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ABSTRACT Purpose To describe the effects of subthalamic nucleus deep brain stimulation (STN-DBS) on the speech of Spanish-speaking Parkinson's disease (PD) patients during the first year of treatment. Methods The speech measures (SMs): maximum phonation time, acoustic voice measures, speech rate, speech intelligibility measures, and oral diadochokinesis rates of nine Colombian idiopathic PD patients (four females and five males; age = 63 ± 7 years; years of PD = 10 ± 7 years; UPDRS-III = 57 ± 6; H&Y = 2 ± 0.3) were studied in OFF and ON medication states before and every three months during the first year after STN-DBS surgery. Praat software and healthy native listeners’ ratings were used for speech analysis. Statistical analysis tried to find significant differences in the SMs during follow-up (Friedman test) and between medication states (Wilcoxon paired test). Also, a pre-surgery variation interval (PSVI) of reference for every participant and SM was calculated to make an individual analysis of post-surgery variation. Results Non-significative post-surgery or medication state-related differences in the SMs were found. Nevertheless, individually, based on PSVIs, the SMs exhibited: no variation, inconsistent or consistent variation during post-surgery follow-up in different combinations, depending on the medication state. Conclusion As a group, participants did not have a shared post-surgery pattern of change in any SM. Instead, based on PSVIs, the SMs varied differently in every participant, which suggests that in Spanish-speaking PD patients, the effects of STN-DBS on speech during the first year of treatment could be highly variable.

ABSTRACT Purpose Establish points on the neck, correspondent to the laryngeal topography, where to apply Low Level Light therapy (LLLT), to evaluate the incidence of light through variables such as skin phototype and body mass index (BMI). Methods This is a cross-sectional, analytical, observational study, carried out with 15 vocally healthy women, between 18 and 50 years of age, who were divided into three groups, according to BMI and skin phototype. Six anatomical reference points were established to locate the larynx and its musculature, with visual monitoring by videonasolaryngoscopy, to assess light reach (present/absent) and degree of illumination (from very weak to very strong) in the larynx during the LASER application at doses of 3J, 6J and 9J. A flexible endoscope was used for visual monitoring during the LASER application, and subsequent image analysis. Results The light reached the larynx at doses of 3J, 6J and 9J, in the anterior commissure of the vocal folds, membranous (thyroarytenoid muscle) and cartilaginous portions of the vocal fold and the cricothyroid muscle. The degree of LASER light illumination decreased in overweight and obese participants and increased in moderate brown and dark brown skin phototypes. Conclusion Data suggest that the LLLT penetrates differently according to skin phototype and BMI, being more evident in individuals with Fitzpatrick IV and V phototypes and less evident with higher BMI levels. The evidence that the LASER light reaches the larynx in specific anatomical points provides direction for the standardization of its use in voice practice.

ABSTRACT Purpose The study aimed to identify (1) whether the age and gender of listeners and the length of vocal stimuli affect emotion discrimination accuracy in voice; and (2) whether the determined level of expression of perceived affective emotions is age and gender-dependent. Methods Thirty-two age-matched listeners listened to 270 semantically neutral voice samples produced in neutral, happy, and angry intonation by ten professional actors. The participants were required to categorize the auditory stimulus based on three options and judge the intensity of emotional expression in the sample using a customized tablet web interface. Results The discrimination accuracy of happy and angry emotions decreased with age, while accuracy in discriminating neutral emotions increased with age. Females rated the intensity level of perceived affective emotions higher than males across all linguistic units. These were: for angry emotions in words (z = -3.599, p < .001), phrases (z = -3.218, p = .001), and texts (z = -2.272, p = .023), for happy emotions in words (z = -5.799, p < .001), phrases (z = -4.706, p < .001), and texts (z = -2.699, p = .007). Conclusion Accuracy in perceiving vocal expressions of emotions varies according to age and gender. Young adults are better at distinguishing happy and angry emotions than middle-aged adults, while middle-aged adults tend to categorize perceived affective emotions as neutral. Gender also plays a role, with females rating expressions of affective emotions in voices higher than males. Additionally, the length of voice stimuli impacts emotion discrimination accuracy.

ABSTRACT Purpose To assess the influence of the listener experience, measurement scales and the type of speech task on the auditory-perceptual evaluation of the overall severity (OS) of voice deviation and the predominant type of voice (rough, breathy or strain). Methods 22 listeners, divided into four groups participated in the study: speech-language pathologist specialized in voice (SLP-V), SLP non specialized in voice (SLP-NV), graduate students with auditory-perceptual analysis training (GS-T), and graduate students without auditory-perceptual analysis training (GS-U). The subjects rated the OS of voice deviation and the predominant type of voice of 44 voices by visual analog scale (VAS) and the numerical scale (score “G” from GRBAS), corresponding to six speech tasks such as sustained vowel /a/ and /ɛ/, sentences, number counting, running speech, and all five previous tasks together. Results Sentences obtained the best interrater reliability in each group, using both VAS and GRBAS. SLP-NV group demonstrated the best interrater reliability in OS judgment in different speech tasks using VAS or GRBAS. Sustained vowel (/a/ and /ɛ/) and running speech obtained the best interrater reliability among the groups of listeners in judging the predominant vocal quality. GS-T group got the best result of interrater reliability in judging the predominant vocal quality. Conclusion The time of experience in the auditory-perceptual judgment of the voice, the type of training to which they were submitted, and the type of speech task influence the reliability of the auditory-perceptual evaluation of vocal quality.

ABSTRACT Purpose To compare the speech and voice patterns of myasthenia gravis (MG) patients over four years, and correlate the results with clinical aspects of the disease. Methods Data was collected for 4 years. The clinical assessment tools included the Quantitative Myasthenia Gravis (QMG) score, the Myasthenia Gravis Foundation of America (MGFA) clinical classification, and the Myasthenia Gravis Quality of Life 15-item Scale (MG-QoL). To assess speech, the recorded speaking tasks were analyzed acoustically and given auditory-perceptual ratings. Sex (equal distribution) and age (p=0.949) were used as matching criteria in the final sample, which consisted of 10 individuals in the MG group (MGG) and 10 individuals in the control group (CG). Results After 4 years, the MG participants presented stable health status, increased mild and moderate dysarthria (from 40% to 90% of the subjects), and a significant deterioration in the respiration, phonation, and articulation subsystems. The acoustic analysis showed a decline in articulatory patterns (speech rate p=0.047, articulation rate p=0.007, mean syllable duration p=0.007) and vocal quality (increased jitter p=0.022). In the follow-up comparison, there was a significant difference between the phonation variables (shimmer and harmonic-to-noise ratio) of the MGG and CG. Conclusion The MG patients presented a decline in speech over four years and an increase in mild and moderate dysarthria. Despite presenting stable health status, their respiratory, phonatory, and articulatory subsystems worsened. There was no correlation between speech patterns and clinical characteristics of the disease (severity and motor scale).

ABSTRACT Purpose Polycystic ovary syndrome (PCOS) is heterogenous condition with commonly associated symptoms include irregular menstrual cycle, hirsutism, baldness, adult acne, and weight gain There have been few attempts at profiling the voice characteristics of women with polycystic ovary syndrome. Videokymography enables to detect even subtle variations in vocal fold vibrations. The aim of the present study was to study the videokymographic characteristics among women with PCOS. Methods A cross-sectional study was carried out among 50 women with and without PCOS diagnosed on ultrasonography. Videokymography was carried out and the characteristics were perceptually analyzed using a vocal fold kymographic rating scale. The analysis of the kymogram was done for the following characteristics; presence of vocal fold vibration,interference of surroundings, Cycle to cycle variability, left-right asymmetry,cycle aberrations and shape of lateral peaks. The kymographic images were obtained for all the participants of both the groups and a subjective consensus evaluation was done by two clinicians. The percentage of participants with the listed kymographic characteristics were tabulated. Chi Square test was also done to decide if there was a significant difference between the two groups for different kymographic features of vocal fold vibration. Results Six of the 25 women with PCOS were found to have abnormal kymographic features such as surrounding structural interference, presence of cycle to cycle variability and the shape of lateral peaks. Conclusion Early detection of the vocal abnormalities in individuals with PCOS would help in the vocal rehabilitation especially for professional voice users.

ABSTRACT Purpose To evaluate and compare the parameters of Digital kymography obtained through the High-speed Videolaryngoscopy of women without laryngeal disorders, of women with vocal fold nodules and of women with vocal cysts. Methods A cross-sectional observational study in which 60 women aged 18 years and 45 years were selected. Three study groups were formed: 20 women without laryngeal disorder forming the control group (Group 1), 20 women with diagnosis of vocal fold nodules forming Group 2 and 20 women with diagnosis of vocal cysts forming Group 3. Subsequently the participants were evaluated by High-speed Videolaryngoscopy for analysis and comparison of laryngeal images using Digital kymography. The laryngeal parameters processed by the program KIPS® were: minimum, maximum and mean opening; dominant amplitude of the left and right vocal folds; dominant frequency of the right and left vocal folds; and close. Results The analysis of Digital kymography suggests that the presence of the vocal fold nodules and the vocal cysts tend to restrict more to the maximum and minimum opening of the vocal fold and the dominant amplitude of the opening variation in the middle region of the glottis. Conclusion Digital kymography parameters were similar in the presence of vocal fold nodules and vocal cysts lesions.