{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T06:29:35Z","timestamp":1786429775738,"version":"build-2736575974"},"reference-count":55,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008590","name":"Dr. Ralph and Marian Falk Medical Research Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008590","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["1UM1TR004405\u201001A1"],"award-info":[{"award-number":["1UM1TR004405\u201001A1"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["K12TR004373"],"award-info":[{"award-number":["K12TR004373"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["NS065701"],"award-info":[{"award-number":["NS065701"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["NS116025"],"award-info":[{"award-number":["NS116025"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TR001456"],"award-info":[{"award-number":["TR001456"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Quantifying treatment\u2010related voice change in adductor laryngeal dystonia (AdLD) is essential for optimizing botulinum neurotoxin (BoNT) therapy, yet clinical practice lacks objective, automated metrics to track response. Counting voice disruptions remains the standard but is labor\u2010intensive and prone to error. This study evaluated whether pitch strength (PS) and percent vocal creak (%VC) (automated indices of pitch salience and irregular phonation) are sensitive to BoNT\u2010related changes. We examined whether these metrics capture treatment effects at the group level, and through individual correlations with manual\/perceptual severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Standardized speech from 16 patients was analyzed for PS, %VC, and two multi\u2010parametric indices before and 1\u2009month after BoNT. Mixed\u2010effects models assessed BoNT and task effects. Spearman correlations examined relationships among acoustic, manual, perceptual, and patient\u2010reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Discontinuity counts, patient\u2010reported outcomes, and perceptual ratings improved post\u2010BoNT. Changes in PS (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.83) and %VC (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.82) strongly correlated with change in disruption frequency. No main BoNT effects or BoNT\u2010by\u2010task interactions were observed for PS or %VC. Acoustic Voice Quality Index increased with a small\u2013medium effect (\n                      <jats:italic>d<\/jats:italic>\n                      \u2009=\u20090.48,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While PS and %VC correlate with changes in disruption frequency and perceptual severity, they did not demonstrate robust group\u2010level treatment sensitivity. Because diverse acoustic manifestations of AdLD disruptions (e.g., F0 shifts vs. aperiodicity) can obscure improvement in summary metrics, these measures should be interpreted cautiously at the group level. At the individual level, PS and %VC may offer supplemental value for longitudinal monitoring but are not substitutes for manual disruption counts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70817","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T05:59:32Z","timestamp":1786427972000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pitch Strength &amp; Percent Vocal Creak to Assess Treatment Response in Adductor Laryngeal Dystonia"],"prefix":"10.1002","author":[{"given":"Jesse D.","family":"Hoffmeister","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maisie K.","family":"Simpson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Minnesota  Minneapolis Minnesota USA"},{"name":"Department of Speech, Language, and Hearing Sciences University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Hayek","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Minnesota  Minneapolis Minnesota USA"},{"name":"Department of Speech, Language, and Hearing Sciences University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Lunos","sequence":"additional","affiliation":[{"name":"Biostatistical Design and Analysis Center, Clinical and Translational Science Institute University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9000-6323","authenticated-orcid":false,"given":"Stephanie","family":"Misono","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4422-5610","authenticated-orcid":false,"given":"J\u00fcrgen","family":"Konczak","sequence":"additional","affiliation":[{"name":"School of Kinesiology University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcomdis.2005.03.003"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1044\/1092\u20104388(2012\/12\u20100140)"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2018.0645"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1044\/1092\u20104388(2002\/037)"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1191\/0269215506cr931oa"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27003"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLG.0000201990.97955.E4"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2013.11.001"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.660909"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000011922"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2020.02.010"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.127.4.393"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072\u2010015\u20102239\u20105"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459989010300515"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/327928"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941112000104"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010199801000\u201000011"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892\u20101997(05)80167\u20105"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892\u20101997(05)80036\u20100"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537\u2010199106000\u201000010"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.38.8.1220"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1044\/1092\u20104388(2002\/067)"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010019\u201054396\u20104"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892\u20101997(05)80211\u20105"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0892\u20101997(05)80168\u20107"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2020.03.012"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2023.03.019"},{"key":"e_1_2_10_29_1","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-540-68888-4","volume-title":"Psychoacoustics: 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