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Introduction: In this study, the correlations between traditional acoustic measures (TAMs) and cepstral analysis (CA) were explored in Persian., Methods: This investigation was a cross-sectional study including 179 dysphonic (n = 141) and normophonic (n = 38) speakers. The TAMs (jitter, shimmer, and noise-to-harmonic ratio) and CA (cepstral peak prominence and cepstral peak prominence smoothed) values were obtained during vowel prolongation, reading a standard sentence, and a nonstandard running speech sample using Praat software. The difference of acoustic measures between normophonic and dysphonic speakers and intercorrelation among acoustic measures and correlation between the acoustic measures and perceived dysphonia levels were analyzed with independent t test, Mann-Whitney U test, Pearson, Spearman, and Kendall's Tau-b correlation tests using IBM SPSS Statistics., Results: The findings showed that dysphonic speakers had higher TAM values and lower CA values than normophonic speakers (p < 0.05). In dysphonic speakers, a large correlation was discovered among all acoustic measurements (r = 0.52-0.96; p < 0.05), while in various perceived dysphonic speakers, there was a correlation of varying strength (r = 0.25-0.97; p < 0.05). Ultimately, there was a significant small-to-large correlation between the acoustic measures and perceived dysphonia levels (r = 0.34-0.58; p < 0.05)., Conclusion: This research demonstrated that Persian speakers with dysphonia experienced a rise in TAM and a corresponding reduction in CA. In the future, multi-parametric indices can be developed using both TAM and CA to include various aspects of vocal production and yield a single, comprehensive value., (© 2024 S. Karger AG, Basel.)

Purpose: The purpose of this study was to analyse the relationship between automatic vowel articulation index (aVAI) and direct magnitude estimation (DME) among speakers with Parkinson's disease (PD) and healthy controls. We further analysed the potential of aVAI to serve as an objective measure of speech impairment in the clinical setting., Method: Speech samples from native Finnish speakers were utilised. Expert raters utilised DME to scale the intelligibility of speech samples. aVAI scores for PD speakers and healthy control speakers were analysed in relationship to DME speech intelligibility ratings and, among PD speakers, disease stage utilising nonparametric statistical analysis., Result: Mean DME intelligibility ratings were lower among PD speakers compared to healthy controls. Mean aVAI scores were nearly the same between speaker groups. DME intelligibility ratings and aVAI were strongly correlated within the PD speaker group. aVAI and DME intelligibility ratings were moderately correlated with disease stage as measured by the Hoehn and Yahr scale., Conclusion: aVAI was observed to be a promising tool for analysing vowel articulation in PD speakers. Further research is warranted on the application of aVAI as an objective measure of severity of speech impairment in the clinical setting, with varying patient populations and speech samples.

Introduction: Many transsexual women seek to feminise their voice through pitch elevation surgeries so that it becomes congruent with their gender identity. This study aims to determine the safety and effectiveness of Wendler glottoplasty (WG) in vocal feminisation through the assessment of acoustic and aerodynamic parameters of the voice, as well as voice-related quality of life (QoL) in male-to-female transsexuals., Material and Methods: We retrospectively reviewed the medical records of transsexual women who underwent WG for voice feminisation at our institution between 2016 and 2023. All acoustic and aerodynamic analyses, a voice self-assessment, and a videolaryngostroboscopic evaluation were performed in the immediate preoperative period and at the follow-up visit 6 weeks after the procedure., Results: A total of 11 patients with a mean age of 32.73 years were included. After WG, there was a significant fundamental frequency and speaking fundamental frequency increase of 109.64 Hz and 83.48 Hz, respectively (p < 0.001), representing an average rise by 9.71 semitones and 8.36 semitones (STs), respectively. No significant differences were found between the mean pre- and postoperative values of fundamental frequencies, frequency range, upper limit of the frequency range of spoken voice, and maximum phonation time. Contrarily, the mean lower limit of frequency range rose by 75.56 Hz (p < 0.001), representing an average increase of 10.56 STs. None of the assessed spirometric parameters changed significantly after WG (p > 0.05). The mean overall Voice Handicap Index (VHI) and Voice-Related Quality of Life (V-RQOL) scores significantly improved after the surgery, decreasing by 24.54 points (p = 0.008) and 11.5 points (p = 0.001), respectively. A significant improvement was observed in the functional and emotional domains of VHI. Additionally, significantly fewer patients considered the overall quality of their voice to be "poor" after WG., Conclusions: WG constitutes an effective method of surgical voice feminisation in male-to-female transsexuals with concurrent improvement in their voice-related QoL. Furthermore, it remains a safe procedure without persistent complications and negative influence on the acoustic-aerodynamic measures of the voice.

Telepractice offers the opportunity to receive care at home without risk of exposure to healthcare acquired infections, especially during a pandemic. Hence, establishing the reliability of the diagnosis of dysphonia via a smartphone is fundamental to providing an alternative service delivery model. A total of 20 participants participated in the study. Recordings of sentence-based voice samples were done using a standardized microphone and the software used in labs and on smartphones. Comparisons were made of acoustic and perceptual voice in real-time and recorded samples speech in persons with typical vs pathological voice. Results revealed no significant differences perceptually between real-time voice and recorded voice in individuals with typical and pathological voices. In acoustic analysis, there was no significant difference in Fundamental frequency (F0) and Auditory Voice Quality Index (AVQI) between real-time voice and recorded voice in individuals with typical and pathological voice., (Copyright © 2023 Meet Nakum, Namita Joshi.)

Introduction: Acoustic analysis is widely used for assessing and monitoring vocal function. Dermatoglyphics is a method that analyzes genetic fingerprint markers, and uses that information for predicting physical skills related to anaerobic (explosive strength and speed) and aerobic (motor coordination and resistance) mechanisms. Therefore, it can be used as an indicator for individualized vocal training., Objective: To characterize the dermatoglyphic profiles and their relation to acoustic measures in voice professionals., Methods: A cross-sectional study involving 79 voice professionals. Acoustic analysis was performed using the PRAAT software. Mean intensity, fundamental frequency (F0), and cepstral peak prominence (CPP) value were extracted from the sustained vowel /a/. Fingerprints were collected using a Watson mini-integrated biometric scanner, and were quantified by design predominance, delta index (D10), total ridge count (TRC), and dermatoglyphic profile. The acoustic measures were analyzed descriptively and compared, considering the subjects' dermatoglyphic profiles. The confidence levels ranged from 90% to 95%., Results: Most subjects exhibited anaerobic dermatoglyphic profiles (P = 0.004) and low TRC (p < 0.001). Higher F0 (P = 0.061), intensity (P = 0.065), and CPP (P = 0.073) were found for anaerobics (P < 0.001). There was a weak and negative correlation between TRC and intensity (P = 0.026), as well as between F0 (P = 0.017) and CPP (P = 0.069)., Conclusion: Anaerobic profiles were predominant. The values of F0, intensity, and CPP increased for the anaerobics. There was a weak negative correlation between the TRC and intensity, F0, and CPP measures. Dermatoglyphics could have been seen as an interesting tool in the voice assessment and training direction for voice professionals., (Copyright © 2021 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Background: The assessment of voice quality can be evaluated perceptually with standard clinical practice, also including acoustic evaluation of digital voice recordings to validate and further interpret perceptual judgments. The goal of the present study was to determine the strongest acoustic voice quality parameters for perceived hoarseness and breathiness when analyzing the sustained vowel [a:] using a new clinical acoustic tool, the VOXplot software., Methods: A total of 218 voice samples of individuals with and without voice disorders were applied to perceptual and acoustic analyses. Overall, 13 single acoustic parameters were included to determine validity aspects in relation to perceptions of hoarseness and breathiness., Results: Four single acoustic measures could be clearly associated with perceptions of hoarseness or breathiness. For hoarseness, the harmonics-to-noise ratio (HNR) and pitch perturbation quotient with a smoothing factor of five periods (PPQ5), and, for breathiness, the smoothed cepstral peak prominence (CPPS) and the glottal-to-noise excitation ratio (GNE) were shown to be highly valid, with a significant difference being demonstrated for each of the other perceptual voice quality aspects., Conclusions: Two acoustic measures, the HNR and the PPQ5, were both strongly associated with perceptions of hoarseness and were able to discriminate hoarseness from breathiness with good confidence. Two other acoustic measures, the CPPS and the GNE, were both strongly associated with perceptions of breathiness and were able to discriminate breathiness from hoarseness with good confidence.

Background: Frailty is a common issue in the aging population. Given that frailty syndrome is little discussed in the literature on the aging voice, the current study aims to examine the relationship between frailty and vocal biomarkers in older people., Methods: Participants aged ≥ 60 years visiting geriatric outpatient clinics were recruited. They underwent frailty assessment (Cardiovascular Health Study [CHS] index; Study of Osteoporotic Fractures [SOF] index; and Fatigue, Resistance, Ambulation, Illness, and Loss of weight [FRAIL] index) and were asked to pronounce a sustained vowel /a/ for approximately 1 s. Four voice parameters were assessed: average number of zero crossings (A1), variations in local peaks and valleys (A2), variations in first and second formant frequencies (A3), and spectral energy ratio (A4)., Results: Among 277 older adults, increased A1 was associated with a lower likelihood of frailty as defined by SOF (odds ratio [OR] 0.84, 95% confidence interval [CI] 0.74-0.96). Participants with larger A2 values were more likely to be frail, as defined by FRAIL and CHS (FRAIL: OR 1.41, 95% CI 1.12-1.79; CHS: OR 1.38, 95% CI 1.10-1.75). Sex differences were observed across the three frailty indices. In male participants, an increase in A3 by 10 points increased the odds of frailty by almost 7% (SOF: OR 1.07, 95% CI 1.02-1.12), 6% (FRAIL: OR 1.06, 95% CI 1.02-1.11), or 6% (CHS: OR 1.06, 95% CI 1.01-1.11). In female participants, an increase in A4 by 0.1 conferred a significant 2.8-fold (SOF: OR 2.81, 95% CI 1.71-4.62), 2.3-fold (FRAIL: OR 2.31, 95% CI 1.45-3.68), or 2.8-fold (CHS: OR 2.82, 95% CI 1.76-4.51, CHS) increased odds of frailty., Conclusions: Vocal biomarkers, especially spectral-domain voice parameters, might have potential for estimating frailty, as a non-invasive, instantaneous, objective, and cost-effective estimation tool, and demonstrating sex differences for individualised treatment of frailty., (© 2022. The Author(s).)

Introduction: Despite its clinical significance, few studies have explored the applicability of the validated Arabic version of the Voice Handicap Index (VHI-Arab) in professional voice users, especially singers. The correlation between VHI-Arab scores and acoustic measures in this targeted group remains unclear. The aim of this study was to explore Arab Kuwaiti prospective professional singers' perception of voice handicap using the validated VHI-Arab. Additionally, we examined the association between VHI-Arab scores and acoustic measures such as fundamental frequency (F0), shimmer, jitter, and signal-to-noise ratio., Methods: VHI-Arab scores and acoustic measures of 100 adult prospective professional singers (50 females and 50 males) were compared with those of 100 adult controls (50 females and 50 males)., Results: Female prospective professional singers differed significantly from female controls in terms of functional and physical subscale scores, total VHI-Arab scores, and shimmer and jitter values. Male prospective professional singers showed significant differences neither in VHI-Arab scores nor in acoustic measures; however, their shimmer values showed significant a difference. There was no correlation between VHI-Arab scores and acoustic measures., Conclusion: Kuwaiti prospective professional singers did not perceive their voice as handicapped. Female prospective professional singers had a better perception of their voice compared with female controls. The results of the current study suggest that the perception of voice handicap and acoustic measures are different attributes that do not correlate., (© 2022 S. Karger AG, Basel.)

Numerous studies have reported on the high accuracy of using voice tasks for the remote detection and monitoring of Parkinson's Disease (PD). Most of these studies, however, report findings on a small number of voice recordings, often collected under acoustically controlled conditions, and therefore cannot scale at large without specialized equipment. In this study, we aimed to evaluate the potential of using voice as a population-based PD screening tool in resource-constrained settings. Using the standard telephone network, we processed 11,942 sustained vowel /a/ phonations from a US-English cohort comprising 1078 PD and 5453 control participants. We characterized each phonation using 304 dysphonia measures to quantify a range of vocal impairments. Given that this is a highly unbalanced problem, we used the following strategy: we selected a balanced subset ( n = 3000 samples) for training and testing using 10-fold cross-validation (CV), and the remaining (unbalanced held-out dataset, n = 8942) samples for further model validation. Using robust feature selection methods we selected 27 dysphonia measures to present into a radial-basis-function support vector machine and demonstrated differentiation of PD participants from controls with 67.43% sensitivity and 67.25% specificity. These findings could help pave the way forward toward the development of an inexpensive, remote, and reliable diagnostic support tool for PD using voice as a digital biomarker.

Objectives: Voice therapy has been the primary treatment for voice feminization in transfemale patients due to concerns that surgery worsens voice quality. We aim to determine the impact of Wendler glottoplasty on acoustic measures of voice., Study Design: Retrospective case series., Methods: Transgender female patients treated for vocal feminization with Wendler glottoplasty at a single tertiary care center were identified. Pre- and postoperative measures were taken with the Kay Elemetrics Real-Time Pitch, Analysis of Dysphonia in Speech and Voice, and Multidimensional Voice Program., Results: Twenty-eight patients were included in this study. There were no statistically significant changes in fundamental frequency variation, peak amplitude variation, soft phonation index, noise-to-harmonics ratio, cepstral peak prominence, or cepstral spectral index of dysphonia at a significance level of P < .05. Average speaking fundamental frequency (SF0) increased from 143 Hz after voice therapy to 163 Hz after surgery (P = .0009). Lower range decreased in 61% and increased in 26% of patients. Upper range decreased in 52% and increased in 48% of patients., Conclusions: Wendler glottoplasty does not worsen voice quality based on acoustic measures. Although most patients experience an increase in average SF0, effects on vocal range are variable with approximately half of patients experiencing a reduction and half experiencing an increase in upper pitch limit., Level of Evidence: 4 Laryngoscope, 131:583-586, 2021., (© 2020 The American Laryngological, Rhinological and Otological Society, Inc.)

Characteristics of true vocal fold vibration such as the proportion of closed phase of vibration to open phase, longitudinal tension, and the amount of medial compression are used to define four conditions during Estill Voice Training. However, it is unknown whether trainees achieve these phonatory differences after training. Acoustic and aerodynamic measures were used to determine differences in Slack, Thick, Thin, and Stiff conditions. Twenty-four female speech-language pathology graduate students received training perceiving and producing these four conditions and volunteered to participate 3-5 months later. After a 20-minute refresher training, participants were recorded using the Phonatory Aerodynamic System with electroglottography and Computerized Speech Lab. Four Estill Voice Training experts independently categorized the voice quality productions. Aerodynamic and acoustic measures of productions classified by at least three of four experts as having the intended quality determined if measures differentiated among voice qualities and supported the hypothesized physiological concepts used in training at Bonferroni corrected P ≤ 0.0063. Results showed that Slack had low fundamental frequency (fo), low sound pressure level (SPL), and high vibratory instability; Thick had high subglottal pressure (Psg), high SPL, and high vibratory stability; Stiff had high airflow while Thin had lower Psg than Thick. Seven measures differentiated the four qualities with 88.1% accuracy while only Psg, airflow, and jitter were required to differentiate Thick, Stiff, and Thin with 88.7% accuracy. As acoustic and aerodynamic measures differentiated among voice qualities and supported the theoretical physiological characteristics used in training, they could be used to track accuracy during training., (Copyright © 2019 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Purpose : This study investigated the acoustic and articulatory movement parameters underlying lexical stress production in children with apraxia of speech (CAS), children with articulation/phonological delay (i.e. speech delay, SD), and children with typical speech-language development (TD). We examined whether there were group differences in these instrumental measures of stress production. Method : Participants were 24 children (seven CAS, eight SD, nine TD) between three and seven years of age. Acoustic and kinematic measures, including acoustic duration, peak and average fundamental frequency, and jaw movement duration and displacement, were taken from perceptually accurate productions of a strong-weak form. Relative stress analyses were conducted using the Pairwise Variability Index (PVI). Result : There was a significant difference between the CAS and TD groups in the PVI for movement duration, with the CAS group showing a smaller movement duration contrast between stressed and unstressed syllables. There were no significant group differences for displacement or any of the acoustic variables. Conclusion : The kinematic findings suggest reduced temporal control for lexical stress production in children with CAS. This finding surfaced during analyses of perceptually accurate productions but suggests a possible basis for lexical stress errors in CAS that could be explored in future studies.

Objective: Purohit, in the Indian religious context (Hindu), means priest. Purohits are professional voice users who use their voice while performing regular worships and rituals in temples and homes. Any deviations in their voice can have an impact on their profession. Hence, there is a need to investigate the voice characteristics of purohits using perceptual and acoustic analyses., Methods: A total of 44 men in the age range of 18-30 years were divided into two groups. Group 1 consisted of purohits who were trained since childhood (n = 22) in the traditional gurukul system. Group 2 (n = 22) consisted of normal controls. Phonation and spontaneous speech samples were obtained from all the participants at a comfortable pitch and loudness. The Praat software (Version 5.3.31) and the Speech tool were used to analyze the traditional acoustic and cepstral parameters, respectively, whereas GRBAS was used to perceptually evaluate the voice., Results: Results of the independent t test revealed no significant differences across the groups for perceptual and traditional acoustic measures except for intensity, which was significantly higher in purohits' voices at P < 0.05. However, the cepstral values (cepstral peak prominence and smoothened cepstral peak prominence) were much higher in purohits than in controls at P < 0.05 CONCLUSIONS: Results revealed that purohits did not exhibit vocal deviations as analyzed through perceptual and acoustic parameters. In contrast, cepstral measures were higher in Indian Hindu purohits in comparison with normal controls, suggestive of a higher degree of harmonic organization in purohits. Further studies are required to analyze the physiological correlates of increased cepstral measures in purohits' voices., (Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Introduction and Objectives: Perceptual rating of overall voice quality and other more specific perceptual dimensions is difficult, as such judgments depend on the listener's subjectivity. Thus, finding objective, valid, and accessible clinical measures to include in comprehensive voice evaluation protocols is a priority. The purposes of this study were to 1) determine the diagnostic accuracy of a single acoustic measure, smoothed cepstral peak prominence (CPPS), to predict voice disorder status from sustained vowels and connected speech samples using the software Praat; 2) to determine the relationship between measures of CPPS and perceptual ratings of vocal quality; and 3) describe the normative values of CPPS., Method: Measures of CPPS were obtained from connected speech and sustained vowel recordings of 72 Spanish-speaking subjects with voice disorders and 52 nondysphonic Spanish-speaking subjects with no vocal disorders using freely downloadable Praat software. IBM SPSS Statistics software version 23 was used to complete the statistical analyses., Results: results revealed a 70% sensitivity rate, a specificity rate of 85%. Estimated severity for sustained vowels and connected speech were strongly correlated and significantly associated with listener ratings of dysphonia severity., Conclusions: A single acoustic measure of CPPS was highly predictive of voice disorder status using Praat software. Clinicians may consider using CPPS to complement clinical voice evaluation and screening protocols., (Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: The purposes of this study were to (1) determine and compare the diagnostic accuracy of a single acoustic measure, smoothed cepstral peak prominence (CPPS), to predict voice disorder status from connected speech samples using two software systems: Analysis of Dysphonia in Speech and Voice (ADSV) and Praat; and (2) to determine the relationship between measures of CPPS generated from these programs., Study Design: This is a retrospective cross-sectional study., Methods: Measures of CPPS were obtained from connected speech recordings of 100 subjects with voice disorders and 70 nondysphonic subjects without vocal complaints using commercially available ADSV and freely downloadable Praat software programs. Logistic regression and receiver operating characteristic (ROC) analyses were used to evaluate and compare the diagnostic accuracy of CPPS measures. Relationships between CPPS measures from the programs were determined., Results: Results showed acceptable overall accuracy rates (75% accuracy, ADSV; 82% accuracy, Praat) and area under the ROC curves (area under the curve [AUC] = 0.81, ADSV; AUC = 0.91, Praat) for predicting voice disorder status, with slight differences in sensitivity and specificity. CPPS measures derived from Praat were uniquely predictive of disorder status above and beyond CPPS measures from ADSV (χ 2 (1) = 40.71, P < 0.001). CPPS measures from both programs were significantly and highly correlated (r = 0.88, P < 0.001)., Conclusions: A single acoustic measure of CPPS was highly predictive of voice disorder status using either program. Clinicians may consider using CPPS to complement clinical voice evaluation and screening protocols., (Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.)

Objective: Parkinson's disease (PD), caused by basal ganglia dysfunction, is associated with motor disturbances including dysarthria. Stimulation of the subthalamic nucleus, a preferred treatment targeting basal ganglia function, improves features of the motor disorder, but has uncertain effects on speech.We studied speech during contrasting stimulation states to reveal subcortical effects on voice and articulation. Measures were made on selected samples of spontaneous and repeated speech., Methods: Persons with Parkinson's disease (PWP) who had undergone bilateral deep brain stimulation of the subthalamic nucleus (DBS-STN) provided spontaneous speech samples and then repeated portions of their monologue both on and off stimulation. Excerpts were presented in a listening protocol probing intelligibility. Also analysed were a continuous phrase repetition task and a second spontaneous speech sample. Fundamental frequency (F0), harmonic-to-noise ratio (HNR), jitter, shimmer and fluency were measured in these three speech samples performed with DBS stimulation on and off., Results: During subcortical stimulation, spontaneous excerpts were less intelligible than repeated excerpts. F0 and HNR were higher and shimmer was decreased in repetition and stimulation. Articulatory dysfluencies were increased for spontaneous speech and during stimulation in all three speech samples., Conclusion: Deep brain stimulation disrupts fluency and improves voice in spontaneous speech, reflecting an inverse influence of subcortical systems on articulatory posturing and laryngeal mechanisms. Better voice and less dysfluency in repetition may occur because an external model reduces the speech planning burden, as seen for gait and arm reach. These orthogonal results for fluency versus phonatory competence may account for ambivalent reports from dysarthric speakers and reveal the complexity of subcortical control of motor speech.

Purpose: To assess the effects of speech therapy on the acoustic characteristics of speech in a group of cleft lip and palate patients., Materials and Methods: In this experimental pilot study, eight patients with unilateral cleft lip and palate participated in the 13-month period of speech therapy. They had some exercises in the class and at home to reduce the hypernasality of speech. Using an acoustic software named Praat, three formants (F1, F2, F3) of speech sounds /b /, /p /, /f /, /v /, /k /, and /g / were obtained pre and post speech therapy. We used paired samples t-test to compare the acoustic variables of each consonant before and after the therapy., Results: No significant differences were found between the pre- and posttherapy acoustic measures for fricative consonants /f /, /v / and stop consonants /k / and /g/. However, a statistically significant improvement in hypernasality of labial consonants /b / and /p / was observed after the speech therapy., Conclusions: The present study underlines the role of a speech therapist in a complete cleft care team, in order to take care of the speech improvement of the patient and to motivate the parents to help the speech development of their child., (© 2013 Special Care Dentistry Association and Wiley Periodicals, Inc.)