

🇩🇪

Bonn, Germany

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