Repetitive Transcranial Magnetic Stimulation in Spasmodic Dysphonia
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Spasmodic Dysphonia
- Sponsor
- University of Minnesota
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- Change in Duration of Cortical Silent Period (CSP)
- Status
- Completed
- Last Updated
- 5 years ago
Overview
Brief Summary
Focal dystonia is a neurological movement disorder characterized by excessive involuntary muscle contractions of any body part. Spasmodic dysphonia (SD) is a type of focal dystonia characterized by excessive contraction of intrinsic muscles in the larynx, leading to difficulty in speaking and affecting effective communication. The cause of SD is unknown and there are no treatments that produce long-term benefits. Previous studies have suggested that SD and other focal dystonias are associated with decreased inhibition in sensorimotor areas in the brain. However, no studies have investigated the effects of modulating excitability of the laryngeal motor cortex in healthy individuals or SD. The goal of this pilot project is to determine if brain excitability of the laryngeal motor cortex can be changed with low-frequency inhibitory repetitive transcranial magnetic stimulation (rTMS) in individuals with SD and healthy controls. Considering that rTMS at low frequencies (≤1 Hz) produces lasting inhibition in the brain, and that SD is associated with decreased cortical inhibition, the purpose of this pilot study is to determine safety, feasibility and response to 1Hz rTMS to the laryngeal motor cortex in individuals with SD and healthy people. The results will help understand changes associated with the disorder, as well as contribute to the development of future clinical interventions for SD.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Primary inclusion for spasmodic dysphonia:
- •Diagnosis of adductor spasmodic dysphonia
- •Symptoms at worst severity if receiving regular botulinum injections
- •Primary inclusion for healthy participants (controls):
- •Absence of vocal fold pathology
Exclusion Criteria
- •Primary exclusion for participants with spasmodic dysphonia:
- •Other forms of dystonia
- •Vocal fold pathology or paralysis
- •Diagnosis of voice tremor
- •Laryngeal surgery
- •Laryngeal cancer or neurological condition other than dystonia
- •Contraindication to TMS
- •Medications with effect on central nervous system
- •Inability to complete tasks associated with study
- •Adult lacking ability to consent
Outcomes
Primary Outcomes
Change in Duration of Cortical Silent Period (CSP)
Time Frame: baseline and 2.5 hours
The change from baseline in CSP duration will be reported. The CSP is an interruption of voluntary muscle contraction after single pulse transcranial stimulation. The duration of the period of silent muscle activity will be measured to test the effects of rTMS intervention. There is no known clinical relevance for this outcome measure.
Adverse Response to rTMS
Time Frame: 2.5 hours
Count of participants who experience and adverse response to rTMS treatment.
Secondary Outcomes
- Change in Cepstral Peak Prominence Smoothed (CPPS)(baseline and 2.5 hours)
- Change in Number of Voice Breaks(baseline and 2.5 hours)
- Change in Voice Quality (Overall Severity) With the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V)(baseline and 2.5 hours)